scholarly journals Peranan Faktor Lingkungan dan Kontributor Selama Kehamilan terhadap Hipospadia

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ester J. Tuju ◽  
Harsali F. Lampus ◽  
Stephanus J. Ch. Tangel
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Literature Review ◽  
Maternal Age ◽  
Strong Relationship ◽  
First Trimester ◽  
Google Scholar ◽  
Increased Risk ◽  
Review Study ◽  
The Relationship

Abstract: The etiology of hypospadias is not certainly known and is still controversial. Environmental factors and their influence during pregnancy can be risk factors for increased incidence of hypospadias. This study was aimed to obtain the risk factors of hypospadias. This was a literature review study using three databases, as follows: ClinicalKey, PubMed, and Google Scholar. There were 47 literatures in this study. The results showed that from the 47 literatures containing risk factors of hypospadias, 8 literatures reported the relationship between pesticides and hypospadias; 3 literatures reported the relationship between smoking and increased risk of hypospadias; 6 literatures revealed that there was a strong relationship between maternal age and increased risk of hypospadias; 8 literatures showed that low births weight babies were associated with hypospadias and placental insufficiency as its cause; 5 literatures stated that several drugs consumed by pregnant women during the first trimester were related to the increased risk of hypospadias. In conclusion, environmental factors and contributors during pregnancy are the risk factors of hypospadias.Keywords: hypospadias, risk factors, environmental factors, contributors during pregnancy Abstrtrak: Etiologi hipospadia belum diketahui dengan pasti dan masih bersifat kontroversial. Faktor lingkungan serta hal yang berpengaruh selama kehamilan dapat menjadi faktor risiko peningkatan kejadian hipospadia. Penelitian ini bertujuan untuk mengetahui faktor risiko hipospadia. Jenis penelitian ialah literature review dengan menggunakan database ClinicalKey, PubMed, dan Google Scholar. Hasil penelitian mendapatkan bahwa dari 47 literatur yang memuat tentang faktor risiko hipospadia, 8 literatur memuat adanya hubungan antara pestisida dengan hipospadia, 3 literatur memuat bahwa merokok berkaitan dengan peningkatan risiko hipospadia, 6 literatur memuat bahwa usia ibu memiliki hubungan kuat dengan peningkatan risiko hipospadia, 8 literatur memuat bahwa bayi berat lahir rendah berkaitan dengan hipospadia dan insufisiensi plasenta menjadi penyebab terjadinya hal tersebut, 5 literatur memuat bahwa beberapa obat obatan yang dikonsumsi ibu hamil selama trimester pertama berkaitan dengan peningkatan risiko hipospadia. Simpulan penelitian ini ialah faktor lingkungan dan kontributor selama kehamilan merupakan faktor risiko hipospadia.Kata kunci: hipospadia, faktor risiko, factor lingkungan, Kontributor selama kehamilan

scholarly journals Pengaruh Kafein terhadap Tekanan Intraokular

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Julian Juanito ◽  
Wenny P. Supit ◽  
Laya M. Rares
Keyword(s):  
Risk Factors ◽  
Intraocular Pressure ◽  
Literature Review ◽  
High Intensity ◽  
External Factors ◽  
Google Scholar ◽  
Caffeine Consumption ◽  
Exclusion Criteria ◽  
Data Bases ◽  
Review Study

Abstract: High intraocular pressure (IOP) is one of the risk factors of glaucoma or worsening of its prognosis. There are a lot of external factors that can affect IOP inter alia exercise, as well as some food and drinks. One of the drinks that could affect IOP is coffee that contains caffeine. This study was aimed to evaluate whether caffeine had an effect on IOP. This was a literature review study using 4 data bases, as follows: Clinical Key, Pub-med, Google Scholar, and Science Direct. The keywords were Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Based on inclusion and exclusion criteria, 10 literatures were selected. The results showed that some literatures reported an increase in IOP after caffeine consumption, the others reported a decrease in IOP, meanwhile some others did not find any change of IOP. In conclusion, the effect of caffeine on IOP was acute. People who had high intensity of caffeine consumption had a more significant increase in IOP after consuming caffeine.Keywords: caffeine, intraocular pressure (IOP)  Abstrak: Peningkatan tekanan intraokular (TIO) merupakan salah satu faktor risiko untuk terjadinya glaukoma atau memperburuk prognosis glaukoma. Terdapat banyak faktor eksternal yang dapat memengaruhi TIO, antara lain olahraga, minuman, dan makanan. Salah satu minuman yang dapat memengaruhi TIO ialah kopi yang mengandung kafein. Penelitian ini bertujuan untuk mengetahui adanya pengaruh kafein pada tekanan intraokular. Jenis penelitian ialah literature review. Pencarian data menggunakan empat database yaitu Clinical key, PubMed, Google scholar, dan Science direct. Kata kunci yang digunakan yaitu Caffeine OR Coffee OR Tea AND IOP OR Intraocular Pressure. Seleksi data berdasarkan kriteria inklusi dan ekslusi mendapatkan 10 literatur. Hasil kajian mendapatkan bahwa beberapa penelitian melaporkan adanya peningkatan TIO setelah konsumsi kafein, penelitian lain melaporkan penurunan TIO, dan terdapat pula penelitian yang tidak menemukan perubahan apapun. Simpulan penelitian ini ialah pengaruh kafein pada TIO hanya berlangsung akut. Individu yang memiliki intensitas konsumsi kafein lebih tinggi menunjukkan peningkatan TIO yang lebih nyata setelah mengonsumsi kafein.Kata kunci: kafein, tekanan intraokular (TIO) 

