scholarly journals PREMATURE OVARIAN FAILURE, ITS CONSEQUENCES, MORTALITY AND IMPACT ON THE CARDIOVASCULAR SYSTEM

2021 ◽  
Vol 9 (1) ◽  
pp. 147-156
Author(s):  
S.V. Lopukhov ◽  
◽  
E.V. Filippov ◽  
Keyword(s):  
Cardiovascular Diseases ◽  
Premature Ovarian Failure ◽  
Correct Diagnosis ◽  
Vascular Diseases ◽  
Ovarian Failure ◽  
Pharmacological Therapy ◽  
The Body ◽  
Risk Of Death ◽  
Increased Risk

This review focuses on the topic of premature ovarian failure (POF) as highly relevant in modern medicine (up to 2% of women in the population suffer from this disease). However, patients with premature ovarian failure not only are still not receiving any treatment, but even making this diagnosis is very difficult. Even after a correct diagnosis is made, these patients are not followed up, despite the fact they have already developed a hormonal imbalance. These women develop two groups of complications: short-term complications associated with a rapid estrogen deficiency in the body, and much more dangerous long-term complications affecting multiple organs and even systems. But in the meanwhile, women with premature ovarian failure are under increased risk of death from all causes, in particular from coronary heart disease (CHD), respiratory diseases, genitourinary diseases and from external causes. And this is despite the fact that cardio-vascular diseases (CVD) are already the leading cause of death among women worldwide. It is women with POF that are at the highest risk of development of cardiovascular diseases, compared to women with normal menopause. These patients, therefore, constitute one of the most important groups to be targeted by screening and prevention strategies primarily for cardiovascular diseases. These strategies should include the use of risk stratification tools to identify women that need lifestyle modifying and pharmacological therapy to prevent development of such diseases in them. This is the only way to maintain a high quality of life in these women over the long term.

scholarly journals A Pathognomonic Case of Isolated Acute Right Ventricular Infarction

2019 ◽  
Vol 14 ◽  
Author(s):  
Francesca Cortese ◽  
Marco Matteo Ciccone ◽  
Michele Clemente ◽  
Giacinto Calculli
Keyword(s):  
Right Ventricular ◽  
Correct Diagnosis ◽  
Good Prognosis ◽  
St Segment Elevation ◽  
Right Ventricular Infarction ◽  
Risk Of Death ◽  
First Line Therapy ◽  
Increased Risk ◽  
Ventricular Infarction

Isolated right ventricular infarction occurs only in about 3% of the overall myocardial ischemic episodes. Clinical presentation is often insidious and variable case by case. The correct diagnosis is therefore crucial for a proper management, and a good prognosis in the short and long term. It is based on the integration of clinical, electrocardiographic, and echocardiographic data. The revascularization strategy is the first line therapy. The involvement of the right ventricle determines an increased risk of death during hospitalization, on the other hand, the long-term prognosis is good. Our case report shows a case of isolated right ventricular infarction with ST segment elevation in right precordial leads, presenting with pathognomonic clinical and physio-pathological findings.

scholarly journals Prognostic role of neoplastic markers in Takotsubo syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Francesco Santoro ◽  
Tecla Zimotti ◽  
Adriana Mallardi ◽  
Alessandra Leopizzi ◽  
Enrica Vitale ◽  
...  
Keyword(s):  
Serum Levels ◽  
Takotsubo Syndrome ◽  
Ca 15.3 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Ca 19.9 ◽  
Long Term Follow Up

