scholarly journals Physical Inactivity: A Modifiable Risk Factor for Morbidity and Mortality in Kidney Transplantation

2021 ◽  
Vol 11 (9) ◽  
pp. 927
Author(s):  
Claudio Ponticelli ◽  
Evaldo Favi
Keyword(s):  
Physical Activity ◽  
Risk Factor ◽  
Physical Exercise ◽  
Physical Inactivity ◽  
Current Knowledge ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Positive Feedbacks ◽  
Exercise Load ◽  
Regular Physical Exercise

In patients with chronic kidney disease, sedentary behavior is widely recognized as a significant risk factor for cardiovascular disease, diabetes, obesity, osteoporosis, cancer, and depression. Nevertheless, the real impact of physical inactivity on the health of kidney transplant (KT) recipients remains uncertain. Over the last decade, there has been a renewed interest in exploring the effects of regular physical exercise on transplant-related outcomes. There is now mounting evidence that physical activity may reduce the burden of cardiovascular risk factors, preserve allograft function, minimize immunosuppression requirement, and ameliorate the quality of life of KT recipients. Many positive feedbacks can be detected in the early stages of the interventions and with a minimal exercise load. Despite these encouraging results, the perceived role of physical activity in the management of KT candidates and recipients is often underrated. The majority of trials on exercise training are small, relatively short, and focused on surrogate outcomes. While waiting for larger studies with longer follow-up, these statistical limitations should not discourage patients and doctors from initiating exercise and progressively increasing intensity and duration. This narrative review summarizes current knowledge about the deleterious effects of physical inactivity after KT. The benefits of regular physical exercise are also outlined.

scholarly journals Effect of eating habits, BMI value, physical activity and smoking cigarettes on blood lipid indices of adolescent boys from Poland

2020 ◽  
pp. 413-422
Author(s):  
Ewa Piotrowska ◽  
Michaela Godyla-Jabłoński ◽  
Monika Bronkowska
Keyword(s):  
Physical Activity ◽  
Risk Factor ◽  
Lipid Metabolism ◽  
Cardiovascular Diseases ◽  
Eating Habits ◽  
Significant Risk ◽  
Blood Lipid ◽  
Significant Risk Factor ◽  
Overweight And Obesity ◽  
Blood Lipid Profile

Background. The lifestyle of young boys has impact on the risks of cardiovascular diseases. Objective. The aim of the study was to evaluate the effect of atherosclerosis risk factors determined by overweight and obesity and lifestyle, i.e.: eating habits, low physical activity and smoking cigarettes, on blood lipid profile of boys at the age of 16 to 18. Material and Methods. The study covered 369 boys from secondary schools. They were evaluated for the supply of dietary constituents with atherogenic and protective actions, for nutritional status acc. to Cole’s criteria, the level of physical activity, and smoking cigarettes. Lipid metabolism was determined based on criteria recommended by the American National Cholesterol Education Program (NCEP). Logistic regression analysis was conducted and risk odds ratio [OR] was determined. Results. Analyses showed the boys to be characterized by overweight (10.8%) and obesity (2.7%), and by inappropriate concentration of total cholesterol (26.5%), LDL (13.3%), HDL (21.7%) and triglycerides (41.7%). High BMI turned out to be a significant risk factor of an elevated total cholesterol concentration: [aOR]=2.27; triglycerides: [aOR]=2.35 and LDL: [aOR]=2.41. Low physical activity was found to negatively affect the concentration of LDL: [aOR]=1.88. The boys smoking cigarettes were shown to have a reduced HDL: [aOR]=1.65. The total content of fat and saturated fatty acids in diet exerted a significantly negative impact on blood lipid profile of the boys. Conclusions. The lifestyle of the young boys was demonstrated to determine the risk of cardiovascular diseases. Overweight and obesity, abdominal obesity in particular, were found to be a significant risk factor of disorders in their lipid metabolism.

