Syndrome In People Research Articles

The efficiency of social workers in the application of quality standards for the social integration programs for children of Asperger's syndrome in centers of people of determination from perspective of the community organization method

The research aims at assessing the efficiency of social workers in applying quality standards for social integration programs for children with Asperger syndrome in people with disabilities centers from the perspective of the community organization method through identifying the general characteristics of social workers working with Asperger Syndrome children, identifying nature of how well the standards of social integration programs for Asperger Syndrome children have been applied in terms of the standard of ethical, professional and competitive necessity, defining the challenges facing social workers in applying quality standards for social integration programs and defining the desired vision of the community organization method in developing the quality of community integration programs for Asperger Syndrome children. The study used the descriptive-analytical method, and the comprehensive social survey method was used for 60 social workers in people with disabilities centers in Ajman, Sharjah, and Ras Al Khaimah. The study found a number of results, the most important of which is that the level of competence of social workers in applying all the quality standards of social integration programs for children with Asperger's syndrome in centers of people of determination obtained a total of 3807 weights with a weighted relative weight of 70.50%, and this indication is considered a moderate indication, as it lies between (3001 - 4200), and this indicates that the level of proficiency is moderate. Among the most important recommendations from the perspective of the community organization method in this study benefits from the successful international experiences of social integration programs.

The prevalence of cognitive impairment and their association with socioeconomic, demographic and anthropometric factors and geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EVKALIPT

Cognitive dysfunction is one of the most common disorders in the elderly and senile age. There are currently 57 million people with dementia worldwide.Objective: to assess cognitive functions, to understand the prevalence of cognitive impairment (CI) and to analyze their associations with socioeconomic, demographic and anthropometric factors and geriatric syndromes in people aged ≥65 years.Patients and methods. Subjects living in 11 regions of the Russian Federation took part in the EVKALIPT epidemiological study. The inclusion criterion was age ≥65 years. Participants were divided into three age groups (65–74 years, 75–84 years, and ≥85 years) according to the protocol. All patients underwent a comprehensive geriatric assessment, comprising a specially designed questionnaire and physical examination. Cognitive functions were assessed using the mini-Cog test. The study included 3545 patients (of which 30% were males) aged 65 to 107 years.Results and discussion. According to the data obtained in our study, CI was detected in 60.8% of the subjects, and severe disorders – in 19.9% (0 or 1 point according to the mini-Cog). Patients with CI had a lower socioeconomic status. One-way regression analysis showed that the risk of CI increased by 10% with increasing age for every 1 year but did not depend on the sex of the subjects. Associated with increased CI risk also were: living alone (by 28%), living in a nursing home (by 90%), widowhood (by 2.2 times) or absence of a partner (by 2.2 times), underweight (by 2.9 times) and normal body weight (by 1.6 times), disability (by 54%), primary (by 4.8 times) and secondary (by 75%) education, bad economic conditions (by 95%). On the contrary, the presence of overweight and obesity reduced the risk of CI by 14 and 24% respectively, living in a family – by 24%, having a spouse – by 55%, divorce – by 29%, having a job – by 73%, higher education and a scientific degree – by 55 and 59%, medium and good economic conditions – by 38 and 52%, respectively. In patients with CI, the incidence of all geriatric syndromes was higher.Conclusion. The frequency of CI among elderly patients was higher compared with data from other studies. The EVKALIPT study was the first to obtain national data on the prevalence and characteristics of CI in persons aged ≥65 years in the general population.

Weight of Clinical and Social Determinants of Metabolic Syndrome in People Living with HIV.

