Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28.174
Filtrar
1.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190014.SUPL.2, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31596385

RESUMO

OBJECTIVES: To analyze the socioeconomic and demographic differences in medication use to control hypertension and diabetes mellitus in Brazil. METHOD: Data from the National Health Survey (Pesquisa Nacional de Saúde - PNS) performed in Brazil in 2013 with a representative sample of the population aged 18years old or older were analyzed. The use of medications for hypertension and diabetes according to income, education, race, possession of a private health insurance plan and region of household were estimated. Theprevalence ratios adjusted for sex and age were also estimated using Poisson regression. RESULTS: 81.4% of the hypertensive population used medication to control the disease. The use was higher among females, white/Caucasian individuals and those with a private health plan. In the case of diabetes mellitus, 80.2% of the population used medication to control the disease and the use was higher in elderly patients, patients with a higher level of education, patients with a private health plan, and patients in the Southeast region. Inequalities according to income and health plan were small even in the strata of sex, age and geographic region analyzed. CONCLUSION: We found a high use of medication to control hypertension and diabetes. Socioeconomic inequalities in use were not expressive, probably due to medication policies that promote greater and equitable access to medicines in Brazil.


Assuntos
Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus/tratamento farmacológico , Inquéritos Epidemiológicos/métodos , Hipertensão/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Inquéritos Epidemiológicos/estatística & dados numéricos , Disparidades em Assistência à Saúde , Humanos , Hipertensão/epidemiologia , Seguro Saúde/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Classe Social , Fatores Socioeconômicos , Adulto Jovem
2.
Medicine (Baltimore) ; 98(43): e17489, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651851

RESUMO

Very few studies have been published on cardiovascular morbidity in Spanish patients diagnosed with systemic lupus erythematosus (SLE). Moreover, knowledge of the predictive factors for the occurrence of nonfatal events in this group of patients is scarce.This was a multicenter, observational, cross-sectional study designed to ascertain the prevalence of nonfatal cardiovascular risk factors and cardiovascular events (CVEs) in 335 Spanish women diagnosed with SLE between 2003 and 2013.The average patient age was 36.0 years (range: 26.4-45.6); 35 patients (10.7%) experienced at least 1 CVE, which most frequently affected the brain, followed by the heart, and finally, the peripheral vasculature. Both the number of admissions because of SLE (95% confidence interval [CI] odds ratio [OR] = 1.024-1.27, P = .017) and the systemic lupus international collaborating clinics (SLICC) chronicity index score (95% CI OR = 1.479-2.400, P = .000) resulted in an increase in the OR of these patients presenting a CVE. Regarding the classic risk factors, only the interaction between hypertension (HT) and treatment with antihypertensive drugs influenced the presence of CVEs (95% CI OR = 2.165-10.377, P = .000). The presence of a family history of early cardiovascular disease was also related to CVEs (95% CI OR = 2.355-40.544, P = .002). Binary logistic regression including the above factors resulted in a model in which the 3 main variables in each group persisted, implying that they must be independent of each other. However, the weight of the interaction between the family history of early cardiovascular disease and the interaction between HT and the use of antihypertensives was higher than for the number of admissions for SLE.The SLE disease activity over time (measured using the SLICC) and the number of hospital admissions due to the disease itself, both increase the risk of women with SLE presenting a CVE. Classic cardiovascular risk factors, especially HT and its treatment, as well as a family history of early CVEs, should be considered when assessing the risk of nonfatal CVEs in women with SLE.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Anti-Hipertensivos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/etiologia , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Medição de Risco , Fatores de Risco , Espanha/epidemiologia
3.
Zhonghua Nei Ke Za Zhi ; 58(10): 751-757, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594173

RESUMO

Objective: To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods: Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF% ≥25% for male and ≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results: A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1% (348/362) were male. Mean sUA was (551±133) µmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576±126)µmol/L vs. (523±134) µmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF% (ß=4.29, P=0.020) and trunk BF% (ß=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion: Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.


