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Fundamentos La hipertensión arterial (HTA) es el principal factor de riesgo para el desarrollo de la obstrucción venosa retiniana (OVR). Objetivos Analizar el perfil hipertensivo con monitorización ambulatoria de la presión arterial (MAPA) en pacientes con una OVR. Pacientes y métodos Estudio con MAPA en 66 pacientes, 33 con OVR pertenecientes a una cohorte con esta enfermedad y 33 controles sin OVR ajustados por edad y sexo. Resultados Los pacientes con OVR tuvieron, respecto a los controles, cifras nocturnas elevadas de PAS 130mmHg (21) vs.119mmHg (11); p=0,01 y PAD 73mmHg (11) vs. 65mmHg (9); p=0,002. Además, presentaron menor descenso del porcentaje de Dipping ratio 6,0% (10,4) vs. 12,3% (6,3); p=0,005. Conclusiones Los pacientes con OVR tienen un perfil hipertensivo nocturno desfavorable. El reconocimiento de este hecho puede ayudar a optimizar el tratamiento (AU)
Background Arterial hypertension (AHT) is the main risk factor for the development of retinal vein occlusion (RVO). Aims To analyze the hypertensive profile with ambulatory blood pressure monitoring (ABPM) in patients with RVO. Patients and methods Retrospective and observational study of 66 patients with ABPM, 33 with retinal vein occlusion from a cohort of these disease and 33 controls without RVO, adjusted for age and sex. Results Compared to controls, patients with RVO had elevated nocturnal values of SBP 130mmHg (21) vs. 119mmHg (11); P=.01 and DBP 73mmHg (11) vs. 65mmHg (9); P=.002. In addition, they presented a lower decrease in the Dipping ratio percentage 6.0% (10.4) vs. 12.3% (6.3); P=.005. Conclusions Patients with RVO have an unfavorable nocturnal hypertensive profile. Recognition of this fact can help optimize their treatment (AU)
Assuntos
Humanos , Oclusão da Veia Retiniana , Hipertensão/diagnóstico , Hipertensão/prevenção & controle , Monitorização Ambulatorial da Pressão Arterial , Seguimentos , Fatores de RiscoRESUMO
BACKGROUND: Arterial hypertension (AHT) is the main risk factor for the development of retinal vein occlusion (RVO). AIMS: To analyze the hypertensive profile with ambulatory blood pressure monitoring (ABPM) in patients with RVO. PATIENTS AND METHODS: Retrospective and observational study of 66 patients with ABPM, 33 with retinal vein occlusion from a cohort of these disease and 33 controls without RVO, adjusted for age and sex. RESULTS: Compared to controls, patients with RVO had elevated nocturnal values of SBP 130mmHg (21) vs. 119mmHg (11); P=.01 and DBP 73mmHg (11) vs. 65mmHg (9); P=.002. In addition, they presented a lower decrease in the Dipping ratio percentage 6.0% (10.4) vs. 12.3% (6.3); P=.005. CONCLUSIONS: Patients with RVO have an unfavorable nocturnal hypertensive profile. Recognition of this fact can help optimize their treatment.
RESUMO
Antecedentes: La obstrucción venosa retiniana (OVR) se relaciona fundamentalmente con los factores de riesgo vascular (FRV). Objetivos: Analizar el perfil lipídico y las concentraciones séricas de ácido fólico, vitamina B12 y homocisteína, en pacientes con OVR y un grupo control poblacional. Pacientes y métodos: Estudio de casos y controles. Los pacientes con OVR fueron estudiados a lo largo de un periodo de 11 años.Resultados: Se incluyeron 368 casos y 325 controles de similar edad y sexo. En los pacientes con OVR respecto a los controles, las concentraciones de HDL colesterol y de ácido fólico fueron menores (52 [43-63] mg/dL vs. 55 [46-66]; p = 0,016 y 7 [5-10] ng/mL vs. 9 [7-13]; p < 0,0001, respectivamente) y las de colesterol no HDL y de homocisteína fueron mayores (148,9 ± 37,3 mg/dL vs. 142,9 ± 3; p = 0,03 y 13,4 [11,2-18,2] μmol/L vs. 11,1 [9,0-14,4]; p < 0,0001). Aunque las cifras de colesterol total, cLDL y triglicéridos fueron mayores y las concentraciones de vitamina B12 fueron menores en los pacientes con OVR, estas diferencias no fueron significativas. Conclusiones: Los pacientes con OVR tienen concentraciones más bajas de colesterol HDL y de ácido fólico y cifras de colesterol no HDL y homocisteína más elevadas que los controles poblacionales de similar edad y sexo. En estos pacientes, además del perfil lipídico, podría ser útil la determinación de la homocisteína, el folato y la vitamina B12, así como el tratamiento de sus alteraciones.(AU)