scholarly journals Mediating role of poverty in the association between environmental factors and cognitive performance in preschoolers

2020 ◽  
Vol 12 (2) ◽  
pp. 24-38
Author(s):  
Carolina Fracchia ◽  
María Soledad Segretin ◽  
María Julia Hermida ◽  
Lucía Prats ◽  
Sebastián J. Lipina
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Cognitive Performance ◽  
Inhibitory Control ◽  
Maternal Age ◽  
Executive Attention ◽  
Mediating Role ◽  
Fluid Reasoning ◽  
The Relationship

TThe association between environmental factors and cognitive performance during childhood could be mediated by poverty (i.e., households with Unsatisfied or Satisfied Basic Needs). This study explored such mediating roles in preschoolers from different socioeconomic backgrounds. Tasks to assess executive attention, working memory, inhibitory control, planning, and fluid reasoning were administered to 250 children aged 4 and 5 years. The results suggested that poverty mediated the effects of family composition, child health, health risk factors, children and adults at home, maternal age, and literacy activities on the performance of executive attention, fluid reasoning, and inhibitory control. These results contribute to our understanding of the relationship between environmental factors and cognitive development through the identification of the mediating role of poverty.

scholarly journals Fatores de Riscos na Fissura Labiopalatina Não Sindrômica

UNICIÊNCIAS ◽  
2021 ◽  
Vol 24 (1) ◽  
pp. 86-93
Author(s):  
Carla Meliso Rodrigues Silvestre ◽  
Renata Cristina Giroto Ferreira da Silva ◽  
Ageo Mario Candido da Silva ◽  
Walkiria Shimoya Bittencourt ◽  
Yolanda Benedita Abadia Martins de Barros ◽  
...  
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Literature Review ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
First Trimester ◽  
Human Beings ◽  
Factors Associated ◽  
Narrative Literature Review

As anomalias craniofaciais representam um grupo amplo de malformações congênitas que afetam uma grande proporção da sociedade mundial. Entre essas se encontram as fissuras de lábio e/ou de palato, anomalia orofacial mais frequente entre os seres humanos que ocasionam problemas estéticos e funcionais nos indivíduos afetados.  A etiologia das fissuras labiopalatinas isoladas ou não-sindrômicas é complexa e multifatorial, associadas à fatores hereditários e ambientais. Este estudo teve como objetivo relatar os fatores genéticos e ambientais associados à etiologia desse tipo de malformação, através de uma revisão narrativa de literatura, a partir das bases de dados: PubMed e Scielo. Os descritores utilizados foram: cleft palate AND cleft lip AND etiology AND risk factors. Incluíram-se artigos nos idiomas inglês e português publicados em periódicos nacionais e internacionais acerca da temática da pesquisa. Baseado na revisão de literatura se pode identificar que os fatores ambientais como: fumo, consumo de álcool, consumo de medicamentos, o não uso de suplementação com polivitamínicos e ácido fólico, exposição a agrotóxicos, idade dos genitores podem aumentar a chance de ocorrência das fissuras labiopalatinas. O acompanhamento gestacional durante o primeiro trimestre gestacional se faz necessário, a fim de monitorar os fatores de risco associados com as fissuras labiopalatinas não sindrômicas.   Palavras-chave: Fissura Palatina. Fenda Labial. Etiologia. Fatores de Risco.   Abstract Craniofacial anomalies represent a broad group of congenital malformations that affect a large proportion of world society. Among them are cleft lip and / or palate, the most frequent orofacial anomaly among human beings that cause aesthetic and functional problems in the affected individuals. The etiology of isolated or non-syndromic cleft lip and palate is complex and multifactorial, associated with hereditary and environmental factors. This study aimed to report the genetic and environmental factors associated with the etiology of this type of malformation through a narrative literature review conducted in October 2020, using the PubMed and Scielo databases. The keywords used were cleft palate AND cleft lip AND etiology AND risk factors. Articles in English and Portuguese published in national and international journals about the research theme were included. Based on the literature review, it can be identified that environmental factors such as smoking, alcohol consumption, medication consumption, the non-use of supplementation with multivitamins and folic acid, exposure to pesticides, age of parents can increase the chance of cleft lip and palate occurrence. Gestational monitoring during the first trimester of pregnancy is necessary in order to monitor the risk factors associated with non-syndromic cleft lip and palate.   Keywords: Cleft Palate. Cleft Lip. Etiology. Risk Factors.

