scholarly journals Renal impairment is closely associated with plasma aldosterone concentration in patients with primary aldosteronism

2019 ◽  
Vol 181 (3) ◽  
pp. 339-350 ◽  
Author(s):  
Akiyuki Kawashima ◽  
Masakatsu Sone ◽  
Nobuya Inagaki ◽  
Yoshiyu Takeda ◽  
Hiroshi Itoh ◽  
...  

Objective Several clinical studies have reported that renal impairments are sometimes observed in patients with primary aldosteronism (PA). We analyzed the prevalence of renal impairments in PA patients and identified parameters that increase the risk for them. Design This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter Japan PA study (JPAS). Data were also collected from patients with essential hypertension (EHT). Methods We compared the prevalences of proteinuria and lowered estimated glomerular filtration rate (eGFR) between patients with PA and age, sex, blood pressure and duration of hypertension-matched patients with EHT. We also performed logistic regression analysis to identify parameters that increase the risk for these renal impairments. Results Among 2366 PA patients, the prevalences of proteinuria and lowered eGFR were 10.3 and 11.6%, respectively. The prevalence of proteinuria was significantly higher in PA patients than matched-EHT patients (16.8 vs 4.4%), whereas there was no significant difference in the prevalence of lowered eGFR (17.2 vs 15.0%). The logistic regression analysis also showed that the plasma aldosterone concentration (PAC) significantly increases the risk of proteinuria and lowered eGFR, independent of other known risk factors. Conclusion Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our earlier finding that the PAC was not itself linearly associated with cardiovascular events such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may differ from that affecting the cardiovascular system.

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Masakatsu Sone ◽  
Youichi Ohno ◽  
Akiyuki Kawashima ◽  
Nobuya Inagaki ◽  
Mitsuhide Naruse ◽  
...  

Abstract BACKGROUND: There have been several clinical studies examining the factors associated with cardiovascular disease (CVD) and renal impairment in patients with primary aldosteronism (PA); however, their results have left it unclear as to whether they are affected by the plasma aldosterone concentration (PAC) itself. Method: This is a retrospective cross-sectional study. We assessed the PA database established by the multicenter JPAS (Japan Primary Aldosteronism Study) and compared the prevalences of CVD (stroke, ischemic heart disease, and heart failure) and renal impairment (proteinuria and lowered eGFR) among patients with PA and those with essential hypertension (EHT). We also performed logistic regression analysis to determine which parameters significantly increased the odds ratio for these complications. Results: The prevalence of CVD was significantly higher among 2814 patients with PA than among matched patients with EHT. The prevalence of proteinuria was also significantly higher among PA than EHT patients, whereas there was no significant difference in the prevalence of lowered eGFR. Multivariable logistic regression analysis showed that the PAC significantly increases the adjusted odds ratios for proteinuria and lowered eGFR independent of other known risk factors. By contrast, the PAC was not linearly related to the adjusted odds ratio for CVD. Conclusion: Plasma aldosterone levels are closely associated with renal impairment in patients with PA. This is contrast to our finding that the PAC was not, itself, linearly associated with CVDs, such as stroke or ischemic heart disease. The mechanism underlying the kidney damage in patients with PA may thus differ from that affecting the cardiovascular system.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tesfaldet Mekonnen Estifanos ◽  
Chen Hui ◽  
Afewerki Weldezgi Tesfai ◽  
Mekonnen Estifanos Teklu ◽  
Matiwos Araya Ghebrehiwet ◽  
...  