Assuntos
Composição Corporal/fisiologia , Gota/diagnóstico , Obesidade/epidemiologia , Ácido Úrico/sangue , Adulto , Dislipidemias/epidemiologia , Feminino , Gota/sangue , Gota/epidemiologia , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/sangue , Prevalência
4.
Zhonghua Zhong Liu Za Zhi ; 41(10): 775-781, 2019 Oct 23.
Artigo em Chinês | MEDLINE | ID: mdl-31648501

RESUMO

Objective: To evaluate the efficacy and safety of apatinib combined with chemotherapy in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with negative driving genes. Methods: From January 2016 to March 2018, 62 advanced NSCLC patients with negative driving genes diagnosed at Xuzhou Cancer Hospital were randomly divided into study group (30 cases) and control group (32 cases), respectively. The patients in the study group were treated with standard first-line chemotherapy combined with apatinib, while those in control group were treated with chemotherapy alone. Results: The disease control rate (DCR) and objective remission rate (ORR) in the study group were 60.0% and 16.7%, respectively, higher than 46.9% and 9.3% in the control group, but without statistical difference (P>0.05). The median progression-free survival (PFS) of study group and control group were 6.4 months and 4.9 months, respectively (P=0.004), and the median overall survival (OS) were 11.3 months and 9.2 months, respectively (P=0.006). Multivariate survival analysis indicated that treatment regimen (P=0.001) was the independent prognostic factor of PFS, and PS score (P=0.002), clinical stage (P=0.02) and treatment regimen (P<0.001) were the independent prognostic factors of OS. After treatment, the incidence of hypertension and hand-foot syndrome in the study group were 46.7% and 53.3%, respectively, significantly higher than 3.3% and 0 in the control group, respectively (P<0.05). The incidence of grade 3-4 adverse drug reactions (ADRs) in the study group was 26.7% (8/30), mainly including hypertension, hand-foot syndrome and bone marrow suppression. The incidence of grade 3-4 ADRs in the control group was 15.6% (5/32), all of which were bone marrow suppression, without significant difference (P=0.286). There was no difference in serum levels of VEGF and CEA between the two groups before treatment. After treatment, the serum level of VEGF in the study group was (169.3±10.1) pg/ml, lower than (211.8±16.7) pg/ml of the control group (P<0.05). Conclusion: Apatinib combined with first-line chemotherapy for advanced NSCLC patients with negative driving genes is safe and beneficial for survival. This therapeutic strategy can significantly prolong the PFS and OS, and further improvement and application can be considered as a choice in the clinical treatment.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Complicações Pós-Operatórias/epidemiologia , Inibidores de Proteínas Quinases/uso terapêutico , Antineoplásicos/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , China/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Síndrome Mão-Pé/complicações , Síndrome Mão-Pé/epidemiologia , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Incidência , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Inibidores de Proteínas Quinases/administração & dosagem , Inibidores de Proteínas Quinases/efeitos adversos , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/uso terapêutico , Análise de Sobrevida , Resultado do Tratamento
5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1139-1144, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594161

RESUMO

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/epidemiologia , Adulto , Idoso , Conscientização , China/epidemiologia , Feminino , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
6.
Medicine (Baltimore) ; 98(40): e17153, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577706

RESUMO

The present study evaluated the association between appendectomy and rheumatoid arthritis (RA) using a national sample cohort of the Korean population. In this cohort study, the Korean National Health Insurance Service-National Sample Cohort of individuals ≥20 years old was collected from 2002 to 2013. A total of 14,995 appendectomy participants were 1:4 matched with 59,980 control subjects for age, group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the occurrence of RA in both the appendectomy and control groups. Appendectomies were identified using operation codes for appendicitis only. RA was defined by International Classification of Disease-10 codes (M05 or M06) and medication histories. Crude and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. Subgroup analyses were performed on groups stratified by age and sex. The adjusted HR for RA was 1.02 (95% confidence interval = 0.76-1.38) in the appendectomy group (P = .883). In all of the subgroup analyses according to age and sex, the adjusted HRs for RA were not higher in the appendectomy group than those in the control group. We could not identify any significant relationship between appendectomy and RA.


Assuntos
Apendicectomia/estatística & dados numéricos , Apendicite/cirurgia , Artrite Reumatoide/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Características de Residência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
7.
Medicine (Baltimore) ; 98(40): e17411, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577753

