scholarly journals Indicators of humoral regulation of the circulatory system in obese patients

2020 ◽  
Vol 5 (2) ◽  
pp. 88-92
Author(s):  
Tatyana S. Zaletova ◽  
Svetlana A. Derbeneva ◽  
Tatyana B. Feofanova ◽  
Andrei A. Katsuba
Keyword(s):  
Circulatory System ◽  
Plasma Renin ◽  
Absolute Number ◽  
Obese Patients ◽  
Normal Range ◽  
Aldosterone Level ◽  
Number Of Patients ◽  
Renin Level ◽  
Grade Iii ◽  
Humoral Regulation

Objectives - to study the indicators of humoral regulation of circulatory system in obese patients as the predictors of CHF development. Materials and methods. Two groups of 40 patients were formed: the first group consisted of patients with I or II grades obesity with BMI of up to 40 kg/m2, the second group included patients with grade III obesity with BMI of over 40 kg/m2. None of the selected patients had a history of cardiovascular events. The concentration value of renin-angiotensin-aldosterone system components and level of N-terminal pro B-type natriuretic peptide (NT-pro-BNP) was determined. Results. Aldosterone level in grade I-II obese patients was close to normal upper border: 58.9 [54.9; 73.8] pg/ml (normal range is 10-60 pg/ml), while in patients with grade III obesity it was 79.5 [64.5; 90.1], which is 25.9% higher than in patients of the first group and 24.5% higher above the normal level (p < 0.05). These two groups was significantly different not only in average plasma aldosterone level, but in absolute number of patients with hyperaldosteronism, whose number accounted for 46.2% in grades I or II obese patients and 85.7% among patients with grade III obesity. Plasma renin level and angiotensin II levels in both groups was within the normal range. NT-proBNP level in the first group was 23.7 [10.6; 23.6] pg/ml, in the second group - 138.0 [121.5; 145.9] pg/ml, which is 5.8 times higher (p = 0.001). In both groups of patients, the correlation analysis showed that aldosterone and NT-proBNP levels are closely related (r = 0.74, p < 0.05). Conclusion. This study suggests that aldosterone level can be used as a predictor of HF.

scholarly journals Estimation of the efficacy of the measurement of plasma renin activity and direct renin in diagnostics of primary aldosteronism

2012 ◽  
Vol 58 (5) ◽  
pp. 21-27
Author(s):  
N P Goncharov ◽  
G S Kolesnikova ◽  
G V Katsiia ◽  
E Iu Rogal'
Keyword(s):  
Plasma Renin Activity ◽  
Primary Aldosteronism ◽  
Plasma Renin ◽  
Pressure Control ◽  
Renin Activity ◽  
Differential Diagnostics ◽  
Control Groups ◽  
Aldosterone Level ◽  
Renin Level

The objective of the present study was to estimate the informative value of the measurements of aldosterone level, direct renin, and plasma renin activity as well as the relationships between these characteristics for differential diagnostics of various forms of hypertension and, first and foremost, of primary aldosteronism. We have examined a total of 162 patients. The results of differential tests were used to allocate them to a few groups including 41 patients presenting with primary aldosteronism, 52 ones with incidentalomas, 26 with essential hypertension, and 43 with various endocrine diseases and normal arterial pressure (control groups). The aldosterone levels, direct renin, and plasma renin activity were measured in blood samples taken in morning hours from the patients in the supine position. The aldosterone to plasma renin activity (A/PRA) and aldosterone to direct renin (A/DR) ratios were calculated. The elevated blood aldosterone level is currently believed to be the principal criterion for primary aldosteronism in the patients suffering arterial hypertension. The RIA technology is the method of choice for the measurement of aldosterone levels. The determination of the A/PR ratio significantly improves the detectability of the disease. The use of direct renin level instead of kinetic renin ensures the high efficacy of screening for primary aldosteronism and its early diagnostics. The cut-off point for the calculation of the A/PRA ratio to differentiate between primary aldosteronism and incidentalomas is 2160 pmol/mcg/hr (sensitivity 100%, specificity 97.8%) in comparison with the analogous cut-off point for the discrimination between primary aldosteronism and endocrine pathology without hypertension is 49 pmol/mU (sensitivity 100%, specificity 95%). The cut-off point for the calculation of the A/PR ratio to differentiate between primary aldosteronism and incidentalomas is 2160 pmol/mcg/hr (sensitivity 89.5%, specificity 99%) in comparison with the analogous cut-off point for the discrimination between primary aldosteronism and endocrine pathology without hypertension is 1432 pmol/mcg/hr (sensitivity 89.5%, specificity 100%). It is concluded that the results of determination of direct renin level in the blood plasma are independent of the endogenous angiotensinogen level, less variable and more reproducible than than the results of the measurement of plasma renin activity. The aldosterone to direct renin ratio may be used for the screening of primary aldosteronism.

