Novel early life risk factors for adult pulmonary hypertension

The role of perinatal insults in the development of adult onset pulmonary hypertension (PH) is unclear. We surveyed patients with and without PH for a history of early life risk factors, and identified prematurity, oxygen use, and respiratory illness each as risk predictors for development of adult PH.

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Protective Factors and Suicidality in Members of Arab Kindred

Crisis ◽

10.1027/0227-5910/a000116 ◽

2012 ◽

Vol 33 (2) ◽

pp. 80-86 ◽

Cited By ~ 6

Author(s):

Sami Hamdan ◽

Nadine Melhem ◽

Israel Orbach ◽

Ilana Farbstein ◽

Mohammad El-Haib ◽

...

Keyword(s):

Risk Factors ◽

Protective Factors ◽

Suicidal Behavior ◽

Composite International Diagnostic Interview ◽

Diagnostic Interview ◽

Suicidal Risk ◽

Arab Population ◽

Psychiatric Interview ◽

History Of

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

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Stress, Cortisol and Suicide Risk

10.31234/osf.io/92b7z ◽

2019 ◽

Author(s):

Daryl Brian O'Connor

Keyword(s):

Risk Factors ◽

Suicidal Behavior ◽

Suicide Risk ◽

Stressful Events ◽

Additional Risk ◽

Global Health Issue ◽

History Of ◽

Hpa Axis Activity ◽

The Impact

Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.

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Respiratory Syncytial Virus Immunoprophylaxis with Palivizumab: 12-Year Observational Study of Usage and Outcomes in Canada

American Journal of Perinatology ◽

10.1055/s-0041-1725146 ◽

2021 ◽

Author(s):

Ian Mitchell ◽

Abby Li ◽

Candice L. Bjornson ◽

Krista L. Lanctot ◽

Bosco A. Paes ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Syncytial Virus ◽

Burden Of Illness ◽

Respiratory Illness ◽

Smoking Exposure ◽

Key Points ◽

Rsv Infection ◽

History Of ◽

Syncytial Virus ◽

Airway Anomalies

Objective This study aimed to evaluate palivizumab (PVZ) use, trends in indications, and outcomes of respiratory illness hospitalizations (RIH) and respiratory syncytial virus hospitalizations (RSVH). Study Design It involves a large, Canadian prospective (2005–2017) observational multicenter study of children at high risk for RSV infection. Results A total of 25,003 infants (56.3% male) were enrolled at 32 sites; 109,579 PVZ injections were administered. Indications included: prematurity (63.3%); “miscellaneous” (17.8%); hemodynamically significant congenital heart disease (10.5%); bronchopulmonary dysplasia/chronic lung disease (8.4%). The “miscellaneous” group increased over time (4.4% in 2005–2006 to 22.5% in 2016–2017) and included: trisomy 21, airway anomalies, pulmonary disorders, cystic fibrosis, neurological impairments, immunocompromised, cardiac aged >2 years, multiple conditions, and a residual “unclassified” group. Adherence measured by expected versus actual doses plus correct interdose interval was 64.7%. A total of 2,054 RIH occurred (6.9%); 198 (9.6%) required intubation. Three hundred thirty-seven hospitalized children were RSV-positive (overall RSVH 1.6%). Risk factors for RSVH included having siblings, attending daycare, family history of atopy, smoking exposure, and crowded household. Infants with 5 risk factors were 9.0 times (95% CI or confidence interval 4.4–18.2; p < 0.0005) more likely to have RSVH than infants without risk factors. Three adverse events occurred; none were fatal. Conclusion Results are relevant to both clinicians and decision-makers. We confirmed the safety of PVZ. Use of PVZ increased steadily for children with miscellaneous conditions and medical complexity. Medical and social factors pose a risk for severe RIH and RSVH with accompanying burden of illness. A vaccine that protects against RSV is urgently required. Key Points

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EXPRESS: Pulmonary Hypertension Associated With Neurofibromatosis Type 2

Pulmonary Circulation ◽

10.1177/20458940211029550 ◽

2021 ◽

pp. 204589402110295

Author(s):

Hirohisa Taniguchi ◽

Tomoya Takashima ◽

Ly Tu ◽

RaphaÃ«l Thuillet ◽

Asuka Furukawa ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Neurofibromatosis Type ◽

