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Sample records for atherosclerosis score index

  1. The atherosclerosis burden score (ABS): a convenient ultrasound-based score of peripheral atherosclerosis for coronary artery disease prediction.

    Science.gov (United States)

    Yerly, Patrick; Marquès-Vidal, Pedro; Owlya, Reza; Eeckhout, Eric; Kappenberger, Lukas; Darioli, Roger; Depairon, Michèle

    2015-03-01

    Ultrasonographic detection of subclinical atherosclerosis improves cardiovascular risk stratification, but uncertainty persists about the most discriminative method to apply. In this study, we found that the "atherosclerosis burden score (ABS)", a novel straightforward ultrasonographic score that sums the number of carotid and femoral arterial bifurcations with plaques, significantly outperformed common carotid intima-media thickness, carotid mean/maximal thickness, and carotid/femoral plaque scores for the detection of coronary artery disease (CAD) (receiver operating characteristic (ROC) curve area under the curve (AUC) = 0.79; P = 0.027 to ABS was also more correlated with CAD extension (R = 0.55; P ABS was weakly correlated with the European Society of Cardiology chart risk categories (R(2) = 0.21), indicating that ABS provided information beyond usual cardiovascular risk factor-based risk stratification. Pending prospective studies on hard cardiovascular endpoints, ABS appears as a promising tool in primary prevention.

  2. Atherosclerosis

    Science.gov (United States)

    Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance ... flow of oxygen-rich blood to your body. Atherosclerosis can lead to serious problems, including Coronary artery ...

  3. Relation of Framingham Risk Score to Subclinical Atherosclerosis Evaluated Across Three Arterial Sites

    Science.gov (United States)

    Karim, Roksana; Hodis, Howard N; Detrano, Robert; Liu, Chao-ran; Liu, Chi-hua; Mack, Wendy J

    2008-01-01

    The Framingham risk score (FRS) is widely used in clinical practice to identify subjects at high risk for developing coronary heart disease (CHD). However, FRS may not accurately identify subjects at risk. We measured subclinical atherosclerosis in the coronary arteries and aorta with the presence of calcium (CAC and AC, respectively) and in the common carotid artery by intima-media thickness (CIMT) in 498 healthy subjects. The distribution of these subclinical atherosclerosis measures was evaluated across 3 strata of the FRS. CAC, AC and CIMT were significantly independently associated with FRS. The FRS increased with the number of arterial sites with atherosclerosis. Sixty-nine percent of the subjects categorized in the low risk group (FRS20%) had 1 or more vascular imaging studies demonstrating subclinical atherosclerosis. Among the low risk group, subjects with atherosclerosis had a longer history of lifetime smoking compared to those without atherosclerosis. In conclusion, subclinical atherosclerosis is prominent across the spectrum of FRS. Evaluation of subclinical atherosclerosis in different arterial sites in addition to FRS may be useful in targeting subjects for lifestyle and other interventions. PMID:18805105

  4. Ankle brachial index, C-reactive protein, and central augmentation index to identify individuals with severe atherosclerosis

    DEFF Research Database (Denmark)

    Eldrup, Nikolaj; Sillesen, Henrik; Prescott, Eva

    2006-01-01

    We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease.......We examined the ability of ankle brachial index, C-reactive protein and central augmentation index to identify individuals in the general population with severe atherosclerosis, diagnosed as those with ischaemic cardiovascular disease....

  5. Periodontal disease and atherosclerosis from the viewpoint of the relationship between community periodontal index of treatment needs and brachial-ankle pulse wave velocity

    Directory of Open Access Journals (Sweden)

    Hoshi Keika

    2006-05-01

    Full Text Available Abstract Background It has been suggested that periodontal disease may be an independent risk factor for the development of atherosclerosis. However, the relationship between periodontal disease and atherosclerosis has not been fully elucidated. This study aimed to assess the effects of periodontal disease on atherosclerosis. Methods The study design was a cross-sectional study. Subjects were 291 healthy male workers in Japan. We used the Community Periodontal Index of Treatment Needs (CPITN score, average probing depth and gingival bleeding index (rate of bleeding gums to assess the severity of periodontal disease. We also used the Brachial-Ankle Pulse Wave Velocity (baPWV as the index for the development of atherosclerosis. Results The unadjusted odds ratio (OR of atherosclerosis in relation to the CPITN score was 1.41 [95% CI: 1.16–1.73]. However, after adjustment for age, systolic blood pressure and smoking, the CPITN score had no relationship with atherosclerosis (adjusted OR: 0.91 [0.68–1.20]. Conclusion Our results show no relationship between mild periodontal disease and atherosclerosis after appropriate adjustments.

  6. PROCAM-, FRAMINGHAM-, SCORE- and SMART-risk score for predicting cardiovascular morbidity and mortality in patients with overt atherosclerosis.

    Science.gov (United States)

    Uthoff, H; Staub, D; Socrates, T; Meyerhans, A; Bundi, B; Schmid, H P; Frauchiger, B

    2010-11-01

    The predictive value of PROCAM, FRAMINGHAM, SCORE and SMART-score to estimate the cardiovascular risk in patients with overt atherosclerosis had never been assessed. 96 consecutive patients with clinically evident atherosclerosis (coronary, cerebrovascular, peripheral artery and renovascular disease) were enrolled in this preliminary observational study. At baseline, medical history and blood chemistry were obtained. Sonographic measurement of the intima-media thickness (IMT) in the common carotid artery was performed and risk estimations according to the above listed risk scores were calculated. During a 6 year follow-up the occurrence of cardiovascular death, acute coronary syndrome and stroke was assessed. Mean (±SD) risk-scores were 10.9±2.5, range 6-17 (SMART); 18.9±18.2%; range 0.2-94.1% (PROCAM); 21.4±13.1%, range 4-56% (FRAMINGHAM); and 4.8±3.9%, range 0.4-15.3% (SCORE). Mean IMT was 0.84±0.14 mm, range 0.51-1.20 mm. All scores correlate significantly with each other (r>0.321; pcardiovascular endpoint was observed in 36 (42%) patients. The AUC (95% confidence interval) for SMART-risk-score predicting a cardiovascular event was 0.67 (0.54-0.77; pcardiovascular event per additional SMART score point of 1.15 (95% CI 1.01-1.30 p=0.03). PROCAM-, FRAMINGHAM- and SCORE-risk score seem to be barely useful in a secondary prevention setting. In patients with overt atherosclerosis, the cardiovascular risk seems to be better assessed by means of the SMART score.

  7. Detection of subclinical atherosclerosis in peripheral arterial beds with B-mode ultrasound: a proposal for guiding the decision for medical intervention and an artifact-corrected volumetric scoring index.

    Science.gov (United States)

    Bedi, Ram; Nagra, Aslam; Fukumoto, Takenori; Lynum, Steven; Sengupta, Partho; Aw, James; Mefford, Ivan; Panwar, Sadik Raja; Bansal, Nikhil; Insaan, Puneet; Singh, Shaanemeet; Panwar, Rajababoo; Vedanthan, Rajesh; Fuster, Valentin; Narula, Jagat

    2014-12-01

    To assess subclinical atherosclerotic cardiovascular disease (ASCVD) using B-mode ultrasound, with special emphasis on the incremental value of performing imaging in multiple peripheral arteries, and to compare imaging findings with traditional risk factors for medical intervention eligibility. Data from 2 asymptomatic cohorts from India with unknown ASCVD risk factors were compared to 2 cohorts from North America with known ASCVD risk factors. Carotid and iliofemoral arteries of the Indian cohorts were examined with automated ultrasound in a high-pace environment by non-experts. A simplified metric of atherosclerotic disease burden (FUster-Narula or FUN Score) was developed from 3D imaging data by summing intima-media volume (IMV) over 5-cm arterial segments. Effectiveness of ASCVD prevention guidelines to direct therapy was compared to results from direct imaging. Of the 941 (mean age 44.27 ± 13.76 years, 34% female) enrollees from India, 224 (24%) demonstrated plaques in at least 1 of the 4 arterial sites examined; 107 (11%) had plaques in only the carotids, 70 (7%) in both the carotids and iliofemoral arteries, and 47 (5%) had plaques in only the iliofemoral arteries. Older age and male sex were associated with the presence of plaque, but association with systolic blood pressure was not observed. Data from 2 North American clinics (n = 481, mean age 59.68 ± 11.95 years, 39% female) showed that 203 subjects (42%) had carotid plaque; 82% of whom would not have qualified for lipid-lowering therapy under the Adult Treatment Panel (ATP) III Guidelines. Using the recently published ATP IV Guidelines, 33% of the individuals with carotid plaque would also have failed to qualify for treatment. B-mode ultrasound examination of bilateral iliofemoral arteries provided an incremental yield in identifying subclinical atherosclerotic disease compared to carotid evaluation alone. Ultrasound examination allowed improved identification of individuals who could be targeted for

  8. Walk Score® and Transit Score® and walking in the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Hirsch, Jana A; Moore, Kari A; Evenson, Kelly R; Rodriguez, Daniel A; Diez Roux, Ana V

    2013-08-01

    Walk Score® and Transit Score® are open-source measures of the neighborhood built environment to support walking ("walkability") and access to transportation. To investigate associations of Street Smart Walk Score and Transit Score with self-reported transport and leisure walking using data from a large multicity and diverse population-based sample of adults. Data from a sample of 4552 residents of Baltimore MD, Chicago IL, Forsyth County NC, Los Angeles CA, New York NY, and St. Paul MN from the Multi-Ethnic Study of Atherosclerosis (2010-2012) were linked to Walk Score and Transit Score (collected in 2012). Logistic and linear regression models estimated ORs of not walking and mean differences in minutes walked, respectively, associated with continuous and categoric Walk Score and Transit Score. All analyses were conducted in 2012. After adjustment for site, key sociodemographic, and health variables, a higher Walk Score was associated with lower odds of not walking for transport and more minutes/week of transport walking. Compared to those in a "walker's paradise," lower categories of Walk Score were associated with a linear increase in odds of not transport walking and a decline in minutes of leisure walking. An increase in Transit Score was associated with lower odds of not transport walking or leisure walking, and additional minutes/week of leisure walking. Walk Score and Transit Score appear to be useful as measures of walkability in analyses of neighborhood effects. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Association of a 62 Variants Type 2 Diabetes Genetic Risk Score With Markers of Subclinical Atherosclerosis: A Transethnic, Multicenter Study.

    Science.gov (United States)

    Dauriz, Marco; Porneala, Bianca C; Guo, Xiuqing; Bielak, Lawrence F; Peyser, Patricia A; Durant, Nefertiti H; Carnethon, Mercedes R; Bonadonna, Riccardo C; Bonora, Enzo; Bowden, Donald W; Florez, Jose C; Fornage, Myriam; Hivert, Marie-France; Jacobs, David R; Kabagambe, Edmond K; Lewis, Cora E; Murabito, Joanne M; Rasmussen-Torvik, Laura J; Rich, Stephen S; Vassy, Jason L; Yao, Jie; Carr, Jeffrey J; Kardia, Sharon L R; Siscovick, David; O'Donnell, Christopher J; Rotter, Jerome I; Dupuis, Josée; Meigs, James B

    2015-06-01

    Type 2 diabetes mellitus (T2D) and cardiovascular disease share risk factors and subclinical atherosclerosis (SCA) predicts events in those with and without diabetes mellitus. T2D genetic risk may predict both T2D and SCA. We hypothesized that greater T2D genetic risk is associated with higher extent of SCA. In a cross-sectional analysis, including ≤9210 European Americans, 3773 African Americans, 1446 Hispanic Americans, and 773 Chinese Americans without known cardiovascular disease and enrolled in the Framingham Heart Study, Coronary Artery Risk Development in Young Adults, Multi-Ethnic Study of Atherosclerosis, and Genetic Epidemiology Network of Arteriopathy studies, we tested a 62 T2D-loci genetic risk score for association with measures of SCA, including coronary artery or abdominal aortic calcium score, common and internal carotid artery intima-media thickness, and ankle-brachial index. We used ancestry-stratified linear regression models, with random effects accounting for family relatedness when appropriate, applying a genetic-only (adjusted for sex) and a full SCA risk factors-adjusted model (significance, PAtherosclerosis Europeans (fully-adjusted P=0.004) and with common carotid artery intima-media thickness in the Framingham Heart Study (P=0.009) was not confirmed in other study cohorts, either separately or in meta-analysis. Secondary analyses showed no consistent associations with β-cell and insulin resistance genetic risk sub-scores in the Framingham Heart Study and in the Coronary Artery Risk Development in Young Adults. SCA does not have a major genetic component linked to a burden of 62 T2D loci identified by large genome-wide association studies. A shared T2D-SCA genetic basis, if any, might become apparent from better functional information about both T2D and cardiovascular disease risk loci. © 2015 American Heart Association, Inc.

  10. A score including ADAM17 substrates correlates to recurring cardiovascular event in subjects with atherosclerosis.

    Science.gov (United States)

    Rizza, Stefano; Copetti, Massimiliano; Cardellini, Marina; Menghini, Rossella; Pecchioli, Chiara; Luzi, Alessio; Di Cola, Giovanni; Porzio, Ottavia; Ippoliti, Arnaldo; Romeo, Franco; Pellegrini, Fabio; Federici, Massimo

    2015-04-01

    Atherosclerosis disease is a leading cause for mortality and morbidity. The narrowing/rupture of a vulnerable atherosclerotic plaque is accountable for acute cardiovascular events. However, despite of an intensive research, a reliable clinical method which may disclose a vulnerable patient is still unavailable. We tested the association of ADAM17 (A Disintegrin and Metallo Protease Domain 17) circulating substrates (sICAM-1, sVCAM-1, sIL6R and sTNFR1) with a second major cardiovascular events [MACEs] (cardiovascular death, peripheral artery surgeries, non-fatal myocardial infarction and non-fatal stroke) in 298 patients belonging to the Vascular Diabetes (AVD) study. To evaluate ADAM17 activity we create ADAM17 score through a RECPAM model. Finally we tested the discrimination ability and the reclassification of clinical models. At follow-up (mean 47 months, range 1-118 months), 55 MACEs occurred (14 nonfatal MI, 14 nonfatal strokes, 17 peripheral artery procedures and 10 cardiovascular deaths) (incidence = 7.8% person-years). An increased risk for incident events was observed among the high ADAM17 score individuals both in univariable (HR 19.20, 95% CI 15.82-63.36, p atherosclerosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Risk scores of common genetic variants for lipid levels influence atherosclerosis and incident coronary heart disease.

    Science.gov (United States)

    Isaacs, Aaron; Willems, Sara M; Bos, Daniel; Dehghan, Abbas; Hofman, Albert; Ikram, M Arfan; Uitterlinden, André G; Oostra, Ben A; Franco, Oscar H; Witteman, Jacqueline C; van Duijn, Cornelia M

    2013-09-01

    Circulating levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, and triglycerides are recognized risk factors for cardiovascular disease. We tested the hypothesis that the cumulative effects of common genetic variants for lipids are collectively associated with subclinical atherosclerosis and incident coronary heart disease. Participants were drawn from the Erasmus Rucphen Family Study (n=2269) and the Rotterdam Study (n=8130). Linear regression and Cox proportional hazards models were applied to assess the influence of 4 risk scores derived from common genetic variants for lipids (total cholesterol, LDL-C, high-density lipoprotein cholesterol, and triglycerides) on carotid plaque, intima-media thickness, incident myocardial infarction, and coronary heart disease. Adjusted for age and sex, all 4 risk scores were associated with carotid plaque. This relationship was the strongest for the LDL-C score, which increased plaque score by 0.102 per SD increase in genetic risk score (P=3.2 × 10(-8)). The LDL-C score was also nominally associated with intima-media thickness, which increased 0.006 mm per SD increase in score (P=0.05). Both the total cholesterol and LDL-C scores were associated with incident myocardial infarction and coronary heart disease with hazard ratios between 1.10 and 1.13 per SD increase in score. Inclusion of additional risk factors as covariates minimally affected these results. Common genetic variants with small effects on lipid levels are, in combination, significantly associated with subclinical and clinical cardiovascular outcomes. As knowledge of genetic variation increases, preclinical genetic screening tools might enhance the prediction and prevention of clinical events.

  12. Climiate Resilience Screening Index and Domain Scores

    Data.gov (United States)

    U.S. Environmental Protection Agency — CRSI and related-domain scores for all 50 states and 3135 counties in the U.S. This dataset is not publicly accessible because: They are already available within the...

  13. Dietary inflammatory index in relation to sub-clinical atherosclerosis and atherosclerotic vascular disease mortality in older women.

    Science.gov (United States)

    Bondonno, Nicola P; Lewis, Joshua R; Blekkenhorst, Lauren C; Shivappa, Nitin; Woodman, Richard J; Bondonno, Catherine P; Ward, Natalie C; Hébert, James R; Thompson, Peter L; Prince, Richard L; Hodgson, Jonathan M

    2017-06-01

    Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual's diet. The primary objective of this study was to assess the association of the DII with common carotid artery-intima-media thickness (CCA-IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted in Western Australian women aged over 70 years (n 1304). Dietary data derived from a validated FFQ (completed at baseline) were used to calculate a DII score for each individual. In multivariable-adjusted models, DII scores were associated with sub-clinical atherosclerosis: a 1 sd (2·13 units) higher DII score was associated with a 0·013-mm higher mean CCA-IMT (P=0·016) and a 0·016-mm higher maximum CCA-IMT (P=0·008), measured at 36 months. No relationship was seen between DII score and carotid plaque severity. There were 269 deaths during follow-up. High DII scores were positively associated with ASVD-related death (per sd, hazard ratio (HR): 1·36; 95 % CI 1·15, 1·60), CVA-related death (per sd, HR: 1·30; 95 % CI 1·00, 1·69) and IHD-related death (per sd, HR: 1·40; 95 % CI 1·13, 1·75). These results support the hypothesis that a pro-inflammatory diet increases systemic inflammation leading to development and progression of atherosclerosis and eventual ASVD-related death.

  14. Association of a 62 Variant Type 2 Diabetes Genetic Risk Score with Markers of Subclinical Atherosclerosis: A Transethnic, Multicenter Study

    Science.gov (United States)

    Dauriz, Marco; Porneala, Bianca C.; Guo, Xiuqing; Bielak, Lawrence F.; Peyser, Patricia A.; Durant, Nefertiti H.; Carnethon, Mercedes R.; Bonadonna, Riccardo C.; Bonora, Enzo; Bowden, Donald W.; Florez, Jose C.; Fornage, Myriam; Hivert, Marie-France; Jacobs, David R.; Kabagambe, Edmond K.; Lewis, Cora E.; Murabito, Joanne M.; Rasmussen-Torvik, Laura J.; Rich, Stephen S.; Vassy, Jason L.; Yao, Jie; Carr, Jeffrey J.; Kardia, Sharon L.R.; Siscovick, David; O'Donnell, Christopher J.; Rotter, Jerome I.; Dupuis, Josée; Meigs, James B.

    2015-01-01

    Background Type 2 diabetes (T2D) and cardiovascular disease (CVD) share risk factors and subclinical atherosclerosis (SCA) predicts events in those with and without diabetes. T2D genetic risk may predict both T2D and SCA. We hypothesized that greater T2D genetic risk is associated with higher extent of SCA. Methods and Results In a cross-sectional analysis including up to 9,210 European Americans, 3,773 African Americans, 1,446 Hispanic Americans and 773 Chinese Americans without known CVD and enrolled in the FHS, CARDIA, MESA and GENOA studies, we tested a 62 T2D-loci genetic risk score (GRS62) for association with measures of SCA, including coronary artery (CACS) or abdominal aortic calcium score, common (CCA-IMT) and internal carotid artery intima-media thickness, and ankle-brachial index (ABI). We used ancestry-stratified linear regression models, with random effects accounting for family relatedness when appropriate, applying a genetic-only (adjusted for sex) and a full SCA risk factors adjusted model (significance = pidentified by large genome-wide association studies. A shared T2D-SCA genetic basis, if any, might become apparent from better functional information about both T2D and CVD risk loci. PMID:25805414

  15. CLINICAL RISK INDEX FOR BABIES (CRIB) II SCORE AS A ...

    African Journals Online (AJOL)

    2011-01-01

    Jan 1, 2011 ... Among them is the scoring system Clinical Risk Index for Babies also known as CRIB II score. ... specificity of 75.3%, and a predictive value of 77.7% compared to 72.5, 71.2, and 71.8% respectively for ... 56, 75 and 66% for sensitivity, specificity and predictive values respectively. Conclusion: CRIB II score ...

  16. Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.

    Science.gov (United States)

    Iannuzzi, Arcangelo; Licenziati, Maria Rosaria; Vacca, Maria; De Marco, Donata; Cinquegrana, Giorgio; Laccetti, Marco; Bresciani, Alessandro; Covetti, Giuseppe; Iannuzzo, Gabriella; Rubba, Paolo; Parillo, Mario

    2009-11-01

    Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (Pglycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.

  17. Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

    2016-09-01

    Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45-84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less-Mediterranean-like dietary patterns. This trial was registered at

  18. Heart-Carotid Pulse Wave Velocity a Useful Index of Atherosclerosis in Chinese Hypertensive Patients.

    Science.gov (United States)

    Li, Chunyue; Xiong, Huahua; Pirbhulal, Sandeep; Wu, Dan; Li, Zhenzhou; Huang, Wenhua; Zhang, Heye; Wu, Wanqing

    2015-12-01

    This study was designed to investigate the relationship between heart-carotid pulse wave velocity (hcPWV) and carotid intima-media thickness (CIMT) in hypertensive patients, and also to examine the effect of pre-ejection period (PEP) on it. Doppler ultrasound device was used to measure CIMT in left common carotid artery. Hypertensive patients were divided into normal (n = 36, CIMT ≤0.8 mm) and thickened (n = 31, CIMT > 0.8 mm) group. Electrocardiogram R-wave-based carotid pulse wave velocity (rcPWV) and aortic valve-carotid pulse wave velocity (acPWV) were calculated as the ratio of the travel length to the pulse transit time with or without PEP, respectively. CIMT has significant relations with rcPWV (r = 0.611, P blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, antihypertensive medication, and plaque occurrence. However, similar results were not found in normal group. Since CIMT has been considered as an index of atherosclerosis, our results suggested that both rcPWV and acPWV could be useful indexes of atherosclerosis in thickened CIMT hypertensive patients. Additionally, if hcPWV is computed with heart-carotid pulse transit time, including PEP could improve the accuracy of atherosclerosis assessment in hypertensive patients.

  19. Association between Framingham risk score and subclinical atherosclerosis among elderly with both type 2 diabetes mellitus and healthy subjects

    Science.gov (United States)

    Amer, Moatassem S; Khater, Mohamed S; Omar, Omar H; Mabrouk, Randa A; Mostafa, Shimaa A

    2014-01-01

    Framingham risk score (FRS) is a widely used tool to identify asymptomatic individuals who are at risk to cardiovascular disease. We aimed to investigate the association between subclinical atherosclerosis and FRS among elderly with both type 2 diabetes mellitus and healthy participants. Methods: As case-control study was done on 58 men and women, who had type 2 diabetes mellitus, and in 59 age and gender matched control participants. They were selected from a geriatric outpatient clinic at Ain Shams University Hospital, Cairo, Egypt. The carotid intima-media thickness (cIMT), clinical variables, plasma lipid profile, high-sensitivity C-reactive protein (hs-CRP) were measured for each participants. Results: Diabetic patients had higher FRS, body mass index (BMI), fasting glucose, total cholesterol level, and LDL levels than control subjects. Mean cIMT values were higher in diabetic than healthy subjects. After multivariate regression analysis, FRS was independently associated with carotid IMT in type 2 diabetes patients after adjustment for other risk factors. However triglycerides and BMI were independently associated with cIMT among the control group. Conclusion: FRS is likely to be more informative about the atherosclerotic state in diabetics but not in the healthy elderly. PMID:24551481

  20. Arterial compliance across the spectrum of ankle-brachial index: the Multiethnic Study of Atherosclerosis.

    Science.gov (United States)

    Lilly, Scott M; Jacobs, David R; Kronmal, Richard; Bluemke, David A; Criqui, Michael; Lima, Joao; Allison, Matthew; Duprez, Daniel; Segers, Patrick; Chirinos, Julio A

    2014-04-01

    A low ankle-brachial index is associated with cardiovascular disease and reduced arterial compliance. A high ankle-brachial index is also associated with an increased risk of cardiovascular events. We tested the hypothesis that subjects with a high ankle-brachial index demonstrate a lower arterial compliance. In addition, we assessed whether pulse pressure amplification is increased among subjects with a high ankle-brachial index. We studied 6814 adults enrolled in the Multiethnic Study of Atherosclerosis who were, by definition, free of clinical cardiovascular disease at baseline. Differences in total arterial compliance (ratio of stroke volume to pulse pressure), aortic and carotid distensibility (measured with magnetic resonance imaging and duplex ultrasound, respectively) were compared across ankle-brachial index subclasses (≤0.90, 0.91-1.29; ≥1.30) with analyses adjusted for cardiovascular risk factors and subclinical atherosclerosis. Peripheral arterial disease was detected in 230 (3.4%) and high ABI in 648 (9.6%) of subjects. Those with high ankle-brachial index demonstrated greater aortic/radial pulse pressure amplification than those with a normal ankle-brachial index. In adjusted models aortic and carotid distensibility as well as total arterial compliance, were lowest among those with ankle-brachial index≤0.9 (p<0.01 vs. all), but were not reduced in subjects with an ankle-brachial index≥1.3. Lower aortic, carotid and total arterial compliance is not present in subjects free of overt cardiovascular disease and with a high ankle-brachial index. However, increased pulse pressure amplification contributes to a greater ankle-brachial index in the general population and may allow better characterization of individuals with this phenotype. Published by Elsevier Ireland Ltd.

  1. The TyG Index as a Marker of Subclinical Atherosclerosis and Arterial Stiffness in Lean and Overweight Postmenopausal Women.

    Science.gov (United States)

    Lambrinoudaki, Irene; Kazani, Maria Vasiliki; Armeni, Eleni; Georgiopoulos, Georgios; Tampakis, Konstantinos; Rizos, Demetrios; Augoulea, Areti; Kaparos, Georgios; Alexandrou, Andreas; Stamatelopoulos, Kimon

    2017-06-16

    The present study aims to examine the association of the metabolic syndrome (MS) as well as of the triglyceride-glucose index (TyG-Index), a novel marker of insulin resistance, with subclinical atherosclerosis in a cohort of postmenopausal women, stratified according to their body mass index. A total of 473 informed-consenting, non-diabetic postmenopausal women, without overt cardiovascular disease, were included in this study. We aimed to compare the association between structural and functional indices of subclinical atherosclerosis (i.e. carotid artery intima-media thickness (IMT), flow-mediated dilation of the brachial artery, pulse wave velocity (PWV)) with the TyG-index or MS, separately for lean and overweight/obese women. The TyG-Index correlated significantly with carotid IMT (r=0.155, p=0.012) and PWV (r=0.157, p=0.013) only in the group of lean women. Multivariate analysis showed that subclinical atherosclerosis was predicted by MS, in the overweight/obese group (OR=2.517, 95% CI: 1.078-5.878, p=0.033), and by the TyG-Index the lean group (OR=3.119, 95% CI: 1.187-8.194, psubclinical atherosclerosis compared to 29.4% in women below the cut-off (p=0.043). The TyG-Index is associated with carotid atherosclerosis and arterial stiffness mainly in lean postmenopausal women, while the MS serves as a better predictor of subclinical atherosclerosis in overweight/obese women. The TyG-Index may prove a useful marker for identifying high-risk women in the normal-weight postmenopausal population. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  2. Expanding the scoring system for the Dynamic Gait Index.

    Science.gov (United States)

    Shumway-Cook, Anne; Taylor, Catherine S; Matsuda, Patricia Noritake; Studer, Michael T; Whetten, Brady K

    2013-11-01

    The Dynamic Gait Index (DGI) measures the capacity to adapt gait to complex tasks. The current scoring system combining gait pattern (GP) and level of assistance (LOA) lacks clarity, and the test has a limited range of measurement. This study developed a new scoring system based on 3 facets of performance (LOA, GP, and time) and examined the psychometric properties of the modified DGI (mDGI). A cross-sectional, descriptive study was conducted. Nine hundred ninety-five participants (855 patients with neurologic pathology and mobility impairments [MI group] and 140 patients without neurological impairment [control group]) were tested. Interrater reliability was calculated using kappa coefficients. Internal consistency was computed using the Cronbach alpha coefficient. Factor analysis and Rasch analysis investigated unidimensionality and range of difficulty. Internal validity was determined by comparing groups using multiple t tests. Minimal detectable change (MDC) was calculated for total score and 3 facet scores using the reliability estimate for the alpha coefficients. Interrater agreement was strong, with kappa coefficients ranging from 90% to 98% for time scores, 59% to 88% for GP scores, and 84% to 100% for LOA scores. Test-retest correlations (r) for time, GP, and LOA were .91, .91, and .87, respectively. Three factors (time, LOA, GP) had eigenvalues greater than 1.3 and explained 79% of the variance in scores. All group differences were significant, with moderate to large effect sizes. The 95% minimal detectable change (MDC95) was 4 for the mDGI total score, 2 for the time and GP total scores, and 1 for the LOA total score. The limitations included uneven sample sizes in the 2 groups. The MI group were patients receiving physical therapy; therefore, they may not be representative of this population. The mDGI, with its expanded scoring system, improves the range, discrimination, and facets of measurement related to walking function. The strength of the

  3. Gait Deviation Index, Gait Profile Score and Gait Variable Score in children with spastic cerebral palsy

    DEFF Research Database (Denmark)

    Rasmussen, Helle Mätzke; Nielsen, Dennis Brandborg; Pedersen, Niels Wisbech

    2015-01-01

    Abstract The Gait Deviation Index (GDI) and Gait Profile Score (GPS) are the most used summary measures of gait in children with cerebral palsy (CP). However, the reliability and agreement of these indices have not been investigated, limiting their clinimetric quality for research and clinical...... practice. The aim of this study was to investigate the intra-rater reliability and agreement of summary measures of gait (GDI; GPS; and the Gait Variable Score (GVS) derived from the GPS). The intra-rater reliability and agreement were investigated across two repeated sessions in 18 children aged 5...

  4. Coronary atherosclerosis evaluation among Iranian patients with zero coronary calcium score in computed tomography coronary angiography

    Directory of Open Access Journals (Sweden)

    Maryam Moradi

    2016-01-01

    Conclusion: Although, CAC scoring is a noninvasive and valuable method to evaluate CAD; but zero CAC score does not absolutely exclude the CAD, especially in the presence of risk factors such as diabetes, hyperlipidemia, and smoking.

  5. Relationship between Blood Stasis Syndrome Score and Cardioankle Vascular Index in Stroke Patients

    Directory of Open Access Journals (Sweden)

    Ki-Ho Cho

    2012-01-01

    Full Text Available Blood stasis syndrome (BSS in traditional Asian medicine has been considered to correlate with the extent of atherosclerosis, which can be estimated using the cardioankle vascular index (CAVI. Here, the diagnostic utility of CAVI in predicting BSS was examined. The BSS scores and CAVI were measured in 140 stroke patients and evaluated with respect to stroke risk factors. Receiver operating characteristic (ROC curve analysis was used to determine the diagnostic accuracy of CAVI for the diagnosis of BSS. The BSS scores correlated significantly with CAVI, age, and systolic blood pressure (SBP. Multiple logistic regression analysis showed that CAVI was a significant associate factor for BSS (OR 1.55, P=0.032 after adjusting for the age and SBP. The ROC curve showed that CAVI and age provided moderate diagnostic accuracy for BSS (area under the ROC curve (AUC for CAVI, 0.703, P<0.001; AUC for age, 0.692, P=0.001. The AUC of the “CAVI+Age,” which was calculated by combining CAVI with age, showed better accuracy (0.759, P<0.0001 than those of CAVI or age. The present study suggests that the CAVI combined with age can clinically serve as an objective tool to diagnose BSS in stroke patients.

  6. Associations between elevated resting heart rate and subclinical atherosclerosis in asymptomatic Korean adults undergoing coronary artery calcium scoring.

    Science.gov (United States)

    Han, Donghee; Lee, Ji Hyun; Rizvi, Asim; Baskaran, Lohendran; Park, Hyo Eun; Choi, Su-Yeon; Chun, Eun Ju; Sung, Jidong; Park, Sung Hak; Han, Hae-Won; Min, James K; Chang, Hyuk-Jae; Ó Hartaigh, Bríain

    2016-10-01

    Elevated resting heart rate (RHR) and the presence of coronary artery calcium (CAC) are closely related with inflammatory activity and cardiovascular disease outcomes. To date, however, the relationship between a high RHR and CAC has not been well studied, especially in non-western populations. We therefore aimed to examine the cross-sectional relationship between high RHR and the burden of subclinical atherosclerosis as measured by CAC score in a large sample of Korean adults. A total 26,018 subjects were enrolled and underwent CAC screening as part of a broader general health examination. RHR was categorized into four groups as: 0, >100, or >400 based on RHR. Mean age of the study population was 53.9 ± 8.2 years, and 79.7 % were male. After adjustment, each 10 beat per minute increment in RHR was associated with greater odds of having a CAC score above 100 (OR 1.13, 95 % CI 1.08-1.18) or 400 (OR 1.22, 95 % CI 1.13-1.31). Likewise, following adjustment, the odds of having a CAC >100 or >400 for those with a RHR ≥80 beats per minute were 1.42 (95 % CI 1.19-1.69) and 1.86 (95 % CI 1.42-2.47), respectively, compared with those who had a RHR <60 beats per minute. In a large cohort of Korean adults, elevations in the RHR, particularly above 80 beats per minute, were found to be independently associated with the presence of subclinical atherosclerosis as measured by CAC scoring.

  7. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score=400, carotid intima...

  8. Comparison of 4 established DASH diet indexes: examining associations of index scores and colorectal cancer123

    Science.gov (United States)

    Cross, Amanda J; Subar, Amy F; Krebs-Smith, Susan M; Park, Yikyung; Powell-Wiley, Tiffany; Hollenbeck, Albert; Reedy, Jill

    2013-01-01

    Background: Multiple diet indexes have been developed to capture the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and examine relations with health outcomes but have not been compared within the same study population to our knowledge. Objective: We compared 4 established DASH indexes and examined associations with colorectal cancer. Design: Scores were generated from a food-frequency questionnaire in the NIH-AARP Diet and Health Study (n = 491,841). Separate indexes defined by Dixon (7 food groups, saturated fat, and alcohol), Mellen (9 nutrients), Fung (7 food groups and sodium), and Günther (8 food groups) were used. HRs and 95% CIs for colorectal cancer were generated by using Cox proportional hazard models. Results: From 1995 through 2006, 6752 incident colorectal cancer cases were ascertained. In men, higher scores were associated with reduced colorectal cancer incidence by comparing highest to lowest quintiles for all indexes as follows: Dixon (HR: 0.77; 95% CI: 0.69, 0.87), Mellen (HR: 0.78; 95% CI: 0.71, 0.86), Fung (HR: 0.75; 95% CI: 0.68, 0.83), and Günther (HR: 0.81; 95% CI: 0.74, 0.90). Higher scores in women were inversely associated with colorectal cancer incidence by using methods defined by Mellen (HR: 0.79; 95% CI: 0.68, 0.91), Fung (HR: 0.84; 95% CI: 0.73, 0.96), and Günther (HR: 0.84; 95% CI: 0.73.0.97) but not Dixon (HR: 1.01; 95% CI: 0.80, 1.28). Conclusion: The consistency in findings, particularly in men, suggests that all indexes capture an underlying construct inherent in the DASH dietary pattern, although the specific index used can affect results. PMID:23864539

  9. Increased risk of subclinical atherosclerosis associated with high visceral adiposity index in apparently healthy Korean adults: the Kangbuk Samsung Health Study.

    Science.gov (United States)

    Park, Hye-Jeong; Kim, Jihyun; Park, Se Eun; Park, Cheol-Young; Lee, Won-Young; Oh, Ki-Won; Park, Sung-Woo; Rhee, Eun-Jung

    2016-09-01

    The visceral adiposity index (VAI) is a mathematical tool that reflects a patient's visceral adiposity and insulin resistance. Recent studies have noted an association between VAI and cardiovascular event. We analyzed the association between VAI and coronary artery calcium score (CACS) in Korean adults. For 33,468 participants (mean age 42 yrs) in a health screening program, VAI was calculated using the following formulae: [waist circumference (WC)/{39.68 + (1.88 * body mass index (BMI))}] * (triglyceride/1.03) * {1.31/high-density lipoprotein cholesterol (HDL-C)} for men and [WC/{36.58 + (1.89 * BMI)}] * (triglyceride/0.81) * (1.52/HDL-C) for women. Coronary artery calcium scores were measured with multi-detector computed tomography. CACS was positively correlated with VAI (r = 0.027, p 0 as the dependent variable, subjects in the highest tertile of VAI (>1.777) had significantly increased odds ratio for CACS >0 compared to subjects in the lowest tertile (<0.967), even after adjusting for confounding variables, including BMI (OR 1.26, 95% CI 1.147-1.381). Subjects with high VAI had increased risk for subclinical atherosclerosis, as assessed by CACS. Key messages Recent studies have noted an association between visceral adiposity index (VAI) and cardiovascular event. Subjects with coronary artery calcification (CAC) showed significantly higher VAI compared to those without CAC. The subjects with high VAI showed increased odds ratio for CAC as compared to subjects with low VAI, suggesting high VAI reflects increased risk for subclinical atherosclerosis.

  10. Association of subclinical atherosclerosis using carotid intima-media thickness, carotid plaque, and coronary calcium score with left ventricular dyssynchrony: the multi-ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Sharma, Ravi K; Donekal, Sirisha; Rosen, Boaz D; Tattersall, Matthew C; Volpe, Gustavo J; Ambale-Venkatesh, Bharath; Nasir, Khurram; Wu, Colin O; Polak, Joseph F; Korcarz, Claudia E; Stein, James H; Carr, James; Watson, Karol E; Bluemke, David A; Lima, João A C

    2015-04-01

    The role of atherosclerosis in the progression of global left ventricular dysfunction and cardiovascular events has been well recognized. Left ventricular (LV) dyssynchrony is a measure of regional myocardial dysfunction. Our objective was to investigate the relationship of subclinical atherosclerosis with mechanical LV dyssynchrony in a population-based asymptomatic multi-ethnic cohort. Participants of the Multi-Ethnic Study of Atherosclerosis (MESA) at exam 5 were evaluated using 1.5T cardiac magnetic resonance (CMR) imaging, carotid ultrasound (n = 2062) for common carotid artery (CCA) and internal carotid artery (ICA) intima-media thickness (IMT), and cardiac computed tomography (n = 2039) for coronary artery calcium (CAC) assessment (Agatston method). Dyssynchrony indices were defined as the standard deviation of time to peak systolic circumferential strain (SD-TPS) and the difference between maximum and minimum (max-min) time to peak strain using harmonic phase imaging in 12 segments (3-slices × 4 segments). Multivariable regression analyses were performed to assess associations after adjusting for participant demographics, cardiovascular risk factors, LV mass, and ejection fraction. In multivariable analyses, SD-TPS was significantly related to measures of atherosclerosis, including CCA-IMT (8.7 ms/mm change in IMT, p = 0.020), ICA-IMT (19.2 ms/mm change in IMT, p atherosclerosis are associated with parameters of subclinical LV dyssynchrony in the absence of clinical coronary event and left-bundle-branch block. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis?

    Science.gov (United States)

    Kurt, Tolga; Temiz, Ahmet; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Sacar, Mustafa

    2015-07-01

    It takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.

  12. Histological evaluation disqualifies IMT and calcification scores as surrogates for grading coronary and aortic atherosclerosis

    NARCIS (Netherlands)

    A. Meershoek (Armelle); R.A. van Dijk (Rogier A.); S. Verhage (Sander); J.F. Hamming (Jaap); A. van den Bogaerdt (Antoon); A.J.J.C. Bogers (Ad); A.F.M. Schaapherder (Alexander); J. Lindeman (J.)

    2016-01-01

    markdownabstract__Background/objectives__ Carotid intimal media thickness (IMT) and coronary calcium scores (CCS) are thought to reflect atherosclerotic burden. The validity of this assumption for IMT is challenged by recent meta-analyses; for CCS by absence of a relationship between negative

  13. Evaluation of a nutrient-rich food index score in the Netherlands

    NARCIS (Netherlands)

    Sluik, D.; Streppel, M.T.; Lee, van L.; Geelen, A.; Feskens, E.J.M.

    2015-01-01

    Nutrient-rich food (NRF) index scores are dietary quality indices based on nutrient density. We studied the design aspects involved in the development and validation of NRF index scores, using the Dutch consumption data and guidelines as an example. We evaluated fifteen NRF index scores against the

  14. Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis12

    Science.gov (United States)

    Levitan, Emily B; Ahmed, Ali; Arnett, Donna K; Polak, Joseph F; Hundley, W Gregory; Bluemke, David A; Heckbert, Susan R; Jacobs, David R; Nettleton, Jennifer A

    2016-01-01

    Background: Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. Objective: We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. Design: We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45–84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). Results: The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. Conclusions: A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less

  15. Diagnosis of subclinical atherosclerosis in HIV-infected patients: higher accuracy of the D:A:D risk equation over Framingham and SCORE algorithms.

    Science.gov (United States)

    Serrano-Villar, Sergio; Estrada, Vicente; Gómez-Garre, Dulcenombre; Ávila, Mario; Fuentes-Ferrer, Manuel; San, Román Jesús; Soriano, Vicente; Sánchez-Parra, Clara; Sainz, Talía; Fernández-Cruz, Arturo

    2014-06-01

    While the detection of subclinical atherosclerosis may provide an opportunity for the prevention of cardiovascular disease (CVD), which currently is a leading cause of death in HIV-infected subjects, its diagnosis is a clinical challenge. We aimed to compare the agreement and diagnostic performance of Framingham, SCORE and D:A:D equations for the recognition of subclinical atherosclerosis in HIV patients and to adjust the D:A:D equation using HIV and CVD variables. Atherosclerosis was evaluated in 203 HIV-infected individuals by measuring the carotid intima-media thickness (IMT). The CVD risk was calculated using the Framingham, SCORE and D:A:D risk equations. Framingham, SCORE and D:A:D equations showed a low agreement with the IMT (Kappa: 0.219, 0.298, 0.244, respectively; p = 0.743) and a moderate predictive performance, (area under the curve [AUC] = 0.686, 0.665 and 0.716, respectively; p = 0.048), with the D:A:D equation being the most accurate. Atherosclerosis was demonstrated in a significant proportion of subjects with low predicted CVD risk by all three algorithms (16.3%, 17.2%, 17.2%, respectively; p = 0.743). In patients with an estimated low CVD risk atherosclerosis was associated with older age (p = 0.012) and low CD4 counts (p = 0.021). A model was developed to adjust the D:A:D equation; a significant increase in accuracy was obtained when CD4 counts and low-grade albuminuria were included (AUC = 0.772; p subclinical atherosclerosis in this population. The accuracy of the D:A:D equation improves when CD4 counts and low-grade albuminuria are incorporated into the equation. © The European Society of Cardiology 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. Improved correlation between carotid and coronary atherosclerosis SYNTAX score using automated ultrasound carotid bulb plaque IMT measurement.

    Science.gov (United States)

    Ikeda, Nobutaka; Gupta, Ajay; Dey, Nilanjan; Bose, Soumyo; Shafique, Shoaib; Arak, Tadashi; Godia, Elisa Cuadrado; Saba, Luca; Laird, John R; Nicolaides, Andrew; Suri, Jasjit S

    2015-05-01

    SYNTAX score and had an improvement of 44.58%. By sampling cIMT in the bulb region, the automated cIMT technique improves the degree of correlation between coronary artery disease lesion complexity and carotid atherosclerosis characteristics. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  17. Assessment of coronary atherosclerosis by cardiac image: complementary amount of the calcium score to myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Vitola, Joao Vicente; Cerci, Rodrigo J.; Zapparoli, Marcello, E-mail: joaovitola@quantamn.com.br [Quanta Diagnostico Nuclear, Curitiba, PR (Brazil)

    2011-04-15

    Over the last decades we have witnessed significant advances on diagnostic tools and management of patients with or suspected cardiovascular disease, and consequently a significant reduction in mortality. Nevertheless, cardiovascular disease remains the leader cause of death in many countries, including Brazil. Identifying the high risk patient is important, so we can intensify prevention strategies. Non invasive diagnostic tools have been developed to identify the high risk patient in need of a myocardial revascularization, notably using myocardial scintigraphy. However, many clinicians still question, what is the best management for a patient with traditional risk factors, who has a positive treadmill test result and a completely normal myocardial scintigraphy? What is the literature showing in relation to the role of coronary calcium score for these patients? In this article we will reflect over these issues which are so frequently encountered in daily cardiology practice. (author)

  18. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Science.gov (United States)

    Prescott, Jennifer; Setiawan, Veronica W; Wentzensen, Nicolas; Schumacher, Fredrick; Yu, Herbert; Delahanty, Ryan; Bernstein, Leslie; Chanock, Stephen J; Chen, Chu; Cook, Linda S; Friedenreich, Christine; Garcia-Closas, Monserrat; Haiman, Christopher A; Le Marchand, Loic; Liang, Xiaolin; Lissowska, Jolanta; Lu, Lingeng; Magliocco, Anthony M; Olson, Sara H; Risch, Harvey A; Shu, Xiao-Ou; Ursin, Giske; Yang, Hannah P; Kraft, Peter; De Vivo, Immaculata

    2015-01-01

    Genome-wide association studies (GWAS) have identified common variants that predispose individuals to a higher body mass index (BMI), an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS) based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002). For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%). However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78). Heterogeneity by BMI did not reach statistical significance (P = 0.06), and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58). In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5). Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  19. [Leptin to adiponectin ratio, as an index of insulin resistance and atherosclerosis development].

