Infantile Apnea

Accumulating data have linked migraine to cerebrovascular and heart diseases. The relationship between migraine and stroke is complex and bidirectional. A stroke, either ischaemic or haemorrhagic, may produce symptoms mimicking a migraine attack; a migraine attack may mimic a stroke; migraine may be directly associated with an ischaemic stroke (migrainous infarction); migraine may represent a risk factor for stroke; several diseases, mostly genetically determined, include among their clinical manifestations attacks of migraine and stroke; lastly, migraine has been associated with subclinical infarct-like brain lesions and white matter hyperintensities. The risk of cardiac vascular events in migraineurs varies greatly among studies, ranging from a lower-than-average to a moderately increased risk as suggested by the most recent data. Initial evidence also suggested an association between migraine and patent foramen ovale, but this possibility has been recently challenged. The mechanisms underlying the relationship of migraine with cerebrovascular and cardiovascular diseases are still cryptic and rather complex. In migraineurs, a heightened vigilance toward some comorbid risk factor is warranted together with caution in prescribing oral contraceptives.

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Increased lipoprotein(a) concentrations in chronic renal failure.

Journal of the American Society of Nephrology ◽

10.1681/asn.v351156 ◽

1992 ◽

Vol 3 (5) ◽

pp. 1156-1162

Author(s):

S M Haffner ◽

K K Gruber ◽

G Aldrete ◽

P A Morales ◽

M P Stern ◽

...

Keyword(s):

Coronary Heart Disease ◽

Renal Failure ◽

Risk Factor ◽

Heart Disease ◽

Chronic Renal Failure ◽

Mexican Americans ◽

Increased Risk ◽

Relationship Of ◽

The Relationship ◽

Hispanic White

Subjects with chronic renal failure have a greatly increased risk of coronary heart disease and dyslipidemia. Relatively few studies have examined the relationship of chronic renal failure to lipoprotein (Lp)(a) concentrations, an important risk factor for coronary heart disease. Diabetic subjects have been reported to have both increased Lp(a) concentrations and an increased risk of renal failure, thereby possibly confounding the Lp(a)-renal failure association. The association between Lp(a) and chronic renal failure in 359 control subjects and 111 subjects with renal failure was examined. Lp(a) (in milligrams per deciliter) was elevated in subjects with chronic renal failure, regardless of ethnicity (Mexican Americans, 19.8 +/- 2.7 versus 14.1 +/- 1.3; P = 0.03; non-Hispanic white patients, 24.9 +/- 3.0 versus 16.3 +/- 1.2; P = 0.006;). These differences persisted after adjustment for diabetes and ethnicity (P < 0.001). The type of treatment for chronic renal failure (diet, hemodialysis, or peritoneal dialysis) did not have an effect on Lp(a) concentrations. Lp(a) levels were not correlated with the level of creatinine in subjects with chronic renal failure. Thus, the elevation of Lp(a) levels in renal failure must occur early in renal failure, or alternatively, elevated Lp(a) levels may promote progression to chronic renal failure. These results indicate that Lp(a) concentrations are increased in chronic renal failure and may increase the risk for coronary heart disease in these subjects.

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Diabetes and COVID19: a bidirectional relationship

European Journal of Clinical Nutrition ◽

10.1038/s41430-021-00961-y ◽

2021 ◽

Author(s):

Ranjit Unnikrishnan ◽

Anoop Misra

Keyword(s):

Clinical Care ◽

Severe Disease ◽

Respiratory Involvement ◽

Pancreatic Damage ◽

Increased Risk ◽

Bidirectional Relationship ◽

Rapid Spread ◽

Relationship Of ◽

The Relationship ◽

New Onset

AbstractThe advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body’s stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.