AbstractTakotsubo syndrome (TTS) is an acute heart failure syndrome with significant rates of in and out-of-hospital mayor cardiac adverse events (MACE). To evaluate the possible role of neoplastic biomarkers [CA-15.3, CA-19.9 and Carcinoembryonic Antigen (CEA)] as prognostic marker at short- and long-term follow-up in subjects with TTS. Ninety consecutive subjects with TTS were enrolled and followed for a median of 3 years. Circulating levels of CA-15.3, CA-19.9 and CEA were evaluated at admission, after 72 h and at discharge. Incidence of MACE during hospitalization and follow-up were recorded. Forty-three (46%) patients experienced MACE during hospitalization. These patients had increased admission levels of CEA (4.3 ± 6.2 vs. 2.2 ± 1.5 ng/mL, p = 0.03). CEA levels were higher in subjects with in-hospital MACE. At long term follow-up, CEA and CA-19.9 levels were associated with increased risk of death (log rank p < 0.01, HR = 5.3, 95% CI 1.9–14.8, HR = 7.8 95% CI 2.4–25.1, respectively, p < 0.01). At multivariable analysis levels higher than median of CEA, CA-19.9 or both were independent predictors of death at long term (Log-Rank p < 0.01). Having both CEA and CA-19.9 levels above median (> 2 ng/mL, > 8 UI/mL respectively) was associated with an increased risk of mortality of 11.8 (95% CI 2.6–52.5, p = 0.001) at follow up. Increased CEA and CA-19.9 serum levels are associated with higher risk of death at long-term follow up in patients with TTS. CEA serum levels are correlated with in-hospital MACE.

Association of Dementia-Related Psychosis With Long-term Care Use and Death

Neurology ◽  
2021 ◽  
Vol 96 (12) ◽  
pp. e1620-e1631
Author(s):  
James B. Wetmore ◽  
Yi Peng ◽  
Heng Yan ◽  
Suying Li ◽  
Muna Irfan ◽  
...  
Keyword(s):  
Long Term Care ◽  
Fold Increase ◽  
Proportional Hazard ◽  
Comorbid Conditions ◽  
Term Care ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

ObjectiveTo determine the association of dementia-related psychosis (DRP) with death and use of long-term care (LTC); we hypothesized that DRP would be associated with increased risk of death and use of LTC in patients with dementia.MethodsA retrospective cohort study was performed. Medicare claims from 2008 to 2016 were used to define cohorts of patients with dementia and DRP. Outcomes were LTC, defined as nursing home stays of >100 consecutive days, and death. Patients with DRP were directly matched to patients with dementia without psychosis by age, sex, race, number of comorbid conditions, and dementia index year. Association of DRP with outcomes was evaluated using a Cox proportional hazard regression model.ResultsWe identified 256,408 patients with dementia. Within 2 years after the dementia index date, 13.9% of patients developed DRP and 31.9% had died. Corresponding estimates at 5 years were 25.5% and 64.0%. Mean age differed little between those who developed DRP (83.8 ± 7.9 years) and those who did not (83.1 ± 8.7 years). Patients with DRP were slightly more likely to be female (71.0% vs 68.3%) and white (85.7% vs 82.0%). Within 2 years of developing DRP, 16.1% entered LTC and 52.0% died; corresponding percentages for patients without DRP were 8.4% and 30.0%, respectively. In the matched cohort, DRP was associated with greater risk of LTC (hazard ratio [HR] 2.36, 2.29–2.44) and death (HR 2.06, 2.02–2.10).ConclusionsDRP was associated with a more than doubling in the risk of death and a nearly 2.5-fold increase in risk of the need for LTC.

Frostbite and Hypothermia

2015 ◽  
Author(s):  
Jeffrey I. Schneider
Keyword(s):  
Body Temperature ◽  
Heat Loss ◽  
Pleural Cavity ◽  
The Body ◽  
Ice Crystals ◽  
Homeless Population ◽  
Outdoor Sports ◽  
Increased Risk ◽  
Long Term Consequences

Frostbite and hypothermia are becoming increasingly common as the popularity of extreme and outdoor sports rises and the homeless population increases. Advanced age is also associated with an increased risk of frostbite and hypothermia; thus, their incidence will likely continue to increase as the population ages. Frostbite occurs when there is sufficient heat loss to produce ice crystals within either superficial or deep flesh. Hypothermia is defined as an involuntary drop in body temperature to below 35°C, but a useful functional definition is a decrease in temperature that results in an inability of the body to maintain its natural functions. This review details the assessment and stabilization, diagnosis, and treatment and disposition for frostbite and hypothermia. Figures show factors that may predispose individuals to developing frostbite, long-term consequences of severe frostbite, and an approach for pleural cavity lavage. Tables list factors that increase the risk of frostbite, degrees of frostbite, three phases of frostbite, and staging of hypothermia. This review contains 3 highly rendered figures, 4 tables, and 71 references.