    Science.gov (United States)

    Kieć-Klimczak, Małgorzata; Malczewska-Malec, Małgorzata; Huszno, Bohdan

    2008-01-01

    Obesity is an effect of interaction of genetic and environmental factors. It leads to development of serious complications, like insulin resistance, diabetes type 2, arterial hypertension and atherosclerosis. The adipose tissue is a place where many adipokines, mainly leptin and adiponectin, are produced and released. Adiponectin, which blood level is decreased in obesity is considered to have antidiabetic and antiatherogenic effect. While leptin, which blood level is increased in obesity, is associated with regulation of appetite, energy expenditure, lipids and carbohydrates metabolism, cellular differentiation and puberty. The aim of this research was estimation of leptin to adiponectin ratio (Lep/AdipoR) in the blood of patients who came from obese families. The study was carried out on 80 patients (43 female and 37 male). The antropometric examination with proportional contents of adipose tissue, oral glucose tolerance test (OGTT) and oral postprandial lipaemia test (OPLT) were performed. The fasting level of leptin (Elisa), adiponectin (Elisa) and von Willebrand factor (Elisa) lipidogram were performed. During OGTT blood was sampled in intervals of 30 minutes up to 2 hours, to measure glucose and insulin concentration. In fasting state and then every 2 hours after consumption of a high-fat meal (OPLT), (0, 2 hours, 4 hours, 6 hours, and 8 hours) blood was sampled for: trigliceride, glucose, free fatty acids and insulin concentration. The insulin resistance ratio (HOMA-IR) was calculated for each patient according to the formula: [insulin (mU/ml) x glucose (mmol/l)]/22.5. Adiponectin blood level was higher in the examined women than in men. It (regardless to the sex) was decreased with decrease of body mass index (BMI). Blood level of leptin (also higher in women) was positively corelated with BMI. In the group of patients with low level of adiponectin in serum (below 5mg/ml in men and 10 mg/ml in women) the highest con- centration of glucose and insulin in

  20. Body Mass Index Genetic Risk Score and Endometrial Cancer Risk.

    Directory of Open Access Journals (Sweden)

    Jennifer Prescott

    Full Text Available Genome-wide association studies (GWAS have identified common variants that predispose individuals to a higher body mass index (BMI, an independent risk factor for endometrial cancer. Composite genotype risk scores (GRS based on the joint effect of published BMI risk loci were used to explore whether endometrial cancer shares a genetic background with obesity. Genotype and risk factor data were available on 3,376 endometrial cancer case and 3,867 control participants of European ancestry from the Epidemiology of Endometrial Cancer Consortium GWAS. A BMI GRS was calculated by summing the number of BMI risk alleles at 97 independent loci. For exploratory analyses, additional GRSs were based on subsets of risk loci within putative etiologic BMI pathways. The BMI GRS was statistically significantly associated with endometrial cancer risk (P = 0.002. For every 10 BMI risk alleles a woman had a 13% increased endometrial cancer risk (95% CI: 4%, 22%. However, after adjusting for BMI, the BMI GRS was no longer associated with risk (per 10 BMI risk alleles OR = 0.99, 95% CI: 0.91, 1.07; P = 0.78. Heterogeneity by BMI did not reach statistical significance (P = 0.06, and no effect modification was noted by age, GWAS Stage, study design or between studies (P≥0.58. In exploratory analyses, the GRS defined by variants at loci containing monogenic obesity syndrome genes was associated with reduced endometrial cancer risk independent of BMI (per BMI risk allele OR = 0.92, 95% CI: 0.88, 0.96; P = 2.1 x 10-5. Possessing a large number of BMI risk alleles does not increase endometrial cancer risk above that conferred by excess body weight among women of European descent. Thus, the GRS based on all current established BMI loci does not provide added value independent of BMI. Future studies are required to validate the unexpected observed relation between monogenic obesity syndrome genetic variants and endometrial cancer risk.

  1. Postural variations in Cardio Stress Index scores | Bagwath Persad ...

    African Journals Online (AJOL)

    Numerous factors influence heart rate variability, including age, exercise and posture. The Cardio Stress Index (CSI) is a transformed measure of heart rate variability that is determined via a miniature digital multi-channel electrocardiogram system. Although the CSI and heart rate variability are reportedly analogous, little is ...

  2. Birth size and coronary heart disease risk score in young adulthood. The Atherosclerosis Risk in Young Adults (ARYA) study

    NARCIS (Netherlands)

    Vos, LE; Oren, A; Bots, ML; Gorissen, WHM; Grobbee, DE; Uiterwaal, CSPM

    Data of the Atherosclerosis Risk in Young Adults (ARYA) study were used to investigate the association between birth size and the absolute risk for coronary heart disease in healthy young adults. The cohort study comprises 750 (46.9% men) subjects born between 1970 and 1973. Birth characteristics

  3. The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis.

    Science.gov (United States)

    Bedi, Pallavi; Chalmers, J D; Goeminne, P C; Mai, C; Saravanamuthu, P; Velu, P Palani; Cartlidge, M K; Loebinger, M R; Jacob, J; Kamal, F; Schembri, N; Aliberti, S; Hill, U; Harrison, M; Johnson, C; Screaton, N; Haworth, C; Polverino, E; Rosales, E; Torres, A; Benegas, M N; Rossi, A G; Patel, D; Hill, A T

    2017-12-13

    The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV1, sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV1, 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase was significantly elevated in the group with emphysema on CT imaging. A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  4. Relationship Between Diastolic Dysfunction and Atherosclerosis and Vascular Calcification in Hemodialysis Patients: Diagnostic Potential of the Cardio-Ankle Vascular Index.

    Science.gov (United States)

    Unagami, Kohei; Nitta, Kosaku; Tago, Kiichiro; Matsushita, Kazumichi

    2016-04-01

    Diastolic dysfunction (DD) commonly causes heart failure with preserved ejection fraction (EF). Here, we examine associations between DD severity and atherosclerosis/vascular calcification in hemodialysis patients. Echocardiography was performed on 101 patients undergoing hemodialysis therapy. Twelve patients (EF cardio-ankle vascular index (CAVI), ankle-brachial pressure index (ABI), toe-brachial pressure index (TBI), and aortic calcification area index (ACAI). Seventy-seven patients (86.5%) with EF ≥ 50% had DD. Associations with advanced age and comorbid diabetes mellitus and cardiovascular disease were observed. The CAVI, TBI, and ACAI, but not ABI, increased proportionally with DD grades. Thus, many hemodialysis patients developed DD, with systolic function maintained. Strong associations between DD grades and progression of both atherosclerosis and vascular calcification could be inferred. © 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  5. An assessment of the new "SCORE" index as a predictor of osteoporosis in women.

    Science.gov (United States)

    Russell, A S; Morrison, R T

    2001-01-01

    The study was done to determine whether the new SCORE (Simple Calculated Osteoporosis Risk Estimation) index might reduce the utilization of bone mineral density (BMD) measurement. 989 consecutive patients who were referred by a range of physicians for BMD assessments at one of two clinics had a SCORE index constructed. Approximately 95% of the subjects were Caucasian. The index is based on only 6 factors: age, previous fractures, rheumatoid arthritis, estrogen use, weight, and race. All but 1 (0.1%) of those with a femoral neck BMD T-score of -2.5. One percent false negatives were also seen in the lumbar spine. The SCORE index correctly predicted those individuals who did not have an osteoporotic T-score. It was of the most value in the assessment and management of individuals possibly at risk for osteoporosis remains controversial. Our results suggest that the prior use of the SCORE index by the referring physicians to screen the patients sent for BMD measurement would have allowed them to exclude over 20% of the patients referred for assessment, and therefore reduce the need and cost of BMD measurement. The proportion of individuals who had a normal SCORE index, and would have been screened out, was 43% in the under 60 year age group, but in the 65 and over age group it provided no additional information to help with, for example, the National Osteoporosis Foundation (NOF) guidelines.

  6. Acidic Polysaccharide Extracts from Gastrodia Rhizomes Suppress the Atherosclerosis Risk Index through Inhibition of the Serum Cholesterol Composition in Sprague Dawley Rats Fed a High-Fat Diet

    Directory of Open Access Journals (Sweden)

    Young-Chan Kim

    2012-02-01

    Full Text Available Obesity is associated with a broad spectrum of cardio-metabolic disturbances, including atherosclerosis and cardiovascular disease (CDV. A high-fat diet has been shown to cause an elevation of the plasma cholesterol levels in humans, and the control of serum cholesterol has been demonstrated to be important in the prevention of CVD and atherosclerosis. The aims of this study were to demonstrate that crude and acidic polysaccharide extracts from Gastrodia rhizomes suppress atherosclerosis through the regulation of serum lipids in Sprague Dawley (SD rats fed a high-fat diet. We examined the concentrations of serum lipids, including total cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol, and low-density lipoproteins (LDL cholesterol, in SD rats fed a high-fat diet and evaluated the atherogenic index. Here, we show that both crude and acidic polysaccharide extracts from Gastrodia rhizomes inhibited the total cholesterol and LDL levels. Moreover, there was a significantly suppressed atherosclerosis risk due to the acidic polysaccharide extract from Gastrodia rhizome. Taken together, our results suggested that acidic polysaccharide extracts from Gastrodia rhizomes might be beneficial for lowering the incidence of CVD and atherosclerosis by reducing the de novo synthesis of total cholesterol and the LDL levels.

  7. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

  8. Correlation between Dietary Glycemic Index and Blood Lipids Abnormality as a Main Risk Factor of Atherosclerosis in Healthy Women from Ahvaz

    Directory of Open Access Journals (Sweden)

    Farideh Shishebor

    2016-01-01

    Full Text Available Background: Atherosclerosis and subsequent coronary artery disease is the leading cause of death in Iranian population. High serum lipid levels, especially the elevated level of low-density lipoprotein (LDL, have been shown to be strongly related to the development of atherosclerosis. The relationship between dietary glycemic index (GI and lipid profile, particularly in nonwestern populations, has not been well studied; also, the result of studies are inconsistent. The aim of this study was to evaluate the relationship between dietary glycemic index (GI and main risk factor of atherosclerosis including abnormal blood lipid levels in healthy women. Methods: This cross-sectional study was done to investigate the associations between dietary GI and lipid profile. The subjects were 87 female personnel of Ahvaz Jundishapur University of Medical Sciences aged 25-55 y; they were recruited randomly. Dietary GI was calculated from six 24 hour recalls (including 4 usual days and 2 holidays. Results: The mean of dietary GI was 72.1±4.07. After adjustment for potential dietary and non- dietary confounding factors, no significant relationship was found between dietary GI with HDL-C and LDL-C. There was also no statistically significant relationship between GI and total cholesterol or fasting Triacylglycerol. Conclusion: Findings of this study did not support the hypothesis of physiologic relevance of GI and lipid profile abnormality as a potential risk factor for atherosclerosis.

  9. Addiction Severity Index (ASI) summary scores: comparison of the Recent Status Scores of the ASI-6 and the Composite Scores of the ASI-5.

    Science.gov (United States)

    Denis, Cécile M; Cacciola, John S; Alterman, Arthur I

    2013-01-01

    The characteristics and the validity of the Recent Status Scores (RSSs), the new summary scores generated by the sixth version of the Addiction Severity Index (ASI-6), are compared to the fifth version of the ASI summary scores, the Composite Scores (CSs). A sample of 82 randomly selected patients from substance abuse treatment programs were interviewed with the ASI-6, the ASI-5 and were administered a validity battery of questionnaires that included measures corresponding to each of the ASI domains. Each ASI-6 RSS was significantly correlated with its corresponding ASI-5 CS. The intercorrelations among the RSSs are low and none of these correlations were statistically different from the intercorrelations among CSs. In five of the seven areas, the ASI-6 RSSs were more highly correlated to the corresponding validity measures than were the ASI-5 CSs. The ASI-6 offers more comprehensive content in its scales than do those derived with earlier ASIs. © 2013.

  10. Mining the Human Phenome Using Allelic Scores That Index Biological Intermediates

    DEFF Research Database (Denmark)

    Evans, David M; Brion, Marie Jo A; Paternoster, Lavinia

    2013-01-01

    indexed three biological intermediates where the results of large GWAS meta-analyses were available: body mass index, C-reactive protein and low density lipoprotein levels. We generated allelic scores in the Avon Longitudinal Study of Parents and Children, and in publicly available data from the first...... hundreds of thousands of genetic markers explained significant portions of the variance in biological intermediates of interest, and many of these scores showed expected correlations with disease. Genome-wide allelic scores however tended to lack specificity suggesting that they should be used with caution...

  11. Pemphigus disease activity measurements: pemphigus disease area index, autoimmune bullous skin disorder intensity score, and pemphigus vulgaris activity score.

    Science.gov (United States)

    Rahbar, Ziba; Daneshpazhooh, Maryam; Mirshams-Shahshahani, Mostafa; Esmaili, Nafiseh; Heidari, Kazem; Aghazadeh, Nessa; Hejazi, Pardis; Ghajarzadeh, Mahsa; Chams-Davatchi, Cheyda

    2014-03-01

    Recently, the clinical pemphigus disease activity indexes of Pemphigus Disease Area Index (PDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), and Pemphigus Vulgaris Activity Score (PVAS) were validated to correlate with physician global assessment. The antidesmoglein (anti-Dsg) autoantibodies are known to correlate mostly with pemphigus disease activity. The correlation between these indexes and anti-Dsg1 and anti-Dsg3 enzyme-linked immunosorbent assay values has not been previously evaluated. To evaluate the PDAI, ABSIS, and PVAS in a large number of patients with pemphigus vulgaris and to compare the interrater reliability of these indexes and the convergent validity according to anti-Dsg values. A cross-sectional study was performed in 2012 in a referral university center for autoimmune bullous diseases. One hundred patients with confirmed diagnoses of pemphigus vulgaris and clinical pemphigus lesions (mean [SD] age, 43.3 [1.7] years; age range, 14-77 years; female-male ratio, 1:3) were studied. Three dermatologists familiar with immunobullous diseases and the indexes rated the patients. All 100 patients were evaluated with the PDAI, ABSIS, and PVAS. Three dermatologists independently rated all 3 indexes for each of the patients on the same day. Serum anti-Dsg1 and anti-Dsg3 enzyme-linked immunosorbent assay values were measured simultaneously. Analyses of interrater reliabilities, convergent validities according to anti-Dsg titers, correlation between the distribution and types of lesions with disease activity, predictors of higher titers of antibody (multiple regression analysis), and cutoff values of measures for 2 titers of anti-Dsg with optimal area under the curve, sensitivity, and specificity were performed. The interrater reliabilities were highest for the PDAI, followed by the ABSIS and the PVAS (intraclass correlation coefficients of 0.98 [95% CI, 0.97-0.98], 0.97 [95% CI, 0.96-0.98], and 0.93 [95% CI, 0.90-0.95], respectively). The

  12. Ultrasound pattern sum score, homogeneity score and regional nerve enlargement index for differentiation of demyelinating inflammatory and hereditary neuropathies.

    Science.gov (United States)

    Grimm, Alexander; Vittore, Debora; Schubert, Victoria; Lipski, Christina; Heiling, Bianka; Décard, Bernhard F; Axer, Hubertus

    2016-07-01

    To investigate the use of nerve ultrasound in the differentiation between Charcot-Marie Tooth hereditary neuropathy (CMT1) and chronic inflammatory demyelinating polyradiculoneuropathies (CIDP), multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensory and motor neuropathies (MADSAM). Ultrasound/electrophysiology of predefined nerves was performed in CMT1a/b, immunoneuropathies, and healthy controls. Ultrasound pattern sum score (UPSS, sum of the amount of 12 predefined measurement points), homogeneity score (HS) and regional nerve enlargement index (RNEI) in ulnar, median, and tibial nerve were used for evaluation of morphology. 13 CMT1, 27 CIDP, 10 MADSAM, 12 MMN, and 23 controls were included. Significant enlargement was shown in all neuropathies compared to the controls, (pdemyelinating neuropathies is operationalized and ameliorated compared to CSA measurements only. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  13. The macrophage and its related cholesterol efflux as a HDL function index in atherosclerosis.

    Science.gov (United States)

    Yamamoto, Suguru; Narita, Ichiei; Kotani, Kazuhiko

    2016-06-01

    The macrophage and its related cholesterol efflux are considered to be a key player in atherosclerotic formation in relation to the function of high-density lipoprotein (HDL). The HDL function can be evaluated by the reaction between lipid-loaded macrophages and lipid-acceptors in the HDL fraction from the plasma, apolipoprotein B-depleted serum, and/or whole serum/plasma. Recent studies have reported that an impaired cholesterol efflux of HDL is observed in patients with cardiometabolic diseases, such as dyslipidemia, diabetes mellitus, and chronic kidney disease. A population-based cohort study has reported an inverse association between the cholesterol efflux capacity of HDL and the incidence of atherosclerotic disease, regardless of the serum HDL-cholesterol level. Moreover, in this paper, when we summarized several clinical interventional studies of statin treatment that examined cholesterol efflux, a potential increase in the efflux in patients treated with statins was implied. However, the effect was not fully defined in the current situation because of the small sample sizes, lack of a unified protocol for measuring the efflux, and short-term intervention periods without cardiovascular outcomes in available studies. Further investigation is necessary to determine the effect of drugs on cholesterol efflux. With additional advanced studies, cholesterol efflux is a promising laboratory index to understand the HDL function. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Subclinical atherosclerosis and metabolic risk: role of body mass index and waist circumference.

    Science.gov (United States)

    Camhi, Sarah M; Katzmarzyk, Peter T; Broyles, Stephanie T; Srinivasan, Sathanur R; Chen, Wei; Bouchard, Claude; Berenson, Gerald S

    2011-04-01

    Carotid artery intima-media thickness (IMT) is greater in adults with elevated metabolic risk profiles. However, the influence of body mass index (BMI) or waist circumference (WC) on the relationship between IMT and metabolic risk is unclear. Adults from the Bogalusa Heart Study were classified as normal weight, overweight, or obese and into WC categories (men, low women, low <80 cm, moderate 80-87.9 cm, high ≥88 cm). Elevated metabolic risk was defined by cardiovascular risk factor clustering (≥2 abnormal risk factors or insulin resistance (upper quartile of homeostasis model of insulin resistance). Carotid ultrasound measurements were obtained and mean IMT was calculated. General linear models compared IMT between elevated versus normal metabolic risk groups, adjusting for sex, age, race/ethnicity, and either BMI or WC category. Adults were 24-43 years of age (n = 991) and 41% had elevated metabolic risk (42% male, 28% African American, 38% obese). IMT (mm) was greater in adults with elevated metabolic risk (0.83 ± 0.007) versus normal risk (0.80 ± 0.006) whether adjusted by BMI or WC (both P < 0.0005). IMT was greater in adults with elevated compared to normal metabolic risk within normal-weight (0.84 ± 0.016 vs. 0.79 ± 0.008; P = 0.002), and obese adults (0.86 ± 0.009 vs. 0.80 ± 0.01; P = 0.03), but not significantly different between risk groups in overweight adults. Similar results were found when stratified by WC category. Adults with elevated metabolic risk have greater IMT than those with normal risk in normal-weight, overweight, low WC, and high WC, but not significant for overweight or moderate WC categories.

  15. Ankle-brachial index and incident diabetes mellitus: the atherosclerosis risk in communities (ARIC) study.

    Science.gov (United States)

    Hua, Simin; Loehr, Laura R; Tanaka, Hirofumi; Heiss, Gerardo; Coresh, Josef; Selvin, Elizabeth; Matsushita, Kunihiro

    2016-12-07

    Individuals with peripheral artery disease (PAD) often have reduced physical activity, which may increase the future risk of diabetes mellitus. Although diabetes is a risk factor for PAD, whether low ankle-brachial index (ABI) predates diabetes has not been studied. We examined the association of ABI with incident diabetes using Cox proportional hazards models in the ARIC Study. ABI was measured in 12,247 black and white participants without prevalent diabetes at baseline (1987-1989). Incident diabetes cases were identified by blood glucose levels at three subsequent visits (1990-92, 1993-95, and 1996-98) or self-reported physician diagnosis or medication use at those visits or during annual phone interview afterward through 2011. A total of 3305 participants developed diabetes during a median of 21 years of follow-up. Participants with low (≤0.90) and borderline low (0.91-1.00) ABI had 30-40% higher risk of future diabetes as compared to those with ABI of 1.10-1.20 in the demographically adjusted model. The associations were attenuated after further adjustment for other potential confounders but remained significant for ABI 0.91-1.00 (HR = 1.17, 95% CI 1.04-1.31) and marginally significant for ABI ≤ 0.90 (HR = 1.19, 0.99-1.43). Although the association was largely consistent across subgroups, a stronger association was seen in participants without hypertension, those with normal fasting glucose, and those with a history of stroke compared to their counterparts. Low ABI was modestly but independently associated with increased risk of incident diabetes in the general population. Clinical attention should be paid to the glucose trajectory among people with low ABI but without diabetes.

  16. Clinical Risk Index for Babies (Crib) Ii Score as a Predictor of ...

    African Journals Online (AJOL)

    Clinical Risk Index for Babies (Crib) Ii Score as a Predictor of Neonatal Mortality among Low Birth Weight Babies at Kenyatta National Hospital. ... Using a cut off point of 4, CRIB II score was found to have a sensitivity of 80.6%, specificity of 75.3%, and a predictive value of 77.7% compared to 72.5, 71.2, and 71.8% ...

  17. Comparison of Voice Handicap Index Scores Between Female Students of Speech Therapy and Other Health Professions.

    Science.gov (United States)

    Tafiadis, Dionysios; Chronopoulos, Spyridon K; Siafaka, Vassiliki; Drosos, Konstantinos; Kosma, Evangelia I; Toki, Eugenia I; Ziavra, Nausica

    2017-09-01

    Students' groups (eg, teachers, speech language pathologists) are presumably at risk of developing a voice disorder due to misuse of their voice, which will affect their way of living. Multidisciplinary voice assessment of student populations is currently spread widely along with the use of self-reported questionnaires. This study compared the Voice Handicap Index domains and item scores between female students of speech and language therapy and of other health professions in Greece. We also examined the probability of speech language therapy students developing any vocal symptom. Two hundred female non-dysphonic students (aged 18-31) were recruited. Participants answered the Voice Evaluation Form and the Greek adaptation of the Voice Handicap Index. Significant differences were observed between the two groups (students of speech therapy and other health professions) through Voice Handicap Index (total score, functional and physical domains), excluding the emotional domain. Furthermore, significant differences for specific Voice Handicap Index items, between subgroups, were observed. In conclusion, speech language therapy students had higher Voice Handicap Index scores, which probably could be an indicator for avoiding profession-related dysphonia at a later stage. Also, Voice Handicap Index could be at a first glance an assessment tool for the recognition of potential voice disorder development in students. In turn, the results could be used for indirect therapy approaches, such as providing methods for maintaining vocal health in different student populations. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Crural Index and extensive atherosclerosis of crural vessels are associated with long-term cardiovascular mortality in patients with symptomatic peripheral artery disease.

    Science.gov (United States)

    Wickström, Jan-Erik; Jalkanen, Juho M; Venermo, Maarit; Hakovirta, Harri H

    2017-09-01

    Limited data exist on the association of the anatomical distribution of atherosclerotic lesions and the extent of atherosclerosis at defined arterial segments with life expectancy. We recently presented a new classification of the extent of atherosclerosis in crural vessels and showed that Crural Index (CIx) was associated with mid-term survival of symptomatic peripheral artery disease (PAD) patients. This study evaluates the significance of the extent of crural atherosclerosis on long-term cardiovascular mortality. 887 consecutive patients with PAD, admitted for digital subtraction angiography (DSA) at Turku University Hospital Department of Vascular Surgery (Turku, Finland) between January 1st, 2009 and July 30th, 2011, were retrospectively analysed. Each crural angiographic image was graded according to CIx criteria. Aorto-iliac and femoro-popliteal arterial segments were similarly graded according to modified TASC II criteria. CIx was used as the categorical variable for the extent of atherosclerosis in crural vessels for survival analysis. Survival was also evaluated with respect to which arterial segment was most severely affected. Causes of death were provided by the Cause of Death Registry of Statistics Finland, updated on January 23rd, 2017. Altogether, 408 (46%) patients died during follow-up. The majority of deaths were due to cardiovascular causes (n = 246, 60%). Cardiovascular mortality was strongly associated with a high CIx (CIx III (Hazard ratio (HR) 2.16, Confidence interval (CI) 95% 1.23-3.80, p = 0.007)) and CIx IV (HR 3.513, 95% CI 1.93-4.565, p cardiovascular mortality was significantly increased (HR 2.321, 95% CI 1.45-3.73, p mortality (HR 2.177, 95% CI 1.53-3.10, p atherosclerosis are associated with long-term cardiovascular mortality, and both may serve as useful indicators of survival among patients with symptomatic PAD. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Efficacy of Mannheim Peritonitis Index (MPI) Score in Patients with Secondary Peritonitis.

    Science.gov (United States)

    V A, Muralidhar; C P, Madhu; S, Sudhir; Srinivasarangan, Madhu

    2014-12-01

    Despite advances in diagnosis, management and critical care of patients with peritonitis due to hollow viscus perforation, prognosis remains poor. Early assessment by scoring systems will influence the management and prognosis. Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the outcome in patients with peritonitis. Prospective study of 50 patients admitted and operated for peritonitis in JSS Medical College Hospital. The structured scoring system i.e. MPI was applied along with other clinical and biochemical parameters recorded in pre-structured proforma. Data was analysed for predicting mortality and morbidity using EPI info and SPSS software. The overall mortality and morbidity was 14% and 38% respectively. MPI scores of ≤ 20, 21-29, and ≥ 30 had a mortality of 5%, 14%, and 50% respectively. MPI score of 25 had highest sensitivity of 72.09% and specificity of 71.43% in predicting mortality, 80.65% sensitivity and 57.89% specificity for morbidity. MPI score of > 25 were associated with 6.45 times higher risk of mortality (p=0.03), 5.72 times higher risk of morbidity (p=0.005) compared to patients with MPI score ≤ 25. MPI is disease specific, easy scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management and hence it should be used routinely in clinical practice.

  20. Evaluation of Mannheim peritonitis index and multiple organ failure score in patients with peritonitis.

    Science.gov (United States)

    Notash, Ali Yaghoobi; Salimi, Javad; Rahimian, Hosein; Fesharaki, Mojgan sadat Hashemi; Abbasi, Ali

    2005-01-01

    Early classification of severity of peritonitis by scoring systems, including the Mannheim peritonitis index (MPI) and the multiple organ failure (MOF) score, modulates surgical and medical management. To predict outcome of patients with peritonitis using the MPI and MOF scoring systems. Prospective evaluation of the MPI and MOF score was performed in 80 consecutive patients with peritonitis who underwent uniform surgical treatment. Risk ratios were calculated for the MPI and other patient characteristics. Risk ratio was not calculable for the MOF score. Overall in-hospital mortality rate was 17.5%, including 80% of patients with MPI>29. In non-survivors the mean score was 4.8 (SD 1.46) and 33.07 (4.81) for the MOF score and MPI, respectively. Survivors had mean MOF score of 0.28 (0.20) and mean MPI of 19.39 (6.68). The MPI and MOF score provide simple and objective means to predict the outcome of patients with peritonitis.

  1. Paediatric Index of Mortality scores: An evaluation of function in the ...

    African Journals Online (AJOL)

    Background. Paediatric Index of Mortality (PIM) and PIM 2 scores have been shown to be valid predictors of outcome among paediatric intensive care unit populations in the UK, New Zealand, Australia and Europe, but have never been evaluated in the South African context. Objective. To evaluate the PIM and PIM 2 as ...

  2. Toward Development of a Fibromyalgia Responder Index and Disease Activity Score: OMERACT Module Update

    DEFF Research Database (Denmark)

    Mease, Philip J; Clauw, Daniel J; Christensen, Robin

    2011-01-01

    Following development of the core domain set for fibromyalgia (FM) in Outcome Measures in Rheumatology Clinical Trials (OMERACT) meetings 7 to 9, the FM working group has progressed toward the development of an FM responder index and a disease activity score based on these domains, utilizing...

  3. Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting.

    Science.gov (United States)

    Natarajan, Pradeep; Young, Robin; Stitziel, Nathan O; Padmanabhan, Sandosh; Baber, Usman; Mehran, Roxana; Sartori, Samantha; Fuster, Valentin; Reilly, Dermot F; Butterworth, Adam; Rader, Daniel J; Ford, Ian; Sattar, Naveed; Kathiresan, Sekar

    2017-05-30

    Relative risk reduction with statin therapy has been consistent across nearly all subgroups studied to date. However, in analyses of 2 randomized controlled primary prevention trials (ASCOT [Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm] and JUPITER [Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin]), statin therapy led to a greater relative risk reduction among a subgroup at high genetic risk. Here, we aimed to confirm this observation in a third primary prevention randomized controlled trial. In addition, we assessed whether those at high genetic risk had a greater burden of subclinical coronary atherosclerosis. We studied participants from a randomized controlled trial of primary prevention with statin therapy (WOSCOPS [West of Scotland Coronary Prevention Study]; n=4910) and 2 observational cohort studies (CARDIA [Coronary Artery Risk Development in Young Adults] and BioImage; n=1154 and 4392, respectively). For each participant, we calculated a polygenic risk score derived from up to 57 common DNA sequence variants previously associated with coronary heart disease. We compared the relative efficacy of statin therapy in those at high genetic risk (top quintile of polygenic risk score) versus all others (WOSCOPS), as well as the association between the polygenic risk score and coronary artery calcification (CARDIA) and carotid artery plaque burden (BioImage). Among WOSCOPS trial participants at high genetic risk, statin therapy was associated with a relative risk reduction of 44% (95% confidence interval [CI], 22-60; Pstatin therapy was 3.6% (95% CI, 2.0-5.1) among those in the high genetic risk group and 1.3% (95% CI, 0.6-1.9) in all others. Each 1-SD increase in the polygenic risk score was associated with 1.32-fold (95% CI, 1.04-1.68) greater likelihood of having coronary artery calcification and 9.7% higher (95% CI, 2.2-17.8) burden of carotid plaque. Those at high genetic risk have a greater

  4. Dietary glycemic index and glycemic load, carbohydrate and fiber intake, and measures of insulin sensitivity, secretion, and adiposity in the Insulin Resistance Atherosclerosis Study.

    Science.gov (United States)

    Liese, Angela D; Schulz, Mandy; Fang, Fang; Wolever, Thomas M S; D'Agostino, Ralph B; Sparks, Karen C; Mayer-Davis, Elizabeth J

    2005-12-01

    We studied the association of digestible carbohydrates, fiber intake, glycemic index, and glycemic load with insulin sensitivity (S(I)), fasting insulin, acute insulin response (AIR), disposition index, BMI, and waist circumference. Data on 979 adults with normal (67%) and impaired (33%) glucose tolerance from the Insulin Resistance Atherosclerosis Study (1992-1994) were analyzed. Usual dietary intake was assessed via a 114-item interviewer-administered food frequency questionnaire from which nutrient intakes were estimated. Published glycemic index values were assigned to food items and average dietary glycemic index and glycemic load calculated per subject. S(I) and AIR were determined by frequently sampled intravenous glucose tolerance test. Disposition index was calculated by multiplying S(I) with AIR. Multiple linear regression modeling was employed. No association was observed between glycemic index and S(I), fasting insulin, AIR, disposition index, BMI, or waist circumference after adjustment for demographic characteristics or family history of diabetes, energy expenditure, and smoking. Associations observed for digestible carbohydrates and glycemic load, respectively, with S(I), insulin secretion, and adiposity (adjusted for demographics and main confounders) were entirely explained by energy intake. In contrast, fiber was associated positively with S(I) and disposition index and inversely with fasting insulin, BMI, and waist circumference but not with AIR. Carbohydrates as reflected in glycemic index and glycemic load may not be related to measures of insulin sensitivity, insulin secretion, and adiposity. Fiber intake may not only have beneficial effects on insulin sensitivity and adiposity, but also on pancreatic functionality.

  5. Could maternal pre-pregnancy body mass index affect Apgar score?

    Science.gov (United States)

    Sekhavat, Leila; Fallah, Razieh

    2013-01-01

    Obesity is one of global health problems and maternal obesity may be associated with increase in risk of pregnancy complications and neonatal death. The purpose of this study was to evaluate the effect of maternal pre-pregnancy body mass index (BMI) on neonate Apgar score at minute 5. In a retrospective cohort study, Apgar score at minute 5 of all singleton term babies of nulliparous women whom were delivered in Shahid Sadoughi Hospital, Yazd, Iran, from 2007 to 2009 were evaluated. Body mass index (BMI: weight in kg/height in m(2)) of the mothers were calculated and BMI less than 18.5, 18.5-24.9, 25-29.9 and more than 30 were considered underweight, normal, overweight and obesity, respectively. Neonatal Apgar score of 3-7 and less than three was considered as low and very low Apgar score, respectively. Eighty-eight (2.8 %) women were underweight, 1,401 (44.9 %) normal weight, 1,389 (44.5 %) overweight and 242 (7.8 %) were obese. 477 (15.3 %) and 31(0.7 %) neonates had low and very low Apgar score, respectively at minute 5. Logistic regression analysis showed maternal overweight [in odd ratio of 3.7, 95 % CI 2.4-4.6] and obesity [in odd ratio of 13.4, 95 % CI 9.7-14.1] were risk factors of neonatal low Apgar score, but they had not any statistically significant effect on neonatal very low Apgar score. Maternal pre-pregnancy overweight should be more concerned to prevent complication of low Apgar score in their newborns.

  6. A combined pulmonary function and emphysema score prognostic index for staging in Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Boutou, Afroditi K; Nair, Arjun; Douraghi-Zadeh, Dariush; Sandhu, Ranbir; Hansell, David M; Wells, Athol U; Polkey, Michael I; Hopkinson, Nicholas S

    2014-01-01

    Chronic Obstructive Pulmonary Disease (COPD) is characterized by high morbidity and mortality. Lung computed tomography parameters, individually or as part of a composite index, may provide more prognostic information than pulmonary function tests alone. To investigate the prognostic value of emphysema score and pulmonary artery measurements compared with lung function parameters in COPD and construct a prognostic index using a contingent staging approach. Predictors of mortality were assessed in COPD outpatients whose lung computed tomography, spirometry, lung volumes and gas transfer data were collected prospectively in a clinical database. Univariate and multivariate Cox proportional hazard analysis models with bootstrap techniques were used. 169 patients were included (59.8% male, 61.1 years old; Forced Expiratory Volume in 1 second % predicted: 40.5±19.2). 20.1% died; mean survival was 115.4 months. Age (HR = 1.098, 95% Cl = 1.04-1.252) and emphysema score (HR = 1.034, 95% CI = 1.007-1.07) were the only independent predictors of mortality. Pulmonary artery dimensions were not associated with survival. An emphysema score of 55% was chosen as the optimal threshold and 30% and 65% as suboptimals. Where emphysema score was between 30% and 65% (intermediate risk) the optimal lung volume threshold, a functional residual capacity of 210% predicted, was applied. This contingent staging approach separated patients with an intermediate risk based on emphysema score alone into high risk (Functional Residual Capacity ≥210% predicted) or low risk (Functional Residual Capacity Emphysema score-Functional Residual Capacity index might provide a better separation of high and low risk patients with COPD, than other individual predictors alone.

  7. Independent associations between a metabolic syndrome severity score and future diabetes by sex and race: the Atherosclerosis Risk In Communities Study and Jackson Heart Study.

    Science.gov (United States)

    Gurka, Matthew J; Golden, Sherita H; Musani, Solomon K; Sims, Mario; Vishnu, Abhishek; Guo, Yi; Cardel, Michelle; Pearson, Thomas A; DeBoer, Mark D

    2017-07-01

    The study aimed to assess for an association between the degree of severity of the metabolic syndrome and risk of type 2 diabetes beyond that conferred by the individual components of the metabolic syndrome. We assessed HRs for an Adult Treatment Panel III (ATP-III) metabolic syndrome score (ATP-III MetS) and a sex- and race-specific continuous metabolic syndrome severity z score related to incident diabetes over a median of 7.8 years of follow-up among participants of two observational cohorts, the Atherosclerosis Risk in Communities study (n = 10,957) and the Jackson Heart Study (n = 2137). The ATP-III MetS had an HR for incident diabetes of 4.36 (95% CI 3.83, 4.97), which was attenuated in models that included the individual metabolic syndrome components. By contrast, participants in the fourth quartile of metabolic syndrome severity (compared with the first quartile) had an HR of 17.4 (95% CI 12.6, 24.1) for future diabetes; in models that also included the individual metabolic syndrome components, this remained significant, with an HR of 3.69 (95% CI 2.42, 5.64). There was a race × metabolic syndrome interaction in these models such that HR was greater for black participants (5.30) than white participants (2.24). When the change in metabolic syndrome severity score was included in the hazard models, this conferred a further association, with changes in metabolic syndrome severity score of ≥0.5 having a HR of 2.66 compared with changes in metabolic syndrome severity score of ≤0. Use of a continuous sex- and race-specific metabolic syndrome severity z score provided an additional prediction of risk of diabetes beyond that of the individual metabolic syndrome components, suggesting an added risk conferred by the processes underlying the metabolic syndrome. Increases in this score over time were associated with further risk, supporting the potential clinical utility of following metabolic syndrome severity over time.

  8. Atherosclerosis (image)

    Science.gov (United States)

    Atherosclerosis is a disease of the arteries in which fatty material is deposited in the vessel wall, ... muscle leads to symptoms such as chest pain. Atherosclerosis shows no symptoms until a complication occurs.

  9. A genetic risk score based on direct associations with coronary heart disease improves coronary heart disease risk prediction in the Atherosclerosis Risk in Communities (ARIC), but not in the Rotterdam and Framingham Offspring, Studies.

    Science.gov (United States)

    Brautbar, Ariel; Pompeii, Lisa A; Dehghan, Abbas; Ngwa, Julius S; Nambi, Vijay; Virani, Salim S; Rivadeneira, Fernando; Uitterlinden, André G; Hofman, Albert; Witteman, Jacqueline C M; Pencina, Michael J; Folsom, Aaron R; Cupples, L Adrienne; Ballantyne, Christie M; Boerwinkle, Eric

    2012-08-01

    Multiple studies have identified single-nucleotide polymorphisms (SNPs) that are associated with coronary heart disease (CHD). We examined whether SNPs selected based on predefined criteria will improve CHD risk prediction when added to traditional risk factors (TRFs). SNPs were selected from the literature based on association with CHD, lack of association with a known CHD risk factor, and successful replication. A genetic risk score (GRS) was constructed based on these SNPs. Cox proportional hazards model was used to calculate CHD risk based on the Atherosclerosis Risk in Communities (ARIC) and Framingham CHD risk scores with and without the GRS. The GRS was associated with risk for CHD (hazard ratio [HR] = 1.10; 95% confidence interval [CI]: 1.07-1.13). Addition of the GRS to the ARIC risk score significantly improved discrimination, reclassification, and calibration beyond that afforded by TRFs alone in non-Hispanic whites in the ARIC study. The area under the receiver operating characteristic curve (AUC) increased from 0.742 to 0.749 (Δ = 0.007; 95% CI, 0.004-0.013), and the net reclassification index (NRI) was 6.3%. Although the risk estimates for CHD in the Framingham Offspring (HR = 1.12; 95% CI: 1.10-1.14) and Rotterdam (HR = 1.08; 95% CI: 1.02-1.14) Studies were significantly improved by adding the GRS to TRFs, improvements in AUC and NRI were modest. Addition of a GRS based on direct associations with CHD to TRFs significantly improved discrimination and reclassification in white participants of the ARIC Study, with no significant improvement in the Rotterdam and Framingham Offspring Studies. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. A new reliable index to measure individual deprivation: the EPICES score.

    Science.gov (United States)

    Labbe, Emilie; Blanquet, Marie; Gerbaud, Laurent; Poirier, Gilles; Sass, Catherine; Vendittelli, Françoise; Moulin, Jean-Jacques

    2015-08-01

    Deprivation is associated with inequalities in health care and higher morbidity and mortality. To assess the reliability of a new individual deprivation score, the EPICES score and to analyse the association between the Townsend index, the Carstairs index and the EPICES score and causes of death in one French administrative region. Eligible patients were 16 years old or more who had come for consultation in Health Examination Centres of the French administrative region of Nord-Pas-de-Calais. An ecological study was performed between 2002 and 2007 in the 392 districts of this administrative region. The EPICES score was compared with the Townsend and the Carstairs indices. These three measurements of deprivation were compared with social characteristics, indicators of morbidity, health-care use and mortality and specific causes of death. The Pearson correlation coefficients were calculated to assess the reliability of the EPICES score. The association between deprivation and mortality was assessed by comparison of the standardized mortality ratio (SMR) between the most and least deprived districts. The EPICES score was strongly correlated with the Townsend and Carstairs indices and with the health indicators measured. SMR increased with deprivation and the higher the deprivation the higher the SMR for all-cause mortality, premature and avoidable deaths and for most specific causes of death. The individual deprivation EPICES score is reliable. Deprivation was related to excess death rate, which clearly indicates that deprivation is a determinant factor that should be considered systematically by health policy makers and health-care providers. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  11. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients.

    Science.gov (United States)

    Podlekareva, D N; Grint, D; Post, F A; Mocroft, A; Panteleev, A M; Miller, R F; Miro, J M; Bruyand, M; Furrer, H; Riekstina, V; Girardi, E; Losso, M H; Caylá, J A; Malashenkov, E A; Obel, N; Skrahina, A M; Lundgren, J D; Kirk, O

    2013-02-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome. A total of 1061 HIV patients diagnosed with TB in four regions, Central/Northern, Southern and Eastern Europe and Argentina, between January 2004 and December 2006 were enrolled in the TB-HIV study. A weighted HCI score (range 0-5), based on independent prognostic factors identified in multivariable Cox models and the final score, included performance of TB drug susceptibility testing (DST), an initial TB regimen containing a rifamycin, isoniazid and pyrazinamide, and start of combination antiretroviral treatment (cART). The mean HCI score was highest in Central/Northern Europe (3.2, 95%CI 3.1-3.3) and lowest in Eastern Europe (1.6, 95%CI 1.5-1.7). The cumulative probability of death 1 year after TB diagnosis decreased from 39% (95%CI 31-48) among patients with an HCI score of 0, to 9% (95%CI 6-13) among those with a score of ≥4. In an adjusted Cox model, a 1-unit increase in the HCI score was associated with 27% reduced mortality (relative hazard 0.73, 95%CI 0.64-0.84). Our results suggest that DST, standard anti-tuberculosis treatment and early cART may improve outcome for TB-HIV patients. The proposed HCI score provides a tool for future research and monitoring of the management of TB-HIV patients. The highest HCI score may serve as a benchmark to assess TB-HIV management, encouraging continuous health care improvement.

  12. Recent status scores for version 6 of the Addiction Severity Index (ASI-6).

    Science.gov (United States)

    Cacciola, John S; Alterman, Arthur I; Habing, Brian; McLellan, A Thomas

    2011-09-01

    To describe the derivation of recent status scores (RSSs) for version 6 of the Addiction Severity Index (ASI-6). 118 ASI-6 recent status items were subjected to nonparametric item response theory (NIRT) analyses followed by confirmatory factor analysis (CFA). Generalizability and concurrent validity of the derived scores were determined. A total of 607 recent admissions to variety of substance abuse treatment programs constituted the derivation sample; a subset (n = 252) comprised the validity sample. The ASI-6 interview and a validity battery of primarily self-report questionnaires that included at least one measure corresponding to each of the seven ASI domains were administered. Nine summary scales describing recent status that achieved or approached both high scalability and reliability were derived; one scale for each of six areas (medical, employment/finances, alcohol, drug, legal, psychiatric) and three scales for the family/social area. Intercorrelations among the RSSs also supported the multi-dimensionality of the ASI-6. Concurrent validity analyses yielded strong evidence supporting the validity of six of the RSSs (medical, alcohol, drug, employment, family/social problems, psychiatric). Evidence was weaker for the legal, family/social support and child problems RSSs. Generalizability analyses of the scales to males versus females and whites versus blacks supported the comparability of the findings, with slight exceptions. The psychometric analyses to derive Addiction Severity Index version 6 recent status scores support the multi-dimensionality of the Addiction Severity Index version 6 (i.e. the relative independence of different life functioning areas), consistent with research on earlier editions of the instrument. In general, the Addiction Severity Index version 6 scales demonstrate acceptable scalability, reliability and concurrent validity. While questions remain about the generalizability of some scales to population subgroups, the overall findings

  13. Comparative study of left colonic Peritonitis Severity Score and Mannheim Peritonitis Index.

    Science.gov (United States)

    Biondo, S; Ramos, E; Fraccalvieri, D; Kreisler, E; Ragué, J Martí; Jaurrieta, E

    2006-05-01

    Prognostic evaluation of patients with left colonic perforation is useful in predicting mortality. The aims of this prospective study were to determine the prognostic value of the left colonic Peritonitis Severity Score (PSS) and to compare it with the Mannheim Peritonitis Index (MPI). One-hundred and fifty-six patients underwent emergency operation for distal colonic peritonitis. The PSS and MPI were calculated for each patient. The Spearman rank correlation coefficient was used to measure the association between the two scores. The predictive power of the two scoring systems and their differences were studied using the area under the receiver-operator characteristic (ROC) curve. Forty-one patients died (26.3 per cent). The relationship between scores and mortality was statistically significant for each scoring system (P < 0.001). The Spearman rank correlation coefficient for the correlation between the MPI and PSS was 0.55 (P < 0.001). There was no difference between areas under the ROC curves for the two systems. The PSS and MPI are both well validated scoring systems for left colonic peritonitis. Their routine use might allow stratification of patients according to mortality risk.