RESUMO

Evidence on the prescription patterns of antihypertensive drug use in children and adolescents in China is scarce. A descriptive analysis of the Beijing Medical Claim Data, which covered over 95% of the urban residents, was conducted to investigate antihypertensive prescribing patterns and trends in children and adolescents aged under 18 from 2009 to 2014 in Beijing, China. An additional meta-analysis of trends in hypertension prevalence was conducted to compare trends with antihypertensive medications.A total of 11,882 patients received at least 1 prescription for antihypertensive drugs from 2009 to 2014. The number of annual antihypertensive users increased from 2009 to 2012, then declined steadily until 2014, which was consistent with the trend of the hypertension prevalence estimated from the meta-analysis. ß-receptor blockers, thiazide diuretics, and angiotensin-converting enzyme inhibitors were the 3 most commonly prescribed antihypertensive drugs. More boys took the antihypertensive drugs than girls. For users aged under 3 years, thiazide diuretics, α-receptor blockers, and angiotensin-converting enzyme inhibitors were the most prescribed drugs, while ß-receptor blockers, thiazide diuretics were the most used drugs for users above 3 years.In conclusion, antihypertensive drug prescribing for children and adolescents increased from 2009 to 2014, with different characteristics in different subgroups.


Assuntos
Anti-Hipertensivos/classificação , Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Adolescente , Fatores Etários , Pequim , Criança , Pré-Escolar , Feminino , Humanos , Hipertensão/epidemiologia , Lactente , Masculino , Padrões de Prática Médica/estatística & dados numéricos , Fatores Sexuais , População Urbana/estatística & dados numéricos
8.
BMJ ; 367: l5367, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31594780

RESUMO

OBJECTIVE: To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN: Matched cohort study. SETTING: Population based, electronic primary healthcare databases before 31 December 2015 from four European countries: Italy (n=1 542 672), Netherlands (n=2 225 925), Spain (n=5 488 397), and UK (n=12 695 046). PARTICIPANTS: 120 795 adults with a recorded diagnosis of NAFLD or NASH and no other liver diseases, matched at time of NAFLD diagnosis (index date) by age, sex, practice site, and visit, recorded at six months before or after the date of diagnosis, with up to 100 patients without NAFLD or NASH in the same database. MAIN OUTCOME MEASURES: Primary outcome was incident fatal or non-fatal AMI and ischaemic or unspecified stroke. Hazard ratios were estimated using Cox models and pooled across databases by random effect meta-analyses. RESULTS: 120 795 patients with recorded NAFLD or NASH diagnoses were identified with mean follow-up 2.1-5.5 years. After adjustment for age and smoking the pooled hazard ratio for AMI was 1.17 (95% confidence interval 1.05 to 1.30; 1035 events in participants with NAFLD or NASH, 67 823 in matched controls). In a group with more complete data on risk factors (86 098 NAFLD and 4 664 988 matched controls), the hazard ratio for AMI after adjustment for systolic blood pressure, type 2 diabetes, total cholesterol level, statin use, and hypertension was 1.01 (0.91 to 1.12; 747 events in participants with NAFLD or NASH, 37 462 in matched controls). After adjustment for age and smoking status the pooled hazard ratio for stroke was 1.18 (1.11 to 1.24; 2187 events in participants with NAFLD or NASH, 134 001 in matched controls). In the group with more complete data on risk factors, the hazard ratio for stroke was 1.04 (0.99 to 1.09; 1666 events in participants with NAFLD, 83 882 in matched controls) after further adjustment for type 2 diabetes, systolic blood pressure, total cholesterol level, statin use, and hypertension. CONCLUSIONS: The diagnosis of NAFLD in current routine care of 17.7 million patient appears not to be associated with AMI or stroke risk after adjustment for established cardiovascular risk factors. Cardiovascular risk assessment in adults with a diagnosis of NAFLD is important but should be done in the same way as for the general population.


Assuntos
Hipertensão/epidemiologia , Fígado/patologia , Infarto do Miocárdio/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Países Baixos/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Espanha/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
9.
Mymensingh Med J ; 28(4): 819-825, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599246

RESUMO

Hypertension is a common disease associated with high mortality and morbidity. Hypertension could have its origin in childhood and go undetected unless specially looked for during this period. With globalization bringing more lifestyle modifications, adolescents are exposed to multiple risk factors including obesity, diet, academic stress, lack of physical work apart from hereditary risk factors. Early diagnosis of hypertension is an important strategy in its control, effective treatment and prevention of complications. This cross sectional descriptive study was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from January 2014 to June 2014. One thousand (1000) school children aged 12-16 years in Sylhet Metropolitan City were included according to inclusion and exclusion criteria. Inclusion criteria were all school children aged 12-16 years in Sylhet Metropolitan City. School children aged under 12 or above 16 years and with any systemic disorder were excluded. This study showed that prevalence of hypertension in school going children of Sylhet city was 0.70% and there was a significant relationship of hypertension with the obesity, family history of hypertension, dietary habit and physical activity. Among 7 (seven) hypertensive children, 3(42.8%) were over weight and 3(42.8%) obese (p=0.001). All of 7(100%) children had family history of hypertension (p=0.001). Dietary habit were found healthy in 1(14.3%) and unhealthy in 6(85.7%) (p=0.001). Among 7 positive respondent, 6(85.7%) was sedentary working and 1(14.3%) was inactive (p=0.001). While waist hip ratio among those, 2(28.6%) were excellent and 5(71.4%) were average; was not significant (p=0.745). Prevalence of hypertension in apparently healthy school going children of Sylhet city was 0.70% and this had a strong relationship with obesity, family history of hypertension, dietary habit and physical activity.