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Diabetes and COVID19: a bidirectional relationship

Nutrition and Diabetes ◽

10.1038/s41387-021-00163-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ranjit Unnikrishnan ◽

Anoop Misra

Keyword(s):

Clinical Care ◽

Severe Disease ◽

Respiratory Involvement ◽

Pancreatic Damage ◽

Increased Risk ◽

Bidirectional Relationship ◽

Rapid Spread ◽

Relationship Of ◽

The Relationship ◽

New Onset

AbstractThe advent and rapid spread of the coronavirus disease-2019 (COVID19) pandemic across the world has focused attention on the relationship of commonly occurring comorbidities such as diabetes on the course and outcomes of this infection. While diabetes does not seem to be associated with an increased risk of COVID19 infection per se, it has been clearly demonstrated that the presence of hyperglycemia of any degree predisposes to worse outcomes, such as more severe respiratory involvement, ICU admissions, need for mechanical ventilation and mortality. Further, COVID19 infection has been associated with the development of new-onset hyperglycemia and diabetes, and worsening of glycemic control in pre-existing diabetes, due to direct pancreatic damage by the virus, body’s stress response to infection (including cytokine storm) and use of diabetogenic drugs such as corticosteroids in the treatment of severe COVID19. In addition, public health measures taken to flatten the pandemic curve (such as lockdowns) can also adversely impact persons with diabetes by limiting their access to clinical care, healthy diet, and opportunities to exercise. Most antidiabetic medications can continue to be used in patients with mild COVID19 but switching over to insulin is preferred in severe disease.

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Relationship between benzodiazepine prescription, aggressive behavior, and behavioral disinhibition: a retrospective study in a Swiss prison

Harm Reduction Journal ◽

10.1186/s12954-021-00504-5 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Stéphanie Baggio ◽

Vladan Starcevic ◽

Patrick Heller ◽

Karen Brändle ◽

Irina Franke ◽

...

Keyword(s):

Propensity Score ◽

Aggressive Behavior ◽

Propensity Score Matching ◽

Potential Role ◽

Behavioral Disinhibition ◽

Increased Risk ◽

Benzodiazepine Use ◽

Logistic Regressions ◽

Relationship Of ◽

The Relationship

Abstract Background Benzodiazepines are commonly prescribed in prisons amidst the controversies surrounding their potential role in causing behavioral disinhibition and aggressive behavior and their association with use and trafficking of illicit and addictive substances. The present study aimed to (1) ascertain the relationship between benzodiazepine prescription (including their dosage and duration of use) and aggressive behavior and behavioral disinhibition in prison and (2) investigate whether there was an association between benzodiazepine prescription, (including their dosage and duration of use) and using and trafficking illicit and addictive substances during imprisonment. Methods Data were extracted from the electronic database of an “open” Swiss prison (n = 1206, 1379 measures) over a 5-year period (2010–2015). Measures included benzodiazepine prescription, duration of benzodiazepine use and mean dosage, and punishable behaviors (physical and verbal aggression, disinhibited but not directly aggressive behaviors, property damage or theft, substance-related offenses, and rule transgression). We assessed the relationship between benzodiazepine prescription and punishable behaviors after propensity score matching. Logistic regressions were also used to test the relationship of benzodiazepine use duration and dosage with punishable behaviors among participants who received benzodiazepines. Results After propensity score matching, benzodiazepine prescription was not significantly associated with any punishable behavior. Among detained persons who took benzodiazepines, there was no significant association of dosage and duration of use with offenses involving illicit or addictive substance use or trafficking. Conclusions Our study did not empirically support the occurrence of increased aggressive or disinhibited behaviors or increased risk of substance abuse in detained persons who received benzodiazepines in prison. This suggests a need to reconsider restrictions in prescribing benzodiazepines in the prison setting.