Investigation of Some Modifiable Risk Factors That Lead to Congenital Anomalies: A Review Article

2020 ◽  
Author(s):  
Fatemeh Abdi ◽  
Mahdieh Mehrvar ◽  
Sima Valizadeh ◽  
Mahta Mazaheri
Keyword(s):  
Risk Factors ◽  
Environmental Factors ◽  
Congenital Anomalies ◽  
Meta Analysis ◽  
First Trimester ◽  
Modifiable Risk Factors ◽  
Inborn Errors ◽  
Topical Retinoids ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: Congenital anomalies are inborn errors of development. Genetic and environmental factors are known causes of congenital anomalies. Environmental factors are modifiable risk factors. This review focuses on modifiable risk factors for birth defects. There is a strong link between alcohol use and an increased risk of congenital anomalies. Marijuana can be expected to cause fetal growth restriction; smoking before conception, even with cessation in the first trimester, may also pose a risk for gastroschisis. Benzodiazepines during the first trimester were associated with Dandy–Walker malformation ,anophthalmia or microphthalmia  and esophageal atresia. While oral retinoids are absolutely contraindicated, topical retinoids, should conservatively be avoided during pregnancy but  if  were used by accident, the existing data can reduce the anxiety of happening adverse pregnancy outcomes. Antihypertensives such as labetalol, methyldopa and extended release nifedipine are relatively safe choices. Antiemeticssuch as doxylamine-pyridoxine and metoclopramide may have potential teratogenicity in first trimester. Ondansetron use was not significantly associated with major congenital anomalies but recent meta-analysis suggested more concern.  An antiepileptic such as valproate poses the highest risk among antiepileptic drugs, whereas the prevalence of congenital anomalies is the lowest with lamotrigine, levetiracetam, and oxcarbazepine. Education and counseling to women who are planning to become pregnant can reduce the risk of congenital anolamies.  

Trimethylamine N-oxide (TMAO): a new attractive target to decrease cardiovascular risk

2021 ◽  
pp. postgradmedj-2021-139839
Author(s):  
Ione Swanepoel ◽  
April Roberts ◽  
Chelsea Brauns ◽  
Devahuti R Chaliha ◽  
Veronica Papa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Literature Review ◽  
Future Development ◽  
Cvd Risk ◽  
Increased Risk ◽  
Cardiometabolic Disorders ◽  
The Relationship

Cardiovascular disease (CVD) is one of the greatest disease burdens and takes the lives of many each year. There are many risk factors both modifiable and non-modifiable which contribute to the onset and progression of the disease. Trimethylamine N-oxide (TMAO) in recent years has been found to have a correlation with CVD onset. Those with increased levels of the metabolite have a markedly increased risk of future development of cardiometabolic disorders.This literature review aimed to critique past studies undertaken to find a consensus of the significance of the interrelationship between TMAO and cardiovascular risk. A definite link between TMAO levels and a CVD outcome was found. The majority of the literature stated the relationship with evidence; however, there is still some uncertainty as to why and how the correlation occurs. Further study needs to be done to further dissect and understand the relationship between TMAO and CVD risk.

scholarly journals Faktor Risiko Terjadinya Coronavirus Disease 2019 (Covid-19) pada Penyandang Diabetes Melitus Tipe 2

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Pomantow A. L. Roeroe ◽  
Bisuk P. Sedli ◽  
Octavianus Umboh
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Literature Review ◽  
Blood Glucose Control ◽  
Google Scholar ◽  
Elderly Age ◽  
Coagulation Activity ◽  
Review Study ◽  
Diabetes Melitus

