1.Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity.
MarIa MOLINA-VEGA ; Araceli MUÑOZ-GARACH ; Miguel DAMAS-FUENTES ; José Carlos FERNÁNDEZ-GARCÍA ; Francisco J TINAHONES
Asian Journal of Andrology 2018;20(6):531-538
Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.
Adult
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Humans
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Hypogonadism/epidemiology*
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Male
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Obesity/epidemiology*
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Prevalence
2.Characteristics and in-hospital mortality of elderly patients with heart failure in Spanish hospitals.
Alberto ESTEBAN-FERNÁNDEZ ; Manuel ANGUITA-SÁNCHEZ ; Juan Luis BONILLA-PALOMAS ; María ANGUITA-GÁMEZ ; María GARCÍA ; José Luis BERNAL ; Náyade Del PRADO ; Cristina FERNÁNDEZ-PÉREZ ; Julián PÉREZ-VILLACASTIN ; Juan José GÓMEZ-DOBLAS ; Francisco Javier ELOLA
Journal of Geriatric Cardiology 2023;20(4):247-255
BACKGROUND:
The prevalence of heart failure (HF) increases with age, and it is one of the leading causes of hospitalization and death in older patients. However, there are little data on in-hospital mortality in patients with HF ≥ 75 years in Spain.
METHODS:
A retrospective analysis of the Spanish Minimum Basic Data Set was performed, including all HF episodes discharged from public hospitals in Spain between 2016 and 2019. Coding was performed using the International Classification of Diseases, 10th Revision. Patients ≥ 75 years with HF as the principal diagnosis were selected. We calculated: (1) the crude in-hospital mortality rate and its distribution according to age and sex; (2) the risk-standardized in-hospital mortality ratio; and (3) the association between in-hospital mortality and the availability of an intensive cardiac care unit (ICCU) in the hospital.
RESULTS:
We included 354,792 HF episodes of patients over 75 years. The mean age was 85.2 ± 5.5 years, and 59.2% of patients were women. The most frequent comorbidities were renal failure (46.1%), diabetes mellitus (35.5%), valvular disease (33.9%), cardiorespiratory failure (29.8%), and hypertension (26.9%). In-hospital mortality was 12.7%, and increased with age [odds ratio (OR) = 1.07, 95% CI: 1.07-1.07, P < 0.001] and was lower in women (OR = 0.96, 95% CI: 0.92-0.97, P < 0.001). The main predictors of mortality were the presence of cardiogenic shock (OR = 19.5, 95% CI: 16.8-22.7, P < 0.001), stroke (OR = 3.5, 95% CI: 3.0-4.0, P < 0.001) and advanced cancer (OR = 2.6, 95% CI: 2.5-2.8, P < 0.001). In hospitals with ICCU, the in-hospital risk-adjusted mortality tended to be lower (OR = 0.85, 95% CI: 0.72-1.00, P = 0.053).
CONCLUSIONS
In-hospital mortality in patients with HF ≥ 75 years between 2016 and 2019 was 12.7%, higher in males and elderly patients. The main predictors of mortality were cardiogenic shock, stroke, and advanced cancer. There was a trend toward lower mortality in centers with an ICCU.