  14. Accurate scoring of the apnea-hypopnea index using a simple non-contact breathing sensor.

    Science.gov (United States)

    Beattie, Zachary T; Hayes, Tamara L; Guilleminault, Christian; Hagen, Chad C

    2013-06-01

    Sleep apnea is a serious condition that afflicts many individuals and is associated with serious health complications. Polysomnography, the gold standard for assessing and diagnosing sleep apnea, uses breathing sensors that are intrusive and can disrupt the patient's sleep during the overnight testing. We investigated the use of breathing signals derived from non-contact force sensors (i.e. load cells) placed under the supports of the bed as an alternative to traditional polysomnography breathing sensors (e.g. nasal pressure, oral-nasal thermistor, chest belt and abdominal belt). The apnea-hypopnea index estimated using the load cells was not different than that estimated using standard polysomnography leads (t44  = 0.37, P = 0.71). Overnight polysomnography sleep studies scored using load cell breathing signals had an intra-class correlation coefficient of 0.97 for the apnea-hypopnea index and an intra-class correlation coefficient of 0.85 for the respiratory disturbance index when compared with scoring using traditional polysomnography breathing sensors following American Academy of Sleep Medicine guidelines. These results demonstrate the feasibility of using unobtrusive load cells installed under the bed to measure the apnea-hypopnea index. © 2013 European Sleep Research Society.

  15. Regression coefficient-based scoring system should be used to assign weights to the risk index.

    Science.gov (United States)

    Mehta, Hemalkumar B; Mehta, Vinay; Girman, Cynthia J; Adhikari, Deepak; Johnson, Michael L

    2016-11-01

    Some previously developed risk scores contained a mathematical error in their construction: risk ratios were added to derive weights to construct a summary risk score. This study demonstrates the mathematical error and derived different versions of the Charlson comorbidity score (CCS) using regression coefficient-based and risk ratio-based scoring systems to further demonstrate the effects of incorrect weighting on performance in predicting mortality. This retrospective cohort study included elderly people from the Clinical Practice Research Datalink. Cox proportional hazards regression models were constructed for time to 1-year mortality. Weights were assigned to 17 comorbidities using regression coefficient-based and risk ratio-based scoring systems. Different versions of CCS were compared using Akaike information criteria (AIC), McFadden's adjusted R(2), and net reclassification improvement (NRI). Regression coefficient-based models (Beta, Beta10/integer, Beta/Schneeweiss, Beta/Sullivan) had lower AIC and higher R(2) compared to risk ratio-based models (HR/Charlson, HR/Johnson). Regression coefficient-based CCS reclassified more number of people into the correct strata (NRI range, 9.02-10.04) compared to risk ratio-based CCS (NRI range, 8.14-8.22). Previously developed risk scores contained an error in their construction adding ratios instead of multiplying them. Furthermore, as demonstrated here, adding ratios fail to even work adequately from a practical standpoint. CCS derived using regression coefficients performed slightly better than in fitting the data compared to risk ratio-based scoring systems. Researchers should use a regression coefficient-based scoring system to develop a risk index, which is theoretically correct. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Comparison between the Reflux Finding Score and the Reflux Symptom Index in the Practice of Otorhinolaryngology

    Science.gov (United States)

    Nunes, Heloisa Sobreira; Pinto, José Antonio; Zavanela, Adma Roberta; Cavallini, André Freitas; Freitas, Gabriel Santos; Garcia, Fabiola Esteves

    2016-01-01

    Introduction  The Gastroesophageal Reflux Disease has a prevalence of ∼12% of the urban population in Brazil. Koufman proposed the term to designate Laryngeal Pharyngeal Reflux (LPR) symptoms, signs or tissue damage resulting from aggression of the gastrointestinal contents in the upper aerodigestive tract. Belafsky et al proposed a score that points to inflammatory laryngeal signs through videolaryngoscopic findings, the Reflux Finding Score (RFS). Moreover, in 2002, they published the Reflux Symptom Index (RSI). Objective  The objective of this study is to provide a comparison between the Reflux Finding Score and the Reflux Symptom Index in the practice of Otorhinolaryngology. Methods  Our study involved a total of 135 patients who visited the Ear, Nose, and Throat (ENT) clinic Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo between April 2014 and May 2015 with suspected LPR. We excluded nine patients and the study group was 126 patients. All patients were ranked by their RSI and RFS scores. Results  The study group consisted of 126 patients (88 women and 38 men). Their main complaints were cough (40.4%), globus (21.4%), dysphonia (19.8%), throat clearing (15.8%), postnasal drip (3.17%), snoring (1.5%), dysphagia (1.5%), cacosmia (0.7%), and regurgitation (1.5%). The RSI ranges from 13 to 42 with a mean of 20.7 (SD = 6.67). The RFS ranged from 3 to 19 with a mean of 9.53 (SD = 2.64). Conclusion  The RSI and RFS can easily be included in ENT routines as objective parameters, with low cost and high practicality. Based on the clinical index, the specialist can evaluate the need for further tests. PMID:27413402

  17. Comparison between the Reflux Finding Score and the Reflux Symptom Index in the Practice of Otorhinolaryngology.

    Science.gov (United States)

    Nunes, Heloisa Sobreira; Pinto, José Antonio; Zavanela, Adma Roberta; Cavallini, André Freitas; Freitas, Gabriel Santos; Garcia, Fabiola Esteves

    2016-07-01

    The Gastroesophageal Reflux Disease has a prevalence of ∼12% of the urban population in Brazil. Koufman proposed the term to designate Laryngeal Pharyngeal Reflux (LPR) symptoms, signs or tissue damage resulting from aggression of the gastrointestinal contents in the upper aerodigestive tract. Belafsky et al proposed a score that points to inflammatory laryngeal signs through videolaryngoscopic findings, the Reflux Finding Score (RFS). Moreover, in 2002, they published the Reflux Symptom Index (RSI). The objective of this study is to provide a comparison between the Reflux Finding Score and the Reflux Symptom Index in the practice of Otorhinolaryngology. Our study involved a total of 135 patients who visited the Ear, Nose, and Throat (ENT) clinic Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo between April 2014 and May 2015 with suspected LPR. We excluded nine patients and the study group was 126 patients. All patients were ranked by their RSI and RFS scores. The study group consisted of 126 patients (88 women and 38 men). Their main complaints were cough (40.4%), globus (21.4%), dysphonia (19.8%), throat clearing (15.8%), postnasal drip (3.17%), snoring (1.5%), dysphagia (1.5%), cacosmia (0.7%), and regurgitation (1.5%). The RSI ranges from 13 to 42 with a mean of 20.7 (SD = 6.67). The RFS ranged from 3 to 19 with a mean of 9.53 (SD = 2.64). The RSI and RFS can easily be included in ENT routines as objective parameters, with low cost and high practicality. Based on the clinical index, the specialist can evaluate the need for further tests.

  18. The Impact of an Academic Integrity Module and Turnitin® on Similarity Index Scores of Undergraduate Student Papers

    Science.gov (United States)

    Ballard, Iva B.

    2013-01-01

    In this quasi-experimental 2 x 2 factorial design study, the impact of an academic integrity module and Turnitin® on undergraduate student similarity index scores was investigated. Similarity index scores were used to measure suggested plagiarism rates of student papers. A purposive sample consisting of 96 undergraduate education students enrolled…

  19. Blood test values and Community Periodontal Index scores in medical checkup recipients.

    Science.gov (United States)

    Takami, Yuko; Nakagaki, Haruo; Morita, Ichizo; Tsuboi, Shinji; Takami, Shuji; Suzuki, Noriko; Niwa, Hisae; Ogura, Yukio

    2003-12-01

    We examined the blood test values of people who received general medical checkups and their Community Periodontal Index (CPI) score. A total of 7,452 persons (5,742 males and 1,710 females), who had general medical and dental checkups, were the subjects of the study. Many were people who worked for companies in and around Nagoya and their family members, ranging in age from 16 to 80 years. The blood test in our study consisted of 37 items used in general blood tests. Partial-mouth recordings were used to measure CPI scores. The highest CPI score for each subject was used for analysis. Odds ratios and confidence interval values were obtained using the Mantel-Haenszel method to analyze the results. CPI scores of 3 and 4 were related to the test values of high-density-lipoprotein cholesterol, serum iron, white blood cell count, fasting blood sugar, glycosylated hemoglobin A1, glycosylated hemoglobin A1c, and C-reactive protein. Blood test values tended to show correlations with CPI scores, more clearly seen in males than in females.

  20. The normative score and the cut-off value of the Oswestry Disability Index (ODI).

    Science.gov (United States)

    Tonosu, Juichi; Takeshita, Katsushi; Hara, Nobuhiro; Matsudaira, Ko; Kato, So; Masuda, Kazuhiro; Chikuda, Hirotaka

    2012-08-01

    The Oswestry Disability Index (ODI) is one of the most common scoring systems used for patients with low back pain (LBP). Although the normative score of the ODI was reported to be 10.19 in a review article, no study has calculated the normative score after adjusting the value based on the age distribution. In addition, none of the previous studies has estimated the cut-off value which separates LBP with disability from LBP without disability. The purpose of this study was to estimate the normative score by adjusting the data for age distribution in Japan, and to determine the cut-off value which separates LBP with disability from LBP without disability. We conducted an internet survey on LBP using the Japanese version of the ODQ. A total of 1,200 respondents, composed of 100 males and 100 females in each age group (from the 20s to 70s), participated in this study. We also asked them to provide information about their backgrounds. We estimated the normative score after correcting for the age distribution of Japan. We also estimated the ODI of those with or without disability, the factors associated with the ODI, and the cut-off value which separates LBP with disability from LBP without disability. The participants' backgrounds were similar to the national survey. The normative score of the ODI was estimated at 8.73. The ODI of the LBP with disability group was 22.07. Those with sciatica and obese subjects showed higher ODI than those without. The optimal cut-off value was estimated to be 12. We defined the normative score and the cut-off value of the ODI.

  1. Toward development of a fibromyalgia responder index and disease activity score: OMERACT module update.

    Science.gov (United States)

    Mease, Philip J; Clauw, Daniel J; Christensen, Robin; Crofford, Leslie J; Gendreau, R Michael; Martin, Susan A; Simon, Lee S; Strand, Vibeke; Williams, David A; Arnold, Lesley M

    2011-07-01

    Following development of the core domain set for fibromyalgia (FM) in Outcome Measures in Rheumatology Clinical Trials (OMERACT) meetings 7 to 9, the FM working group has progressed toward the development of an FM responder index and a disease activity score based on these domains, utilizing outcome indices of these domains from archived randomized clinical trials in FM. Possible clinical domains that could be included in a responder index and disease activity score include pain, fatigue, sleep disturbance, cognitive dysfunction, mood disturbance, tenderness, stiffness, and functional impairment. Outcome measures for these domains demonstrate good to adequate psychometric properties, although measures of cognitive dysfunction need to be further developed. The approach used in the development of responder indices and disease activity scores for rheumatoid arthritis and ankylosing spondylitis represents heuristic models for our work, but FM is challenging in that there is no clear algorithm of treatment that defines disease activity based on treatment decisions, nor are there objective markers that define thresholds of severity or response to treatment. The process of developing candidate dichotomous responder definitions and continuous quantitative disease activity measures is described, along with participant discussions from OMERACT 10. Final results of this work will be published in a separate report pending completion of analyses.

  2. Superior assessment of CVD death by MACD index compared with the framingham score is highly associated with predisposition to diabetes

    DEFF Research Database (Denmark)

    Soltyskinska, Ewa; Barascuk, Natascha; Ganz, Melanie

    Background and Purpose: Aortic calcification is a major risk factor for cardiovascular disease (CVD) related deaths. More than 50% of patients die without clinical symptoms. This is a need to risk-stratify asymptomatic individuals with sub-clinical atherosclerosis, for identification of highest...... factors.   Methods: 308 women aged 48 to 76 were followed for 8.3±0.3 years and cardiovascular, cancer and all-cause deaths were recorded. Several aortic calcification markers were quantified: number, morphology and distribution from outlines of the calcified plaques in lumbar X-rays at baseline....... These markers were compared to SCORE card, Framingham score, and the Aortic Calcification Severity score - AC24, and correlated to baseline demographics and all standard traditional risk-factors.   Results: AC24 adjusted by age, waist circumference, and triglyceride levels predicted mortality in postmenopausal...

  3. Equivalence and standard scores of the Hurlbert Index of Sexual Assertiveness across Spanish men and women

    Directory of Open Access Journals (Sweden)

    Pablo Santos-Iglesias

    2014-01-01

    Full Text Available The purpose of the present study was to analyze the measurement invariance and differential item functioning of the Spanish version of the Hurlbert Index of Sexual Assertiveness across gender. The sample was composed of 1,600 women and 1,598 men from Spain, with ages ranging from 18 to 84 years old. The Hurlbert Index of Sexual Assertiveness only showed weak invariance for men and women. The differential item functioning analysis showed that only item 2 ("I feel that I am shy when it comes to sex" flagged moderate uniform differential item functioning. More specifically, women tended to respond "Always" to this item more frequently than did men. Results strongly suggested eliminating item 2, resulting in a final version with 18 items clustered into two dimensions with good reliability values for men and women. Standard scores for both Initiation and No Shyness/Refusal reflected traditional sexual scripts for men and women.

  4. Choosing the best index for the average score intraclass correlation coefficient.

    Science.gov (United States)

    Shieh, Gwowen

    2016-09-01

    The intraclass correlation coefficient (ICC)(2) index from a one-way random effects model is widely used to describe the reliability of mean ratings in behavioral, educational, and psychological research. Despite its apparent utility, the essential property of ICC(2) as a point estimator of the average score intraclass correlation coefficient is seldom mentioned. This article considers several potential measures and compares their performance with ICC(2). Analytical derivations and numerical examinations are presented to assess the bias and mean square error of the alternative estimators. The results suggest that more advantageous indices can be recommended over ICC(2) for their theoretical implication and computational ease.

  5. Pittsburgh Sleep Quality Index scores and their relationship with body measurements in late menopause patients.

    Science.gov (United States)

    Ayrim, Aylin; Aktepe Keskın, Esra; Özol, Duygu

    2014-01-01

    With an increase in life expectancy, women live about one-third of their lives in the postmenopausal period. Our aim was to investigate the findings regarding quality of sleep and sleep apnea in postmenopausal women and research the relationship between sleep complaints and body measurements. The Pittsburgh Sleep Quality Index (PSQI) was administered to all participants and their height, weight, and neck circumferences were measured. A total of 206 patients (mean age: 61.4 ± 8.8 years) were included. Their mean weight gain after menopause was 8.1 ± 12.8 kg, and their mean neck circumference and body mass index was 39.7 ± 2.6 cm and 33.4 ± 2.1, respectively. The rate of patients who snored each night increased from 3.4% to 13.2% (P = 0.000) after menopause. The rate of self-reported poor sleep quality was found in 57.8% of patients according to the PSQI global score (≥5). The prevalence of sleep medication usage increased from 5.8% to 11.2% with menopause. Although body measurements were a little lower in patients with a total PSQI score of less than 5, this difference was insignificant. The prevalence of self-reported poor sleep quality was high in the postmenopausal period and the prevalence of snoring increased significantly with weight gain after menopause.

  6. The Capillary Index Score as a Marker of Viable Cerebral Tissue: Proof of Concept-The Capillary Index Score in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Trial

    NARCIS (Netherlands)

    Al-Ali, Firas; Berkhemer, Olvert A.; Yousman, Wina P.; Elias, John J.; Bender, Evin N.; Lingsma, Hester F.; van der Lugt, Aad; Dippel, Diederik W. J.; Roos, Yvo B. W. E. M.; van Oostenbrugge, Robert J.; van Zwam, Wim H.; Dillon, William P.; Majoie, Charles B. L. M.

    2016-01-01

    The capillary index score (CIS) is based on the hypothesis that areas lacking capillary blush on pretreatment cerebral digital subtraction angiograms correspond to nonviable cerebral tissue. Pretreatment digital subtraction angiograms and post-treatment noncontrast enhanced computed tomographic

  7. Red cell indexes made easy using an interactive animation: do students and their scores concur?

    Science.gov (United States)

    Kachroo, Upasana; Vinod, Elizabeth; Balasubramanian, Sivakumar; W, Jesi; Prince, Neetu

    2018-03-01

    A good understanding of red cell indexes can aid medical students in a considerable manner, serving as a basis to unravel both concepts in red cell physiology and abnormalities associated with the same. In this study, we tried to assess whether an interactive animation was helpful in improving student comprehension and understanding of red cell indexes compared with conventional classroom teaching. Eighty-eight first-year MBBS students participated, of which 44 were assigned to group A and 44 were assigned to group B after randomization. After further creation of smaller groups, students were provided with 45 min to revise red cell indexes, after which they were required to complete a multimodal questionnaire. Group A subgroups used written material for revision, whereas group B subgroups had access to an interactive animation. After completion of the questionnaire, group A students also used the animation after which feedback was collected from all students. Efficacy of the animation to improve learning and retention was demonstrated, as group B students scored significantly higher than group A students on the questionnaire ( P = 0.0003). A clear majority of the students agreed/strongly agreed that the animation was easy to operate, conveyed important concepts efficiently, and improved their knowledge of related clinical aspects as well. From the results and feedback, we found that the animation was a simple, well-received model, which, by significantly improving student performance, corroborated our hypothesis that inclusion of interactive animation into student curriculum can advance their academic attainment, compared with didactic teaching alone.

  8. Systemic atherosclerosis and voiding symptom.

    Science.gov (United States)

    Yeniel, A Ozgur; Ergenoglu, A Mete; Meseri, Reci; Ari, Anıl; Sancar, Ceren; Itil, Ismail Mete

    2017-03-01

    To evaluate the effect of atherosclerosis on the storage and voiding symptoms of the bladder in women with overactive bladder (OAB). We retrospectively reviewed the charts of women with OAB who were evaluated between 2013 and 2015 in our urogynecology unit. Charts were assessed for history, examination findings, urinary diary, quality of life (QOL) questionnaires, urodynamic studies (UDSs), and four main risk factors for atherosclerosis: hypertension, diabetes mellitus, smoking, and hyperlipidemia. In a previous study, these were defined as vascular risk factors. Cases were excluded for insufficient data, diabetes mellitus with dysregulated blood glucose, or prolapse greater than 1cm to avoid confusing bladder outlet obstruction. We included 167 eligible cases in this study. We evaluated storage and voiding symptoms such as frequency, nocturia, residual urine volume, and voiding difficulties and UDS findings such as maximum bladder capacity, first desire, strong desire, detrusor overactivity, and bladder contractility index. The vascular risk score was categorized as "no risk" if the woman did not have any of the four risk factors and "at risk" if she had any of the factors. Independent sample t-test and chi-square tests were performed for analyses. Among the participants (n=167), 71.9% had at least one vascular risk factor. Those who were at risk were facing significantly more wet-type OAB (p=0.003) and nocturia (p=0.023). Moreover, mean age (p=0.008) and mean gravidity (p=0.020) were significantly higher in the at-risk group, whereas mean total nocturia QOL questionnaire scores (p=0.029) were significantly lower. Our findings suggest that aging and atherosclerosis may be associated with severe OAB and poorer QOL. Nocturia and related parameters of poor quality can be explained by impaired bladder neck perfusion. Future trials need to assess vascular and molecular changes in women with OAB. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Carotid versus coronary atherosclerosis burdens in acute compared with chronic symptomatic coronary artery disease.

    Science.gov (United States)

    LeBlanc, Stéphanie; Bibeau, Karine; Bertrand, Olivier F; Lévesque, Valérie; Deschênes St-Pierre, Béatrice; Pibarot, Philippe; Després, Jean-Pierre; Larose, Eric

    2017-08-01

    Prediction of coronary events remains elusive. Carotid atherosclerosis may be a surrogate for coronary risk, as carotid and coronary diseases occur simultaneously - albeit at times with a weak association - depending on clinical presentation. We investigated carotid and coronary atherosclerosis in men with new-onset unstable coronary artery disease (CAD) presenting with acute ST-segment elevation myocardial infarction (STEMI) vs. long-standing severe chronic stable angina (CSA). Bilateral carotid artery and 3-vessel coronary artery atherosclerosis burdens were measured within 1 month, respectively, by 3D-volumetric carotid magnetic resonance imaging and coronary angiography-derived modified CASS-50 score. Men with STEMI (n = 50) and long-standing CSA (n = 50), matched for age, were enrolled (58.6 ± 8.8 years). All of them had carotid atherosclerosis. Atherosclerosis burden was greater in the carotid arteries of STEMI vs. CSA (wall volume: 196.2 ± 44.4 vs. 169.2 ± 38.0 mm3/4 mm, p = 0.002), but greater in the coronary arteries of CSA vs. STEMI (modified CASS-50 score: 3 vs. 1, p < 0.0001). Normalized wall index (NWI) of internal carotid was associated with modified CASS-50 score in STEMI (ρ = 0.40, p = 0.022) and in CSA (ρ = -0.39, p = 0.031). Carotid atherosclerosis was observed in all CAD patients, and atherosclerosis burden in carotid and in coronary arteries varied according to clinical presentation.

  10. Is there a relation between priapism occurring after penile doppler ultrasonography and international erectile function index score and erection hardness score levels?

    Science.gov (United States)

    Sönmez, Mehmet Giray; Öztürk, Ahmet

    2017-12-01

    The relation between Erection Hardness Score (EHS) and The International Erectile Function Index (IIEF) Questionnaire- Erectile Function Domain Score (IIEF-EF score) used in erectile dysfunction (ED) evaluation and the prevalence of priapism after penile Doppler ultrasonography (PDU) was examined in this study. A total of 62 patients who had PDU were included in the study. Patients were divided into two groups; there were 33 patients in IIEF-EF score ≤10, EHS 10, EHS ≥2 group (Group 2). The two groups separated according to their scores were compared for age, body mass index (BMI), prevalence of priapism, vascular comorbidities and duration of erection. When compared to Group 2, median age, rate of vascular comorbidities rate and BMI were detected to be higher in Group 1 with IIEF-EF score ≤10 and EHS 10 and EHS ≥2 (p<0.001, p=0.027, p=0.049 respectively). High IIEF-EF and EHS scores, younger ages and lower rates of vascular comorbidities in patients from whom PDU was demanded increase the prevalence of priapism.

  11. Relative resistance index (RRI) - a scoring system for antibiotic resistance in Pseudomonas aeruginosa.

    Science.gov (United States)

    Ewing, J; McCaughan, J; Moore, J; Fairley, D; Sutherland, B; Reid, A; Downey, D

    2017-10-01

    There is a need to measure antibiotic resistance of Pseudomonas aeruginosa (PA) in cystic fibrosis (CF), either qualitatively or quantitatively, to inform patient management. The aim of this study was to develop a simple method by which resistance can be quantified by calculating a relative resistance index (RRI), and to assess correlation of RRIs with clinical variables. In our model, RRIs were calculated based on resistance to aztreonam, ceftazidime, ciprofloxacin, colistin, meropenem, tazocin, temicillin and tobramycin. Eighty-five adults with CF and chronic PA colonisation were identified. For each, all PA cultures were allocated a score of 0 for susceptible, 0.5 for intermediate resistance or 1 for resistance for each antibiotic listed above, and the RRI calculated by dividing the sum of these by the number of antibiotics, giving a maximum score of 1. The mean RRIs for all cultures were correlated with key clinical variables monitored in CF patients (including age, FEV1, IV antibiotic days and BMI). RRIs for non-mucoid PA exhibited moderate positive correlation with total number of IV days (r = 0.405; p resistance.

  12. NT-proBNP levels, atherosclerosis and vascular function in asymptomatic type 2 diabetic patients with microalbuminuria: peripheral reactive hyperaemia index but not NT-proBNP is an independent predictor of coronary atherosclerosis

    DEFF Research Database (Denmark)

    Reinhard, Henrik; Wiinberg, Niels; Hansen, Peter R

    2011-01-01

    for atherosclerosis is unclear. We examined the interrelationship between P-NT-proBNP, presence of atherosclerosis and/or vascular dysfunction in the coronary, carotid and peripheral arteries in asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment. METHODS...... AND RESULTS: P-NT-proBNP was measured in 200 asymptomatic type 2 patients without known cardiac disease that received intensive multifactorial treatment for CV risk reduction. Patients were examined for coronary, carotid and peripheral atherosclerosis, as defined by coronary calcium score≥400, carotid intima...

  13. Ethnic Disparities in Emergency Severity Index Scores among U.S. Veteran's Affairs Emergency Department Patients.

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    Jacob M Vigil

    Full Text Available The goal of these analyses was to determine whether there were systematic differences in Emergency Severity Index (ESI scores, which are intended to determine priority of treatment and anticipate resource needs, across categories of race and ethnicity, after accounting for patient-presenting vital signs and examiner characteristics, and whether these differences varied among male and female Veterans Affairs (VA ED patients.We used a large national database of electronic medical records of ED patients from twenty-two U.S. Department of Veterans Affairs ED stations to determine whether ESI assignments differ systematically by race or ethnicity. Multi-level, random effects linear modeling was used to control for demographic characteristics and patient's vital signs (heart rate, respiratory rate, and pain level, as well as age, gender, and experience of triage nurses. The dataset included 129,991 VA patients presenting for emergency care between 2008 and 2012 (91% males; 61% non-Hispanic White, 28% Black, 7% Hispanic, 2% Asian, <1% American Indian/Alaska Native, 1% mixed ethnicity and 774 nurses for a total of 359,642 patient/examiner encounters. Approximately 13% of the variance in ESI scores was due to patient characteristics and 21% was due to the nurse characteristics. After controlling for characteristics of nurses and patients, Black patients were assigned less urgent ESI scores than White patients, and this effect was more prominent for Black males compared with Black females. A similar interaction was found for Hispanic males. It remains unclear how these results may generalize to EDs and patient populations outside of the U.S. VA Health Care system.The findings suggest the possibility that subgroups of VA patients receive different ESI ratings in triage, which may have cascading, downstream consequences for patient treatment quality, satisfaction with care, and trust in the health equity of emergency care.

  14. Association of a body mass index genetic risk score with growth throughout childhood and adolescence.

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    Nicole M Warrington

    Full Text Available While the number of established genetic variants associated with adult body mass index (BMI is growing, the relationships between these variants and growth during childhood are yet to be fully characterised. We examined the association between validated adult BMI associated single nucleotide polymorphisms (SNPs and growth trajectories across childhood. We investigated the timing of onset of the genetic effect and whether it was sex specific.Children from the ALSPAC and Raine birth cohorts were used for analysis (n = 9,328. Genotype data from 32 adult BMI associated SNPs were investigated individually and as an allelic score. Linear mixed effects models with smoothing splines were used for longitudinal modelling of the growth parameters and measures of adiposity peak and rebound were derived.The allelic score was associated with BMI growth throughout childhood, explaining 0.58% of the total variance in BMI in females and 0.44% in males. The allelic score was associated with higher BMI at the adiposity peak (females  =  0.0163 kg/m(2 per allele, males  =  0.0123 kg/m(2 per allele and earlier age (-0.0362 years per allele in males and females and higher BMI (0.0332 kg/m(2 per allele in females and 0.0364 kg/m(2 per allele in males at the adiposity rebound. No gene:sex interactions were detected for BMI growth.This study suggests that known adult genetic determinants of BMI have observable effects on growth from early childhood, and is consistent with the hypothesis that genetic determinants of adult susceptibility to obesity act from early childhood and develop over the life course.

  15. Association of a Body Mass Index Genetic Risk Score with Growth throughout Childhood and Adolescence

    Science.gov (United States)

    Wu, Yan Yan; Timpson, Nicholas J.; Tilling, Kate; Pennell, Craig E.; Newnham, John; Davey-Smith, George; Palmer, Lyle J.; Beilin, Lawrence J.; Lye, Stephen J.; Lawlor, Debbie A.; Briollais, Laurent

    2013-01-01

    Background While the number of established genetic variants associated with adult body mass index (BMI) is growing, the relationships between these variants and growth during childhood are yet to be fully characterised. We examined the association between validated adult BMI associated single nucleotide polymorphisms (SNPs) and growth trajectories across childhood. We investigated the timing of onset of the genetic effect and whether it was sex specific. Methods Children from the ALSPAC and Raine birth cohorts were used for analysis (n = 9,328). Genotype data from 32 adult BMI associated SNPs were investigated individually and as an allelic score. Linear mixed effects models with smoothing splines were used for longitudinal modelling of the growth parameters and measures of adiposity peak and rebound were derived. Results The allelic score was associated with BMI growth throughout childhood, explaining 0.58% of the total variance in BMI in females and 0.44% in males. The allelic score was associated with higher BMI at the adiposity peak (females  =  0.0163 kg/m2 per allele, males  =  0.0123 kg/m2 per allele) and earlier age (-0.0362 years per allele in males and females) and higher BMI (0.0332 kg/m2 per allele in females and 0.0364 kg/m2 per allele in males) at the adiposity rebound. No gene:sex interactions were detected for BMI growth. Conclusions This study suggests that known adult genetic determinants of BMI have observable effects on growth from early childhood, and is consistent with the hypothesis that genetic determinants of adult susceptibility to obesity act from early childhood and develop over the life course. PMID:24244521

  16. Bispectral index score and observer′s assessment of awareness/sedation score may manifest divergence during onset of sedation: Study with midazolam and propofol

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    Dipanjan Bagchi

    2013-01-01

    Full Text Available Background: Correlation between the clinical and electroencephalogram-based monitoring has been documented sporadically during the onset of sedation. Propofol and midazolam have been studied individually using the observer′s assessment of awareness/sedation (OAA/S score and Bispectral index score (BIS. The present study was designed to compare the time to onset of sedation for propofol and midazolam using both BIS and OAA/S scores, and to find out any correlation. Methods: A total of 46 patients (18-60 years, either sex, American Society of Anesthesiologists (ASA I/II posted for infraumbilical surgeries under spinal anaesthesia were randomly allocated to receive either injection propofol 1 mg/kg bolus followed by infusion 3 mg/kg/h (Group P, n=23 or injection midazolam 0.05 mg/kg bolus followed by infusion 0.06 mg/kg/h (Group M, n=23. Spinal anaesthesia was given with 2.5 ml to 3.0 ml of 0.5% bupivacaine heavy. When sensory block reached T6 level, sedation was initiated. The time to reach BIS score 70 and time to achieve OAA/S score 3 from the start of study drug were noted. OAA/S score at BIS score 70 was noted. Data from 43 patients were analyzed using SPSS 12 for Windows. Results: Time to reach BIS score 70 using propofol was significantly lower than using the midazolam (P<0.05. Time to achieve OAA/S score 3 using propofol was comparable with midazolam (P=0.358. Conclusion: A divergence exists between the time to reach BIS score 70 and time to achieve OAA/S score 3 using midazolam, compared with propofol, during the onset of sedation.

  17. Ankle-Brachial Pressure Index Measured Using an Automated Oscillometric Method as a Predictor of the Severity of Coronary Atherosclerosis in Patients with Coronary Artery Disease

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    Ho-Ming Su

    2004-06-01

    Full Text Available Ankle-brachial pressure index (ABI measured using a conventional Doppler method is an independent predictor of the number of coronary vessels affected in coronary artery disease (CAD. Recently, a new clinical device has been developed to measure ABI using an oscillometric method. It is unclear whether ABI measured using this device is a significant predictor of the severity of coronary atherosclerosis. We retrospectively included 87 patients from our outpatient clinic who had ever undergone coronary angiography. ABI was determined in all subjects using the new ABI-form device. The lower value of ABI in either limb was used for analysis. We divided our subjects into two groups, with either ABI less than 0.9 or at least 0.9, and compared basal characteristics between groups. We analyzed the relationship between ABI and the severity of CAD. In addition, we calculated the sensitivity, specificity, and positive and negative predictive values of ABI less than 0.9 in predicting multivessel (two-vessel + three-vessel involvement in our patients. There were 15 patients with ABI less than 0.9 and 72 with ABI at least 0.9. Patients with ABI less than 0.9 were older and had higher plasma levels of uric acid. The prevalence of diabetes mellitus, hypertension, smoking, and diuretic use was significantly higher in patients with ABI less than 0.9. In addition, the group with ABI less than 0.9 had a lower prevalence of one-vessel CAD and higher prevalence of three-vessel or multivessel CAD. The sensitivity, specificity, and positive and negative predictive values of ABI less than 0.9 in predicting multivessel CAD were 22%, 96%, 93%, and 34%, respectively. In conclusion, ABI measured using the automated oscillometric method can be used to predict the severity of coronary atherosclerosis in patients with CAD.

  18. Association of glycemic index and glycemic load with risk of incident coronary heart disease among Whites and African Americans with and without type 2 diabetes: The Atherosclerosis Risk in Communities Study

    Science.gov (United States)

    Hardy, Dale; Hoelscher, Deanna M.; Aragaki, Corinne; Stevens, June; Steffen, Lyn M.; Pankow, James S.; Boerwinkle, Eric

    2011-01-01

    Purpose This study examined whether high glycemic index (GI) and glycemic load (GL) diets are associated with increased risk of developing CHD in Whites and African Americans with and without type 2 diabetes. Methods Data on 13,051 individuals aged 45-64 years from the Atherosclerosis Risk in Communities (ARIC) study were analyzed. The ARIC food frequency questionnaire baseline data provided GI and GL indices. A propensity score was created to estimate the effect of an individual's covariates on energy-adjusted GI or GL. During a maximum of 17 years of follow-up, 1,683 cases of CHD (371 with diabetes and 1,312 without diabetes) were recorded. Results For every 5-units increase in GI, there was a 1.16-fold (95% CI:1.01, 1.33) increased risk of incident CHD in African Americans. For every 30-units increase in GL, there was a 1.11-fold (95% CI:1.01, 1.21) increased risk of incident CHD in Whites. High GL was an especially important CHD risk factor for Whites without diabetes (per 30-units increase) (HR=1.14; 95% CI:1.02, 1.26). However, these relationships were not seen in individuals with diabetes. Conclusions Nutritional advice to reduce the GI and GL in diets of African Americans, and Whites (without diabetes) may play a role in reducing CHD risk. PMID:20609341

  19. Diagnostic Utility of WISC-IV General Abilities Index and Cognitive Proficiency Index Difference Scores among Children with ADHD

    Science.gov (United States)

    Devena, Sarah E.; Watkins, Marley W.

    2012-01-01

    The Wechsler Intelligence Scale for Children-Fourth Edition General Abilities Index and Cognitive Proficiency Index have been advanced as possible diagnostic markers of attention deficit hyperactivity disorder. This hypothesis was tested with a hospital sample with attention deficit hyperactivity disorder (n = 78), a referred but nondiagnosed…

  20. Association of a Genetic Risk Score With Body Mass Index Across Different Birth Cohorts.

    Science.gov (United States)

    Walter, Stefan; Mejía-Guevara, Iván; Estrada, Karol; Liu, Sze Y; Glymour, M Maria

    2016-07-05

    Many genetic variants are associated with body mass index (BMI). Associations may have changed with the 20th century obesity epidemic and may differ for black vs white individuals. Using birth cohort as an indicator for exposure to obesogenic environment, to evaluate whether genetic predisposition to higher BMI has a larger magnitude of association among adults from more recent birth cohorts, who were exposed to the obesity epidemic at younger ages. Observational study of 8788 adults in the US national Health and Retirement Study who were aged 50 years and older, born between 1900 and 1958, with as many as 12 BMI assessments from 1992 to 2014. A multilocus genetic risk score for BMI (GRS-BMI), calculated as the weighted sum of alleles of 29 single nucleotide polymorphisms associated with BMI, with weights equal to the published per-allele effects. The GRS-BMI represents how much each person's BMI is expected to differ, based on genetic background (with respect to these 29 loci), from the BMI of a sample member with median genetic risk. The median-centered GRS-BMI ranged from -1.68 to 2.01. BMI based on self-reported height and weight. GRS-BMI was significantly associated with BMI among white participants (n = 7482; mean age at first assessment, 59 years; 3373 [45%] were men; P obesogenic environments.

  1. Dietary inflammatory index scores differ by shift work status: NHANES 2005 to 2010.

    Science.gov (United States)

    Wirth, Michael D; Burch, James; Shivappa, Nitin; Steck, Susan E; Hurley, Thomas G; Vena, John E; Hébert, James R

    2014-02-01

    Shift workers are affected by diet- and inflammation-related diseases, including cardiovascular disease, diabetes, and cancer. We examined a dietary inflammatory index (DII) in relation to shift work from the National Health and Nutrition Examination Survey data (2005 to 2010). The DII was calculated using data from a 24-hour dietary recall. Shift work categories included day workers, evening/night shift workers, or rotating shift workers. General linear models were fit to examine the relationship between shift work and adjusted mean DII values. Among all shift workers and specifically rotating shift workers, higher (ie, more pro-inflammatory) mean DII scores (1.01 and 1.07 vs 0.86; both P ≤ 0.01) were observed compared with day workers. Women tended to express strong evening/night shift effects. More proinflammatory diets observed among shift workers may partially explain increased inflammation-related chronic disease risk observed in other studies among shift workers compared with their day-working counterparts.

  2. Body mass index and depressive symptoms: instrumental-variables regression with genetic risk score.

    Science.gov (United States)

    Jokela, M; Elovainio, M; Keltikangas-Järvinen, L; Batty, G D; Hintsanen, M; Seppälä, I; Kähönen, M; Viikari, J S; Raitakari, O T; Lehtimäki, T; Kivimäki, M

    2012-11-01

    The causal role of obesity in the development of depression remains uncertain. We applied instrumental-variables regression (Mendelian randomization) to examine the association of adolescent and adult body mass index (BMI) with adult depressive symptoms. Participants were from the Young Finns prospective cohort study (n = 1731 persons, 2844 person-observations), with repeated measurements of BMI and depressive symptoms (modified Beck's Depression Inventory). Genetic risk score of 31 single nucleotide polymorphisms previously identified as robust genetic markers of body weight was used as a proxy for variation in BMI. In standard linear regression analysis, higher adult depressive symptoms were predicted by higher adolescent BMI (B = 0.33, CI = 0.06-0.60, P = 0.017) and adult BMI (B = 0.47, CI = 0.32-0.63, P regression (P = 0.04). These findings provide additional evidence to support a causal role for high BMI in increasing symptoms of depression. However, the present analysis also demonstrates potential limitations of applying Mendelian randomization when using complex phenotypes. © 2012 The Authors. Genes, Brain and Behavior © 2012 Blackwell Publishing Ltd and International Behavioural and Neural Genetics Society.

  3. The MCID of the transition dyspnea index is a total score of one unit.

    Science.gov (United States)

    Mahler, Donald A; Witek, Theodore J

    2005-03-01

    The Baseline (BDI) and Transition (TDI) Dyspnea Indexes provide interview-based measurements of breathlessness related to activities of daily living. The BDI is a discriminative instrument that includes specific criteria for each of three components at a single point in time. The TDI is an evaluative instrument that includes specific criteria for each of three components to measure changes from a baseline state. Observational studies have shown that patients with COPD generally experience a gradual progression of breathing difficulty as measured by the TDI over time. Randomized controlled trials have demonstrated excellent measurement characteristics of the TDI; these include responsiveness (ability to detect change) and construct validity (a change in the TDI correlates with changes in other variables). Supporting evidence for one unit as the minimal clinically important difference (MCID) of the TDI is based on: expert preference; use of the physician's global evaluation score as an anchor; and distribution estimates (standard error of measurement and 0.5 of the standard deviation). As an alternative to the interview process, self-administered computerized (SAC) versions of the BDI/TDI have been developed to provide direct patient-reported ratings of dyspnea. To further establish the MCID of the interview-administered and/or the SAC TDI, we recommend that a patient's report of global ratings of change by used as an independent standard or anchor.

  4. Coronary artery calcium score using electron beam tomography in the patients with acute obstructive coronary arterial disease : comparative study within asymptomatic high-risk group of atherosclerosis and chronic obstructive coronary arterial disease group

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    Ryu, Seok Jong; Choi, Byoung Wook; Choe, Kyu Ok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    2001-04-01

    To compare, through analysis of the coronary artery calcium (CAC) score and the risk factors for atherosclerosis, the characteristics of acute coronary syndrome between an asymptomatic high-risk group of atherosclerosis patients and a chronic coronary arterial obstructive disease(CAOD) group. The CAC scores of an asymptomatic high-risk group of atherosclerosis patients (group I, n=284), a chronic CAOD croup (group II, n=39) and an acute coronary syndrome group (group III, n=21) were measured by electron beam tomography. Forty-seven patients with CAOD from groups II and III underwent coronary angiography, and we scrutinized age, sex and risk factors including diabetes mellitus, hypertension, obesity, smoking, hypercholesterolemia and low high-density lipoproteinemia. The numbers of stenotic coronary arterial branches and degree of stenosis revealed by coronary angiography were also recorded. We determined the differences between the three groups in terms of CAC score and the risk factors, the relationship between CAC score and risk factors, and the characteristic features of each type of CAOD group. The mean CA score of group III (135.1) was not statistically different from that of group I (135.7) or group II (365.8). Among patients aged below 50, the mean CAC score of group III (127.4) was significantly higher than that of group I (6.2), (p=0.0006). The mean CAC score at the sixth decade was also significantly different between group I(81.5) and group II (266.9). The mean age of group III (54.2 years) was significantly lower than that of group I (58.1 years) (p=0.047) and of group II (60.1) (p=0.022). There was significant correlation between the number of stenotic coronary arterial branches and log(CAC +1) (p<.01). The square root of the CAC score and the maximal degree of stenosis was also well correlated (p<.01). There was no difference in the mean number of risk factors among the three groups, though the incidence of smoking in group III was significantly

  5. Correlation between body mass index (BMI) and the Gleason score of prostate biopsies in Chinese population.

    Science.gov (United States)

    Zhou, Feng; Chen, Xi; Pu, Jinxian; Ouyang, Jun; Li, Gang; Ping, Jigen; Lu, Yong; Hou, Jianquan; Han, Yong

    2016-09-27

    We assessed the correlation between BMI and Gleason score in prostate biopsies in Chinese Population. In this retrospective study, we collected the Gleason score, PSA, BMI, age, race, and other related clinical data on 290 patients who had undergone prostatic biopsy. We then compared the prostate cancer detection rates and Gleason scores between the high BMI group (BMI ≥ 25; 143 cases) and low BMI group (Gleason scores (Gleason score Gleason scores (≥ 7). Within the high BMI group, 44.76% had high Gleason scores, which was significantly greater than the 38.10% in the low BMI group (P = 0.027). These results indicate that while there was no effect of BMI on the rate of positive prostate cancer biopsies, the rate of high Gleason scores was greater in the high BMI group than the normal BMI group.

  6. Dietary inflammatory index, Mediterranean diet score, and lung cancer: a prospective study.

    Science.gov (United States)

    Hodge, A M; Bassett, J K; Shivappa, N; Hébert, J R; English, D R; Giles, G G; Severi, G

    2016-07-01

    To investigate prospectively the associations of Dietary Inflammatory Index (DII) and Mediterranean Diet Score (MDS) with lung cancer. We used data from men and women aged 40-69 years at recruitment in 1990-1994, who were participants in the Melbourne Collaborative Cohort Study (n = 35,303). A total of 403 incident lung cancer cases were identified over an average 18-year follow-up. Hazard ratios (HR) were estimated using Cox regression, adjusting for smoking status and other risk factors, with age as the time metric. An inverse correlation was observed between the DII and MDS (ρ = -0.45), consistent with a higher DII being pro-inflammatory and less 'healthy,' while a high MDS reflects a 'healthier' diet. The DII was positively associated with risk of lung cancer in current smokers [HRQ4 vs Q1 = 1.70 (1.02, 2.82); Ptrend = 0.008] (p interaction between DII quartiles and smoking status = 0.03). The MDS was inversely associated with lung cancer risk overall [HR7-9 vs 0-3 = 0.64 (0.45, 0.90); Ptrend = 0.005] and for current smokers (HR7-9 vs 0-3 = 0.38 (0.19, 0.75); Ptrend = 0.005) (p interaction between MDS categories and smoking status = 0.31). The MDS showed an inverse association with lung cancer risk, especially for current smokers. A high DII, indicating a more pro-inflammatory diet, was associated with risk of lung cancer only for current smokers. A healthy diet may reduce the risk of lung cancer, especially in smokers.

  7. Neighborhood ethnic composition, spatial assimilation, and change in body mass index over time among Hispanic and Chinese immigrants: Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Lê-Scherban, Félice; Albrecht, Sandra S; Osypuk, Theresa L; Sánchez, Brisa N; Diez Roux, Ana V

    2014-11-01

    We investigated relations between changes in neighborhood ethnic composition and changes in body mass index (BMI) and waist circumference among Chinese and Hispanic immigrants in the United States. We used Multi-Ethnic Study of Atherosclerosis data over a median 9-year follow-up (2000-2002 to 2010-2012) among Chinese (n = 642) and Hispanic (n = 784) immigrants aged 45 to 84 years at baseline. We incorporated information about residential moves and used econometric fixed-effects models to control for confounding by time-invariant characteristics. We characterized neighborhood racial/ethnic composition with census tract-level percentage Asian for Chinese participants and percentage Hispanic for Hispanic participants (neighborhood coethnic concentration). In covariate-adjusted longitudinal fixed-effects models, results suggested associations between decreasing neighborhood coethnic concentration and increasing weight, although results were imprecise: within-person BMI increases associated with an interquartile range decrease in coethnic concentration were 0.15 kilograms per meters squared (95% confidence interval [CI] = 0.00, 0.30) among Chinese and 0.17 kilograms per meters squared (95% CI = -0.17, 0.51) among Hispanic participants. Results did not differ between those who did and did not move during follow-up. Residential neighborhoods may help shape chronic disease risk among immigrants.

