scholarly journals Acute Childhood Cardiorenal Syndrome and Impact of Cardiovascular Morbidity on Survival

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Wasiu A. Olowu
Keyword(s):  
Risk Factors ◽  
Kidney Function ◽  
Preventive Measures ◽  
Cardiorenal Syndrome ◽  
Cardiovascular Morbidity ◽  
Acute Glomerulonephritis ◽  
Cumulative Mortality ◽  
All Cause Mortality ◽  
Type 3 ◽  
Better Than

Cardiorenal syndrome (CRS) clinical types, prevalence, aetiology, and acute cardiovascular morbidity impact on the outcome of acute kidney function perturbation were determined. Forty-seven of 101 (46.53%) patients with perturbed kidney function had CRS. Types 3 and 5 CRS were found in 10 and 37 patients, respectively. Type 3 CRS was due to acute glomerulonephritis (AGN; ), captopril (), frusemide (), and hypovolaemia (). Malaria-associated haemoglobinuria (), septicaemia (), lupus nephritis (), tumour lysis syndrome (), and acute lymphoblastic leukaemia () caused Type 5 CRS. The cumulative mortality in hypertensive CRS was similar to nonhypertensive CRS (51.4% versus 40.9%; ). Mortality in CRS and non-CRS was similar (45.7% versus 24.5%; ). Type 5 survived better than type 3 CRS (66.7% versus 12.5%; ). Risk factors for mortality were Type 3 CRS (), AGN-associated CRS (), dialysis requiring CRS (), and heart failure due to causes other than anaemia (). All-cause-mortality was 34.2%. Preventive measures aimed at the preventable CRS aetiologies might be critical to reducing its prevalence.

scholarly journals Predictive Value of Creatinine-based Equations of Kidney Function in the Long-term Prognosis in United Arab Emirates Patients

2021 ◽  
Vol 36 (1) ◽  
pp. e217-e217
Author(s):  
Saif Al-Shamsi ◽  
Romona D. Govender ◽  
Jeffrey King
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Kidney Function ◽  
Mortality Prediction ◽  
The Body ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cox Regression Analysis ◽  
All Cause Mortality

Objectives: Chronic kidney disease (CKD) is an independent predictor of mortality. Several creatinine-based equations are used to assess the estimated glomerular filtration rate or creatinine clearance and mortality prediction in various ethnic populations. Similarly, renal insufficiency is associated with poor prognosis of UAE nationals with cardiovascular disease (CVD) risk factors. However, the equation that best assesses prognosis among these patients is unknown. This study aimed to compare the prognostic abilities of different creatinine-based kidney function equations for predicting all-cause mortality in UAE nationals with vascular comorbidities. Methods: This retrospective observational study analyzed 1186 patients (54.0% men) with CVD risk factors. Multivariable Cox regression analysis was used to evaluate the associations of categorical renal function stages with all-cause mortality. Measures of performance in each equation assessed with respect to all-cause mortality were evaluated and compared to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation by calculating the C-index, net reclassification index (NRI), and integrated discrimination index. Results: Over a median follow-up of 8.9 years, the cumulative incidence of all-cause mortality was 9.4% (n = 112). After multivariable adjustment, the discriminative ability for all-cause mortality was significantly higher in the body surface area-adjusted Cockcroft-Gault (BSA-CG) formula than in the CKD-EPI equation (C-indices: 0.869 vs. 0.861, respectively, p =0.037). NRI was significantly positive and favored the BSA-CG formula (0.54; 95% confidence interval: 0.35–0.64) compared to the CKD-EPI equation. Conclusions: Our findings suggest that the BSA-CG equation may have the potential to slightly improve mortality prediction compared to the CKD-EPI equation in UAE nationals with vascular risk. Further large multicenter studies are warranted to confirm our findings.

scholarly journals One-hour glucose value as a long-term predictor of cardiovascular morbidity and mortality: the Malmö Preventive Project

2018 ◽  
Vol 178 (3) ◽  
pp. 225-236 ◽  
Author(s):  
Mette L Nielsen ◽  
Manan Pareek ◽  
Margrét Leósdóttir ◽  
Karl-Fredrik Eriksson ◽  
Peter M Nilsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Events ◽  
Cardiovascular Death ◽  
Cardiovascular Morbidity ◽  
Clinical Risk Factors ◽  
Morbidity And Mortality ◽  
Ratio Test ◽  
Clinical Risk ◽  
Cardiovascular Morbidity And Mortality ◽  
All Cause Mortality

