HIV and Hodgkin Lymphoma Survival: A Prospective Study in Botswana

PURPOSE People living with HIV (PLWH) experience increased risk of Hodgkin lymphoma (HL) despite effective initiation of antiretroviral therapy (ART). In high-income countries, outcomes following HIV HL have been reported to be non-differential, or inferior for PLWH. We sought to assess the effect of HIV on HL survival in Botswana, an African country with a generalized HIV epidemic and high ART coverage, to describe a context more reflective of global HIV populations. PATIENTS AND METHODS In the Thabatse Cancer Cohort, consenting participants initiating treatment for HL at one of four cancer centers in Botswana were enrolled from 2010 to 2020. Patients were followed quarterly for up to 5 years. The impact of HIV on survival following treatment initiation was assessed using an inverse probability–weighted Cox marginal structural model adjusted for age, performance status, and disease stage. RESULTS Seventy-eight new HL cases were enrolled, 47 (60%) were PLWH and 31 (40%) were HIV-uninfected. Baseline characteristics were similar between groups. The majority (61%) of patients presented with regional disease (stage I or II) with no statistically significant difference by HIV status ( P = .38). Nearly all (87%) PLWH participants were on ART before their HL diagnosis (median ART duration 42 months), and median CD4 count was 413 cells/μL (interquartile range 253-691). Survival, in unadjusted analyses, was lower among patients without HIV compared with PLWH (log rank P = .021). In adjusted analysis, HIV infection was not significantly associated with survival in inverse probability–weighted Cox model (hazard ratio 0.43; 95% CI, 0.16 to 1.16; P = .094). CONCLUSION In this cohort of patients treated for HL in Botswana, survival in PLWH (87% on long-standing ART) was at least as good as in individuals without HIV.

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Impact of Weight-Band Dosing of Tinzaparin for Venous Thromboembolism Prophylaxis on Persistent Wound Drainage in Adult Patients Undergoing Hip and Knee Arthroplasty

Annals of Pharmacotherapy ◽

10.1177/10600280211024294 ◽

2021 ◽

pp. 106002802110242

Author(s):

Cassandra Cooper ◽

Ouida Antle ◽

Jennifer Lowerison ◽

Deonne Dersch-Mills ◽

Ashley Kenny

Keyword(s):

Body Weight ◽

Venous Thromboembolism ◽

Knee Arthroplasty ◽

Total Joint Arthroplasty ◽

Joint Arthroplasty ◽

Thromboembolism Prophylaxis ◽

Wound Drainage ◽

Increased Risk ◽

Significant Difference ◽

The Impact

Background: Persistent wound drainage and venous thromboembolism (VTE) are potential complications of total joint arthroplasty, and these risks can be challenging to balance in clinical practice. Anecdotal observation has suggested that following joint arthroplasty, persistent wound drainage occurs more frequently with higher body weight and higher doses of tinzaparin when compared with lower body weight and lower doses of tinzaparin. Objective: The overall purpose of this study was to describe the impact of a tinzaparin weight-band dosing table for VTE prophylaxis on wound healing, thrombosis, and bleeding outcomes in patients undergoing total joint arthroplasty. Methods: This retrospective chart review included patients who underwent total hip or knee arthroplasty and received tinzaparin for thromboprophylaxis per their weight-banding category. The primary outcome was the incidence of persistent wound drainage. Secondary outcomes include the occurrence of VTE and clinically important bleeding during hospital admission. Results: A total of 231 patients were included in the analysis. There was no significant difference in persistent wound drainage between the 3 weight categories, and there were no differences in rates of VTE or clinically important bleeding. Concurrent use of low-dose acetylsalicylic acid was associated with a 3-fold increased risk of persistent wound drainage (risk ratio = 3.35; 95% CI = 2.14-5.24; P = 0.00003). Conclusion and Relevance: In joint arthroplasty patients, we observed no significant difference in rates of persistent wound drainage between various weight categories receiving different weight-banded doses of tinzaparin. Our results do not suggest that the current weight-band dosing table for tinzaparin needs to be adjusted to optimize patient outcomes.

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The Management of Myelomeningocele Study: Short-Term Neonatal Outcomes

Fetal Diagnosis and Therapy ◽

10.1159/000509245 ◽

2020 ◽

Vol 47 (12) ◽

pp. 865-872 ◽

Cited By ~ 1

Author(s):

Natalie E. Rintoul ◽

Roberta L. Keller ◽

William F. Walsh ◽

Pamela K. Burrows ◽

Elizabeth A. Thom ◽

...