  8. Can transient elastography, Fib-4, Forns Index, and Lok Score predict esophageal varices in HCV-related cirrhotic patients?

    Science.gov (United States)

    Hassan, Eman M; Omran, Dalia A; El Beshlawey, Mohamad L; Abdo, Mahmoud; El Askary, Ahmad

    2014-02-01

    Gastroesophageal varices are present in approximately 50% of patients with liver cirrhosis. The aim of this study was to evaluate liver stiffness measurement (LSM), Fib-4, Forns Index and Lok Score as noninvasive predictors of esophageal varices (EV). This prospective study included 65 patients with HCV-related liver cirrhosis. All patients underwent routine laboratory tests, transient elastograhy (TE) and esophagogastroduodenoscopy. FIB-4, Forns Index and Lok Score were calculated. The diagnostic performances of these methods were assessed using sensitivity, specificity, positive predictive value, negative predictive value, accuracy and receiver operating characteristic curves. All predictors (LSM, FIB-4, Forns Index and Lok Score) demonstrated statistically significant correlation with the presence and the grade of EV. TE could diagnose EV at a cutoff value of 18.2kPa. Fib-4, Forns Index, and Lok Score could diagnose EV at cutoff values of 2.8, 6.61 and 0.63, respectively. For prediction of large varices (grade 2, 3), LSM showed the highest accuracy (80%) with a cutoff of 22.4kPa and AUROC of 0.801. Its sensitivity was 84%, specificity 72%, PPV 84% and NPV 72%. The diagnostic accuracies of FIB-4, Forns Index and Lok Score were 70%, 70% and76%, respectively, at cutoffs of 3.3, 6.9 and 0.7, respectively. For diagnosis of large esophageal varices, adding TE to each of the other diagnostic indices (serum fibrosis scores) increased their sensitivities with little decrease in their specificities. Moreover, this combination decreased the LR- in all tests. Noninvasive predictors can restrict endoscopic screening. This is very important as non invasiveness is now a major goal in hepatology. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  9. Scholarly Productivity of Social Work Faculty at Historically Black Colleges and Universities: Are h-Index Scores a Suitable Measure?

    Science.gov (United States)

    Marshall, Isiah, Jr.; Smith, Belinda Davis; Green, Makeba T.; Anderson, Brian; Harry, Sonja V.; Byrd, Yolanda M.; Pratt-Harris, Natasha C.; Bolden, Errol S.; Hill, Solomon

    2016-01-01

    Faculty scholarship at historically Black colleges and universities (HBCU) has in the past served as a blueprint for the Black masses. Even today, HBCU faculty scholarship continues to be an informative source to communicate accurate information regarding marginalized groups. This study examines h-index scores of 65 faculty members at five…

  10. The Relationship between Schools' Costs per Pupil and Nevada School Performance Framework Index Scores in Clark County School District

    Science.gov (United States)

    Rice, John; Huang, Min

    2015-01-01

    Clark County School District (CCSD) asked the Western Regional Education Laboratory (REL West) to examine the relationship between spending per pupil and Nevada School Performance Framework (NSPF) index scores in the district's schools. Data were examined from three school years (2011/12, 2012/13, 2013/14) and for three types of schools…

  11. A comparison between the APACHE II and Charlson Index Score for predicting hospital mortality in critically ill patients.

    Science.gov (United States)

    Quach, Susan; Hennessy, Deirdre A; Faris, Peter; Fong, Andrew; Quan, Hude; Doig, Christopher

    2009-07-30

    Risk adjustment and mortality prediction in studies of critical care are usually performed using acuity of illness scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), which emphasize physiological derangement. Common risk adjustment systems used in administrative datasets, like the Charlson index, are entirely based on the presence of co-morbid illnesses. The purpose of this study was to compare the discriminative ability of the Charlson index to the APACHE II in predicting hospital mortality in adult multisystem ICU patients. This was a population-based cohort design. The study sample consisted of adult (>17 years of age) residents of the Calgary Health Region admitted to a multisystem ICU between April 2002 and March 2004. Clinical data were collected prospectively and linked to hospital outcome data. Multiple regression analyses were used to compare the performance of APACHE II and the Charlson index. The Charlson index was a poor predictor of mortality (C = 0.626). There was minimal difference between a baseline model containing age, sex and acute physiology score (C = 0.74) and models containing either chronic health points (C = 0.76) or Charlson index variations (C = 0.75, 0.76, 0.77). No important improvement in prediction occurred when the Charlson index was added to the full APACHE II model (C = 0.808 to C = 0.813). The Charlson index does not perform as well as the APACHE II in predicting hospital mortality in ICU patients. However, when acuity of illness scores are unavailable or are not recorded in a standard way, the Charlson index might be considered as an alternative method of risk adjustment and therefore facilitate comparisons between intensive care units.

  12. The Chemistry Scoring Index (CSI: A Hazard-Based Scoring and Ranking Tool for Chemicals and Products Used in the Oil and Gas Industry

    Directory of Open Access Journals (Sweden)

    Tim Verslycke

    2014-06-01

    Full Text Available A large portfolio of chemicals and products is needed to meet the wide range of performance requirements of the oil and gas industry. The oil and gas industry is under increased scrutiny from regulators, environmental groups, the public, and other stakeholders for use of their chemicals. In response, industry is increasingly incorporating “greener” products and practices but is struggling to define and quantify what exactly constitutes “green” in the absence of a universally accepted definition. We recently developed the Chemistry Scoring Index (CSI which is ultimately intended to be a globally implementable tool that comprehensively scores and ranks hazards to human health, safety, and the environment for products used in oil and gas operations. CSI scores are assigned to products designed for the same use (e.g., surfactants, catalysts on the basis of product composition as well as intrinsic hazard properties and data availability for each product component. As such, products with a lower CSI score within a product use group are considered to have a lower intrinsic hazard compared to other products within the same use group. The CSI provides a powerful tool to evaluate relative product hazards; to review and assess product portfolios; and to aid in the formulation of products.

  13. D-index: A New Scoring System in Febrile Neutropenic Patients for Predicting Invasive Fungal Infections

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    Gülden Yılmaz

    2016-05-01

    Full Text Available Objective: Neutropenia is a critical risk factor for invasive fungal infections (IFIs. We retrospectively performed this study to assess the performance of the D-index, a new test that combines both the duration and the severity of neutropenia, in predicting IFIs among patients with acute myelogenous leukemia. Materials and Methods: Fifteen patients with IFIs and 28 patients who did not develop IFIs were enrolled in the study. The D-index was defined as the area over the neutrophil curve, whereas the cumulativeD-index (c-D-index was the area over the neutrophil curve from the start of neutropenia until the first clinical manifestation of IFI. Results: The D-index and the c-D-index tended to be significantly higher in patients with IFIs, with medians of 10,150 (range: 4000- 22,000 and 5300 (range: 2300-22,200, respectively (p=0.037 and p=0.003, respectively. The receiver operating characteristic analyses showed that there was a cutoff point of 3875 for the D-index in predicting IFI; the sensitivity, specificity, and positive and negative predictive values were 100%, 67.9%, 35.4%, and 100%, respectively. There was also a cutoff point of 4225 for the c-D-index in predicting IFI; the sensitivity, specificity, and positive and negative predictive values for the c-D-index were 93.3%, 71.4%, 36.6%, and 98.4%. Conclusion: The D-index and especially the c-D-index could be useful tools with high negative predictive value to exclude as well as to predict IFIs in the management of neutropenic patients.

  14. Comparison of diagnostic utilities of ankle–brachial index and Carotid intima-media thickness as surrogate markers of significant coronary atherosclerosis in Indians

    Directory of Open Access Journals (Sweden)

    Babu Ezhumalai

    2013-03-01

    Conclusion: ABI and CIMT are simple noninvasive tools providing insight into coronary atherosclerosis. They can be done at bedside and easily repeated than coronary angiography. ABI  0.63 mm in South Indians with CAD.

  15. Continuous metabolic syndrome risk score, body mass index percentile, and leisure time physical activity in American children.

    Science.gov (United States)

    Okosun, Ike S; Boltri, John M; Lyn, Rodney; Davis-Smith, Monique

    2010-08-01

    The objective of this study was to determine independent and joint association of body mass index (BMI) percentile and leisure time physical activity (LTPA) with continuous metabolic syndrome (cMetS) risk score in 12- to 17-year-old American children. The 2003 to 2004 US National Health and Nutrition Examination Survey data were used for this investigation. LTPA was determined by self-report. cMetS risk score was calculated using standardized residuals of arterial blood pressure, triglycerides, glucose, waist circumference, and high-density lipoprotein cholesterol. Multiple linear regression analysis was used to evaluate association of BMI percentile and LTPA with cMetS risk score, adjusting for confounders. Increased BMI percentile and LTPA were each associated with increased and decreased cMetS risk score, respectively ((Pmetabolic syndrome in US children. (c) 2010 Wiley Periodicals, Inc.

  16. Systemic lupus international collaborating clinics renal activity/response exercise: development of a renal activity score and renal response index.

    Science.gov (United States)

    Petri, Michelle; Kasitanon, Nuntana; Lee, Shin-Seok; Link, Kimberly; Magder, Laurence; Bae, Sang-Cheol; Hanly, John G; Isenberg, David A; Nived, Ola; Sturfelt, Gunnar; van Vollenhoven, Ronald; Wallace, Daniel J; Alarcón, Graciela S; Adu, Dwomoa; Avila-Casado, Carmen; Bernatsky, Sasha R; Bruce, Ian N; Clarke, Ann E; Contreras, Gabriel; Fine, Derek M; Gladman, Dafna D; Gordon, Caroline; Kalunian, Kenneth C; Madaio, Michael P; Rovin, Brad H; Sanchez-Guerrero, Jorge; Steinsson, Kristjan; Aranow, Cynthia; Balow, James E; Buyon, Jill P; Ginzler, Ellen M; Khamashta, Munther A; Urowitz, Murray B; Dooley, Mary Anne; Merrill, Joan T; Ramsey-Goldman, Rosalind; Font, Josef; Tumlin, James; Stoll, Thomas; Zoma, Asad

    2008-06-01

    To develop a measure of renal activity in systemic lupus erythematosus and use it to develop a renal response index. Abstracted data from the medical records of 215 patients with lupus nephritis were sent to 8 nephrologists and 29 rheumatologists for rating. Seven nephrologists and 22 rheumatologists completed the ratings. Each physician rated each patient visit with respect to renal disease activity (none, mild, moderate, or severe). Using the most commonly selected rating for each patient as the gold standard, stepwise regression modeling was performed to identify the variables most related to renal disease activity, and these variables were then used to create an activity score. This activity score could then be applied to 2 consecutive visits to define a renal response index. The renal activity score was computed as follows: proteinuria 0.5-1 gm/day (3 points), proteinuria 0.5-1 gm/day = 3 points, proteinuria >1-3 gm/day = 5 points, proteinuria >3 gm/day = 11 points, [corrected] urine red blood cell count > = 5/hpf = 3 points, [corrected] urine white blood cell count > or = 5/hpf = 1 point. [corrected] The chance-adjusted agreement between the renal response index derived from the activity score applied to the paired visits and the plurality physician response rating was 0.69 (95% confidence interval 0.59-0.79). Ratings derived from this index for rating of renal response showed reasonable agreement with physician ratings in a pilot study. The index will require further refinement, testing, and validation. A data-driven approach to create renal activity and renal response indices will be useful in both clinical care and research settings.

  17. Associations of Neighborhood Crime and Safety and With Changes in Body Mass Index and Waist Circumference: The Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Powell-Wiley, Tiffany M; Moore, Kari; Allen, Norrina; Block, Richard; Evenson, Kelly R; Mujahid, Mahasin; Diez Roux, Ana V

    2017-08-01

    Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we evaluated associations of neighborhood crime and safety with changes in adiposity (body mass index (BMI) and waist circumference). MESA is a longitudinal study of cardiovascular disease among adults aged 45-84 years at baseline in 2000-2002, from 6 US sites, with follow-up for MESA participants until 2012. Data for this study were limited to Chicago, Illinois, participants in the MESA Neighborhood Ancillary Study, for whom police-recorded crime data were available, and who had complete baseline data (n = 673). We estimated associations of individual-level safety, aggregated neighborhood-level safety, and police-recorded crime with baseline levels and trajectories of BMI and waist circumference over time using linear mixed modeling with random effects. We also estimated how changes in these factors related to changes in BMI and waist circumference using econometric fixed-effects models. At baseline, greater individual-level safety was associated with more adiposity. Increasing individual- and neighborhood-level safety over time were associated with decreasing BMI over the 10-year period, with a more pronounced effect observed in women for individual-level safety and men for neighborhood-level safety. Police-recorded crime was not associated with adiposity. Neighborhood-level safety likely influences adiposity change and subsequent cardiovascular risk in multiethnic populations. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  18. The reliability of the ankle-brachial index in the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS

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    Catellier Diane J

    2006-02-01

    Full Text Available Abstract Background A low ankle-brachial index (ABI is associated with increased risk of coronary heart disease, stroke, and death. Regression model parameter estimates may be biased due to measurement error when the ABI is included as a predictor in regression models, but may be corrected if the reliability coefficient, R, is known. The R for the ABI computed from DINAMAP™ readings of the ankle and brachial SBP is not known. Methods A total of 119 participants in both the Atherosclerosis Risk in Communities (ARIC study and the NHLBI Family Heart Study (FHS had repeat ABIs taken within 1 year, using a common protocol, automated oscillometric blood pressure measurement devices, and technician pool. Results The estimated reliability coefficient for the ankle systolic blood pressure (SBP was 0.68 (95% CI: 0.57, 0.77 and for the brachial SBP was 0.74 (95% CI: 0.62, 0.83. The reliability for the ABI based on single ankle and arm SBPs was 0.61 (95% CI: 0.50, 0.70 and the reliability of the ABI computed as the ratio of the average of two ankle SBPs to two arm SBPs was estimated from simulated data as 0.70. Conclusion These reliability estimates may be used to obtain unbiased parameter estimates if the ABI is included in regression models. Our results suggest the need for repeated measures of the ABI in clinical practice, preferably within visits and also over time, before diagnosing peripheral artery disease and before making therapeutic decisions.

  19. Associations of work hours with carotid intima-media thickness and ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA).

    Science.gov (United States)

    Charles, Luenda E; Fekedulegn, Desta; Burchfiel, Cecil M; Fujishiro, Kaori; Landsbergis, Paul; Diez Roux, Ana V; Macdonald, Leslie; Foy, Capri G; Andrew, Michael E; Stukovsky, Karen H; Baron, Sherry

    2012-10-01

    Long working hours may be associated with cardiovascular disease (CVD). The objective was to investigate cross-sectional associations of work hours with carotid intima-media thickness (CIMT) and ankle-brachial index (ABI). Participants were 1694 women and 1868 men from the Multi-Ethnic Study of Atherosclerosis. CIMT and ABI were measured using standard protocols. Information on work hours was obtained from questionnaires. Mean values of CIMT and ABI were examined across five categories of hours worked per week (≤20, 21-39, 40, 41-50 and >50) using analysis of variance/analysis of covariance. p Values for trend were obtained from linear regression models. Mean age of participants was 56.9±8.4 years; 52.4% were men. Distinct patterns of association between work hours and the subclinical CVD biomarkers were found for women and men, although this heterogeneity by gender was not statistically significant. Among women only, work hours were positively associated with common (but not internal) CIMT (p=0.073) after full risk factor adjustment. Compared with women working 40 h, those working >50 h were more likely to have an ABI work hours and ABI were inversely associated (p=0.046). There was some evidence that the association between work hours and ABI was modified by occupational category (interaction p=0.061). Among persons classified as management/professionals, longer work hours was associated with lower ABI (p=0.015). No significant associations were observed among other occupational groups. Working longer hours may be associated with subclinical CVD. These associations should be investigated using longitudinal studies.

  20. MCAT Scores to Grade Point Ratio: An Index of College Grade Inflation.

    Science.gov (United States)

    Lacher, David A.; Wagner, Steven M.

    1987-01-01

    In an investigation of trends in grade inflation, the grade point averages and Medical College Admission Tests scores for medical school applicants in all undergraduate colleges with at least five such applicants were compared over four years. (MSE)

  1. Validity of index of learning styles scores: multitrait-multimethod comparison with three cognitive/learning style instruments.

    Science.gov (United States)

    Cook, David A; Smith, Alan J

    2006-09-01

    Cognitive and learning styles research is limited by the lack of evidence supporting valid interpretations of style assessment scores. We sought evidence to support the validity of scores from 4 instruments: the Index of Learning Styles (ILS); the Learning Style Inventory (LSI); the Cognitive Styles Analysis (CSA), and the Learning Style Type Indicator (LSTI). The ILS assesses 4 domains: sensing-intuitive (SensInt), active-reflective (ActRefl), sequential-global (SeqGlob) and visual-verbal (VisVerb), each of which parallel a similar domain in at least 1 of the other instruments. We administered the ILS, LSI and CSA to family medicine and internal medicine residents and Year 1 and 3 medical students and applied the multitrait-multimethod matrix to evaluate convergence and discrimination. After 3 months participants repeated the ILS and completed the LSTI. A total of 89 residents and medical students participated. Multitrait-multimethod analysis showed evidence of both convergence and discrimination for ActRefl (ILS, LSI and LSTI) and SensInt (ILS and LSTI) scores. ILS SeqGlob and SensInt scores showed unanticipated correlation. No other domains met the criteria for convergence or discrimination. Test-retest reliabilities for ILS scores were 0.856 for SensInt, 0.809 for ActRefl, 0.703 for SeqGlob and 0.684 for VisVerb. Cronbach's alpha values were > or = 0.810 for LSI and 0.237-0.758 for LSTI. At least 9 participants misinterpreted the LSI instructions. These data support the validity of ILS active-reflective and sensing-intuitive scores, LSI active-reflective scores and LSTI sensing-intuitive scores for determining learning styles in this population. Cognitive style and learning style scores may not be interchangeable, even for constructs with similar definitions.

  2. Minimal clinically important differences in Rowe and Western Ontario Shoulder Instability Index scores after arthroscopic repair of anterior shoulder instability.

    Science.gov (United States)

    Park, In; Lee, Jae-Hoo; Hyun, Hwan-Sub; Lee, Tae-Kyoung; Shin, Sang-Jin

    2017-12-15

    The minimal clinically important difference (MCID) is the threshold value for a change that would be considered meaningful by the patient. The purpose of this study was to determine the MCIDs for the Rowe score and the Western Ontario Shoulder Instability Index (WOSI) score after arthroscopic repair of anterior shoulder instability. The study enrolled 198 patients who underwent an arthroscopic stabilization procedure for anterior shoulder instability. Patients were assigned to no change and minimal change groups by a 15-item questionnaire at the 1-year postoperative visit. The Rowe and WOSI scores were assessed preoperatively and at a 1-year postoperative follow-up. The MCID was calculated using an anchor-based method and a distribution-based method. There were 9 patients in the no change group and 26 patients in the minimal change group. The MCID for the Rowe score was 9.7 according to the anchor-based method. By the anchor-based method, the authors could not calculate MCID for the WOSI score because of insignificant difference of the mean score changes between the no change and minimal change groups. By the distribution-based method, MCIDs for the Rowe and the WOSI scores were 5.6 and 151.9 with the standard deviation-based estimate and 2.2 and 60.7 with the effect size-based estimate, respectively. To assess the effectiveness of an arthroscopic stabilization procedure for anterior shoulder instability using the Rowe score, a difference of at least 9.7 in the score is clinically relevant. To compare clinical outcomes between different modalities, we should consider not only statistically significant differences but also the MCID. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Saturated Fat Intake Modulates the Association between an Obesity Genetic Risk Score and Body Mass Index in Two US Populations

    OpenAIRE

    P. Casas-Agustench; Arnett, Dk; Smith, CE; Lai, CQ; Parnell, LD; Borecki, IB; Frazier-Wood, AC; Allison, M; Chen, YDI; Taylor, Kd; Rich, SS; Rotter, JI; Lee, YC; Ordovás, JM

    2014-01-01

    © 2014 Academy of Nutrition and Dietetics. Combining multiple genetic variants related to obesity into a genetic risk score (GRS) might improve identification of individuals at risk of developing obesity. Moreover, characterizing gene-diet interactions is a research challenge to establish dietary recommendations to individuals with higher predisposition to obesity. Our objective was to analyze the association between an obesity GRS and body mass index (BMI) in the Genetics of Lipid Lowering D...

  4. Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume.

    Science.gov (United States)

    de Lima Oliveira, Marcelo; Picarelli, Helder; Menezes, Marcos Roberto; Amorim, Robson Luis; Teixeira, Manoel Jacobsen; Bor-Seng-Shu, Edson

    2017-07-01

    The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades. Patients with a CM diagnosis were included in this study. Surgical treatment was either supported or not by IOUS. Pre- and postoperative KPS scores were determined by the oncology team, and cerebral tumor volume was estimated through pre- and postoperative magnetic resonance imaging. The surgical team determined whether it was possible to perform a total CM resection. There were 78 patients treated using surgical management (35 with and 43 without IOUS). In the IOUS group, the postoperative KPS scores were higher (80 vs. 70, respectively; P = 0.045) and the KPS evolution was superior (P = 0.036), especially in the following subgroups: difficulty of tumor resection ranking score tumor in an eloquent area (P = 0.043), tumor not associated with vessels or nerves (P = 0.007), and solitary lesions (P = 0.038). The residual tumor volume was lower in the IOUS group (9.5% and 1.6 mm(3) vs. 30.8% and 9 mm(3), respectively; P = 0.05). In patients with a KPS score ≥70, 62% of them had tumors (76% in the IOUS group and 45% in the non-IOUS group; P = 0.032; odds ratio, 3.8). IOUS may improve postoperative KPS scores and decrease residual tumor volumes in CM surgeries. These findings should be confirmed in future studies. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Instrument-Defined Estimates of the Minimally Important Difference for EQ-5D-5L Index Scores.

    Science.gov (United States)

    McClure, Nathan S; Sayah, Fatima Al; Xie, Feng; Luo, Nan; Johnson, Jeffrey A

    2017-04-01

    The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) is a preference-based measure of health-related quality of life (HRQOL), which yields an index score anchored at 0 (dead) and 1 (full health). We lack evidence on estimates for the minimally important difference (MID) of the EQ-5D-5L that will help in interpreting differences or changes in HRQOL measured by this scale score. To estimate the MID of the EQ-5D-5L index score for available scoring algorithms including algorithms from Canada, China, Spain, Japan, England, and Uruguay. A simulation-based approach based on instrument-defined single-level transitions was used to estimate the MID values of the EQ-5D-5L for each country-specific scoring algorithm. The simulation-based instrument-defined MID estimates (mean ± SD) for each country-specific scoring algorithm were as follows: Canada, 0.056 ± 0.011; China, 0.069 ± 0.007; Spain, 0.061 ± 0.008; Japan, 0.048 ± 0.004; England, 0.063 ± 0.013; and Uruguay, 0.063 ± 0.019. Differences in MID estimates reflect differences in population preferences, in valuation techniques used, as well as in modeling strategies. After excluding the maximum-valued scoring parameters, the MID estimates (mean ± SD) were as follows: Canada, 0.037 ± 0.001; China, 0.058 ± 0.005; Spain, 0.045 ± 0.009; Japan, 0.044 ± 0.004; England, 0.037 ± 0.008; and Uruguay, 0.040 ± 0.010. Simulation-based estimates of the MID of the EQ-5D-5L index score were generally between 0.037 and 0.069, which are similar to the MID estimates of other preference-based HRQOL measures. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. The Capillary Index Score as a Marker of Viable Cerebral Tissue: Proof of Concept-The Capillary Index Score in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Trial.

    Science.gov (United States)

    Al-Ali, Firas; Berkhemer, Olvert A; Yousman, Wina P; Elias, John J; Bender, Evin N; Lingsma, Hester F; van der Lugt, Aad; Dippel, Diederik W J; Roos, Yvo B W E M; van Oostenbrugge, Robert J; van Zwam, Wim H; Dillon, William P; Majoie, Charles B L M

    2016-09-01

    The capillary index score (CIS) is based on the hypothesis that areas lacking capillary blush on pretreatment cerebral digital subtraction angiograms correspond to nonviable cerebral tissue. Pretreatment digital subtraction angiograms and post-treatment noncontrast enhanced computed tomographic scans from the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) trial were evaluated for areas lacking capillary blush and with tissue hypodensity, respectively. Because the superior and middle zones of the CIS correspond to the 7 cerebral cortex regions of the Alberta Stroke Program Early CT (ASPECT) score, capillary blush was scored in these 2 zones (0-2), called sub-CIS, and compared with the ASPECT score in these 7 regions (0-7), called hypodensity score. The presence and extent of hypodensity were compared between sub-CIS zones with contingency tables and nonparametric comparisons between groups, respectively. On the basis of a sample size of 50 subjects, 100% with sub-CIS URL: http://www.trialregister.nl. Unique identifier: NTR number 1804. URL: http://www.isrctn.com. Unique identifier: ISRCTN10888758. © 2016 American Heart Association, Inc.

  7. Applying a Score Confidence Interval to Aiken's Item Content-Relevance Index

    Science.gov (United States)

    Penfield, Randall D.; Giacobbi, Peter R., Jr

    2004-01-01

    Item content-relevance is an important consideration for researchers when developing scales used to measure psychological constructs. Aiken (1980) proposed a statistic, "V," that can be used to summarize item content-relevance ratings obtained from a panel of expert judges. This article proposes the application of the Score confidence interval to…

  8. Putting the pyramid into action: the Healthy Eating Index and Food Quality Score.

    Science.gov (United States)

    Kennedy, Eileen

    2008-01-01

    Consumption patterns are changing globally. As a result both researchers and policy makers require simple, easy to use measures of diet quality. The Healthy Eating Index (HEI) was developed as a single, summary measure of diet quality. The original HEI was a ten component index based on the US Dietary Guidelines and the Food Guide Pyramid. Research on the HEI indicates that the index correlates significantly with the RDA's for a range of nutrients and with an individual's self-rating of their diet. The revised HEI provides a more disaggregated version of the original index based on the 2005 Dietary Guidelines for Americans. Within each of the five major food groups, some foods are more nutrient dense than others. Nutrient Density algorithms have been developed to rate foods within food groups. The selection of the most nutrient dense foods within food groups lead to a dietary pattern with a higher HEI. The implications of using the HEI and nutrient density to develop interventions are discussed in this presentation.

  9. Red Cell Indexes Made Easy Using an Interactive Animation: Do Students and Their Scores Concur?

    Science.gov (United States)

    Kachroo, Upasana; Vinod, Elizabeth; Balasubramanian, Sivakumar; W., Jesi; Prince, Neetu

    2018-01-01

    A good understanding of red cell indexes can aid medical students in a considerable manner, serving as a basis to unravel both concepts in red cell physiology and abnormalities associated with the same. In this study, we tried to assess whether an interactive animation was helpful in improving student comprehension and understanding of red cell…

  10. Development of a body condition scoring index for female African elephants validated by ultrasound measurements of subcutaneous fat.

    Directory of Open Access Journals (Sweden)

    Kari A Morfeld

    Full Text Available Obesity-related health and reproductive problems may be contributing to non-sustainability of zoo African elephant (Loxodonta africana populations. However, a major constraint in screening for obesity in elephants is lack of a practical method to accurately assess body fat. Body condition scoring (BCS is the assessment of subcutaneous fat stores based on visual evaluation and provides an immediate appraisal of the degree of obesity of an individual. The objective of this study was to develop a visual BCS index for female African elephants and validate it using ultrasound measures of subcutaneous fat. To develop the index, standardized photographs were collected from zoo (n = 50 and free-ranging (n = 57 female African elephants for identifying key body regions and skeletal features, which were then used to visually determine body fat deposition patterns. This information was used to develop a visual BCS method consisting of a list of body regions and the physical criteria for assigning an overall score on a 5-point scale, with 1 representing the lowest and 5 representing the highest levels of body fat. Results showed that as BCS increased, ultrasound measures of subcutaneous fat thickness also increased (P<0.01, indicating the scores closely coincide with physical measures of fat reserves. The BCS index proved to be reliable and repeatable based on high intra- and inter-assessor agreement across three assessors. In comparing photographs of wild vs. captive African elephants, the median BCS in the free-ranging individuals (BCS = 3, range 1-5 was lower (P<0.001 than that of the zoo population (BCS = 4, range 2-5. In sum, we have developed the first validated BCS index for African elephants. This tool can be used to examine which factors impact body condition in zoo and free-ranging elephants, providing valuable information on how it affects health and reproductive potential of individual elephants.

  11. Predicting SF-6D utility scores from the Neck Disability Index and Numeric Rating Scales for Neck and Arm Pain

    Science.gov (United States)

    Carreon, Leah Y.; Anderson, Paul A.; McDonough, Christine M.; Djurasovic, Mladen; Glassman, Steven D.

    2010-01-01

    Study Design Cross-sectional cohort Objective This study aims to provide an algorithm estimate SF-6D utilities using data from the NDI, neck pain and arm pain scores. Summary of Background Data Although cost-utility analysis is increasingly used to provide information about the relative value of alternative interventions, health state values or utilities are rarely available from clinical trial data. The Neck Disability Index (NDI) and numeric rating scales for neck and arm pain, are widely used disease-specific measures of symptoms, function and disability in patients with cervical degenerative disorders. The purpose of this study is to provide an algorithm to allow estimation of SF-6D utilities using data from the NDI, and numeric rating scales for neck and arm pain. Methods SF-36, NDI, neck and arm pain rating scale scores were prospectively collected pre-operatively, at 12 and 24 months post-operatively in 2080 patients undergoing cervical fusion for degenerative disorders. SF-6D utilities were computed and Spearman correlation coefficients were calculated for paired observations from multiple time points between NDI, neck and arm pain scores and SF-6D utility scores. SF-6D scores were estimated from the NDI, neck and arm pain scores using a linear regression model. Using a separate, independent dataset of 396 patients in which and NDI scores were available SF-6D was estimated for each subject and compared to their actual SF-6D. Results The mean age for those in the development sample, was 50.4 ± 11.0 years and 33% were male. In the validation sample the mean age was 53.1 ± 9.9 years and 35% were male. Correlations between the SF-6D and the NDI, neck and arm pain scores were statistically significant (p<0.0001) with correlation coefficients of 0.82, 0.62, and 0.50 respectively. The regression equation using NDI alone to predict SF-6D had an R2 of 0.66 and a root mean square error (RMSE) of 0.056. In the validation analysis, there was no statistically

  12. Liver transplant length of stay (LOS) index: A novel predictive score for hospital length of stay following liver transplantation.

    Science.gov (United States)

    Rana, Abbas; Witte, Ellen D; Halazun, Karim J; Sood, Gagan K; Mindikoglu, Ayse L; Sussman, Norman L; Vierling, John M; Kueht, Michael L; Galvan, Nhu Thao N; Cotton, Ronald T; O'Mahony, Christine A; Goss, John A

    2017-12-01

    An index to predict hospital length of stay after liver transplantation could address unmet clinical needs. Length of stay is an important surrogate for hospital costs and efforts to limit stays can preserve our healthcare resources. Here, we devised a scoring system that predicts hospital length of stay following liver transplantation. We used univariate and multivariate analyses on 73 635 adult liver transplant recipient data and identified independent recipient and donor risk factors for prolonged hospital stay (>30 days). Multiple imputation was used to account for missing variables. We identified 22 factors as significant predictors of prolonged hospital stay, including the most significant risk factors: intensive care unit (ICU) admission (OR 1.75, CI 1.58-1.95) and previous transplant (OR 1.60, CI 1.47-1.75). The length of stay (LOS) index assigns weighted risk points to each significant factor in a scoring system to predict prolonged hospital stay after liver transplantation with a c-statistic of 0.75. The LOS index demonstrated good discrimination across the entire population, dividing the cohort into tertiles, which had odds ratios of 2.25 (CI 2.06-2.46) and 7.90 (7.29-8.56) for prolonged hospital stay (>30 days). The LOS index utilizes 22 significant donor and recipient factors to accurately predict hospital length of stay following liver transplantation. The index further demonstrates the basis for a clear clinical recommendation to mitigate risk of long hospitalization by minimizing cold ischemia time. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Performance of the Hack's Impairment Index Score: A Novel Tool to Assess Impairment from Alcohol in Emergency Department Patients.

    Science.gov (United States)

    Hack, Jason B; Goldlust, Eric J; Ferrante, Dennis; Zink, Brian J

    2017-10-01

    Over 35 million alcohol-impaired (AI) patients are cared for in emergency departments (EDs) annually. Emergency physicians are charged with ensuring AI patients' safety by identifying resolution of alcohol-induced impairment. The most common standard evaluation is an extemporized clinical examination, as ethanol levels are not reliable or predictive of clinical symptoms. There is no standard assessment of ED AI patients. The objective was to evaluate a novel standardized ED assessment of alcohol impairment, Hack's Impairment Index (HII score), in a busy urban ED. A retrospective chart review was performed for all AI patients seen in our busy urban ED over 24 months. Trained nurses evaluated AI patients with both "usual" and HII score every 2 hours. Patients were stratified by frequency of visits for AI during this time: high (≥ 6), medium (2-5), and low (1). Within each category, comparisons were made between HII scores, measured ethanol levels, and usual nursing assessment of AI. Changes in HII scores over time were also evaluated. A total of 8,074 visits from 3,219 unique patients were eligible for study, including 7,973 (98.7%) with ethanol levels, 5,061 (62.7%) with complete HII scores, and 3,646 (45.2%) with health care provider assessments. Correlations between HII scores and ethanol levels were poor (Pearson's R2  = 0.09, 0.09, and 0.17 for high-, medium-, and low-frequency strata). HII scores were excellent at discriminating nursing assessment of AI, while ethanol levels were less effective. Omitting extrema, HII scores fell consistently an average 0.062 points per hour, throughout patients' visits. The HII score applied a quantitative, objective assessment of alcohol impairment. HII scores were superior to ethanol levels as an objective clinical measure of impairment. The HII declines in a reasonably predictable manner over time, with serial evaluations corresponding well with health care provider evaluations. © 2017 by the Society for Academic

  14. Validation of a Blood Stability Score as an easy-to-use blood sample quality index.

    Science.gov (United States)

    Robinson, N; Kirchbichler, A; Banuls, O; Mader, M; Aikin, R; Sottas, P-E; D'Onofrio, G

    2016-12-01

    The athlete biological passport (ABP) was implemented based on conservative requirements on sample storage and transport to ensure blood integrity. Blood remains stable over periods longer than the currently employed time limits. We investigated whether time and temperature requirements for sample storage can be used in a flexible model rather than based on fixed limits. A literature review was performed analyzing the stability blood variables. A Blood Stability Score (BSS) was derived to integrate the direct dependence of the degradation rate on temperature. A validation study was then carried out in real testing conditions with antidoping blood samples. Upon sample reception, a full blood count was obtained, and then again after refrigeration for an extended period. A BSS formula integrating storage temperature (T) and collection to analysis time (CAT) was developed: BSS = CAT + 3 × T. In real testing conditions, negligible differences were observed for some variable as BSS values approached a score of 95, while no difference was observed in HGB and RET%. This study confirms that samples can be transported for longer periods and that the adaptive time and temperature approach as formalized in a rule that the BSS should not exceed 85 guarantees the stability of RBC variables used in the ABP. © 2016 John Wiley & Sons Ltd.

  15. An assessment of the agreement between the New Zealand Veterinary Association Hip Dysplasia Scoring System and the PennHIP Distraction Index in German Shepherd dogs.

    Science.gov (United States)

    Worth, A J; Laven, R A; Erceg, V H

    2009-12-01

    To determine the level of agreement between the New Zealand Veterinary Association (NZVA) Hip Dysplasia Scoring System and the University of Pennsylvania Hip Improvement Program (PennHIP) Distraction Index in German Shepherd dogs, and whether using the NZVA subtotal score or its components affected the level of agreement. A prospective study was performed using 47 German Shepherd police dogs undergoing breeding evaluation. All dogs were scored using the NZVA system and the PennHIP index. The relationships between the individual hip-distraction index scores and the scores from the NZVA system, i.e. the total score, the subtotal score, and the scores for the categories making up the subtotal score, were analysed using correlation, followed by univariate ANOVA for the subtotal categories alone. The scores from the NZVA system and the distraction index were then dichotomised into either low or high risk of canine hip dysplasia (CHD). A sign test was then used to determine whether three NZVA thresholds identified the same proportion of 'at-risk' dogs as the distraction-index threshold. Where this was the case, the Kappa value was calculated to identify the degree of agreement between the NZVA measures and the distraction index. The left-hip distraction index was significantly correlated to both left-subtotal and left-total NZVA score, however for right-hip scores there was no such correlation. The individual categories of the subtotal NZVA score were not significantly associated with the distraction index except for the subluxation score of the left hip. The proportion of dogs identified as being 'at risk' for CHD identified using a distraction-index threshold of 0.3 was similar to that identified by an NZVA total or subtotal score of >2 (44/47 cf. 45/47, respectively). However, none of the dogs identified as low risk using the distraction index was identified as low risk by either of the NZVA scores. This poor agreement (Kappa value 1 in any of the categories used to

  16. Relationship between functional movement screen scores, core strength, posture, and body mass index in school children in Moldova.

    Science.gov (United States)

    Mitchell, Ulrike H; Johnson, A Wayne; Adamson, Brynn

    2015-05-01

    The assessment of functionality should include parameters that consider postural control, limb asymmetries, range of motion limitations, proprioceptive deficits, and pain. An increasingly popular battery of tests, the Functional Movement Screen (FMS), is purported to assess the above named parameters. The purpose of our study was twofold: (a) to report differences in total FMS scores in children, provide preliminary normative reference values of each of the 7 individual FMS scores for both genders and report on asymmetries and (b) to evaluate the relationship between total FMS scores, age, body mass index (BMI), core strength/stability, and postural angles to explore the possibility of using the FMS in the assessment of children's functional fitness. Descriptive data on 77 children aged 8-11 years were collected. The children performed core strength/stability exercises. Photographs were taken from a lateral view for later calculation of postural angles. The children performed the FMS while being videotaped for later review. The average total FMS score (of 21) was 14.9 (+1.9), and BMI was 16.4 (+2.2). Static posture is not related to results of the FMS. Core strength was positively correlated to the total FMS score (r = 0.31; p = 0.006). Over 60% demonstrated at least 1 asymmetry. The individual test scores indicate that none of the test items is too difficult for the children. Based on the screen's correlation to core strength, and the fact that it identifies areas of asymmetry, we suggest to further investigate its possible use in the assessment of children's functional fitness.

  17. Relative Influence of Capillary Index Score, Revascularization and Time on Stroke Outcomes from the IMS III Trial

    Science.gov (United States)

    Al-Ali, Firas; Elias, John J.; Tomsick, Thomas A.; Liebeskind, David S; Broderick, Joseph P.

    2015-01-01

    Background and Purpose Until recently, acute ischemic stroke (AIS) trials have failed to show a benefit of endovascular therapy (EVT) compared to standard therapy, leading some authors to recommend decreasing the time from ictus to revascularization (TIR) to improve outcomes. We hypothesize that improving patient selection using the capillary index score (CIS) may also be a useful strategy. Methods CIS was calculated, blinded to outcome, from pre-treatment diagnostic cerebral angiograms for 78 subjects in the Interventional Management of Stroke (IMS) III database with internal carotid artery (ICA) and middle cerebral artery trunk (M1) occlusion. The CIS was dichotomized into favorable (fCIS = 2 or 3) and poor (pCIS = 0 or 1). Outcomes were categorized based on the modified Rankin Scale (mRS) score at 90-days (0 to 2 considered a good outcome). Modified thrombolysis in cerebral infarction (mTICI) score 2b or 3 was considered good revascularization. Multivariable logistic regression was performed to relate CIS, TIR, mTICI score, and NIH Stroke Scale score to good outcomes. Results Only CIS and mTICI score were correlated with good outcomes (p < 0.01). Patients with fCIS and good revascularization achieved 71% mRS ≤ 2, compared to 13% for patients with pCIS and good revascularization. Conclusions In this subset of patients from the IMS III Trial, CIS and mTICI were strong predictors of outcome after endovascular reperfusion. Using the CIS to improve patient selection could be a powerful strategy to improve rate of good outcomes in EVT. A randomized trial is needed. Clinical Trial Registration: www.clinicaltrials.gov. Unique identifier: NCT00359424 PMID:25953374

  18. Improved risk stratification by the integration of the revised international prognostic scoring system with the myelodysplastic syndromes comorbidity index.

    Science.gov (United States)

    van Spronsen, M F; Ossenkoppele, G J; Holman, R; van de Loosdrecht, A A

    2014-12-01

    Myelodysplastic syndromes (MDS) comprise bone marrow failure diseases with a diverse clinical outcome. For improved risk stratification, the International Prognostic Scoring System (IPSS) has recently been revised (IPSS-R). This single-centre study aimed to validate the IPSS-R and to evaluate prior prognostic scoring systems for MDS. We retrospectively analysed 363 patients diagnosed with MDS according to the FAB criteria between 2000 and 2012. The IPSS, MD Anderson Risk Model Score (MDAS), World Health Organisation (WHO)-classification based Prognostic Scoring System (WPSS), refined WPSS (WPSS-R), IPSS-R and MDS-Comorbidity Index (MDS-CI) were applied to 222 patients considered with primary MDS following the WHO criteria and their prognostic power was investigated. According to the IPSS-R, 18 (8%), 81 (37%), 50 (23%), 43 (19%) and 30 (13%) patients were classified as very low, low, intermediate, high and very high risk with, respectively, a median overall survival of 96 (95% Confidence interval (CI) not reached), 49 (95% CI 34-64), 22 (95% CI 0-49), 19 (95% CI 11-27) and 10 (95% CI 6-13) months (pMDS-CI refined the risk stratification of MDS patients stratified according to the IPSS-R. In conclusion, accounting for the disease status by means of the IPSS-R and comorbidity through the MDS-CI considerably improves the prognostic assessment in MDS patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Effects of electrical stimulation in early Bells palsy on facial disability index scores

    Directory of Open Access Journals (Sweden)

    P. Alakram

    2011-02-01

    Full Text Available Recovery following facial nerve palsy is variable. Physiotherapists try  to restore  function  in  patients  with  Bell’s  palsy.  The  choice  of treatment modality  depends  on  the  stage  of  the  condition.  Although limited  evidence  exists  for  the  use  of  electrical  stimulation  in  the acute  stage  of  Bell’s  palsy, some physiotherapists in South Africa have been applying this modality. This study examined the effects of electrical stimulation on functional recovery from  Bell’s palsy using the Facial Disability Index, a tool that documents recovery from the patients’ perspective. A two group pre-test post-test experimental design comprising of 16 patients with Bell’s Palsy of less than 30 days duration was utilized. Patients with a clinical diagnosis of Bell’s Palsy were systematically allocated to the control and experimental groups. Patients (n=16 were pre-tested and post-tested using the Facial Disability Index. Both groups were treated with heat, massage, exercises and given a home program. The experimental group also received electrical stimulation. The FDI of the control group improved between 17, 8% and 95, 4% with a mean of 52, 8%. The improvement in the experimental group ranged between 14, 8% and 126% with a mean of 49, 8%. Certain clinical residuals persisted in a mild form in both groups on discharge from the study.  The effects of electrical stimulation as used in this study during the acute phase of Bell’s palsy, quantified as the FDI was clinically but not statistically significant. A larger sample size, longer stimulation time or both should be investigated.

  20. Fast index based algorithms and software for matching position specific scoring matrices

    Directory of Open Access Journals (Sweden)

    Homann Robert

    2006-08-01

    Full Text Available Abstract Background In biological sequence analysis, position specific scoring matrices (PSSMs are widely used to represent sequence motifs in nucleotide as well as amino acid sequences. Searching with PSSMs in complete genomes or large sequence databases is a common, but computationally expensive task. Results We present a new non-heuristic algorithm, called ESAsearch, to efficiently find matches of PSSMs in large databases. Our approach preprocesses the search space, e.g., a complete genome or a set of protein sequences, and builds an enhanced suffix array that is stored on file. This allows the searching of a database with a PSSM in sublinear expected time. Since ESAsearch benefits from small alphabets, we present a variant operating on sequences recoded according to a reduced alphabet. We also address the problem of non-comparable PSSM-scores by developing a method which allows the efficient computation of a matrix similarity threshold for a PSSM, given an E-value or a p-value. Our method is based on dynamic programming and, in contrast to other methods, it employs lazy evaluation of the dynamic programming matrix. We evaluated algorithm ESAsearch with nucleotide PSSMs and with amino acid PSSMs. Compared to the best previous methods, ESAsearch shows speedups of a factor between 17 and 275 for nucleotide PSSMs, and speedups up to factor 1.8 for amino acid PSSMs. Comparisons with the most widely used programs even show speedups by a factor of at least 3.8. Alphabet reduction yields an additional speedup factor of 2 on amino acid sequences compared to results achieved with the 20 symbol standard alphabet. The lazy evaluation method is also much faster than previous methods, with speedups of a factor between 3 and 330. Conclusion Our analysis of ESAsearch reveals sublinear runtime in the expected case, and linear runtime in the worst case for sequences not shorter than |A MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92Aae

  1. The comparative validity and reproducibility of a diet quality index for adults: the Australian Recommended Food Score.