Assuntos
Hipertensão/epidemiologia , Adolescente , Bangladesh/epidemiologia , Criança , Estudos Transversais , Humanos , Prevalência , Fatores de Risco
10.
Mymensingh Med J ; 28(4): 849-853, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599250

RESUMO

Hypertension has its origin in childhood but goes undetected unless specially looked for detection of hypertension in children will increase the awareness and lead to preventive strategies. The objective of the study was to determine the prevalence of hypertension in school children. This cross sectional study was conducted among children aged 10 to 17 years in three secondary level schools of Dhaka city, Bangladesh. This study included 1146 participants (both boys and girls) by systematic random sampling. Blood pressure was measured and plotted in Blood pressure (BP) chart to define hypertension and structured questionnaire were used to collect socio demographic information. The prevalence of hypertension in school children was 1.8% (male was 1.68% and female was 1.99%). It was noted that there was a strong correlation between body weight and BMI of the children with hypertension. A significant portion of the respondents had family history of hypertension, diabetes and obesity. There was also a positive relation between hypertension and food habit that include low vegetables and more fast food. It was concluded that hypertension exists among secondary level school children in Dhaka, Bangladesh and it is related with obesity, increased BMI, family history and dietary habit.


Assuntos
Hipertensão/epidemiologia , Instituições Acadêmicas , Adolescente , Bangladesh/epidemiologia , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco
11.
Zhonghua Jie He He Hu Xi Za Zhi ; 42(10): 750-754, 2019 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-31594108

RESUMO

Objective: To analyzed the clinical characteristics and prognosis of patients with H7N9 avian influenza. Methods: The baseline characteristics, clinical manifestations, treatments, laboratory and imaging findings were collected and analyzed for 20 patients with H7N9 avian influenza admitted to the First Affiliated Hospital of Nanchang University from December 2016 to March 2017. According to the final clinical outcome, the patients were divided into the death group and the survival group. Ten patients in the death group died, and 10 patients in the survival group were discharged. The data with normal distribution were analyzed by t test. The data with non-normal distribution were analyzed by Wilcoxon rank sum test. Results: Of the 20 patients, 13 were males and 7 were females, aging 40-82 years, with a mean age of (60±12) years. Twelve patients had a definite history of poultry exposure and 10 had chronic underlying diseases such as hypertension and diabetes. The clinical manifestations were mainly fever, cough, hemoptysis, respiratory distress, fatigue, etc. In the survival group, the platelet count was(167-315)×10(9)/L, while it was (78-152)×10(9)/L in the death group. The average white blood cell count was (7.78-11.52)×10(9)/L and (9.91-15.93)×10(9)/L in the survival and death groups respectively. The average value of lymphocyte count was (0.69-1.59)×10(9)/L and (0.58-0.86)×10(9)/L in the survival and death groups respectively. In the death group the glutamic-pyruvic transaminase (ALT) value was (14.0-352.0) U/L, the total bilirubin value was (6.9-34.5) µmol/L, the creatine kinase MB (CK-MB) was (16.0-162.0) U/L, the serum calcium value was (1.4-2.0) mmol/L, the C-reactive protein value was (33.1-414.0) mg/L, and the calcium reduction prime value was (0.6-100.0) µg/L. In the survival group,the ALT value was (25.0-181.0) U/L, the total bilirubin value was (4.8-25.9) µmol/L, the CK-MB value was (15.0-40.0) U/L, the serum calcium value was (1.9-2.4) mmol/L, the C-reaction protein value was (12.8-52.5) mg/L, and the procalcitonin value was (0.3-23.3) µg/L. Sixteen cases suffered severe pneumonia. Twelve patients received extracorporeal membrane oxygenation (ECMO), and 4 survived. The cause of death was mainly related to factors such as age, chronic underlying diseases and severity of illness. Conclusions: Human infection with H7N9 avian influenza virus was highly pathogenic, and prone to progress into severe pneumonia, with a high mortality. Decreased platelet count was associated with mortality (t=4.07, P=0.001), predictive of patient outcome.