P1828Aortic calcification detected by computed tomography and aortic vulnerable plaques: aortic angioscopy study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Kojima ◽  
Y Ebuchi ◽  
S Migita ◽  
T Morikawa ◽  
T Mineki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cardiovascular Disease ◽  
Suspected Coronary Artery Disease ◽  
The Body ◽  
Aortic Calcification ◽  
Plaque Instability ◽  
Risk Of Death ◽  
Vulnerable Plaques ◽  
Increased Risk ◽  
Atheromatous Plaques

Abstract Background Aortic calcification is associated with atherosclerotic risk factors and an increased risk of death and cardiovascular disease. However, the relationships aortic calcification and aortic plaque instability are not yet elucidated. Recently, some reports showed non-obstructive aortic angioscopy seemed to visualize atherosclerotic changes of aortic wall more clearly compared with computed tomography (CT). The purpose of this study was to evaluate whether aortic calcification is associated with aortic vulnerable plaques in patients with cardiovascular disease. Methods We investigated 60 consecutive patients with confirmed or suspected coronary artery disease who underwent both aortic angioscopy and CT. The AC volume (ACV) was measured using the volume-rendering method by extracting the area >130 HU within the whole aorta. ACV index (ACVI) was defined as ACV divided by the body surface area. We evaluated the number of ruptured plaque (RP), ulceration and fissure by aortic angioscopy in the whole aorta. We excluded 4 hemodialysis patients. All patients were divided into the median value of ACVI. Results The mean age of patients was 68±10. The median of ACVI was 10.7 ml/m2 [3.9–22.7]. High ACVI patients had significantly greater number of RP, ulceration and atheromatous plaques detected by aortic angioscopy compared with those of low ACVI (2.2±2.7 vs 0.8±1.1, p=0.033, 1.6±1.2 vs 0.9±1.0, p=0.041, 4.0±3.1 vs 1.9±1.8, p=0.009, respectively). Furthermore, the patients without aortic calcification did not have RP at all. In a multivariate model, the number of the atheromatous plaques was independently associated with high ACVI (odds ratio 1.57, 95% confidence interval 1.07–2.69, p=0.018) Conclusions Aortic calcification detected by CT was related to aortic vulnerable plaques in patients with cardiovascular disease.

scholarly journals The Impact of a Long-Term Rivastigmine and Donepezil Treatment on All-Cause Mortality in Patients With Alzheimer’s Disease

2018 ◽  
Vol 33 (6) ◽  
pp. 385-393 ◽  
Author(s):  
Jakub Kazmierski ◽  
Chaido Messini-Zachou ◽  
Mara Gkioka ◽  
Magda Tsolaki
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cox Regression ◽  
Symptomatic Treatment ◽  
Risk Of Death ◽  
Increased Risk ◽  
Functional Assessments ◽  
The Impact

Cholinesterase inhibitors (ChEIs) are the mainstays of symptomatic treatment of Alzheimer’s disease (AD); however, their efficacy is limited, and their use was associated with deaths in some groups of patients. The aim of the current study was to assess the impact of the long-term use of ChEIs on mortality in patients with AD. This observational, longitudinal study included 1171 adult patients with a diagnosis of AD treated with donepezil or rivastigmine. Each patient was observed for 24 months or until death. The cognitive and functional assessments, the use of ChEIs, memantine, antipsychotics, antidepressants, and anxiolytics were recorded. The total number of deaths at the end of the observational period was 99 (8.45%). The patients who had received rivastigmine treatment were at an increased risk of death in the follow-up period. The higher risk of death in the rivastigmine group remained significant in multivariate Cox regression models.

