scholarly journals Dynamic Aortic Aneurism Risk Factors

2021 ◽  
Author(s):  
Oleg Metsker ◽  
Georgy Kopanitsa ◽  
Olga Irtyuga ◽  
Vladimir Uspenskiy
Keyword(s):  
Risk Factors ◽  
Outpatient Clinic ◽  
Hospital Admissions ◽  
Imaging Techniques ◽  
Screening Method ◽  
Aortic Aneurysms ◽  
Research Centre ◽  
Aortic Dilatation ◽  
National Medical ◽  
Echocardiographic Examination

According to different systematic reviews incidence of thoracic aortic aneurysms (TAA) in the general population is increasing in frequency ranging from 5 to 10.4 per 100000 patients. However, only few studies have illustrated the role of different risk factors in the onset and progression of ascending aortic dilatation. Currently, noninvasive imaging techniques are used to assess the progression rate of aortic and aortic valve disease. Transthoracic (TT) Echocardiographic examination routinely includes evaluation of the aorta It is the most available screening method for diagnosis of proximal aortic dilatation. Since the predominant area of dilation is the proximal aorta, TT-echo is often sufficient for screening. We retrospectively analyzed the ECHO database with 78499 echocardiographic records in the Almazov National Medical Research Centre to identify patients with aneurysm. Detailed information including demographic characteristics, ECHO results and comorbidities were extracted from outpatient clinic and from hospital charts related to hospitalizations occurring within a year before index echocardiography was performed. Comorbid diseases were similarly extracted from outpatient clinic and/or hospital admissions. The classifier showed an AUC-ROC for predicting of aneurism detection after a repeated ECHO at 82%.

scholarly journals Malaria in patients with sickle cell anemia: burden, risk factors, and outcome at the outpatient clinic and during hospitalization

Blood ◽  
2010 ◽  
Vol 115 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Julie Makani ◽  
Albert N. Komba ◽  
Sharon E. Cox ◽  
Julie Oruo ◽  
Khadija Mwamtemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Outpatient Clinic ◽  
Hospital Admissions ◽  
Clinical Malaria ◽  
Dar Es Salaam ◽  
Severe Illness ◽  
Severe Anemia ◽  
Prospective Surveillance

Abstract Approximately 280 000 children are born with sickle cell anemia (SCA) in Africa annually, yet few survive beyond childhood. Falciparum malaria is considered a significant cause of this mortality. We conducted a 5-year prospective surveillance study for malaria parasitemia, clinical malaria, and severe malarial anemia (SMA) in Dar-es-Salaam, Tanzania, between 2004 and 2009. We recorded 10 491 visits to the outpatient clinic among 1808 patients with SCA and 773 visits among 679 patients without SCA. Similarly, we recorded 691 hospital admissions among 497 patients with SCA and 2017 in patients without SCA. Overall, the prevalence of parasitemia was lower in patients with SCA than in patients without SCA both at clinic (0.7% vs 1.6%; OR, 0.53; 95% CI, 0.32-0.86; P = .008) and during hospitalization (3.0% vs 5.6%; OR, 0.46; 95% CI, 0.25-0.94; P = .01). Furthermore, patients with SCA had higher rates of malaria during hospitalization than at clinic, the ORs being 4.29 (95% CI, 2.63-7.01; P < .001) for parasitemia, 17.66 (95% CI, 5.92-52.71; P < .001) for clinical malaria, and 21.11 (95% CI, 8.46-52.67; P < .001) for SMA. Although malaria was rare among patients with SCA, parasitemia during hospitalization was associated with both severe anemia and death. Effective treatment for malaria during severe illness episodes and further studies to determine the role chemoprophylaxis are required.

scholarly journals Risk Factors of Peripartum Cardiomyopathy

Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 20-25
Author(s):  
I.E. Zazerskaya ◽  
◽  
K.A. Rudenko ◽  
Ya.S. Talanina ◽  
E.V. Karelkina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Research ◽  
Test Methods ◽  
Peripartum Cardiomyopathy ◽  
Research Centre ◽  
Important Conclusion ◽  
Study Objective ◽  
National Medical ◽  
History Of ◽  
The Impact