    Science.gov (United States)

    Collins, Clare E; Burrows, Tracy L; Rollo, Megan E; Boggess, May M; Watson, Jane F; Guest, Maya; Duncanson, Kerith; Pezdirc, Kristine; Hutchesson, Melinda J

    2015-01-23

    Adult diet quality indices are shown to predict nutritional adequacy of dietary intake as well as all-cause morbidity and mortality. This study describes the reproducibility and validity of a food-based diet quality index, the Australian Recommended Food Score (ARFS). ARFS was developed to reflect alignment with the Australian Dietary Guidelines and is modelled on the US Recommended Food Score. Dietary intakes of 96 adult participants (31 male, 65 female) age 30 to 75 years were assessed in two rounds, five months apart. Diet was assessed using a 120-question semi-quantitative food frequency questionnaire (FFQ). The ARFS diet quality index was derived using a subset of 70 items from the full FFQ. Reproducibility of the ARFS between round one and round two was confirmed by the overall intraclass correlation coefficient of 0.87 (95% CI 0.83, 0.90), which compared favourably to that for the FFQ at 0.85 (95% CI 0.80, 0.89). ARFS was correlated with FFQ nutrient intakes, particularly fiber, vitamin A, beta-carotene and vitamin C (0.53, 95% CI 0.37-0.67), and with mineral intakes, particularly calcium, magnesium and potassium (0.32, 95% CI 0.23-0.40). ARFS is a suitable brief tool to evaluate diet quality in adults and reliably estimates a range of nutrient intakes.

  2. Development of a body condition scoring index for female African elephants validated by ultrasound measurements of subcutaneous fat.

    Science.gov (United States)

    Morfeld, Kari A; Lehnhardt, John; Alligood, Christina; Bolling, Jeff; Brown, Janine L

    2014-01-01

    Obesity-related health and reproductive problems may be contributing to non-sustainability of zoo African elephant (Loxodonta africana) populations. However, a major constraint in screening for obesity in elephants is lack of a practical method to accurately assess body fat. Body condition scoring (BCS) is the assessment of subcutaneous fat stores based on visual evaluation and provides an immediate appraisal of the degree of obesity of an individual. The objective of this study was to develop a visual BCS index for female African elephants and validate it using ultrasound measures of subcutaneous fat. To develop the index, standardized photographs were collected from zoo (n = 50) and free-ranging (n = 57) female African elephants for identifying key body regions and skeletal features, which were then used to visually determine body fat deposition patterns. This information was used to develop a visual BCS method consisting of a list of body regions and the physical criteria for assigning an overall score on a 5-point scale, with 1 representing the lowest and 5 representing the highest levels of body fat. Results showed that as BCS increased, ultrasound measures of subcutaneous fat thickness also increased (Pelephants, the median BCS in the free-ranging individuals (BCS = 3, range 1-5) was lower (Pelephants. This tool can be used to examine which factors impact body condition in zoo and free-ranging elephants, providing valuable information on how it affects health and reproductive potential of individual elephants.

  3. Efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score to predict gestational trophoblastic tumor from hydatidiform mole

    Directory of Open Access Journals (Sweden)

    Khrismawan Khrismawan

    2004-03-01

    Full Text Available A prospective longitudinal analytic study assessing the efficacy of NETDC (New England Trophoblastic Disease Center prognostic index score in predicting malignancy after hydatidiform mole had been performed. Of the parameter evaluated; age of patients, type of hydatidiform mole, uterine enlargement, serum hCG level, lutein cyst, and presence of complicating factors were significant risk factors for malignancy after hydatidiform mole were evacuated (p<0.032. The study were done on 50 women diagnosed with hydatidiform mole with 1 year observation (January 2001-December 2002 at the Department of Obstetrics and Gynecology, Mohammad Hoesin Hospital, Palembang. The results showed that the NETDC prognostic index score predicted malignancy in 50% of high risk group and 10% in low risk group (p<0.05. This showed a higher number than that found by the WHO (19%-30%. The risk for incidence of  malignancy after hydatidiform mole in the high risk group is 9.0 times higher compared to that of the low risk group (CI: 1.769-45.786. (Med J Indones 2004; 13: 40-6 Keywords: New England Trophoblastic Disease Center (NETDC, gestational trophoblastic tumor, hydatidiform mole, high and low risk

  4. Sleep Characteristics and Carotid Atherosclerosis Among Midlife Women.

    Science.gov (United States)

    Thurston, Rebecca C; Chang, Yuefang; von Känel, Roland; Barinas-Mitchell, Emma; Jennings, J Richard; Hall, Martica H; Santoro, Nanette; Buysse, Daniel J; Matthews, Karen A

    2017-02-01

    Midlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women. Two hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol). Shorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ≥ 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [β, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ≥ 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol. Shorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol.

  5. Functional ability level development and validation: providing clinical meaning for Spinal Cord Injury Functional Index scores.

    Science.gov (United States)

    Sinha, Richa; Slavin, Mary D; Kisala, Pamela A; Ni, Pengsheng; Tulsky, David S; Jette, Alan M

    2015-08-01

    To develop functional ability levels for the Spinal Cord Injury Functional Index (SCI-FI) and to validate them using calibration and reliability samples. Three-phase strategy involved (1) performing quantitative synthesis of SCI-FI data to create item maps; (2) using a panel of experts to identify functional ability levels after the bookmarking and Delphi consensus-building process; and (3) performing quantitative analyses to examine demographic characteristics across 2 samples, assessing the distribution pattern across functional ability levels, and examining concurrent validity using the self-reported functional measure and the observer-rated FIM. Inpatient and community settings. People 18 years or older with traumatic spinal cord injury (N=1124) were recruited from the Spinal Cord Injury Model Systems programs and stratified by diagnosis, severity, and time since injury (n=855 and n=269 for calibration and reliability samples, respectively). Not applicable. SCI-FI. Five functional ability levels were identified for all SCI-FI domains, except fine motor having 4 functional ability levels. Statistical test results indicated no significant differences in the distribution pattern across the 2 samples across functional ability levels for all domains except for ambulation. Known-group comparisons were able to discern the spinal cord injury population as expected. Basic mobility, self-care, and wheelchair mobility domains had a cluster of persons with paraplegia and incomplete lesions at higher functional ability levels and persons with tetraplegia and complete lesions at lower functional ability levels. For the ambulation domain, the distribution was skewed to the lower end, with a relatively small percentage of persons with incomplete lesions (paraplegia and tetraplegia) at higher functional ability levels. For the fine motor domain, the distribution was skewed to higher functional ability levels, with a high percentage of persons with paraplegia at the highest

  6. Academic Self-Efficacy Partially Mediates the Relationship between Scottish Index of Multiple Deprivation and Composite Attainment Score.

    Science.gov (United States)

    Perry, John L; Dempster, Martin; McKay, Michael T

    2017-01-01

    A developing literature continues to testify to the relationship between higher socio-economic status (SES) and better academic attainment. However, the literature is complex in terms of the variety of SES and attainment indicators used. Against the backdrop of a Scottish Government initiative to close the attainment gap between higher and lower SES children, the present study examined the relationship between individual-level Scottish Index of Multiple Deprivation (SIMD) and National Lower Tariff Score in school children in the West of Scotland. Results showed a practically significant relationship between SIMD and Tariff Score. This relationship was partially mediated by higher academic self-efficacy, so that higher belief in academic competency partially mediated the SIMD-Tariff Score relationship. Further, this partial mediation was robust to the influence of gender, sensation seeking, level of school attendance and past month frequency of Heavy Episodic Drinking. It is suggested that increasing attendance and perceived academic competence are viable ways (among others) of attempting to close the attainment gap.

  7. The Responsiveness and Minimal Important Change of the Western Ontario Shoulder Instability Index and Oxford Shoulder Instability Score.

    Science.gov (United States)

    van der Linde, Just A; van Kampen, Derk A; van Beers, Loes W A H; van Deurzen, Derek F P; Saris, Daniël B F; Terwee, Caroline B

    2017-06-01

    Study Design Prospective cohort study. Background Patient-reported outcome measurements (PROMs) are widely used to evaluate functional limitations. Considering PROMs for shoulder instability, information is lacking with regard to what constitutes a relevant change from baseline scores. Objectives To evaluate the responsiveness of the Western Ontario Shoulder Instability Index (WOSI) and the Oxford Shoulder Instability Score (OSIS) and estimate their minimal important change (MIC). Methods One hundred five consecutive patients with shoulder instability completed 5 PROMs at baseline and at 6-month follow-up. The PROMs included the WOSI and OSIS, the Simple Shoulder Test, the Oxford Shoulder Score, and the Disabilities of the Arm, Shoulder and Hand assessment. Patients also rated their functional change on an anchor question at follow-up. Responsiveness was evaluated by testing 9 hypotheses regarding predefined correlations between the changes in PROM scores, by calculating the area under the receiver operating characteristic curve and by calculating the standardized response mean and effect size statistics. The MIC was determined by identifying the optimal cutoff on the receiver operating characteristic curve. Results Seven out of 9 hypotheses (78%) were confirmed; as expected, a high correlation (0.77) was found between change scores of the WOSI and OSIS, whereas the correlations of the change scores of the WOSI and OSIS with those of general shoulder PROMs were slightly lower (0.61-0.75). The area under the curve was 0.83 (95% confidence interval: 0.75, 0.91) for the OSIS and 0.82 (95% confidence interval: 0.74, 0.90) for the WOSI. The MIC was about 6 points for the OSIS and about 14 points for the WOSI. Conclusion Both the WOSI and OSIS are able to measure change in shoulder function in patients with shoulder instability. The estimated MIC is 6 points for the OSIS (on a scale from 0 to 48) and 14 points for the WOSI (on a scale from 0 to 100). J Orthop Sports Phys

  8. The limitations of transforming very high body mass indexes into z-scores among 8.7 million 2- to 4-year-old children

    Science.gov (United States)

    To examine the associations among several body mass index (BMI) metrics (z-scores, percent of the 95th percentile (%BMIp95) and BMI minus 95th percentile as calculated in the growth charts from the Centers for Disease Control and Prevention (CDC). It is known that the widely used BMI z-scores (BMIz)...

  9. ADHD Subtypes and Co-Occurring Anxiety, Depression, and Oppositional-Defiant Disorder: Differences in Gordon Diagnostic System and Wechsler Working Memory and Processing Speed Index Scores

    Science.gov (United States)

    Mayes, Susan Dickerson; Calhoun, Susan L.; Chase, Gary A.; Mink, Danielle M.; Stagg, Ryan E.

    2009-01-01

    Objective: Wechsler Intelligence Scale for Children Freedom-from-Distractibility/Working Memory Index (FDI/WMI), Processing Speed Index (PSI), and Gordon Diagnostic System (GDS) scores in ADHD children were examined as a function of subtype and coexisting anxiety, depression, and oppositional-defiant disorder. Method: Participants were 587…

  10. Correlation of body mass index Z-scores with glucose and lipid profiles among overweight and obese children and adolescents.

    Science.gov (United States)

    Nogueira-de-Almeida, Carlos Alberto; Mello, Elza Daniel de

    2017-09-04

    To evaluate the prevalence of abnormalities in plasma lipid and glucose profiles among overweight and obese children and adolescents, and to assess the presence of a correlation between body mass index Z-scores and indicators of comorbidities related to both profiles. This was a multicenter cross-sectional study conducted at two outpatient clinics. The study included all 417 comers for the first visit from 2008 to 2012, aged between 7 and 18 years, with BMI above the Z-score +1. Anthropometry and blood sampling were obtained. The prevalence of dyslipidemias, hyperglycemia, and insulin resistance were evaluated, together with the correlations of these variables with the increase of Z-BMI. Dyslipidemia was observed in 43.4% of the boys and 66.1% of the girls, with no difference between genders. High glucose levels were detected in 6.2% of the individuals. Insulin resistance was present in 32.3% and 41.7% of the cases, with no statistical significance between boys and girls. Correlations between the Z-BMI were noted for triglycerides in the entire group and among girls; for HDL-c, only among girls; for glucose, a correlation was observed for the entire group, but not when stratified by gender. The indicators of insulin resistance were all correlated with Z-BMI, even when corrected for age. Overweight and obesity give origin to a high prevalence of dyslipidemia and insulin resistance. BMI Z-scores showed a weak positive correlation with glucose and triglyceride, and negative with HDL-c. In turn, the strongest positive correlation was found with insulin resistance indicators. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  11. Atherosclerosis and Stroke

    Science.gov (United States)

    ... Inspirational Stories Stroke Heroes Among Us Atherosclerosis and Stroke Updated:Oct 24,2016 Excerpted and adapted from " ... it can cause difficulty walking and eventually gangrene. Stroke and atherosclerosis There are two types of ischemic ...

  12. The interface of inflammation and subclinical atherosclerosis in granulomatosis with polyangiitis (Wegener's): a preliminary study.

    Science.gov (United States)

    Hajj-Ali, Rula A; Major, Jennifer; Langford, Carol; Hoffman, Garry S; Clark, Tiffany; Zhang, Li; Sun, Zhiyuan; Silverstein, Roy L

    2015-10-01

    The objective of this study is to assess the relationship between inflammatory disease in granulomatosis with polyangiitis (GPA, Wegener's) and the development of subclinical atherosclerosis. A total of 46 adult patients with GPA were enrolled. Disease status was measured by Birmingham vasculitis assessment scores as modified for GPA, vasculitis damage index, disease duration, and number of relapses. Classic atherosclerotic risk factors, platelet aggregation responses, and circulating microparticle (MP) levels were recorded. All patients underwent carotid artery intima-media thickness (IMT) measurement as outcome for subclinical atherosclerosis. In univariate analyses, systolic and diastolic blood pressure, creatinine, and age were significantly associated with higher IMT (ρ values 0.37, 0.38, 0.35, and 0.054, respectively [P subclinical atherosclerosis. The correlation with subclinical atherosclerosis could be because of glucocorticoid use and not the inflammatory process in GPA, giving the inherent bias that exits with the use of glucocorticoid with each relapse. The findings of increased levels of circulating leukocyte-derived MPs and enhanced platelet reactivity during relapse suggest possible roles for MPs and platelets in disease pathogenesis and support a growing literature that links inflammation, atherosclerosis, and platelet activation. This hypothesis is further substantiated by our demonstration that MPs isolated from plasma of GPA patients can activate platelets and vascular endothelial cells. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Epicardial fat is associated with severity of subclinical coronary atherosclerosis in familial hypercholesterolemia.

    Science.gov (United States)

    Mangili, Leonardo C; Mangili, Otavio C; Bittencourt, Márcio S; Miname, Márcio H; Harada, Paulo H; Lima, Leonardo M; Rochitte, Carlos E; Santos, Raul D

    2016-11-01

    Familial hypercholesterolemia (FH) is a common genetic disorder characterized by elevated blood cholesterol, increased prevalence of subclinical atherosclerosis and high risk of premature coronary heart disease. However, this risk is not explained solely by elevated LDL-cholesterol concentrations, and other factors may influence atherosclerosis development. There is evidence that increased adiposity may predispose to atherosclerosis in FH. Epicardial fat has been associated with subclinical coronary atherosclerosis in the general population. This study evaluated the association of epicardial fat (EFV) volume with the presence and extent of subclinical coronary atherosclerosis detected by computed tomography angiography in FH patients. Ninety-seven FH subjects (35% male, mean age 45 ± 13 years, LDL-C 281 ± 56 mg/dL, 67% with proven molecular defects) underwent computed tomography angiography and coronary artery calcium (CAC) scoring. EFV was measured in non-contrast images using a semi-automated method. Segment-stenosis score (SSS) and segment-involvement score (SIS) were calculated. Multivariate Poisson regression was utilized to assess an independent association of EFV with coronary atherosclerotic burden. EFV was positively associated with age, body mass index, waist circumference, blood glucose, the presence of the metabolic syndrome components, but not with LDL-C. After adjusting for confounders and abdominal circumference, an independent association (shown as β coefficients and 95% confidence intervals) of EVF with CAC scores [β = 0.263 (0.234; 0.292), p=0.000], SIS [β = 0.304 (0.141; 0.465) p=0.000] and SSS [β = 0.296 (0.121; 0.471), p=0.001] was found. In FH, EFV was independently associated with coronary atherosclerotic presence and severity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Vaccination to Modulate Atherosclerosis

    Science.gov (United States)

    Kimura, Takayuki; Tse, Kevin; Sette, Alessandro; Ley, Klaus

    2015-01-01

    Atherosclerosis is a chronic inflammatory disease of the artery wall. Adaptive immunity plays a key role in the pathogenesis of atherosclerosis. Recently, modulation of the immune response against atherosclerotic plaque antigen(s) has attracted attention as a potentially preventive and therapeutic approach. Here we review a series of studies on immunization with various antigens targeting treatment and prevention of atherosclerosis. Atherosclerosis-related antigens include oxidized LDL, apolipoprotein B-100, and heat shock protein 60/65. Accumulating evidence supports the idea that immunization with these antigenic proteins or peptides may reduce atherosclerosis. In this review, we discuss the current status of immunization studies and possible associated mechanisms of atheroprotection. PMID:25683179

  15. The usefulness of the Mannheim Peritonitis Index score in assessing the condition of patients treated for peritonitis.

    Science.gov (United States)

    Budzyński, Piotr; Dworak, Jadwiga; Natkaniec, Michał; Pędziwiatr, Michał; Major, Piotr; Migaczewski, Marcin; Matłok, Maciej; Budzyński, Andrzej

    2015-06-01

    The aim of the study was to verify the Mannheim Peritonitis Index (MPI) suitability to determine the probability of death among patients in Polish population operated due to peritonitis and to assess the possibility of using the Index to determine the risk of postoperative complications, relaparotomy and need for postoperative hospitalization in intensive care unit. Retrospective analysis covered 168 patients (M: F = 83: 85, mean age = 48.45 years, SD ± 22.2) treated for peritonitis. The MPI score was calculated for each patient. According to MPI results, patients were divided to the appropriate groups ( 29) and within analyzed. The statistical analysis used Chi-square, Mann Withney U and Kolmogorov-Smirnov test. The best cut-off point for MPI was calculated on the basis of ROC analisys. Mortality in the study group was 13.1%. In groups 29 points according to MPI mortality was 1.75%, 28.13% and 50% respectively, the difference was statistically significant (p = 0.0124). Significant differences were observed in mortality depending on the diagnosis. Based on the ROC curve the cut-off point was identified as 32 with an accuracy of 85.9% and AUC = 81%. There has been a significant correlation between the MPI count and and the occurrence of: cardio-respiratory failure, acidosis, electrolyte imbalance, surgical wound complications, the need for treatment in the intensive care unit after surgery. The MPI is a simple and effective predictor of death among patients operated due to peritonitis. It can also provide assistance in assessing the risk of postoperative complications and the need for treatment in the intensive care unit.

  16. Do genetic risk scores for body mass index predict risk of phobic anxiety? Evidence for a shared genetic risk factor.

    Science.gov (United States)

    Walter, S; Glymour, M M; Koenen, K; Liang, L; Tchetgen Tchetgen, E J; Cornelis, M; Chang, S-C; Rewak, M; Rimm, E; Kawachi, I; Kubzansky, L D

    2015-01-01

    Obesity and anxiety are often linked but the direction of effects is not clear. Using genetic instrumental variable (IV) analyses in 5911 female participants from the Nurses' Health Study (NHS, initiated 1976) and 3697 male participants from the Health Professional Follow-up Study (HPFS, initiated 1986), we aimed to determine whether obesity increases symptoms of phobic anxiety. As instrumental variables we used the fat mass and obesity-associated (FTO) gene, the melanocortin 4 receptor (MC4R) gene and a genetic risk score (GRS) based on 32 single nucleotide polymorphisms (SNPs) that significantly predict body mass index (BMI). 'Functional' GRSs corresponding with specific biological pathways that shape BMI (adipogenesis, appetite and cardiopulmonary) were considered. The main outcome was phobic anxiety measured by the Crown Crisp Index (CCI) in 2004 in the NHS and in 2000 in the HPFS. In observational analysis, a 1-unit higher BMI was associated with higher phobic anxiety symptoms [women: β = 0.05, 95% confidence interval (CI) 0.030-0.068; men: β = 0.04, 95% CI 0.016-0.071). IV analyses showed that BMI was associated with higher phobic anxiety symptoms in the FTO-instrumented analysis (p = 0.005) but not in the GRS-instrumented analysis (p = 0.256). Functional GRSs showed heterogeneous, non-significant effects of BMI on phobic anxiety symptoms. Our findings do not provide conclusive evidence in favor of the hypothesis that higher BMI leads to higher levels of phobic anxiety, but rather suggest that genes that influence obesity, in particular FTO, may have direct effects on phobic anxiety, and hence that obesity and phobic anxiety may share common genetic determinants.

  17. The effects of acupoint-catgut embedment combined with medical treatment on the BODE index scores of chronic obstructive pulmonary disease (COPD) patients

    Science.gov (United States)

    Giri, P. B. S. W.; Srilestari, A.; Abdurrohim, K.; Yunus, F.

    2017-08-01

    Chronic Obstructive Pulmonary Disease (COPD) is now the fourth leading cause of death in the world. As COPD medications are associated with high mortality levels, continuous research into the improvement of treatment modalities is being conducted. This study aimed to identify the effects of acupoint-catgut embedment combined with medical treatment on the Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (BODE) index scores of COPD patients. A single-blind randomized controlled trial was conducted on 48 patients; participants were allocated into either the acupoint-catgut embedment with medication group (case group) or the sham acupuncture with medication group (control group). Acupoint-catgut embedment was conducted at the BL13 Feishu, BL43 Gaohuangshu, BL20 Pishu, BL23 Shenshu, and ST40 Fenglong points two times at an interval of 15 days. The BODE index, a primary outcome indicator, was assessed on Day 1 and Day 30. The results showed statistically and clinically significant differences between the two groups—in fact, BODE index scores were reduced by 1.83 points in the case group (p = 0.000). Ultimately, BODE index scores were lower in the intervention group than in the control group, thus indicating a statistically significant and clinically important improvement of COPD-related symptoms. According to these results, acupoint-catgut embedment combined with medical treatment is concluded to be more effective than medical treatment alone in reducing BODE index scores.

  18. Grading Crohn disease activity with MRI: interobserver variability of MRI features, MRI scoring of severity, and correlation with Crohn disease endoscopic index of severity.

    Science.gov (United States)

    Tielbeek, Jeroen A W; Makanyanga, Jesica C; Bipat, Shandra; Pendsé, Doug A; Nio, C Yung; Vos, Frans M; Taylor, Stuart A; Stoker, Jaap

    2013-12-01

    The purpose of this article is to assess the interobserver variability for scoring MRI features of Crohn disease activity and to correlate two MRI scoring systems to the Crohn disease endoscopic index of severity (CDEIS). Thirty-three consecutive patients with Crohn disease undergoing 3-T MRI examinations (T1-weighted with IV contrast medium administration and T2-weighted sequences) and ileocolonoscopy within 1 month were independently evaluated by four readers. Seventeen MRI features were recorded in 143 bowel segments and were used to calculate the MR index of activity and the Crohn disease MRI index (CDMI) score. Multirater analysis was performed for all features and scoring systems using intraclass correlation coefficient (icc) and kappa statistic. Scoring systems were compared with ileocolonoscopy with CDEIS using Spearman rank correlation. Thirty patients (median age, 32 years; 21 women and nine men) were included. MRI features showed fair-to-good interobserver variability (intraclass correlation coefficient or kappa varied from 0.30 to 0.69). Wall thickness in millimeters, presence of edema, enhancement pattern, and length of the disease in each segment showed a good interobserver variability between all readers (icc = 0.69, κ = 0.66, κ = 0.62, and κ = 0.62, respectively). The MR index of activity and CDMI scores showed good reproducibility (icc = 0.74 and icc = 0.78, respectively) and moderate CDEIS correlation (r = 0.51 and r = 0.59, respectively). The reproducibility of individual MRI features overall is fair to good, with good reproducibility for the most commonly used features. When combined into the MR index of activity and CDMI score, overall reproducibility is good. Both scores show moderate agreement with CDEIS.

  19. Migraine and subclinical atherosclerosis in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Goulart, Alessandra C; Santos, Itamar S; Bittencourt, Márcio S; Lotufo, Paulo A; Benseñor, Isabela M

    2016-08-01

    The relationship between migraine and coronary heart disease (CHD) remains controversial. We aimed to investigate the association of subclinical atherosclerosis and migraine with or without aura compared to a non-migraine subgroup (reference) in a large Brazilian multicentric cohort study, the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Migraine diagnostic was based on International Headache Society criteria, and aura symptoms were validated by a medical doctor in a sub-sample of the ELSA-Brasil, who also underwent coronary artery calcium score (CAC) and carotid intima-media thickness (C-IMT) evaluations. Subclinical atherosclerosis indexes (CAC and C-IMT) were analyzed as dependent variables and migraine (all, with aura, without aura) as an independent variable in the linear and multinomial logistic regression models adjusted for possible confounders. Of 3217 ELSA participants free from CVD at baseline, we found a migraine frequency of 11.9% (5.1% with aura and 6.8% without aura). Overall, migraineurs were mostly women, younger and had lower frequency of CV risk factors, such as hypertension, diabetes and low HDL-cholesterol, compared to non-migraineurs. The strongest inverse correlation between migraine and subclinical atherosclerosis was verified with CAC score. However, all associations lost their significance after multivariate adjustment. In this cross-sectional evaluation of the ELSA study, migraine was not associated with subclinical atherosclerosis, regardless of aura symptoms. © International Headache Society 2015.

  20. Genetic risk score does not correlate with body mass index of Latina women in a clinical trial.

    Science.gov (United States)

    Coenen, Kimberly R; Karp, Sharon M; Gesell, Sabina B; Dietrich, Mary S; Morgan, Thomas M; Barkin, Shari L

    2011-10-01

    Obesity disproportionately affects Latina women. Common genetic variants are convincingly associated with body mass index (BMI) and may be used to create genetic risk scores (GRS) for obesity that could define genetically influenced forms of obesity and alter response to clinical trial interventions. The objective of this study was (1) to identify the frequency and effect size of common obesity genetic variants in Latina women; (2) to determine the clinical utility of a GRS for obesity with Latina women participating in a community-based clinical trial. DNA from 85 Latina women was genotyped for eight genetic variants previously associated with BMI in Caucasians, but not yet assessed in Latina populations. The main outcome measure was the correlation of GRS (sum of eight risk alleles) with BMI, waist circumference, and percent body fat. A majority (83%) of participants had a BMI ≥25. Frequency of loci near FTO, MC4R, and GNPDA2 were lower in Latinas than Caucasians. Association of each locus with BMI was lower in Latinas compared to Caucasians with no significant correlations with BMI. We conclude that an eight locus GRS has no clinical utility for explaining obesity or predicting response to intervention in Latina women participating in a clinical trial. © 2011 Wiley Periodicals, Inc.

  1. Alternate Mediterranean diet score is positively associated with skeletal muscle mass index in middle-aged adults.

    Science.gov (United States)

    Tian, Hui-Yuan; Qiu, Rui; Jing, Li-Peng; Chen, Zhan-Yong; Chen, Geng-Dong; Chen, Yu-Ming

    2017-04-01

    Researches have suggested Mediterranean diet might lower the risk of chronic diseases, but data on skeletal muscle mass (SMM) are limited. This community-based cross-sectional study examined the association between the alternate Mediterranean diet score (aMDS) and SMM in 2230 females and 1059 males aged 40-75 years in Guangzhou, China. General information and habitual dietary information were assessed in face-to-face interviews conducted during 2008-2010 and 3 years later. The aMDS was calculated by summing the dichotomous points for the items of higher intakes of whole grain, vegetables, fruits, legumes, nuts, fish and ratio of MUFA:SFA, lower red meat and moderate ethanol consumption. The SMM of the whole body, limbs, arms and legs were measured using dual-energy X-ray absorptiometry during 2011-2013. After adjusting for potential covariates, higher aMDS was positively associated with skeletal muscle mass index (SMI, SMM/height2, kg/m2) at all of the studied sites in males (all P trend0·05). Age-stratified analyses showed that the favourable associations tended to be more pronounced in the younger subjects aged less than the medians of 59·2 and 62·2 years in females and males (P interaction>0·10). In conclusion, the aMDS shows protective associations with SMM in Chinese adults, particularly in male and younger subjects.

  2. Severe obesity is a limitation for the use of body mass index standard deviation scores in children and adolescents.

    Science.gov (United States)

    Júlíusson, Pétur B; Roelants, Mathieu; Benestad, Beate; Lekhal, Samira; Danielsen, Yngvild; Hjelmesaeth, Jøran; Hertel, Jens K

    2017-10-09

    We analysed the distribution of the body mass index standard deviation scores (BMI-SDS) in children and adolescents seeking treatment for severe obesity, according to the International Obesity Task Force (IOTF), World Health Organization (WHO) and the national Norwegian Bergen Growth Study (BGS) BMI reference charts and the percentage above the International Obesity Task Force 25 cut-off (IOTF-25). This was a cross-sectional study of 396 children aged four to 17 years, who attended a tertiary care obesity centre in Norway from 2009 to 2015. Their BMI was converted to SDS using the three growth references and expressed as the percentage above IOTF-25. The percentage of body fat was assessed by bioelectrical impedance analysis. Regardless of which BMI reference chart was used, the BMI-SDS was significantly different between the age groups, with a wider range of higher values up to 10 years of age and a more narrow range of lower values thereafter. The distributions of the percentage above IOTF-25 and percentage of body fat were more consistent across age groups. Our findings suggest that it may be more appropriate to use the percentage above a particular BMI cut-off, such as the percentage above IOTF-25, than the IOTF, WHO and BGS BMI-SDS in paediatric patients with severe obesity. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. Comparison of Geriatric Nutritional Risk Index scores on physical performance among elderly patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Matsumura, Takuro; Mitani, Yuji; Oki, Yutaro; Fujimoto, Yukari; Ohira, Mineko; Kaneko, Hiromi; Kawashima, Tsunehiro; Nishio, Masato; Ishikawa, Akira

    2015-01-01

    The Geriatric Nutritional Risk Index (GNRI) is a new prognostic indicator for nutritional status-related complications and mortality among the elderly. Here we aimed to compare 6-min walk distance (6MWD) between high and low GNRI groups for patients with COPD. We enrolled 63 elderly men with COPD. These subjects were divided into two groups based on their GNRI scores: high GNRI group (≥92 points; n = 44) and low GNRI group (n = 19); we compared 6MWD between these groups. The subjects' characteristics between the high and the low GNRI groups were similar, except for BMI and serum albumin levels. 6MWD were significantly lower in the low GNRI group (279.5 ± 112.3 m versus 211.1 ± 125.3 m; p = 0.03). The GNRI has a more close relation with exercise tolerance and may be a useful nutritional assessment scale for elderly patients with COPD. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Calculation of cut-off values based on the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI) pemphigus scoring systems for defining moderate, significant and extensive types of pemphigus.

    Science.gov (United States)

    Boulard, C; Duvert Lehembre, S; Picard-Dahan, C; Kern, J S; Zambruno, G; Feliciani, C; Marinovic, B; Vabres, P; Borradori, L; Prost-Squarcioni, C; Labeille, B; Richard, M A; Ingen-Housz-Oro, S; Houivet, E; Werth, V P; Murrell, D F; Hertl, M; Benichou, J; Joly, P

    2016-07-01

    Two pemphigus severity scores, Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI), have been proposed to provide an objective measure of disease activity. However, the use of these scores in clinical practice is limited by the absence of cut-off values that allow differentiation between moderate, significant and extensive types of pemphigus. To calculate cut-off values defining moderate, significant and extensive pemphigus based on the ABSIS and PDAI scores. In 31 dermatology departments in six countries, consecutive patients with newly diagnosed pemphigus were assessed for pemphigus severity, using ABSIS, PDAI, Physician's Global Assessment (PGA) and Dermatology Life Quality Index (DLQI) scores. Cut-off values defining moderate, significant and extensive subgroups were calculated based on the 25th and 75th percentiles of the ABSIS and PDAI scores. The median ABSIS, PDAI, PGA and DLQI scores of the three severity subgroups were compared in order to validate these subgroups. Ninety-six patients with pemphigus vulgaris (n = 77) or pemphigus foliaceus (n = 19) were included. The median PDAI activity and ABSIS total scores were 27·5 (range 3-84) and 34·8 points (range 0·5-90·5), respectively. The respective cut-off values corresponding to the first and third quartiles of the scores were 15 and 45 for the PDAI, and 17 and 53 for ABSIS. The moderate, significant and extensive subgroups were thus defined, and had distinguishing median ABSIS (P < 0·001), PDAI (P < 0·001), PGA (P < 0·001) and DLQI (P = 0·03) scores. This study suggests cut-off values of 15 and 45 for PDAI and 17 and 53 for ABSIS, to distinguish moderate, significant and extensive pemphigus forms. Identifying these pemphigus activity subgroups should help physicians to classify and manage patients with pemphigus. © 2016 British Association of Dermatologists.

  5. Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia

    Directory of Open Access Journals (Sweden)

    Zech Loren A

    2008-03-01

    Full Text Available Abstract Background A relationship between corneal arcus and atherosclerosis has long been suspected but is controversial. The homozygous familial hypercholesterolemia patients in this study present a unique opportunity to assess this issue. They have both advanced atherosclerosis and corneal arcus. Methods This is a cross-sectional study of 17 patients homozygous for familial hypercholesterolemia presenting to the Clinical Center of the National Institutes of Health. Plasma lipoproteins, circumferential extent of arcus, thoracic aorta and coronary calcific atherosclerosis score, and Achilles tendon width were measured at the National Institutes of Health. Results Patients with corneal arcus had higher scores for calcific atherosclerosis (mean 2865 compared to 412, cholesterol-year score (mean 11830 mg-yr/dl compared to 5707 mg-yr/dl, and Achilles tendon width (mean 2.54 cm compared to 1.41 cm than those without. Corneal arcus and Achilles tendon width were strongly correlated and predictive of each other. Although corneal arcus was correlated with calcific atherosclerosis (r = 0.67; p = 0.004, it was not as highly correlated as was the Achilles tendon width (r = 0.855; p Conclusion Corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis. Corneal arcus is not as good an indicator of calcific atherosclerosis as Achilles tendon thickness, but its presence suggests increased atherosclerosis in these hypercholesterolemic patients.

  6. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2017-03-01

    Full Text Available Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients who underwent one or more ICD-10 defined procedures discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score and LACE index were a significant predictors of hospital readmission within 30 days. Results During the study period, 463 discharges were recorded for the hospitalist service. The analysis includes data for the 432 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 35 (8% were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.75 (95% CI [0.67–0.83], indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.069, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 3.71 with a p value of 0.59. A receiver operating characteristic evaluation of the LACE index for this patient population shows a C statistic of 0.58 (95% CI [0.48–0.68], indicating poor discrimination for hospital readmission. The Brier score for the LACE index in this setting was 0.082, indicating good

  7. Correlation between high density lipoprotein-cholesterol and remodeling index in patients with coronary artery disease: IDEAS (IVUS diagnostic evaluation of atherosclerosis in Singapore)-HDL study.

    Science.gov (United States)

    Lee, Chi-Hang; Tai, Bee-Choo; Lim, Gek-Hsiang; Chan, Mark Y; Low, Adrian F; Tan, Kathryn C; Chia, Boon-Lock; Tan, Huay-Cheem

    2012-01-01

    Serum level of high density lipoprotein (HDL)-cholesterol is associated with risk of coronary artery disease. We correlated the serum level of cholesterol with coronary artery remodeling index of patients with coronary artery disease. A total of 120 patients with de novo lesions located in native coronary artery were studied. Remodeling index was based on intravascular ultrasound (IVUS) interrogation of the lesions using the static approach, and was defined as external elastic membrane (EEM) area at lesion/average EEM area at proximal and distal reference segments. The average remodeling index was 0.9 (SD: 0.2). The remodeling index was not associated with any of the demographic and coronary risk factors. Stable angina was associated with a low remodeling index. Remodeling index correlated with white blood cell count and HDL-cholesterol, but not with total cholesterol, LDL-cholesterol and triglyceride. In the multiple linear regression analysis, HDL-cholesterol and procedure indication were the only 2 significant predictors of remodeling index. An increase of 1 mg/dL of HDL-cholesterol resulted in a decrease of 0.003 (95% CI: 0.0001, 0.007; P = 0.046) in remodeling index, after adjusting for procedural indications. When stratified according to diabetic status, the negative correlation persisted in non-diabetic (P = 0.023), but not in diabetic, patients (P = 0.707). We found a negative correlation between HDL-cholesterol level and remodeling index. Diabetic status may have an influence on the observed relationship.

  8. Inter-examiner reproducibility of Ocular Response Analyzer using the waveform score quality index in healthy subjects.

    Science.gov (United States)

    Mandalos, Achilleas; Anastasopoulos, Eleftherios; Makris, Leonidas; Dervenis, Nikolaos; Kilintzis, Vasilis; Topouzis, Fotis

    2013-02-01

    To evaluate the inter-examiner reproducibility of Ocular Response Analyzer (ORA) parameters in healthy subjects using the waveform score (WS) for quality control of acquisition. Fifteen healthy subjects had their intraocular pressure (IOP) measured with ORA by 2 masked examiners. An acquisition protocol that aimed at obtaining 4 reliable measurements in each eye with WS≥6 and with as few repeated measurements as possible was employed, whereas a maximum of 8 measurements per eye was allowed. Additional good quality criteria included symmetrical force-in and force-out applanation signal peaks on the ORA waveform and few or no distortions of the applanation signal curve. Only the right eyes were included in the analysis. Examiners were trained but not experienced. The inter-examiner reproducibility of ORA parameters was assessed using the intraclass correlation coefficient (ICC). Mean values of the best 4 measurements were considered in analysis. ICC including the best 4 measurements per eye was high for all ORA parameters. Specifically, ICC for Goldmann-correlated IOP was 0.961, for corneal-compensated IOP was 0.962, for corneal resistance factor was 0.987, and for corneal hysteresis was 0.988. Similar reproducibility was found when only the 3 best measurements per eye were included in the analysis. The protocol for IOP measurement with ORA using the WS ≥6 as quality index achieved high inter-examiner reproducibility for all ORA parameters. High reproducibility was obtained even by inexperienced examiners when considering the mean of the best 3 measurements per eye.

  9. Acute Ischemic Stroke Treatment, Part 2: Treatment “Roles of Capillary Index Score, Revascularization and Time”

    Science.gov (United States)

    Al-Ali, Firas; Elias, John J.; Filipkowski, Danielle E.

    2015-01-01

    Due to recent results from clinical intra-arterial treatment for acute ischemic stroke (IAT-AIS) trials such as the interventional management of stroke III, IAT-AIS and the merit of revascularization have been contested. Even though intra-arterial treatment (IAT) has been shown to improve revascularization rates, a corresponding increase in good outcomes has only recently been noted. Even though a significant percentage of patients achieve good revascularization in a timely manner, results do not translate into good clinical outcomes (GCOs). Based on a review of the literature, the authors suspect limited GCOs following timely and successful revascularization are due to poor patient selection that led to futile and possibly even harmful revascularization. The capillary index score (CIS) is a simple angiography-based scale that can potentially be used to improve patient selection to prevent revascularization being performed on patients who are unlikely to benefit from treatment. The CIS characterizes presence of capillary blush related to collateral flow as a marker of residual viable tissue, with absence of blush indicating the tissue is no longer viable due to ischemia. By only selecting patients with a favorable CIS for IAT, the rate of GCOs should consistently approach 80–90%. Current methods of patient selection are primarily dependent on time from ischemia. Time from cerebral ischemia to irreversible tissue damage seems to vary from patient to patient; so focusing on viable tissue based on the CIS rather than relying on an artificial time window seems to be a more appropriate approach to patient selection. PMID:26082751

  10. Inflammasomes and Atherosclerosis

    Directory of Open Access Journals (Sweden)

    S. Vallurupalli, MD

    2016-09-01

    Full Text Available Inflammation plays an important role in atherosclerosis. Inflammasomes play a crucial role in innate immunity, which mediates the body’s response to various pathogens. Of the different types of inflammasomes, NLRP3 has been implicated in atherosclerosis through the production of proinflammatory cytokines, IL-1β and IL-18. This review describes the role of the NLRP3 inflammasome in atherosclerosis and discusses potential therapeutic targets in the inflammasome pathway.

  11. Evaluering af overensstemmelsen af body condition score og feline body mass index sammenlignet med dual energy X-ray absorptiometry hos katte

    DEFF Research Database (Denmark)

    Falkenberg, Michael; Hølmkjær, Kirsten Madsen; Cronin, Anna

    2016-01-01

    Formål: Obesitet er et stigende problem blandt katte, og der er derfor brug for nemme, billige og hurtige metoder til vurdering af kattes kropssammensætning i praksis. Indeværende studie sammenligner to klinisk applicerbare metoder: Body condition score (BCS) og feline body mass index (FBMI) mod...

  12. Health literacy is associated with healthy eating index scores and sugar-sweetened beverage intake: findings from the rural lower Mississippi delta

    Science.gov (United States)

    Although health literacy has been a public health priority area for more than a decade, the relationship between health literacy and dietary quality has not been thoroughly explored. This study, evaluates health literacy skills in relation to Healthy Eating Index (HEI) scores and sugar-sweetened bev...

  13. Work ability as prognostic risk marker of disability pension : Single-item work ability score versus multi-item work ability index

    NARCIS (Netherlands)

    Roelen, C.A.M.; Rhenen, van W.; Groothoff, J.W.; Klink, van der J.J.L.; Twisk, W.R.; Heymans, M.W.

    2014-01-01

    Work ability predicts future disability pension (DP). A single-item work ability score (WAS) is emerging as a measure for work ability. This study compared single-item WAS with the multi-item work ability index (WAI) in its ability to identify workers at risk of DP.

  14. Cardiometabolic risk assessments by body mass index z-score or waist-to-height ratio in a multiethnic sample of sixth-graders

    Science.gov (United States)

    Convention defines pediatric adiposity by the body mass index z-score (BMIz) referenced to normative growth charts. Waist-to-height ratio (WHtR) does not depend on sex-and-age references. In the HEALTHY Study enrollment sample, we compared BMIz with WHtR for ability to identify adverse cardiometabol...

  15. Extravascular lung water index measurement in critically ill children does not correlate with a chest x-ray score of pulmonary edema.

    NARCIS (Netherlands)

    Lemson, J.; Die, L. van; Hemelaar, A.E.A.; Hoeven, J.G. van der

    2010-01-01

    INTRODUCTION: Extravascular lung water index (EVLWI) can be measured at the bedside using the transpulmonary thermodilution technique (TPTD). The goal of this study was to compare EVLWI values with a chest x-ray score of pulmonary edema and markers of oxygenation in critically ill children. METHODS:

  16. Morphological Atherosclerosis Calcification Distribution (MACD) Index is a Strong Predictor of Cardio-Vascular Death and Include Predictive Power of BMD

    DEFF Research Database (Denmark)

    Christiansen, Claus; Karsdal, Morten; Ganz, Melanie

    Aortic calcification is a major risk factor for cardiovascular disease (CVD) related deaths. We investigated the relation between mortality and aspects of number, size, morphology and distribution of calcified plaques in the lumbar aorta and BMD of postmenopausal women. 308 women aged 48 to 76 were...... was significantly higher than AC24 and any single or multivariate metabolic/physical marker. BMD correlates with AC24 among CVD dead patients (p=0.03) unlike MACD (p=0.43). The recent MACD-index provides a unique combination of morphology and distribution of aortic calcifications, factors that in a combination...... increase the biological relevance of the index by emphasizing that smaller plaques with a spread elongated morphology have a larger growth potential and thereby subsequent rupture potential. It includes the predictive power of BMD unlike the AC24 index. Thereby, in the current cohort with a long term...

  17. MR Enterography Assessment of Bowel Inflammation Severity in Crohn Disease Using the MR Index of Activity Score: Modifying Roles of DWI and Effects of Contrast Phases.

    Science.gov (United States)

    Kim, Jin Sil; Jang, Hye Young; Park, Seong Ho; Kim, Kyung-Jo; Han, Kyunghwa; Yang, Suk-Kyun; Ye, Byong Duk; Park, Sang Hyoung; Lee, Jong Seok; Kim, Hyun Jin

    2017-05-01

    The purpose of this article is to appraise the use of the MR index of activity (MaRIA) score in evaluating Crohn disease (CD) on present-day MR enterography images, with an emphasis on determining the modifying roles of DWI and the effects of different contrast enhancement phases. Fifty patients prospectively underwent MR enterography, including DWI and enteric and portal phase scans, and ileocolonoscopy with segmental CD endoscopic index of severity (CDEIS) scoring within a week. Thirty-nine terminal ilea and 40 right-sided colons (mean [± SD] segmental CDEIS score, 14.3 ± 12.1) from 42 patients with CD (mean age, 27 ± 6.2 years) were finally analyzed by three independent readers. Original and modified (ulcer replaced with DWI grade) MaRIA scores were compared regarding their correlation with segmental CDEIS score, accuracy in diagnosing active (segmental CDEIS score ≥ 3) and severe (segmental CDEIS score ≥ 12) inflammation, and interobserver reproducibility. The primary analysis used portal phase data, and the agreement between portal and enteric phase scores was analyzed. MaRIA and modified MaRIA scores correlated similarly with CDEIS scores (r = 0.737 and 0.742; p = 0.387) and did not significantly differ in terms of AUC values for the diagnosis of active (0.909 and 0.903; p = 0.571) or severe (0.907 and 0.892; p = 0.443) inflammation. The intraclass correlation coefficient was significantly higher for modified MaRIA than for MaRIA (0.845 and 0.701; p < 0.001). The mean difference between portal and enteric phase scores (i.e., portal minus enteric) was 0.33-0.36 score points for individual readers, and the Bland-Altman repeatability coefficient was 0.9-1.42 score points. Interobserver reproducibility in evaluating the severity of bowel inflammation in CD using the MaRIA score can be improved by modification with DWI. MaRIA scoring provides steady results across enteric and portal phases.