Background. Comorbidities in people living with HIV (PLWH) represent a major clinical challenge today, and metabolic syndrome (MTBS) is one of the most important. Objective. Our objective was to assess the prevalence of MTBS and the role of both clinical/socio-behavioral risk factors for MTBS in a cohort of PLWH. Methods. All PLWH, over 18 years of age, attending all Infectious Disease Units in Calabria Region (Southern Italy) for their routine checks from October 2019–January 2020 were enrolled. MTBS was defined by NCEP-ATP III criteria. Logistic regression analysis was performed to assess factors significantly associated with the main outcome (MTBS). Results. We enrolled 356 PLWH, mostly males (68.5%), with a mean age of 49 years (standard deviation: 12), including 98 subjects with and 258 without MTBS. At logistic regression analysis, a statistically significant association was found between MTBS and alcohol use, osteoporosis, polypharmacy, and a history of AIDS. Conclusions. Identifying and addressing risk factors, including those that are socio-behavioral or lifestyle-related, is crucial to prevent and treat MTBS. Our results suggest the importance of implementing educational/multidimensional interventions to prevent MTBS in PLWH, especially for those with particular risk factors (alcohol abuse, osteoporosis, previous AIDS events, and polypharmacy). Moreover, alcohol consumption or abuse should be routinely investigated in clinical practice.

Understanding the hidden epidemic of metabolic syndrome in people accessing community rehabilitation: a cross-sectional study of physical activity, dietary intake, and health literacy

Purpose To determine the prevalence of metabolic syndrome in patients attending outpatient community rehabilitation in Melbourne, Australia and to compare health literacy, physical activity, and dietary intake of people with and without metabolic syndrome. Materials and methods A cross-sectional, multi-centre, observational study of adults (n = 193) presenting to rehabilitation with various health complaints. Metabolic syndrome was determined according to the International Diabetes Federation joint consensus worldwide definition. Health literacy was assessed using the Rapid Estimate of Adult literacy in Medicine (REALM) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Physical activity was assessed using accelerometers and dietary intake was assessed using a food frequency questionnaire. Results One hundred and twenty three participants (64%) had metabolic syndrome. Of these, only three (2%) knew they had it. People with metabolic syndrome scored lower on health literacy (S-TOFHLA MD −2.10, 95% confidence interval (CI) −3.98 to −0.22) and took 1311 (95%CI 375 to 2246) fewer daily steps than those without metabolic syndrome. There were no differences in dietary intake. Conclusions Metabolic syndrome is a prevalent and under-recognised condition in community rehabilitation. Community healthcare professionals and health services may need to consider a broader approach to management including lifestyle assessment and intervention of patients with various conditions. Implications for rehabilitation Almost two-thirds of adults in community rehabilitation had underlying, undetected metabolic syndrome. Adults with metabolic syndrome completed less objectively measured physical activity and had lower health literacy levels than those without metabolic syndrome. A broader approach to management may need to be considered in community rehabilitation where patients presenting for rehabilitation of various conditions would likely benefit from lifestyle assessment and intervention.

A Better Understanding of Moyamoya in Trisomy 21: A Systematic Review.

Moyamoya disease is defined as stenosis of the internal carotid artery or the middle, anterior or posterior cerebral arteries with considerable collateral development. This collateral vessel has a particular appearance in angiographic examinations. Moyamoya syndrome is a term used to describe when moyamoya disease occurs in conjunction with other systemic disorders. One of the associations is Down syndrome. Moyamoya syndrome is very common in patients with Down syndrome, and the cause for this is unknown. The majority of patients present in their first decade, with the clinical presentation varying with age. The cause of moyamoya syndrome in people with trisomy 21 is unknown. This research aimed to learn more about the genesis and pathology of moyamoya syndrome in people with Down syndrome.The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were used to conduct this systematic review. Several publications connected to this topic were searched through a comprehensive database search. They were narrowed down to a final number of ten articles after applying inclusion and exclusion criteria and analyzing the quality of each work. Several possibilities were presented in these final papers to explain the link between moyamoya syndrome and trisomy 21. Trisomy 21 patients have a genetic predisposition to vascular problems. The RNF213 gene may interact with the genes on chromosome 21 that influence vascular physiology and elasticity in patients with Down syndrome, resulting in the whole picture of moyamoya syndrome.