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Surgical Anatomy for Extended Facelift Techniques

Facial Plastic Surgery ◽

10.1055/s-0040-1712472 ◽

2020 ◽

Vol 36 (03) ◽

pp. 309-316

Author(s):

Ozcan Cakmak ◽

Ismet Emrah Emre

Keyword(s):

Facial Nerve ◽

Soft Tissues ◽

Extended Techniques ◽

Surgical Anatomy ◽

Superficial Musculoaponeurotic System ◽

Increased Risk ◽

The Face ◽

Facial Soft Tissues ◽

Relationship Of ◽

The Relationship

AbstractPreservation of the facial nerve is crucial in any type of facial procedure. This is even more important when performing plastic surgery on the face. An intricate knowledge of the course of the facial nerve is a requisite prior to performing facelifts, regardless of the technique used. The complex relationship of the ligaments and the facial nerve may put the nerve at an increased risk of damage, especially if its anatomy is not fully understood. There are several danger zones during dissection where the nerve is more likely to be injured. These include the areas where the nerve branches become more superficial in the dissection plane, and where they traverse between the retaining ligaments of the face. Addressing these ligaments is crucial, as they prevent the transmission of traction during facelifts. Without sufficient release, a satisfying pull on the soft tissues may be limited. Traditional superficial musculoaponeurotic system techniques such as plication or imbrication do not include surgical release of these attachments. Extended facelift techniques include additional dissection to release the retaining ligaments to obtain a more balanced and healthier look. However, these techniques are often the subject of much debate due to the extended dissection that carries a higher risk of nerve complications. In this article we aim to present the relationship of both the nerve and ligaments with an emphasis on the exact location of these structures, both in regard to one another and to their locations within the facial soft tissues, to perform extended techniques safely.

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Associations of CTLA4 Gene Polymorphisms with Graves’ Ophthalmopathy: A Meta-Analysis

International Journal of Genomics ◽

10.1155/2014/537969 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Pengfei Du ◽

Xiaojie Ma ◽

Changjiang Wang

Keyword(s):

Genetic Model ◽

Meta Analysis ◽

Case Control Studies ◽

Graves Ophthalmopathy ◽

Increased Risk ◽

Exon 1 ◽

Ctla4 Gene ◽

Relationship Of ◽

The Relationship ◽

Susceptible Gene

Many studies have established that T-lymphocyte antigen-4 (CTLA4) is a susceptible gene for Graves’ disease (GD). Also many studies showed the association between the CTLA4 exon-1 49A/G polymorphism and the risk of developing Graves’ ophthalmopathy (GO) in GD patients. But those results were inconsistent. In recent years many new studies were published which helped to shed light on the relationship of CTLA4 SNP49 with GO. So we performed the meta-analysis to explore the association between the SNP49 and GO susceptibility in GD patients. Studies up to February 29, 2012, were searched by using PubMed. The odds ratio was used to evaluate the strength of the association. Altogether 12 case-control studies involving 2,505 participants were included in the meta-analysis. Results showed that the G allele was related to the increased risk of GO compared with the A allele under allelic genetic model (OR = 1.14, 95% CI: 1.14–1.72,P=0.001) in European subgroup. No publication bias was detected. Our results showed that the SNP49 polymorphism of CTLA4 gene was related to increased risk of GO.

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THE RISK OF FALLS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Rheumatology Science and Practice ◽

10.14412/1995-4484-2016-705-711 ◽

2017 ◽

Vol 54 (6) ◽

pp. 705-711 ◽

Cited By ~ 1

Author(s):

N. V. Toroptsova ◽

A. Yu. Feklistov

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Risk Factor ◽

Independent Risk Factor ◽

Risk Of Falls ◽

Relationship Of ◽

The Relationship

The paper discusses the materials of investigations dealing with falls as an independent risk factor for fractures in patients with rheumatoid arthritis (RA). It gives data on the incidence and possible risk factors of falls in this category of patients. According to the data obtained, the prevalence of falls in different countries varies from 10 to 50%, which may be related to differences in the methods of collecting information, and the relationship of the investigated factors with the risk of falls in patients with RA is uniquely unproven and calls for further investigations.

