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1.
Glob Public Health ; 19(1): 2361782, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38837785

RESUMO

A growing body of evidence has shown the effects of poor preconception health on adverse pregnancy outcomes and, subsequently, maternal and child morbidity and mortality. However, the cost of poor preconception health remains relatively unexplored. Using the case of Nigeria, this study provides the first estimate of the disease and economic burden of poor preconception health at a country level. Using data from international databases and the scientific literature, the study used a cost-of-illness approach to quantify the foregone productivity and direct healthcare costs resulting from six preconception risk factors (adolescent pregnancy, short birth interval, overweight and obesity, intimate partner violence, female genital mutilation, folate deficiency). The results indicate that 6.7% of maternal deaths, 10.9% of perinatal deaths, and 10.5% of late neonatal deaths were attributable to the selected preconception risk factors in 2020. The economic burden of poor preconception health in Nigeria was estimated at US$ 3.3 billion in 2020, of which over 90% was generated by premature mortality. If prevalence rates remain constant, total economic losses could amount to US$ 46.2 billion by 2035. This analysis paves the way for further studies investigating the economic costs and benefits of preconception interventions and policies in low and middle-income countries.


Assuntos
Cuidado Pré-Concepcional , Humanos , Feminino , Nigéria , Gravidez , Cuidado Pré-Concepcional/economia , Efeitos Psicossociais da Doença , Fatores de Risco , Adulto , Custos de Cuidados de Saúde , Recém-Nascido , Adolescente , Adulto Jovem
2.
Neurology ; 102(12): e209479, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38838229

RESUMO

BACKGROUND AND OBJECTIVES: Current benefits of invasive intracranial aneurysm treatment to prevent aneurysmal subarachnoid hemorrhage (aSAH) rarely outweigh treatment risks. Most intracranial aneurysms thus remain untreated. Commonly prescribed drugs reducing aSAH incidence may provide leads for drug repurposing. We performed a drug-wide association study (DWAS) to systematically investigate the association between commonly prescribed drugs and aSAH incidence. METHODS: We defined all aSAH cases between 2000 and 2020 using International Classification of Diseases codes from the Secure Anonymised Information Linkage databank. Each case was matched with 9 controls based on age, sex, and year of database entry. We investigated commonly prescribed drugs (>2% in study population) and defined 3 exposure windows relative to the most recent prescription before index date (i.e., occurrence of aSAH): current (within 3 months), recent (3-12 months), and past (>12 months). A logistic regression model was fitted to compare drug use across these exposure windows vs never use, controlling for age, sex, known aSAH risk factors, and health care utilization. The family-wise error rate was kept at p < 0.05 through Bonferroni correction. RESULTS: We investigated exposure to 205 commonly prescribed drugs between 4,879 aSAH cases (mean age 61.4, 61.2% women) and 43,911 matched controls. We found similar trends for lisinopril and amlodipine, with a decreased aSAH risk for current use (lisinopril odds ratio [OR] 0.63, 95% CI 0.44-0.90, amlodipine OR 0.82, 95% CI 0.65-1.04) and an increased aSAH risk for recent use (lisinopril OR 1.30, 95% CI 0.61-2.78, amlodipine OR 1.61, 95% CI 1.04-2.48). A decreased aSAH risk in current use was also found for simvastatin (OR 0.78, 95% CI 0.64-0.96), metformin (OR 0.58, 95% CI 0.43-0.78), and tamsulosin (OR 0.55, 95% CI 0.32-0.93). By contrast, an increased aSAH risk was found for current use of warfarin (OR 1.35, 95% CI 1.02-1.79), venlafaxine (OR 1.67, 95% CI 1.01-2.75), prochlorperazine (OR 2.15, 95% CI 1.45-3.18), and co-codamol (OR 1.31, 95% CI 1.10-1.56). DISCUSSION: We identified several drugs associated with aSAH, of which 5 drugs (lisinopril and possibly amlodipine, simvastatin, metformin, and tamsulosin) showed a decreased aSAH risk. Future research should build on these signals to further assess the effectiveness of these drugs in reducing aSAH incidence. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that some commonly prescribed drugs are associated with subsequent development of aSAH.