Assuntos
Antivirais/uso terapêutico , Subtipo H7N9 do Vírus da Influenza A/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/tratamento farmacológico , Síndrome do Desconforto Respiratório do Adulto/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Aves , China/epidemiologia , Tosse/etiologia , Diabetes Mellitus/epidemiologia , Exposição Ambiental , Feminino , Febre/etiologia , Humanos , Hipertensão/epidemiologia , Influenza Aviária , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Masculino , Pessoa de Meia-Idade , Pneumonia/epidemiologia , Pneumonia/etiologia , Pneumonia/virologia , Prognóstico , Resultado do Tratamento
12.
Rev Saude Publica ; 53: 66, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553376

RESUMO

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Assuntos
Sobrepeso/complicações , Medição de Risco/métodos , Razão Cintura-Estatura , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/fisiopatologia , Distribuição de Poisson , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
13.
Cancer Invest ; 37(9): 478-488, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31557062

RESUMO

Hypertension is associated with enzalutamide in the treatment of prostate cancer. We performed a meta-analysis of randomized clinical trials to determine the risk of hypertension. Databases including Pubmed and Google scholar were searched to identify randomized clinical trials with enzalutamide. A total of seven studies including 7347 patients were selected. The overall incidences of all-grade and high-grade hypertension were 11.9% (95%% CI: 8.8-16.0%) and 4.9% (95%% CI: 3.5-6.8%) respectively, with a relative risk of 2.82 (95%% CI: 2.34-3.38, p < 0.001) for all-grade and 2.27 (95%% CI: 1.73-2.96, p < 0.001) for high-grade. There was a significant risk of developing hypertension with enzalutamide.


Assuntos
Hipertensão/epidemiologia , Feniltioidantoína/análogos & derivados , Neoplasias da Próstata/tratamento farmacológico , Humanos , Hipertensão/induzido quimicamente , Incidência , Masculino , Feniltioidantoína/efeitos adversos , Feniltioidantoína/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Pan Afr Med J ; 33: 140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558938

RESUMO

Introduction: The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. Methods: The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. Results: Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). Conclusion: These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.


Assuntos
Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Intolerância à Glucose/epidemiologia , Adulto , Fatores Etários , Doenças Cardiovasculares/etiologia , Comores/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Jejum , Feminino , Humanos , Hipertensão/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Circunferência da Cintura
15.
J Assoc Physicians India ; 67(9): 24-26, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561683

RESUMO

Introduction: Hypertension is one of the most challenging health problems in the world. Hypertension is closely related to kidney diseases. Microalbuminuria is a reflection of early kidney dysfunction and a marker of asymptomatic preclinical disease which precedes and predicts the occurrence of major morbid events. Aims and objectives: To investigate the relationship between microalbuminuria and LVH in patients with primary hypertension. To establish microalbuminuria as an independent risk factor for increased Left Ventricular Mass Index in patients with Primary Hypertension. Methods: This was a cross-sectional prevalence, analytical study conducted for a period of two years in a tertiary care teaching hospital in Western India. 126 patients diagnosed as primary hypertension, according to JNC 7 criteria were included in the study. Left ventricular Mass Index was measured using 2 D Echo Machine using the formula of Left ventricular mass. Multiple logistic regression was conducted to find out independent correlation of Left Ventricular Hypertrophy. Results: Mean age was 64.32 years in patients without LVH while it was 63.85 years in patients with LVH. Serum creatinine, albumin-creatinine ration and Microalbuminuria were independently correlated with the Left Ventricular hyper trophy. Multiple logistic regression concluded that presence of microalbuminuria increases risk of LVH 2.04 times more as compared to absence of microalbuminuria. Serum creatinine level was higher in patients with LVH compare to patients without LVH. patients with Microalbuminuria were higher in LVH group compare to non LVH group and this difference was statistically significant. Conclusion: This study demonstrates that microalbuminuria has an independent correlation with Left Ventricular Mass Index and hence an independent risk factor for increased cardiovascular morbidity and mortality.


