scholarly journals Hypertension in employees of a University General Hospital

2004 ◽  
Vol 59 (6) ◽  
pp. 329-336 ◽  
Author(s):  
Decio Mion Jr. ◽  
Angela M. G. Pierin ◽  
Alberto P. Bambirra ◽  
Jorge H. Assunção ◽  
Juliana M. Monteiro ◽  
...  

PURPOSE: To find out the prevalence of hypertension in employees of the Hospital and relate it to social demographic variables. METHODS: Blood pressure measurement was performed with a mercury sphygmomanometer, using an appropriate cuff size for arm circumference, weight, and height in a population sample of 864 individuals out of the 9,905 employees of a University General Hospital stratified by gender, age, and job position. RESULTS: Hypertension prevalence was 26% (62% of these reported being aware of their hypertension and 38% were unaware but had systolic/diastolic blood pressures of >140 and/or >90 mm Hg at the moment of the measurement). Of those who were aware of having hypertension, 51% were found to be hypertensive at the moment of the measurement. The prevalence was found to be 17%, 23%, and 29% (P <.05) in physicians, nursing staff, and "others", respectively. The univariate analysis showed a significant odds ratio for the male gender, age >50 years, work unit being the Institute of Radiology and the Administration Building, educational level <elementary school, length of work >10 years, and body mass index >30 kg/m². The multivariate logistic regression model revealed a statistically significant association of hypertension with the following variables: gender, age, skin color, family income, and body mass index. CONCLUSIONS: Hypertension prevalence was high, mainly in those who were not physicians or members of the nursing staff. High-risk groups (obese, non-white, men, low family income) should be better advised of prevention and early diagnosis of hypertension by means of special programs.

2013 ◽  
Vol 36 (6) ◽  
pp. 297 ◽  
Author(s):  
Peng Xing ◽  
Ji-Guang Li ◽  
Feng Jin ◽  
Ting-Ting Zhao ◽  
Qun Liu ◽  
...  

Purpose: Obesity has been recognized as a significant risk factor for postmenopausal breast cancer. The aim of this study is to investigate the prognostic significance of body mass index (BMI) in hormone receptor-positive, operable breast cancer. Methods: In this retrospective cohort study, 1,192 consecutive patients with curative resection of primary breast cancer were enrolled. Patients were assigned to two groups according to BMI: normal or underweight (BMI < 23.0 kg/m2) and overweight or obese (BMI ≥23.0 kg/m2). Associations among BMI and clinicopathological characteristics and prognosis of patients were assessed. Results: A high BMI was significantly (P < 0.01) correlated with age, nodal stage, ALNR, ER positivity, PR positivity and menopausal status at diagnosis. Univariate analysis revealed that BMI, pathologic T stage, nodal stage, axillary lymph node ratio (ALNR) and adjuvant radiotherapy history were significantly (P < 0.05) associated with disease-free survival and overall survival, irrespective of tumour hormone receptor status. Multivariate analysis revealed BMI as an independent prognostic factor in all cases and in hormone receptor-positive cases. Conclusion: A high BMI (≥23.0 kg/m^2) is independently associated with poor prognosis in hormone receptor-positive breast cancer.


2021 ◽  
Vol 10 (10) ◽  
pp. 2138
Author(s):  
Michał Szyszka ◽  
Piotr Skrzypczyk ◽  
Anna Stelmaszczyk-Emmel ◽  
Małgorzata Pańczyk-Tomaszewska

Experimental studies suggest that periostin is involved in tissue repair and remodeling. The study aimed to evaluate serum periostin concentration as potential biomarker in pediatric patients with primary hypertension (PH). We measured serum periostin, blood pressure, arterial damage, biochemical, and clinical data in 50 children with PH and 20 age-matched healthy controls. In univariate analysis, children with PH had significantly lower serum periostin compared to healthy peers (35.42 ± 10.43 vs. 42.16 ± 12.82 [ng/mL], p = 0.038). In the entire group of 70 children serum periostin concentration correlated negatively with peripheral, central, and ambulatory blood pressure, as well as with aortic pulse wave velocity (aPWV). In multivariate analysis, periostin level significantly correlated with age (β = −0.614, [95% confidence interval (CI), −0.831–−0.398]), uric acid (β = 0.328, [95%CI, 0.124–0.533]), body mass index (BMI) Z-score (β = −0.293, [95%CI, −0.492–−0.095]), high-density lipoprotein (HDL)-cholesterol (β = 0.235, [95%CI, 0.054–0.416]), and triglycerides (β = −0.198, [95%CI, −0.394–−0.002]). Neither the presence of hypertension nor blood pressure and aPWV influenced periostin level. To conclude, the role of serum periostin as a biomarker of elevated blood pressure and arterial damage in pediatric patients with primary hypertension is yet to be unmasked. Age, body mass index, uric acid, and lipid concentrations are key factors influencing periostin level in pediatric patients.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Elvira Verduci ◽  
Giuseppe Banderali ◽  
Elisabetta Di Profio ◽  
Sara Vizzuso ◽  
Gianvincenzo Zuccotti ◽  
...  