scholarly journals Unimed Recife's experience in treating 1,039 patients with Covid-19

2021 ◽  
Author(s):  
Marcelo Moraes Valença ◽  
Martha Maria Romeiro Figueiroa F. Fonseca ◽  
Cátia Arcuri Branco ◽  
Alex Maurício Garcia Santos ◽  
Antonio Oliveira ◽  
...  
Keyword(s):  
Health Management ◽  
Demographic Data ◽  
The Elderly ◽  
Obese Patients ◽  
Mechanical Ventilator ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
Management Platform ◽  
Pathophysiological Process ◽  
Number Of Patients

ObjectiveTo describe the features related to patients with Covid-19 admitted to Unimed Recife hospitals, Recife, Brazil, evaluating demographic data, lethality, use of a mechanical ventilator, presence of associated diseases, the need to use the ICU, among other aspects related to the prognosis of these patients.MethodData were collected from the DRG Brazil health management platform, including the period from March 16, 2020, when the first patient with Covid-19 was admitted to the Hospital da Unimed III, until January 31, 2021. All patients admitted to one of the three hospitals of Unimed Recife - Hospital Unimed Recife I, Hospital Unimed Recife III, and Hospital Geral Unimed Recife – were included in the study. In the same period, we evaluated the number of patients with Covid-19 or suspected Covid-19 who were seen in the emergency room at Hospital Unimed Recife III.ResultsOne hundred twenty-six thousand five hundred fifty-three patients were seen in the Emergency Unit of Hospital Unimed Recife III in the period between March 26, 2020, and January 31, 2021; of those 126,553 patients seen in the emergency 39,340 (31.09%) patients were diagnosed with having Covid-19 or suspected of Covid-19. In the 10-month period, 1,039 patients with Covid-19 were hospitalized, 61% with hypertension, 31.1% with SARS, 30.0% with diabetes, and 9.9% were obese. The average hospital stay was 11.2 days. 342/1,039 (32.9%) patients were admitted to the ICU, and 57.9% of them had mechanical ventilation. The overall lethality was 13.76% (143 deaths/1,039 inpatients). An increase in lethality by Covid-19 was associated with increased age. Lethality in the first period of the Covid-19 pandemic was significantly higher when compared to the last 5 months of the pandemic(17.6% versus 9.7%). Obesity significantly increased lethality in patients with Covid-19 [120 deaths/1,016 non-obese patients (11.8%) versus 23 deaths/103 obese patients (22.3%), OR 2.15 (1.30 - 3.50), p = 0.005)].ConclusionWe conclude that Covid-19 is a disease with a poor prognosis, especially in the elderly and obese patients. In the second 5-month period of the Covid-19 pandemic, we noticed a significant reduction in lethality by Covid-19 in hospitalized patients. Covid-19 is a new disease and the mechanism by which the viruses multiply or how the pathophysiological process occurs in the infected organism are still barely understood.

scholarly journals Vitrectomy for branch retinal vein occlusion with vitreous hemorrhage: proposal for a new grading system

2020 ◽  
Author(s):  
Gengmin Tong ◽  
Xuting Hu ◽  
Chenlei Zhu ◽  
Zhiqiang Gao ◽  
Xuhao Chen ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Vitreous Hemorrhage ◽  
Grading System ◽  
Vein Occlusion ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Significant Difference ◽  
Grade Iii