Assuntos
Albuminúria/microbiologia , Hipertensão/epidemiologia , Idoso , Estudos Transversais , Humanos , Hipertrofia Ventricular Esquerda , Índia/epidemiologia , Prevalência
16.
Pan Afr Med J ; 33: 100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489078

RESUMO

Introduction: Hypertension, among diabetic patients, is a worldwide public-health challenge and a leading modifiable risk factor for other cardiovascular diseases. The main purpose of this study was to identify determinants of hypertension among diabetic patients. Methods: Data were collected from January to March 2018 using an interviewer-administered structured questionnaire. Data collectors and supervisors were trained before the period of data collection. The questionnaire was pretested on 5% of the sample at Suhul hospital. Bivariable logistic regression was employed to examine the crude associations between the outcome variable and determinant variables. This was followed by multivariable analysis to examine the determinants of hypertension among diabetic patients by selecting variables which had p value ≤0.2 in the bivariable analysis. Results: The age range of the respondents was 18-80 years, with the median age of 51.56±14.92 years. Not attending diabetes mellitus education sessions (AOR=2.61, 95% CI (1.12,6.1), duration since diagnosis with diabetes (AOR=8.52; 95% CI (1.97, 36.84), poor glycemic control (AOR=22.99, 95CI (5.92,89.28), overweight (AOR=4.84, 95%CI (1.42,16.51), and non-adherence to diabetes medication (AOR=4.66, 95% CI (2.22,9.79), diet (AOR=9.70,95% CI (3.34,28.22), exercise (AOR= 5.47, 95% CI (2.35,12.75), and self-monitoring blood glucose (AOR=6.62, 95% CI (3.16, 13.86) were found to be the determinants of hypertension among diabetic patients. Conclusion: This research concludes that longer duration with diabetes, nonattendance of diabetes education sessions, poor glycemic control, and not-adherence to antidiabetic medications, diet, exercise and self-monitoring blood glucose were found to be the determinants of hypertension among diabetic patients.


Assuntos
Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , Hipoglicemiantes/administração & dosagem , Adesão à Medicação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Estudos de Casos e Controles , Diabetes Mellitus/tratamento farmacológico , Etiópia/epidemiologia , Feminino , Hospitais Públicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
17.
Pan Afr Med J ; 33: 87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489065

RESUMO

Introduction: The introduction of highly active antiretroviral therapy (HAART) in the treatment of HIV infection has provided different good results: like long-term viral suppression, the decrease of opportunistic infections, and repair of the immune system. Methods: We carried out a hospital-based cross-sectional analytic study involving 315 participants 228 were on HAART (group 1) and 87 were HAART-naïve (group 2) at the HIV treatment centre of the Bamenda regional hospital with our study population being all people living with HIV (PLWHIV) in the North West region of Cameroon. The sampling was performed from the 15th of March to the 30th of June 2017. The questionnaire was administered face to face with participants and their vital signs taken. Blood pressure was measured using an automated electronic blood pressure monitor and hypertension (HTN) was considered as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90mmHg. Results: The prevalence of hypertension in the HAART group was 36.44% (n=82, CI: 30.15%-43.10%) compared to that of the HAART-naïve group which was 13.33% (n=12, CI: 7.08%-22.13%, P=0.01). HAART was associated with HTN after controlling for gender, family history of hypertension, body mass index (BMI), smoking and alcohol consumption. The odds ratio of the HAART-treated versus the HAART-naïve was 3.86 (95% CI: 1.98-7.50). We also found an association between TDF/3TC/EFV (OR=2.83), AZT/3TC/NVP (OR=2.82), AZT/3TC+EFV (OR=3.48) and TDF/3TC+NVP (OR=2.36) and HTN whereas those on AZT+3TC+ATV/r (OR=0.84) and TDF+3TC+ATV/r (OR=0.45) were not associated to hypertension. Conclusion: Our result suggests that blood pressure should be periodically measured and treated when necessary in PLWHIV on HAART.


Assuntos
Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/tratamento farmacológico , Hipertensão/epidemiologia , Adulto , Idoso , Fármacos Anti-HIV/efeitos adversos , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Terapia Antirretroviral de Alta Atividade/métodos , Pressão Sanguínea , Camarões , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários , Adulto Jovem
18.
Pan Afr Med J ; 33: 91, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489069

RESUMO

Introduction: Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the procedure. These may include hypotension or hypertension. Methods: This was a retrospective study that reviewed chronic kidney disease (CKD) patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis unit. Results: There were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and 43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP), MAP, greater number of antihypertensive medications and longer duration of haemodialysis. Conclusion: Our study shows that there are several modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University of Calabar Teaching Hospital, Calabar.


