scholarly journals Obesity as a mortality risk factor in the medical ward: a case control study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Shelly Soffer ◽  
Eyal Zimlichman ◽  
Benjamin S. Glicksberg ◽  
Orly Efros ◽  
Matthew A. Levin ◽  
...  
Keyword(s):  
New York ◽  
Risk Factor ◽  
Severe Obesity ◽  
Multivariate Logistic Regression Analysis ◽  
Medical Ward ◽  
J Curve ◽  
Medicine Physician ◽  
Medical Wards ◽  
The Impact ◽  
Internal Medicine Physician

Abstract Background Research regarding the association between severe obesity and in-hospital mortality is inconsistent. We evaluated the impact of body mass index (BMI) levels on mortality in the medical wards. The analysis was performed separately before and during the COVID-19 pandemic. Methods We retrospectively retrieved data of adult patients admitted to the medical wards at the Mount Sinai Health System in New York City. The study was conducted between January 1, 2011, to March 23, 2021. Patients were divided into two sub-cohorts: pre-COVID-19 and during-COVID-19. Patients were then clustered into groups based on BMI ranges. A multivariate logistic regression analysis compared the mortality rate among the BMI groups, before and during the pandemic. Results Overall, 179,288 patients were admitted to the medical wards and had a recorded BMI measurement. 149,098 were admitted before the COVID-19 pandemic and 30,190 during the pandemic. Pre-pandemic, multivariate analysis showed a “J curve” between BMI and mortality. Severe obesity (BMI > 40) had an aOR of 0.8 (95% CI:0.7–1.0, p = 0.018) compared to the normal BMI group. In contrast, during the pandemic, the analysis showed a “U curve” between BMI and mortality. Severe obesity had an aOR of 1.7 (95% CI:1.3–2.4, p < 0.001) compared to the normal BMI group. Conclusions Medical ward patients with severe obesity have a lower risk for mortality compared to patients with normal BMI. However, this does not apply during COVID-19, where obesity was a leading risk factor for mortality in the medical wards. It is important for the internal medicine physician to understand the intricacies of the association between obesity and medical ward mortality.

Impact of Obesity on Perioperative Outcomes of Retroperitoneal Laparoscopic Adrenalectomy

2015 ◽  
Vol 95 (3) ◽  
pp. 361-366 ◽  
Author(s):  
Qingfeng Hu ◽  
Zhenyu Hang ◽  
Yaatfat Ho ◽  
Chuanyu Sun ◽  
Ke Xu ◽  
...  
Keyword(s):  
Risk Factor ◽  
Postoperative Complications ◽  
Laparoscopic Adrenalectomy ◽  
Operative Time ◽  
Multivariate Logistic Regression Analysis ◽  
Perioperative Outcomes ◽  
Estimated Blood Loss ◽  
Overweight Group ◽  
Postoperative Length ◽  
The Impact

Introduction: Obesity is usually considered a risk factor for postoperative complications; however, previous studies conclude contradictory results in retroperitoneal laparoscopic adrenalectomy (LA). We aim to evaluate the impact of obesity on the perioperative outcomes of LA. Methods: A retrospective cohort study from a single center including 353 patients from 2011 to 2013 was conducted. Perioperative outcomes of patients from different groups were compared according to their body mass index (BMI). Results: All the patients were divided into 3 groups: normal (n = 149), overweight (n = 141) and obese (n = 63). Operative time (OT) for patients belonging to the obese group was significantly longer than that in the normal and overweight group, and the results of estimated blood loss, postoperative length of stay in hospital and postoperative complications were all similar. In the multivariate logistic regression analysis, OT was an independent risk factor for postoperative complications (odds ratio 1.020; 95% confidence interval 1.001-1.039; p = 0.037), while other factors including BMI had negligible effect. Conclusions: Retroperitoneal LA offers similar perioperative outcomes for patients with different obesity statuses, which could be safe and feasible for obese patients.

scholarly journals Mental and behavioural disorders and COVID-19-associated death in older people

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Billy Boland ◽  
Tim Gale
Keyword(s):  
Mental Health ◽  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Older People ◽  
Severe Obesity ◽  
Behavioural Disorders ◽  
Health Factors ◽  
Health Related ◽  
Health Risk Factor ◽  
The Impact

Summary Health factors such as diabetes, severe obesity and chronic kidney disease are all associated with a more severe outcome following coronavirus disease 2019 (COVID-19) infection. However, there has been little exploration into the impact of mental and behavioural disorders on outcomes associated with COVID-19. We investigated outcomes for older people who used mental health services. Those who had a COVID-19-associated death had previously rated worse across a range of health and social problems, including mental health related problems. Our findings evidence the need to urgently explore whether mental and behavioural disorders should also be considered a health risk factor for a more severe outcome from COVID-19 infection in older people.