Abstract Background Youth in general and young females, in particular, remain at the center of HIV/AIDS epidemic. To avoid and prevent HIV infection, comprehensive knowledge as well as correct understanding of transmission and prevention strategies are crucial. Thus, the aim of this study is to explore the predictors of comprehensive knowledge on HIV/AIDS and accepting attitude towards PLWHIV. Methods A cross-sectional study was conducted using data from the 2016 Uganda Demographic Health Survey. A two-stage probability sampling method was applied and data were collected using a standard questionnaire. Of the total 8674 women aged 15–49 years, 1971 eligible women aged 15–24 years were included in this analysis. Data analysis was done using SPSS version 23. A Chi-square test followed by logistic regression analysis was used to explore the relationship between specific explanatory variables and outcome variables. The results were reported using odds ratios with 95% confidence interval. P value less than 0.05 was considered as statistically significant. Results Overall, 99.3% of the unmarried women aged 15–24 years were aware of HIV/AIDS, but only 51.9% had comprehensive knowledge on HIV/AIDS. Around 70% of the respondents were aware that "using condoms every time when having sex" and "having only one faithful uninfected partner" can prevent HIV transmission. About 68% of the unmarried women rejected at least two common local misconceptions about HIV/AIDS. An alarmingly small (20.6%) proportion of the respondents had a positive acceptance attitude towards PLWHIV. All variables were significantly associated with having comprehensive knowledge on HIV/AIDS in the unadjusted logistic regression analysis. After adjustment, older age (20–24 years), being educated, wealthier, and ever been tested for HIV/AIDS became predictors of adequate comprehensive HIV/AIDS knowledge. Moreover, respondents with adequate comprehensive knowledge of HIV/AIDS were more likely (OR 1.64, 95% CI 1.30–2.08) to have a positive acceptance attitude towards PLWHIV than their counterparts. Conclusion Our study demonstrated a remarkably high level of awareness about HIV/AIDS among study participants, but the knowledge and positive acceptance attitude towards PLWHIV were not encouraging. Thus, endeavors to expand and strengthen educational campaigns on HIV/AIDS in communities, health facilities, and schools are highly recommended. Attention should particularly focus on young-aged and disadvantaged women with low educational level, poor socioeconomic status and those who have never been tested for HIV/AIDS.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Huiwu Han ◽  
Fan Zheng ◽  
Weiwei Dai ◽  
Hua Peng ◽  
Shi Zhou ◽  
...  

Objectives. Metabolic syndrome (MetS) is now becoming a serious public health threat. Some behaviors risk factors were considered to be associated with MetS and interacted to adversely affect MetS. However, the clustering effects of behavior risk factors of MetS among Chinese population remain unclear. The aim of this study is to observe the behavior risk factors and their clustering effects of MetS in China. Methods. A cross-sectional study design was used. Subjects were recruited in the departments of Cardiology Clinic, Endocrine Clinic, and Health Management from March to December 2019. A demographic sheet was designed to collect the demographic and clinical characteristics of the subjects. International Physical Activity Questionnaire-Short was applied to evaluate the level of PA in this study. Other behavior risk factors were observed by the questionnaire. The stepwise logistic regression analysis was performed to identify the determinants of MetS. The multiple logistic regression analysis was used to analyze the clustering effects of behavior risk factors in MetS. Results. There are a total of 532 eligible subjects (56.6% females; mean age was 48.4±15.3 years), and approximately 33.3% were diagnosed as MetS. The subjects with a smoking habit (heavy and long-time history) had a 1.833-fold higher risk for MetS than their counterparts (none and light smoking), and the subjects that preferred salty taste had a 1.626-fold higher risk for MetS than the comparison cohort. Smoking and alcohol drinking had the highest clustering effect on MetS among the behavior risk factors. Conclusions. The main finding of this study was that smoking and salty taste preference were the independent determinants of MetS. Smoking and alcohol consumption had the highest clustering effect on southern Chinese MetS.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaoying Duan ◽  
Meng Li ◽  
Jialiang Zhao ◽  
Huiyu Yang ◽  
Jinfeng He ◽  
...  

Abstract Background A nomogram is a tool that transforms complex regression equations into simple and visual graphs and enables clinicians and patients to conveniently compute output probabilities without needing medical knowledge and complex formulas. The aim of this study was to develop and validate a predictive nomogram to screen for severe caries among 12-year-old children based on risk factors in Sichuan Province, China. Methods A cross-sectional study of 4573 12-year-olds was conducted up to May 2016 in middle schools from three districts and three counties in Sichuan Province, China. All the children underwent oral examinations and completed questionnaires to assess general information, oral impacts on daily performance, dietary habits, subjective health conditions, history of dental trauma, frequency of toothache, dental visits, and knowledge, attitudes, and behaviours toward oral hygiene. Univariate analysis and multivariate logistic regression analysis were used to determine which variables were significantly associated with severe caries (operationalized as DMFT ≥ 3). A nomogram was developed and validated by using the ‘rms’ package and two cross-validation methods. Results Severe caries was found in 537 of the 4573 children (11.74%). Multivariate logistic regression analysis revealed that the following variables predicted a higher risk of severe caries: ‘female’ [odds ratio (OR) = 1.985, 95% confidence interval (95% CI): 1.63–2.411], ‘urban’ (OR = 2.389, 95% CI: 1.96–2.91), ‘non-only child’ (OR = 1.317, 95% CI: 1.07–1.625), ‘very poor self-assessment of oral health status’ (OR = 2.157, 95% CI: 1.34–3.467) and ‘visited a dentist less than 6 months’ (OR = 1.861, 95% CI: 1.38–2.505). Multivariate logistic regression analysis also indicated that the following variables predicted a lower risk of severe caries: ‘middle level of urbanization’ (OR = 0.395, 95% CI: 0.32–0.495) and ‘high level of urbanization’ (OR = 0.466, 95% CI: 0.37–0.596). Both the fivefold and leave-one-out cross-validation methods indicated that the nomogram model built by these 6 variables displayed good disease recognition ability. Conclusions The nomogram was a simple-to-use model to screen children for severe caries. This model was found to facilitate non-dental professionals in assessing risk values without oral examinations and making referrals to dental professionals.


PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12553
Author(s):  
Yanni Wang ◽  
Lingyun Zeng ◽  
Lijuan Chen ◽  
Xin Zhou ◽  
Lijuan Huo ◽  
...  

Background Diabetes mellitus (DM) is common among patients with schizophrenia. However, information on patients comorbid DM and schizophrenia is limited in China. The present study investigated the prevalence of DM and its clinical characteristics in Chinese inpatients with chronic schizophrenia. Methods A cross-sectional study was performed in Chinese inpatients with chronic schizophrenia. Diagnosis of Diabetes was established using World Health Organization diagnostic criteria for diabetes mellitus (persistent fasting glucose levels ≥ 126 mg/dl or 2-h plasma glucose ≥ 200 mg/dL after a 75-g Oral Glucose Tolerance Test). Patients were also measured height, weight, waist circumference, hip circumference, triglyceride level, and cholesterol level. Patients’ psychiatric symptoms were measured by the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression analysis was performed to examine the associated demographic and clinical variables in chronic schizophrenia. Results A total of 988 inpatients (64.6% male, average age of 47.19 ± 12.55) was recruited. The prevalence of DM in Chinese patients with chronic schizophrenia was 13.8% (95% CI [11.6–15.9]%). Logistic regression analysis showed that overweight (OR = 1.90, 95% CI [1.20–3.03], p = 0.006), obesity (OR = 1.85, 95% CI [1.07–3.21], p = 0.028), comorbid hypertension (OR = 2.14, 95% CI [1.34–3.42], p = 0.002), and course of schizophrenia (OR = 1.03, 95% CI [1.01–1.06], p = 0.040) were significantly associated with the DM risk in patients with schizophrenia. Conclusion The findings indicated that diabetes mellitus was non-negligible in patients with chronic schizophrenia. Patients with schizophrenia should be regularly monitored for DM. Overweight/obesity, long duration of schizophrenia, and comorbid hypertension possibly were risk factors for diabetes.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037792
Author(s):  
Tsegaye Gebremedhin ◽  
Asmamaw Atnafu ◽  
Endalkachew Dellie

ObjectiveThe community-based newborn care (CBNC) is a newborn care package along the maternal and newborn health continuum of care that has been implemented at the community level in Ethiopia. The utilisation which might be affected by several factors has not been well assessed. Thus, this study aimed to examine the utilisation of CBNC and associated factors among women who delivered recently in Geze Gofa rural district, south Ethiopia.DesignCross-sectional study.SettingCommunity-based.ParticipantsThree-hundred seventy-one women who had their newborns recently were randomly selected. Then, they were interviewed at their places using an interviewer-administered structured questionnaire.MethodsA binary logistic regression analysis was done. In the multivariable logistic regression analysis, a p value of <0.05 and adjusted OR (AOR) with 95% CI were used to identify factors statistically associated with CBNC utilisation.OutcomesCBNC utilisation.ResultsThe findings showed that the overall utilisation of CBNC by women who delivered recently with their newborns was 37.5% (95% CI: 32.6 to 42.6). Factors associated with the utilisation of CBNC included women who attended elementary school (AOR: 1.76, 95% CI: 1.01 to 3.07), college and above (AOR: 3.71, 95% CI: 1.12 to 12.24), farmer women (AOR: 0.35, 95% CI: 0.16 to 0.79), women in the lowest (AOR: 3.76, 95% CI: 1.65 to 8.54) and middle quantile of wealth status (AOR: 1.96, 95% CI: 1.01 to 3.76), and those whose preference was visiting hospital only when they faced any signs of danger (AOR: 0.29, 95% CI: 0.11 to 0.78).ConclusionThe use of the CBNC programme in the study area was surprisingly low. To increase utilisation and potentially improve the outcomes of these neonates, we need to increase awareness at community levels, make convenient arrangements and increase the availability of services at nearby health facilities that are essential to improve the uptake of CBNC in the rural district.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1471.2-1472
Author(s):  
N. Gokcen ◽  
I. Coskun Benlidayi ◽  
L. Tamam ◽  
M. E. Demirkol ◽  
C. Yesiloglu ◽  
...  

