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19 result(s)
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19 result(s)
Journal Article > ResearchFull Text

Cardiovascular event predictors in hospitalized chronic kidney disease (CKD) patients: A nationwide inpatient sample analysis

Cureus. 29 October 2023; Volume 15 (Issue 10); e47912.; DOI:10.7759/cureus.47912
Uwumiro F, Nebuwa C, Nwevo CO, Okpujie V, Osemwota O,  et al.
Cureus. 29 October 2023; Volume 15 (Issue 10); e47912.; DOI:10.7759/cureus.47912
INTRODUCTION
This study seeks to confirm the risk factors linked to cardiovascular (CV) events in chronic kidney disease (CKD), which have been identified as CKD-related. We aim to achieve this using a larger, more diverse, and nationally representative dataset, contrasting with previous research conducted on smaller patient cohorts.

METHODS
The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with CV events. Risk factors and CV events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. CV events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between CKD-specific risk factors and CV events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking.

RESULTS
A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and mostly hospitalized at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a Charlson comorbidity index (CCI) of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all CKD hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). A total of 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of CV events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06-1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26-1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29-1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09-1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26-1.53; p<0.001).

CONCLUSION
The study confirmed the predictive reliability of malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for CV events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing CV events.
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Journal Article > ResearchAbstract

Factors associated with Condom Use Problems during Vaginal Sex with main and non-main partners

Sex Transm Dis. 1 September 2012 (Issue 9)
Danna LH, Korosteleva O, Warner L, Douglas J, Paul S,  et al.
Sex Transm Dis. 1 September 2012 (Issue 9)
Incorrect condom use is a common problem that can undermine their prevention impact. We assessed the prevalence of 2 condom use problems, breakage/slippage and partial use, compared problems by partnership type, and examined associations with respondent, partner, and partnership characteristics.More
Journal Article > CommentaryFull Text

High Cancer Drug Prices in the United States: Reasons and Proposed Solutions

J Oncol Pract. 6 May 2014; Volume 10 (Issue 4); DOI:10.1200/JOP.2013.001351
Kantarjian H, Steensma D, Rius Sanjuan J, Elshaug A, Light D
J Oncol Pract. 6 May 2014; Volume 10 (Issue 4); DOI:10.1200/JOP.2013.001351
The increase in drug prices poses questions: Are cancer drug prices too high? Are they hurting patients and our health care system? And can we do something about it? The answer to each is affirmative.
Journal Article > LetterFull Text

Legislation governing the US incentive scheme for neglected diseases needs to be amended, urges MSF

BMJ. 30 September 2014; Volume 349; DOI:10.1136/bmj.g5861
Reid J, Potet J, Athersuch K, Grovestock M, Sanjuan J
BMJ. 30 September 2014; Volume 349; DOI:10.1136/bmj.g5861
Journal Article > ResearchAbstract

Viral Load Monitoring as a Tool to Reinforce Adherence: A Systematic Review

J Acquir Immune Defic Syndr. 14 June 2013; Volume 64 (Issue 1); DOI:10.1097/QAI.0b013e31829f05ac
Bonner K, Mezochow A, Roberts TR, Ford NP, Cohn J
J Acquir Immune Defic Syndr. 14 June 2013; Volume 64 (Issue 1); DOI:10.1097/QAI.0b013e31829f05ac
Viral load monitoring has been proposed as a tool to reinforce adherence, but outcomes have never been systematically assessed.
Journal Article > CommentaryFull Text

Diabetes in humanitarian crises: the Boston Declaration

Lancet Diabetes Endocrinol. 1 August 2019; DOI:10.1016/S2213-8587(19)30197-4.
Kehlenbrink S, Jaacks LM, Perone SA, Ansbro É, Ashbourne E,  et al.
Lancet Diabetes Endocrinol. 1 August 2019; DOI:10.1016/S2213-8587(19)30197-4.
Journal Article > CommentaryFull Text

An unfolding tragedy of Chagas disease in North America

PLoS Negl Trop Dis. 31 October 2013; Volume 7 (Issue 10); e2300.; DOI:10.1371/journal.pntd.0002300
Hotez PJ, Dumonteil E, Cravioto MB, Bottazzi ME, Tapia-Conyer R,  et al.
PLoS Negl Trop Dis. 31 October 2013; Volume 7 (Issue 10); e2300.; DOI:10.1371/journal.pntd.0002300
Journal Article > ResearchFull Text

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients

PLOS Med. 28 August 2012; Volume 9 (Issue 8); DOI:10.1371/journal.pmed.1001300
Ahuja SD, Ashkin D, Avendano M, Banerjee R, Bayona J,  et al.
PLOS Med. 28 August 2012; Volume 9 (Issue 8); DOI:10.1371/journal.pmed.1001300
Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB.More
Journal Article > ResearchFull Text

Determining the lower limit of detection required for HCV viral load assay for test of cure following direct-acting antiviral based treatment regimens: evidence from a global dataset

J Viral Hepat. 12 March 2022; Online ahead of print; DOI: 10.1111/jvh.13672
Morgan JR, Marsh E, Savinkina A, Shilton S, Shadaker S,  et al.
J Viral Hepat. 12 March 2022; Online ahead of print; DOI: 10.1111/jvh.13672
Achieving global elimination of hepatitis C virus requires a substantial scale-up of testing. Point-of-care HCV viral load assays are available as an alternative to laboratory-based assays to promote access in hard to reach or marginalized populations. The diagnostic performance and lower limit of detection are important attributes of these new assays for both diagnosis and test of cure. Therefore, our objective was to determine an acceptable LLoD for detectable HCV viraemia as a test for cure, 12-weeks post-treatment (SVR12). We assembled a global dataset of patients with detectable viraemia at SVR12 from observational databases from 9 countries (Egypt, the United States, United Kingdom, Georgia, Ukraine, Myanmar, Cambodia, Pakistan, Mozambique), and two pharmaceutical-sponsored clinical trial registries. We examined the distribution of HCV viral load at SVR12 and presented the 90th , 95th, 97th, and 99th percentiles. We used logistic regression to assess characteristics associated with low-level virological treatment failure (defined as <1000 IU/mL). There were 5,973 cases of detectable viremia at SVR12 from the combined dataset. Median detectable HCV RNA at SVR12 was 287,986 IU/mL. The level of detection for the 95th percentile was 227 IU/mL (95% CI 170-276). Females and those with minimal fibrosis were more likely to experience low-level viremia at SVR12 compared to men (adjusted odds ratio AOR = 1.60 95% confidence interval [CI] 1.30-1.97 and those with cirrhosis (AOR=1.49 95% CI 1.15-1.93). In conclusion, an assay with a level of detection of 1000 IU/mL or greater may miss a proportion of those with low-level treatment failureMore
Journal Article > CommentaryAbstract

Reply: Benefit of the Shorter Multidrug-Resistant Tuberculosis Treatment Regimen in California and Modified Eligibility Criteria

Am J Respir Crit Care Med. 1 December 2017; Volume 196 (Issue 11); DOI:10.1164/rccm.201705-0988LE
Varaine FFV, Guglielmetti L, Mitnick CD
Am J Respir Crit Care Med. 1 December 2017; Volume 196 (Issue 11); DOI:10.1164/rccm.201705-0988LE