Prevalence of restless legs syndrome in people with diabetes mellitus: A pooling analysis of observational studies

SummaryBackgroundDiabetes mellitus (DM) is associated with different clinical complications. The aim of this study was to explore the prevalence of RLS in people with diabetes mellitus and compare the risk of restless leg syndrome (RLS) between diabetic and non-diabetic population.MethodsWe searched for studies of RLS prevalence in DM through PubMed, Embase, and Web of Science. Two authors independently completed the literature screening, data extraction, and bias risk assessment of eligible studies. All observational studies that assessed the prevalence or risk of RLS in DM were included, where the diagnosis of RLS was based on the International Restless Legs Syndrome Study Group (IRLSSG). Percentages, odds ratio (OR) with 95% confidence intervals (CI) were used to assess pooled estimates of RLS prevalence and risk based on random-effects models. Newcastle-Ottawa-scale (NOS) or a modified NOS were used to evaluate the quality of studies.FindingsA total of 42 studies, including 835,986 participants, met the eligibility criteria for the meta-analysis. Among them, 30 studies were included in meta-analysis to analyze the prevalence of RLS. A second meta-analysis was conducted using 31 studies to determine RLS risk between diabetes and non-diabetes. The results indicate that between 25% (95% confidence interval 21%-29%) of people with diabetes showed signs of RLS, and people with diabetes had an increased risk of developing RLS compare to people without diabetes (OR 1.98, 95%CI 1.66- 2.34, p < 0.001). However, the available evidence was limited due to potential risk of bias and variability between studies (I2>75%), all of observational design.InterpretationOur study suggests that the prevalence and risk of RLS might be higher in DM patients than in non-diabetes population. However, given limitations in the analysis and study design, the findings need to be corroborated in future studies.FundingThis work was supported by the Basic Conditions Platform Construction Project of Sichuan Science and Technology Department (2019JDPT0015), and the “1・3・5 project for disciplines of excellence, West China Hospital, Sichuan University” (ZYJC18003).

Motoric cognitive risk syndrome in people with multiple sclerosis: prevalence and correlations with disease-related factors.

Background:The motoric cognitive risk (MCR) syndrome, defined as the coexistence of slow gait and subjective cognitive complaints, has as yet not been researched in people with multiple sclerosis (pwMS).Objective:To examine the prevalence of the MCR syndrome in pwMS and its association with disability, disease duration, perceived fatigue, and fear of falling.Methods:The study comprised 618 pwMS [43.7 (SD = 12.6) years, 61.7% females]. Gait speed was measured by the GAITRite™ electronic walkway (CIR Systems, Inc. Haverton, PA, USA). Cognitive status was defined according to the global cognitive score computed by the NeuroTrax™ cognitive battery (NeuroTrax Corporation, Medina, NY, USA). The sample was divided into four main groups: ‘normal’, ‘cognitively impaired’, ‘gait impaired’ or ‘MCR’. Perceived fatigue was assessed by the Modified Fatigue Impact Scale; fear of falling by the Falls Efficacy Scale International.Results:Sixty-three (10.2%) patients were diagnosed with MCR. The percentage of subjects categorized as MCR was 26.0% in severely disabled pwMS compared with 10.9%, 6.0%, and 4.6% in moderately, mildly and very mildly disabled pwMS, respectively. Subjects in the MCR group presented with elevated fatigue compared with patients classified as normal [49.7 (SD = 23.3) vs 26.5 (SD = 19.2), p < 0.001]. Fear of falling was significantly higher in the MCR and gait impairment groups compared with the cognitively impaired and normal groups.Conclusions:The current study corroborates the presence of MCR in pwMS. Nevertheless, future longitudinal research is warranted to better understand its application.

Arterial fibromuscular dysplasia as a factor in sudden cardiac death in young adults

The objective of the study is to consider the problem of diagnostics of a rare vasculopathy, fibromuscular dysplasia of coronary arteries, by the case study of a 19-year-old serviceman, an athlete with sudden death occurred during slight physical exertion. After repeated histological examination as part of the forensic medical examination, the diagnosis was made: «multifocal fibromuscular dysplasia of the coronary arteries and ascending aortic arch, complicated by acute left ventricular failure.» This disease often manifests with the acute coronary syndrome in people of young age. Therefore, special attention was given to the macroscopic and histological features of fibromuscular dysplasia of arteries.

Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population.

ABSTRACT.The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet.Objectives:This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group.Methods:A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB.Results:FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided.Conclusions:This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.

