Association between cardiovascular mortality and STOP-Bang questionnaire scores in a cohort of hospitalized patients: a prospective study.

OBJECTIVE: Obstructive sleep apnea (OSA) is associated with an increased risk of mortality and cardiometabolic diseases. The STOP-Bang questionnaire is a tool to screen populations at risk of OSA and prioritize complementary studies. Our objective was to evaluate the clinical utility of this questionnaire in identifying patients at an increased risk of mortality after discharge in a cohort of hospitalized patients. METHODS: This was a prospective cohort study involving consecutive patients admitted to an internal medicine unit between May and June of 2017 who were reevaluated three years after discharge. At baseline, we collected data on comorbidities (hypertension, obesity, diabetes, and fasting lipid profile) and calculated STOP-Bang scores, defining the risk of OSA (0-2 score, no risk; ≥ 3 score, risk of OSA; and ≥ 5 score, risk of moderate-to-severe OSA), which determined the study groups. We also recorded data regarding all-cause and cardiovascular mortality at the end of the follow-up period. RESULTS: The sample comprised 435 patients. Of those, 352 (80.9%) and 182 (41.8%) had STOP-Bang scores ≥ 3 and ≥ 5, respectively. When compared with the group with STOP-Bang scores of 0-2, the two groups showed higher prevalences of obesity, hypertension, diabetes, and dyslipidemia. Multivariate analysis showed an independent association between cardiovascular mortality and STOP-Bang score ≥ 5 (adjusted hazard ratio = 3.12 [95% CI, 1.39-7.03]; p = 0.01). Additionally, previous coronary heart disease was also associated with cardiovascular mortality. CONCLUSIONS: In this cohort of hospitalized patients, STOP-Bang scores ≥ 5 were able to identify patients at an increased risk of cardiovascular mortality three years after discharge.

Da vida marinha ao sentimento oceânico: Alister Hardy e o estudo da experiência religiosa / From the marine life to the ocean feeling: Alister Hardy and the study of religious experience

Um reconhecido biólogo britânico, premiadíssimo por suas contribuições no estudo da vida marinha, imediatamente após se aposentar na Universidade de Oxford, no Reino Unido, aos 73 anos, passa a se dedicar integralmente ao estudo da vitalidade do fenômeno religioso, fundando uma Unidade de Pesquisa em Experiência Religiosa (RERU). Trata-se de Alister Hardy (1896-1985), cujas história, principais obras e concepções, influências recebidas e contribuições decorrentes para a Psicologia da Religião são focos deste artigo,de cunho teórico e historiográfico, escrito por ocasião dos 50 anos de fundação da referida unidade. Atualmente, situada em Lampeter, País de Gales, acolhida pela University of Wales Trinity University, desde 2000, recebe o nome de Alister Hardy Religious Experience Research Centre (RERC).

A well-known British biologist, knighted for his contributions to the study of marine life, devoted his life after retiring from Oxford University in the United Kingdom, at 73 years old, to the study of the vitality of the religious phenomenon by founding a Research Unit in Religious Experience (RERU) in Oxford. The biologist was Sir Alister Hardy (1896-1985), whose stories, main works and conceptions, influences and ensuing contributions to the Psychology of Religion are the focus of this paper. It reflects the theoretical and historiographical impact of his work, written on the occasion of the 50th anniversary of the RERU. Currently it is located in Lampeter, Wales, hosted by the University of Wales Trinity University since 2000, and named Alister Hardy Religious Experience Research Centre (RERC).