Assuntos
Hemorragia Subaracnóidea , Humanos , Hemorragia Subaracnóidea/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Incidência , Adulto , Idoso , Medicamentos sob Prescrição/uso terapêutico , Medicamentos sob Prescrição/efeitos adversos , Estudos de Casos e Controles , Aneurisma Intracraniano/epidemiologia , Fatores de Risco
8.
Mayo Clin Proc ; 99(6): 971-979, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38839189

RESUMO

Clostridioides difficile infection (CDI) is a significant public health challenge in the developed world. Although previously CDI was primarily a health care-acquired infection, there are now rising numbers of community-acquired cases in patients without traditional risk factors, such as antibiotic exposure. The landscape for the treatment of CDI has changed significantly during the past decade, including newer diagnostic tests, novel antibiotic regimens, and strategies for microbiome restoration in the form of traditional fecal microbiota transplant and approved live biotherapeutics in an effort to address the underlying pathophysiologic process of gut microbial dysbiosis. We present a concise review for clinicians on the diagnosis and management of both primary and recurrent CDI.


Assuntos
Antibacterianos , Infecções por Clostridium , Transplante de Microbiota Fecal , Humanos , Infecções por Clostridium/terapia , Infecções por Clostridium/diagnóstico , Antibacterianos/uso terapêutico , Transplante de Microbiota Fecal/métodos , Clostridioides difficile , Microbioma Gastrointestinal , Fatores de Risco
9.
Am J Clin Nutr ; 119(6): 1386-1396, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38839194

RESUMO

BACKGROUND: The independent effect of waist-to-height ratio (WHtR) and body fat percentage (BF%) on ischemic cardiovascular disease (CVD) remains uncertain. OBJECTIVES: This study aimed to investigate the independent associations of WHtR and BF% with ischemic CVD. METHODS: This prospective cohort study used data from the UK Biobank. BF% was calculated as fat mass divided by body weight, measured by bioimpedance. Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for overall and sex-specific associations of BF% and WHtR with risks of ischemic CVD and its main subtypes [myocardial infarction (MI) and ischemic stroke (IS)], adjusted for a range of potential confounders, including mutual adjustment for BF% and WHtR. RESULTS: In total, 468,333 participants without existing CVD were included in the analysis. During 12 y of follow-up, 20,151 ischemic CVD events, 13,604 MIs, and 6681 ISs were recorded. WHtR was linearly associated with ischemic CVD, MI, and IS, with an HR per 5% increase of 1.23 (95% CI: 1.20, 1.25), 1.24 (95% CI: 1.21, 1.27), and 1.22 (95% CI: 1.18, 1.26), respectively, independent of BF%. A stronger association between WHtR and MI was seen in females than in males. The association of BF% with these outcomes was substantially attenuated in both sexes after adjustment for WHtR. For example, in females, the HR (highest compared with lowest fifth) was reduced from 1.94 (95% CI: 1.76, 2.15) to 1.04 (95% CI: 0.90, 1.01) for ischemic CVD, from 2.04 (95% CI: 1.79, 2.32) to 0.97 (95% CI: 0.81, 1.16) for MI, and from 1.81 (95% CI: 1.54, 2.13) to 1.07 (95% CI: 0.85, 1.33) for IS. CONCLUSIONS: WHtR, when used as a proxy measure for central obesity, is linearly associated with ischemic CVD in both sexes, which is independent of BF%. In contrast, the relationship of BF% with these health outcomes is predominantly driven by its correlation with WHtR.


Assuntos
Tecido Adiposo , Bancos de Espécimes Biológicos , Razão Cintura-Estatura , Humanos , Masculino , Feminino , Estudos Prospectivos , Reino Unido/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Adulto , Estudos de Coortes , Biobanco do Reino Unido
10.
J UOEH ; 46(2): 203-213, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38839288

RESUMO

This study aimed to investigate the risk factors affecting stress and burnout among teachers after the COVID-19 pandemic in Thailand. The sample comprised 400 school teachers in the municipality of Chonburi province. The results found that the factors affecting stress were working more than 8 hours per day (2.03; 95%CI, 1.01-4.09), and being sick but having to come to work (2.30; 95%CI, 1.12-4.70). Factors affecting teacher burnout in the emotional exhaustion dimension were having frequent or almost constant time pressure (2.57; 95%CI, 1.92-6.73), a low level of job satisfaction (4.00; 95%CI, 1.55-10.34), and a low level of their own ability to work (2.57; 95%CI, 1.92-7.17). Factors affecting the cynicism dimension were having daily conflicts at work or having a moderate to high level of work-related problems (5.55; 95%CI, 1.71-18.04), and a low level of their own ability to work (3.40; 95%CI, 1.41-8.17). It is recommended that the schools' personnel development department allocate work to suit the needs and expertise of teachers so that they can work to their full potential.


