Features of the course of ante- and prenatal periods in premature infants: evaluation of neurobiological risk factors affecting the child development

Background : A successful birth outcome is defined as the birth of a healthy baby to a healthy mother. While relatively low in industrialized world, maternal and fetal morbidity and mortality and neonatal deaths occur disproportionately in developing countries. Aim of the Study: To assess birth outcome and identify some risk factors affecting it for achieving favorable birth outcome in Tikrit Teaching Hospital

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Does HbA1cc Play a Role in the Development of Cardiovascular Diseases?

Current Pharmaceutical Design ◽

10.2174/1381612824666180903121957 ◽

2018 ◽

Vol 24 (24) ◽

pp. 2876-2882 ◽

Cited By ~ 4

Author(s):

Kailash Prasad

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Cardiovascular System ◽

Half Life ◽

Serum Levels ◽

Serum Glucose ◽

Cvd Risk ◽

Factors Affecting ◽

Diagnosis And Management ◽

Coronary Artery Atherosclerosis

Cardiovascular diseases (CVD) may be mediated through increases in the cardiovascular risk factors. Hemoglobin A1c (HbA1c) also called glycated hemoglobin is presently used for the diagnosis and management of diabetes. It has adverse effects on cardiovascular system. This review deals with its synthesis and effects on the cardiovascular system. The serum levels of HbA1c have been reported to be affected by various factors including, the lifespan of erythrocytes, factors affecting erythropoiesis, agents interfering glycation of Hb, destruction of erythrocytes, drugs that shift the formation of Hb, statins, and drugs interfering the HbA1c assay. Levels of HbA1c are positively correlated with serum glucose and advanced glycation end products ( AGE), but no correlation between AGE and serum glucose. AGE cannot replace HbA1c for the diagnosis and management of diabetes because there is no correlation of AGE with serum glucose, and because the half-life of protein with which glucose combines is only 14-20 days as compared to erythrocytes which have a half-life of 90-120 days. HbA1c is positively associated with CVD such as the carotid and coronary artery atherosclerosis, ischemic heart disease, ischemic stroke and hypertension.HbA1c induces dyslipidemia, hyperhomocysteinemia, and hypertension, and increases C-reactive protein, oxidative stress and blood viscosity that would contribute to the development of cardiovascular diseases. In conclusion, HbA1c serves as a useful marker for the diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors.

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The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures

Indian Journal of Surgery ◽

10.1007/s12262-021-02955-3 ◽

2021 ◽

Author(s):

Justyna Jończyk ◽

Jerzy Jankau

Keyword(s):

Risk Factors ◽

Postoperative Complications ◽

Breast Reconstruction ◽

Complication Rate ◽

Clinical Factors ◽

Early Complications ◽

Reconstructive Procedures ◽

Factors Affecting ◽

Rehospitalization Rate ◽

Early Postoperative Complications

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.

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Effects of fenofibrate therapy on renal function in primary gout patients

Rheumatology ◽

10.1093/rheumatology/keab231 ◽

2021 ◽

Author(s):

Xinde Li ◽

Wenyan Sun ◽

Jie Lu ◽

Yuwei He ◽

Ying Chen ◽

...

Keyword(s):

