Prevalence and predictors of seizure in patients with Alzheimer’s disease at a tertiary care center in Riyadh, Saudi Arabia

Purpose: To assess the prevalence and predictors of seizures in patients with Alzheimer’s disease (AD) at a Saudi tertiary hospital.Methods: A retrospective, matched case-control study was conducted using the electronic medical records of patients with AD who had an unprovoked seizure, from October 2015 to May 2018.Results: Nineteen cases and 195 controls were identified. Statistically significant risk factors for an unprovoked seizure in patients diagnosed with AD were hypertension (p = 0.001), autoimmune disease, stroke and TIA (p = 0.001). The multivariate logistic regression analysis identified hypertension (OR = 2.89; p = 0.009) and autoimmune disease (OR = 19.6; p = 0.045) as predictors of unprovoked seizure in AD patients.Conclusion: The occurrence of unprovoked seizures is more likely in severe cases of AD. In addition, the risk of seizure in patients with AD increases with two co-morbid conditions, hypertension, and autoimmune disease. However, further studies are required to determine the underlying mechanism of the association between the two risk factors and AD.

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The Viral Hypothesis in Alzheimer’s Disease: Novel Insights and Pathogen-Based Biomarkers

Journal of Personalized Medicine ◽

10.3390/jpm10030074 ◽

2020 ◽

Vol 10 (3) ◽

pp. 74 ◽

Cited By ~ 2

Author(s):

Sean X Naughton ◽

Urdhva Raval ◽

Giulio M. Pasinetti

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Innate Immune System ◽

Antimicrobial Properties ◽

Significant Risk ◽

Amyloid Β ◽

Innate Immune ◽

Microbial Pathogens ◽

Viral Hypothesis

Early diagnosis of Alzheimer’s disease (AD) and the identification of significant risk factors are necessary to better understand disease progression, and to develop intervention-based therapies prior to significant neurodegeneration. There is thus a critical need to establish biomarkers which can predict the risk of developing AD before the onset of cognitive decline. A number of studies have indicated that exposure to various microbial pathogens can accelerate AD pathology. Additionally, several studies have indicated that amyloid-β possess antimicrobial properties and may act in response to infection as a part of the innate immune system. These findings have led some to speculate that certain types of infections may play a significant role in AD pathogenesis. In this review, we will provide an overview of studies which suggest pathogen involvement in AD. Additionally, we will discuss a number of pathogen-associated biomarkers which may be effective in establishing AD risk. Infections that increase the risk of AD represent a modifiable risk factor which can be treated with therapeutic intervention. Pathogen-based biomarkers may thus be a valuable tool for evaluating and decreasing AD risk across the population.

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Physical activity in Alzheimer's disease: research in its infancy or why we need more randomized controlled trials

International Psychogeriatrics ◽

10.1017/s1041610213001981 ◽

2013 ◽

Vol 26 (1) ◽

pp. 7-7 ◽

Cited By ~ 2

Author(s):

Nicola T. Lautenschlager

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Randomized Controlled Trials ◽

Physical Inactivity ◽

Significant Risk ◽

Controlled Trials ◽

Randomized Controlled

With the global aging of our societies and predicted increase of cognitive impairment and dementia, it is no surprise that there is an increasing interest in the research community, but also among clinicians and the general population to learn more about how to focus on modifiable protective factors and how to avoid modifiable risk factors. A recent review of systematic reviews and meta-analyses on significant risk factors for Alzheimer's disease (AD) highlighted the importance of diabetes, hypertension, obesity, smoking, depression, cognitive inactivity, and physical inactivity (Barnes and Yaffe, 2011). For physical inactivity, for example, the authors reported that up to one million cases of AD could be prevented globally if a physical inactivity could be reduced by 25%. However, we should not forget about the various stages of prevention, and especially in the field of psychogeriatrics should also ask what preventative measures might be effective for older adults who have already experienced cognitive impairment. So we could focus on a secondary prevention approach for individuals with mild cognitive impairment (MCI) or on a tertiary preventative approach for patients with dementia. The number of randomized controlled trials (RCT) investigating the effectiveness of physical activity on cognition is limited for healthy participants and those with MCI, but is even more sparse for those with dementia. Even with the limited number of studies it often is difficult to compare RCTs due to the huge variation in inclusion and exclusion criteria, methodology, instruments used and outcomes, intervention and duration of interventions, and observations.