Assuntos
Esgotamento Profissional , Professores Escolares , Humanos , Esgotamento Profissional/epidemiologia , Fatores de Risco , Estudos Transversais , Tailândia/epidemiologia , Professores Escolares/psicologia , Feminino , Masculino , Adulto , Satisfação no Emprego , Pessoa de Meia-Idade , COVID-19/psicologia , COVID-19/epidemiologia , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Estresse Psicológico/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-38839368

RESUMO

Esophagogastric junction cancer (EGJC) is a rare malignant disease that occurs in the gastroesophageal transition zone. In recent years, its incidence has been rapidly increasing not only in Western countries but also in East Asia, and it has been attracting the attention of both clinicians and researchers. EGJC has a worse prognosis than gastric cancer (GC) and is characterized by complex lymphatic drainage pathways in the mediastinal and abdominal regions. EGJC was previously treated in the same way as GC or esophageal cancer, but, in recent years, it has been treated as an independent malignant disease, and treatment focusing only on EGJC has been developed. A recent multicenter prospective study revealed the frequency of lymph node metastasis by station and established the optimal extent of lymph node dissection. In perioperative treatment, the combination of multi-drug chemotherapy, radiation therapy, molecular targeted therapy, and immunotherapy is expected to improve the prognosis. In this review, we summarize previous clinical trials and their important evidence on surgical and perioperative treatments for EGJC.


Assuntos
Neoplasias Esofágicas , Esofagectomia , Junção Esofagogástrica , Humanos , Junção Esofagogástrica/cirurgia , Junção Esofagogástrica/patologia , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/terapia , Resultado do Tratamento , Esofagectomia/efeitos adversos , Esofagectomia/mortalidade , Gastrectomia/mortalidade , Gastrectomia/efeitos adversos , Neoplasias Gástricas/cirurgia , Neoplasias Gástricas/patologia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/terapia , Excisão de Linfonodo , Quimioterapia Adjuvante , Metástase Linfática , Fatores de Risco , Terapia Neoadjuvante/efeitos adversos , Terapia Neoadjuvante/mortalidade
12.
Wei Sheng Yan Jiu ; 53(3): 427-434, 2024 May.
Artigo em Chinês | MEDLINE | ID: mdl-38839584

RESUMO

OBJECTIVE: To investigate the association between long-term fine particulate matter(PM_(2.5)) exposure and the risk of chronic kidney disease(CKD) in people with abnormal metabolism syndrome(MS) components. METHODS: Based on health checkup data from a hospital in Beijing, a retrospective cohort study was used to collect annual checkup data from 2013-2019. A questionnaire was used to obtain information on demographic characteristics and lifestyle habits. We measured blood pressure, height, weight, waist circumference, concentrations of triglycerides(TG), fasting glucose, and high-density lipoprotein cholesterol(HDL-C). Longitude and latitude were also extracted from the addresses of the study subjects for pollutant exposure data estimation. Logistic regression models were used to explore the estimated effect of long-term PM_(2.5) exposure on the risk of CKD prevalence in people with abnormal MS components. Two-pollutant and multi-pollutant models were developed to test the stability of these result. Subgroup analysis was conducted based on age, the presence of MS, individual MS component abnormalities, and dual-component MS abnormalities. RESULTS: The study included 1540 study subjects with abnormal MS components at baseline, 206 with CKD during the study period. The association between long-term PM_(2.5) exposure and increased risk of CKD in people with abnormal MS fractions was statistically significant, with a 2.26-fold increase in risk of CKD for every 10 µg/m~3 increase in PM_(2.5) exposure(OR=3.26, 95% CI 2.72-3.90). The result in the dual-pollutant models and multi-pollutant models suggested that the association between long-term PM_(2.5) exposure and increased risk of CKD in people with abnormal MS fractions remained stable after controlling for contemporaneous confounding by other air pollutants. The result of subgroup analysis revealed that individuals aged 45 or older, without MS, with TG<1.7 mmol/L, HDL-C≥1.04 mmol/L, without hypertension, and with central obesity and high blood sugar had a stronger association between PM_(2.5) exposure and CKD-related health effects. CONCLUSION: Long-term exposure to PM_(2.5) may increase the risk of CKD in people with abnormal MS components. More attention should be paid to middle-aged and elderly people aged ≥45 years, people with central obesity and hyperglycemia.