scholarly journals Current management of NAFLD

2016 ◽  
Vol 89 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Mihai Alexandru Munteanu ◽  
Georgiana Anca Nagy ◽  
Petru Adrian Mircea
Keyword(s):  
Liver Disease ◽  
General Population ◽  
Pharmacological Therapy ◽  
Lifestyle Changes ◽  
Current Management ◽  
Alcoholic Fatty Liver ◽  
Risk Of Death ◽  
Increased Risk ◽  
Diet And Lifestyle ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. It affects about 1 billion individuals worldwide. While people with simple steatosis have no higher risk of death than the general population, people with non-alcoholic steatohepatitis are at increased risk of death compared to general population. Current management for NAFLD includes diet and lifestyle changes, management of underlying metabolic risk factors and pharmacological therapies. The objective of therapy is to prevent the complications. The problem with dietary and lifestyle interventions is that they are hard to implement. Compliance is the key. Until now, there is still no approved drug for the treatment of NAFLD. Insulin resistance is the main target of pharmacological therapy, but the question that we ask ourselves as physicians is who should receive medical treatment among NAFLD patients and for how long.

Incidence and predictors of venous thromboembolism in post-acute care patients

2010 ◽  
Vol 104 (10) ◽  
pp. 734-740 ◽  
Author(s):  
Walter Ageno ◽  
Andrea Airoldi ◽  
Erminio Bonizzoni ◽  
Mauro Campanini ◽  
Gualberto Gussoni ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Confidence Interval ◽  
Multivariable Analysis ◽  
Hazard Ratio ◽  
Term Care ◽  
Risk Of Death ◽  
Increased Risk ◽  
Rehabilitation Facilities ◽  
Overall Mortality

SummaryFew studies have addressed the topic of venous thromboembolism (VTE) in patients hospitalised in rehabilitation facilities. This patient population is rapidly growing, and data aimed to better define VTE risk in this setting are needed. Primary aim of this prospective observational study was to evaluate the frequency of symptomatic, objectively confirmed VTE in a cohort of unselected consecutive patients admitted to rehabilitation facilities, after medical diseases or surgery. Further objectives were to assess overall mortality, to identify risk factors for VTE and mortality, and to assess the attitude of physicians towards thromboprophylaxis. A total of 3,039 patients were included in the study, and the median duration of hospitalisation was 26 days. Seventy-two patients (2.4%) had symptomatic VTE. The median time to VTE from admission to the long-term care unit was 13 days. According to multivariable analysis, previous VTE (hazard ratio 5.67, 95% confidence interval 3.30–9.77) and cancer (hazard ratio 2.26, 95% confidence interval 1.36–3.75) were significantly associated to the occurrence of VTE. Overall in-hospital mortality was 15.1%. Age over 75 years, male gender, disability, cancer, and the absence of thromboprophylaxis were significantly associated to an increased risk of death (multivariable analysis). In-hospital antithrombotic prophylaxis was administered to 75.1% of patients, and low-molecular-weight heparin was the most widely used agent. According to our study, patients admitted to rehabilitation facilities remain at substantially increased risk for VTE. Because this applies to the majority of these patients, there is a great need for clinical trials assessing optimal prophylactic strategies.

scholarly journals The Long and Short of It: The Role of Telomeres in Fetal Origins of Adult Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Stephanie E. Hallows ◽  
Timothy R. H. Regnault ◽  
Dean H. Betts
Keyword(s):  
Intrauterine Growth Restriction ◽  
The Body ◽  
Premature Aging ◽  
Fetal Origins ◽  
Maternal Malnutrition ◽  
Adult Disease ◽  
Increased Risk

Placental insufficiency, maternal malnutrition, and other causes of intrauterine growth restriction (IUGR) can significantly affect short-term growth and long-term health. Following IUGR, there is an increased risk for cardiovascular disease and Type 2 Diabetes. The etiology of these diseases is beginning to be elucidated, and premature aging or cellular senescence through increased oxidative stress and DNA damage to telomeric ends may be initiators of these disease processes. This paper will explore the areas where telomere and telomerase biology can have significant effects on various tissues in the body in IUGR outcomes.

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