Objective To examine the predictive capability of a 1-h vs 2-h postload glucose value for cardiovascular morbidity and mortality. Design Prospective, population-based cohort study (Malmö Preventive Project) with subject inclusion 1974–1992. Methods 4934 men without known diabetes and cardiovascular disease, who had blood glucose (BG) measured at 0, 20, 40, 60, 90 and 120 min during an OGTT (30 g glucose per m2 body surface area), were followed for 27 years. Data on cardiovascular events and death were obtained through national and local registries. Predictive capabilities of fasting BG (FBG) and glucose values obtained during OGTT alone and added to a clinical prediction model comprising traditional cardiovascular risk factors were assessed using Harrell’s concordance index (C-index) and integrated discrimination improvement (IDI). Results Median age was 48 (25th–75th percentile: 48–49) years and mean FBG 4.6 ± 0.6 mmol/L. FBG and 2-h postload BG did not independently predict cardiovascular events or death. Conversely, 1-h postload BG predicted cardiovascular morbidity and mortality and remained an independent predictor of cardiovascular death (HR: 1.09, 95% CI: 1.01–1.17, P = 0.02) and all-cause mortality (HR: 1.10, 95% CI: 1.05–1.16, P < 0.0001) after adjusting for various traditional risk factors. Clinical risk factors with added 1-h postload BG performed better than clinical risk factors alone, in predicting cardiovascular death (likelihood-ratio test, P = 0.02) and all-cause mortality (likelihood-ratio test, P = 0.0001; significant IDI, P = 0.0003). Conclusion Among men without known diabetes, addition of 1-h BG, but not FBG or 2-h BG, to clinical risk factors provided incremental prognostic yield for prediction of cardiovascular death and all-cause mortality.

scholarly journals The Corona care – Prevention is better than cure

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 81-85
Author(s):  
Archana R ◽  
Varadharaju B
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Preventive Measures ◽  
Virus Transmission ◽  
Care Providers ◽  
Effective Prevention ◽  
Susceptible Population ◽  
Hygienic Measures ◽  
Threatening Situation ◽  
Better Than

The threat of Coronavirus disease caused by a novel corona virus SARS-Cov2 is becoming a global life threatening situation. In the affected countries and regions , innumerable measures have been enforced to reduce the person to person virus transmission as well as to curb the outbreak. In the case of  infectious pandemics like this, prevention is always better than cure. The specific focus of preventive measures is more on the susceptible population of children , health care providers and elderly people. Many of the people practice safety measures without proper knowledge as to whether these measures are sufficient or not to prevent the spread of the virus . It is therefore highly relevant to be aware of the  preventive measures for Corona so as to practice it effectively. The major  primary preventive measures to be implemented are regular practice of hygienic measures, social distancing , avoiding person to person contact , judicious use of masks, practice of screening and quarantine. Along with these, usage of  secondary preventive measures along with avoidance of the risk factors are to be properly exercised. The current review highlights  thepractice of  salient primary measures, secondary measures and screening measures along with the elaboration of risk factors which will beadvantageous in adding to the knowledge and awareness about effective prevention for Covid 19.

Graft detachments in endothelial keratoplasty

2021 ◽  
pp. bjophthalmol-2020-318092
Author(s):  
Rashmi Deshmukh ◽  
Sridevi Nair ◽  
Darren Shu Jeng Ting ◽  
Tushar Agarwal ◽  
Jacqueline Beltz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preventive Measures ◽  
Endothelial Keratoplasty ◽  
Common Complication ◽  
Prevention Measures ◽  
Descemet Stripping Endothelial Keratoplasty ◽  
Secondary Interventions ◽  
Different Types ◽  
Incidence Risk ◽  
Donor Graft

Graft detachment is the most common complication of endothelial keratoplasty. With the ongoing advancements in the field of endothelial keratoplasty, our understanding of risk factors of graft detachments and its management has been evolving. Various prevention measures have been described in literature including presoaking the donor graft, anterior chamber tamponade, venting incisions, sutures to prevent dislocation of graft. Management of a detached graft involves secondary interventions such as rebubbling, suturing and regrafts. In this review, we discuss graft detachment in different types of endothelial keratoplasty techniques including Descemet stripping endothelial keratoplasty, Descemet stripping automated endothelial keratoplasty and Descemet’s membrane endothelial keratoplasty; with emphasis on incidence, risk factors, preventive measures and their management.