Assuntos
Exposição Ambiental , Síndrome Metabólica , Material Particulado , Insuficiência Renal Crônica , Humanos , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/epidemiologia , Síndrome Metabólica/etiologia , Síndrome Metabólica/epidemiologia , Feminino , Masculino , Material Particulado/efeitos adversos , Material Particulado/análise , Pessoa de Meia-Idade , Estudos Retrospectivos , Exposição Ambiental/efeitos adversos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Adulto , Estudos de Coortes , Fatores de Risco , Pequim/epidemiologia , Idoso , Inquéritos e Questionários , Modelos Logísticos
13.
Wei Sheng Yan Jiu ; 53(3): 389-395, 2024 May.
Artigo em Chinês | MEDLINE | ID: mdl-38839593

RESUMO

OBJECTIVE: To analyze the association between dietary fat intake and the risk of polycystic ovarian syndrome(PCOS). METHODS: PCOS patients treated in a tertiary hospital in Anhui Province from October 2021 to October 2022 were selected as the case group, and non-PCOS patients treated in the hospital during the same period were selected as the control group. A total of 262 subjects were included in the study, 131 were included in the case group and 131 in the control group. A semi-quantitative dietary frequency questionnaire was used to investigate the dietary intake in the past year, and the daily intake of various fatty acids and the ratio of fatty acid energy supply were calculated according to the food intake. Logistic regression analysis was used to investigate the association between dietary fat intake and the risk of PCOS. RESULTS: The dietary intakes of total fat, fatty acid, saturated fatty acid and monounsaturated fatty acid in PCOS patients were higher than those in control group(P>0.05), and there was statistical significance in daily intakes of eicosapentaenoic acid between two groups(P<0.05). After adjusting for confounding factors such as long-term residence, occupation, family per capita monthly income, menstrual cycle regularity, menstrual volume, and weight loss experience, Logistic regression analysis showed that the ratio of fat supply to energy was positively correlated with the risk of PCOS(OR=1.622, 95%CI 1.237-2.127). The energy supply ratio of monosaturated fatty acids(OR=0.597, 95%CI 0.373-0.955) and polyunsaturated fatty acids(OR=0.585, 95%CI 0.372-0.921) were negatively correlated with the risk of PCOS(P<0.05). CONCLUSION: The energy supply ratio of fat was positively correlated with the risk of PCOS, while the energy supply ratio of monosaturated fatty acids and the energy supply ratio of polyunsaturated fatty acids were negatively correlated with the risk of PCOS.


Assuntos
Gorduras na Dieta , Síndrome do Ovário Policístico , Humanos , Feminino , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/efeitos adversos , Adulto , Fatores de Risco , Estudos de Casos e Controles , Inquéritos e Questionários , Ácidos Graxos/administração & dosagem , China/epidemiologia , Adulto Jovem , Dieta/efeitos adversos
14.
Clin Oral Investig ; 28(7): 357, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38839609

RESUMO

OBJECTIVES: Risk factors for non-syndromic orofacial cleft (NSOFCs) include genetic profile and environmental exposure to medication and illnesses during pregnancy. We assessed the association between the COVID-19 vaccination and the incidence of NSOFC across five Middle Eastern countries. MATERIALS AND METHODS: This multi-country, hospital-based, case-control study included infants with NSOFCs whose first 3 intrauterine months coincided with the time when pregnant women were allowed to receive COVID-19 vaccination in the countries participating in the study. Newborns with NSOFCs were examined for cleft type and their parents were interviewed for maternal exposures and COVID-19 vaccination. Controls were newborns matched to cases in gender and setting. RESULTS: The study recruited 977 (348 children with NSOFCs and 629 controls). Maternal use of nicotine (Adjusted Odds Ratio (AOR): 2.437; P = 0.044) and family history of NSOFC (AOR: 11.059; P < 0.001) increased significantly the AOR of having a child with NSOFC. On the other hand, COVID-19 vaccine administration to pregnant mothers have significantly decreased the AOR of having a child with NSOFC (AOR: 0.337; P = 0.006). CONCLUSION: This study suggests that COVID-19 vaccination is not related to NSOFC and might protect against having a child affected with such a congenital anomaly. CLINICAL RELEVANCE: The finding of this study is important for healthcare providers for considering COVID-19 vaccination for pregnant woman. Clear communication and education about the potential risks and benefits would be crucial for informed decision-making. The study's results would directly impact pregnant individuals, as they would need accurate information to make informed decisions about their health and the health of their infants.