Abstract Background The Atherogenic Index of Plasma is a predictive biomarker of atherosclerosis in adults but there is a lack of studies in paediatric population aimed at evaluating the longitudinal changes of the AIP and of the cardiometabolic blood profile related to nutritional interventions. The aim of this study was to compare the effect of individual- versus collective-based nutritional-lifestyle intervention on the Atherogenic Index of Plasma in schoolchildren with obesity. Methods One-hundred sixty-four children aged 6–12 years with Body Mass Index z-score > 2 referred to the Paediatric Obesity Clinic, San Paolo Hospital, Milan, Italy, were consecutively enrolled and randomized to undergo to either an individual- (n = 82) or a collective- (n = 82) based intervention promoting a balanced normo-caloric diet and physical activity. In addition, the individual intervention included a tailored personalized nutritional advice and education based on the revised Coventry, Aberdeen, and London-Refined taxonomy. Both at baseline and after 12 months of intervention, dietary habits and anthropometric measures were assessed, a fasting blood sample were taken for biochemistry analysis. Results The participation rate at 12 months was 93.3% (n = 153 patients), 76 children in the individual-intervention and 77 children in the collective intervention. At univariate analysis, mean longitudinal change in Atherogenic Index of Plasma was greater in the individual than collective intervention (− 0.12 vs. − 0.05), as well as change in triglyceride-glucose index (− 0.22 vs. − 0.08) and Body Mass Index z-score (− 0.59 vs. − 0.37). At multiple analysis, only change in Body Mass Index z-score remained independently associated with intervention (odds ratio 3.37). Conclusion In children with obesity, an individual-based nutritional and lifestyle intervention, including techniques from the CALO-RE taxonomy, could have an additional beneficial effect over a collective-based intervention, although the actual size of the effect remains to be clarified. Trial Registration Clinical Trials NCT03728621


2021 ◽  
pp. 205141582098403
Author(s):  
Antônio Antunes Rodrigues ◽  
Valdair Muglia ◽  
Emanuel Veras de Albuquerque ◽  
Rafael Ribeiro Mori ◽  
Rafael Neuppmann Feres ◽  
...  

Objective: To identify risk factors for major post-biopsy complications under augmented prophylaxis protocol. The risk factors already described mainly comprise outdated antibiotic prophylaxis protocols. Material and methods: This retrospective cohort study included patients that underwent transrectal ultrasound-guided biopsies, from 2011 to 2016. All patients had received antibiotic prophylaxis with ciprofloxacin and gentamicin. Patients were grouped according to the presence or absence of post-biopsy complications. Demographic variables and possible risk factors based on routine clinical assessment were registered. Correlation tests, univariate and multivariate analyses were used to identify risk factors for post-biopsy complications. Results: Of the 404 patients that were included, 25 (6.2%) presented 27 post-biopsy complications, distributed as follows: acute urinary retention ( n = 14, 3.5%), infections ( n = 11, 2.7%) and hemorrhage ( n = 2, 0.5%). On univariate analysis, patients who presented complications showed higher body mass index and post-voiding residual volumes. Multivariate analysis identified ethnicity and prostate-specific antigen (PSA) density as possible risk factors for biopsy complications. The presence of bacterial resistance identified by rectal swabs did not correlate with the incidence of complications and infections. Conclusions: Non-infectious post-biopsy complications were more frequent than infectious ones in this cohort. Higher post-voiding residual volumes and PSA density, that indicates prostate enlargement, were identified as risk factors and interpreted as secondary to bladder outlet obstruction. The higher body mass index and ethnicity were also identified as risk factors and attributed to the heterogeneity of the patients included. Level of evidence: Not applicable for this multicentre audit.