Pulmonary Vascular Remodeling ◽

Life Threatening ◽

History Of ◽

Pulmonary Arterial ◽

First Time

Although precapillary pulmonary hypertension (PH) is a rare but severe complication of patients with neurofibromatosis type 1 (NF1), its association with NF2 remains unknown. Herein, we report a case of a 44-year-old woman who was initially diagnosed with idiopathic pulmonary arterial hypertension (IPAH) and treated with PAH-specific combination therapy. However, a careful assessment for a relevant family history of the disease and genetic testing reveal that this patient had a mutation in the NF2 gene. Using immunofluorescence and Western blotting, we demonstrated a decrease in endothelial NF2 protein in lungs from IPAH patients compared to control lungs, suggesting a potential role of NF2 in PAH development. To our knowledge, this is the first time that precapillary PH has been described in a patient with NF2. The altered endothelial NF2 expression pattern in PAH lungs should stimulate work to better understand how NF2 is contributing to the pulmonary vascular remodeling associated to these severe life-threatening conditions.

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Is there a link between glucose levels and heart failure? An update

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302010000500010 ◽

2010 ◽

Vol 54 (5) ◽

pp. 488-497 ◽

Cited By ~ 6

Author(s):

Arnaldo Schainberg ◽

Antônio Ribeiro-Oliveira Jr. ◽

José Marcio Ribeiro

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Epidemiological Studies ◽

Left Ventricular ◽

Glucose Levels ◽

Factors Analysis ◽

History Of ◽

Cv Disease ◽

The Relationship

It has been well documented that there is an increased prevalence of standard cardiovascular (CV) risk factors in association with diabetes and with diabetes-related abnormalities. Hyperglycemia, in particular, also plays an important role. Heart failure (HF) has become a frequent manifestation of cardiovascular disease (CVD) among individuals with diabetes mellitus. Epidemiological studies suggest that the effect of hyperglycemia on HF risk is independent of other known risk factors. Analysis of datasets from populations including individuals with dysglycemia suggests the pathogenic role of hyperglycemia on left ventricular function and on the natural history of HF. Despite substantial epidemiological evidence of the relationship between diabetes and HF, data from available interventional trials assessing the effect of a glucose-lowering strategy on CV outcomes are limited. To provide some insight into these issues, we describe in this review the recent important data to understand the natural course of CV disease in diabetic individuals and the role of hyperglycemia at different times in the progression of HF.

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Evaluation of Hypercholesterolemia in Childhood

Pediatrics in Review ◽

10.1542/pir.17.3.94 ◽

1996 ◽

Vol 17 (3) ◽

pp. 94-97

Author(s):

Thomas J. Starc ◽

Richard J. Deckelbaum

Keyword(s):

Risk Factors ◽

At Risk ◽

Heart Disease ◽

Family History ◽

Direct Proof ◽

Children At Risk ◽

History Of

For many adults, the risk of atherosclerosis can be reduced by intervention and treatment of known risk factors. Direct proof that similar intervention will be effective in children is not available. However, evidence suggests that prevention beginning in childhood will lead to a decrease in incidence of heart disease later in life. The majority of families are eager to take steps to prevent heart disease in their children, especially if there is a family history of early heart disease. It is the role of the pediatrician to identify those children at risk for early heart disease and to initiate advice on reducing risk factors.

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Childhood trauma and being at-risk for psychosis are associated with higher peripheral endocannabinoids

Psychological Medicine ◽

10.1017/s0033291719001946 ◽

2019 ◽

Vol 50 (11) ◽

pp. 1862-1871 ◽

Cited By ~ 2

Author(s):

E. Appiah-Kusi ◽

R. Wilson ◽

M. Colizzi ◽

E. Foglia ◽

E. Klamerus ◽

...

Keyword(s):