The prevalence of osteoarthritis and its association with geriatric syndromes in people over 65: data from the Russian epidemiological study EVKALIPT

Osteoarthritis (OA) in elderly and senile patients is not only common, but also one of the main diseases affecting the duration of active life, its quality, the appearance of addictions and loss of autonomy. Data on the relationship between OA and geriatric syndromes (GS) in our country are extremely scarce. To estimate the prevalence of OA and to analyze its associations with HS in persons aged 65 years. The study included 4308 people (30% of men) aged 65 to 107 years, living in 11 regions of Russia. The patients were divided into 2 groups: with OA (n=2464) and without OA (n=1821). All patients underwent a comprehensive geriatric assessment. The prevalence of OA was 57.6%. With age, the frequency of OA increased significantly. According to the results of a comprehensive geriatric assessment, patients with OA had lower walking speed, the sum of points on the Bartel, Lawton scales and a short battery of physical functioning tests and higher the sum of points on the geriatric scale of depression and the age is not a hindrance scale. Patients with OA rated the quality of life and health status lower and higher the intensity of pain syndrome. Patients with OA were more likely to use any assistive device, with the exception of a wheelchair. In patients with OA, the most common HS were chronic pain syndrome (92%), senile asthenia syndrome (64%), basic (66%) and instrumental (56%) dependence in everyday life, cognitive impairment (62%), probable depression (51%) and urinary incontinence (50%). Univariate regression analysis showed that OA is associated with a 1.23.0-fold increase in the risk of a number of GS and a 28% decrease in the risk of malnutrition. OA is widespread in the elderly population. The presence of OA is associated with a number of GS associated with loss of autonomy.

Prevalence of Psychological Disorders in Patients with COVID-19 Syndrome

The coronavirus 2019 first broke out on December 17, 2019 in Wuhan, China, and on March 11, 2020, it was announced as a worldwide pandemic by the World Health Organization. Despite nutritious diets and promising vaccines, health tips such as wearing a mask, social distancing, home quarantine, and not traveling are still the best ways to control the spread of COVID-19.While the widespread prevalence of COVID-19, severe restrictions, lack of definitive treatment, and the high infection and mortality rates have led to cognitive psychological disorders among the general population of the world. One of the epidemic consequences of COVID-19 syndrome in people who have defeated the coronavirus was psychological disorders. Considering the role of mental health in boosting the immune system, improving the effectiveness of the COVID-19 vaccine and accelerating the treatment process of patients, it is suggested that in the post-COVID era, more attention be paid to the psychological health of the community.

Current possibilities of predicting the development of pre-diabetes and type 2 diabetes mellitus

Type 2 diabetes mellitus is a serious chronic disease that poses a serious public health problem since this pathology has a significant impact on health due to the high risk of occurrence and development of severe complications, which directly affects the socio-economic well-being of the population. The presented article analyzes the most significant links in the pathogenesis of type 2 diabetes mellitus, which makes it possible to determine the risk factors for its occurrence and development. The influence of obesity on disorders of carbohydrate metabolism, as well as other associated metabolic conditions, such as atherosclerosis, hypertension, dyslipidemia, has been emphasized. Anthropometric parameters and various indices are presented, allowing them to be assessed in relation to metabolic changes. The review summarizes the most convincing biochemical markers that have prognostic value in relation to the development of pre-diabetes and type 2 diabetes mellitus. The article pays special attention to the analysis and evidence base of the existing scales for assessing the risk of developing pre-diabetes and type 2 diabetes mellitus, including the first domestic calculator based on the DIARISK questionnaire. In addition, the article presents statistical data on the higher incidence of metabolic syndrome in people professionally associated with high psychoemotional load. However, the methods for assessing the risk of pre-diabetes and T2DM do not reflect the contribution of this factor to the development of carbohydrate metabolism disorders.