Study Objective: To assess risk factors of peripartum cardiomyopathy (PCMP) based on the past medical history, genetic predisposition and peculiarities if this pregnancy. Study Design: retrospective cohort case study. Materials and Methods. We have performed a retrospective analysis of pregnancies and labours of 13 patients at V.A. Almazov National Medical Research Centre with PCMP in 2012–2019. For diagnostics and differential diagnosis, we used general, laboratory and instrumental test methods. Results. We have identified such risk factors as family history of cardiovascular pathologies (61.5%), age 35+ years (53.8%), obesity (53.8%), first labour (46.2%), preeclampsia (38.4%), caesarean delivery (23.1%), gestational diabetes mellitus (15.4%), multiple fetation (15.4%), and history of smoking (15.4%). 76.9% of patients had PCMP developed during pregnancy; 23.1% — on day 1–3 postpartum; a significant factor was operative delivery due to obstetrical symptoms; in one case, caesarean section was followed by a massive blood loss resulting from normal placenta abruption. Prevention of preeclampsia with drugs was indicated for one woman, although in 15.4% of patients it was diagnosed during the previous pregnancy, and 38.4% of women had preeclampsia during the current pregnancy. Conclusion. PCMP is a rare pathology with poorly studied ethiology and high risk of maternal mortality. When analysing clinical cases of 13 patients hospitalised with PCMP to V.A. Almazov National Medical Research Centre, we found out a significant number of PCMP risk factors; however, we have not identified any clear evidence of the impact from a certain factor. An important conclusion is the relation between PCMP and preeclampsia, which can be seen both in our study and in studies by foreign researchers; it is a potential platform for further research of this phenomenon. Keywords: peripartum cardiomyopathy, risk factors, pregnancy, labour

scholarly journals Risk Factor Assessment in a Greek Cohort of Patients With Large Abdominal Aortic Aneurysms

Angiology ◽  
2018 ◽  
Vol 70 (1) ◽  
pp. 35-40 ◽  
Author(s):  
Georgios Makrygiannis ◽  
Evanthia Mourmoura ◽  
Konstantinos Spanos ◽  
Nikolaos Roussas ◽  
Helena Kuivaniemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Screening Program ◽  
Multiple Logistic Regression Analysis ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Aortic Dilatation ◽  
Nucleotide Polymorphisms ◽  
Current Smoking ◽  
Abdominal Aortic

Environmental and genetic risk factors contribute to the etiology of abdominal aortic aneurysms (AAAs). Matrix metalloproteinases (MMPs) have been associated with the pathophysiology of AAAs. A prospective, nonrandomized case–control study was undertaken to investigate the risk factors for large AAAs (≥5.5 cm) among 175 male Greek AAA patients and to compare the results with a cohort of 166 male controls free from any aortic dilatation, as confirmed by ultrasonography from an existing AAA screening program in the same region. We also assessed the potential association between 2 functional single nucleotide polymorphisms in the genes MMP9 (−1561C/T; rs3918242) and MMP13 (−77A/G; rs2252070), and the presence of large AAAs. Multiple logistic regression analysis revealed AAA family history ( P = .028), hypercholesterolemia ( P < .001), and current smoking ( P < .001) as AAA risk factors. Statistical difference was reached in genotype ( P = .047) and allele ( P = .037) frequencies for rs2252070, but the results did not remain significant after correction for multiple testing. No significant differences in genotype or allele frequencies for rs3918242 were detected. In summary, AAA family history, hypercholesterolemia, and current smoking were found to be risk factors for large AAAs.

scholarly journals Knowledge and awareness of cervical cancer, its screening and HPV vaccination among out patients in a tertiary care institute in India

2019 ◽  
Vol 6 (10) ◽  
pp. 4437
Author(s):  
Devi Balasubramaniam ◽  
Kavitha Yogini Duraisamy ◽  
Sangeetha Karunanithi
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
Tamil Nadu ◽  
Pap Smear ◽  
Public Awareness ◽  
Hpv Vaccination ◽  
Tertiary Care ◽  
Screening Method ◽  
Research Centre ◽  
Indian Women