Keyword(s):

New England ◽

Gestational Age ◽

Periventricular Leukomalacia ◽

Ductus Arteriosus ◽

Outcome Data ◽

Neonatal Outcomes ◽

Increased Risk ◽

Significant Difference ◽

The Impact ◽

Prenatal Surgery

Introduction: The Management of Myelomeningocele Study was a multicenter randomized trial to compare prenatal and standard postnatal repair of myelomeningocele (MMC). Neonatal outcome data for 158 of the 183 randomized women were published in The New England Journal of Medicine in 2011. Objective: Neonatal outcomes for the complete trial cohort (N = 183) are presented outlining the similarities with the original report and describing the impact of gestational age as a mediator. Methods: Gestational age, neonatal characteristics at delivery, and outcomes including common complications of prematurity were assessed. Results: Analysis of the complete cohort confirmed the initial findings that prenatal surgery was associated with an increased risk for earlier gestational age at birth. Delivery occurred before 30 weeks of gestation in 11% of neonates that had fetal MMC repair. Adverse pulmonary sequelae were rare in the prenatal surgery group despite an increased rate of oligohydramnios. There was no significant difference in other complications of prematurity including patent ductus arteriosus, sepsis, necrotizing enterocolitis, periventricular leukomalacia, and intraventricular hemorrhage. Conclusion: The benefits of prenatal surgery outweigh the complications of prematurity.

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Sleep Deprivation and Sleep-Onset Insomnia are Associated with Blunted Physiological Reactivity to Stressors

Military Medicine ◽

10.1093/milmed/usaa464 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 246-252

Author(s):

Devon A Hansen ◽

Brieann C Satterfield ◽

Matthew E Layton ◽

Hans P A Van Dongen

Keyword(s):

Sleep Deprivation ◽

Laboratory Study ◽

Salivary Cortisol ◽

Sleep Onset ◽

Deprivation Condition ◽

Increased Risk ◽

Significant Difference ◽

Sleep Deficiency ◽

The Impact ◽

Chronic Sleep

ABSTRACT Introduction Military operations often involve intense exposure to stressors combined with acute sleep deprivation, while military personnel also experience high prevalence of chronic sleep deficiency from insomnia and other sleep disorders. However, the impact of acute and chronic sleep deficiency on physiologic stressor responses is poorly understood. In a controlled laboratory study with normal sleepers and individuals with chronic sleep-onset insomnia, we measured responses to an acute stressor administered in a sleep deprivation condition or a control condition. Methods Twenty-two adults (aged 22-40 years; 16 females)—11 healthy normal sleepers and 11 individuals with sleep-onset insomnia—completed a 5-day (4-night) in-laboratory study. After an adaptation day and a baseline day, subjects were assigned to a 38-hour total sleep deprivation (TSD) condition or a control condition; the study ended with a recovery day. At 8:00 PM after 36 hours awake in the sleep deprivation condition or 12 hours awake in the control condition, subjects underwent a Maastricht Acute Stress Test (MAST). Salivary cortisol was measured immediately before the MAST at 8:00 PM, every 15 minutes after the MAST from 8:15 PM until 9:15 PM, and 30 minutes later at 9:45 PM. Baseline salivary cortisol was collected in the evening of the baseline day. Additionally, before and immediately upon completion of the MAST, self-report ratings of affect and pain were collected. Results The MAST elicited a stressor response in both normal sleepers and individuals with sleep-onset insomnia, regardless of the condition, as evidenced by increases in negative affect and pain ratings. Relative to baseline, cortisol levels increased immediately following the MAST, peaked 30 minutes later, and then gradually returned to pre-MAST levels. At the cortisol peak, there was a significant difference across groups and conditions, reflecting a pronounced blunting of the cortisol response in the normal sleepers in the TSD condition and the sleep-onset insomnia group in both the TSD and control conditions. Conclusions Blunted stressor reactivity as a result of sleep deficiency, whether acute or chronic, may reflect reduced resiliency attributable to allostatic load and may put warfighters at increased risk in high-stakes, rapid response scenarios.

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482. Impact of COVID-19 Pandemic on Psychosocial and Clinical Factors among people with and without HIV living in Miami

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.675 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S308-S308

Author(s):

Patricia RaccamarichClaudia S Uribe ◽

Ana S Salazar Zetina ◽

Emily K Montgomerie ◽

Douglas Salguero ◽

Alejandro M Mantero ◽

...