Novel staging classification of primary mitral regurgitation based on the presence of cardiac damage

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.L Van Wijngaarden ◽  
Y.L Hiemstra ◽  
P Van Der Bijl ◽  
V Delgado ◽  
N Ajmone Marsan ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Kidney Function ◽  
Left Ventricular ◽  
Prognostic Impact ◽  
Cardiac Damage ◽  
Stage 4 ◽  
All Cause Mortality ◽  
Primary Mitral Regurgitation ◽  
Stage 1 ◽  
Staging Classification

Abstract Background The indication for surgery in patients with severe primary mitral regurgitation (MR) is currently based on the presence of symptoms, left ventricular (LV) dilatation and dysfunction, atrial fibrillation and pulmonary hypertension. The aim of this study was to evaluate the prognostic impact of a new staging classification based on cardiac damage including the known risk factors but also including global longitudinal strain (GLS), severe left atrial (LA) dilatation and right ventricular (RV) dysfunction. Methods In total 614 patients who underwent surgery for severe primary MR with available baseline transthoracic echocardiograms were included. Patients were classified according to the extent of cardiac damage (Figure): Stage 0-no cardiac damage, Stage 1-LV damage, Stage 2-LA damage, Stage 3-pulmonary vasculature or tricuspid valve damage and Stage 4-RV damage. Patients were followed for all-cause mortality. Results Based on the proposed classification, 172 (28%) patients were classified as Stage 0, 102 (17%) as Stage 1, 134 (21%) as Stage 2, 135 (22%) as Stage 3 and 71 (11%) as Stage 4. The more advanced the stage, the older the patients were with worse kidney function, more symptoms and higher EuroScore. Kaplan-Meier curve analysis revealed that patients with more advanced stages of cardiac damage had a significantly worse survival (log-rank chi-square 35.2; p&lt;0.001) (Figure). On multivariable analysis, age, male, chronic obstructive pulmonary disease, kidney function, and stage of cardiac damage were independently associated with all-cause mortality. For each stage increase, a 22% higher risk for all-cause mortality was observed (95% CI: 1.064–1.395; p=0.004). Conclusion In patients with severe primary MR, a novel staging classification based on the extent of cardiac damage, may help refining risk stratification, particularly including also GLS, LA dilatation and RV dysfunction in the assessment. Funding Acknowledgement Type of funding source: None

scholarly journals Risk factors for COVID-19 diagnosis, hospitalization, and subsequent all-cause mortality in Sweden: a nationwide study

2021 ◽  
Vol 36 (3) ◽  
pp. 287-298
Author(s):  
Jonathan Bergman ◽  
Marcel Ballin ◽  
Anna Nordström ◽  
Peter Nordström
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Long Term Care ◽  
Care Facility ◽  
Prescription Medication ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
All Cause Mortality

AbstractWe conducted a nationwide, registry-based study to investigate the importance of 34 potential risk factors for coronavirus disease 2019 (COVID-19) diagnosis, hospitalization (with or without intensive care unit [ICU] admission), and subsequent all-cause mortality. The study population comprised all COVID-19 cases confirmed in Sweden by mid-September 2020 (68,575 non-hospitalized, 2494 ICU hospitalized, and 13,589 non-ICU hospitalized) and 434,081 randomly sampled general-population controls. Older age was the strongest risk factor for hospitalization, although the odds of ICU hospitalization decreased after 60–69 years and, after controlling for other risk factors, the odds of non-ICU hospitalization showed no trend after 40–49 years. Residence in a long-term care facility was associated with non-ICU hospitalization. Male sex and the presence of at least one investigated comorbidity or prescription medication were associated with both ICU and non-ICU hospitalization. Three comorbidities associated with both ICU and non-ICU hospitalization were asthma, hypertension, and Down syndrome. History of cancer was not associated with COVID-19 hospitalization, but cancer in the past year was associated with non-ICU hospitalization, after controlling for other risk factors. Cardiovascular disease was weakly associated with non-ICU hospitalization for COVID-19, but not with ICU hospitalization, after adjustment for other risk factors. Excess mortality was observed in both hospitalized and non-hospitalized COVID-19 cases. These results confirm that severe COVID-19 is related to age, sex, and comorbidity in general. The study provides new evidence that hypertension, asthma, Down syndrome, and residence in a long-term care facility are associated with severe COVID-19.