  18. Establishing score equivalence of the Functional Independence Measure motor scale and the Barthel Index, utilising the International Classification of Functioning, Disability and Health and Rasch measurement theory.

    Science.gov (United States)

    Prodinger, Birgit; O'Connor, Rory J; Stucki, Gerold; Tennant, Alan

    2017-05-16

    Two widely used outcome measures to assess functioning in neurological rehabilitation are the Functional Independence Measure (FIM™) and the Barthel Index. The current study aims to establish the equivalence of the total score of the FIM™ motor scale and the Barthel Index through the application of the International Classification of Functioning, Disability and Health, and Rasch measurement theory. Secondary analysis of a large sample of patients with stroke, spinal cord injury, and multiple sclerosis, undergoing rehabilitation was conducted. All patients were assessed at the same time on both the FIM™ and the Barthel Index. The International Classification of Functioning, Disability and Health Linking Rules were used to establish conceptual coherency between the 2 scales, and the Rasch measurement model to establish an exchange of the total scores. Using the FIM™ motor scale, items from both scales linked to the International Classification of Functioning, Disability and Health d4 Mobility or d5 Self-care chapters. Their co-calibration satisfied the assumptions of the Rasch model for each of 3 diagnostic groups. A ceiling effect was observed for the Barthel Index when contrasted against the FIM™ motor scale. Having a Rasch interval metric to transform scores between the FIM™ motor scale and Barthel Index is valuable for monitoring functioning, meta-analysis, quality audits and hospital benchmarking.

  19. Arterial stiffness is associated to cardiorespiratory fitness and body mass index in young Swedish adults: The Lifestyle, Biomarkers, and Atherosclerosis study.

    Science.gov (United States)

    Fernberg, Ulrika; Fernström, Maria; Hurtig-Wennlöf, Anita

    2017-11-01

    Background Early changes in the large muscular arteries are already associated with risk factors as hypertension and obesity in adolescence and young adulthood. The present study examines the association between arterial stiffness measurements, pulse wave velocity and augmentation index and lifestyle-related factors, body composition and cardiorespiratory fitness, in young, healthy, Swedish adults. Design This study used a population-based cross-sectional sample. Methods The 834 participants in the study were self-reported healthy, non-smoking, age 18-25 years. Augmentation index and pulse wave velocity were measured with applanation tonometry. Cardiorespiratory fitness was measured by ergometer bike test to estimate maximal oxygen uptake. Body mass index (kg/m2) was calculated and categorised according to classification by the World Health Organisation. Results Young Swedish adults with obesity and low cardiorespiratory fitness have significantly higher pulse wave velocity and augmentation index than non-obese young adults with medium or high cardiorespiratory fitness. The observed U-shaped association between pulse wave velocity and body mass index categories in women indicates that it might be more beneficial to be normal weight than underweight when assessing the arterial stiffness with pulse wave velocity. The highest mean pulse wave velocity was found in overweight/obese individuals with low cardiorespiratory fitness. The lowest mean pulse wave velocity was found in normal weight individuals with high cardiorespiratory fitness. Cardiorespiratory fitness had a stronger effect than body mass index on arterial stiffness in multiple regression analyses. Conclusions The inverse association between cardiorespiratory fitness and arterial stiffness is observed already in young adults. The study result highlights the importance of high cardiorespiratory fitness, but also that underweight individuals may be a possible risk group that needs to be further studied.

  20. Pretransplant malnutrition, inflammation, and atherosclerosis affect cardiovascular outcomes after kidney transplantation.

    Science.gov (United States)

    Hwang, Jin Ho; Ryu, Jiwon; An, Jung Nam; Kim, Clara Tammy; Kim, Hyosang; Yang, Jaeseok; Ha, Jongwon; Chae, Dong Wan; Ahn, Curie; Jung, In Mok; Oh, Yun Kyu; Lim, Chun Soo; Han, Duck-Jong; Park, Su-Kil; Kim, Yon Su; Kim, Young Hoon; Lee, Jung Pyo

    2015-07-21

    Malnutrition, inflammation, and atherosclerosis (MIA) syndrome is associated with a high mortality rate in patients with end-stage renal disease. However, the clinical relevance of MIA syndrome in kidney transplantation (KT) recipients remains unknown. We enrolled 1348 adult KT recipients. Recipients were assessed based on serum albumin, cholesterol, or body mass index for the malnutrition factor and C-reactive protein level for the inflammation factor. Any history of cardiovascular (CV), cerebrovascular, or peripheral vascular disease satisfied the atherosclerosis factor. Each MIA factors were assessed by univariate analysis and we calculated an overall risk score by summing up scores for each independent variable. The enrolled patients were divided into 4 groups depending on the MIA score (0, 2-4, 6, 8-10). The patients with higher MIA score showed worse outcome of fatal/non-fatal acute coronary syndrome (ACS) (p mortality (p < 0.001) than with the lower MIA score. In multivariate analysis, ACS showed significantly higher incidence in the MIA score 8-10 group than in the MIA score 0 group (Hazard ratio 6.12 95 % Confidence interval 1.84-20.32 p = 0.003). The presence of MIA factors before KT is an independent predictor of post-transplant CV outcomes.

  1. An analysis of reliability and validity of the papilla index score of implant-supported single crowns of maxillary central incisors

    DEFF Research Database (Denmark)

    Peng, Min; Fei, Wei; Hosseini, Mandana

    2012-01-01

    inter-observer agreement. The PIS score demonstrated significant correlation to the corresponding PP value (rs=.567, p=.000). Conclusions: The feasibility, reliability and validity of the PIS made the parameter useful for quality control of the pri-implant soft tissue of ISSCs.......Objectives: To test the reliability and validity of the papilla index scores of the implant-supported single crowns (ISSCs) of maxillary central incisors. Materials and Methods: Twenty-five patients with 25 ISSCs were included. Two prosthodontists evaluated the papilla index score (PIS) of three...... fill percent (PP) was calculated. The validity of PIS was tested against the corresponding papilla fill percent (PP) by using the Spearman correlation analysis. Results: The intra-observer agreement was >70% in 4/5 and >50% in all observations, the pooled Cohen’s ¿ was 0.64 and 0.70 for two observers...

  2. Phenotypic and genetic correlations for body structure scores (frame) with productive traits and index for CEIP classification in Nellore beef cattle.

    Science.gov (United States)

    Horimoto, A R V R; Ferraz, J B S; Balieiro, J C C; Eler, J P

    2007-03-29

    The present study was carried out to estimate both (co)variance components and genetic parameters for frame scores obtained using two methods (FRAME_GMA and FRAME_BIF) as well as phenotypic and genetic correlations with traits such as weaning weight, weight gain from weaning to yearling, scrotal circumference, muscle score, and an empiric index for animal classification for the Special Certificate of Identification and Production (CEIP). Data on 12,728 animals, raised in Southeastern Brazil, with ages from 490 to 610 days were analyzed. Estimates of heritability for FRAME_GMA and FRAME_BIF in multi-trait analysis were 0.28 and 0.24, respectively. Genetic correlation coefficients between frame scores and the growth trait were of medium magnitude, which indicates that genetic selection for weight resulted in undesirable responses, increasing the animals' frames. Small changes should be expected in the frame of animals that have been submitted to a genetic selection regarding muscle score and scrotal circumference. The low magnitude of phenotypic and genetic correlation between frame scores and the empirical selection index that classifies animals for CEIP, a Brazilian official certificate that recognizes the value of seedstock that is not registered at breeders associations, but is genetically evaluated, does not indicate important responses in giving a CEIP to animals that have been directly or indirectly selected for frame. Other studies must be performed to determine estimates of the genetic parameters for frame scores in other beef cattle populations.

  3. Vaccination against atherosclerosis

    NARCIS (Netherlands)

    Es, Thomas van

    2009-01-01

    Atherosclerosis, the predominantly underlying pathology of cardiovascular events, is the consequence of lipid deposition in the arterial wall, mostly as consequence of high levels of serum cholesterol. Treatment of atherosclerosis is mainly focused at the reduction of cholesterol levels by lipid

  4. Challenges in Evaluating the Severity of Fibropapillomatosis: A Proposal for Objective Index and Score System for Green Sea Turtles (Chelonia mydas) in Brazil.

    Science.gov (United States)

    Rossi, Silmara; Sánchez-Sarmiento, Angélica María; Vanstreels, Ralph Eric Thijl; Dos Santos, Robson Guimarães; Prioste, Fabiola Eloisa Setim; Gattamorta, Marco Aurélio; Grisi-Filho, José Henrique Hildebrand; Matushima, Eliana Reiko

    2016-01-01

    Fibropapillomatosis (FP) is a neoplastic disease that affects marine turtles worldwide, especially green sea turtles (Chelonia mydas). FP tumors can develop on the body surface of marine turtles and also internally in the oral cavity and viscera. Depending on their quantity, size and anatomical distribution, these tumors can interfere with hydrodynamics and the ability to feed, hence scoring systems have been proposed in an attempt to quantify the clinical manifestation of FP. In order to establish a new scoring system adapted to geographic regions, we examined 214 juvenile green sea turtles with FP caught or rescued at Brazilian feeding areas, counted their 7466 tumors and classified them in relation to their size and anatomical distribution. The patterns in quantity, size and distribution of tumors revealed interesting aspects in the clinical manifestation of FP in specimens studied in Brazil, and that FP scoring systems developed for other areas might not perform adequately when applied to sea turtles on the Southwest Atlantic Ocean. We therefore propose a novel method to evaluate the clinical manifestation of FP: fibropapillomatosis index (FPI) that provides the Southwest Atlantic fibropapillomatosis score (FPSSWA). In combination, these indexing and scoring systems allow for a more objective, rapid and detailed evaluation of the severity of FP in green sea turtles. While primarily designed for the clinical manifestation of FP currently witnessed in our dataset, this index and the score system can be adapted for other areas and compare the characteristics of the disease across regions. In conclusion, scoring systems to classify the severity of FP can assist our understanding on the environmental factors that modulate its development and its impacts on the individual and population health of green sea turtles.

  5. The Development and Psychometric Evaluation of a Supplementary Index Score of the Neuropsychological Assessment Battery Screening Module that is Sensitive to Traumatic Brain Injury.

    Science.gov (United States)

    Hacker, David; Jones, Christopher A; Clowes, Zoe; Belli, Antonio; Su, Zhangjie; Sitaraman, Murugan; Davies, David; Taylor, Ross; Flahive, Elizabeth; Travis, Clare; O'Neil, Nicci; Pettigrew, Yvonne

    2017-03-01

    This study examines the validity of the NAB Screening Module (screening module of the neuropsychological assessment battery, S-NAB) in an acute traumatic brain injury (TBI) inpatient population and provides psychometric evaluation of an original index sensitive to TBI impairment. The utility of the S-NAB as a TBI screen was examined using a between groups design. One-hundred and four patients with mild complicated to severe TBI were recruited from a consecutive cohort of patients admitted as inpatients to a UK Major Trauma Centre. Ninety-eight control participants were selected from the S-NAB normative sample. All TBI patients completed the S-NAB during their inpatient stay. Control participants scored significantly higher than TBI participants on the Total Screening index (t = 3.626, p < 0.01), The Attention index (t = 7.882, p < 0.01), and the Executive index (t = 5.577, p < 0.01). A briefer TBI Impairment index of six subtests was constructed which accurately discriminated TBI patients from normative controls (t = 9.9, p < 0.01; Cohen's d = 1.54). The TBI index had excellent classification accuracy (AUC = 0.83), superior to that of the standard S-NAB indices. The TBI Index, Attention Index, and Total Screening Index demonstrated increasing impairment with increased severity of injury. The S-NAB TBI index is a robust, reliable screening index for use with acute TBI patients, which is sensitive to the effects of acute TBI. It affords a briefer cognitive screen than the S-NAB and demonstrates a dose response relationship to TBI severity.

  6. An optimized patient-reported ulcerative colitis disease activity measure derived from the Mayo score and the simple clinical colitis activity index.

    Science.gov (United States)

    Bewtra, Meenakshi; Brensinger, Colleen M; Tomov, Vesselin T; Hoang, Tram B; Sokach, Carly E; Siegel, Corey A; Lewis, James D

    2014-06-01

    There is a need for simple, noninvasive patient-driven disease assessment instruments in ulcerative colitis (UC). We sought to further assess and refine the previous described 6-point Mayo score. A cross-sectional study of 282 UC patients was conducted assessing the correlation of the 2 patient-reported Mayo score components (6-point Mayo score) with the simple clinical colitis activity index (SCCAI) and a single Likert scale of patient-reported disease activity. Spearman's correlation, sensitivity, specificity, and area under the receiver operating curves (AUC) were calculated. A separate validation study in 59 UC patients was also conducted. Participants predominantly had long-standing disease (83%) and were in self-reported remission (63%). The 6-point Mayo score correlated well with the SCCAI (rho = 0.71; P < 0.0001) and patient-reported disease activity (rho = 0.65; P < 0.0001). Using a cutpoint of 1.5, the 6-point Mayo score had 83% sensitivity and 72% specificity for patient-defined remission, and 89% sensitivity and 67% specificity for SCCAI-defined remission (score, <2.5). The 6-point Mayo score and SCCAI had similar accuracy of predicting patient-defined remission (AUC = 0.84 and 0.87, respectively). Addition of the SCCAI general well-being question to the 6-point Mayo improved the predictive ability for patient-defined remission; and a new weighted score had an AUC of 0.89 in the development cohort and 0.93 in the validation cohort. The optimal cutpoint was 1.6. The patient-reported UC severity index that includes stool frequency, bleeding, and general well-being accurately measures clinical disease activity without requiring direct physician contact.

  7. Mediterranean Diet in patients with acute ischemic stroke: Relationships between Mediterranean Diet score, diagnostic subtype, and stroke severity index.

    Science.gov (United States)

    Tuttolomondo, Antonino; Casuccio, Alessandra; Buttà, Carmelo; Pecoraro, Rosaria; Di Raimondo, Domenico; Della Corte, Vittoriano; Arnao, Valentina; Clemente, Giuseppe; Maida, Carlo; Simonetta, Irene; Miceli, Giuseppe; Lucifora, Benedetto; Cirrincione, Anna; Di Bona, Danilo; Corpora, Francesca; Maugeri, Rosario; Iacopino, Domenico Gerardo; Pinto, Antonio

    2015-11-01

    Adherence to a Mediterranean Diet appears to reduce the risk of cardiovascular disease, cancer, Alzheimer's disease, and Parkinson's disease, as well as the risk of death due to cardiovascular disease. No study has addressed the association between diagnostic subtype of stroke and its severity and adherence to a Mediterranean Diet in subjects with acute ischemic stroke. To evaluate the association between Mediterranean Diet adherence, TOAST subtype, and stroke severity by means of a retrospective study. The type of acute ischemic stroke was classified according to the TOAST criteria. All patients admitted to our ward with acute ischemic stroke completed a 137-item validated food-frequency questionnaire adapted to the Sicilian population. A scale indicating the degree of adherence to the traditional Mediterranean Diet was used (Me-Di score: range 0-9). 198 subjects with acute ischemic stroke and 100 control subjects without stroke. Stroke subjects had a lower mean Mediterranean Diet score compared to 100 controls without stroke. We observed a significant positive correlation between Me-Di score and SSS score, whereas we observed a negative relationship between Me-Di score and NIHSS and Rankin scores. Subjects with atherosclerotic (LAAS) stroke subtype had a lower mean Me-Di score compared to subjects with other subtypes. Multinomial logistic regression analysis in a simple model showed a negative relationship between MeDi score and LAAS subtype vs. lacunar subtype (and LAAS vs. cardio-embolic subtype). Patients with lower adherence to a Mediterranean Diet are more likely to have an atherosclerotic (LAAS) stroke, a worse clinical presentation of ischemic stroke at admission and a higher Rankin score at discharge. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. The responsiveness and minimal important change of the western Ontario shoulder instability index and oxford shoulder instability score

    NARCIS (Netherlands)

    Van Der Linde, Just A.; Van Kampen, Derk A.; Van Beers, Loes W.A.H.; Van Deurzen, Derek F.P.; Saris, Daniël B.F.; Terwee, Caroline B.

    2017-01-01

    BACKGROUND: Patient-reported outcome measurements (PROMs) are widely used to evaluate functional limitations. Considering PROMs for shoulder instability, information is lacking with regard to what constitutes a relevant change from baseline scores. OBJECTIVES: To evaluate the responsiveness of the

  9. Clinically atypical spitzoid lesions: semi-quantitative histologic index correlation with dermoscopic scores (ABCD rule, 7-point checklist and pattern analysis).

    Science.gov (United States)

    Saravia, M; Pellicer, Z; Martin, J M; Monteagudo, C

    2015-04-01

    The distinction of Spitz and Reed nevi with atypical features from melanoma may be a difficult task. In these cases, the dermoscopic scores could bring variable results and not always correlate with the histologic diagnosis. The aim of this study was to compare the histopathologic and dermoscopic findings in a cohort of clinically atypical Spitz and Reed nevi. We retrospectively reviewed 19 cases of atypical Spitz and Reed nevi from our files. We constructed a new semi-quantitative histologic index (HI) based on the reproducible microscopic features, and correlated it with two dermoscopic scores: ABCD and 7-point checklist, as well as with the predominant dermoscopic pattern. The HI values differs significantly when the multicomponent dermoscopic pattern was compared with the rest of patterns (U = 22.5, Z = 2.23, P = 0.01). The ABCD and the 7-point checklist scores did not show statistically significant correlation with the HI. To our knowledge, this is the first report in which a semi-quantitative histologic score is compared to different dermoscopic scores in clinically atypical spitzoid lesions. This score can be used to correlate in an objective way the entire histologic picture with the standardized dermoscopic scores. In our series we found a higher HI for those spitzoid lesions with multicomponent pattern. © 2014 European Academy of Dermatology and Venereology.

  10. Indexed

    CERN Document Server

    Hagy, Jessica

    2008-01-01

    Jessica Hagy is a different kind of thinker. She has an astonishing talent for visualizing relationships, capturing in pictures what is difficult for most of us to express in words. At indexed.blogspot.com, she posts charts, graphs, and Venn diagrams drawn on index cards that reveal in a simple and intuitive way the large and small truths of modern life. Praised throughout the blogosphere as “brilliant,” “incredibly creative,” and “comic genius,” Jessica turns her incisive, deadpan sense of humor on everything from office politics to relationships to religion. With new material along with some of Jessica’s greatest hits, this utterly unique book will thrill readers who demand humor that makes them both laugh and think.

  11. Intelligence in Childhood and Atherosclerosis of the Carotid and Peripheral Arteries in Later Life: The Lothian Birth Cohort 1936

    Science.gov (United States)

    Gale, Catharine R.; Eadie, Elizabeth; Thomas, Avril; Bastin, Mark E.; Starr, John M.

    2015-01-01

    Objective There is some evidence that people who score higher on tests of intelligence in childhood have lower carotid intima-media thickness and higher ankle brachial index in middle age. These findings need replicating in other, older populations. We investigated the prospective relationship between intelligence in childhood and atherosclerosis in the carotid and peripheral arteries at age 73 years. Methods Participants were 713 members of the Lothian Birth Cohort 1936 whose intelligence was assessed at age 11 years. At age 73 years, carotid intima-media thickness and degree of stenosis were measured using ultrasound imaging; ankle-brachial index was measured using Doppler ultrasound. Results There were no significant associations between intelligence at age 11 and measures of atherosclerosis at age 73. In age- and sex-adjusted analyses, for a standard deviation higher score in intelligence, intima-media thickness (x 10) was lower by 0.07 (-0.20, 0.06) mm and ankle brachial index (x 10) was lower by 0.09 (-0.24, 0.07); odds ratios for having carotid stenosis >25% or peripheral arterial disease were 0.98 (0.82, 1.16) and 1.05 (0.81, 1.36) respectively. Conclusion In this study of people aged 73 years, higher childhood intelligence was not associated with reduced risk of atherosclerosis in the carotid or peripheral arteries. PMID:25915652

  12. Novel serum biomarkers modified by the body mass index z-score for the detection of liver fibrosis and steatosis in children with chronic hepatitis C.

    Science.gov (United States)

    Pokorska-Śpiewak, Maria; Kowalik-Mikołajewska, Barbara; Aniszewska, Małgorzata; Pluta, Magdalena; Marczyńska, Magdalena

    2017-05-23

    There is a need for validation of noninvasive alternatives to liver biopsy for the evaluation of fibrosis in children with chronic hepatitis C (CHC). The aim of this study was to evaluate the diagnostic performance of serum biomarkers modified by the body mass index z-score (BMI z-score) for the detection of fibrosis and steatosis in children with CHC. Thirty children aged 9.4 ± 3.7 years (14 males, 16 females) with CHC underwent liver biopsy. Fibrosis was scored using a 5-point METAVIR scale (≥2 = significant fibrosis). For all the children, the following noninvasive markers were calculated: The aspartate transaminase (AST)-to-platelets ratio index (APRI), the modified APRI (M-APRI: BMI z-score × APRI), the Fibrosis-4 index (FIB-4), the modified FIB-4 (M-FIB-4: BMI z-score × FIB-4), and a novel marker, B-AST (BMI z-score × AST). The area under the receiver operator characteristic curve (AUROC) was calculated to detect significant fibrosis and steatosis. In the histopathological evaluation, 22/30 (73%) patients presented with fibrosis, and 8/30 (27%) presented with steatosis. For the detection of significant fibrosis, the AUROCs for M-APRI, M-FIB-4 and B-AST were 0.842, 0.823, and 0.848, respectively. For significant steatosis, the AUROCs were more than 0.9 for all markers that included the BMI z-score. B-AST, with a cut-off of 92.8, showed 71% sensitivity and 95% specificity for detecting significant fibrosis. For predicting severe steatosis, B-AST had 100% sensitivity and 92% specificity. Negative values of all three markers that included BMI z-scores excluded all patients with both significant fibrosis and significant steatosis. Including the BMI z-score in serum biomarker formulas enhances their diagnostic ability to detect significant fibrosis and steatosis. B-AST may thus act as an effective alternative to liver biopsy.

  13. Histone deacetylases and atherosclerosis.

    Science.gov (United States)

    Zheng, Xia-xia; Zhou, Tian; Wang, Xin-An; Tong, Xiao-hong; Ding, Jia-wang

    2015-06-01

    Atherosclerosis is the most common pathological process that leads to cardiovascular diseases, a disease of large- and medium-sized arteries that is characterized by a formation of atherosclerotic plaques consisting of necrotic cores, calcified regions, accumulated modified lipids, smooth muscle cells (SMCs), endothelial cells, leukocytes, and foam cells. Recently, the question about how to suppress the occurrence of atherosclerosis and alleviate the progress of cardiovascular disease becomes the hot topic. Accumulating evidence suggests that histone deacetylases(HDACs) play crucial roles in arteriosclerosis. This review summarizes the effect of HDACs and HDAC inhibitors(HDACi) on the progress of atherosclerosis. Copyright © 2015. Published by Elsevier Ireland Ltd.

  14. Evaluation of mentum deformities of Chironomus spp. (Chironomidae: Diptera) larvae using modified toxic score index (MTSI) to assess the environmental stress in Juru River Basin, Penang, Malaysia.

    Science.gov (United States)

    Al-Shami, Salman Abdo; Salmah, Mad Rawi Che; Hassan, Ahmad Abu; Azizah, Mohd Nor Siti

    2011-06-01

    Morphological mentum deformities which represent sublethal effect of exposure to different types of pollutants were evaluated in Chironomus spp. larvae inhabiting three polluted rivers of Juru River Basin in northwestern peninsular Malaysia. Using mentum deformity incidences, the modified toxic score index (MTSI) was developed based on Lenat's toxic score index (TSI). The suggested MTSI was compared with TSI in terms of its effectiveness to identify different pollutants including heavy metals. The MTSI showed stronger relationship to total deformity incidence expressed as percentage. Additionally, the multivariate RDA model showed higher capability of MTSI to explain the variations in heavy metal contents of the river sediments. The MTSI was recommended in bioassessment of water and sediment quality using the mentum deformities of Chironomus spp. larvae from aquatic ecosystems receiving anthropogenic, agricultural, or industrial discharges.

  15. Coverage of Acta Dermatovenerologica Alpina, Pannonica et Adriatica in Elsevier's CiteScore index: a new tool for measuring the citation impact of academic journals.

    Science.gov (United States)

    Poljak, Mario

    2017-03-01

    In December 2016, Elsevier launched a new tool that helps measure the citation impact of academic journals, called the CiteScore index. The CiteScore index values for 2015 confirmed the status of Acta Dermatovenerologica Alpina, Pannonica et Adriatica (Acta Dermatovenerol APA) as the leading journal in dermatology and sexually transmitted infections in the region. Sixty-five articles published in Acta Dermatovenerol APA from 2012 to 2014 received a total of 77 citations in 2015, resulting in a CiteScore index value of 1.18 for the journal. More than half of the articles published from 2012 to 2014 received at least one citation in 2015. Acta Dermatovenerol APA performed well in all three categories listed because it is ranked 384th out of 1,549 journals in the category General Medicine (75th percentile), 53rd out of 122 journals in the category Dermatology (56th percentile), and 142nd out of 246 journals in the category Infectious Diseases (42nd percentile).

  16. Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI) Z-score among Brazilian adolescents.

    Science.gov (United States)

    Enes, Carla C; Slater, Betzabeth

    2013-06-01

    To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI) z-score change among adolescents. The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004) (hereafter, baseline) and 299 in wave II (2005) (hereafter, follow-up). BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04) and sweetened natural fruit juices (β = 0.05, p = 0.03) was positively associated with the rise in BMI z-score. Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

  17. Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI Z-score among Brazilian adolescents*

    Directory of Open Access Journals (Sweden)

    Carla C. Enes

    2013-06-01

    Full Text Available Objective: To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI z-score change among adolescents. Methods: The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004 (hereafter, baseline and 299 in wave II (2005 (hereafter, follow-up. BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. Results: The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04 and sweetened natural fruit juices (β = 0.05, p = 0.03 was positively associated with the rise in BMI z-score. Conclusions: Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

  18. The Mediterranean Diet Score Is More Strongly Associated with Favorable Cardiometabolic Risk Factors over 2 Years Than Other Diet Quality Indexes in Puerto Rican Adults.

    Science.gov (United States)

    Mattei, Josiemer; Sotos-Prieto, Mercedes; Bigornia, Sherman J; Noel, Sabrina E; Tucker, Katherine L

    2017-04-01

    Background: Multiple diet quality scores have been used to evaluate adherence to specific dietary recommendations or to consumption of healthful foods and nutrients. It remains unknown which score can more strongly predict longitudinal changes in cardiometabolic risk factors. Objective: We aimed to determine associations of 5 diet quality scores [AHA diet score (AHA-DS), Dietary Approaches to Stop Hypertension (DASH), Healthy Eating Index (HEI)-2005, Mediterranean diet score (MeDS), and Alternative Healthy Eating Index (AHEI)] with 2-y changes in cardiometabolic risk factors in adults 45-75 y old. Methods: Data from the Boston Puerto Rican Health Study were analyzed ( n = 1194). Diet quality scores were calculated from a baseline-validated food-frequency questionnaire. Multivariable-adjusted, repeated-subjects, mixed-effects models, adjusted for baseline measures, estimated associations between each z score and 14 individual cardiometabolic factors measured at 2 y. Results: MeDS was significantly associated with lower 2-y waist circumference (β coefficient ± SE: -0.52 ± 0.26, P = 0.048); body mass index (BMI; -0.23 ± 0.08, P = 0.005); log-insulin (-0.06 ± 0.02, P = 0.005); log-homeostasis model assessment of insulin resistance (HOMA-IR; -0.05 ± 0.02, P = 0.030), and log-C-reactive protein (-0.13 ± 0.03, P = 0.0002). Similar but weaker associations were observed for the AHEI with BMI, insulin, and HOMA-IR. The AHA-DS was inversely associated with BMI (-0.17 ± 0.08, P = 0.033). Neither the HEI-2005 nor DASH was significantly associated with any variable. Traditional Puerto Rican foods consumed by individuals with high MeDSs included vegetables and meats in homemade soups, orange juice, oatmeal, beans and legumes, fish, whole milk, corn oil, and beer. Conclusions: The MeDS comprises food components and scores associated with a favorable cardiometabolic profile over 2 y in Puerto Rican adults. An overall healthy diet may be particularly beneficial for

  19. How Is Atherosclerosis Treated?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  20. How Is Atherosclerosis Diagnosed?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  1. What Is Atherosclerosis?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  2. What Causes Atherosclerosis?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  3. Living with Atherosclerosis

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  4. Infection and Atherosclerosis Development

    Science.gov (United States)

    Campbell, Lee Ann; Rosenfeld, Michael E.

    2015-01-01

    Atherosclerosis is a chronic disease hallmarked by chronic inflammation, endothelial dysfunction and lipid accumulation in the vasculature. Although lipid modification and deposition are thought to be a major source of the continuous inflammatory stimulus, a large body of evidence suggests that infectious agents may contribute to atherosclerotic processes. This could occur by either direct effects through infection of vascular cells and/or through indirect effects by induction of cytokine and acute phase reactant proteins by infection at other sites. Multiple bacterial and viral pathogens have been associated with atherosclerosis by seroepidemiological studies, identification of the infectious agent in human atherosclerotic tissue, and experimental studies demonstrating an acceleration of atherosclerosis following infection in animal models of atherosclerosis. This review will focus on those infectious agents for which biological plausibility has been demonstrated in animal models and on the challenges of proving a role of infection in human atherosclerotic disease. PMID:26004263

  5. [Epigenetics in atherosclerosis].

    Science.gov (United States)

    Guardiola, Montse; Vallvé, Joan C; Zaina, Silvio; Ribalta, Josep

    2016-01-01

    The association studies based on candidate genes carried on for decades have helped in visualizing the influence of the genetic component in complex diseases such as atherosclerosis, also showing the interaction between different genes and environmental factors. Even with all the knowledge accumulated, there is still some way to go to decipher the individual predisposition to disease, and if we consider the great influence that environmental factors play in the development and progression of atherosclerosis, epigenetics is presented as a key element in trying to expand our knowledge on individual predisposition to atherosclerosis and cardiovascular disease. Epigenetics can be described as the discipline that studies the mechanisms of transcriptional regulation, independent of changes in the sequence of DNA, and mostly induced by environmental factors. This review aims to describe what epigenetics is and how epigenetic mechanisms are involved in atherosclerosis. Copyright © 2015 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  6. Phytosterols and atherosclerosis

    DEFF Research Database (Denmark)

    Schrøder, Malene

    in its “Guidelines for assessment and management of cardiovascular risk” the following risk factors to influence progressive atherosclerosis: hypertension, abnormal blood lipids, diabetes, unhealthy diet, physical inactivity and smoking. Phytosterols (plant sterols and plant stanols) are known...

  7. Inter-rater reliability of h-index scores calculated by Web of Science and Scopus for clinical epidemiology scientists.

    Science.gov (United States)

    Walker, Benjamin; Alavifard, Sepand; Roberts, Surain; Lanes, Andrea; Ramsay, Tim; Boet, Sylvain

    2016-06-01

    We investigated the inter-rater reliability of Web of Science (WoS) and Scopus when calculating the h-index of 25 senior scientists in the Clinical Epidemiology Program of the Ottawa Hospital Research Institute. Bibliometric information and the h-indices for the subjects were computed by four raters using the automatic calculators in WoS and Scopus. Correlation and agreement between ratings was assessed using Spearman's correlation coefficient and a Bland-Altman plot, respectively. Data could not be gathered from Google Scholar due to feasibility constraints. The Spearman's rank correlation between the h-index of scientists calculated with WoS was 0.81 (95% CI 0.72-0.92) and with Scopus was 0.95 (95% CI 0.92-0.99). The Bland-Altman plot showed no significant rater bias in WoS and Scopus; however, the agreement between ratings is higher in Scopus compared to WoS. Our results showed a stronger relationship and increased agreement between raters when calculating the h-index of a scientist using Scopus compared to WoS. The higher inter-rater reliability and simple user interface used in Scopus may render it the more effective database when calculating the h-index of senior scientists in epidemiology. © 2016 Health Libraries Group.

  8. Wechsler Adult Intelligence Scale-Third Edition Short Form for Index and IQ Scores in a Psychiatric Population

    Science.gov (United States)

    Christensen, Bruce K.; Girard, Todd A.; Bagby, R. Michael

    2007-01-01

    An eight-subtest short form (SF8) of the Wechsler Adult Intelligence Scale, Third Edition (WAIS-III), maintaining equal representation of each index factor, was developed for use with psychiatric populations. Data were collected from a mixed inpatient/outpatient sample (99 men and 101 women) referred for neuropsychological assessment. Psychometric…

  9. Inflammatory Obesity Phenotypes, Gender Effects, and Subclinical Atherosclerosis in African Americans: The Jackson Heart Study.

    Science.gov (United States)

    Lin, Albert; Lacy, Mary E; Eaton, Charles; Correa, Adolfo; Wu, Wen-Chih

    2016-12-01

    Reasons for variations in atherosclerotic burden among individuals with similar levels of obesity are poorly understood, especially in African Americans. This study examines whether high-sensitivity C-reactive protein (hsCRP) is useful for discriminating between benign and high-risk obesity phenotypes for subclinical atherosclerosis in African Americans. Participants from the Jackson Heart Study (n=4682) were stratified into 4 phenotypes based on the presence of National Heart and Lung and Blood Institute definition of obesity or obesity-equivalent (body mass index ≥30 or body mass index 25-30 with waist circumference >102 cm in men and >88 cm in women) and inflammation by hsCRP ≥2 mg/L. Using multivariate regression models, we conducted cross-sectional analyses of the association between inflammatory obesity phenotypes and subclinical atherosclerosis determined by carotid intima-media thickness or coronary artery calcium scores. Sex-specific analyses were conducted given significant interaction for gender (P=0.03). The prevalence of obesity or equivalent was 65%, of which 30% did not have inflammation. Conversely, 37% of nonobese individuals had inflammation. Among nonobese men, hsCRP ≥2 mg/L identified a subset of individuals with higher carotid intima-media thickness (adjusted mean difference =0.05, 95% confidence interval 0.02, 0.08 mm) compared with their noninflammatory counterparts. Among obese men, hsCRP obese individuals with less subclinical atherosclerosis. © 2016 American Heart Association, Inc.

  10. Optimal antiretroviral therapy adherence as evaluated by CASE index score tool is associated with virological suppression in HIV-infected adults in Dakar, Senegal.

    Science.gov (United States)

    Byabene, A K; Fortes-Déguénonvo, L; Niang, K; Manga, M N; Bulabula, A N H; Nachega, J B; Seydi, M

    2017-06-01

    To determine the prevalence and factors associated with optimal antiretroviral therapy (ART) adherence and virological failure (VLF) among HIV-infected adults enrolled in the national ART programme at the teaching hospital of Fann, Dakar, Senegal. Cross-sectional study from 1 September 2013 to 30 January 2014. (1) optimal ART adherence by the Center for Adherence Support Evaluation (CASE) Index Score (>10) and (2) VLF (HIV RNA > 1000 copies/ml). Diagnostic accuracy of CASE Index Score assessed using sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and corresponding 95% confidence intervals (CIs). Multivariate logistic regression analysis was performed to identify independent factors associated with optimal adherence and VLF. Of 98 HIV-infected patients on ART, 68% were female. The median (IQR) age was 42 (20-50) years. A total of 57 of 98 (60%) were on ART more than 3 years, and majority (88%) were on NNRTI-based first-line ART regimen. A total of 79 of 98 (80%) patients reported optimal ART adherence, and only five of 84 (5.9%) had documented VLF. Patients with VLF were significantly more likely to have suboptimal ART adherence (17.7% vs. 2.9%; P = 0.02). CASE Index Score showed the best trade-off in Se (78.9%, 95% CI: 54.4-93.9%), Sp (20.0%, 95% CI: 11.1-31.7), PPV (22.4, 95% CI: 13.1-34.2%) and NPV (76.5%, 95% CI: 50.1-93.2), when used VLF threshold of HIV RNA >50 copies/ml. Factors independently associated with VLF were CASE Index Score <10 ([aOR] = 13.0, 95% CI: 1.1-147.9; P = 0.04) and being a boosted PI-based ART regimen ([aOR] = 27.0, 95% CI: 2.4-309.4; P = 0.008). Optimal ART adherence is achievable in a high proportion of HIV-infected adults in this study population. CASE Index Score was independently associated with virological outcomes, supporting usefulness of this low-cost ART adherence monitoring tool in this setting. © 2017 John Wiley & Sons Ltd.

  11. Balance index score as a predictive factor for lower sports results or anterior cruciate ligament knee injuries in Croatian female athletes--preliminary study.

    Science.gov (United States)

    Vrbanić, Tea Schnurrer-Luke; Ravlić-Gulan, Jagoda; Gulan, Gordan; Matovinović, Damir

    2007-03-01

    Female athletes participating in high-risk sports suffer anterior cruciate ligament (ACL) knee injury at a 4- to 6-fold greater rate than do male athletes. ACL injuries result either from contact mechanisms or from certain unexplained non-contact mechanisms occurring during daily professional sports activities. The occurrence of non-contact injuries points to the existence of certain factors intrinsic to the knee that can lead to ACL rupture. When knee joint movement overcomes the static and the dynamic constraint systems, non-contact ACL injury may occur. Certain recent results suggest that balance and neuromuscular control play a central role in knee joint stability, protection and prevention of ACL injuries. The purpose of this study is to evaluate balance neuromuscular skills in healthy Croatian female athletes by measuring their balance index score, as well as to estimate a possible correlation between their balance index score and balance effectiveness. This study is conducted in an effort to reduce the risk of future injuries and thus prevent female athletes from withdrawing from sports prematurely. We analysed fifty-two female athletes in the high-risk sports of handball and volleyball, measuring for their static and dynamic balance index scores, using the Sport KAT 2000 testing system. This method may be used to monitor balance and coordination systems and may help to develop simpler measurements of neuromuscular control, which can be used to estimate risk predictors in athletes who withdraw from sports due to lower sports results or ruptured anterior cruciate ligament and to direct female athletes to more effective, targeted preventive interventions. The tested Croatian female athletes with lower sports results and ACL knee injury incurred after the testing were found to have a higher balance index score compared to healthy athletes. We therefore suggest that a higher balance index score can be used as an effective risk predictor for lower sports results

  12. Among 4 Diet Quality Indexes, Only the Alternate Mediterranean Diet Score Is Associated with Better Colorectal Cancer Survival and Only in African American Women in the Multiethnic Cohort.

    Science.gov (United States)

    Jacobs, Simone; Harmon, Brook E; Ollberding, Nicholas J; Wilkens, Lynne R; Monroe, Kristine R; Kolonel, Laurence N; Le Marchand, Loic; Boushey, Carol J; Maskarinec, Gertraud

    2016-09-01

    Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, with a 5-y survival rate of ∼65%. Therefore, the identification of modifiable health factors to improve CRC survival is crucial. We investigated the association of 4 prediagnostic a priori diet quality indexes with CRC-specific and all-cause mortality in the Multiethnic Cohort (MEC). The MEC included >215,000 African-American, Native Hawaiian, Japanese-American, Latino, and white adults living in Hawaii and California who completed a validated quantitative food-frequency questionnaire in 1993-1996. CRC cases and deaths were identified through linkages to cancer registries and to state and national vital registries. Sex-specific HRs and 95% CIs were estimated for the Healthy Eating Index (HEI) 2010, the Alternative HEI (AHEI) 2010, the alternate Mediterranean Diet (aMED) score, and the Dietary Approaches to Stop Hypertension (DASH) index with CRC-specific and overall mortality as the primary outcomes. Ethnicity-specific analyses were the secondary outcomes. Among 4204 MEC participants diagnosed with invasive CRC through 2010, 1976 all-cause and 1095 CRC-specific deaths were identified. A higher aMED score was associated with lower CRC-specific mortality in women [HR continuous pattern score divided by its respective SD (HR1SD): 0.86; 95% CI: 0.77, 0.96] but not in men (HR1SD: 1.01; 95% CI: 0.92, 1.11). A higher aMED score was also associated with lower all-cause mortality in women (HR1SD: 0.88; 95% CI: 0.81, 0.96) but not in men (HR1SD: 1.00; 95% CI: 0.93, 1.07). The HEI-2010, AHEI-2010, and DASH index were not significantly associated with CRC-specific or with all-cause mortality. The inverse relation for the aMED score was limited to African Americans and to colon (compared with rectal) cancer. The aMED score was related to lower mortality only in African-American women (1 of 5 ethnic groups studied). The results should be interpreted with caution due to the small

  13. Obesity Is Associated With Progression of Atherosclerosis During Statin Treatment.

    Science.gov (United States)

    Sandfort, Veit; Lai, Shenghan; Ahlman, Mark A; Mallek, Marissa; Liu, Songtao; Sibley, Christopher T; Turkbey, Evrim B; Lima, João A C; Bluemke, David A

    2016-07-13

    This study aimed to determine the relationship of statin therapy and cardiovascular risk factors to changes in atherosclerosis in the carotid artery. Carotid magnetic resonance imaging was used to evaluate 106 hyperlipidemic participants at baseline and after 12 months of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) treatment. Multivariable logistic regression was used to determine factors associated with progression (change in carotid wall volume >0) or regression (change ≤0) of carotid atherosclerosis. Computed tomography coronary calcium scores were obtained at baseline for all participants. The median age was 65 years (interquartile range 60-69 years), and 63% of the participants were male. Body mass index >30, elevated C-reactive protein, and hypertension were associated with increased carotid wall volume (obesity: odds ratio for progression 4.6, 95% CI 1.8-12.4, Pobesity remained associated with progression (Pobese participants was +4.8% versus -4.2% in nonobese participants (Pobese participants. In a population with hyperlipidemia, obese patients showed atheroma progression despite optimized statin therapy. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01212900. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  14. A score to predict and stratify risk of tuberculosis in adult contacts of tuberculosis index cases: a prospective derivation and external validation cohort study.

    Science.gov (United States)

    Saunders, Matthew J; Wingfield, Tom; Tovar, Marco A; Baldwin, Matthew R; Datta, Sumona; Zevallos, Karine; Montoya, Rosario; Valencia, Teresa R; Friedland, Jon S; Moulton, Larry H; Gilman, Robert H; Evans, Carlton A

    2017-11-01

    Contacts of tuberculosis index cases are at increased risk of developing tuberculosis. Screening, preventive therapy, and surveillance for tuberculosis are underused interventions in contacts, particularly adults. We developed a score to predict risk of tuberculosis in adult contacts of tuberculosis index cases. In 2002-06, we recruited contacts aged 15 years or older of index cases with pulmonary tuberculosis who lived in desert shanty towns in Ventanilla, Peru. We followed up contacts for tuberculosis until February, 2016. We used a Cox proportional hazards model to identify index case, contact, and household risk factors for tuberculosis from which to derive a score and classify contacts as low, medium, or high risk. We validated the score in an urban community recruited in Callao, Peru, in 2014-15. In the derivation cohort, we identified 2017 contacts of 715 index cases, and median follow-up was 10·7 years (IQR 9·5-11·8). 178 (9%) of 2017 contacts developed tuberculosis during 19 147 person-years of follow-up (incidence 0·93 per 100 person-years, 95% CI 0·80-1·08). Risk factors for tuberculosis were body-mass index, previous tuberculosis, age, sustained exposure to the index case, the index case being in a male patient, lower community household socioeconomic position, indoor air pollution, previous tuberculosis among household members, and living in a household with a low number of windows per room. The 10-year risks of tuberculosis in the low-risk, medium-risk, and high-risk groups were, respectively, 2·8% (95% CI 1·7-4·4), 6·2% (4·8-8·1), and 20·6% (17·3-24·4). The 535 (27%) contacts classified as high risk accounted for 60% of the tuberculosis identified during follow-up. The score predicted tuberculosis independently of tuberculin skin test and index-case drug sensitivity results. In the external validation cohort, 65 (3%) of 1910 contacts developed tuberculosis during 3771 person-years of follow-up (incidence 1·7 per 100 person-years, 95

  15. Subclinical atherosclerosis and subsequent cognitive function.

    Science.gov (United States)

    Rossetti, Heidi C; Weiner, Myron; Hynan, Linda S; Cullum, C Munro; Khera, Amit; Lacritz, Laura H

    2015-07-01

    To examine the relationship between measures of subclinical atherosclerosis and subsequent cognitive function. Participants from the Dallas Heart Study (DHS), a population-based multiethnic study of cardiovascular disease pathogenesis, were re-examined 8 years later (DHS-2) with the Montreal Cognitive Assessment (MoCA); N = 1904, mean age = 42.9, range 8-65. Associations of baseline measures of subclinical atherosclerosis (coronary artery calcium, abdominal aortic plaque, and abdominal aortic wall thickness) with MoCA scores measured at follow-up were examined in the group as a whole and in relation to age and ApoE4 status. A significant linear trend of successively lower MoCA scores with increasing numbers of atherosclerotic indicators was observed (F(3, 1150) = 5.918, p = .001). CAC was weakly correlated with MoCA scores (p = .047) and MoCA scores were significantly different between participants with and without CAC (M = 22.35 vs 23.69, p = 0.038). With the exception of a small association between abdominal AWT and MoCA in subjects over age 50, abdominal AWT and abdominal aortic plaque did not correlate with MoCA total score (p ≥ .052). Cognitive scores and atherosclerosis measures were not impacted by ApoE4 status (p ≥ .455). In this ethnically diverse population-based sample, subclinical atherosclerosis was minimally associated with later cognitive function in middle-aged adults. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Effect of glycemic control on the Diabetes Complications Severity Index score and development of complications in people with newly diagnosed type 2 diabetes.