Assuntos
Vacinas contra COVID-19 , Fenda Labial , Fissura Palatina , Humanos , Estudos de Casos e Controles , Feminino , Masculino , Fenda Labial/epidemiologia , Gravidez , Fatores de Risco , Recém-Nascido , Oriente Médio , COVID-19/prevenção & controle , COVID-19/epidemiologia , Incidência , SARS-CoV-2 , Adulto
15.
Neurosurg Rev ; 47(1): 258, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38839660

RESUMO

Administration of acetylsalicylic acid (ASA) at early stage after surgery for spontaneous intracerebral hemorrhage (SICH) may increase the risk of postoperative intracranial bleeding (PIB), because of potential inhibition of platelet function. This study aimed to investigate whether early ASA administration after surgery was related to increased risk of PIB. This retrospective study enrolled SICH patients receiving surgery from September 2019 to December 2022 in seven medical institution. Based on postoperative ASA administration, patients who continuously received ASA more than three days within seven days post-surgery were identified as ASA users, otherwise as non-ASA users. The primary outcome was symptomatic PIB events within seven days after surgery. Incidence of PIB was compared between ASA users and non-ASA users using survival analysis. This study included 744 appropriate patients from 794 SICH patients. PIB occurred in 42 patients. Survival analysis showed no statistical difference between ASA users and non-ASA users in incidence of PIB (P = 0.900). Multivariate Cox analysis demonstrated current smoker (hazard ratio [HR], 2.50, 95%CI, 1.33-4.71, P = 0.005), dyslipidemia (HR = 3.03; 95%CI, 1.31-6.99; P = 0.010) and pre-hemorrhagic antiplatelet therapy (HR = 3.05; 95% CI, 1.64-5.68; P < 0.001) were associated with PIB. Subgroup analysis manifested no significant difference in incidence of PIB between ASA users and non-ASA users after controlling the effect from factors of PIB (i.e., sex, age, current smoker, regular drinker, dyslipidemia, pre-hemorrhagic antiplatelet therapy and hematoma location). This study revealed that early ASA administration to SICH patients after surgery was not related to increased risk of PIB.


Assuntos
Aspirina , Hemorragia Cerebral , Inibidores da Agregação Plaquetária , Humanos , Masculino , Feminino , Aspirina/efeitos adversos , Aspirina/administração & dosagem , Idoso , Pessoa de Meia-Idade , Estudos Retrospectivos , Inibidores da Agregação Plaquetária/efeitos adversos , Inibidores da Agregação Plaquetária/administração & dosagem , Hemorragia Pós-Operatória/epidemiologia , Fatores de Risco , Adulto , Hemorragias Intracranianas/epidemiologia
16.
Arch Esp Urol ; 77(4): 391-396, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38840282

RESUMO

OBJECTIVE: Urinary tract infection (UTI) is a common postoperative complication, so exploring its risk factors is helpful to provide a basis for clinical prevention. This study aims to analyse the risk factors for UTI after lumbar interbody fusion (LIF). METHODS: A single-centre retrospective study was conducted on the clinical data of 358 patients treated with LIF from April 2020 to April 2023. In accordance with the results of postoperative urine culture, the patients were divided into UTI group (n = 19, those with UTI after LIF) and control group (n = 332, those without UTI after LIF). Binary logistic regression analysis was carried out through collecting the medical records of the two groups to probe into the risk factors for UTI after LIF. RESULTS: After seven patients were excluded, the remaining 351 patients were included in the analysis. In this study, 19 patients (5.41%) developed postoperative UTI, whereas 332 patients (94.59%) had no UTI. Regression analysis results showed drinking (odds ratio (OR) = 16.193, 95% confidence interval (CI): 1.017-257.860) and high preoperative C-reactive protein (CRP) level (OR = 3.237, 95% CI: 1.213-8.636) as risk factors for UTI after LIF. A high professional title of main surgeon (OR = 0.095, 95% CI: 0.010-0.932) and preoperative red blood cell (RBC) count (OR = 0.001, 95% CI: 0.000-0.198) were protective factors for UTI after LIF (p < 0.05). CONCLUSIONS: This study advocated strengthening the prevention and treatment of UTI in patients who had drinking history, high preoperative CRP level and low preoperative RBC count, and received LIF based on the study results. Attention should be paid to the training of physicians with low professional title.