P0574IS PERIPROCEDURAL BLOOD LOSS FOLLOWING PERCUTANEOUS CORONARY INTERVENTION A RISK FACTOR FOR CONTRAST-INDUCED ACUTE KIDNEY INJURY ?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Indu Ramachandra Rao ◽  
Ganesh Paramasivam ◽  
Ravindra Attur Prabhu ◽  
Shankar Prasad Nagaraju ◽  
Tom Devasia ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Blood Loss ◽  
Prediction Models ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Close Monitoring ◽  
Percutaneous Coronary ◽  
Baseline Values ◽  
The Impact

Abstract Background and Aims Contrast-induced acute kidney injury (CI-AKI) is a significant concern with the use of intraarterial contrast agents, especially in percutaneous coronary interventions (PCI) in which higher contrast volumes are used. Presence of anemia is a risk factor for CI-AKI and is a component of various risk-prediction models. However, the impact of periprocedural hemoglobin (Hb) drop following PCI on CI-AKI is not known, despite the fact that significant blood loss is fairly common in patients undergoing PCI. The aim of this study was to examine whether periprocedural Hb drop is a risk factor for development of CI-AKI following PCI. Method This was a single-center, retrospective study of patients admitted for elective or primary PCI at our center between January 2015 and December 2018. Patients with baseline eGFR &lt;15mL/min/1.73m2 were excluded. CI-AKI was defined as per the KDIGO 2012 guidelines as an increase in serum creatinine by at least 0.3 mg/dl, or 1.5-1.9 times the baseline values within 48 hours after administration of contrast media. Periprocedural Hb drop was defined as fall in Hb by at least 1g/dL below baseline values within 48 hours following PCI. Results A total of 6418 patients were included. Baseline characteristics of the study population are shown in table 1. Overall incidence of CI-AKI in our study was 7.6% (n=490), of which 3.9% (n=19) required dialysis. Higher incidence of CI-AKI was seen in those with baseline eGFR &lt; 60 ml/min/1.73m2 (16.4%) and a pre-procedural Mehran score &gt;11 (33%). Peri-PCI Hb drop was seen in 49.9% (n=3203), with a drop &gt;2g/dL in 18.5% (n=1185). On multivariate logistic regression analysis (Table 2), it was found that periprocedural Hb drop &gt;2g/dL was independently associated with CI-AKI (OR 1.49, 95% CI 1.18-1.88, P=0.001). Furthermore, in those with periprocedural blood loss, the risk of CI-AKI was increased by 1.3 times for each 1g/dL drop in Hb (OR 1.30, 95% CI 1.14-1.49, P&lt;0.001). Additionally, apart from traditional risk factors, hypertension was independently associated with development of CI-AKI (Table 2). Conclusion Periprocedural blood loss was associated with a higher risk of CI-AKI after PCI. Moreover, risk of CI-AKI increased with increasing severity of blood loss. Whether measures to minimize blood loss, like using a transradial approach, staging complex procedures and close monitoring of anticoagulation/antiplatelet regimens, will help reduce risk of CI-AKI needs to be studied.

Mechanisms of liver damage in COVID-19

2020 ◽  
Vol 1 (19) ◽  
pp. 39-46
Author(s):  
T. V. Pinchuk ◽  
N. V. Orlova ◽  
T. G. Suranova ◽  
T. I. Bonkalo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Risk Factor ◽  
Liver Disease ◽  
Liver Function ◽  
Liver Damage ◽  
The World ◽  
Coronavirus Infection ◽  
The Impact ◽  
Analyze Data

At the end of 2019, a new coronavirus (SARS-CoV-2) was discovered in China, causing the coronavirus infection COVID-19. The ongoing COVID-19 pandemic poses a major challenge to health systems around the world. There is still little information on how infection affects liver function and the significance of pre-existing liver disease as a risk factor for infection and severe COVID-19. In addition, some drugs used to treat the new coronavirus infection are hepatotoxic. In this article, we analyze data on the impact of COVID-19 on liver function, as well as on the course and outcome of COVID-19 in patients with liver disease, including hepatocellular carcinoma, or those on immunosuppressive therapy after liver transplantation.