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The Relationship of Drug Abuse to Unexplained Sudden Death

Archives of Pathology & Laboratory Medicine ◽

10.5858/132.12.1903 ◽

2008 ◽

Vol 132 (12) ◽

pp. 1903-1906

Author(s):

Amy C. Gruszecki ◽

Gerald McGwin, Jr ◽

C. Andrew Robinson, Jr ◽

Gregory G. Davis

Keyword(s):

Drug Abuse ◽

Cause Of Death ◽

Control Group ◽

Manner Of Death ◽

Increased Risk ◽

History Of ◽

Matched Case ◽

Relationship Of ◽

The Relationship ◽

Control Study

Abstract Context.—Forensic pathologists regularly investigate the deaths of individuals with a history of drug abuse. Autopsy, including toxicology testing, reveals no cause for death in a subset of this cohort. Objective.—To determine whether deaths with an undetermined cause and manner of death are associated with a history of drug abuse. Design.—Retrospective matched case-control study of 52 decedents whose cause of death remained undetermined following autopsy, matched 1:2 to a control group of living patients admitted for cholecystectomy according to age and date of death or procedure. Results.—Individuals whose cause of death was undetermined were 5.3 times (95% confidence interval, 1.9– 14.5) more likely to have a history of drug abuse than were patients with cholecystitis. Conclusions.—Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicologic finding at autopsy to account for death.

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Abstract 5108: Microalbuminuria is Associated with Progression of Coronary Atherosclerosis in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.118.suppl_18.s_1147-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Andrew P DeFilippis ◽

Holly J Kramer ◽

Ronit Katz ◽

Nathan Wong ◽

Alain Bertoni ◽

...

Keyword(s):

Lipid Lowering ◽

Albumin Creatinine Ratio ◽

Ethnic Study ◽

Median Increase ◽

Increased Risk ◽

History Of ◽

Relationship Of ◽

The Relationship ◽

Progression Of Atherosclerosis

Background: Microalbuminuria (MA) is associated with an increased risk of cardiovascular disease (CVD) but the mechanism by which microalbuminuria imparts this increased risk is not known. In this study we assessed the relationship between MA and the development and progression of atherosclerosis by measuring the incidence of new CAC and the progression of existing CAC in individuals free of clinical CVD. Methods : The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective cohort study of 6,814 participants free of clinical CVD at entry who underwent assessment of coronary artery calcification (CAC) by computerized tomography at baseline. Overall, 6,775 individuals had data available on urinary albumin creatinine ratio (UACR); 1,109 individuals were excluded for missing data or macroalbuminuria (UACR≥300 mg/g). Incident CAC was defined as detectable CAC at follow-up among those with CAC=0 at baseline, and absolute CAC score change among those with CAC>0 at baseline. Relative risk (RR) regression adjusted for covariates; and multivariable adjusted median regression was employed to assess the independent relationship of MA with CAC incidence and progression. Results : Of the 5,666 subjects (mean age 62±10 years, 48% males), baseline MA was seen in 424 (7%) participants, who were more likely to have CAC compared to those with normal UACR (62% vs. 48%, p<0.0001). During a mean follow-up of 2.4±0.8 years, those with MA were more likely to develop CAC (28% vs. 15%, p<0.0001) and they had a higher absolute median increase in CAC (47 vs. 29 Agatston Units, p<0.0001). After adjustment for age, gender, ethnicity, site, follow-up duration, diabetes, hypertension, smoking, family history of heart attack, total cholesterol, lipid lowering medications and body mass index; MA was associated with incident CAC (RR 1.65; 95%CI 1.41–2.48) among those with CAC=0 at baseline. Among those with CAC>0 at baseline, MA was associated with a median increase in CAC of 7.93 (95%CI 0.38 –15.47) Agatston Units in multivariable adjusted analyses (variables noted above). Conclusion : MA is independently associated with development of incident CAC and progression of CAC in an asymptomatic multi-ethnic population, and may in part explain its associated increased risk of CVD.

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