Assuntos
Vértebras Lombares , Complicações Pós-Operatórias , Fusão Vertebral , Infecções Urinárias , Humanos , Fusão Vertebral/efeitos adversos , Infecções Urinárias/etiologia , Infecções Urinárias/epidemiologia , Masculino , Fatores de Risco , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Vértebras Lombares/cirurgia , Idoso , Medição de Risco
17.
Minerva Pediatr (Torino) ; 76(3): 321-327, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38842379

RESUMO

BACKGROUND: Left ventricular hypertrophy (LVH) is an important complication of infants of diabetic mothers (IDMs). However, the defined factors, such as the influence of glycemic control, insulin administration of diabetic mothers and large for gestational age (LGA) in infants, are largely unknown on the incidence of LVH. Therefore, this study aimed to evaluate the prevalence of maternal and neonatal risk factors associated with LVH in IDMs. METHODS: This prospective analytic study was conducted at tertiary care hospitals in a 1-year period. Inborn IDMs were enrolled, and ventricular hypertrophy was identified by 2D echocardiography in the first 72 hours after birth. RESULTS: A total of 160 IDMs met the inclusion criteria, 33 (20.6%) of which had LVH. The incidence of infants with LVH born to mothers with poor glycemic control (fasting blood sugar >95 mg/dL) was significantly elevated than those with good glycemic control (45.5% vs. 14.4%, P<0.001). Twelve IDMs (12/33, 36.5%) of LVH and 17 IDMs (17/127, 13.4%) of non-LVH were LGA. IDMs with LVH, compared those with non-LVH, had significantly increased left ventricular (LV) geometry; IVSd (6.5±0.8 vs. 4.0±0, 7 mm), LV IDd (16.8±3.3 mm vs. 18.4±1.1), left ventricular ejection fraction (LVEF) (68.3±8.5% vs. 62.9±17.5%), left ventricular fraction shortening (LVFS) (35.9±6.6% vs. 32.2±5.5%), LV mass (15.3±11.6 vs. 9.3±2.5 g) and LV mass index (66.2±17.5 vs. 46.6±9.7 g/m2), all with P<0.001. There was significant correlation in LV mass with infants' weight, height and body surface area (BSA) (r=0.408, 0.337 and 0.424, respectively; P<0.001). CONCLUSIONS: The prevalence of neonatal ventricular hypertrophy in IDMs was 20.6%. Maternal poor glycemic control and LGA status in IDMs were dominant risk factors of LVH.


Assuntos
Ecocardiografia , Controle Glicêmico , Hipertrofia Ventricular Esquerda , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Hipertrofia Ventricular Esquerda/etiologia , Feminino , Recém-Nascido , Estudos Prospectivos , Gravidez , Fatores de Risco , Masculino , Adulto , Gravidez em Diabéticas/epidemiologia , Incidência , Prevalência , Insulina/uso terapêutico , Glicemia/análise
18.
Niger J Clin Pract ; 27(5): 604-611, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38842710

RESUMO

BACKGROUND: Breast cancer is the type of cancer that is seen all over the world and ranks first among female cancers in terms of incidence and cause of death. OBJECTIVE: This research was conducted to determine the breast cancer risk level and breast cancer knowledge level in women living in Northern Cyprus. METHODS: The study, which was planned as a relational survey, was carried out as web-based. The research was completed with 657 adult female participants living in Northern Cyprus who volunteered to participate in the study. In order to collect data, the first section includes the introductory features, the second section includes the "Breast Cancer Risk Assessment Form" for determining breast cancer risk levels, the third section includes the "Comprehensive Breast Cancer Knowledge Test" to determine the breast cancer knowledge levels of the participants, and the fourth section includes the "Champion Health Belief Model Scale" was used. RESULTS: It was determined that 95.2% of women were in the low risk group for breast cancer. The knowledge test mean score is 12.05, and it can be said that the scores obtained are above the average (min:4- max:18). It was found that 55.7% of the women knew how to do Breast Self-Examination (BSE), but only 15.4% of them regularly performed BSE every month. It was found that 80.9% of the women never had mammography and their knowledge scores increased with increasing education level (p< 0.001) and there was a significant relationship between non-smokers and their knowledge levels (p< 0.01). IMPLICATIONS FOR PRACTICE: Despite the high scores of women in knowledge tests, it was observed that the frequency of applying BSE and having mammography was very low. Regardless of the risk factors for breast cancer, the importance of regular check-ups and BSE for every woman should be taught to women by health professionals, and group trainings should be planned for women who do not have training on this subject.