Keyword(s):

Health Care ◽

Health Care Access ◽

Access To Health Care ◽

People Living With Hiv ◽

Coping With Stress ◽

Care Access ◽

Significant Difference ◽

Physical Consequences ◽

The Impact ◽

Hiv Negative

Abstract Background As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIV-negative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%); there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH; OR 0.40, p=0.03). Conclusion The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care. Disclosures All Authors: No reported disclosures

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Ureteral Involvement and Diabetes Increase the Risk of Subsequent Bladder Recurrence after Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

BioMed Research International ◽

10.1155/2015/527976 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Che-Yuan Hu ◽

Yu-Chieh Tsai ◽

Shuo-Meng Wang ◽

Chao-Yuan Huang ◽

Huai-Ching Tai ◽

...

Keyword(s):

Prognostic Factors ◽

Urinary Tract ◽

Urothelial Carcinoma ◽

Cox Model ◽

Medical Center ◽

Upper Urinary Tract ◽

Increased Risk ◽

The Impact ◽

Bladder Recurrence ◽

Urinary Tract Urothelial Carcinoma

Objectives.To investigate the prognostic factors for bladder recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UUT-UC).Methods.From 1994 to 2012, 695 patients with UUT-UC treated with RNU were enrolled in National Taiwan University Medical Center. Among them, 532 patients with no prior bladder UC history were recruited for analysis. We assessed the impact of potentially prognostic factors on bladder recurrence after RNU.Results.The median follow-up period was 47.8 months. In the Cox model, ureteral involvement and diabetes mellitus (DM) were significantly associated with a higher bladder recurrence rate in the multivariate analysis (hazard ratio [HR]: 1.838;P=0.003and HR: 1.821;P=0.010, resp.). In the Kaplan-Meier analysis, DM patients with concomitant ureteral UC experienced about a threefold increased risk of bladder recurrence as compared to those without both factors (HR: 3.222;P<0.001). Patients with either of the two risk factors experienced about a twofold increased risk as compared to those without both factors (with DM, HR: 2.184,P=0.024; with ureteral involvement, HR: 2.006,P=0.003).Conclusions.Ureteral involvement and DM are significantly related to bladder recurrence after RNU in patients with UUT-UC.

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A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV

Diagnostics ◽

10.3390/diagnostics11112047 ◽

2021 ◽

Vol 11 (11) ◽

pp. 2047

Author(s):

Davide Fiore Bavaro ◽

Paola Laghetti ◽

Mariacristina Poliseno ◽

Nicolò De Gennaro ◽

Francesco Di Gennaro ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Cardiovascular Risk ◽

Kidney Disease ◽

Current Knowledge ◽

Disease Stage ◽

Oral Glucose ◽

People Living With Hiv ◽

Diagnosis And Management ◽

Increased Risk ◽

Living With Hiv

The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes.

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MOLECULAR GENETIC STUDY OF THE IMPACT OF SNP C677T OF THE GENE MTHFR IN THE DEVELOPMENT OF CONGENITAL ISOLATED CLEFT LIP AND PALATE

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-5-104-110 ◽

2018 ◽

Vol 25 (5) ◽

pp. 104-110

Author(s):

V. S. Uchaeva ◽

Yu. A. Vasiliev ◽

A. S. Gracheva ◽

O. V. Gulenko ◽

I. G. Udina

Keyword(s):

Genetic Study ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Control Group ◽

