RESUMO
INTRODUCTION: Metabolic syndrome (MetS) is one contributing factor to cardiovascular diseases (CVD). Although there have been several reports showing MetS to be a risk factor for CVD, there are limited data available on which of the diagnostic criteria for MetS carries the greatest risk for CVD in the elderly population. This study thus aimed to evaluate these criteria in terms of risk of CVD in this population. METHODS: This was a retrospective cohort study conducted at three referral hospitals in Thailand. The study period was between January 1, 2007 and December 31, 2016. Eligible patients were identified whether presence of MetS or not at the beginning of study and followed until the end of study. The primary outcome of study was presence of CVD. Predictors for CVD were analyzed by Cox proportional-hazards regression. RESULTS: During the study period, there were 1080 patients who met the study criteria, 253 (23.42%) of whom had CVD. There were five factors significantly associated with CVD occurrence including age, smoking, SBP, FPG, and HDL-c. The two factors with the highest adjusted hazard ratio were FPG and SBP at 2.92 and 2.34, respectively. CONCLUSIONS: The three MetS criteria including SBP, FPG, and HDL-c may be predictors for cardiovascular diseases in elderly populations. Physician may need to focus on these particular factors of MetS in terms of CVD prevention in elderly patients.
RESUMO
BACKGROUND: Several studies showed that inhaled corticosteroids (ICS) may be a potential treatment in acute asthma exacerbation in children. This study was an update meta-analysis on the roles of ICS in the management of acute asthma exacerbation in children presenting to the hospital. MATERIALS AND METHODS: Published articles with key words of ICS for asthma exacerbation, asthma attacks, and acute asthma in children aged under 18 years in the hospital setting with outcome of hospital admission between 2009 and 2018 were enrolled. The databases used in this study were Medline, Scopus, and Web of Science. Odds ratio of comparison between ICS and other treatments on hospital admissions was calculated. RESULTS: There were 311 eligible studies met the searching criteria; seven eligible studies for the analysis; comprised of three meta-analysis and four added studies. The ICS had a significant reduction in hospital admission compared with placebo in overall with odds ratio of 0.63 (95% confidence interval [CI]: 0.41-0.96) and in moderate-to-severe group with odds ratio of 0.17 (95% CI: 0.05-0.51). Comparing with systemic corticosteroid (SC), ICS had significantly lower hospital admissions overall and in mild-to-moderate group with odds ratios of 0.63 and 0.26, respectively. The combination of ICS and SC had odds ratio of 0.75 (95% CI: 0.57-0.99) over SC in moderate-to-severe asthma exacerbation. CONCLUSIONS: ICS significantly reduced hospital admission in asthma exacerbation in children. It may be used alone for mild-to-moderate asthma exacerbation and combination with SC for moderate-to-severe asthma exacerbation.