Association between cardiovascular mortality and STOP-Bang questionnaire scores in a cohort of hospitalized patients: a prospective study / Associação entre mortalidade cardiovascular e pontuação do questionário STOP-Bang em uma coorte de pacientes hospitalizados: um estudo prospectivo

ABSTRACT Objective: Obstructive sleep apnea (OSA) is associated with an increased risk of mortality and cardiometabolic diseases. The STOP-Bang questionnaire is a tool to screen populations at risk of OSA and prioritize complementary studies. Our objective was to evaluate the clinical utility of this questionnaire in identifying patients at an increased risk of mortality after discharge in a cohort of hospitalized patients. Methods: This was a prospective cohort study involving consecutive patients admitted to an internal medicine unit between May and June of 2017 who were reevaluated three years after discharge. At baseline, we collected data on comorbidities (hypertension, obesity, diabetes, and fasting lipid profile) and calculated STOP-Bang scores, defining the risk of OSA (0-2 score, no risk; ≥ 3 score, risk of OSA; and ≥ 5 score, risk of moderate-to-severe OSA), which determined the study groups. We also recorded data regarding all-cause and cardiovascular mortality at the end of the follow-up period. Results: The sample comprised 435 patients. Of those, 352 (80.9%) and 182 (41.8%) had STOP-Bang scores ≥ 3 and ≥ 5, respectively. When compared with the group with STOP-Bang scores of 0-2, the two groups showed higher prevalences of obesity, hypertension, diabetes, and dyslipidemia. Multivariate analysis showed an independent association between cardiovascular mortality and STOP-Bang score ≥ 5 (adjusted hazard ratio = 3.12 [95% CI, 1.39-7.03]; p = 0.01). Additionally, previous coronary heart disease was also associated with cardiovascular mortality. Conclusions: In this cohort of hospitalized patients, STOP-Bang scores ≥ 5 were able to identify patients at an increased risk of cardiovascular mortality three years after discharge.

RESUMO Objetivo: A apneia obstrutiva do sono (AOS) está associada a um risco maior de mortalidade e doenças cardiometabólicas. O questionário STOP-Bang é uma ferramenta para rastrear populações em risco de AOS e assim priorizar estudos complementares. Nosso objetivo foi avaliar a utilidade clínica desse questionário na identificação de pacientes com risco aumentado de mortalidade após a alta em uma coorte de pacientes hospitalizados. Métodos: Estudo de coorte prospectivo com pacientes consecutivos internados em uma unidade de medicina interna entre maio e junho de 2017 que foram reavaliados três anos após a alta. No momento basal, coletamos dados sobre comorbidades (hipertensão, obesidade, diabetes e perfil lipídico em jejum) e calculamos as pontuações no STOP-Bang, definindo o risco de OSA (pontuação 0-2, sem risco; pontuação ≥ 3, risco de AOS; e pontuação ≥ 5, risco de AOS moderada a grave), que determinou os grupos de estudo. Também registramos dados sobre mortalidade por todas as causas e mortalidade cardiovascular ao final do período de acompanhamento. Resultados: Foram incluídos 435 pacientes. Desses, 352 (80,9%) e 182 (41,8%) apresentaram pontuações no STOP-Bang ≥ 3 e ≥ 5, respectivamente. Quando comparados com o grupo com pontuação no STOP-Bang de 0-2, os outros dois grupos apresentaram prevalências mais elevadas de obesidade, hipertensão, diabetes e dislipidemia. A análise multivariada mostrou uma associação independente entre mortalidade cardiovascular e pontuação no STOP-Bang ≥ 5 (razão de risco ajustada = 3,12 [IC95%, 1,39-7,03]; p = 0,01). Além disso, doença coronariana prévia também foi associada à mortalidade cardiovascular. Conclusões: Nesta coorte de pacientes hospitalizados, pontuações no STOP-Bang ≥ 5 foram capazes de identificar pacientes com risco aumentado de mortalidade cardiovascular três anos após a alta.

[Association between high vitamin B12 levels and one year mortality in older people admitted to the hospital]. / Asociación entre niveles de vitamina B-12 y mortalidad en pacientes hospitalizados adultos mayores.