Abstract Purpose To investigate the long-term surgical outcomes after treatment with pars plana vitrectomy (PPV) combined with photocoagulation in different severities of branch retinal vein occlusion (BRVO) with vitreous hemorrhage (VH) in order to propose a new grading system. Methods We retrospectively reviewed the medical records of 117 eyes of 117 patients who underwent PPV for VH associated with BRVO and who were followed up for at least 12 months. Preoperative best-corrected visual acuity (BCVA), surgical intervention, final BCVA, and central foveal thickness (CFT) were evaluated using optical coherence tomography. We proposed a system to grade BRVO with VH from Grade I to Grade III with increasing severity: Grade I,pure persistent VH; Grade II,VH with epiretinal membrane (EM) (Grade IIa,VH with EM without macular involvement; Grade IIb,VH with EM with macular involvement); and Grade III,VH with tractive retinal detachment. Different surgical methods were appliedaccording to the different retinal conditions. Results BCVA significantly improved at final follow-up in all groups. There was no significant difference among the four groups in terms of preoperative BCVA, final BCVA,CFT,or the number of patients whose macular edema recurred after surgery (p>0.05), but there was a significant difference in vision improvement(p<0.05). Vision improvement in the Grade IIb group was significantly worse than in the Grade I group(p=0.006) and in the Grade IIa group(p=0.046). The percentage of patients in the Grade I, Grade IIa, Grade IIb, and Grade III groups needing further laser treatment after surgery was 0%, 8.3%, 16.3%, and 23.5%, respectively (p<0.05). Conclusion We proposed a new grading system for BRVO treated with PPV. Vitrectomy is a safe and effective treatment for BRVO with VH. Visual acuity improvement was significantly worse when the EM had macular involvement (Grade IIb).

scholarly journals Is Obesity a Risk Factor for Spinal Surgeries? A Retrospective Study in a Specialized Orthopedic Spine Center

2021 ◽  
Vol 8 (1) ◽  
pp. 37-42
Author(s):  
Hasan Ghandhari ◽  
◽  
Ebrahim Ameri ◽  
Mohsen Motalebi ◽  
Mohamad-Mahdi Azizi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Obese Group ◽  
Obese Patients ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Various studies have shown the effects of morbid obesity on the adverse consequences of various surgeries, especially postoperative infections. However, some studies have shown that the complications of spinal surgery in obese and non-obese patients are not significantly different. Objectives: This study investigated and compared the duration of surgery, length of hospital stay, and complications after common spinal surgeries by orthopedic spine fellowship in obese and non-obese patients in a specialized spine center in Iran. Methods: All patients who underwent decompression with or without lumbar fusion were included in this retrospective study. These patients were classified into two groups: non-obese (BMI <30 kg/m2) and obese (BMI ≥30 kg/m2). The data related to type and levels of surgery, 30-day hospital complications, length of hospital stay, rate of postoperative wound infection, blood loss, and need for transfusion were all extracted and compared between the two groups. Results: A total of 148 patients (74%) were in the non-obese group and 52 patients (26%) in the obese group. The number of patients that need packed cells was significantly higher in the obese group (51.8% vs 32.6%) (P=0.01). Otherwise, there were not a significant difference between type of treatment (fusion or only decompression) (P=0.78), interbody fusion (P=0.26), osteotomy (P=0.56), duration of surgery (P=0.25), length of hospital stay (P=0.72), mean amount of blood loss (P=0.09), and postoperative complications (P=0.68) between the two groups. Conclusion: Our results suggest that duration of surgery, length of hospital stay, and postoperative complications are not associated with the BMI of the patients.

scholarly journals INFLAMMATORY DISORDERS ASSOCIATED WITH HELICOBACTER PYLORI IN THE ROUX-EN-Y BYPASS GASTRIC POUCH

2016 ◽  
Vol 29 (suppl 1) ◽  
pp. 31-34 ◽  
Author(s):  
Luiz Claudio Lopes CHAVES ◽  
Isabela Klautau Leite Chaves BORGES ◽  
Maíra Danielle Gomes de SOUZA ◽  
Ian Passos SILVA ◽  
Lyz Bezerra SILVA ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Helicobacter Pylori ◽  
Gastric Pouch ◽  
Obese Patients ◽  
Inflammatory Lesions ◽  
Low Incidence ◽  
H Pylori ◽  
A Prospective Study ◽  
Grade Iii

ABSTRACT Background: The prevalence of Helicobacter pylori in obese candidates for bariatric surgery and its role in the emergence of inflammatory lesions after surgery has not been well established. Aim: To identify the incidence of inflammatory lesions in the stomach after bariatric surgery and to correlate it with H. pylori infection. Methods: This is a prospective study with 216 patients undergoing Roux-en-Y gastric bypass. These patients underwent histopathological endoscopy to detect H. pylori prior to surgery. Positive cases were treated with antibiotics and a proton inhibitor pump followed by endoscopic follow-up in the 6th and 12th month after surgery. Results: Most patients were female (68.1%), with grade III obesity (92.4%). Preoperative endoscopy revealed gastritis in 96.8%, with H. pylori infection in 40.7% (88/216). A biopsy was carried out in 151 patients, revealing H. pylori in 60/151, related to signs of inflammation in 90% (54/60). In the 6th and 12th month after surgery, the endoscopy and the histopathological exam showed a normal gastric pouch in 84% of patients and the incidence of H. pylori was 11% and 16%, respectively. The presence of inflammation was related to H. pylori infection (p<0,001). Conclusion: H. pylori has a similar prevalence in both obese patients scheduled to undergo bariatric surgery and the general population. There is a low incidence of it in the 6th and 12th months after surgery, probably owing to its eradication when detected prior to surgery. When inflammatory disease is present in the new gastric reservoir it is directly related to H. pylori infection.