Risk Factors ◽

Treatment Period ◽

Mixed Model ◽

Interaction Analysis ◽

Serum Urate ◽

Factors Affecting ◽

Primary Gout ◽

Potential Risk Factors ◽

Multivariable Regression ◽

Risk Predictors

Abstract Objective To investigate the incidence and potential risk factors for development of fenofibrate-associated nephrotoxicity in gout patients. Methods A total of 983 gout patients on fenofibrate treatment who visited the dedicated Gout Clinic at the Affiliated Hospital of Qingdao University between September 2016 and June 2020 were retrospectively enrolled from the electronic records system. Fenofibrate-associated nephrotoxicity was defined as an increase in serum creatinine (SCr) ≥0.3 mg/dl within 6 months of fenofibrate initiation. The change trend of SCr and uric acid levels during the treatment period were assessed by a generalised additive mixed model (GAMM). Multivariate analysis was performed for risk factors affecting elevated SCr. Results A total of 100 (10.2%) patients experienced an increase in SCr ≥0.3 mg/dl within 6 months after fenofibrate initiation. The median change of SCr in the whole cohort was 0.11 mg/dl [interquartile range (IQR) 0.03–0.20], whereas it was 0.36 (0.33–0.45) in the fenofibrate-associated nephrotoxicity group. In a multivariable regression model, chronic kidney disease (CKD) [odds ratio (OR) 2.39 (95% CI 1.48, 3.86)] and tophus [OR 2.29 (95% CI 1.39, 3.78)] were identified to be risk predictors, independent of measured covariates, of fenofibrate-associated nephrotoxicity. During the treatment period, although SCr temporarily increased, serum urate and triglyceride concentrations decreased using the interaction analysis of GAMM. Of those with fenofibrate withdrawal records, the SCr increase in 65% of patients was reversed after an average of 49 days off the drug. Conclusions This observational study implied that fenofibrate-associated nephrotoxicity occurs frequently in gout patients, especially in patients with tophi or CKD. The potential renal risks of fenofibrate usage in gout needs additional research.

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Pathways to stronger futures? The role of social protection in reducing psychological risk factors for child development in Haiti

World Development ◽

10.1016/j.worlddev.2021.105423 ◽

2021 ◽

Vol 142 ◽

pp. 105423

Author(s):

Keetie Roelen ◽

Amrita Saha

Keyword(s):

Risk Factors ◽

Child Development ◽

Social Protection ◽

Psychological Risk Factors ◽

Psychological Risk

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First-Ray Radiographic Changes After Flexible Adult Acquired Flatfoot Deformity Correction

Foot & Ankle International ◽

10.1177/10711007211034516 ◽

2021 ◽

pp. 107110072110345

Author(s):

Chien-Shun Wang ◽

Yun-Hsuan Tzeng ◽

Tzu-Cheng Yang ◽

Chun-Cheng Lin ◽

Ming-Chau Chang ◽

...

Keyword(s):

Risk Factors ◽

Hallux Valgus ◽

Reconstructive Surgery ◽

Case Series ◽

Deformity Correction ◽

Level Of Evidence ◽

Factors Affecting ◽

Radiographic Parameters ◽

Case Series Study ◽

Adult Acquired Flatfoot Deformity

Background: Adult acquired flatfoot deformity (AAFD) and hallux valgus (HV) are common foot and ankle deformities. Few studies have reported the changes in radiographic parameters of HV after reconstructive surgery for AAFD. This study aimed to evaluate the changes in radiographic parameters of HV and analyze the risk factors for increased HV after correction of AAFD. Methods: Adult patients with flexible AAFD who underwent similar bony procedures including medializing calcaneal osteotomy and Cotton osteotomy were included. Radiographic parameters were measured on weightbearing radiographs preoperatively, postoperatively, and at the final follow-up. Patients were divided into hallux valgus angle (HVA) increased and HVA nonincreased groups; logistic regression analysis was performed to identify risk factors affecting increased HV. Results: Forty-six feet of 43 patients were included. After AAFD reconstructive surgery, the tibial sesamoid position improved by 1 grade, but the HVA increased 4 degrees in average. Further, 21 of 46 feet (46%) showed an HVA increase ≥5 degrees immediately after AAFD correction surgery. Preoperative talonavicular coverage angle <21.6 degrees was a risk factor associated with HV increase immediately after the surgery. Conclusion: In this case series, using plain radiographs to measure standard parameters of foot alignment, we found the association between AAFD correction and HV deformity measures somewhat paradoxical. Correction of overpronation of the hindfoot and midfoot appears to improve the first metatarsal rotational deformity but may also increase HVA. A lower preoperative talonavicular coverage angle was associated with an increase of the HVA after surgery. Level of Evidence: Level IV, case series study.

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