Assuntos
Hipertensão/epidemiologia , Hipotensão/epidemiologia , Diálise Renal/métodos , Insuficiência Renal Crônica/terapia , Adolescente , Adulto , Idoso , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea , Feminino , Hospitais de Ensino , Humanos , Hipertensão/etiologia , Hipotensão/etiologia , Masculino , Pessoa de Meia-Idade , Nigéria , Prevalência , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Fatores de Tempo , Adulto Jovem
19.
Niger J Clin Pract ; 22(8): 1140-1146, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417059

RESUMO

Objective: Hypertension among adolescents is an emerging public health problem. The current study aims to estimate the burden of hypertension and identify its risk factors among male adolescents of intermediate and secondary schools. Subjects and Methods: This is a school-based cross-sectional study that targeted 400 male adolescents in the age group of 15-17 years. Blood pressure was defined as per the "Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents". An electronic device approved for use by the European Society of Hypertension International Protocol revision 2010, (Omron M3W; HEM-7202-E) was used for measuring blood pressure. CDC's body mass index tool was adopted for defining overweight and obesity. Descriptive analysis for hypertension and the risk factors were carried out. Chi-square test and odds ratios were calculated to assess any association between categorical variables. Results: Overall 36 (9.0%) adolescents had prehypertension and 69 (17.2%) had hypertension. Systolic prehypertension, systolic hypertension, diastolic prehypertension, and diastolic hypertension were present in 6.5%, 17.2%, 5.8%, and 9.0% of the adolescents, respectively. Bivariate analysis revealed that overweight and obesity, no physical activity, or once-a-week physical activity, positive family history of hypertension, and smoking were predictors of systolic prehypertension and showed a significant relationship with systolic hypertension. Conclusion: There is a considerable prevalence of prehypertension and hypertension, among school-going male adolescents. We recommend school-based health education programs and routine screening directed toward the risk factors of noncommunicable diseases like hypertension with special attention to obesity, physical inactivity, and smoking.


Assuntos
Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Hipertensão/epidemiologia , Programas de Rastreamento/métodos , Pré-Hipertensão/epidemiologia , Adolescente , Índice de Massa Corporal , Estudos Transversais , Exercício , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/etiologia , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Instituições Acadêmicas , Inquéritos e Questionários
20.
Medicine (Baltimore) ; 98(35): e17007, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464957

RESUMO

Poor outcomes of hepatocellular carcinomas (HCC) in chronic kidney disease (CKD) patients are well described. Transarterial therapy is the standard treatment for HCC, following which regular contrast-enhanced imaging for residual disease is recommended. CKD is considered a relative contraindication for transarterial therapy owing to renal failure.This retrospective study investigated the outcomes of transarterial therapy in HCC patients with CKD. In total, 132 HCC patients who received transarterial therapy were enrolled, of whom 36 had CKD. Most CKD patients were elderly, with mean age of diagnosis of 69.7 ±â€Š11.4 years. Hypertension (odds ratio [OR]; 5.06; 95% confidence interval [Cl]; 1.83-13.94), hepatitis C virus carrier rate (OR; 4.12, 95% CI; 1.13-14.99) and diabetes (OR; 3.62, 95% CI; 1.22-10.72) were significant predictors for CKD in HCC patients. Post therapy, the estimated glomerular filtration rate significantly decreased 13.7% from baseline in the CKD patients (P = .03). There were more post-therapy complications than in the non-CKD group, e.g. acute renal failure and sepsis (P < .01 vs P < .01). Overall survival in the CKD group was significantly poor (10.9 ±â€Š8.5 vs 23.5 ±â€Š16.3 months, P < .01).The lower survival of CKD patients was unrelated to treatment modality or less contrast-enhanced imaging follow-up. Further research on patient care and factors leading to poor outcomes for CKD is needed.


Assuntos
Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/terapia , Insuficiência Renal Crônica/epidemiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/mortalidade , Quimioembolização Terapêutica/efeitos adversos , Diabetes Mellitus/epidemiologia , Feminino , Taxa de Filtração Glomerular , Hepatite C/epidemiologia , Humanos , Hipertensão/epidemiologia , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA