scholarly journals Frequency of metabolic syndrome in stroke: a study in a tertiary health care centre in north Kerala

Author(s):  
Swapna P. K.

Background: Stroke is a leading cause of death and disability in developing countries beginning to affect young adults. Key components of the metabolic syndrome are important risk factors for stroke. This study intended to study the prevalence of metabolic syndrome in patients with stroke. Screening adolescents and young adults for components of metabolic syndrome will prove useful in clinical management, and its elements ultimately become important therapeutic targets for the reduction of stroke burden in the general population.Methods: Data was collected from 150 patients who were admitted with cerebrovascular accident (CVA) in the Department of Medicine. Frequency tests were conducted for various risk factors. Chi-square and Fisher exact test were used to test the significance of proportion of study parameters in the classes. The observations in this study were analysed using SPSS software.Results: Metabolic syndrome was present in 46% of the study population. Among the components of the metabolic syndrome, Hypertension was the most prevalent risk factor (68%). 67.14% of the population had 2 components of metabolic syndrome which predisposes them to a greater risk of developing metabolic syndrome over a period of few months to years.Conclusions: With the obesity epidemic, the impact of the metabolic syndrome is likely to increase. Thus, diagnosing and adequately managing metabolic syndrome is an important step in the preventing cerebrovascular disease. This study emphasises the need to target the population with one or more components of the metabolic syndrome as they are at high risk of developing stroke in the future.

2013 ◽  
Vol 111 (6) ◽  
pp. 1069-1076 ◽  
Author(s):  
Satu Pirilä ◽  
Mervi Taskinen ◽  
Heli Viljakainen ◽  
Outi Mäkitie ◽  
Merja Kajosaari ◽  
...  

The aim of the present study was to evaluate the impact of infant breast-feeding on cardiovascular risk in young adults. This unique study group involved 158 subjects (eighty-two females) originally collected prospectively at birth in 1975 and followed up to the age of 32 years. Frequent visits during the first year guaranteed the knowledge of the precise duration of breast-feeding. All infants received at least some breast milk. Participants were assessed for both individual cardiovascular risk factors (blood pressure, plasma lipids, homeostatic model assessment of insulin resistance and waist circumference) and the general clinical risk of cardiovascular events by calculating the Framingham risk score (FRS) and the metabolic syndrome criteria score (NCEP-ATPIII; National Cholesterol Education Program's Adult Treatment Panel III). Data on lifestyle factors were carefully collected. Linear regression analyses revealed that the effect of the duration of breast-feeding was not relevant (0·02 decrease in the FRS per one additional breast-feeding month; 95 % CI − 0·19, 0·09). Similarly, the effect of breast-feeding was minor on all of the individual cardiovascular risk factors. We used sex, physical activity, dietary fat and vitamin C, smoking and alcohol consumption as covariates. Again, logistic regression analyses detected no significant impact of the duration of breast-feeding on the risk of the metabolic syndrome according to the NCEP-ATPIII (OR 0·95, 95 % CI 0·8, 1·1). The strongest independent predictor for later CVD risk was male sex. In conclusion, in this prospectively followed cohort of young adults born at term and at weight appropriate for gestational age, the duration of breast-feeding did not have an impact on the accumulation of cardiovascular risk factors.


1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Nicole Karazurna ◽  
Caitlin Porter ◽  
Jesse Stabile Morrell ◽  
Sherman Bigornia

Abstract Objectives Evidence suggests that omega-3 fatty acid (n-3 FA) and fish consumption may reduce the risk of the metabolic syndrome (MetS) in older adults. We previously reported that MetS components are prevalent among college students. Identifying modifiable risk factors of developing MetS and its components in young adults will inform potential targets to reduce the risk of age-related health conditions. Our objectives were to measure the cross-sectional impacts of n-3 FA and fish consumption on ≥2 or ≥3 MetS criteria and individual criteria among college students. Methods The College Health and Nutrition Assessment Survey is an on-going cross-sectional study at a public New England college. We examined data from Jan 2008 – May 2017. After excluding those with missing data our final sample size was n = 4271 for n-3 FA & n = 2072 for fish intake analyses. Diet was assessed by a 3 day food record; MetS criteria were collected in fasted state. We expressed n-3 FAs as g/1000 kcals/d. Servings of fish/week was obtained via an online survey. Individuals were categorized as consuming ≥ 2 servings/week or not. MetS was defined as meeting ≥ 3 criteria: elevated glucose, triglycerides, blood pressure, waist circumference, and low HDL. Analyses were conducted by logistic regression. Results The average n-3 FA intake was 0.4 g/1000 kcal/d ± 0.25 & 40% consumed ≥ 2 servings of fish/week. Prevalence estimates for meeting ≥ 2 criteria was 18.8% and 4.8% for MetS. In sex- and energy- adjusted models, n-3 FA consumption was inversely associated with MetS (OR = 0.38; 95%CI: 0.20, 0.71) and ≥2 MetS criteria (OR = 0.67; 95%CI: 0.49, 0.91). Associations were no longer significant after considering additional confounders. Fish consumption was not significantly associated with MetS or ≥2 criteria in any model. Further n-3 FAs and fish consumption was not associated with any individual MetS criteria. Conclusions In this cross-sectional study among college students, n-3 FA and fish consumption were not significantly associated with MetS outcomes. Further research is needed in this population using longitudinal study designs to understand long-term impact of n-3 consumption on the development of MetS and associated cardio metabolic risk factors in young adults. Funding Sources New Hampshire Agriculture Experiment Station and USDA National Institute of Food and Agriculture Hatch Project 1010738.