Background: Cervical cancer, despite being a preventable disease, its screening and vaccination still remains poor in our country. The aim of our study was to assess the knowledge and awareness regarding cervical cancer, its risk factors, screening and HPV vaccination.Methods: This cross sectional study was carried out among outpatients attending gynaecology OPD in GEM hospital and Research Centre, a tertiary care centre in Tamil Nadu during the period of April 2019 to June 2019. A total of 500 women, aged 16 years and above were analyzed using a structured questionnaire with multiple choices regarding socio demographic profile, knowledge and awareness about the cervical cancer, its risk factors, screening method and HPV vaccination.Results: Only 16.6% knew that cervical cancer is the most common cancer in Indian women. Majority (74.6%) of them were married, of which 36.2% were aware of Pap smear. Of those who were aware, only one third (12.6%) had their Pap smear done. The awareness of HPV vaccination was only 25% and 3.4% of them were vaccinated. 70.2% of the study participants were willing to be vaccinated after knowing about the vaccination.Conclusions: This study serves to highlight that, the majority of women lack knowledge and awareness concerning cervical cancer and its preventive aspects. This is a major hindrance among Indian women to undergo early screening and timely prevention. Hence creating public awareness of cervical cancer and its prevention is still a priority. 

Glutathione system participation in thoracic aneurysms from patients with Marfan syndrome

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 177-186 ◽  
Author(s):  
Alejandra María Zúñiga-Muñoz ◽  
Israel Pérez-Torres ◽  
Verónica Guarner-Lans ◽  
Elías Núñez-Garrido ◽  
Rodrigo Velázquez Espejel ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Marfan Syndrome ◽  
Aortic Aneurysms ◽  
Aortic Dilatation ◽  
Glutathione S Transferase ◽  
Reduced And Oxidized Glutathione ◽  
Total Antioxidant ◽  
Elevated Activity ◽  
Acute Dissection ◽  
Thoracic Aneurysms

Abstract. Background: Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients. Spectrophotometrical determination of activity of glutathione peroxidase (GPx), glutathione-S-transferase (GST), glutathione reductase (GR), lipid peroxidation (LPO) index, carbonylation, total antioxidant capacity (TAC), and concentration of reduced and oxidized glutathione (GSH and GSSG respectively), was performed in the homogenate from aortic aneurysm tissue. Results: LPO index, carbonylation, TGF-β1, and GR activity were increased in MFS patients (p < 0.04), while TAC, GSH/GSSG ratio, GPx, and GST activity were significantly decreased (p < 0.04). Conclusions: The depletion of GSH, in spite of the elevated activity of GR, not only diminished the activity of GSH-depend GST and GPx, but increased LPO, carbonylation and decreased TAC. These changes could promote the structural and functional alterations in the thoracic aorta of MFS patients.

Risk factors of hospital admissions and recurrent emergency department visits among pediatric asthma patients

2020 ◽  
pp. 1011-1015
Author(s):  
Abdullah Aldamigh ◽  
Afaf Alnefisah ◽  
Abdulrahman Almutairi ◽  
Fatima Alturki ◽  
Suhailah Alhtlany ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admissions ◽  
Pediatric Asthma ◽  
Emergency Department Visits ◽  
Asthma Patients

scholarly journals Quantitative not qualitative histology differentiates aneurysmal from nondilated ascending aortas and reveals a net gain of medial components

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sameh Yousef ◽  
Nana Matsumoto ◽  
Issam Dabe ◽  
Makoto Mori ◽  
Alden B. Landry ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Quantitative Assessment ◽  
Cell Number ◽  
Aortic Aneurysms ◽  
Aortic Dilatation ◽  
Adaptive Responses ◽  
Cross Sectional ◽  
Thoracic Aortic Aneurysms ◽  
Medial Degeneration ◽  
The Media

AbstractMedial degeneration is a common histopathological finding in aortopathy and is considered a mechanism for dilatation. We investigated if medial degeneration is specific for sporadic thoracic aortic aneurysms versus nondilated aortas. Specimens were graded by pathologists, blinded to the clinical diagnosis, according to consensus histopathological criteria. The extent of medial degeneration by qualitative (semi-quantitative) assessment was not specific for aneurysmal compared to nondilated aortas. In contrast, blinded quantitative assessment of elastin amount and medial cell number distinguished aortic aneurysms and referent specimens, albeit with marked overlap in results. Specifically, the medial fraction of elastin decreased from dilution rather than loss of protein as cross-sectional amount was maintained while the cross-sectional number, though not density, of smooth muscle cells increased in proportion to expansion of the media. Furthermore, elastic lamellae did not thin and interlamellar distance did not diminish as expected for lumen dilatation, implying a net gain of lamellar elastin and intralamellar cells or extracellular matrix during aneurysmal wall remodeling. These findings support the concepts that: (1) medial degeneration need not induce aortic aneurysms, (2) adaptive responses to altered mechanical stresses increase medial tissue, and (3) greater turnover, not loss, of mural cells and extracellular matrix associates with aortic dilatation.