Assuntos
Neoplasias da Mama , Autoexame de Mama , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Chipre/epidemiologia , Adulto , Pessoa de Meia-Idade , Autoexame de Mama/estatística & dados numéricos , Autoexame de Mama/psicologia , Inquéritos e Questionários , Medição de Risco/métodos , Fatores de Risco , Adulto Jovem , Idoso , Detecção Precoce de Câncer , Adolescente
19.
Niger J Clin Pract ; 27(5): 612-619, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38842711

RESUMO

BACKGROUND: Controlling Nutritional Assessment (CONUT) score has been shown to have a higher predictive value compared to other nutritional scores in acute coronary syndrome. AIM: To determine the relationship between CONUT score and long-term mortality in patients with chronic coronary syndrome (CCS). METHODS: Between 2017 and 2020, 585 consecutive patients newly diagnosed and proven to have CCS by coronary angiography were included in the study. CONUT score and demographic and laboratory data of all patients were evaluated. The relationship between results and mortality was evaluated. RESULTS: The mean age of the patients was 64 years and 75% were male. Mortality was observed in 56 (9.6%) patients after a median follow-up period of 3.5 years. The median CONUT score was significantly higher in patients with mortality (P < 0.001). In multivariate regression analysis, the CONUT score was associated with mortality (Hazard ratio (HR): 1.63 (95% confidence interval (CI): 1.34-1.98 P < 0.001)). The area under curve (AUC) for long-term mortality estimation for the CONUT score was 0.75 (95% CI 0.67-0.82 P < 0.001). When the CONUT score value was accepted as 0.5, the sensitivity was 78% and the specificity was 60. CONCLUSION: CONUT score was found to be predictive of mortality in long-term follow-up of patients with CCS.


Assuntos
Avaliação Nutricional , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Turquia/epidemiologia , Angiografia Coronária , Estado Nutricional , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/diagnóstico , Valor Preditivo dos Testes , Fatores de Risco , Medição de Risco/métodos
20.
Front Endocrinol (Lausanne) ; 15: 1390140, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38828408

RESUMO

Objective: The aim of this study was to identify potential causal cytokines in thymic malignancies and benign tumors from the FinnGen database using Mendelian randomization (MR). Methods: In this study, data from genome-wide association studies (GWAS) of 91 cytokines were used as exposure factors, and those of thymic malignant tumors and thymic benign tumors were the outcome variables. Two methods were used to determine the causal relationship between exposure factors and outcome variables: inverse variance weighting (IVW) and MR-Egger regression. Sensitivity analysis was performed using three methods, namely, the heterogeneity test, the pleiotropy test, and the leave-one-out test. Results: There was a causal relationship between the expression of fibroblast growth factor 5, which is a risk factor for thymic malignant tumors, and thymic malignant tumors. C-C motif chemokine 19 expression, T-cell surface glycoprotein CD5 levels, and interleukin-12 subunit beta levels were causally related to thymic malignant tumors and were protective. Adenosine deaminase levels, interleukin-10 receptor subunit beta expression, tumor necrosis factor (TNF)-related apoptosis-inducing ligand levels, and TNF-related activation-induced cytokine levels showed a causal relationship with thymic benign tumors, which are its risk factors. Caspase 8 levels, C-C motif chemokine 28 levels, interleukin-12 subunit beta levels, latency-associated peptide transforming growth factor beta 1 levels, and programmed cell death 1 ligand 1 expression showed a causal relationship with thymic benign tumors, which are protective factors. Sensitivity analysis showed no heterogeneity. Conclusion: Cytokines showed a causal relationship with benign and malignant thymic tumors. Interleukin-12 subunit beta is a common cytokine that affects malignant and benign thymic tumors.


Assuntos
Citocinas , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Proteômica , Neoplasias do Timo , Humanos , Citocinas/metabolismo , Citocinas/genética , Neoplasias do Timo/genética , Proteômica/métodos , Biomarcadores Tumorais/genética , Fatores de Risco
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