Risk Factors ◽

At Risk ◽

Childhood Trauma ◽

Childhood Maltreatment ◽

Peripheral Blood ◽

Endocannabinoid System ◽

History Of Childhood ◽

Increased Risk ◽

History Of

AbstractBackgroundEvidence has been accumulating regarding alterations in components of the endocannabinoid system in patients with psychosis. Of all the putative risk factors associated with psychosis, being at clinical high-risk for psychosis (CHR) has the strongest association with the onset of psychosis, and exposure to childhood trauma has been linked to an increased risk of development of psychotic disorder. We aimed to investigate whether being at-risk for psychosis and exposure to childhood trauma were associated with altered endocannabinoid levels.MethodWe compared 33 CHR participants with 58 healthy controls (HC) and collected information about previous exposure to childhood trauma as well as plasma samples to analyse endocannabinoid levels.ResultsIndividuals with both CHR and experience of childhood trauma had higher N-palmitoylethanolamine (p < 0.001) and anandamide (p < 0.001) levels in peripheral blood compared to HC and those with no childhood trauma. There was also a significant correlation between N-palmitoylethanolamine levels and symptoms as well as childhood trauma.ConclusionsOur results suggest an association between CHR and/or childhood maltreatment and elevated endocannabinoid levels in peripheral blood, with a greater alteration in those with both CHR status and history of childhood maltreatment compared to those with either of those risks alone. Furthermore, endocannabinoid levels increased linearly with the number of risk factors and elevated endocannabinoid levels correlated with the severity of CHR symptoms and extent of childhood maltreatment. Further studies in larger cohorts, employing longitudinal designs are needed to confirm these findings and delineate the precise role of endocannabinoid alterations in the pathophysiology of psychosis.

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Cephalosporins: A Focus on Side Chains and β-Lactam Cross-Reactivity

Pharmacy ◽

10.3390/pharmacy7030103 ◽

2019 ◽

Vol 7 (3) ◽

pp. 103 ◽

Cited By ~ 9

Author(s):

Saira B. Chaudhry ◽

Michael P. Veve ◽

Jamie L. Wagner

Keyword(s):

Risk Factors ◽

Clinical Practice ◽

Antimicrobial Stewardship ◽

Clinical Utility ◽

Cross Reactivity ◽

Penicillin Allergy ◽

Side Chain ◽

Safety And Efficacy ◽

History Of

Cephalosporins are among the most commonly prescribed antibiotic classes due to their wide clinical utility and general tolerability, with approximately 1–3% of the population reporting a cephalosporin allergy. However, clinicians may avoid the use of cephalosporins in patients with reported penicillin allergies despite the low potential for cross-reactivity. The misdiagnosis of β-lactam allergies and misunderstanding of cross-reactivity among β-lactams, including within the cephalosporin class, often leads to use of broader spectrum antibiotics with poor safety and efficacy profiles and represents a serious obstacle for antimicrobial stewardship. Risk factors for cephalosporin allergies are broad and include female sex, advanced age, and a history of another antibiotic or penicillin allergy; however, cephalosporins are readily tolerated even among individuals with true immediate-type allergies to penicillins. Cephalosporin cross-reactivity potential is related to the structural R1 side chain, and clinicians should be cognizant of R1 side chain similarities when prescribing alternate β-lactams in allergic individuals or when new cephalosporins are brought to market. Clinicians should consider the low likelihood of true cephalosporin allergy when clinically indicated. The purpose of this review is to provide an overview of the role of cephalosporins in clinical practice, and to highlight the incidence of, risk factors for, and cross-reactivity of cephalosporins with other antibiotics.

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Pulmonary Hypertension Associated with Connective Tissue Disease

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0039-1685214 ◽

2019 ◽

Vol 40 (02) ◽

pp. 173-183 ◽

Cited By ~ 6

Author(s):

Hossam Fayed ◽

J. Gerry Coghlan

Keyword(s):

Rheumatoid Arthritis ◽

Pulmonary Hypertension ◽

Connective Tissue ◽

Connective Tissue Disease ◽

Best Practice ◽

Reference Source ◽

History Of ◽

Pulmonary Arterial ◽

Primary Physicians

Pulmonary hypertension (PH) is common in most forms of connective tissue disease (CTD); the prevalent type of PH depends on the particular CTD. Thus, pulmonary arterial hypertension (PAH) is dominantly associated with scleroderma, while postcapillary PH is most common in rheumatoid arthritis and lung disease-associated PH is typically found in myositis and sarcoidosis.Considerable expertise is required to identify, diagnose, and manage CTD-PH, as the primary physicians providing the majority of care for this population, rheumatologists, need a good working knowledge of CTD-PH, its rather subtle presentation, and how to access the necessary investigations to screen for and identify patients with PH. The role of the rheumatologist does not stop at diagnosis; in some conditions such as lupus, optimizing immunosuppression is key to the management of PH, and unlike simple idiopathic PAH, the natural history of CTD-PH is often punctuated by complications of the CTD rather than just events due to progression of PH or therapy-related adverse events.The aim of this article is to provide an overview of all forms of CTD-PH, and to provide an easy reference source on current best practice.

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