scholarly journals Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lytfi Krasniqi ◽  
Mads P. Kronby ◽  
Lars P. S. Riber
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Risk ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Long Term Survival ◽  
All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

scholarly journals Molecularly imprinted membrane for transport of urea, creatinine, and vitamin B12 as a hemodialysis candidate membrane

2021 ◽  
Vol 19 (1) ◽  
pp. 806-817
Author(s):  
Muhammad Cholid Djunaidi ◽  
Nabilah Anindita Febriola ◽  
Abdul Haris
Keyword(s):  
Polyethylene Glycol ◽  
Vitamin B12 ◽  
Kidney Function ◽  
Cross Linking ◽  
Vitamin B ◽  
Molecularly Imprinted ◽  
Selective Transport ◽  
Molecularly Imprinted Membrane ◽  
Better Than ◽  
Imprinted Membrane

Abstract High levels of urea and creatinine in the blood are a sign of decreased kidney function. To remove these substances from the blood, hemodialysis which utilizes membranes could be used. In this study, a molecularly imprinted membrane (MIM) was synthesized for the selective transport of urea. The synthesis is initiated with the polymerization of eugenol into polyeugenol and then into polyeugenoxy acetate (PA). The PA is then contacted with urea and then used as the functional polymer in the synthesis of MIM with polysulfone as the membrane base, and polyethylene glycol as the cross-linking agent. The result was later analyzed with FTIR and SEM-EDX. The membrane is then used in the transport of urea, creatinine, and vitamin B12 and then compared with the non-imprinted membrane (NIM) performance. By using UV-Vis spectrophotometry, the results showed that the membrane with 10 h heating variation is able to transport more urea and is more selective than NIM; this proves that the urea template on the MIM enables it to recognize urea molecules better than creatinine and vitamin B12. The order of transport from the best results is urea > creatinine > vitamin B12.

scholarly journals Prediction of All-Cause Mortality Using an Echocardiography-Based Risk Score in Hemodialysis Patients

2020 ◽  
pp. 1-11
Author(s):  
Jing Zhu ◽  
Chao Tang ◽  
Han Ouyang ◽  
Huaying Shen ◽  
Tao You ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Model ◽  
Prognostic Score ◽  
Basic Model ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Cardiac Valve Regurgitation ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

<b><i>Aim:</i></b> To derive an echocardiography-based prognostic score for a 3-year risk of mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). <b><i>Methods:</i></b> 173 ESRD patients hospitalized in the second affiliated hospital of Soochow University from January 1, 2010, to July 31, 2016, were enrolled and followed up for 3 years. All subjects began to receive HD from recruitment. Baseline clinical and echocardiographic parameters were collected and screened for risk factors using univariate and multivariate analysis. The prognostic value of echocardiographic indexes was determined by concordance indexes and reclassification assay. Restricted cubic spline models (RCS) and forest plots were employed to visualize the association between risk factors and all-cause mortality. A multivariate nomogram including the identified factors was developed to estimate the prognosis. <b><i>Results:</i></b> After multivariate adjustment for advanced age, hypertension, diabetes, and decreased hemoglobin (Hb), echocardiographic indexes including left atrial diameter index (LADI), cardiac valvular calcification, and moderate to severe cardiac valve regurgitation were independently associated with the risk of 3-year mortality in HD patients. RCS showed that age, Hb, and LADI were positively associated with the risk of mortality. Adding multiple echocardiographic indexes to a basic model containing age, hypertension, diabetes, and Hb increased the concordance index and improved reclassification. A multivariate Cox model-derived nomogram showed the association between each factor and mortality by the end of follow-up. <b><i>Conclusions:</i></b> Echocardiographic indexes showed independent predictive power for mortality in ESRD patients and may constitute a promising prognostic tool in this population.

scholarly journals Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose–response analysis protocol for systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049866
Author(s):  
Chenghui Zhou ◽  
Baohui Lou ◽  
Hui Li ◽  
Xin Wang ◽  
Hushan Ao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Right Ventricular ◽  
Dose Response ◽  
Meta Analysis ◽  
Adult Patients ◽  
Sensitivity Analyses ◽  
Prognostic Effect ◽  
All Cause Mortality ◽  
Incidence Risk

IntroductionEmerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19.MethodsA systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S’, FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose–response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR).Ethics and disseminationThere was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42021231689.

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