2021 ◽  
pp. 68-70
Author(s):  
Ketan Prajapati ◽  
Sanket Makwana ◽  
M. J. Sonagara

INTRODUCTION:Hypertension is one of the most important risk factors for cardiovascular disease. The incidence of microalbuminuria is more common among hypertensive patients, even in nondiabetic patients. Microalbuminuria is an independent predictor of cardiovascular morbidity and mortality in patients with essential hypertension. Therefore, current guidelines recommend routine screening of microalbuminuria in hypertensive patients to ensure appropriate interventions are initiated early in the disease process before progression to chronic kidney disease and/or renal failure. AIMS & OBJECTIVES:This study is done to estimate the prevalence of microalbuminuria in patients with normoglycemic hypertension and to identify other variables associated with it. MATERIAL & METHODS:In this study, we randomly selected 100 patients with essential hypertension based on inclusion and exclusion criteria. CBC, renal function test, 24-hour urine albumin excretion (UAE), Body mass index (BMI), and arterial blood pressure measurement were done among all selected patients. Data entry was done in Microsoft Ofce Excel and analysis was done using the software package Epi Info (Version 7.1.5) from CDC, Atlanta, U.S.A. OBSERVATIONS & RESULTS: The study was conducted among 100 hypertensive patients out of which 74 were male and 24 were female. Out of 100 patients, microalbuminuria was present in 44 patients. Mean arterial pressure was found high among patients with microalbuminuria than patients without microalbuminuria. The presence of microalbumin in urine was found to increase with the increasing severity of hypertension. Mean body mass index and serum creatinine were found higher in the microalbuminuric group than the normoalbuminuric group. CONCLUSION:The incidence of microalbuminuria is more common among hypertensive patients, even in nondiabetic patients. The presence of microalbuminuria is an independent predictor of cardiovascular morbidity and mortality in patients with essential hypertension. Screening for microalbuminuria is a relatively simple process, should facilitate early vascular disease detection.


Author(s):  
V. V. Kucheryavchenko

In recent years, the concept of "metabolic syndrome" has become more spreading, and in parallel with disorders of carbohydrate and lipid metabolism, endothelial dysfunction is no less significant. The aim of our work was to analyze changes in homocysteine (HC) as a marker of metabolic syndrome in patients with an increased body mass index (IBMI) in polytrauma. The study involved 224 patients with polytrauma, who had different initial values of body mass index (BMI) and were treated at the polytrauma department and the intensive care unit for patients with combined injuries for a period from 1 day to 1 year since the moment of injury. All the patients were subjected to identifying the level of serum HC. The patients had the same severity according to the APACHE II scale, 14 ± 5.8, at the admission to the hospital, and were divided into 3 stratified clinical groups depending on the initial values of anthropometric parameters and BMI. The study was conducted on the 1, 3, 7, 14, 30 and 360 days from the date of polytrauma. Assessment of blood serum HC was performed by ELISA. It was found that the overweight patients with BMI ≤ 29.9 demonstrated an increase in the mean values of blood HC on the 7th and 14th days of the treatment, with a further decrease on the 15th day since the date of injury. For the patients with BMI within the range of 30.0 - 39.9, the persistence of the HC index during the first month of the treatment at baseline with an increase on the 360th day was found out. The patients with BMI ˃ 40.0 showed an increase in the level of blood HC through the year since the date of polytrauma. It was revealed that the level of HС directly affects the course of traumatic disease in patients with increased BMI, its severity in terms of uniformity of injuries received and the same range of severity according to the APACHE II scale depends on BMI at the admission to the hospital.


2021 ◽  
pp. 089033442110603
Author(s):  
Eliot N. Haddad ◽  
Lynn E. Ferro ◽  
Kathleen E. B. Russell ◽  
Kameron Y. Sugino ◽  
Jean M. Kerver ◽  
...  

Background: Previous research examined effects of human milk on the infant gut microbiota, but little attention has been given to the microbiota of lactating women. Research Aim: To determine associations between exclusive human milk feeding and gut microbiota characteristics in mothers and infants at 6-weeks postpartum. Methods: A sample of mother–infant dyads ( N = 24) provided fecal samples and questionnaire responses at 6-weeks postpartum as part of the Pregnancy, EAting & POstpartum Diapers study. Deoxyribonucleic acid was extracted from stool samples, followed by (V4) 16S ribosomal ribonucleic acid gene amplicon sequencing. Alpha and beta diversity, in addition to taxa differences, were compared by human milk exposure status, exclusive versus non-exclusive. A subset of dyads (those exclusively fed human milk; n = 14) was analyzed for shared bifidobacterial species using polymerase chain reaction. Results: Alpha diversity was significantly lower in exclusively human milk-fed infants. Maternal lactation status (exclusive vs. partial) and Shannon diversity were associated in univariate analysis but were no longer associated in multivariable regression including body mass index category in the model. Beta diversity (Sorensen dissimilarity) of fecal samples from women and infants was significantly associated with human milk feeding. Of six infants with Bifidobacterium longum subspecies longum in their fecal samples, all their mothers shared the same species. Conclusion: Maternal gut microbiotas differ by lactation status, a relationship potentially confounded by body mass index category. Further research is needed to identify whether lactation directly influences the maternal gut microbiota, which may be another mechanism by which lactation influences health.