Abstract: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 and has been declared as a pandemic by WHO in March 11, 2020. This disease is an additional problem in people with type 2 diabetes mellitus (T2DM). Several studies have shown that diabetes is a risk factor for COVID-19. This study was aimed to determine the risk factors for the occurrence of Coronavirus Disease 2019 (COVID-19) in T2DM patients. This was a literature review study using several journal databases, namely Google Scholar, PubMed, and Science Direct. Literature searching was performed by using the PICOS method and the analysis was carried out qualitatively The results obtained 10 literatures reporting that T2DM would increase the severity and mortality of COVID-19 patients related to elderly age, obesity, chronic systemic inflammation, increased coagulation activity, potential direct damage to the pancreas, changes in expression of ACE2 receptors, dysregulation of the number, activity of immune cells, alveolar dysfunction, and endothelial dysfunction. There was not yet strong evidence regarding discontinuation or continuation of various diabetes drugs in COVID-19 patients, but insulin remains the recommended agent for blood glucose control. In conclusion, T2DM increases the severity and mortality rate of COVID-19 patients Keywords: diabetes mellitus; COVID-19; risk factors Abstrak: Coronavirus Disease 2019 (COVID-19) merupakan salah satu penyakit infeksi yang disebabkan oleh SARS-CoV-2 dan telah ditetapkan sebagai pandemi oleh WHO pada 11 Maret 2020. Penyakit ini menjadi masalah tambahan bagi penyandang diabetes melitus tipe 2 (DMT2). Beberapa penelitian menunjukkan bahwa diabetes merupakan salah satu faktor risiko terjadinya COVID-19. Penelitian ini bertujuan untuk mengetahui faktor risiko terjadinya COVID-19 pada penyandang DMT2. Jenis penelitian ialah literature review menggunakan laporan penelitian dari beberapa database jurnal, yaitu google scholar, PubMed, dan ClinicalKey. Pencarian artikel menggunakan metode PICOS dan analisis dilakukan secara kualitatif. Hasil penelitian mendapatkan 10 laporan penelitian yang melaporkan bahwa DMT2 meningkatkan tingkat keparahan dan mortalitas pasien COVID-19 akibat adanya mekanisme terkait dengan usia lanjut, obesitas, peradangan sistemik kronis, peningkatan aktivitas koagulasi, potensi kerusakan langsung pankreas, perubahan ekspresi reseptor ACE2, disregulasi jumlah dan aktivitas sel imun, disfungsi alveolar, dan disfungsi endotel. Belum terdapat bukti kuat mengenai penghentian atau pelanjutan berbagai obat diabetes pada pasien COVID-19, tetapi insulin tetap menjadi obat yang disarankan untuk mengontrol glukosa darah. Simpulan penelitian ini ialah DMT2 meningkatkan tingkat keparahan dan mortalitas dari pasien COVID-19.Kata kunci: diabetes melitus tipe 2 (DMT2), COVID-19, faktor risiko

scholarly journals Pneumonia Covid-19 dengan Gangguan Ginjal Akut

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rivaldy Wahab ◽  
Efata Poli ◽  
Cerelia Sugeng
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Literature Review ◽  
Kidney Injury ◽  
Google Scholar ◽  
Nephrotoxic Drugs ◽  
Review Study ◽  
Diabetes Melitus