Population Genetic Study ◽

Molecular Genetic Study ◽

Increased Risk ◽

Significant Difference ◽

Congenital Cleft ◽

The Impact

Aim. This research was designed to conduct an associative population genetic study for the consideration of the impact of SNP C677T of the gene MTHFR in the congenital maxillofacial developmental anomalies (CMDA): congenital cleft lip (CCL), congenital cleft palate (CCP), congenital cleft lip and palate (CCLP) in the Krasnodar territory. The aim of the study is to establish the associations between SNP C677T of the gene MTHFR and the development of congenital cleft lip and/ or palate.Materials and methods. In this research, the peculiarities of distribution of SNP C667T of the gene MTHFR in children with congenital cleft lip and/or palate (n=223) and their mothers (n=78) in comparison with the control group (n=124) were studied in the Krasnodar territory. The genetic demographic questionnaires were gathered for children with CMDA, the information about diagnosis was obtained from the medical records. The biological samples, including blood or scrapings of oral mucosa, were collected from children with the pathology and their mothers. The DNA was extracted from the samples by the standard method. The study of the peculiarities of distribution of alleles of SNP C677T of the gene MTHFR was performed by PCR-PFLP with endonuclease Hinf I or by tetra-primer ARMS-PCR method in children with CCL, CCP, CCLP, their mothers and the control group. Statistical processing of the obtained data was performed by the algorithms of the “Statistica” program.Results. While comparing the profiles of frequencies of SNP C677T in children with CCL, CCP and CCLP with the control group, there were identified no significant differences in the frequency of this SNP and no peculiarities of genotypes distribution. There was identified a significant difference in the peculiarities of genotypes distribution with the control group (G=19,5232, d.f.=1, p<0,001) as well as united genotypes (С/C и С/T) in accordance to T/T (G=10,4657, d.f.=1; p<0,001) and united genotypes (C/T и T/T) in accordance to C/C (G=15,1896, d.f.=1, p<0,001) for the mothers of children with CCL, CCP and CCLP.Conclusion. As a result of the study, we established the association of SNP C677T of the MTHFR gene with the development of congenital cleft lip and/or palate: mothers’ T/T genotype is associated with the increased risk of giving birth to a child with CCL, CCP and CCLP (in comparison with mothers with C/C+C/T genotype): odds ratio [OR]=16,63, 95% CI: 3,86-71,71; p=0,0003 and also for mothers with genotypes (C/T+T/T) in comparison with mothers with genotypes C/C: OR=3,22, CI:1,71-6,08; p=0,0002. The amount of risk is not significant in children with CMDA for T/T genotype. So it is possible to make a conclusion about the impact of C677T of the gene MTHFR in the development of CCL, CCP and CCLP only in mother’s genotype.

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Impact of cytochrome P450 2C19 polymorphisms on the clinical efficacy and safety of voriconazole: an update systematic review and meta-analysis

10.22541/au.162546769.92188192/v1 ◽

2021 ◽

Author(s):

Ying Zhang ◽

Xu Hao ◽

Kelu Hou ◽

Lei Hu ◽

Jingyuan Shang ◽

...

Keyword(s):

Cytochrome P450 ◽

Adverse Events ◽

Success Rate ◽

Clinical Efficacy ◽

Search Algorithm ◽

Efficacy And Safety ◽

Increased Risk ◽

Significant Difference ◽

The Impact ◽

Cyp2c19 Polymorphisms

Aims: To assess the impact of cytochrome P450 (CYP) 2C19 polymorphisms on the clinical efficacy and safety of voriconazole. Methods: We systematically searched PubMed, EMBASE, CENTRAL, ClinicalTrials.gov, and three Chinese databases from their inception to March 18, 2021 using a predefined search algorithm to identify relevant studies. Studies that reported voriconazole-treated patients and information on CYP2C19 polymorphisms were included. The efficacy outcome was success rate. The safety outcomes included overall adverse events, hepatotoxicity and neurotoxicity. Results: A total of 20 studies were included. Intermediate metabolizers (IMs) and Poor metabolizers (PMs) were associated with increased success rates compared with normal metabolizers (NMs) (risk ratio (RR): 1.18, 95% confidence interval (CI): 1.03~1.34, I2=0%, p=0.02; RR: 1.28, 95%CI: 1.06~1.54, I2=0%, p=0.01). PMs were at increased risk of overall adverse events in comparison with NMs and IMs (RR: 2.18, 95%CI: 1.35~3.53, I2=0%, p=0.001; RR: 1.80, 95% CI: 1.23~2.64, I2=0%, p=0.003). PMs demonstrated a trend towards an increased incidence of hepatotoxicity when compared with NMs (RR: 1.60, 95%CI: 0.94~2.74, I2=27%, p=0.08), although there was no statistically significant difference. In addition, there was no significant association between CYP2C19 polymorphisms and neurotoxicity. Conclusions: IMs and PMs were at a significant higher success rate in comparison with NMs. PMs were significantly associated with an increased incidence of all adverse events compared with NMs and IMs. Researches are expected to further confirm these findings. Additionally, the relationship between hepatotoxicity and CYP2C19 polymorphisms deservers clinical attention.

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P747 Adherence to ECCO guidelines for cancer surveillance is associated to the detection of early cancer: A retrospective, single-centre, cohort study

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.875 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S598-S599

Author(s):

T L PARIGI ◽

G Roda PhD ◽

M Allocca ◽

F Furfaro ◽

L Loy ◽

...