Синдром возрастной полости рта как компонент гериатрического статуса

According to the literature, there is a high prevalence of the syndrome of senile asthenia (frailty) among the elderly. This condition is associated with a number of physical, functional and biochemical changes in the body. The interrelationships of the senile mouth with the malnutrition syndrome are known, the associations with other geriatric syndromes are insufficiently studied. At the same time, early diagnosis of conditions and diseases as the risk factors for the development of senile mouth is very important. The aim of the study: To study the role of the senile mouth in the formation of geriatric status. Materials and methods: In total, 570 elderly and senile people were included in the study (58 persons without adentia, 512 persons with adentia. The age of the patients ranged from 65 to 84 years. The groups of patients without adentia and with adentia were comparable in age and sex composition. Results: The study showed that the senile mouth is associated with the loss of 11 or more teeth in any variant of adentia, and with a smaller number of lost teeth – with the 1st and 4th classes of adentia according to E. Kennedy, while the ethiological causes of adentia do not have a significance in increasing the risk for developing of senile mouth. Cardiovascular pathology, type 2 diabetes mellitus and diseases of the musculoskeletal system increase the risk of developing the progression of the senile mouth. The senile mouth is associated with such geriatric syndromes as the syndrome of malnutrition and the risk of its development, dina/ sarcopenia, falls syndrome, depression, cognitive disorders and uncorrected sensory deficits. Conclusion: Senile mouth take place in the processes of formation of geriatric status in elderly patients. It is necessary to investigate the state of the dentition according to E. Kennedy. The patients with complete adentia, as well as with grades 1, 4 of adentia and its mixed forms are the groups of increased risk of frailty. It is also advisable to conduct a comprehensive geriatric assessment with targeted correction of the identified geriatric syndromes in people with senile mouth before and after dental intervention.

Increased Risk of Carpal Tunnel Syndrome in People With Spinal Cord Injury: A Nationwide Longitudinal Follow-Up Study

ObjectiveTo investigate the long-term risk of carpal tunnel syndrome (CTS) in people with spinal cord injury (SCI). DesignRetrospective cohort study. SettingTaiwan's Longitudinal Health Insurance Database 2005, containing data about 1 million people randomly sampled from among those registered in the National Health Insurance Program as of 2005. ParticipantsThe SCI group consisted of 1681 subjects with SCI, and the comparison group comprised 6724 propensity score-matched subjects without SCI (N=8405). The variables included in propensity-score matching were age, sex, comorbid conditions, and socioeconomic status. InterventionsNot applicable. Main Outcome MeasuresThe occurrence of newly diagnosed CTS, defined by at least 1 hospital discharge or 2 outpatient visits with a diagnosis of CTS. ResultsThe incidence density of CTS in the SCI group was 7.55 per 1000 person-years (95% confidence interval [CI], 6.03-9.33), and in the comparison group, 4.61 per 1000 person-years (95% CI, 4.08-5.19). The hazard ratio (HR) of CTS for the SCI group was therefore 1.59 (95% CI, 1.24-2.03). Additionally, the HR of CTS for the cervical-SCI subgroup, 1.90 (95% CI, 1.21-2.97) was considerably higher than that of its noncervical counterpart, 1.47 (95% CI, 1.09-1.98). ConclusionsPeople with both cervical and noncervical SCI have an increased risk of developing CTS, as compared with those without SCI. Moreover, the CTS risk appears to be higher for individuals with cervical SCI than their noncervical SCI counterparts.

High Levels of TNF-α and TIM-3 as a Biomarker of Immune Reconstitution Inflammatory Syndrome in People with HIV Infection.

Immune reconstitution inflammatory syndrome (IRIS) is an exacerbated immune response that can occur to HIV+ patients after initiating antiretroviral therapy (ART). IRIS pathogenesis is unclear, but dysfunctional and exhausted cells have been reported in IRIS patients, and the TIM-3/Gal-9 axis has been associated with chronic phases of viral infection. This study aimed to evaluate the soluble levels of TIM-3 and Gal-9 and their relationship with IRIS development. TIM-3, Gal-9, TNF-α, IFN-γ, IL-6, TNFR1, TNFR2, E-cadherin, ADAM10, and ADAM17 were measured to search for IRIS-associated biomarkers in plasma samples from 0-, 4-, 8-, 12-, and 24-weeks after ART initiation of 61 HIV+ patients (15 patients developed IRIS, and 46 did not). We found that patients who developed IRIS had higher levels of TIM-3 [median 4806, IQR: 3206–6182] at the time of the IRIS events, compared to any other follow-up time evaluated in these patients or compared with a control group of patients who did not develop IRIS. Similarly, IRIS patients had a higher TNF-α level [median 10.89, IQR: 8.36–12.34] at IRIS events than any other follow-up time evaluated. Other molecules related to the TIM-3 and TNF-α pathway (Gal-9, IL-6, IFN-γ, TNFR1, TNFR2, ADAM-10, and ADAM-17) did not change during the IRIS events. In conclusion, our data suggest that a high level of soluble TIM-3 and TNF-α could be used as an IRIS biomarker.