Abstract: SARS-CoV-2 infection causes various symptoms, including mild, moderate, severe, and critical symptoms. Severe SARS-CoV-2 infection can cause pneumonia, acute respiratory syndrome, kidney failure, and even death. This study was aimed to evaluate patients with COVID-19 pneumonia associated with acute kidney injury (AKI). This was a literature review study using three databases, namely PubMed, ClinicalKey, and Google Scholar. The keywords used were acute kidney injury AND pneumonia AND COVID-19. The results showed 10 selected literatures based on inclusion and exclusion criteria. All literatures stated that males dominated the study samples (52.4-73%). The risk factors of AKI in COVID-19 pneumonia were co-morbidities which were predominantly hypertension, diabetes mellitus, COPD, cardiovascular diseases, and respiratory diseases, as well as nephrotoxic drugs. AKI was the complication of pneumonia COVID-19. The mortality rate was higher among pneumonia COVID-19 patients with AKI compared to pneumonia COVID-19 patients without AKI. In conclusion, AKI is the complication of COVID-19 pneumonia. Nephrotoxic drugs and co-morbidities are the risk factors of AKI in COVID-19 pneumonia.  The mortality rate is higher in patients with AKI compared to those without AKI.Keywords: acute kidney injury, pneumonia COVID-19, coronavirus disease 2019  Abstrak: Infeksi SARS-CoV-2 menimbulkan berbagai gejala baik yang ringan, sedang, berat        hingga kritis. Infeksi SARS-CoV-2 yang berat dapat menyebabkan pneumonia, sindrom pernapasan akut, gagal ginjal, bahkan kematian. Penelitian ini bertujuan untuk mengetahui gambaran pneumonia COVID-19 dengan gangguan ginjal akut (GGA). Jenis penelitian ialah literature review dengan pencarian data menggunakan tiga database yaitu PubMed, ClinicalKey, dan Google Scholar. Kata kunci yang digunakan ialah acute kidney injury AND pneumonia AND COVID-19. Hasil penelitian mendapatkan 10 literatur berdasarkan kriteria inklusi dan eksklusi. Pada semua literatur didapatkan jenis kelamin laki-laki yang mendominasi sampel penelitian (52,4-73%). Riwayat penyakit didominasi oleh hipertensi, diabetes melitus, PPOK, penyakit kardiovaskuler, dan penyakit pernapasan. GGA merupakan komplikasi pada pneumonia COVID-19. Pasien pneumonia COVID-19 dengan gangguan ginjal akut memiliki angka kematian yang lebih tinggi dibandingkan dengan pasien pneumonia COVID-19 tanpa gangguan ginjal akut di rumah sakit. Faktor risiko gangguan ginjal akut pada pneumonia COVID-19, antara lain: penggunaan obat yang bersifat nefrotoksik, memiliki komorbid (usia tua, diabetes mellitus, penyakit kardiovaskular, penyakit ginjal kronis, dll). Sinpulan penelitian ini ialah GGA merupakan komplikasi pada pneumonia COVID-19. Penggunaan obat yang bersifat nefrotoksik dan adanya komorbid merupakan faktor risiko terjadinya GGA pada pasien pneumonia COVID-19. Angka kematian lebih tinggi terdapat pada pasien pneumonia COVID-19 dengan GGA dibandingkan dengan yang tanpa GGA.kata kunci: gangguan ginjal akut, pneumonia COVID-19, coronavirus disease 2019

scholarly journals LITERATURE REVIEW: RISK FACTORS OF INCREASING TUBERCULOSIS INCIDENCE

2021 ◽  
Vol 16 (1) ◽  
pp. 106-113
Author(s):  
Joko Sapto Pramono
Keyword(s):  
Risk Factors ◽  
Literature Review ◽  
Close Contact ◽  
Google Scholar ◽  
Social Contacts ◽  
Increased Risk ◽  
The Family ◽  
Family Level ◽  
History Of ◽  
And Behavior

ABSTRACT   Globally, the incidence of Tuberculosis was still quite high, there were an estimated that 10 million people are infected with Tuberculosis and even 44% of cases are in Southeast Asia, Indonesia was in the 2nd position in the world after India and every year it is still increasing. Tuberculosis is transmitted through droplets of sufferers when coughing or sneezing, close contact is very vulnerable to the transmission process in addition to other supporting factors. This paper aims to review various sources regarding the risk factors for an increase in the incidence of tuberculosis. The method used was literature review sourced from the Google scholar, ScienceDirect, and ProQuest database as well as other sources such as textbooks and reports published in 2015 to 2020. The results of the literature review showed that most of the risk factors for the incidence of tuberculosis were a history of close contact, age, gender, lifestyle and behavior. Meanwhile, the factors that contribute to the increased risk are occupancy density, ventilation and house lighting, as well as factors for decreased immune system including nutritional status and comorbidities, although at the age of 0-5 years who have received BCG immunization, they were still susceptible to primary tuberculosis infection. Controlling the increased incidence of tuberculosis should be directed at preventing transmission, especially at the family level and   close social contacts as well as increasing awareness of correct coughing and sputum behavior. Key words: risk factors; incidence; tuberculosis     ABSTRAK   Serara global angka insidensi Tuberkulosis dunia   masih cukup tinggi, diperkirakan 10 juta   orang  terinfeksi tuberkulosis bahkan 44% kasus  berada di  Asia Tenggara, Indonesia pada posisi rangking   ke-2 dunia setelah India  dan setiap tahun masih meningkat. Tuberkulosis ditularkan melalui droplet  penderita saat batuk atau bersin, kontak dekat menjadi sangat rentan terjadinya proses penularan disamping faktor-faktor lain yang menunjang.  Tulisan  ini bertujuan untuk mengulas berbagai sumber mengenai faktor risiko peningkatan angka insidensi Tuberkulosis. Metode yang digunakan adalah  tinjauan literatur    yang bersumber dari  database Google scholar, ScienceDirect, dan ProQuest   selain itu juga sumber lainnya seperti buku ajar dan laporan yang diterbitkan pada tahun 2015 hingga 2020.  Hasil tinjauan literatur menunjukkan sebagian besar faktor risiko angka insidensi Tuberkulosis adalah riwayat kontak erat, usia, jenis kelamin,  gaya hidup dan perilaku. Sementara faktor yang menunjang peningkatan risiko adalah kepadatan hunian, ventilasi dan pencahayaan rumah, begitu pula faktor penurunan daya tahan tubuh meliputi status gizi dan  penyakit penyerta, walaupun pada usia 0-5 tahun yang telah mendapatkan imunisasi BCG, namun masih rentan terinfeksi Tuberkulosis primer.   Hendaknya  pengendalaian peningkatan insidensi Tuberkulosis   diarahkan pada pencegahan penularan khususnya di tingkat keluarga  dan kontak sosial dekat serta peningkatan kesadaran perilaku batuk dan membuang dahak yang benar. Kata kunci: Faktor risiko; insidensi; tuberkulosis