Recent epidemiological trends in extrapulmonary TB in Galicia, Spain

2021 ◽  
Vol 25 (5) ◽  
pp. 373-381
Author(s):  
L. Ferreiro ◽  
A. Ruano-Raviña ◽  
R. Otero-Mallo ◽  
C. Pou-Álvarez ◽  
V. Riveiro-Blanco ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Prevention And Control ◽  
Extrapulmonary Tuberculosis ◽  
Absolute Number ◽  
Incidence Rates ◽  
Age Group ◽  
Number Of Patients ◽  
Epidemiological Trends ◽  
And Control ◽  
Epidemiological Characteristics

OBJECTIVE: To describe the epidemiological trends and characteristics of extrapulmonary tuberculosis (EPTB) in Galicia, Spain, from 2000 to 2019.METHODS: This was a retrospective cohort study based on data from the Galician TB information system.RESULTS: Of the total number of TB cases (n = 15,871), 5,428 (34.2%) had EPTB. The absolute number of cases and incidence of EPTB decreased dramatically (from 480 cases and 17.8 cases/100,000 in 2000, to 172 and 6.4 cases/100,000 in 2019, respectively), with a mean annual decrease of respectively 64% and 4.7% for absolute cases and incidence rates. The risk for EPTB was higher in men than in women (RR 3.86, 95% CI 3.66–4.07). The most frequent age group was 15–44 years (2,234 patients, 41.2%); overall reductions per age group were 82% (0–14 years), 75% (15–44 years), 44% (45–64 years) and 63% (≥65 years), with statistically significant differences. The most frequently locations were the pleura (1,916 cases; 35.3%) and the lymph nodes (1,504; 27.7%).CONCLUSION: The incidence of EPTB in Galicia has decreased significantly in the last 20 years. The epidemiological characteristics have not changed, except for the number of patients with risk factors. This improvement of EPTB epidemiological trends coincides with the implementation of the programme for the prevention and control of TB, which suggests that it has been very effective in the control of the EPTB.

Central effects of angiotensin II and dopamine in sodium-depleted sheep

1985 ◽  
Vol 248 (5) ◽  
pp. R541-R548
Author(s):  
B. S. Huang ◽  
R. L. Malvin ◽  
R. J. Grekin
Keyword(s):  
Angiotensin Ii ◽  
Enzyme Inhibitor ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Ang Ii ◽  
Angiotensin System ◽  
Aldosterone Level ◽  
Central Effects ◽  
Dopaminergic Pathway

The effects of intracerebroventricular (IVT) infusion of angiotensin II (ANG II), the converting enzyme inhibitor SQ 20881, and dopamine were studied in 15 conscious Na-depleted sheep. IVT ANG II (25 ng/min) significantly increased plasma aldosterone (163 +/- 24%) and vasopressin (ADH) (533 +/- 100%). Plasma renin activity (PRA) was decreased to 64 +/- 10% of basal. IVT SQ (1 microgram/min) decreased aldosterone to 70 +/- 10% and ADH to 55 +/- 9% of basal. PRA increased to 124 +/- 10%. There were no significant changes in plasma Na, K, or cortisol levels nor in mean arterial or intracranial pressure after either infusion. Increasing the dose of SQ to 10 micrograms/min resulted in an increased magnitude of change in the same variables. IVT SQ (1 microgram/min) significantly decreased aldosterone level in five nephrectomized sheep. The responses to IVT dopamine (20 micrograms/min) were qualitatively similar to those elicited by IVT SQ. These data support the existence of an endogenous brain renin-angiotensin system (RAS) independent of the renal RAS. ANG II acts centrally to regulate plasma ADH, aldosterone, and PRA levels. The similarity of the responses to SQ and dopamine suggests that a dopaminergic pathway may be involved in these responses.

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