Preventable and Non-Preventable Risk Factors for Adverse Drug Events Related to Hospital Admissions in the Elderly

2002 ◽  
Vol 22 (6) ◽  
pp. 385-392 ◽  
Author(s):  
J. Doucet ◽  
A. Jego ◽  
D. Noel ◽  
C.E. Geffroy ◽  
C. Capet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Drug Events ◽  
Hospital Admissions ◽  
The Elderly

scholarly journals THU0417 READMISSION RISK AND QUALITY OF CARE IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH GOUT FLARES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 446.2-446
Author(s):  
L. Brunetti ◽  
J. Vekaria ◽  
P. Lipsky ◽  
N. Schlesinger
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Economic Burden ◽  
Hospital Admissions ◽  
Medical Center ◽  
Research Support ◽  
Increased Risk ◽  
Comorbidity Index ◽  
Anti Inflammatory ◽  
Gout Flares

Background:Gout is the most common form of inflammatory arthritis and its economic burden is substantial, with estimates for the overall cost exceeding $20 billion (US) annually. Contributing to the economic burden are hospital admissions and iatrogenic events associated with pharmacotherapy. Identification of modifiable risk factors would be an important contribution to clinical practice.Objectives:The aim of this study was to identify opportunities for enhancing gout care in patients presenting to the Emergency Department (ED) with gout flares.Methods:This retrospective cohort study used data from electronic medical records (EMR) at a large community hospital. All consecutive patients visiting the medical center ED with a primary diagnosis of gout from 1/1/2016 to 7/1/2019 were included. Patients were then followed for 90 days to determine whether they were readmitted to the ED for any reason. A chart review identified whether they were on appropriate medications in terms of gout flare management. All data were summarized using descriptive statistics. A multiple logistic regression was constructed to identify risk factors for ED utilization within 90 days of the index visit.Results:A total of 214 patients were included in the analysis. Most patients were male (79%), mean age was 59.4 ± 15.6 years, and mean Charlson comorbidity index was 0.5 ± 1.14. The most common medications prescribed during the ED visit included NSAIDs (41.6%), opioids (28%), corticosteroids (26.6%), and colchicine (21%). Allopurinol and febuxostat were initiated in the ED in 4.7% and 0.9%, respectively. Discharge medications for the management of gout included NSAIDs (37%), corticosteroids (34.6%), opioids (23.8%), colchicine (14%), febuxostat (7%), and allopurinol (6.5%). Of the patients sent home with an opioid, 40% were newly prescribed. An anti-inflammatory medication was not prescribed in 29.6% of patients discharged from the ED. Readmission within 90 days was recorded in 16.8% of patients. Of these readmissions, 33.3% were gout-related and 11.1% were cardiac related.After adjusting for age and comorbidity index, patients receiving colchicine were 2.8 times more likely (OR, 2.81; 95% CI, 1.12 to 7.02; p=0.027) to return to the ED within 90 days. The most common cause of readmission in this subset was gout-related (54.5%).Conclusion:Nearly 30% of patients were discharged from the ED without an anti-inflammatory medication, whereas initiation of urate lowering therapy was rare. Opiates were used frequently, but the indication was uncertain. Only 5.6% of subjects revisited the ED for gout-related diagnoses in the subsequent 3 months. Colchicine prescription was associated with an increased risk of gout-related ED utilization within 90 days. Treatment of gout in the ED is sub-optimal and often does not follow established guidelines.Disclosure of Interests: :Luigi Brunetti Grant/research support from: Astellas Pharma, CSL Behring, Consultant of: Horizon Foundation of New Jersey, Janaki Vekaria: None declared, Peter Lipsky Consultant of: Horizon Therapeutics, Naomi Schlesinger Grant/research support from: Pfizer, AMGEN, Consultant of: Novartis, Horizon Pharma, Selecta Biosciences, Olatec, IFM Therapeutics, Mallinckrodt Pharmaceuticals, Speakers bureau: Takeda, Horizon

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