scholarly journals Risk of Typical Diabetes-Associated Complications in Different Clusters of Diabetic Patients: Analysis of Nine Risk Factors

2021 ◽  
Vol 11 (5) ◽  
pp. 328
Author(s):  
Michael Leutner ◽  
Nils Haug ◽  
Luise Bellach ◽  
Elma Dervic ◽  
Alexander Kautzky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Diabetic Patients ◽  
Complication Risk ◽  
Increased Risk ◽  
Icd 10 ◽  
Healthy Control ◽  
Design And Methods ◽  
The Relationship ◽  
Observation Period

Objectives: Diabetic patients are often diagnosed with several comorbidities. The aim of the present study was to investigate the relationship between different combinations of risk factors and complications in diabetic patients. Research design and methods: We used a longitudinal, population-wide dataset of patients with hospital diagnoses and identified all patients (n = 195,575) receiving a diagnosis of diabetes in the observation period from 2003–2014. We defined nine ICD-10-codes as risk factors and 16 ICD-10 codes as complications. Using a computational algorithm, cohort patients were assigned to clusters based on the risk factors they were diagnosed with. The clusters were defined so that the patients assigned to them developed similar complications. Complication risk was quantified in terms of relative risk (RR) compared with healthy control patients. Results: We identified five clusters associated with an increased risk of complications. A combined diagnosis of arterial hypertension (aHTN) and dyslipidemia was shared by all clusters and expressed a baseline of increased risk. Additional diagnosis of (1) smoking, (2) depression, (3) liver disease, or (4) obesity made up the other four clusters and further increased the risk of complications. Cluster 9 (aHTN, dyslipidemia and depression) represented diabetic patients at high risk of angina pectoris “AP” (RR: 7.35, CI: 6.74–8.01), kidney disease (RR: 3.18, CI: 3.04–3.32), polyneuropathy (RR: 4.80, CI: 4.23–5.45), and stroke (RR: 4.32, CI: 3.95–4.71), whereas cluster 10 (aHTN, dyslipidemia and smoking) identified patients with the highest risk of AP (RR: 10.10, CI: 9.28–10.98), atherosclerosis (RR: 4.07, CI: 3.84–4.31), and loss of extremities (RR: 4.21, CI: 1.5–11.84) compared to the controls. Conclusions: A comorbidity of aHTN and dyslipidemia was shown to be associated with diabetic complications across all risk-clusters. This effect was amplified by a combination with either depression, smoking, obesity, or non-specific liver disease.

scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies

2021 ◽  
Vol 14 ◽  
pp. 117954412110287
Author(s):  
Mir Sohail Fazeli ◽  
Vadim Khaychuk ◽  
Keith Wittstock ◽  
Boris Breznen ◽  
Grace Crocket ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Literature Review ◽  
Rheumatoid Factor ◽  
Qualitative Evidence Synthesis ◽  
Cvd Risk ◽  
Rheumatoid Arthritis Risk ◽  
Published Evidence ◽  
Increased Risk

Objective: To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents. Methods: Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out. Results: A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients. Conclusion: Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.

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