3.Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
Thanh N. NGUYEN ; Muhammad M. QURESHI ; Piers KLEIN ; Hiroshi YAMAGAMI ; Mohamad ABDALKADER ; Robert MIKULIK ; Anvitha SATHYA ; Ossama Yassin MANSOUR ; Anna CZLONKOWSKA ; Hannah LO ; Thalia S. FIELD ; Andreas CHARIDIMOU ; Soma BANERJEE ; Shadi YAGHI ; James E. SIEGLER ; Petra SEDOVA ; Joseph KWAN ; Diana Aguiar DE SOUSA ; Jelle DEMEESTERE ; Violiza INOA ; Setareh Salehi OMRAN ; Liqun ZHANG ; Patrik MICHEL ; Davide STRAMBO ; João Pedro MARTO ; Raul G. NOGUEIRA ; ; Espen Saxhaug KRISTOFFERSEN ; Georgios TSIVGOULIS ; Virginia Pujol LEREIS ; Alice MA ; Christian ENZINGER ; Thomas GATTRINGER ; Aminur RAHMAN ; Thomas BONNET ; Noémie LIGOT ; Sylvie DE RAEDT ; Robin LEMMENS ; Peter VANACKER ; Fenne VANDERVORST ; Adriana Bastos CONFORTO ; Raquel C.T. HIDALGO ; Daissy Liliana MORA CUERVO ; Luciana DE OLIVEIRA NEVES ; Isabelle LAMEIRINHAS DA SILVA ; Rodrigo Targa MARTÍNS ; Letícia C. REBELLO ; Igor Bessa SANTIAGO ; Teodora SADELAROVA ; Rosen KALPACHKI ; Filip ALEXIEV ; Elena Adela CORA ; Michael E. KELLY ; Lissa PEELING ; Aleksandra PIKULA ; Hui-Sheng CHEN ; Yimin CHEN ; Shuiquan YANG ; Marina ROJE BEDEKOVIC ; Martin ČABAL ; Dusan TENORA ; Petr FIBRICH ; Pavel DUŠEK ; Helena HLAVÁČOVÁ ; Emanuela HRABANOVSKA ; Lubomír JURÁK ; Jana KADLČÍKOVÁ ; Igor KARPOWICZ ; Lukáš KLEČKA ; Martin KOVÁŘ ; Jiří NEUMANN ; Hana PALOUŠKOVÁ ; Martin REISER ; Vladimir ROHAN ; Libor ŠIMŮNEK ; Ondreij SKODA ; Miroslav ŠKORŇA ; Martin ŠRÁMEK ; Nicolas DRENCK ; Khalid SOBH ; Emilie LESAINE ; Candice SABBEN ; Peggy REINER ; Francois ROUANET ; Daniel STRBIAN ; Stefan BOSKAMP ; Joshua MBROH ; Simon NAGEL ; Michael ROSENKRANZ ; Sven POLI ; Götz THOMALLA ; Theodoros KARAPANAYIOTIDES ; Ioanna KOUTROULOU ; Odysseas KARGIOTIS ; Lina PALAIODIMOU ; José Dominguo BARRIENTOS GUERRA ; Vikram HUDED ; Shashank NAGENDRA ; Chintan PRAJAPATI ; P.N. SYLAJA ; Achmad Firdaus SANI ; Abdoreza GHOREISHI ; Mehdi FARHOUDI ; Elyar SADEGHI HOKMABADI ; Mazyar HASHEMILAR ; Sergiu Ionut SABETAY ; Fadi RAHAL ; Maurizio ACAMPA ; Alessandro ADAMI ; Marco LONGONI ; Raffaele ORNELLO ; Leonardo RENIERI ; Michele ROMOLI ; Simona SACCO ; Andrea SALMAGGI ; Davide SANGALLI ; Andrea ZINI ; Kenichiro SAKAI ; Hiroki FUKUDA ; Kyohei FUJITA ; Hirotoshi IMAMURA ; Miyake KOSUKE ; Manabu SAKAGUCHI ; Kazutaka SONODA ; Yuji MATSUMARU ; Nobuyuki OHARA ; Seigo SHINDO ; Yohei TAKENOBU ; Takeshi YOSHIMOTO ; Kazunori TOYODA ; Takeshi UWATOKO ; Nobuyuki SAKAI ; Nobuaki YAMAMOTO ; Ryoo YAMAMOTO ; Yukako YAZAWA ; Yuri SUGIURA ; Jang-Hyun BAEK ; Si Baek LEE ; Kwon-Duk SEO ; Sung-Il SOHN ; Jin Soo LEE ; Anita Ante ARSOVSKA ; Chan Yong CHIEH ; Wan Asyraf WAN ZAIDI ; Wan Nur Nafisah WAN YAHYA ; Fernando GONGORA-RIVERA ; Manuel MARTINEZ-MARINO ; Adrian INFANTE-VALENZUELA ; Diederik DIPPEL ; Dianne H.K. VAN DAM-NOLEN ; Teddy Y. WU ; Martin