Background:Fibromyalgia (FM) is a condition characterized by chronic widespread pain, fatigue, sleep disturbances. Etiopathogenesis remains unclear; however, growing data regarding the effect of psychosocial factors on disease etiopathogenesis have drawn attention. Psychosocial elements such as type D personality and low level of self-esteem might increase disease burden (1). Accordingly, many researchers so far, have examined psychological parameters in FM and a limited number of studies focused on the personality type among patients with FM (2-5).Objectives:The current study aimed to investigate type D personality and self-esteem in patients with FM.Methods:Female patients with fibromyalgia and age-matched healthy controls were enrolled in this cross-sectional study. Type D personality was evaluated by using the type D scale (DS-14). The Rosenberg self-esteem scale (RSES) was used to assess self-esteem and psychosomatic symptoms. Psychological status was evaluated by the Beck Depression and Beck Anxiety Inventories. Fibromyalgia Impact Questionnaire (FIQ) was performed to assess functional impairment and health status in patients with FM. The potential confounders of type D personality were evaluated by binary logistic regression analysis.Results:Seventy patients with FM and 60 controls were included. Type D personality was observed in 58.6% of the patients and in 21.7% of the control group (p<0.001). When compared to patients with non-type D personality, those with type D personality revealed lower self-esteem and poorer health status (p<0.05 for both), higher anxiety and depression scores (p<0.001 for both). According to binary logistic regression analysis, depression (β=1.178, Cl 95% 1.055−1.316, p=0.004) and lower education level (β=0.818, Cl 95% 0.682−0.982, p=0.031) were significantly related to type D personality in FM (Table 1).Conclusion:Type D personality is more common in female patients with FM when compared to healthy women. Patients with type D personality have lower level of self-esteem when compared to those with non-type D personality. Depression and lower education level are potential confounders of type D personality in FM.References:[1]Bazzichi L, Giacomelli C, Consensi A, Giorgi V, Batticciotto A, Di Franco M, Sarzi-Puttini P (2020) One year in review 2020: fibromyalgia. Clin Exp Rheumatol 38 Suppl 123(1):3-8.[2]Conversano C, Marchi L, Ciacchini R, Carmassi C, Contena B, Bazzichi LM, Gemignani A (2018) Personality Traits in Fibromyalgia (FM): Does FM Personality Exists? A Systematic Review. Clin Pract Epidemiol Ment Health 14:263.[3]Türkoğlu G, Selvi Y (2020) The relationship between chronotype, sleep disturbance, severity of fibromyalgia, and quality of life in patients with fibromyalgia. Chronobiol Int 37(1):68-81.[4]Garip Y, Güler T, Bozkurt Tuncer Ö, Önen S (2019) Type D Personality is Associated With Disease Severity and Poor Quality of Life in Turkish Patients With Fibromyalgia Syndrome: A Cross-Sectional Study. Arch Rheumatol 35(1):13-19.[5]Ablin JN, Zohar AH, Zaraya-Blum R, Buskila D (2016) Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients. PeerJ 4:e2421.Table 1.Binary logistic regression analysis for the evaluation of potential confounders of type D personality in patients with fibromyalgia.WaldSEβ (95%CI)pEducation (years)4.6640.0930.818 (0.682−0.982)0.031Occupation duration (years)0.1160.0371.013 (0.942−1.089)0.733Self-esteem scale (D1)0.3690.4230.774 (0.338−1.771)0.544BDI8.4460.0561.178 (1.055−1.316)0.004BAI0.7890.0321.029 (0.966−1.095)0.374BDI: Beck Depression Inventory, BAI: Beck Anxiety Inventory, SE: standard error, CI: confidence intervalDisclosure of Interests:None declared


Author(s):  
Shweta Suri ◽  
Anuradha Dutta ◽  
Rita Singh Raghuvanshi ◽  
Anupama Singh ◽  
C. S. Chopra

Background: In India, Anaemia among children is still one of the major nutritional problems of public health concern. Aim of the Study: The aim of the present study was to assess the prevalence of anaemia among Anganwadi children (3-6 years of age) and to determine the important risk factors associated with anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Study was conducted among 390 Anganwadi children of Udham Singh Nagar district of Uttarakhand, during April, 2019- August, 2019. Methodology: In this cross sectional study, data on socio-demographic, socioeconomic, hygiene and dietary practices were collected using a self-structured questionnaire. Hemoglobin (Hb) and anthropometric measurements were carried out. Multivariable logistic regression analysis was employed to estimate the adjusted odds ratio (AOR). Results: A majority, 70.54% of the Anganwadi children were found to be anaemic, with higher prevalence among male children (51.30%) as compared to female children (48.70%). The mean hemoglobin concentration of children was 9.91 (±1.9 g/dl). Stunting was higher among males (54.83%) as compared to females (45.17%).Multivariable logistic regression analysis showed that anaemia was significantly associated with monthly income of family AOR (95% CI) 3.25(2.49, 4.00), mother's illiteracy AOR (95% CI) 1.98 (1.49, 2.46), history of anaemia in mother AOR (95% CI) 1.60(0.67, 2.52 ), history of worms in child's stool AOR (95% CI) 3.17(2.26,4.03), barefoot walking AOR (95% CI) 3.08(2.11,4.04) and lack of habit of hand washing AOR (95% CI) 1.55(0.98, 2.11). Conclusion: The prevalence of anaemia among children was high. Iron supplementation, nutrition education among mothers and overall personal hygiene are important to ameliorate their iron status.


2020 ◽  
Author(s):  
Yeshambel Agumas Ambelie ◽  
Getu Degu Alene ◽  
Damen Hailemariam Gebrekiros

Abstract Aim: The purpose of this study was to determine the levels of competence and predictors to lead, manage, and govern among the health system workforce. Methods: A cross-sectional study was carried out in northwest Ethiopia. Eight hundred thirteen workforce were participated in the study. Competence to lead, manage, and govern was computed from 20 items. It was also leveled into four categories. Ordinal logistic regression analysis was conducted to identify predictors of this competence. Results: From 813 participants, 396 (48.7%) and 582 (71.6%) were females and service owners respectively. The estimates for low, moderate, high and very high levels of competence to lead, manage and govern were 41.3%; 42.7%; 13.5% and 2.5% respectively. Sex (p = .031) and responsibility (p = .019) were identified as main predictors. Conclusions: Competence to lead, manage and govern among the health system workforce in northwest Ethiopia is inadequate. Policymakers, program planners and researchers need to take action giving due attention to females and service owners. Feature research could be conducted considering hierarchical variables.


2020 ◽  
Vol 20 (3) ◽  
pp. 759-767
Author(s):  
Emanuelle Mandú Meira dos Santos ◽  
Bruna Constantino ◽  
Marina Monzani da Rocha ◽  
Marco Fabio Mastroeni

Abstract Objectives: the purpose of this study was to evaluate the predictors of low perceptual-motor skills in children at preschool age. Methods: this is a cross-sectional study nested in a birth cohort involving mother-child pairs. The children’s perceptual-motor skills were assessed individually in their homes when they were 4-5 years old using the Pre-Literacy Skills and Knowledge Test (THCP®), a vali-dated Brazilian instrument. Logistic regression analysis was used to estimate the association between cognitive perceptual-motor skills and potential maternal and child risk factors. Results: of the 199 children included in the study, 53.8% were boys, 90.8% attended school, and 91.1% were enrolled in a public school. Among the children, 114 (57.3%), 41 (20.6%) and 44 (22.1%) had low, moderate and high perceptual-motor skills, respectively. Multivariate logistic regression analysis revealed greater odds of children at preschool age having low perceptual motor skills for boys (OR=2.10; CI95%= 1.14-3.88), children who did not attend school (OR=4.61; CI95%= 1.21-17.49), and those with a household income <5 minimum wages (MW) (OR=4.28; CI95%= 1.49-12.26). Conclusions: our study showed that male gender, not attending school and a monthly household income <5 MW were predictors of low perceptual-motor skills in children at 4-5 years of age.


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