Physical Illness and Suicide Risk in Rural Residents of Contemporary China

Crisis ◽  
2014 ◽  
Vol 35 (5) ◽  
pp. 330-337 ◽  
Author(s):  
Cun-Xian Jia ◽  
Lin-Lin Wang ◽  
Ai-Qiang Xu ◽  
Ai-Ying Dai ◽  
Ping Qin
Keyword(s):  
Risk Factor ◽  
Family Income ◽  
Rural China ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Health Condition ◽  
Physical Illness ◽  
Rural Residents ◽  
Increased Risk ◽  
Study Population

Background: Physical illness is linked with an increased risk of suicide; however, evidence from China is limited. Aims: To assess the influence of physical illness on risk of suicide among rural residents of China, and to examine the differences in the characteristics of people completing suicide with physical illness from those without physical illness. Method: In all, 200 suicide cases and 200 control subjects, 1:1 pair-matched on sex and age, were included from 25 townships of three randomly selected counties in Shandong Province, China. One informant for each suicide or control subject was interviewed to collect data on the physical health condition and psychological and sociodemographic status. Results: The prevalence of physical illness in suicide cases (63.0%) was significantly higher than that in paired controls (41.0%; χ2 = 19.39, p < .001). Compared with suicide cases without physical illness, people who were physically ill and completed suicide were generally older, less educated, had lower family income, and reported a mental disorder less often. Physical illness denoted a significant risk factor for suicide with an associated odds ratio of 3.23 (95% CI: 1.85–5.62) after adjusted for important covariates. The elevated risk of suicide increased progressively with the number of comorbid illnesses. Cancer, stroke, and a group of illnesses comprising dementia, hemiplegia, and encephalatrophy had a particularly strong effect among the commonly reported diagnoses in this study population. Conclusion: Physical illness is an important risk factor for suicide in rural residents of China. Efforts for suicide prevention are needed and should be integrated with national strategies of health care in rural China.

scholarly journals Higher premature atrial complex burden from the Holter examination predicts poor cardiovascular outcome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Chun Huang ◽  
Po-Tseng Lee ◽  
Mu-Shiang Huang ◽  
Pei-Fang Su ◽  
Ping-Yen Liu
Keyword(s):  
Risk Factor ◽  
Dose Response ◽  
Cox Model ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cardiovascular Death ◽  
Specific Model ◽  
Distribution Model ◽  
All Cause Mortality ◽  
Quartile Group

AbstractPremature atrial complexes (PACs) have been suggested to increase the risk of adverse events. The distribution of PAC burden and its dose–response effects on all-cause mortality and cardiovascular death had not been elucidated clearly. We analyzed 15,893 patients in a medical referral center from July 1st, 2011, to December 31st, 2018. Multivariate regression driven by ln PAC (beats per 24 h plus 1) or quartiles of PAC burden were examined. Older group had higher PAC burden than younger group (p for trend < 0.001), and both genders shared similar PACs distribution. In Cox model, ln PAC remained an independent risk factor for all-cause mortality (hazard ratio (HR) = 1.09 per ln PAC increase, 95% CI = 1.06‒1.12, p < 0.001). PACs were a significant risk factor in cause-specific model (HR = 1.13, 95% CI = 1.05‒1.22, p = 0.001) or sub-distribution model (HR = 1.12, 95% CI = 1.04‒1.21, p = 0.004). In ordinal PAC model, 4th quartile group had significantly higher risk of all-cause mortality than those in 1st quartile group (HR = 1.47, 95% CI = 1.13‒1.94, p = 0.005), but no difference in cardiovascular death were found in competing risk analysis. In subgroup analysis, the risk of high PAC burden was consistently higher than in low-burden group across pre-specified subgroups. In conclusion, PAC burden has a dose response effect on all-cause mortality and cardiovascular death.

Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

2020 ◽  
pp. 1-7
Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Risk Adjustment ◽  
Community Hospital ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bivariate Analysis ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

scholarly journals Type-2 Diabetes as a Risk Factor for Severe COVID-19 Infection

2021 ◽  
Vol 9 (6) ◽  
pp. 1211
Author(s):  
Mahnaz Norouzi ◽  
Shaghayegh Norouzi ◽  
Alistaire Ruggiero ◽  
Mohammad S. Khan ◽  
Stephen Myers ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Inflammatory Responses ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Diabetic Patients ◽  
Angiotensin Converting Enzyme 2 ◽  
Immune System Dysfunction ◽  
Current Outbreak

The current outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), termed coronavirus disease 2019 (COVID-19), has generated a notable challenge for diabetic patients. Overall, people with diabetes have a higher risk of developing different infectious diseases and demonstrate increased mortality. Type 2 diabetes mellitus (T2DM) is a significant risk factor for COVID-19 progression and its severity, poor prognosis, and increased mortality. How diabetes contributes to COVID-19 severity is unclear; however, it may be correlated with the effects of hyperglycemia on systemic inflammatory responses and immune system dysfunction. Using the envelope spike glycoprotein SARS-CoV-2, COVID-19 binds to angiotensin-converting enzyme 2 (ACE2) receptors, a key protein expressed in metabolic organs and tissues such as pancreatic islets. Therefore, it has been suggested that diabetic patients are more susceptible to severe SARS-CoV-2 infections, as glucose metabolism impairments complicate the pathophysiology of COVID-19 disease in these patients. In this review, we provide insight into the COVID-19 disease complications relevant to diabetes and try to focus on the present data and growing concepts surrounding SARS-CoV-2 infections in T2DM patients.

Lymphedema: A Significant Risk Factor for Infection and Implant Failure After Total Knee Arthroplasty

2020 ◽  
Vol 28 (23) ◽  
pp. 996-1002 ◽  
Author(s):  
Joshua M. Kolz ◽  
William G. Rainer ◽  
Cody C. Wyles ◽  
Matthew T. Houdek ◽  
Kevin I. Perry ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Risk Factor ◽  
Knee Arthroplasty ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Implant Failure ◽  
Total Knee

scholarly journals Timing of resumption of antithrombotic agents following surgical evacuation of chronic subdural hematomas: a retrospective cohort study

2015 ◽  
Vol 42 (S1) ◽  
pp. S11-S11 ◽  
Author(s):  
D Guha ◽  
S Coyne ◽  
RL Macdonald
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Postoperative Complications ◽  
Retrospective Cohort ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Antithrombotic Agents ◽  
Major Hemorrhage ◽  
Subdural Hematomas ◽  
Surgical Evacuation

Background: Antithrombosis (AT), with antiplatelets or anticoagulants, is a significant risk factor for the development of chronic subdural hematomas (cSDH). Resumption of AT following hematoma evacuation is variable, with scant evidence for guidance. Methods: We retrospectively analyzed 479 patients with surgically-evacuated cSDH at St. Michael’s Hospital from 2007-2012. Collected variables included type of AT, indication for AT, timing and type of postoperative complications, and restart intervals for AT agents. Postoperative complications were classified as major or minor hemorrhages, or thromboembolism. Results: Among all patients, 14.8% experienced major hemorrhage, 23.0% minor hemorrhage, and 1.67% thromboembolism. Patients on any preoperative AT were at higher risk of major hemorrhage (OR=1.93, p=0.014), experienced earlier major hemorrhage (mean 16.2 versus 26.5d, p=0.052) and earlier thromboembolism (mean 2.7 versus 51.5d, p=0.036). The type of agent did not affect complication frequency or timing. Patients restarted on any AT postoperatively were at decreased risk of major rebleed following resumption, than those not restarted (OR=0.06, p<0.01). Conclusions: Patients on preoperative AT experienced thromboembolism significantly earlier, at 3d postoperatively, with no increase in rebleed risk following AT resumption. We provide cursory evidence that resuming AT early, at 3d postoperatively, may be safe. Larger prospective studies are required for definitive recommendations.

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