Keyword(s):

Family History ◽

Skin Cancer ◽

Disease Duration ◽

Early Cancer ◽

Cancer Surveillance ◽

Early Cancer Diagnosis ◽

Increased Risk ◽

Significant Difference ◽

History Of ◽

The Impact

Abstract Background Patients with inflammatory bowel disease (IBD), such as ulcerative colitis (UC) and Crohn’s disease (CD) are at increased risk of developing gastrointestinal (GI) malignancies. The aim of this study is to assess the risk of malignancies in IBD patients and the impact of cancer screening according to the ECCO guidelines in a tertiary referral centre. Methods We retrospectively analysed the electronic database of all IBD patients followed by the IBD Centre of Humanitas Research Hospital, Milan, from January 2010 to October 2019, and collected all new diagnoses of solid and haematological tumours since 2010. The annual standardised incidence rate (SIR), rate of mortality and early cancer diagnosis were calculated and a descriptive analysis of drug exposure, disease duration, family history of any cancer, smoking habits was made. Results We included 5239 patients, with a total 19820 patient-years follow-up. Eighty-four malignancies in 81 patients were retrieved, 71 were included in the final analysis (38 CD, 32 UC, 31 females). Average age at tumour diagnosis was 52.9 years (range 19–78). 64% of patients were former or active smokers, 31% had a family history of cancer or IBD. Sixty-two per cent of patients were previously exposed or had 5-ASA at the time of cancer, 40% azathioprine, 43% anti-TNF or vedolizumab. The annual SIR for all kinds of malignancy was 0.358%. GI malignancies were the most frequent (n = 17, 23.9%, 47% UC, 53% in CD). Six over 8 GI tract malignancies in UC patients were found in the colon or rectum (mean disease duration 22.5 years), whereas in CD patients 5/9 were in the small-bowel (mean disease duration 7.0 years). Melanoma and breast cancer (n = 8 each) were the most common non-GI cancers, followed by prostate (n = 7) and bladder (n = 6). No significant difference in incidence was found between CD or UC. Non-Hodgkin lymphomas and leukaemia (3 and 1, respectively) only occurred in CD patients. Other tumours included thyroid (n = 5), lungs (n = 4), testicle (n = 3), ovary (n = 2), kidney (n = 2), head-nose-throat (n = 2), pancreas (n = 1), brain (n = 1), and non-melanoma skin cancer (n = 1). Death occurred in 11% of patients, 8 of them for late stage cancer. Only 2 were related to the concomitant IBD (1 colo-rectal and 1 anal cancer). In patients regularly screened according to the ECCO Guidelines (GI cancer, haematological and skin cancer), there was a significantly higher number of detection of early cancer (28 vs. 1, p = 0.003), although no differences in mortality rates were reported in the two groups (2 vs. 2, p = 0.10). Conclusion The overall incidence of cancer in our cohort was not different from the current literature available. Adherence to the ECCO Guidelines for cancer surveillance improves the detection of early cancer in IBD patients.

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Seasonal variation in the prevalence of profound hyponatremia (<125 mmol/l) in patients on admission to an acute hospital in Japan

Proceedings of Singapore Healthcare ◽

10.1177/2010105819839373 ◽

2019 ◽

Vol 28 (3) ◽

pp. 211-213 ◽

Cited By ~ 1

Author(s):

Nobukazu Sasaki ◽

Yuji Aoki

Keyword(s):

Salt Intake ◽

Medical Center ◽

Relevant Literature ◽

Warm Season ◽

Cold Season ◽

Acute Hospital ◽

Drug Induced ◽

Increased Risk ◽

Significant Difference ◽

The Impact

Hyponatremia is a common but important electrolyte disorder mostly complicated with other diseases. Recently, we experienced a case of a hypertensive patient in her seventies taking a thiazide diuretic, who presented with disorientation due to severe hyponatremia (serum sodium level, 104 mmol/l) on admission. Taking this opportunity, patients with profound hyponatremia (<125 mmol/l) on admission were investigated. Patients newly admitted to Matsumoto Medical Center (an acute hospital) were surveyed retrospectively for one year from May 1, 2016 to April 30, 2017. Patients with profound hyponatremia on admission were selected, and their clinical characteristics were evaluated. A total of 108 out of 4223 patients (2.6%; 67 men, 41 women) showed profound hyponatremia, and 101 out of 108 patients were 65 years old and over. The prevalence of profound hyponatremia in the warm season of April to October (3.1%, 76 in 2444 patients) was significantly ( p = 0.002, χ2 test) higher than that in the cold season of November to March (1.8%, 32 in 1779 patients). The monthly prevalence tended to correlate with the monthly average temperature of the local area ( r = 0.517, p = 0.085). There were six patients treated with thiazide diuretics in the warm season, while there were no such patients in the cold season, not reaching a significant difference ( p = 0.240). The present study demonstrated an increased risk of hyponatremia in elderly patients during the warm season. Considering also the relevant literature, health professionals should pay enough attention to thiazide- or drug-induced hyponatremia and the impact of water/salt intake for heat exposure.

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