    Science.gov (United States)

    Pantalone, Kevin M; Misra-Hebert, Anita D; Hobbs, Todd M; Wells, Brian J; Kong, Sheldon X; Chagin, Kevin; Dey, Tanujit; Milinovich, Alex; Weng, Wayne; Bauman, Janine M; Burguera, Bartolome; Zimmerman, Robert S; Kattan, Michael W

    2017-10-04

    The aim of the present study was to assess the longitudinal accumulation of diabetes-related complications and the effect of glycemic control on the Diabetes Complications Severity Index (DCSI) score in people with newly diagnosed type 2 diabetes (T2D). A retrospective cohort study was conducted using electronic health records from a large integrated healthcare system. People with newly diagnosed T2D were identified between 2005 and 2016 and stratified by initial HbA1c category (glycemic (HbA1c) control on longitudinal changes in DCSI scores. Of 32 174 people identified as having newly diagnosed T2D, 14 016 (44%), 21 657 (67%), and 9983 (31%) had an initial or baseline HbA1c glycemic control was significantly associated with a 10%, 19%, or 16% increase in the risk of experiencing an increased DCSI score, respectively (all P glycemic control had no apparent effect on longitudinal changes in DCSI score. Worsening or persistently poor glycemic control was associated with an increased risk of an increase in the DCSI score. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  17. Impact of body mass index levels on lipid abnormalities in Chinese Asians, American Blacks and American Whites: The People’s Republic of China (PRC) and Atherosclerosis Risk in Communities (ARIC) Studies

    Science.gov (United States)

    Truesdale, Kimberly P; Stevens, June; Cai, Jianwen

    2011-01-01

    Background Several researchers have reported that Chinese adults may have a greater chronic disease burden than Whites, especially at lower body mass index (BMI) levels. Objectives To compare the incidence of lipid abnormalities in Chinese (n=5,303), White (n=10,752) and Black (n=3,408) middle-aged adults and the effect of BMI on these incidences. Methods Data were from the People’s Republic of China (PRC) and the Atherosclerosis Risk in Communities (ARIC) studies. In each ethnic group, we calculated the adjusted cumulative incidence for high total cholesterol (≥240 mg/dL), LDL-cholesterol (≥160 mg/dL), and triglycerides (≥200 mg/dL) and low HDL-cholesterol (≤40 in men and ≤50 mg/dL in women) adjusted for age, gender, education, field site, smoking and drinking status. Risk differences associated with BMI (referent=18.5–22.9 kg/m2) were calculated using weighted linear regression and slopes compared using the Wald test. Results Chinese had lower incidence of abnormal total cholesterol, LDL-cholesterol and triglycerides than Whites in most BMI groups and had lower incidence of abnormal HDL-cholesterol and triglycerides than Blacks. Across the range of 18.5 to cholesterol in Chinese and Whites than in Blacks. Similar trends were seen for LDL-cholesterol and triglycerides, but were not always statistically significant. In contrast, BMI was more highly associated with incidence of low HDL-cholesterol in Whites than in Chinese or Blacks. Conclusion Although differences in the incidence of lipid abnormalities and the impact of BMI were identified, results varied by lipid type indicating no consistent ethnic/national pattern. PMID:21802083

  18. Impact of body mass index levels on lipid abnormalities in Chinese Asians, American Blacks and American Whites: the People's Republic of China (PRC) and Atherosclerosis Risk in Communities (ARIC) Studies.

    Science.gov (United States)

    Truesdale, Kimberly P; Stevens, June; Cai, Jianwen

    2011-10-01

    Several researchers have reported that Chinese adults may have a greater chronic disease burden than Whites, especially at lower body mass index (BMI) levels. To compare the incidence of lipid abnormalities in Chinese (n=5303), White (n=10,752) and Black (n=3408) middle-aged adults and the effect of BMI on these incidences. Data were from the People's Republic of China (PRC) and the Atherosclerosis Risk in Communities (ARIC) studies. In each ethnic group, we calculated the adjusted cumulative incidence for high total cholesterol (≥240mg/dL), LDL-cholesterol (≥160mg/dL), and triglycerides (≥200mg/dL) and low HDL-cholesterol (≤40 in men and ≤50mg/dL in women) adjusted for age, gender, education, field site, smoking and drinking status. Risk differences associated with BMI (referent=18.5-22.9kg/m(2)) were calculated using weighted linear regression and slopes compared using the Wald test. Chinese had lower incidence of abnormal total cholesterol, LDL-cholesterol and triglycerides than Whites in most BMI groups and had lower incidence of abnormal HDL-cholesterol and triglycerides than Blacks. Across the range of 18.5 to cholesterol in Chinese and Whites than in Blacks. Similar trends were seen for LDL-cholesterol and triglycerides, but were not always statistically significant. In contrast, BMI was more highly associated with incidence of low HDL-cholesterol in Whites than in Chinese or Blacks. Although differences in the incidence of lipid abnormalities and the impact of BMI were identified, results varied by lipid type indicating no consistent ethnic/national pattern. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. The Norberg angle is not an accurate predictor of canine hip conformation based on the distraction index and the dorsolateral subluxation score.

    Science.gov (United States)

    Gaspar, Ana R; Hayes, Galina; Ginja, Catarina; Ginja, Mário M; Todhunter, Rory J

    2016-12-01

    Canine hip dysplasia (CHD) is a common complex trait characterized by abnormal hip joint development. Hip joint laxity, an early characteristic of CHD, results in degeneration of the joint due to mechanical trauma, which is a clinical problem mostly in medium to large breed dogs. Clinical signs include pain, decreased activity and lameness. A retrospective, multi-center, cross sectional study of 437 dogs was performed to determine if a Norberg angle (NA) ≥105° accurately predicts a non-dysplastic hip based on a distraction index (DI) cut-off of ≤0.3 or a dorsolateral subluxation (DLS) score cut-off of ≥55%. The predictive capacity of the NA against a DI ≤0.3 or a DLS score ≥55% was assessed using area under the receiver operator characteristic (ROC) curve analysis. The ROC curve of NA for the prediction of a DI ≤0.3 was 0.59 (95% CI=0.50-0.69) and for the prediction of DLS score ≥55% was 0.69 (95% CI=0.63-0.75). Optimizing the specificity of the NA to ≥80% for prediction of a DI ≤0.3 and a DLS score ≥55% gave a cut-point for the NA of ≥112° and 108.7°, respectively. In conclusion, at the cut-point of 105°, the NA is not an accurate measurement to score normal or abnormal hips, based on the DI or DLS score. Application of screening methods for CHD based on hip laxity, such as the DI or the DLS score, would help to remove additional dysplastic dogs from the breeding pool or the NA criterion should be higher when selecting unaffected dogs for breeding. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Elevated serum levels of pregnancy-associated plasma protein-A in type 2 diabetics compared to healthy controls: associations with subclinical atherosclerosis parameters.

    Science.gov (United States)

    Heidari, Behnam; Fotouhi, Akbar; Sharifi, Frshad; Mohammad, Kazem; Pajouhi, Mohammad; Paydary, Koosha; Fakhrzadeh, Hossein

    2015-07-01

    Type 2 diabetes mellitus is associated with increased inflammation and accelerated atherosclerosis. The association of the pro-inflammatory and potentially pro-atherosclerotic molecule, pregnancy associated plasma protein-A (PAPP-A) with diabetes and vascular diseases remains to be further established. A total of 107 patients with type 2 diabetes and 101 healthy controls participated in this study. Serum levels of PAPP-A was measured by Enzyme-linked Immunosorbent Assay (ELISA). We also evaluated the lipid profile, aortic augmentation index, coronary calcium score, ankle brachial index, flow mediated dilation, and carotid intima media thickness. Serum level of PAPP-A was significantly higher in patients with diabetes compared to controls (PPAPP-A was positively correlated with diabetes (PPAPP-A were significantly higher in diabetics compared to healthy controls and correlated with aortic augmentation index and coronary calcification. Our study results suggest that PAPP-A can be a marker of subclinical atherosclerosis in patients with diabetes.

  1. Cerebrospinal fluid ferritin and albumin index: potential candidates for scoring system to differentiate between bacterial and viral meningitis in children.

    Science.gov (United States)

    Jebamalar, Angelin A; Prabhat; Balakrishnapillai, Agiesh K; Parmeswaran, Narayanan; Dhiman, Pooja; Rajendiran, Soundravally

    2016-07-01

    To evaluate the diagnostic role of cerebrospinal fluid (CSF) ferritin and albumin index (AI = CSF albumin/serum albumin × 1000) in differentiating acute bacterial meningitis (ABM) from acute viral meningitis (AVM) in children. The study included 42 cases each of ABM and AVM in pediatric age group. Receiver operating characteristic (ROC) analysis was carried out for CSF ferritin and AI. Binary logistic regression was also done. CSF ferritin and AI were found significantly higher in ABM compared to AVM. Model obtained using AI and CSF ferritin along with conventional criteria is better than existing models.

  2. A randomized clinical trial comparing the impact of different oral hygiene protocols and sealant applications on plaque, gingival, and caries index scores.

    Science.gov (United States)

    Zingler, Sebastian; Pritsch, Maria; Wrede, Dirk J; Ludwig, Björn; Bister, Dirk; Kneist, Susanne; Lux, Christopher J

    2014-04-01

    This prospective randomized clinical trial investigated the impact of different tooth brushing strategies and sealant application on patients with fixed appliances: plaque, gingival, caries index scores, periodontal parameters, microbial, and molecular biological parameters were assessed. Fifty-five male and 63 female patients aged 11-15 years were enrolled in this 12-week, four-arm parallel-group trial. Patients of group 1 used a Sonicare FlexCare electric brush, patients of group 2 used a manual (elmex interX short head) plus interdental (Curaprox CPS 15) brush, and patients of group 3 and 4 used a manual brush only. The teeth of patients in groups 1, 2, and 3 were sealed with a filled resin (ProSeal). Patients were advised to brush twice daily and measured time spent brushing mornings and evenings [tooth brushing duration (TBD)]. Plaque (PIB, TQHI, MAPI) and gingival index (PBI) as well as caries index (DMFT/DMFS) scores were assessed at baseline and after 4, 8, and 12 weeks. TBD did not differ significantly between patients using the electric or manual brush only (between 197 and 209 seconds) but was longer when using the combination of two manual brushes. TBD was slightly longer in the evenings. There was no gender difference. Although TBD was longer for the combination group, we failed to demonstrate any beneficial effect on outcome parameters for this group. No differences between sealed or unsealed tooth surfaces or for use of a manual or electric brush were observed.

  3. Age-adjusted Charlson comorbidity index score as predictor of survival of patients with digestive system cancer who have undergone surgical resection.

    Science.gov (United States)

    Tian, Yaohua; Jian, Zhong; Xu, Beibei; Liu, Hui

    2017-10-03

    Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015. The Cox proportional hazard regression model was applied to evaluate the effect of ACCI score on postoperative mortality, with adjustments for sex, type of resection, anesthesia methods, and caseload of each healthcare institution. The postoperative in-hospital mortality rate in the study cohort was 1.2% (3,631/315,464). ACCI score had a positive graded association with the risk of postoperative in-hospital mortality for all cancer subtypes. The adjusted HRs for postoperative in-hospital mortality scores ≥ 6 for esophagus, stomach, colorectum, pancreas, and liver and gallbladder cancer were 2.05 (95% CI: 1.45-2.92), 2.00 (95% CI: 1.60-2.49), 2.54 (95% CI: 2.02-3.21), 2.58 (95% CI: 1.68-3.97), and 4.57 (95% CI: 3.37-6.20), respectively, compared to scores of 0-1. These findings suggested that a high ACCI score is an independent predictor of postoperative in-hospital mortality in Chinese patients with digestive system cancer who have undergone surgical resection.

  4. Kamp K'aana, a 2-Week Residential Weight Management Summer Camp, Shows Long-Term Improvement in Body Mass Index z Scores.

    Science.gov (United States)

    Farhat, Alicia Elena; Sharma, Shreela; Abrams, Stephanie H; Wong, William W; Barlow, Sarah E

    2016-03-01

    Long-term effects of Kamp K'aana, a 2-week residential weight management camp, on body mass index (BMI) measures were evaluated on 71 of 108 (66%) obese youth 10 to 14 years of age. Measures were obtained at 11-month study follow-up (n = 38) or extracted from medical record (n = 33). Compared with baseline, BMI increased (P < 0.001), but both BMI percentile and BMI z score decreased (98.7 ± 1.0 to 97.3 ± 6.7 and 2.34 ± 0.30 to 2.23 ± 0.34, P < 0.001). A decrease in BMI z score of ≥0.2 units was seen in 27% of the participants (P < 0.001). The short program has sustained effect.

  5. Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain

    DEFF Research Database (Denmark)

    Juul, Tina; Søgaard, Karen; Davis, Aileen M.

    2016-01-01

    Objective:To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients. Study Design and Setting: Internal consistency was assessed by Cronbach alpha. Test...... correlating subscale scores from NOOS and SF-36 and NDI items. Results: At baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88–0.95), for NDI, and for SF-36...... with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19–0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales. Conclusions: In conclusion, the NOOS...

  6. Differences in body mass index z-scores and weight status in a Dutch pediatric psychiatric population with and without use of second-generation antipsychotics.

    Science.gov (United States)

    de Hoogd, Sjoerd; Overbeek, Wieske A; Heerdink, Eibert R; Correll, Christoph U; de Graeff, Elisabeth R; Staal, Wouter G

    2012-04-01

    Weight gain and metabolic adverse effects of second-generation antipsychotics (SGAs) have become a major concern, particularly in youth. However, the specific contribution of SGAs versus other medications or the underlying illness is unclear. In a chart review study of psychiatric outpatients aged ≤ 18 years treated with SGAs and psychiatric controls without lifetime SGA, use body mass index (BMI) z-scores between patients and controls were compared in the entire sample, patients without co-medications, diagnostic subgroups, and age subgroups. In patients with follow-up data, weight z-score change was calculated. Altogether, 592 Caucasian patients aged 4-18 (mean: 10.0) years with a psychiatric diagnosis were included. BMI z-scores in 96 youth treated with SGAs for 9.0 ± 6.1 months were significantly higher than in 496 patients without lifetime SGA use (0.81 ± 1.1 vs. 0.05 ± 1.2; pweight z-score increased significantly from -0.17 ± 1.5 to 0.25 ± 1.4 (pweight and weight status in young pediatric Caucasian samples with and without use of SGAs independent of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR) (American Psychiatric Association 2000 ) diagnosis and nonantipsychotic medications. Weight status and metabolic effects of SGAs require careful attention, especially in youth.

  7. Reflection magnitude as a predictor of mortality: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Zamani, Payman; Jacobs, David R; Segers, Patrick; Duprez, Daniel A; Brumback, Lyndia; Kronmal, Richard A; Lilly, Scott M; Townsend, Raymond R; Budoff, Matthew; Lima, Joao A; Hannan, Peter; Chirinos, Julio A

    2014-11-01

    Arterial wave reflections have been associated with mortality in an ethnically homogenous Asian population. It is unknown whether this association is present in a multiethnic population or whether it is independent of subclinical atherosclerosis. We hypothesized that reflection magnitude (defined as the ratio of the amplitude of the backward wave [Pb] to that of the forward wave [Pf]) is associated with all-cause mortality in a large multiethnic adult community-based sample. We studied 5984 participants enrolled in the Multi-Ethnic Study of Atherosclerosis who had analyzable arterial tonometry waveforms. During 9.8±1.7 years of follow-up, 617 deaths occurred, of which 134 (22%) were adjudicated cardiovascular deaths. In Cox proportional hazards models, each 10% increase in reflection magnitude was associated with a 31% increased risk for all-cause mortality (hazard ratio [HR]=1.31; 95% confidence interval [CI]=1.11-1.55; P=0.001). This relationship persisted after adjustment for various confounders and for markers of subclinical atherosclerosis (HR=1.23; 95% CI=1.01-1.51; P=0.04), including the coronary calcium score, ankle-brachial index, common carotid intima-media thickness, and ascending thoracic aortic Agatston score. Pb was independently associated with all-cause mortality in a similarly adjusted model (HR per 10 mm Hg increase in P(b)=2.18; 95% CI=1.21-3.92; P=0.009). Reflection magnitude (HR=1.71; 95% CI=1.06-2.77; P=0.03) and P(b) (HR=5.02; 95% CI=1.29-19.42; P=0.02) were mainly associated with cardiovascular mortality. In conclusion, reflection magnitude is independently associated with all-cause mortality in a multiethnic population initially free of clinically evident cardiovascular disease. This relationship persists after adjustment for a comprehensive set of markers of subclinical atherosclerosis. © 2014 American Heart Association, Inc.

  8. Integrin signaling in atherosclerosis.

    Science.gov (United States)

    Finney, Alexandra C; Stokes, Karen Y; Pattillo, Christopher B; Orr, A Wayne

    2017-06-01

    Atherosclerosis, a chronic lipid-driven inflammatory disease affecting large arteries, represents the primary cause of cardiovascular disease in the world. The local remodeling of the vessel intima during atherosclerosis involves the modulation of vascular cell phenotype, alteration of cell migration and proliferation, and propagation of local extracellular matrix remodeling. All of these responses represent targets of the integrin family of cell adhesion receptors. As such, alterations in integrin signaling affect multiple aspects of atherosclerosis, from the earliest induction of inflammation to the development of advanced fibrotic plaques. Integrin signaling has been shown to regulate endothelial phenotype, facilitate leukocyte homing, affect leukocyte function, and drive smooth muscle fibroproliferative remodeling. In addition, integrin signaling in platelets contributes to the thrombotic complications that typically drive the clinical manifestation of cardiovascular disease. In this review, we examine the current literature on integrin regulation of atherosclerotic plaque development and the suitability of integrins as potential therapeutic targets to limit cardiovascular disease and its complications.

  9. Phytosterols and atherosclerosis

    DEFF Research Database (Denmark)

    Schrøder, Malene

    Cardiovascular disease (CVD) is the major cause of premature deaths worldwide. Coronary heart disease is the most common CVD, caused by atherosclerosis in the coronary arteries. Atherosclerosis is a multifactorial disease influenced by both genetic and environmental factors. WHO has in 2007 listed...... in its “Guidelines for assessment and management of cardiovascular risk” the following risk factors to influence progressive atherosclerosis: hypertension, abnormal blood lipids, diabetes, unhealthy diet, physical inactivity and smoking. Phytosterols (plant sterols and plant stanols) are known...... for decades for their natural ability to reduce cholesterol levels in the blood. In the last decade numerous food products added phytosterol esters have been placed on the market, e.g. yellow fat spread, yoghurt, dressing. The products are being marketed as a natural means for people who want to lower...

  10. Molecular imaging in atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Glaudemans, Andor W.J.M.; Slart, Riemer H.J.A. [Dept. of Nuclear Medecine and Molecular Imaging, Groningen Univ. (Netherlands); Bozzao, Alessandro [Dept. of Neuroradiology, Univ. Rome (Italy); Bonanno, Elena [Univ. Tor Vergata, Rome (Italy). Dept. of Biopathologoy and Diagnostic Imaging; Arca, Marcello [Univ. Rome (Italy). 1. Faculty of Medicine; Dierckx, Rudi A.J.O. [Dept. of Nuclear Medecine and Molecular Imaging, Groningen Univ. (Netherlands); Ghent Univ. (Belgium); Signore, Alberto [Dept. of Nuclear Medecine and Molecular Imaging, Groningen Univ. (Netherlands); Univ. Rome (Italy). 2. Faculty of Medicine; Univ. of Rome (Italy). Medicina Nucleare Ospedale

    2010-12-15

    Atherosclerosis is the major cause of cardiovascular disease, which still has the leading position in morbidity and mortality in the Western world. Many risk factors and pathobiological processes are acting together in the development of atherosclerosis. This leads to different remodelling stages (positive and negative) which are both associated with plaque physiology and clinical presentation. The different remodelling stages of atherosclerosis are explained with their clinical relevance. Recent advances in basic science have established that atherosclerosis is not only a lipid storage disease, but that also inflammation has a fundamental role in all stages of the disease. The molecular events leading to atherosclerosis will be extensively reviewed and described. Further on in this review different modalities and their role in the different stages of atherosclerosis will be discussed. Non-nuclear invasive imaging techniques (intravascular ultrasound, intravascular MRI, intracoronary angioscopy and intravascular optical coherence tomography) and non-nuclear non-invasive imaging techniques (ultrasound with Doppler flow, electron-bean computed tomography, coronary computed tomography angiography, MRI and coronary artery MR angiography) will be reviewed. After that we focus on nuclear imaging techniques for detecting atherosclerotic plaques, divided into three groups: atherosclerotic lesion components, inflammation and thrombosis. This emerging area of nuclear imaging techniques can provide measures of biological activity of atherosclerotic plaques, thereby improving the prediction of clinical events. As we will see in the future perspectives, at present, there is no special tracer that can be called the diagnostic tool to diagnose prospective stroke or infarction in patients. Nevertheless, we expect such a tracer to be developed in the next few years and maybe, theoretically, it could even be used for targeted therapy (in the form of a beta-emitter) to combat

  11. Molecular imaging in atherosclerosis

    Science.gov (United States)

    Glaudemans, Andor W. J. M.; Slart, Riemer H. J. A.; Bozzao, Alessandro; Bonanno, Elena; Arca, Marcello; Dierckx, Rudi A. J. O.

    2010-01-01

    Atherosclerosis is the major cause of cardiovascular disease, which still has the leading position in morbidity and mortality in the Western world. Many risk factors and pathobiological processes are acting together in the development of atherosclerosis. This leads to different remodelling stages (positive and negative) which are both associated with plaque physiology and clinical presentation. The different remodelling stages of atherosclerosis are explained with their clinical relevance. Recent advances in basic science have established that atherosclerosis is not only a lipid storage disease, but that also inflammation has a fundamental role in all stages of the disease. The molecular events leading to atherosclerosis will be extensively reviewed and described. Further on in this review different modalities and their role in the different stages of atherosclerosis will be discussed. Non-nuclear invasive imaging techniques (intravascular ultrasound, intravascular MRI, intracoronary angioscopy and intravascular optical coherence tomography) and non-nuclear non-invasive imaging techniques (ultrasound with Doppler flow, electron-bean computed tomography, coronary computed tomography angiography, MRI and coronary artery MR angiography) will be reviewed. After that we focus on nuclear imaging techniques for detecting atherosclerotic plaques, divided into three groups: atherosclerotic lesion components, inflammation and thrombosis. This emerging area of nuclear imaging techniques can provide measures of biological activity of atherosclerotic plaques, thereby improving the prediction of clinical events. As we will see in the future perspectives, at present, there is no special tracer that can be called the diagnostic tool to diagnose prospective stroke or infarction in patients. Nevertheless, we expect such a tracer to be developed in the next few years and maybe, theoretically, it could even be used for targeted therapy (in the form of a beta-emitter) to combat

  12. Gender differences between WOMAC index scores, health-related quality of life and physical performance in an elderly Taiwanese population with knee osteoarthritis.

    Science.gov (United States)

    Fang, Wen-Hui; Huang, Guo-Shu; Chang, Hsien-Feng; Chen, Ching-Yang; Kang, Chi-Yu; Wang, Chih-Chien; Lin, Chin; Yang, Jia-Hwa; Su, Wen; Kao, SenYeong; Su, Sui-Lung

    2015-09-15

    To investigate the importance of the WOMAC index score, health-related quality of life and physical performance in each domain affected by knee osteoarthritis (OA) and to identify gender differences in the importance of these domains and physical performances. We performed a population-based study for radiographic knee OA among participants aged more than 65 years. Demographic data were collected and anthropometric measurement, radiographic assessment, the WOMAC index score, the short-form 12 (SF-12), the Timed and Up to Go Test (TUGT) and the Five Times Sit to Stand Test (FTSST) were performed. There were 901 individuals (409 males and 492 females) aged 74.04±6.92 (male: 76.35±7.33; female: 72.12±5.92) years included in this study. The WOMAC scores of participants with OA were higher than those without OA in males and females (male: 11.97±15.79 vs 8.23±12.84, pphysical component summary (PCS) score was only significant in females with knee OA (62.14±24.66 vs 66.59±23.85, p=0.043), while the mental component summary (MCS) score was only significant in males with knee OA (78.02±18.59 vs 81.98±15.46, p=0.02). The TUGT and FTSST were not significant in individuals with and without OA in males and females. Moreover, the multivariate results for the WOMAC score were significant for females (3.928 (95% CI 1.287 to 6.569), p=0.004). The PCS domains of SF-12 and MCS domains of SF-12 are crucial in Taiwanese females and elderly males, respectively, with knee OA. Different evaluation and treatment strategies based on gender differences should be considered in elderly Taiwanese patients with knee OA to improve their quality of life. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Education and inequalities in risk scores for coronary heart disease and body mass index: evidence for a population strategy.

    Science.gov (United States)

    Liu, Sze Yan; Kawachi, Ichiro; Glymour, M Maria

    2012-09-01

    Concerns have been raised that education may have greater benefits for persons at high risk of coronary heart disease (CHD) than for those at low risk. We estimated the association of education (less than high school, high school, or college graduates) with 10-year CHD risk and body mass index (BMI), using linear and quantile regression models, in the following two nationally representative datasets: the 2006 wave of the Health and Retirement Survey and the 2003-2008 National Health and Nutrition Examination Survey (NHANES). Higher educational attainment was associated with lower 10-year CHD risk for all groups. However, the magnitude of this association varied considerably across quantiles for some subgroups. For example, among women in NHANES, a high school degree was associated with 4% (95% confidence interval = -9% to 1%) and 17% (-24% to -8%) lower CHD risk in the 10th and 90th percentiles, respectively. For BMI, a college degree was associated with uniform decreases across the distribution for women, but with varying increases for men. Compared with those who had not completed high school, male college graduates in the NHANES sample had a BMI that was 6% greater (2% to 11%) at the 10th percentile of the BMI distribution and 7% lower (-10% to -3%) at the 90th percentile (ie, overweight/obese). Estimates from the Health and Retirement Survey sample and the marginal quantile regression models showed similar patterns. Conventional regression methods may mask important variations in the associations between education and CHD risk.

  14. Severity strata for Eczema Area and Severity Index (EASI), modified EASI, Scoring Atopic Dermatitis (SCORAD), objective SCORAD, Atopic Dermatitis Severity Index and body surface area in adolescents and adults with atopic dermatitis.

    Science.gov (United States)

    Chopra, R; Vakharia, P P; Sacotte, R; Patel, N; Immaneni, S; White, T; Kantor, R; Hsu, D Y; Silverberg, J I

    2017-11-01

    Scoring systems for assessing the signs of atopic dermatitis (AD) are complex and difficult to interpret. Severity strata are helpful to interpret these assessments properly. To confirm previously reported strata for the Eczema Area and Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD) and the objective component of SCORAD (oSCORAD), and to develop strata for the modified EASI (mEASI), Atopic Dermatitis Severity Index (ADSI) and body surface area (BSA) for use in adults with AD. Skin examination was performed in 673 adolescents and adults (age ≥ 13 years) with diagnosed AD, in a dermatology practice setting. Strata were selected using an anchoring approach based on a four-point Investigator's Global Assessment of severity (clear of active skin lesions, mild, moderate or severe disease). We determined potential severity strata for EASI (0 clear, 0·1-5·9 mild, 6·0-22·9 moderate, 23·0-72 severe; κ = 0·69), mEASI (0-0·9 clear, 1-8·9 mild, 9·0-29·9 moderate, 30·0-90 severe; κ = 0·71), oSCORAD (0-7·9 clear, 8·0-23·9 mild, 24·0-37·9 moderate, 38·0-83 severe; κ = 0·70), SCORAD (0-9·9 clear, 10·0-28·9 mild, 29·0-48·9 moderate, 49·0-103 severe; κ = 0·68), ADSI (0-1·9 clear, 2-5·9 mild, 6·0-8·9 moderate, 9·0-15 severe; κ = 0·55) and BSA (0 clear, 0·1-15·9 mild, 16·0-39·9 moderate, 40·0-100 severe; κ = 0·66). oSCORAD values > 0 were found in clear skin due to the presence of xerosis, which is scored in oSCORAD. Similarly, SCORAD values > 0 were found in clear skin due to the scoring of xerosis, pruritus and sleeplessness. Similarly, mEASI and ADSI scores > 0 occurred in patients with clear skin due to scoring of pruritus. We recommend using these strata for interpretation of their respective measures in clinical trials of AD. There are important differences between the five assessments, which profoundly impact the interpretation of their scores. © 2017 British Association of Dermatologists.

  15. Impact of Age at Diagnosis and Hypothalamic Involvement on Body Mass Index Z-Score Change in Pediatric Brain Tumor Survivors.

    Science.gov (United States)

    Strobel, Katie; Simpson, Pippa; Donohoue, Patricia A; Firat, Selim; Jogal, Sachin

    2016-01-01

    Obesity risk is increased for pediatric central nervous system tumor survivors. Hypothalamic involvement (HI) by tumor or treatment increases the risk. In healthy children, body mass index (BMI) normally declines until adiposity rebound (AR). We hypothesized that HI and diagnosis before AR would lead to increased BMI at follow-up. A chart review of 114 brain tumor survivors diagnosed between 2001-2011 at the Children's Hospital of Wisconsin extracted tumor location, treatment and BMI z-scores at diagnosis and 2-year follow-up. Children were categorized based on age at diagnosis relative to AR and presence/absence of HI. Children diagnosed pre-AR and post-AR with HI had higher BMI z-scores at 2-year follow-up (pre-AR: 1.6, post-AR: 1.3) than at diagnosis (0.5, 0.6). All groups without HI showed no increase in BMI z-score from diagnosis to 2-year follow-up (pre-AR: 0.7-0.6, during AR: 0.7-0.8, post-AR: 0.7-0.8). The pre-AR and during-AR cohorts with HI had a higher BMI z-score at 2-year follow-up relative to those without HI, while the post-AR group did not. Except for the post-AR group, patients with HI have increased BMI at 2 years after diagnosis compared to those without HI. Diagnosis pre-AR is associated with greater follow-up BMI z-score. © 2016 S. Karger AG, Basel.

  16. Healthy Eating Index scores associated with symptoms of depression in Cuban-Americans with and without type 2 diabetes: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Exebio Joel C

    2011-12-01

    Full Text Available Abstract Background Low diet quality and depression symptoms are independently associated with poor glycemic control in subjects with type 2 diabetes (T2D; however, the relationship between them is unclear. The aim of this study was to determine the association between diet quality and symptoms of depression among Cuban-Americans with and without T2D living in South Florida. Methods Subjects (n = 356 were recruited from randomly selected mailing list. Diet quality was determined using the Healthy Eating Index-2005 (HEI-05 score. Symptoms of depression were assessed using the Beck Depression Inventory (BDI. Both linear and logistic regression analyses were run to determine whether or not these two variables were related. Symptoms of depression was the dependent variable and independent variables included HEI-05, gender, age, marital status, BMI, education level, A1C, employment status, depression medication, duration of diabetes, and diabetes status. Analysis of covariance was used to test for interactions among variables. Results An interaction between diabetes status, gender and HEI-05 was found (P = 0.011. Among males with a HEI-05 score ≤ 55.6, those with T2D had a higher mean BDI score than those without T2D (11.6 vs. 6.6 respectively, P = 0.028. Among males and females with a HEI-05 score ≤ 55.6, females without T2D had a higher mean BDI score compared to males without T2D (11.0 vs. 6.6 respectively, P = 0.012 Conclusions Differences in symptoms of depression according to diabetes status and gender are found in Cuban-Americans with low diet quality.

  17. Assessment of subclinical atherosclerosis in ankylosing spondylitis: correlations with disease activity indices

    Directory of Open Access Journals (Sweden)

    F.M. Perrotta

    2013-07-01

    Full Text Available The aim of the study was to evaluate atherosclerosis in ankylosing spondylitis (AS through the assessment of morphological and functional measures of subclinical atherosclerosis. Twenty patients [M/F=12/8, age (median/range 43.5/28-69 years; disease duration (median/range 9.7/1-36 years] with AS classified according to modified New York criteria and twenty age and sex related healthy controls with negative past medical history for cardiovascular events were enrolled in the study. In all patients and controls, the intima-media thickness (IMT of common carotid artery, carotid bulb and internal carotid artery, and the flow-mediated dilatation (FMD of non-dominant arm brachial artery were determined, using a sonographic probe Esaote GPX (Genoa, Italy. Furthermore, we assess the main disease activity and disability indices [bath ankylosing spondylitis disease activity index, ankylosing spondylitis disease activity score-eritrosedimentation rate (ASDAS-ESR, ASDAS-C-reactive protein (CRP, bath ankylosing spondylitis metrology index, bath ankylosing spondylitis functional index and acute phase reactants. Plasmatic values of total cholesterol, low-density lipoprotein, high-density lipoprotein, triglyceride and homocysteine were carried out in all twenty patients. IMT at carotid bulb was significant higher in patients than in controls (0.67 mm vs 0.54 mm; P=0.03. FMD did not statistically differ between patients and controls (12.5% vs 15%; P>0.05. We found a correlation between IMT at carotid bulb and ESR (rho 0.43; P=0.04. No correlation was found between FMD and disease activity and disability indices. This study showed that in AS patients, without risk factors for cardiovascular disease, carotid bulb IMT, morphological index of subclinical atherosclerosis, is higher than in controls.

  18. Phosphatidylserine in atherosclerosis

    OpenAIRE

    Darabi, Maryam; Kontush, Anatol

    2016-01-01

    International audience; Purpose of review: It is now widely acknowledged that phosphatidylserine is a multifunctional bioactive lipid. In this review, we focus on the function of phosphatidylserine in modulating cholesterol metabolism, influencing inflammatory response and regulating coagulation system, and discuss promising phosphatidylserine-based therapeutic approaches and detection techniques in atherosclerosis.

  19. Alcohol and atherosclerosis

    Directory of Open Access Journals (Sweden)

    DA LUZ PROTASIO L.

    2001-01-01

    Full Text Available Atherosclerosis is manifested as coronary artery disease (CAD, ischemic stroke and peripheral vascular disease. Moderate alcohol consumption has been associated with reduction of CAD complications. Apparently, red wine offers more benefits than any other kind of drinks, probably due to flavonoids. Alcohol alters lipoproteins and the coagulation system. The flavonoids induce vascular relaxation by mechanisms that are both dependent and independent of nitric oxide, inhibits many of the cellular reactions associated with atherosclerosis and inflammation, such as endothelial expression of vascular adhesion molecules and release of cytokines from polymorphonuclear leukocytes. Hypertension is also influenced by the alcohol intake. Thus, heavy alcohol intake is almost always associated with systemic hypertension, and hence shall be avoided. In individuals that ingest excess alcohol, there is higher risk of coronary occlusion, arrhythmias, hepatic cirrhosis, upper gastrointestinal cancers, fetal alcohol syndrome, murders, sex crimes, traffic and industrial accidents, robberies, and psychosis. Alcohol is no treatment for atherosclerosis; but it doesn't need to be prohibited for everyone. Thus moderate amounts of alcohol (1-2 drinks/day, especially red wine, may be allowed for those at risk for atherosclerosis complications.

  20. [Atherosclerosis and infection?].

    Science.gov (United States)

    Zeman, K

    2006-09-01

    Atherosclerosis is guided by chronicle inflammation process. In the last decades of the 20th century, studies considering infection another possible risk factor of atherosclerosis development were written. Helicobacter pylori, Porphyromas gingivalis, some viruses but most frequently Chlamydia pneumonie are infection agens mentioned in these studies. Some of them emphasize also combined infections caused by more pathogenic factors having influence on vascular inflammation. Serological, epidemiological, histological and imunological studies show the pathogenic influence of acute or chronic infections. Many studies selected makrolid antibiotics as treatment in patients with ischaemic heart disease. However, existing experience with antibiotics did not bring clear results. These studies have mentioned the fact antibiotics have not been indicated as treatment in patients with acute or chronic vascular system infliction by atherosclerosis. Since the experimental and clinical research of influence of inflammations on the development of atherosclerosis moved forward a lot, no exact evidence of this complicated pathogenic mechanism was given. It will obviously take some time to confirm whether the relation between infections and artherosclerosis is causal, i.e. initiating the pathogenic process, accelerating it or keeping it alive.

  1. Animal Models of Atherosclerosis

    Science.gov (United States)

    Getz, Godfrey S.; Reardon, Catherine A.

    2012-01-01

    Atherosclerosis is a chronic inflammatory disorder that is the underlying cause of most cardiovascular disease. Both cells of the vessel wall and cells of the immune system participate in atherogenesis. This process is heavily influenced by plasma lipoproteins, genetics and the hemodynamics of the blood flow in the artery. A variety of small and large animal models have been used to study the atherogenic process. No model is ideal as each has its own advantages and limitations with respect to manipulation of the atherogenic process and modeling human atherosclerosis or lipoprotein profile. Useful large animal models include pigs, rabbits and non-human primates. Due in large part to the relative ease of genetic manipulation and the relatively short time frame for the development of atherosclerosis, murine models are currently the most extensively used. While not all aspects of murine atherosclerosis are identical to humans, studies using murine models have suggested potential biological processes and interactions that underlie this process. As it becomes clear that different factors may influence different stages of lesion development, the use of mouse models with the ability to turn on or delete proteins or cells in tissue specific and temporal manner will be very valuable. PMID:22383700

  2. High prevalence of subclinical atherosclerosis in psoriatic arthritis patients: a study based on carotid ultrasound.

    Science.gov (United States)

    Ibáñez-Bosch, Rosario; Restrepo-Velez, Juliana; Medina-Malone, Miguel; Garrido-Courel, Laura; Paniagua-Zudaire, Inmaculada; Loza-Cortina, Eduardo

    2017-01-01

    Analyse the presence of subclinical atherosclerosis in psoriatic arthritis patients (PsA). A cross-sectional study of 53 patients with PsA and 53 controls matched for age and sex was designed. Carotid intima-media thickness (IMT) and the presence of carotid plaques (CP) were assessed with carotid ultrasound. Data on cardiovascular (CV) risk factors were collected. Patients with PsA had a higher prevalence rate of obesity and tobacco smoking. CP were detected more frequently in patients with PsA than in controls with an OR of 4.15, 95% CI 1.4-12.1, which adjusted for smoking and those with history of CV disease gave an OR of 3.9, 95% CI 1.2-12.7, p = 0.026. Carotid IMT was significantly higher in patients with PsA adjusted for age and tobacco smoking. According to ultrasound data, 30.2% of patients with PsA had carotid atherosclerosis (presence of CP and/or carotid IMT > 0.90 mm) compared with 9.4% of controls. The SCORE index (Systematic Coronary Risk Evaluation) underestimated the CV risk in these patients: most patients with CP had an intermediate CV risk. According to carotid ultrasound data, PsA patients have a high prevalence of subclinical atherosclerosis. These results support the importance of screening for CV risk and to include carotid ultrasound in CV prevention strategies in these patients.

  3. Assessment of Mobility in Older People Hospitalized for Medical Illness Using de Morton Mobility Index and Cumulated Ambulation Score-Validity and Minimal Clinical Important Difference.

    Science.gov (United States)

    Trøstrup, Jeanette; Andersen, Helle; Kam, Charlotte Agger Meiner; Magnusson, S Peter; Beyer, Nina

    2017-12-15

    Older adults acutely hospitalized for medical illness typically have comorbidity and disability, and inhospital physical inactivity greatly increases the likelihood of developing new disability. Thus, assessment of the patients' mobility status is crucial for planning and carrying out targeted interventions that ensure mobilization during hospital admission. The aim of this study was to determine convergent validity, known group validity, floor and ceiling effects, and anchor-based minimal clinically important difference (MCID) of the more time-consuming de Morton Mobility Index (DEMMI) and the less time-consuming Cumulated Ambulation Score (CAS) in older adults acutely hospitalized for medical illness. In this multicenter cohort study, 235 older hospitalized adults, with a mean (standard deviation) age of 84.8 (7.1) years, were consecutively included. Assessments of mobility using the DEMMI (score range 0-100), the CAS (score range 0-6), and the Barthel Index (BI, score range 0-100) were performed by physical or occupational therapists at hospital admission and discharge. In addition, at discharge patients and therapists were independently asked to assess the patients' current mobility status compared with their mobility status at hospital admission using the Global Rating of Change scale. Complete data sets were obtained for 155 patients. Baseline characteristics of those with complete data sets did not differ from those with incomplete data sets, except for the number of secondary diagnoses, which was lower in the latter. Significant and moderate relationships existed both at admission and at discharge between scores in the DEMMI and the BI (rs = 0.68, P mobility and can be considered to have the required properties for measuring mobility in older adults who are hospitalized in medical and geriatric wards. In contrast, the CAS appears to be appropriate to identify whether a patient is independently mobile or needs assistance, while the measure is less suitable

  4. APACHE score, Severity Index of Paraquat Poisoning, and serum lactic acid concentration in the prognosis of paraquat poisoning of Chinese Patients.

    Science.gov (United States)

    Xu, Shuyun; Hu, Hai; Jiang, Zhen; Tang, Shiyuan; Zhou, Yuangao; Sheng, Jie; Chen, Jinggang; Cao, Yu

    2015-02-01

    Many prognostic indictors have been studied to evaluate the prognosis of paraquat poisoning. However, the optimal indicator remains unclear. To determine the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the Severity Index of Paraquat Poisoning (SIPP), and serum lactate levels in the prognosis of paraquat poisoning, we performed a prospective study that enrolled 143 paraquat patients. Data were collected from patients (161) at West China Hospital in Chengdu, China, including details about the patients' general conditions, laboratory examinations, and treatment. Receiver operating characteristic curves for predicting inpatient mortality based on APACHE II score, SIPP, and lactate levels were generated. To analyze the best cutoff values for lactate levels, APACHE II scores, and SIPP in predicting the prognosis of paraquat poisoning, the initial parameters on admission and 7-day survival curves of patients with lactate levels greater than or equal to 2.95 mmol/L, APACHE II score greater than or equal to 15.22, and SIPP greater than or equal to 5.50 h · mg/L at the time of arrival at West China Hospital were compared using the 1-way analysis of variance and the log-rank test. The APACHE II score (5.45 [3.67] vs 11.29 [4.31]), SIPP (2.78 [1.89] vs 7.63 [2.46] h · mg/L), and lactate level (2.78 [1.89] vs 7.63 [2.46] mmol/L) were significantly lower in survivors (77) after oral ingestion of paraquat, compared with nonsurvivors (66). The APACHE II score, SIPP, and lactate level had different areas under the curve (0.847, 0.789, and 0.916, respectively) and accuracy (0.64, 0.84, and 0.89, respectively). Respiratory rate, serum creatinine level, Paco2, and mortality rate at 7 days after admission in patients with lactate levels greater than or equal to 2.95 mmol/L were markedly different compared with those of other patients (P APACHE II score and SIPP for acute oral paraquat poisoning.

  5. Patients with tattoo reactions have reduced quality of life and suffer from itch: Dermatology Life Quality Index and Itch Severity Score measurements.

    Science.gov (United States)

    Hutton Carlsen, K; Serup, J

    2015-02-01

    Tattoos are a trend with increasing side-effects. The burden of local reaction with swelling, itching and discomfort may impel sufferers to consult medical assistance. To assess tattoo reactions and their influence on quality of life and itching by utilizing the Dermatology Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients attending their routine consultations completed the ISS and DLQI questionnaires. Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated with itch. Tattoo reactions warrant diagnosis and treatment with same professional intent shared with other skin diseases. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Relationships between results of the Ortolani method of hip joint palpation and distraction index, Norberg angle, and hip score in dogs.

    Science.gov (United States)

    Puerto, D A; Smith, G K; Gregor, T P; LaFond, E; Conzemius, M G; Cabell, L W; McKelvie, P J

    1999-02-15

    To determine whether results of the Ortolani method of hip joint palpation in dogs were related to distraction index (DI), Norberg angle, or radiographic hip score. Cross-sectional study. 459 clinically normal dogs. Dogs were sedated for radiography and palpation of the hip joints. Results of hip joint palpation were classified as negative, mild positive, moderate positive, or severe positive. Distraction indices were measured for all dogs. Norberg angles were measured for 380 dogs for which ventrodorsal hip-extended radiographic projections were available. Hip scores assigned by the Orthopedic Foundation for Animals (OFA) were available for 95 dogs. Age, weight, and sex were not significantly associated with results of hip joint palpation. There was moderate correlation between results of hip joint palpation and DI (r = 0.636), low-moderate correlation between results of hip joint palpation and OFA hip scores (rs = 0.437), and weak negative correlation (r = -0.236) between results of hip joint palpation and Norberg angle. For joints without degenerative joint disease (DJD), there was a significant linear relationship between results of hip palpation and DI; however, for joint with DJD, there was not. Results of hip joint palpation were 5.3-fold as likely to be negative for dogs with DJD as for dogs without. Results of hip joint palpation were at best moderately correlated with radiographic measures of hip joint laxity. Therefore, hip joint palpation should be combined with hip-extended and stress radiography when assessing hip joint quality.