Analysis of the Time-To-Onset and Factors Affecting Clinical Outcomes of Immune Reconstitution Inflammatory Syndrome in People Living with HIV Using Data from the Japanese Spontaneous Reporting Database.

Data on immune reconstitution inflammatory syndrome (IRIS), despite being a widely recognized complication of antiretroviral therapy, remain limited. The objective of the present study was to evaluate the time-to-onset and factors affecting clinical outcomes of IRIS in people living with HIV (PLWH) using data from the Japanese Adverse Drug Event Report (JADER) database. Data of PLWH who developed IRIS as an adverse event were extracted from the JADER database. Cases with the data of both the start date of anti-HIV drug therapy and date of IRIS onset were included in the study. The survey items included sex, age, anti-HIV drug use, IRIS-compatible events, time-to-onset of IRIS, and clinical outcome. The time-to-onset of IRIS was evaluated in relation to anchor drug use. Overall, 79 cases were included in the analysis. The median (range) time-to-onset of IRIS was 29 (1-365) days, and it differed significantly between IRIS-compatible events (P = 0.029). In particular, the time-to-onset of Pneumocystis pneumonia-IRIS was the shortest among the IRIS-compatible events (median [range]: 12 [5-301] days). Age ≥ 50 years at IRIS onset appeared to be related to the poor clinical outcomes of IRIS in PLWH (P = 0.048). The use of integrase strand transfer inhibitors did not affect the time-to-onset of IRIS or clinical outcome of IRIS in PLWH. This analysis based on the data from the JADER database revealed that IRIS-compatible events were related to the time-to-onset of IRIS and that patients older than 50 years had poorer clinical outcomes of IRIS. This finding will be useful for healthcare professionals when considering medications for patients with HIV infection/AIDS and for the management of IRIS.

A study of effect of anti-retroviral therapy regimen on metabolic syndrome in people living with HIV/AIDS: Post hoc analysis from a tertiary care hospital in western India

Background and aimsIndian guidelines for anti-retroviral therapy (ART) are changing. More patients are now on protease-inhibitor (PI) based therapy. While the association of dyslipidemia with nucleoside reverse transcriptase (NRTI) based regimens is well-reported, the effect of Tenofovir (TDF) or PIs has not been studied in detail in India. This study looks at the impact of ART regimen on Metabolic Syndrome (MetS) in people living with HIV/AIDS (PLHA). MethodsThis study is a post hoc analysis of a cross-sectional study in ART clinics of a hospital in India between Dec 2016 and Nov 2018. A total of 1208 PLHA on ART were part of this study. Chi square test, Mann-Whitney U test, logistic regression analysis was done. ResultsThe prevalence of MetS is 21.3%. This study found TDF based PI regimens had a two fold risk of MetS against patients of HIV on other ART regimens. Also, risk is significantly higher than both TDF based 2NRTI/NNRTI regimens and AZT based PI regimens. ConclusionPatients on TDF based PIs have a significantly higher prevalence of MetS. This has significance in India which relies heavily on TDF as a backbone of ART and is seeing increased use of PIs.

Prevalence and characteristics of impaired awareness of hypoglycemia in King Fahad Medical City, Saudi Arabia