828-P: The Impact of Diabetes and Depression Status on Weight Loss Outcomes in Mexican Patients with Severe Obesity

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 828-P
Author(s):  
MARCELA RODRIGUEZ FLORES ◽  
SYLVANA STEPHANO Z. ◽  
MARÍA RABASA ◽  
JUANA MONTOYA ◽  
CLAUDIA VELEZ ◽  
...  
Keyword(s):  
Weight Loss ◽  
Severe Obesity ◽  
Depression Status ◽  
Weight Loss Outcomes ◽  
The Impact ◽  
Mexican Patients

Roundtable Discussion of the Impact of the 4th World Symposium on Pulmonary Hypertension

2009 ◽  
Vol 8 (2) ◽  
pp. 89-94
Author(s):  
Robyn J. Barst ◽  
Marc Humbert ◽  
Ivan M. Robbins ◽  
Lewis J. Rubin ◽  
Robyn J. Park
Keyword(s):  
New York ◽  
Pulmonary Hypertension ◽  
Vascular Diseases ◽  
Assistant Professor ◽  
Associate Professor ◽  
Future Research ◽  
Columbia University ◽  
School Of Medicine ◽  
Maryland School ◽  
The Impact

A discussion among attendees of the 4th World Symposium on Pulmonary Hypertension took place to share “an insider's look” into the current and future research and treatment implications in pulmonary hypertension. Myung H. Park, MD, guest editor of this issue of Advances in Pulmonary Hypertension, Assistant Professor of Medicine and Director, Pulmonary Vascular Diseases Program, Division of Cardiology, University of Maryland School of Medicine, Baltimore, moderated the discussion. Participants included Robyn Barst, MD, Professor Emerita, Columbia University, New York; Marc Humbert, MD, PhD, Universite Paris-Sud, French Referal Center for Pulmonary Hypertension, Hopital Antoine-Beclere, Assistance Publique Hopitaux de Paris, Clamart, France; Ivan Robbins, MD, Associate Professor of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; and Lewis J. Rubin, MD, Clinical Professor, Department of Medicine, University of California, San Diego.

COVID-19: Time-Dependent Effective Reproduction Number and Sub-notification Effect Estimation Modeling (Preprint)

2020 ◽  
Author(s):  
Eduardo Atem De Carvalho ◽  
Rogerio Atem De Carvalho
Keyword(s):  
New York ◽  
Reproduction Number ◽  
Moving Average ◽  
Real Data ◽  
Time Dependent ◽  
Initial Value ◽  
Health Authorities ◽  
Reproduction Numbers ◽  
Effect Estimation ◽  
The Impact

BACKGROUND Since the beginning of the COVID-19 pandemic, researchers and health authorities have sought to identify the different parameters that govern their infection and death cycles, in order to be able to make better decisions. In particular, a series of reproduction number estimation models have been presented, with different practical results. OBJECTIVE This article aims to present an effective and efficient model for estimating the Reproduction Number and to discuss the impacts of sub-notification on these calculations. METHODS The concept of Moving Average Method with Initial value (MAMI) is used, as well as a model for Rt, the Reproduction Number, is derived from experimental data. The models are applied to real data and their performance is presented. RESULTS Analyses on Rt and sub-notification effects for Germany, Italy, Sweden, United Kingdom, South Korea, and the State of New York are presented to show the performance of the methods here introduced. CONCLUSIONS We show that, with relatively simple mathematical tools, it is possible to obtain reliable values for time-dependent, incubation period-independent Reproduction Numbers (Rt). We also demonstrate that the impact of sub-notification is relatively low, after the initial phase of the epidemic cycle has passed.

scholarly journals The Myth of King Kong and the Religious Background That Nests in the Human Soul

Religions ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 185
Author(s):  
Juan Antonio Roche Cárcel
Keyword(s):  
New York ◽  
Social Structure ◽  
Human Soul ◽  
Religious Background ◽  
The Social ◽  
Tribal Society ◽  
The Impact

The four most important King Kong films (1933, 1976, 2005, and 2017) contain religious sentiments that are related to the numinous and mysterious fear of Nature and death that gives meaning to life, and to the institutionalization of society. In this way, as observed in the films, the Society originated by religion is a construction against Nature and Death. Based on these hypotheses, the objective of this work is to (a) show that the social structure of the tribal society that lives on Skull Island is reinforced by the religious feelings that they profess towards the Kong divinity, and (b) reveal the impact that the observation of the generalized alterity that characterizes the isolated tribal society of the island produces on Western visitors—and therefore, on film viewers. The article concludes that the return to New York, after the trip, brings an unexpected guest: the barbarism that is installed in the heart of civilization; that the existing order is reinforced and the society in crisis is renovated; and that the rationality subject to commercial purposes that characterizes modernity has not been able to escape from the religiosity that nests in the depths of the human soul.

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