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Incidence and risk factors for retinopathy of prematurity at a medical college hospital in rural Tamil Nadu, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20204410 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2119

Author(s):

Sengodi Elumalai ◽

Rajasekaran Kathavarayan ◽

Venkatesh Govindasamy

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Blood Transfusion ◽

Retinopathy Of Prematurity ◽

Tamil Nadu ◽

Care Center ◽

Tertiary Care ◽

Significant Risk ◽

College Hospital

Background: The objective of the research was to evaluate the incidence of retinopathy of prematurity (ROP), association of prenatal and postnatal risk factors, pattern of ROP and treatment outcomes among infants admitted to neonatal intensive care unit (NICU) of tertiary care center located in Thiruvannamalai, Tamil Nadu.Methods: A retrospective study done in all infants admitted between April 2019 and March 2020 who met the criteria for ROP screening with gestational age (GA) less than or equal to 36 weeks or birth weight less than 2000 grams or with GA more than 36 weeks and birth weight more than 2000 gram with significant risk factors like intrauterine growth restriction, respiratory distress syndrome, sepsis, long term oxygen use, phototherapy, blood transfusion and maternal anemia. Treatment was offered to infants with stage 3 ROP and stage 2 in zone 2 with or without plus disease. Qualified infants were treated with argon laser photocoagulation within 72 hours of diagnosis. They were followed until the disease was successfully treated.Results: Out of total 3121 neonates, 717 neonates met the screening criteria. Incidence of ROP was found to be 33% (n=237). 46.4% (n=110) of ROP belongs to 32-36 weeks GA. 42.6% (n=101) of ROP belongs to 1500-2000 gm birth weight.Conclusions: Incidence of ROP is quite high in high risk neonates in our unit. Significant risk factors are long term oxygen use, blood transfusion and sepsis.

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Risk factors for symptomatic venous thromboembolism in Thai hospitalised medical patients

Thrombosis and Haemostasis ◽

10.1160/th11-08-0555 ◽

2011 ◽

Vol 106 (12) ◽

pp. 1103-1108 ◽

Cited By ~ 7

Author(s):

Noppacharn Uaprasert ◽

Laddawan Vajragupta ◽

Numphung Numkarunarunrote ◽

Nathaporn Tanpowpong ◽

Pranee Sutcharitchan ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

High Risk ◽

Autoimmune Disease ◽

Tertiary Care ◽

Significant Risk ◽

Solid Tumours ◽

Medical Patients ◽

High Risk Patients ◽

Risk Patients

SummaryThromboprophylaxis for venous thromboembolism (VTE) failed to reduce overall mortality in hospitalised medical patients. As a VTE prediction model for Asians is still lacking, this study aimed to identify very high risk patients who would be the main target for prevention. In 2009, medical patients admitted to King Chulalongkorn Memorial hospital, a tertiary care centre, were prospectively evaluated for risk factors. The high-risk cohort was monitored for symptomatic VTE until six weeks after discharge. No heparin prophylaxis was given. Of 1,290 high-risk patients, 27 (2.1%, 95% confidence interval [CI] 1.3–2.9) developed proven VTE, 25.9% of which were diagnosed after discharge. Cases with VTE stayed longer in the hospital (median 18 vs. 11 days, p < 0.001). The significant risk factors in a multivariate analysis were autoimmune disease, solid tumours, family history of VTE, varicose vein and oestrogen with the relative risks of 11.8, 4.7, 120.3, 40.1 and 17.1 (p < 0.001, 0.001, 0.001, 0.002 and 0.038), respectively. Either autoimmune disease or solid tumours were found in 63% of VTE with the relative risk of 4.5 (95% CI 2.1–9.7, p < 0.001). In contrast, previously reported VTE scores in western patients could not stratify the VTE risks, but all the scores predicted higher mortality. In conclusion, VTE is common in Asian hospitalised medical patients. Patients with autoimmune disease and those with solid tumours are highly susceptible to VTE. A prophylactic strategy in these groups is required.

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Cytomegalovirus Retinitis Outcomes in HIV-Infected and Non–HIV Patients at a Tertiary Care Center

Journal of VitreoRetinal Diseases ◽

10.1177/2474126416683084 ◽

2017 ◽

Vol 1 (1) ◽

pp. 57-64 ◽

Cited By ~ 2

Author(s):

Anton Orlin ◽

Jennifer Nadelmann ◽

Mrinali Gupta ◽

Sarju Patel ◽

Donald J. D’Amico ◽

...