Background: Retinal vein occlusion (RVO) is mainly related with vascular risk factors (VRF). Objectives: To analyze the lipid profile and serum folate, vitamin B12 and homocysteine levels, in patients with RVO and a population-based control group. Patients and Methods: Case-control study. Patients with RVO were assessed during an 11-year period. Results: We included 368 patients and 325 controls of similar age and sex. HDL cholesterol and folate levels were lower (52 [43-63] mg/dL vs. 55 [46-66]; p = 0.016 and 7 [5-10] ng/mL vs. 9 [7-13]; p < 0.0001, respectively) and non-HDL cholesterol and homocysteine levels higher (148.9 ± 37.3 mg/dL vs. 142.9 ± 34.5; p = 0.03 and 13.4 [11.2-18.2] μmol/L vs. 11.1 [9.0-14.4]; p < 0.001) in patients with RVO than controls. Although total cholesterol, LDL-C, and triglyceride levels were higher and serum vitamin B12 levels were lower in RVO patients, these differences did not reach statistical significance. Conclusions: RVO-patients have lower serum HDL-C and folate levels and higher non-HDL-C and serum homocysteine levels than population-based controls of similar age and sex. In patients with RVO, apart from the lipid profile, determination of serum homocysteine, folate and vitamin B12 levels might be useful, as well as the treatment of their alterations.(AU)
Assuntos
Humanos , Masculino , Feminino , Homocisteína , Vitamina B 12 , Ácido Fólico , Diabetes Mellitus , Oclusão da Veia Retiniana , Fatores de Risco , Estudos de Casos e ControlesRESUMO
There is some evidence that male gender could have a negative impact on the prognosis and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of the present study was to compare the characteristics of coronavirus disease 2019 (COVID-19) between hospitalized men and women with confirmed SARS-CoV-2 infection. This multicenter, retrospective, observational study is based on the SEMI-COVID-19 Registry. We analyzed the differences between men and women for a wide variety of demographic, clinical, and treatment variables, and the sex distribution of the reported COVID-19 deaths, as well as intensive care unit (ICU) admission by age subgroups. This work analyzed 12,063 patients (56.8% men). The women in our study were older than the men, on average (67.9 vs. 65.7 years; p < 001). Bilateral condensation was more frequent among men than women (31.8% vs. 29.9%; p = 0.007). The men needed non-invasive and invasive mechanical ventilation more frequently (5.6% vs. 3.6%, p < 0.001, and 7.9% vs. 4.8%, p < 0.001, respectively). The most prevalent complication was acute respiratory distress syndrome, with severe cases in 19.9% of men (p < 0.001). In men, intensive care unit admission was more frequent (10% vs. 6.1%; p < 0.001) and the mortality rate was higher (23.1% vs. 18.9%; p < 0.001). Regarding mortality, the differences by gender were statistically significant in the age groups from 55 years to 89 years of age. A multivariate analysis showed that female sex was significantly and independently associated with a lower risk of mortality in our study. Male sex appears to be related to worse progress in COVID-19 patients and is an independent prognostic factor for mortality. In order to fully understand its prognostic impact, other factors associated with sex must be considered.
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BACKGROUND: Retinal vein occlusion (RVO) is mainly related with vascular risk factors (VRF). OBJECTIVES: To analyze the lipid profile and serum folate, vitamin B12 and homocysteine levels, in patients with RVO and a population-based control group. PATIENTS AND METHODS: Case-control study. Patients with RVO were assessed during an 11-year period. RESULTS: We included 368 patients and 325 controls of similar age and sex. HDL cholesterol and folate levels were lower (52 [43-63] mg/dL vs. 55 [46-66]; p = 0.016 and 7 [5-10] ng/mL vs. 9 [7-13]; p < 0.0001, respectively) and non-HDL cholesterol and homocysteine levels higher (148.9 ± 37.3 mg/dL vs. 142.9 ± 34.5; p = 0.03 and 13.4 [11.2-18.2] µmol/L vs. 11.1 [9.0-14.4]; p < 0.001) in patients with RVO than controls. Although total cholesterol, LDL-C, and triglyceride levels were higher and serum vitamin B12 levels were lower in RVO patients, these differences did not reach statistical significance. CONCLUSIONS: RVO-patients have lower serum HDL-C and folate levels and higher non-HDL-C and serum homocysteine levels than population-based controls of similar age and sex. In patients with RVO, apart from the lipid profile, determination of serum homocysteine, folate and vitamin B12 levels might be useful, as well as the treatment of their alterations.
Assuntos
Oclusão da Veia Retiniana , Vitamina B 12 , Estudos de Casos e Controles , Ácido Fólico , Homocisteína , Humanos , Lipídeos , Fatores de Risco , VitaminasRESUMO
BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.