2019 ◽  
Vol 130 (2) ◽  
pp. 629-638 ◽  
Author(s):  
Kingsley O. Abode-Iyamah ◽  
Hsiu-Yin Chiang ◽  
Royce W. Woodroffe ◽  
Brian Park ◽  
Francis J. Jareczek ◽  
...  

OBJECTIVEDeep brain stimulation is an effective surgical treatment for managing some neurological and psychiatric disorders. Infection related to the deep brain stimulator (DBS) hardware causes significant morbidity: hardware explantation may be required; initial disease symptoms such as tremor, rigidity, and bradykinesia may recur; and the medication requirements for adequate disease management may increase. These morbidities are of particular concern given that published DBS-related infection rates have been as high as 23%. To date, however, the key risk factors for and the potential preventive measures against these infections remain largely uncharacterized. In this study, the authors endeavored to identify possible risk factors for DBS-related infection and analyze the efficacy of prophylactic intrawound vancomycin powder (VP).METHODSThe authors performed a retrospective cohort study of patients who had undergone primary DBS implantation at a single institution in the period from December 2005 through September 2015 to identify possible risk factors for surgical site infection (SSI) and to assess the impact of perioperative (before, during, and after surgery) prophylactic antibiotics on the SSI rate. They also evaluated the effect of a change in the National Healthcare Safety Network’s definition of SSI on the number of infections detected. Statistical analyses were performed using the 2-sample t-test, the Wilcoxon rank-sum test, the chi-square test, Fisher’s exact test, or logistic regression, as appropriate for the variables examined.RESULTSFour hundred sixty-four electrodes were placed in 242 adults during 245 primary procedures over approximately 10.5 years; most patients underwent bilateral electrode implantation. Among the 245 procedures, 9 SSIs (3.7%) occurred within 90 days and 16 (6.5%) occurred within 1 year of DBS placement. Gram-positive bacteria were the most common etiological agents. Most patient- and procedure-related characteristics did not differ between those who had acquired an SSI and those who had not. The rate of SSIs among patients who had received intrawound VP was only 3.3% compared with 9.7% among those who had not received topical VP (OR 0.32, 95% CI 0.10–1.02, p = 0.04). After controlling for patient sex, the association between VP and decreased SSI risk did not reach the predetermined level of significance (adjusted OR 0.32, 95% CI 0.10–1.03, p = 0.06). The SSI rates were similar after staged and unstaged implantations.CONCLUSIONSWhile most patient-related and procedure-related factors assessed in this study were not associated with the risk for an SSI, the data did suggest that intrawound VP may help to reduce the SSI risk after DBS implantation. Furthermore, given the implications of SSI after DBS surgery and the frequency of infections occurring more than 90 days after implantation, continued follow-up for at least 1 year after such a procedure is prudent to establish the true burden of these infections and to properly treat them when they do occur.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Duke Appiah ◽  
Pamela J Schreiner ◽  
Raegan W Durant ◽  
Sharina D Person ◽  
Catarina I Kiefe ◽  
...  