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Care Center ◽

Tertiary Care ◽

Significant Risk ◽

Final Visual Acuity ◽

Tertiary Care Center ◽

Hiv Patients ◽

Cmv Retinitis

Purpose: To describe cytomegalovirus (CMV) retinitis outcomes in HIV-infected and non–HIV patients at a tertiary care center. Participants: Twenty-six eyes from 20 patients with active CMV retinitis were included in this study. Patients were immunocompromised due to HIV or secondary to immunosuppressive therapy for malignancy and organ transplantation. Methods: This is a retrospective, observational study of patients with newly diagnosed active CMV retinitis. The main outcomes included the incidence of visual acuity loss, the loss of visual acuity to 20/200 or worse, and the loss of 3 lines of vision or more. Secondary outcomes included the identification of risk factors for these visual results and the development of various complications such as retinal detachment (RD) and cataract formation. Results: In all, 51.9% (n = 14) of eyes lost vision from baseline at most recent follow-up and 34.6% (n = 9) lost 3 lines or more of vision, 34.6% (n = 9) of the eyes lost significant vision at most recent follow-up and had a final vision of 20/200 or worse, and 22.73% of phakic eyes underwent cataract surgery, whereas 23.1% (n = 6) of eyes developed RD. Patients presenting with a CD4+ T-cell count <100 cells/µL were more likely to lose vision when compared to those presenting with a count >100 cells/µL ( P = .0440). Although not statistically significant, patients who were immunocompromised due to HIV were less likely to lose 3 or more lines of vision ( P = .1881) and less likely to have a final visual acuity of 20/200 or worse ( P = .1881), when compared to patients who were immunocompromised due to other reasons. There was also a nonsignificant trend for eyes affected by a larger area of CMV retinitis at baseline (>25%) to have a final visual acuity of 20/200 or worse when compared to eyes with CMV retinitis involving <25% of the total retina ( P = .089). We did not detect trends or associations between any other risk factors tested and visual outcomes. We did not identify an association between HIV status and baseline area or zone affected by CMV retinitis. Conclusions: Our cohort demonstrated that CMV retinitis remains a vision-threatening problem among patients who are immunocompromised due to HIV or other conditions. Immunocompromised patients are still at a significant risk of vision loss and complications from CMV retinitis and should be managed by a multidisciplinary team of physicians. In the immediate future, improved therapies are necessary to achieve immune recovery in patients, particularly for those remaining chronically immunosuppressed.

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Risk of progression from mild memory impairment to clinically diagnosable Alzheimer's disease in a Japanese community (from the Nakayama Study)

International Psychogeriatrics ◽

10.1017/s104161021000222x ◽

2010 ◽

Vol 23 (5) ◽

pp. 772-779 ◽

Cited By ~ 2

Author(s):

Naomi Sonobe ◽

Ryuji Hata ◽

Tomohisa Ishikawa ◽

Kantaro Sonobe ◽

Teruhisa Matsumoto ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Family History ◽

Memory Impairment ◽

Significant Risk ◽

The Elderly ◽

Elderly Subjects ◽

Risk Of Progression ◽

History Of

ABSTRACTBackground: Memory impairment has been proposed as the most common early sign of Alzheimer's disease (AD). The aims of this work were to evaluate the risk of progression from mild memory impairment/no dementia (MMI/ND) to clinically diagnosable AD in a community-based prospective cohort and to establish the risk factors for progression from MMI/ND to AD in the elderly.Methods: Elderly subjects aged over 65 years were selected from the participants in the first Nakayama study. MMI/ND was defined as memory deficit on objective memory assessment, without dementia, impairment of general cognitive function, or disability in activities of daily living. A total of 104 MMI/ND subjects selected from 1242 community-dwellers were followed longitudinally for five years.Results: During the five-year follow-up, 11 (10.6%) subjects were diagnosed with AD, five (4.8%) with vascular dementia (VaD), and six (5.8%) with dementia of other etiology. Logistic regression analysis revealed that diabetes mellitus (DM) and a family history of dementia (within third-degree relatives) were positively associated with progression to AD, while no factor was significantly associated with progression to VaD or all types of dementia.Conclusions: DM and a family history of dementia were significant risk factors for progression from MMI/ND to clinically diagnosable AD in the elderly in a Japanese community.

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Predictors of mortality in children hospitalized with severe acute malnutrition

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201644 ◽

2020 ◽

Vol 7 (5) ◽

pp. 1088

Author(s):

Vinnamangalam Mani Baskaran ◽

Sridevi A. Naaraayan ◽

Dorairaj Priyadharishini

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Severe Acute Malnutrition ◽

Care Center ◽

Univariate Analysis ◽

Tertiary Care ◽

Significant Risk ◽

Acute Malnutrition ◽

World Health ◽

Prognostic Features

Background: Severe acute malnutrition (SAM) is a leading cause of morbidity and mortality in children worldwide. Identification of factors contributing to mortality is crucial to decrease the mortality due to SAM. This study aims at identification of factors affecting mortality in hospitalized SAM children.Methods: This study was done in general pediatric wards of a Government tertiary care center from July 2015 to June 2016. Total 200 children admitted to the hospital with Severe Acute Malnutrition (SAM) as per World Health Organization (WHO) criteria were enrolled. Demographic and clinical data were recorded in structured proforma. These children were followed up till death or discharge and their progress and outcome were noted. The risk factors considered were younger age (infancy), female sex and presence of systemic illness, sepsis, retroviral positivity, severe anaemia, pneumonia and diarrhea and these were compared between those who died and survivors. Univariate analysis and logistic regression analysis were performed to determine the significant risk factors.Results: The mortality rate was 10.5%. Presence of systemic illness, sepsis and retroviral positivity were significant risk factors at the end of univariate analysis and multivariate logistic regression, while the others were insignificant.Conclusions: Systemic diseases, sepsis and retroviral disease are poor prognostic features and are risk factors of mortality in hospitalized SAM children.

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