Background: Impaired awareness of hypoglycemia (IAH) is an acquired syndrome in people with insulin-treated diabetes, with a diminished or absent ability to perceive the onset of hypoglycemia. It can result in severe hypoglycemia and possibly death. At present, no previous study was performed in Saudi Arabia region to ascertain the IAH prevalence. Objectives: The aim of the current study was to investigate the self-reported prevalence of moderate, severe hypoglycemia, and IAH among patient visiting KFMC Obesity Metabolic Endocrine Centre (OEMC) Type 1 and Type 2 diabetics. In addition, we assessed the possible determinants of IAH. Materials and Methods: This was an observational cross-sectional study conducted on diabetic patients attending outpatient clinics of the OEMC of King Fahd Medical City during a period of 12 months using Clarke questionnaire. Results: Findings showed a low prevalence of IAH in the region (13.8%) and that IAH patients had experienced a significantly higher rate of severe hypoglycemia compared to hypoglycemic aware patients. These findings are consistent with the hypothesis that IAH develops mostly in patients with type 1 diabetes (T1D) but also presented in type 2 diabetes (T2D). This remains to place them at risk of experiencing severe hypoglycemia. Conclusion: IAH and severe hypoglycemia are relatively common among T1D and T2D patients. Prospective investigations that concentrate particularly on restoring awareness of hypoglycemia are required to promote measures to manage this severe complication of insulin treatment.

RELATIONSHIP AND IMPACTS OF CENTRAL SLEEP APNEA SYNDROME IN PEOPLE WITH HEART FAILURE: A BIBLIOGRAPHIC REVIEW

Central sleep apnea (CSA) is a disorder of the central ventilatory control of the nervous system characterized by prolonged episodes of apnea during the individual’s sleep period. One of the etiologies described by several scientific studies for this condition is congestive heart failure (CHF), a disease of big prevalence and relevance for contemporary medicine. This article, in addition to describing the significant aspects of sleep physiology to the current study, seeks to correlate the sleep process with the mechanisms involved in the pathophysiology of CSA in patients with CHF, as well as the impacts on the quality of life of these people.

937. Factors Associated with Metabolic Syndrome in People with HIV under 40 Years in Guatemala

BackgroundHIV infection and antiretroviral therapy (ART) can lead to metabolic abnormalities associated with increased cardiovascular disease risk, some of these abnormalities (central obesity, elevated fasting glucose, triglycerides, and blood pressure and low HDL cholesterol) are in metabolic syndrome (MetS). The prevalence of MetS increases with age. Currently, the status of MetS in people with HIV (PWH) Guatemala is unknown. We assessed the prevalence of MetS and potential predictors in PWH participating in prospective cohort study at Hospital Roosevelt in Guatemala City.MethodsWe performed a cross-sectional analysis of PWH under 40 years old receiving ART for at least 6 months from July 2019 to March 2020. The harmonized criteria for MetS and the cut-off for waist circumference recommended by the Latin American Diabetes Association were used. Association between MetS and gender, place of residency, ethnicity, educational level, baseline and current CD4 count, smoking, alcohol consumption, physical activity, viral load, body mass index (BMI) and ART exposure was assessed in bivariate analysis. Potential predictors (p-value < 0.1) were included in a multivariate binary logistic regression model.ResultsOf total cohort of 757 participants enrolled390 (51.5%) were younger than 40 years. Of those under < 40 years, 150 (38.5%) were women, 59 (15.1%) Mayan, median age was 32 years (IQR 27, 37). 93 (23.8%) had MetS. Between group differences in Table 1. Of those with Met, 51 (54.8%) had elevated waist circumference, 87 (93.5%) elevated triglycerides, 83 (89.2%) low HDL-c, 56 (60.2%) elevated blood pressure and 35 (37.6%) elevated fasting glucose. Body mass index (BMI) ≥ 25 kg/m2 or higher and 2 years or more of cumulative non-nucleoside reverse transcription inhibitors (NNRTI) where more common in those < 40 years with MetS compared to those without MetS. On multivariable regression, MetS was associated with current CD4 count < 200 (OR 3.1; IC 1.51, 6.34; p-value < 0.01) and BMI ≥ 25 kg/m2 (OR; 6.53; IC 3.64, 11.73; p-value < 0.01).Table1. Between group differences (No MetS vs MetS) ConclusionNearly one in every four PWH under 40 years old in our cohort was affected by MetS. Dyslipidemia (elevated triglycerides and low HDL-c) was the main driver of MetS. Lower CD4 count and overweight were predictors for MetS in PWH under 40.Disclosures Andrej Spec, MD, MSCI, Astellas (Grant/Research Support)Mayne (Consultant)Scynexis (Consultant)