PUNTER ; Tajudeen Temitayo ADEBAYO ; Abiodun H. BELLO ; Taofiki Ajao SUNMONU ; Kolawole Wasiu WAHAB ; Antje SUNDSETH ; Amal M. AL HASHMI ; Saima AHMAD ; Umair RASHID ; Liliana RODRIGUEZ-KADOTA ; Miguel Ángel VENCES ; Patrick Matic YALUNG ; Jon Stewart Hao DY ; Waldemar BROLA ; Aleksander DĘBIEC ; Malgorzata DOROBEK ; Michal Adam KARLINSKI ; Beata M. LABUZ-ROSZAK ; Anetta LASEK-BAL ; Halina SIENKIEWICZ-JAROSZ ; Jacek STASZEWSKI ; Piotr SOBOLEWSKI ; Marcin WIĄCEK ; Justyna ZIELINSKA-TUREK ; André Pinho ARAÚJO ; Mariana ROCHA ; Pedro CASTRO ; Patricia FERREIRA ; Ana Paiva NUNES ; Luísa FONSECA ; Teresa PINHO E MELO ; Miguel RODRIGUES ; M Luis SILVA ; Bogdan CIOPLEIAS ; Adela DIMITRIADE ; Cristian FALUP-PECURARIU ; May Adel HAMID ; Narayanaswamy VENKETASUBRAMANIAN ; Georgi KRASTEV ; Jozef HARING ; Oscar AYO-MARTIN ; Francisco HERNANDEZ-FERNANDEZ ; Jordi BLASCO ; Alejandro RODRÍGUEZ-VÁZQUEZ ; Antonio CRUZ-CULEBRAS ; Francisco MONICHE ; Joan MONTANER ; Soledad PEREZ-SANCHEZ ; María Jesús GARCÍA SÁNCHEZ ; Marta GUILLÁN RODRÍGUEZ ; Gianmarco BERNAVA ; Manuel BOLOGNESE ; Emmanuel CARRERA ; Anchalee CHUROJANA ; Ozlem AYKAC ; Atilla Özcan ÖZDEMIR ; Arsida BAJRAMI ; Songul SENADIM ; Syed I. HUSSAIN ; Seby JOHN ; Kailash KRISHNAN ; Robert LENTHALL ; Kaiz S. ASIF ; Kristine BELOW ; Jose BILLER ; Michael CHEN ; Alex CHEBL ; Marco COLASURDO ; Alexandra CZAP ; Adam H. DE HAVENON ; Sushrut DHARMADHIKARI ; Clifford J. ESKEY ; Mudassir FAROOQUI ; Steven K. FESKE ; Nitin GOYAL ; Kasey B. GRIMMETT ; Amy K. GUZIK ; Diogo C. HAUSSEN ; Majesta HOVINGH ; Dinesh JILLELA ; Peter T. KAN ; Rakesh KHATRI ; Naim N. KHOURY ; Nicole L. KILEY ; Murali K. KOLIKONDA ; Stephanie LARA ; Grace LI ; Italo LINFANTE ; Aaron I. LOOCHTAN ; Carlos D. LOPEZ ; Sarah LYCAN ; Shailesh S. MALE ; Fadi NAHAB ; Laith MAALI ; Hesham E. MASOUD ; Jiangyong MIN ; Santiago ORGETA-GUTIERREZ ; Ghada A. MOHAMED ; Mahmoud MOHAMMADEN ; Krishna NALLEBALLE ; Yazan RADAIDEH ; Pankajavalli RAMAKRISHNAN ; Bliss RAYO-TARANTO ; Diana M. ROJAS-SOTO ; Sean RULAND ; Alexis N. SIMPKINS ; Sunil A. SHETH ; Amy K. STAROSCIAK ; Nicholas E. TARLOV ; Robert A. TAYLOR ; Barbara VOETSCH ; Linda ZHANG ; Hai Quang DUONG ; Viet-Phuong DAO ; Huynh Vu LE ; Thong Nhu PHAM ; Mai Duy TON ; Anh Duc TRAN ; Osama O. ZAIDAT ; Paolo MACHI ; Elisabeth DIRREN ; Claudio RODRÍGUEZ FERNÁNDEZ ; Jorge ESCARTÍN LÓPEZ ; Jose Carlos FERNÁNDEZ FERRO ; Niloofar MOHAMMADZADEH ; Neil C. SURYADEVARA, MD ; Beatriz DE LA CRUZ FERNÁNDEZ ; Filipe BESSA ; Nina JANCAR ; Megan BRADY ; Dawn SCOZZARI
Journal of Stroke 2022;24(2):256-265
Background:
and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.
Methods:
We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020).
Results:
There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths.
Conclusions
During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.