Introduction: Cardiovascular disease (CVD) mortality has decreased over recent decades, in part, due to changes in the prevalence of risk factors. However, few studies have explored the impact of the obesity epidemic on CVD risk prediction in young adults. Hypothesis: We assessed the hypothesis that BMI trends are positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores from young adulthood to middle age beyond the effect of other CVD risk factors included in the scores (age, sex, race, lipids, blood pressure, hypertension medication, diabetes, smoking). METHODS: Data were obtained from 2437 black and white men and women aged 18-30 years at baseline (1985-1986) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study with follow-up exams at year 0, 5, 10, 15, 20 and 25 (ages 43-55 years). Repeated-measures regression was used to model the association between ASCVD risk scores and time-varying BMI measures. RESULTS: The average 10-year ASCVD risk increased from 0.6% at baseline (mean age: 25.3) to 3.9% at year 25 (mean age: 50.3) with the change higher for men (blacks: 1.0 to 8.2%, whites: 0.3 to 4.6%) than women (blacks: 0.5 to 3.6%, whites: 1.2 to 1.4%). The overall prevalence of obesity at baseline and year 25 was 10% and 42% respectively. BMI trends were positively associated with 10-year change in ASCVD risk scores (0.12% per 1 kg/m2 increase, p<0.001). BMI adjustment minimally reduced risk scores trends with the greatest change between unadjusted and adjusted risk scores observed among black women (0.1 to 3.0%) (Figures A and B). CONCLUSION: In young adults, BMI trends are associated positively with 10-year changes in ASCVD risk independent of other risk factors. This adds to the evidence that weight control in early adulthood is an important predictor of lower future CVD risk.


2021 ◽  
Vol 20 (1) ◽  
pp. 26-32
Author(s):  
Kendrick Klaudius Hartedja ◽  
Ricky Yue ◽  
Lucky H. Moehario

Introduction: Deep neck abscess is a pus accumulation in the space and tissue of the cervical fascia caused by an infection and has the potential for several complications. Appropriate use of antibiotics can prevent these complications, but long culture time has been a main concern. Diabetes and oral hygiene are identified as commonly found risk factors for deep neck abscess. This study aims to analyze patients’ characteristics and the usage of antibiotics in treating deep neck abscess patients in Atma Jaya Hospital as well as assessing the effect of diabetes and oral hygiene as the causes for deep neck abscess. Methods: This was a cohort retrospective, descriptive analytic study. The samples were from 23 deep neck abscess patients undergoing treatment in Atma Jaya Hospital and met the inclusion and exclusion criteria. Chi square and Fisher exact test were used to determine the significance effect of diabetes and higiene oral in relation to deep neck abscess. Results: There were more male patients than female patients with age range 20-30 years old. Streptococcus viridans and Streptococcus pyogenes were the most common bacteria causing deep neck abscesses. Metronidazole, gentamicin and ceftriaxone were the most widely used antibiotics and it had shown great compatibility to fight against germs found in this disease. Statistical test results on the effect of oral hygiene oral to submandibular abscesses, peritonsillar, and Ludwig’s angina were p(AS)=0.605, p(AP)=1.000, and p(LA)=1.000, while of diabetes were p(AS)=0.685, p(AP)=0.657, and p(LA)=1.000. Conclusion: Deep neck abscess tends to occur in male patients of productive age. Metronidazole, gentamicin and ceftriaxone were the recommended empiric antibiotics. There was no significant relationship between oral hygiene and diabetes on the occurrence of deep neck abscesses.


2016 ◽  
Vol 12 (3) ◽  
pp. 143-152 ◽  
Author(s):  
Akbar Sharip ◽  
Anthony Firek ◽  
Serena Tonstad

Objective: To evaluate the impact of short-term smoking cessation on Metabolic Syndrome (Mets) component risk factors, and hormones related to MetS and human metabolism.Methods: Smoking veterans with MetS, attending stop smoking class, were followed up close to one year. Paired comparisons between after the follow up and baseline data were made using t-test.Results: A total of 95 smoking veterans with MetS completed average close to one year follow up. Thirty subjects completely quit for the average of 6 months, while 36 subjects continued smoking during the follow up. At the end of study, quitters average waist circumference increased 2.98 cm (0.69–5.27), weight increased 2.05 kg (−0.03 to 4.13), HDL cholesterol increased 4.17 mg/dl (1.03–7.32), triglyceride decreased 56.17 mg/dl ((−1.96 to 111.20), and MetS prevalence decreased 13% (p = 0.05). The changes in ghrelin were moderately positively associated with duration of quitting smoking (R2 = 43.99, and p < 0.01).Conclusion: Compared to the baseline, quitters HDL was up, triglyceride was down, and overall MetS prevalence was lower. The longer the duration of quitting, bigger the increase in ghrelin. There were no significant changes in serum leptin, ghrelin, serum insulin, and insulin resistance after quitting smoking.


Diabetes Care ◽  
2004 ◽  
Vol 27 (11) ◽  
pp. 2707-2715 ◽  
Author(s):  
M. R. Carnethon ◽  
C. M. Loria ◽  
J. O. Hill ◽  
S. Sidney ◽  
P. J. Savage ◽  
...  

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