2019 ◽  
Vol 29 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Ross F Harrison ◽  
Jeremiah E Mcnamara ◽  
Claire B Beaumont ◽  
Elizabeth A Sadowski ◽  
Richard J Chappell ◽  
...  

ObjectivesTo determine if linear measurements of adiposity from pre-operative imaging can improve anticipation of surgical difficulty among endometrial cancer patients.MethodsEighty patients with newly diagnosed endometrial cancer were enrolled. Routine pre-operative imaging (MRI or CT) was performed. Radiologic linear measurements of the following were obtained: anterior-to-posterior skin distance; anterior skin to anterior edge of L5 distance (total anterior); anterior peritoneum to anterior edge of L5 distance (visceral obesity); and posterior edge of L5 to posterior skin distance (total posterior). Surgeons completed questionnaires quantifying preoperative anticipated operative difficulty and postoperative reported operative difficulty. The primary objective was to assess for a correlation between linear measurements of visceral fat and reported operative difficulty.ResultsSeventy-nine patients had questionnaires completed, preoperative imaging obtained, and surgery performed. Univariate analysis showed all four linear measurements, body mass index, weight, and anticipated operative difficulty were associated with increased reported operative difficulty (P< 0.05). Multivariate analysis demonstrated that body mass index and linear measurements visceral obesity and total posterior were independently associated with increased reported operative difficulty (P< 0.05). Compared with body mass index, the visceral obesity measurement was more sensitive and specific for predicting increased reported operative difficulty (visceral obesity; sensitivity 54%, specificity 91 %; body mass index; sensitivity 38%, specificity 89%). A difficulty risk model combining body mass index, visceral obesity, and total posterior demonstrated better predictive performance than any individual preoperative variable.ConclusionsSimple linear measurements of visceral fat obtained from preoperative imaging are more predictive than body mass index alone in anticipating surgeon-reported operative difficulty. These easily obtained measurements may assist in preoperative decision making in this challenging patient population.


2008 ◽  
Vol 61 (9-10) ◽  
pp. 443-451 ◽  
Author(s):  
Djordje Petrovic ◽  
Aleksandra Novakov-Mikic ◽  
Vesna Mandic

The cervical length is an important factor in the risk evaluation of preterm delivery. The aim of this work was to determine the correlation between the cervical length and the demographic characteristics. A transversal type prospective study was done on a sample of 579 pregnant women at various gestational age of low risk mono-fetal pregnancy. The cervical length was measured by trans-vaginal ultrasound procedure within the regular pregnancy monitoring process. The following data were taken into consideration: the woman's age, her body mass at the beginning of the pregnancy and her height in order to calculate the body mass index as well as her smoking habit at the moment of conception. The mean cervical length was 34.3 mm and 35 mm in the group of women aged 30 and less and 31 and over, respectively. The cervix was insignificantly shorter in younger women (being 34.9 mm/35.9 mm in the 1st trimester, 34.5 mm/35.1 mm in the 2nd one and 33.9 mm/34.7 mm in the 3rd trimester). The sample of 579 pregnant women consisted of 448 non-smokers and 131 smokers. The difference in the length of the cervix in smokers and non-smokers was not significant (being 32.2 mm/35.9 mm; 35 mm/34 mm and 34.4 mm/33.5 mm in the 1st, 2nd and 3rd trimester, respectively). The correlation between the body mass index and the cervical length was analyzed by trimesters. In the first trimester the increase in the body mass index was followed by the shortening of the cervix; the cervical length was not affected by the BMI in the second trimester, whereas the higher the body mass index the longer the cervix in the third trimester. Our study has shown that the cervical length is affected neither by the age of the woman nor her smoking habit but it is affected by the body mass index at the moment of conception, that linear trend being negative in the 1st trimester but positive in the 3rd one. Since the cervical length may be affected not only by the socio-demographic characteristics but the gynecologic obstetric history of the woman as well, we strongly suggest further investigations in this field.


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