BACKGROUND: Supplementation of vitamin B12 in older adults is a common practice to avoid vitamin B12 insufficiency. However, there is a paucity of information about the effects of cobalamin excess. AIM: To asses any potential effects of high levels vitamin B12 on mortality on adults aged ≥ 65 years admitted to an internal medicine service. MATERIAL AND METHODS: We Prospectively studied patients admitted to an internal medicine service of an academic hospital from September 2017 to September 2018, who were able to give their consent and answer questionnaires. We tabulated age, gender, medical history, comorbidity index (Charlson), frailty score (Fried scale), admission diagnosis and blood tests performed within 48 hours of admission. The primary outcome was death by any cause in less of 30 days or after one of year follow up, determined according to death certificates. RESULTS: We included 93 patients aged 65 to 94 years (53% males). Fifteen patients died during the year of follow up (five within 30 days of admission). Those who died had higher cobalamin levels than survivors (1080.07 ± 788.09 and 656.68 ± 497.33 pg/mL respectively, p = 0.02). Patients who died had also a significantly lower corrected serum calcium, sodium (p = 0.04) and a medical history of chronic liver disease (p = 0.03). In the multivariable analysis, only vitamin B12 preserved the association with mortality (p = 0.009). CONCLUSIONS: There was a significant association between high levels of cobalamin and all-cause mortality in this group of patients aged ≥ 65 years-old.

Asociación entre niveles de vitamina B-12 y mortalidad en pacientes hospitalizados adultos mayores / Association between high vitamin B12 levels and one year mortality in older people admitted to the hospital

Background: Supplementation of vitamin B12 in older adults is a common practice to avoid vitamin B12 insufficiency. However, there is a paucity of information about the effects of cobalamin excess. Aim: To asses any potential effects of high levels vitamin B12 on mortality on adults aged ≥ 65 years admitted to an internal medicine service. Material and Methods: We Prospectively studied patients admitted to an internal medicine service of an academic hospital from September 2017 to September 2018, who were able to give their consent and answer questionnaires. We tabulated age, gender, medical history, comorbidity index (Charlson), frailty score (Fried scale), admission diagnosis and blood tests performed within 48 hours of admission. The primary outcome was death by any cause in less of 30 days or after one of year follow up, determined according to death certificates. Results: We included 93 patients aged 65 to 94 years (53% males). Fifteen patients died during the year of follow up (five within 30 days of admission). Those who died had higher cobalamin levels than survivors (1080.07 ± 788.09 and 656.68 ± 497.33 pg/mL respectively, p = 0.02). Patients who died had also a significantly lower corrected serum calcium, sodium (p = 0.04) and a medical history of chronic liver disease (p = 0.03). In the multivariable analysis, only vitamin B12 preserved the association with mortality (p = 0.009). Conclusions: There was a significant association between high levels of cobalamin and all-cause mortality in this group of patients aged ≥ 65 years-old.

Da vida marinha ao sentimento oceânico: Alister Hardy e o estudo da experiência religiosa / From the marine life to the ocean feeling:Alister Hardy and the study of religious experience

Um reconhecido biólogo britânico, premiadíssimo por suas contribuições no estudo da vida marinha, imediatamente após se aposentar na Universidade de Oxford, no Reino Unido, aos 73 anos, passa a se dedicar integralmente ao estudo da vitalidade do fenômeno religioso, fundando uma Unidade de Pesquisa em Experiência Religiosa (RERU). Trata-se de Alister Hardy (1896-1985), cujas história, principais obras e concepções, influências recebidas e contribuições decorrentes para a Psicologia da Religião são focos deste artigo, de cunho teórico e historiográfico, escrito por ocasião dos 50 anos de fundação da referida unidade. Atualmente, situada em Lampeter, País de Gales, acolhida pela University of Wales Trinity University, desde 2000, recebe o nome de Alister Hardy Religious Experience Research Centre (RERC).

A well-known British biologist, knighted for his contributions to the study of marine life, devoted his life after retiring from Oxford University in the United Kingdom, at 73 years old, to the study of the vitality of the religious phenomenon by founding a Research Unit in Religious Experience (RERU) in Oxford. The biologist was Sir Alister Hardy (1896-1985), whose stories, main works and conceptions, influences and ensuing contributions to the Psychology of Religion are the focus of this paper. It reflects the theoretical and historiographical impact of his work, written on the occasion of the 50th anniversary of the RERU. Currently it is located in Lampeter, Wales, hosted by the University of Wales Trinity University since 2000, and named Alister Hardy Religious Experience Research Centre (RERC).