  7. Measuring the modified early warning score and the Rothman index: advantages of utilizing the electronic medical record in an early warning system.

    Science.gov (United States)

    Finlay, G Duncan; Rothman, Michael J; Smith, Robert A

    2014-02-01

    Early detection of an impending cardiac or pulmonary arrest is an important focus for hospitals trying to improve quality of care. Unfortunately, all current early warning systems suffer from high false-alarm rates. Most systems are based on the Modified Early Warning Score (MEWS); 4 of its 5 inputs are vital signs. The purpose of this study was to compare the accuracy of MEWS against the Rothman Index (RI), a patient acuity score based upon summation of excess risk functions that utilize additional data from the electronic medical record (EMR). MEWS and RI scores were computed retrospectively for 32,472 patient visits. Nursing assessments, a category of EMR inputs only used by the RI, showed sharp differences 24 hours before death. Receiver operating characteristic curves for 24-hour mortality demonstrated superior RI performance with c-statistics, 0.82 and 0.93, respectively. At the point where MEWS triggers an alarm, we identified the RI point corresponding to equal sensitivity and found the positive likelihood ratio (LR+) for MEWS was 7.8, and for the RI was 16.9 with false alarms reduced by 53%. At the RI point corresponding to equal LR+, the sensitivity for MEWS was 49% and 77% for RI, capturing 54% more of those patients who will die within 24 hours. Published 2013. The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.

  8. The Association of Food Consumption Scores, Body Shape Index, and Hypertension in a Seven-Year Follow-Up among Indonesian Adults: A Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Emyr Reisha Isaura

    2018-01-01

    Full Text Available Aims: The concept of food security and its association with chronic diseases are both well-established. During the years within the scope of the study, there was a significant increase in the body shape index (ABSI of Indonesian adults. This study tested the hypothesis that the association between food security and chronic diseases is mediated, in part, by ABSI. Methods: Data was obtained from 2156 Indonesian adults using the Indonesia Family Life Survey (IFLS in 2007 and 2014. Longitudinal study participants were interviewed face-to-face for dietary intake data using the food frequency questionnaire (FFQ. Food security, a concept developed by the World Food Programme (WFP, was calculated based on a food consumption score analysis using the FFQ. A generalized estimating equation (GEE and a Sobel–Goodman test were used to test the hypothesis in this study. Results: The food consumption score was negatively associated with ABSI. It was also negatively associated with systolic blood pressure (p < 0.001. In a formal mediation analysis, ABSI significantly mediated the pathway between the food consumption score and systolic blood pressure (p < 0.001. Conclusions: The effect of food security on hypertension is mediated through body shape. Strategies to improve the prevention of hypertension among adults may need to take the ABSI and food security, along with nutrition education, into account.

  9. Implications of alcoholic cirrhosis in atherosclerosis of autopsied patients

    Directory of Open Access Journals (Sweden)

    Luciano Alves Matias da Silveira

    Full Text Available Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. Method: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. Results: Microscopic atherosclerosis was higher in young subjects (early injury and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.

  10. Comparison of serum procalcitonin with Ranson, APACHE-II, Glasgow and Balthazar CT severity index scores in predicting severity of acute pancreatitis.

    Science.gov (United States)

    Woo, Su Mi; Noh, Myung Hwan; Kim, Byung Geun; Hsing, Chien Ter; Han, Ji Sun; Ryu, Seung Hee; Seo, Jeong Min; Yoon, Hyun Ah; Jang, Jin Seok; Choi, Seok Reyol; Cho, Jin Han

    2011-07-01

    The aim of this study is to assess serum procalcitonin (PCT) for early prediction of severe acute pancreatitis compared with multiple scoring systems and biomarkers. Forty-four patients with acute pancreatitis confirmed by radiological evidences, laboratory assessments, and clinical manifestation were prospectively enrolled. All blood samples and image studies were obtained within 24 hours of admission. Acute pancreatitis was graded as severe in 19 patients and mild in 25 patients according to the Atlanta criteria. Levels of serum PCT were significantly higher in severe acute pancreatitis (p=0.001). The accuracy of serum PCT as a predicting marker was 77.3%, which was similar to the acute physiology and chronic health examination (APACHE)-II score, worse than the Ranson score (93.2%) and better than the Balthazar CT index (65.9%). The most effective cut-off level of serum PCT was estimated at 1.77 ng/mL (AUC=0.797, 95% CI=0.658-0.935). In comparision to other simple biomarkers, serum PCT had more accurate value (77.3%) than C-reactive protein (68.2%), urea (75.0%) and lactic dehydrogenase (72.7%). Logistic regression analysis revealed that serum PCT has statistical significance in acute severe pancreatitis. Assessment of serum PCT levels and length of hospital stay by simple linear regression analysis revealed effective p-value with low R square level, which could make only possibilty for affection of serum PCT to admission duration (r2=0.127, p=0.021). Serum PCT was a promising simple biomarker and had similar accuracy of APACHE-II scores as predicting severity of acute pancreatitis.

  11. Severity of systemic calcified atherosclerosis is associated with airflow limitation and emphysema.

    Science.gov (United States)

    Chae, Eun Jin; Seo, Joon Beom; Oh, Yeon-Mok; Lee, Jae Seung; Jung, Youngju; Lee, Sang Do

    2013-01-01

    We investigated the association between systemic calcified atherosclerosis and airflow limitation. A prospective cohort of 134 patients with chronic obstructive pulmonary disease (male:female = 124:10; mean age, 65.4 years) and 101 smokers without airflow limitation (male:female = 87:14; mean age, 51.8 y) were assessed by computed tomography, pulmonary function test, and blood sampling. We measured the extent of calcification in the major thoracic arteries (thoracic aorta, coronary arteries, aortic/mitral valvular annuli, and proximal neck vessels) as indicators of systemic calcified atherosclerosis. After adjustment for age and smoking, total calcium score correlated with volume fraction of emphysematous lung (r = 0.19, P = 0.005) and diffusing capacity (r = - 0.15, P = 0.028). Multivariate logistic regression showed significant associations between total calcium score and forced expiratory volume at 1 second/forced vital capacity (P = 0.016) and between coronary calcium score and forced expiratory volume at 1 second/forced vital capacity (P = 0.016; P = 0.004) and diffusing capacity (P = 0.041), independent of age, body mass index, and smoking amount. The amount of calcification was associated with the extent of emphysema on computed tomography and airflow limitation.

  12. The Epidemiology of Subclavian Stenosis and its Association with Markers of Subclinical Atherosclerosis: the Multi-Ethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

    Aboyans, Victor; Kamineni, Aruna; Allison, Matthew A.; McDermott, Mary McGrae; Crouse, John R.; Ni, Hanyu; Szklo, Moyses; Criqui, Michael H.

    2010-01-01

    Background Recent studies indicate that subclavian stenosis (SS), diagnosed by a large systolic blood pressure difference (SBPD) between the right and left brachial arteries, is associated with cardiovascular disease (CVD) risk factors and outcomes. We sought to describe the epidemiology of SS and determine its association with markers of subclinical CVD in the baseline cohort of the Multi-Ethnic Study of Atherosclerosis. Methods We defined SS by an absolute SBPD ≥15 mmHg. Peripheral artery disease (PAD) was defined by an ankle-brachial index ≤0.90. The coronary artery calcium score (CAC) and the common-carotid artery intima-media thickness (CCA-IMT) were measured by computed tomography and B-mode ultrasound, respectively. Odds ratios for the associations of SS with risk factors and subclinical disease were estimated using logistic regression. Results Of 6,743 subjects studied, 307 participants (4.6%) had SS, with a higher prevalence in women (5.1%) than men (3.9%), and in African-Americans (7.4%) and non-Hispanic whites (5.1%) than Hispanic (1.9%) or Chinese (1.0%) participants (p100 vs. score=0; OR=1.43; 1.03-2.01). Conclusions The subclavian stenosis is positively associated with other markers of subclinical atherosclerosis. PMID:20138280

  13. Secondary Cutaneous Diffuse Large B-cell Lymphoma has a Higher International Prognostic Index Score and Worse Prognosis Than Diffuse Large B-cell Lymphoma, Leg Type.

    Science.gov (United States)

    Lee, Woo Jin; Won, Kwang Hee; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan; Park, Chan-Sik; Huh, Jooryung; Suh, Cheolwon; Lee, Mi Woo

    2016-02-01

    Diffuse large B-cell lymphoma (DLBCL) can be separated into 2 groups: nodal and extranodal disease. The aim of this study was to analyse the clinical features of skin lesions and survival outcomes of cutaneous DLBCL according to the primary tumour site. A total of 44 patients with cutaneous DLBCL were classified as primary cutaneous DLBCL, leg type or cutaneous DLBCL secondary to primary disease. Although skin lesion characteristics did not differ significantly between groups, extensive cutaneous lesions were more often observed in secondary cutaneous DLBCL compared with DLBCL, leg type. Secondary cutaneous DLBCL was more commonly associated with an advanced stage and higher International Prognostic Index score than DLBCL, leg type. DLBCL, leg type demonstrated a better survival outcome than secondary cutaneous DLBCL. The multiplicity of skin lesions and time-point of cutaneous involvement were associated with prognosis in secondary cutaneous DLBCL. Survival outcomes and prognostic factors differ depending on the primary tumour site of cutaneous DLBCL.

  14. Patients' outcome after total hip arthroplasty: a comparison between the Western Ontario and McMaster Universities index and the Oxford 12-item hip score.

    Science.gov (United States)

    Garbuz, Donald S; Xu, Min; Sayre, Eric C

    2006-10-01

    This prospective cohort study included 402 patients who had primary total hip arthroplasty. The Western Ontario and McMaster Universities Index (WOMAC) and the Oxford 12-item Hip Score (OHS) were used to assess patients preoperatively and at 1 year postoperation. The OHS has a higher responsiveness than the WOMAC in the global scale and in the pain subscale. However, the WOMAC has better responsiveness in its function scale. The point estimate of relative precision of measuring postoperative quality of life shows that the OHS has a tendency toward a better performance than the WOMAC; however, this finding is not statistically significant. The OHS also demonstrates similar floor and ceiling effect patterns as does the WOMAC. We recommend that the choice should depend on which scale researchers are using to power a study.

  15. Connective tissue diseases and noninvasive evaluation of atherosclerosis

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    Ardita G

    2014-06-01

    Full Text Available Giorgio Ardita, Giacomo Failla, Paolo Maria Finocchiaro, Francesco Mugno, Luigi Attanasio, Salvatore Timineri, Michelangelo Maria Di SalvoCardiovascular Department, Angiology Unit, Ferrarotto Hospital, Catania, ItalyAbstract: Connective tissue diseases (CTDs are associated with increased risk of cardiovascular disease due to accelerated atherosclerosis. In patients with autoimmune disorders, in addition to traditional risk factors, an immune-mediated inflammatory process of the vasculature seems to contribute to atherogenesis. Several pathogenetic mechanisms have been proposed, including chronic inflammation and immunologic abnormalities, both able to produce vascular damage. Macrovascular atherosclerosis can be noninvasively evaluated by ultrasound measurement of carotid or femoral plaque. Subclinical atherosclerosis can be evaluated by well-established noninvasive techniques which rely on ultrasound detection of carotid intima-media thickness. Flow-mediated vasodilatation and arterial stiffness are considered markers of endothelial dysfunction and subclinical atherosclerosis, respectively, and have been recently found to be impaired early in a wide spectrum of autoimmune diseases. Carotid intima-media thickness turns out to be a leading marker of subclinical atherosclerosis, and many studies recognize its role as a predictor of future vascular events, both in non-CTD individuals and in CTD patients. In rheumatic diseases, flow-mediated dilatation and arterial stiffness prove to be strongly correlated with inflammation, disease damage index, and with subclinical atherosclerosis, although their prognostic role has not yet been conclusively shown. Systemic lupus erythematosus, rheumatoid arthritis, and likely antiphospholipid syndrome are better associated with premature and accelerated atherosclerosis. Inconclusive results were reported in systemic sclerosis.Keywords: rheumatic disease, subclinical atherosclerosis, arterial stiffness

  16. Genetic Susceptibility to Atherosclerosis

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    Sanja Kovacic

    2012-01-01

    Full Text Available Atherosclerosis is a complex multifocal arterial disease involving interactions of multiple genetic and environmental factors. Advances in techniques of molecular genetics have revealed that genetic ground significantly influences susceptibility to atherosclerotic vascular diseases. Besides further investigations of monogenetic diseases, candidate genes, genetic polymorphisms, and susceptibility loci associated with atherosclerotic diseases have been identified in recent years, and their number is rapidly increasing. This paper discusses main genetic investigations fields associated with human atherosclerotic vascular diseases. The paper concludes with a discussion of the directions and implications of future genetic research in arteriosclerosis with an emphasis on prospective prediction from an early age of individuals who are predisposed to develop premature atherosclerosis as well as to facilitate the discovery of novel drug targets.

  17. Insulin resistance and atherosclerosis

    OpenAIRE

    Semenkovich, Clay F.

    2006-01-01

    Considerable evidence supports the association between insulin resistance and vascular disease, and this has led to wide acceptance of the clustering of hyperlipidemia, glucose intolerance, hypertension, and obesity as a clinical entity, the metabolic syndrome. While insulin resistance, by promoting dyslipidemia and other metabolic abnormalities, is part of the proatherogenic milieu, it is possible that insulin resistance itself in the vascular wall does not promote atherosclerosis. Recent fi...

  18. The MoCA-Memory Index Score: An Efficient Alternative to Paragraph Recall for the Detection of Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Kaur, Antarpreet; Edland, Steven D; Peavy, Guerry M

    2018-01-09

    To compare ability of 2 measures of delayed memory (word list, story paragraph) to discriminate Normal Control (NC) subjects from those with amnestic mild cognitive impairment (aMCI). Demographic, neuropsychological, and diagnostic data contributed by 34 Alzheimer's Disease Centers to the National Alzheimer's Coordinating Center characterized 2717 individuals with a diagnosis of either NC (n=2205) or aMCI (n=512). The Montreal Cognitive Assessment-Memory Index Score (MoCA-MIS) assessed delayed word recall, and the Craft Story 21, delayed story recall. Logistic regression and receiver operator characteristic curves controlling for age, sex, and education assessed the ability of each test to differentiate NCs from subjects with aMCI. The MoCA-MIS had significantly better sensitivity and specificity (area under the receiver operator characteristic curve 0.83 vs. 0.80, P=0.004). At sensitivity 80%, the specificity of the MoCA-MIS was 69.1%, compared with 62.8% for the Craft Story. These data suggest that the MoCA-MIS, a recall score from items within the MoCA, is better at discriminating NCs from subjects with aMCI than the Craft Story. Word recall may be an efficient alternative to paragraph recall for diagnostic screening within clinical practice and research settings.

  19. The Barthel Index and the Cumulated Ambulation Score are superior to the de Morton Mobility Index for the early assessment of outcome in patients with a hip fracture admitted to an acute geriatric ward.

    Science.gov (United States)

    Hulsbæk, Signe; Larsen, Rikke Faebo; Rosthøj, Susanne; Kristensen, Morten Tange

    2018-01-15

    To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively. Corresponding floor effects were 39% and 31% for DEMMI, 12% and 5% for BI, and 22% and 6%, respectively, for CAS. Convergent validity was strong between DEMMI and CAS (r = 0.76, 95% CI: 0.69-0.81), and moderate between DEMMI and BI (r = 0.58, 95% CI: 0.48-0.66) and CAS and BI (r = 0.49, 95% CI: 0.39-0.59). Responsiveness, as indicated by the effect size was 0.76 for DEMMI, 1.78 for BI and 1.04 for CAS. Baseline scores of DEMMI, BI, and CAS showed similar properties in predicting discharge destination of patients from own home. The value of using DEMMI and 30-s CST in patients with hip fracture during the acute hospitalization seems limited in comparison with BI and CAS. DEMMI and CAS seem to assess similar constructs. Implications for Rehabilitation Outcome measures used for the evaluation of patients with hip fracture should be validated in the specific time-line and rehabilitation setting following surgery, before being implemented in daily clinical practice. We suggest the Cumulated Ambulation Score for monitoring basic mobility during the acute hospitalization for the entire group of patients recovering from a hip fracture, while DEMMI seems more feasible for the subgroup of patients with higher functional levels. The modified Barthel Index seems useful for the assessment of activities of daily living in the acute care setting of patients with hip fracture. We cannot recommend the original 30-s Chair

  20. The dischargeable cut-off score of Oswestry Disability Index (ODI) in the inpatient care for low back pain with disability.

    Science.gov (United States)

    Park, Sang-Won; Shin, Ye-Sle; Kim, Hye-Jin; Lee, Jin-Ho; Shin, Joon-Shik; Ha, In-Hyuk

    2014-10-01

    The admission due to low back pain (LBP) became prevalent cause of international economic losses. Since LBP patients with disability are often subject to inpatient care, it is important to determine the appropriate time of discharge. The purpose of this study is to set the cut-off value of appropriate Oswestry Disability Index (ODI) at the time of discharge. Of 1,394 LBP patients admitted in hospital specialized in spinal disease, 774 eligible patients with disability were included in this study. And several clinical variables including numerical rating score, ODI, satisfaction level were observed during the hospital stay. We considered satisfaction level as an important factor for discharge, categorized patients into satisfied group and dissatisfied group. Through the statistical analysis, appropriate factor for determining dischargeable patients satisfied with their current condition and its cut-off value of ODI were found. And proper predictors for the cut-off value were extracted statistically and logically from a pool of several clinical indexes. The ODI at the time of discharge was most accurate in determining dischargeable patients. The cut-off value of ODI was 30. Predictors were ODI questions 4 and 6. We set the cut-off value of dischargeable ODI for LBP inpatient with disability and found its predictor.

  1. Analysis of the Relationship between Sleep Duration and Body Mass Index in a South Korean Adult Population: A Propensity Score Matching Approach.

    Science.gov (United States)

    Sung, Baksun

    2017-07-01

    One-third of the present adults in South Korea are obese, and previous studies have demonstrated that sleep duration is considered a risk factor for obesity. Hence, I assessed the relationship between sleep duration and body mass index in a South Korean adult population. This cross-sectional study consists of a representative sample of 4,218 South Korean adults (20-64 years) who participated in the sixth Korea National Health and Nutrition Examination Survey (2015). As statistical analysis methods, data were analyzed using chi-square test and multiple logistic regression. Propensity score matching (PSM) was applied to control selection bias, and obesity-related factors were used as covariates in PSM. According to the multiple logistic regression analysis, people who sleep for more than seven hours a day were less likely to be obese than those who sleep for less than seven hours a day in the pre-match (OR = 0.75, 95%CI = 0.65-0.88) and post-match (OR = 0.77, 95%CI = 0.65-0.90) samples. This finding suggests that South Korean adults who reported sleeping more than 7 hours a day were linked to decreased body mass index. Hence, the proper amount of sleep is necessary to reduce the prevalence of obesity in this population.

  2. Association Between Change in Body Mass Index, Unified Parkinson’s Disease Rating Scale Scores, and Survival Among Persons With Parkinson Disease

    Science.gov (United States)

    Wills, Anne-Marie A.; Pérez, Adriana; Wang, Jue; Su, Xiao; Morgan, John; Rajan, Suja S.; Leehey, Maureen A.; Pontone, Gregory M.; Chou, Kelvin L.; Umeh, Chizoba; Mari, Zoltan; Boyd, James

    2017-01-01

    IMPORTANCE Greater body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) is associated with improved survival among persons with Huntington disease or amyotrophic lateral sclerosis. Weight loss is common among persons with Parkinson disease (PD) and is associated with worse quality of life. OBJECTIVE To explore the association between change in BMI, Unified Parkinson’s Disease Rating Scale (UPDRS) motor and total scores, and survival among persons with PD and to test whether there is a positive association between BMI at randomization and survival. DESIGN, SETTING, AND PARTICIPANTS Secondary analysis (from May 27, 2014, to October 13, 2015) of longitudinal data (3–6 years) from 1673 participants who started the National Institute of Neurological Disorders and Stroke Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1). This was a double-blind randomized placebo-controlled clinical trial of creatine monohydrate (10 g/d) that was performed at 45 sites throughout the United States and Canada. Participants with early (within 5 years of diagnosis) and treated (receiving dopaminergic therapy) PD were enrolled from March 2007 to May 2010 and followed up until September 2013. MAIN OUTCOMES AND MEASURES Change across time in motor UPDRS score, change across time in total UPDRS score, and time to death. Generalized linear mixed models were used to estimate the effect of BMI on the change in motor and total UPDRS scores after controlling for covariates. Survival was analyzed using Cox proportional hazards models of time to death. A participant’s BMI was measured at randomization, and BMI trajectory groups were classified according to whether participants experienced weight loss (“decreasing BMI”), weight stability (“stable BMI”), or weight gain (“increasing BMI”) during the study. RESULTS Of the 1673 participants (mean [SD] age, 61.7 [9.6] years; 1074 [64.2%] were male), 158 (9.4%) experienced weight loss

  3. Comparison of the GRACE risk score and the TIMI risk index in predicting the extent and severity of coronary artery disease in patients with acute coronary syndrome.

    Science.gov (United States)

    Bekler, Adem; Altun, Burak; Gazi, Emine; Temiz, Ahmet; Barutçu, Ahmet; Güngör, Ömer; Özkan, Muhammed Turgut Alper; Özcan, Sedat; Gazi, Sabri; Kırılmaz, Bahadır

    2015-10-01

    The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis In Myocardial Infarction (TIMI) risk index (TRI) has been reported in coronary artery disease (CAD) patients. We aimed to evaluate the relationship between the GRS, TRI, and severity of CAD evaluated by SYNTAX score (SS) in patients with acute coronary syndrome (ACS). Patients with ACS who were admitted to the coronary care unit of our institution were retrospectively evaluated in this study. A total of 287 patients with ACS [154 non-ST elevated ACS (NSTE-ACS), 133 ST elevated myocardial infarction (STEMI)] were included in the study. The GRS and TRI were calculated on admission using specified variables. The severity of CAD was evaluated using the SS. The patients were divided into low (GRS140)-risk groups and group 1 (TRI26) according to GRS and TRI scores. A Pearson correlation analysis was used for the relation between GRS, TRI, and SS. Patients with a history of coronary artery bypass surgery, those who had missing data for calculating the GRS and TRI, and those whose systolic blood pressure (SBP) was more than 180 mm Hg or whose diastolic blood pressure (DBP) was more than 110 mm Hg were excluded from the study. Were excluded from the study. There were significant differences in mean age (prisk groups. There was a positive significant correlation between the GRS and the SS (r=0.427, p<0.001), but there were no significant correlation between the TRI and SS (r=0.121, p=0.135). The area under the ROC curve value for GRS was 0.65 (95% CI: 0.56-0.74, p=0.001) in the prediction of severity of CAD. The GRS is more associated with SS than TRI in predicting the severity of CAD in patients with ACS.

  4. Effect of Heart Rate and Body Mass Index on the Interscan and Interobserver Variability of Coronary Artery Calcium Scoring at Prospective ECG-Triggered 64-Slice CT

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    Horiguchi, Jun; Kiguchi, Masao; Fujioka, Chikako [Hiroshima University Hospital, Hiroshima (Japan); Matsuura, Noriaki; Yamamoto, Hideya; Kitagawa, Toshiro; Ito, Katsuhide [Hiroshima University, Hiroshima (Japan)

    2009-08-15

    To test the effects of heart rate, body mass index (BMI) and noise level on interscan and interobserver variability of coronary artery calcium (CAC) scoring on a prospective electrocardiogram (ECG)-triggered 64-slice CT. One hundred and ten patients (76 patients with CAC) were scanned twice on prospective ECG-triggered scans. The scan parameters included 120 kV, 82 mAs, a 2.5 mm thickness, and an acquisition center at 45% of the RR interval. The interscan and interobserver variability on the CAC scores (Agatston, volume, and mass) was calculated. The factors affecting the variability were determined by plotting it against heart rate, BMI, and noise level (defined as the standard deviation: SD). The estimated effective dose was 1.5 {+-} 0.2 mSv. The mean heart rate was 63 {+-} 12 bpm (range, 44-101 bpm). The patient BMIs were 24.5 {+-} 4.5 kg/m{sup 2} (range, 15.5-42.3 kg/m2). The mean and median interscan variabilities were 11% and 6%, respectively by volume, and 11% and 6%, respectively, by mass. Moreover, the mean and median of the algorithms were lower than the Agatston algorithm (16% and 9%, respectively). The mean and median interobserver variability was 10% and 4%, respectively (average of algorithms). The mean noise levels were 15 {+-} 4 Hounsfield unit (HU) (range, 8-25 HU). The interscan and interobserver variability was not correlated with heart rate, BMI, or noise level. The interscan and interobserver variability of CAC on a prospective ECG-triggered 64-slice CT with high image quality and 45% of RR acquisition is not significantly affected by heart rate, BMI, or noise level. The volume or mass algorithms show reduced interscan variability compared to the Agatston scoring (p < 0.05)

  5. Role of Micronutrients on Subclinical Atherosclerosis Micronutrients in Subclinical Atherosclerosis.

    Science.gov (United States)

    Kocyigit, Duygu; Gurses, Kadri Murat; Yalcin, Muhammed Ulvi; Tokgozoglu, Lale

    2016-01-01

    Atherosclerotic cardiovascular disease (CVD) leading to coronary heart disease is the leading cause of morbidity and mortality in the world. Nutrition is one of the key factors in the etiology of atherosclerosis. Micronutrient supplements are widely used to prevent many chronic diseases including atherosclerosis. However, scientific evidence regarding this issue is still insufficient and current data on the association of dietary micronutrients and CVD risk is contradictory. Most of the randomized studies have failed to demonstrate beneficial effects of micronutrient supplementation on markers of subclinical atherosclerosis. In this review, role of each micronutrient on subclinical atherosclerosis will be evaluated thoroughly.

  6. The interface of inflammation and subclinical atherosclerosis in Granulomatosis with Polyangiitis (Wegener’s): a preliminary study

    Science.gov (United States)

    Hajj-Ali, RA; Major, J; Langford, CA; Hoffman, GS; Clark, T; Zhang, L; Sun, Z; Silverstein, RL

    2016-01-01

    The objective of this study is to assess the relationship between inflammatory disease in granulomatosis with polyangiitis (GPA, Wegener’s) with the development of subclinical atherosclerosis. 46 adult patients with GPA were enrolled. Disease status was measured by Birmingham Vasculitis Assessment Scores as modified for GPA (BVAS-WG), Vasculitis Damage Index (VDI), disease duration and number of relapses. Classic atherosclerotic risk factors, platelet aggregation responses and circulating microparticles (MP) levels were recorded. All patients underwent carotid artery intima media thickness (IMT) measurement as outcome for subclinical atherosclerosis. In univariate analyses, systolic and diastolic blood pressure, creatinine, and age were significantly associated with higher IMT [rho values: 0.37, 0.38, 0.35 and 0.054 respectively (p < 0.02 for all)]. In a multiple regression model, greater number of relapses, older age at onset of disease, and higher diastolic blood pressure were found to be associated with higher IMT (p values 0.003, <0.001 and 0.031 respectively). MP counts and platelet reactivity correlated well with disease activity in GPA. Furthermore, MP were found to activate vascular endothelial cells and platelets in vitro. The cumulative burden of systemic inflammation in GPA correlated with development of subclinical atherosclerosis. The correlation with subclinical atherosclerosis could be due to glucocorticoid use and not the inflammatory process in GPA, giving the inherent bias that exits with the use of glucocorticoid with each relapse. The findings of elevated levels of circulating leukocyte-derived MP and enhanced platelet reactivity during relapse suggest possible roles for MP and platelets in disease pathogenesis and support a growing literature that links inflammation, atherosclerosis, and platelet activation. This hypothesis is further substantiated by our demonstration that MP isolated from plasma of GPA patients can activate platelets and

  7. Accuracy of the prostate health index versus the urinary prostate cancer antigen 3 score to predict overall and significant prostate cancer at initial biopsy.

    Science.gov (United States)

    Seisen, Thomas; Rouprêt, Morgan; Brault, Didier; Léon, Priscilla; Cancel-Tassin, Géraldine; Compérat, Eva; Renard-Penna, Raphaële; Mozer, Pierre; Guechot, Jérome; Cussenot, Olivier

    2015-01-01

    It remains unclear whether the Prostate Health Index (PHI) or the urinary Prostate-Cancer Antigen 3 (PCA-3) score is more accurate at screening for prostate cancer (PCa). The aim of this study was to prospectively compare the accuracy of PHI and PCA-3 scores to predict overall and significant PCa in men undergoing an initial prostate biopsy. Double-blind assessments of PHI and PCA-3 were conducted by referent physicians in 138 patients who subsequently underwent trans-rectal ultrasound-guided prostate biopsy according to a 12-core scheme. Predictive accuracies of PHI and PCA-3 were assessed using AUC and compared according to the DeLong method. Diagnostic performances with usual cut-off values for positivity (i.e., PHI >40 and PCA-3 >35) were calculated, and odds ratios associated with predicting PCa overall and significant PCa as defined by pathological updated Epstein criteria (i.e., Gleason score ≥7, more than three positive cores, or >50% cancer involvement in any core) were estimated using logistic regression. Prevalences of overall and significant PCa were 44.9% and 28.3%, respectively. PCA-3 (AUC = 0.71) was the most accurate predictor of PCa overall, and significantly outperformed PHI (AUC = 0.65; P = 0.03). However, PHI (AUC = 0.80) remained the most accurate predictor when screening exclusively for significant PCa and significantly outperformed PCA-3 (AUC = 0.55; P = 0.03). Furthermore, PCA-3 >35 had the best accuracy, and positive or negative predictive values when screening for PCa overall whereas these diagnostic performances were greater for PHI >40 when exclusively screening for significant PCa. PHI > 40 combined with PCA-3 > 35 was more specific in both cases. In multivariate analyses, PCA-3 >35 (OR = 5.68; 95%CI = [2.21-14.59]; P 40 (OR = 9.60; 95%CI = [1.72-91.32]; P = 0.001) was the only independent predictor for detecting significant PCa. Although PCA-3 score is the best predictor for PCa

  8. Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies.

    Science.gov (United States)

    Schwingshackl, Lukas; Bogensberger, Berit; Hoffmann, Georg

    2018-01-01

    Diets of the highest quality have been associated with a significantly lower risk of noncommunicable diseases. It was the aim of this study to update a previous systematic review investigating the associations of diet quality as assessed by the Healthy Eating Index (HEI), Alternate Healthy Eating Index (AHEI), and Dietary Approaches to Stop Hypertension (DASH) score and multiple health outcomes. As an additional topic, the associations of these diet quality indices with all-cause mortality and cancer mortality among cancer survivors were also investigated. A literature search for prospective cohort studies that were published up to May 15, 2017 was performed using the electronic databases PubMed, Scopus, and Embase. Summary risk ratios (RRs) and 95% CIs were estimated using a random effects model for high vs low adherence categories. The updated review process showed 34 new reports (total number of reports evaluated=68; including 1,670,179 participants). Diets of the highest quality, as assessed by the HEI, AHEI, and DASH score, resulted in a significant risk reduction for all-cause mortality (RR 0.78, 95% CI 0.77 to 0.80; I2=59%; n=13), cardiovascular disease (incidence or mortality) (RR 0.78, 95% CI 0.76 to 0.80; I2=49%; n=28), cancer (incidence or mortality) (RR 0.84, 95% CI 0.82 to 0.87; I2=66%; n=31), type 2 diabetes (RR 0.82, 95% CI 0.78 to 0.85; I2=72%; n=10), and neurodegenerative diseases (RR 0.85, 95% CI 0.74 to 0.98; I2=51%; n=5). Among cancer survivors, the association between diets for the highest quality resulted in a significant reduction in all-cause mortality (RR 0.88, 95% CI 0.81 to 0.95; I2=38%; n=7) and cancer mortality (RR 0.90, 95% CI 0.83 to 0.98; I2=0%; n=7). In the updated meta-analyses, diets that score highly on the HEI, AHEI, and DASH were associated with a significant reduction in the risk of all-cause mortality, cardiovascular disease, cancer, type 2 diabetes, and neurodegenerative disease by 22%, 22%, 16%, 18%, and 15%, respectively

  9. Assessment of subclinical atherosclerosis using contrast-enhanced ultrasound.

    Science.gov (United States)

    van den Oord, Stijn C H; ten Kate, Gerrit L; Akkus, Zeynettin; Renaud, Guillaume; Sijbrands, Eric J G; ten Cate, Folkert J; van der Lugt, Aad; Bosch, Johan G; de Jong, Nico; van der Steen, Antonius F W; Schinkel, Arend F L

    2013-01-01

    The sensitivity of standard carotid ultrasound and colour Doppler for the detection of subclinical atherosclerotic plaques is suboptimal. The aim of this study is to assess whether contrast-enhanced ultrasound (CEUS) added to standard carotid ultrasound improves the detection of subclinical atherosclerosis. Carotid intima-media thickness (CIMT) measurement, standard carotid ultrasound including colour Doppler imaging, and CEUS were performed in 100 asymptomatic patients with one or more risk factors for atherosclerosis. CEUS was performed using intravenous administration of SonoVue™ contrast agent (Bracco S.p.A., Milan, Italy). CIMT, standard ultrasound, colour Doppler, and CEUS were reviewed by two independent observers. Standard ultrasound, colour Doppler, and CEUS were scored for the presence of atherosclerotic plaques. Subclinical atherosclerosis was diagnosed if patients had a CIMT above their age-corrected threshold value or if atherosclerotic plaques were present on standard carotid ultrasound clips or CEUS clips. McNemar's test was performed to compare between groups. Twenty-one patients (21%) had a thickened CIMT value and were considered to have subclinical atherosclerosis. Standard carotid ultrasound including colour Doppler demonstrated atherosclerotic plaques in 77 patients (77%). The addition of CEUS to the standard ultrasound protocol demonstrated atherosclerotic plaques in 88 patients (88%). The incorporation of CEUS into the standard carotid ultrasound protocol resulted in a significantly improved detection of patients with subclinical atherosclerosis (P subclinical atherosclerosis in the carotid arteries. Atherosclerotic plaques which were only detected with CEUS and not with standard carotid ultrasound and colour Doppler imaging were predominantly hypoechoic.

  10. Relationship between body mass index, fat mass and lean mass with SF-36 quality of life scores in a group of fibromyalgia patients.

    Science.gov (United States)

    Arranz, Laura; Canela, Miguel Angel; Rafecas, Magda

    2012-11-01

    Patients suffering from fibromyalgia (FM) had widespread musculoskeletal pain and stiffness, fatigue, sleep disorders, cognitive impairment and other symptoms, which seriously affects their quality of life (QoL), making it difficult to perform normal activities. Moreover, FM has been associated with a higher prevalence of overweight and obesity than in the general population. Weight reduction has been beneficial in both FM and other rheumatic patients. Obesity and overweight have been pointed as playing a relevant role in FM symptoms; however, it is necessary to find out more about this relationship. The objective of this study was to evaluate the relationship between body mass index (BMI), fat mass (fM) and lean mass (lM) with quality of life in a group of FM patients. 103 women, with a mean age of 53.74 ± 7.81, and members of different FM patient associations from Spain participated in our study. Some anthropometric measures were taken like weight, height, BMI, body fat mass and lean mass. FM patients QoL was assessed by the Short-Form Health Survey, SF-36 questionnaire. Statistical reports were based on mean, standard deviation and correlation, but significance was tested by nonparametric methods. BMI, fM and lM correlated differently with the specific SF-36 scores. BMI had a high negative correlation with emotional role, fM with bodily pain and lM almost with all scores but specially with emotional role, vitality and physical role. The outcome of this study reveals some interesting relationships, which need to be further investigated to improve the management of FM patients.

  11. Different minimally important clinical difference (MCID) scores lead to different clinical prediction rules for the Oswestry disability index for the same sample of patients.

    Science.gov (United States)

    Schwind, Julie; Learman, Kenneth; O'Halloran, Bryan; Showalter, Christopher; Cook, Chad

    2013-05-01

    Minimal clinically important difference (MCID) scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. There are numerous outcome instruments used for analyzing pain, disability, and dysfunction of the low back; perhaps the most common of these is the Oswestry disability index (ODI). A single agreed-upon MCID score for the ODI has yet to be established. What is also unknown is whether selected baseline variables will be universal predictors regardless of the MCID used for a particular outcome measure. To explore the relationship between predictive models and the MCID cutpoint on the ODI. Data were collected from 16 outpatient physical therapy clinics in 10 states. Secondary database analysis using backward stepwise deletion logistic regression of data from a randomized controlled trial (RCT) to create prognostic clinical prediction rules (CPR). One hundred and forty-nine patients with low back pain (LBP) were enrolled in the RCT. All were treated with manual therapy, with a majority also receiving spine-strengthening exercises. The resultant predictive models were dependent upon the MCID used and baseline sample characteristics. All CPR were statistically significant (P MCID cutpoints used resulted in completely different significant predictor variables with no predictor significant across all models. The primary limitations include sub-optimal sample size and study design. There is extreme variability among predictive models created using different MCIDs on the ODI within the same patient population. Our findings highlight the instability of predictive modeling, as these models are significantly affected by population baseline characteristics along with the MCID used. Clinicians must be aware of the fragility of CPR prior to applying each in clinical practice.

  12. Evaluation of the relationship between Orthopedic Foundation for Animals' hip joint scores and PennHIP distraction index values in dogs.

    Science.gov (United States)

    Powers, Michelle Y; Karbe, Georga T; Gregor, Thomas P; McKelvie, Pamela; Culp, William T N; Fordyce, Hilary H; Smith, Gail K

    2010-09-01

    To compare 2 screening methods for detecting evidence of hip dysplasia (Orthopedic Foundation for Animals [OFA] and PennHIP) in dogs. Diagnostic test evaluation study. Animals-439 dogs >or= 24 months of age that received routine hip joint screening from June 1987 through July 2008. Dogs were sedated, and PennHIP radiography was performed (hip joint- extended [HE], compression, and distraction radiographic views). The HE radiographic view was submitted for OFA evaluation. A copy of the HE radiographic view plus the compression and distraction radiographic views were submitted for routine PennHIP evaluation, including quantification of hip joint laxity via the distraction index (DI). 14% (60/439) of dogs had hip joints scored as excellent by OFA standards; however, 52% (31/60) of those had a DI >or= 0.30 (range, 0.14 to 0.61). Eighty-two percent of (183/223) dogs with OFA-rated good hip joints had a DI >or= 0.30 (range, 0.10 to 0.77), and 94% (79/84) of dogs with OFA-rated fair hip joints had a DI >or= 0.30 (range, 0.14 to 0.77). Of all dogs with fair to excellent hip joints by OFA standards, 80% (293/367) had a DI >or= 0.30. All dogs with OFA-rated borderline hip joints or mild, moderate, or severe hip dysplasia had a DI >or= 0.30 (range, 0.30 to 0.83). Dogs judged as phenotypically normal by the OFA harbored clinically important passive hip joint laxity as determined via distraction radiography. Results suggested that OFA scoring of HE radiographs underestimated susceptibility to osteoarthritis in dogs, which may impede progress in reducing or eliminating hip dysplasia through breeding.

  13. G-231A and G+70C polymorphisms of endothelin receptor type-A gene could affect the psoriasis area and severity index score and endothelin 1 levels

    Directory of Open Access Journals (Sweden)

    Gökhan Okan

    2015-01-01

    Full Text Available Background: The etiopathogenesis of psoriasis has not been clearly elucidated although the role of chronic inflammation, imbalance between pro- and anti-inflammatory cytokines, and many immunological events have been established. Endothelin 1 (EDN1 and endothelin receptor type-A (EDNRA are implicated in the inflammatory process. The relationships between EDN1 and EDNRA polymorphisms with several diseases have been found. Aims and Objectives: This study examined the possible association of EDN1 (G5665T and T-1370G and EDNRA (G-231A and G + 70C single nucleotide polymorphisms (SNPs with the occurence of psoriasis, and evaluated the relationship between genotypes and clinical/laboratory manifestation of psoriasis. Materials and Methods: We analyzed genotype and allele distributions of the above-mentioned polymorphisms in 151 patients with psoriasis and 152 healthy controls by real-time PCR combined with melting curve analysis. Results: We did not find significant differences in the genotype and allele distributions of EDN1 T-1370G, EDNRA G-231A, and EDNRA G+70C polymorphisms between patients with psoriasis and healthy controls. Psoriasis area and severity index (PASI score of EDNRA -231 polymorphic A allele carrying subjects (AA and AA + AG was higher than that of wild homozygotes (P = 0.044 and P = 0.027, respectively. In addition, EDN1 levels in EDNRA+70 polymorphic C allele carriers (CC + CG were elevated when compared with GG genotype; however, the difference was at borderline significance (P = 0.05. Conclusion: Although there were no associations between studied polymorphisms and psoriasis susceptibility, the PASI score and EDN1 levels seem to be affected by EDNRA G-231A and G + 70C polymorphisms.

  14. 70. Epicardial fat quality effect on subclinical atherosclerosis

    Directory of Open Access Journals (Sweden)

    R. Abazid

    2016-07-01

    Full Text Available Epicardial fat quality measured as Hounsfield Unit (HU by computed tomography has significant impact on atherosclerosis. Excessive epicardial adipose tissue (EAT is considered a risk factor for coronary artery disease (CAD. There are limited data, however, about the quality of epicardial fat as a CAD risk factor. We investigated the relation between EAT volume and quality and subclinical CAD defined by positive coronary artery calcification (CAC using computed tomography (CT. We reviewed 609 CT scans to assess the EAT volume, which was measured by manually tracing the parietal pericardial sac on axial images. Fat density was recorded in mean Hounsfield units (HU. Coronary calcium scores were measured using the Agatston method. The patients’ mean age was 50 ± 11 years, and 398 (65.4% were men. The mean EAT volume was 65 ± 27 cm3, and it had a density of 87.0 ± 3.4 HU. Calcium was present in 135 (22% of the patients: 97 (16% of the total were men and 38 (6% were women. There was no difference between the sexes in regard to EAT volume (66 ± 27 vs. 63 ± 26, p = 0.34 or density (87.4 ± 3.2 vs. 87.0 ± 3.6, p = 0.28. Obese patients (body mass index ⩾30 kg/m2 had significantly higher EAT volumes than nonobese patients (73 ± 30 vs. 61 ± 29, p = 0.011, but no difference was seen in CAC (33 ± 97 vs. 27 ± 103, p = 0.34 or fat density (87.7 ± 4.0 vs. 88.0 ± 2.7, p = 0.48. Univariate regression analyses showed that higher fat attenuation (HU was associated with a lower coronary atherosclerosis hazard ratio (HR (0.871, 95% confidence interval [CI] 0.790–0.948, p < 0.0001, and an increased EAT volume was associated with more CAC (HR 1.16, 95% CI 1.078–1.245, p = 0.0001. The quality of EAT, measured as HU on CT, is a strong predictor of subclinical CAD as defined by coronary artery calcifications, with a higher HU associated with a lower incidence of atherosclerosis.

  15. Association Between Coronary Artery Disease Genetic Variants and Subclinical Atherosclerosis: An Association Study and Meta-analysis.

    Science.gov (United States)

    Zabalza, Michel; Subirana, Isaac; Lluis-Ganella, Carla; Sayols-Baixeras, Sergi; de Groot, Eric; Arnold, Roman; Cenarro, Ana; Ramos, Rafel; Marrugat, Jaume; Elosua, Roberto

    2015-10-01

    Recent studies have identified several genetic variants associated with coronary artery disease. Some of these genetic variants are not associated with classical cardiovascular risk factors and the mechanism of such associations is unclear. The aim of the study was to determine whether these genetic variants are related to subclinical atherosclerosis measured by carotid intima media thickness, carotid stiffness, and ankle brachial index. A cross-sectional study nested in the follow-up of the REGICOR cohort was undertaken. The study included 2667 individuals. Subclinical atherosclerosis measurements were performed with standardized methods. Nine genetic variants were genotyped to assess associations with subclinical atherosclerosis, individually and in a weighted genetic risk score. A systematic review and meta-analysis of previous studies that analyzed these associations was undertaken. Neither the selected genetic variants nor the genetic risk score were significantly associated with subclinical atherosclerosis. In the meta-analysis, the rs1746048 (CXCL12; n = 10581) risk allele was directly associated with carotid intima-media thickness (β = 0.008; 95% confidence interval, 0.001-0.015), whereas the rs6725887 (WDR12; n = 7801) risk allele was inversely associated with this thickness (β = -0.013; 95% confidence interval, -0.024 to -0.003). The analyzed genetic variants seem to mediate their association with coronary artery disease through different mechanisms. Our results generate the hypothesis that the CXCL12 variant appears to influence coronary artery disease risk through arterial remodeling and thickening, whereas the WDR12 risk variant could be related to higher plaque vulnerability. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Asymptomatic cervicocerebral atherosclerosis, intracranial vascular resistance and cognition: the AsIA-neuropsychology study.

    Science.gov (United States)

    López-Olóriz, Jorge; López-Cancio, Elena; Arenillas, Juan F; Hernández, María; Jiménez, Marta; Dorado, Laura; Barrios, Maite; Soriano-Raya, Juan José; Miralbell, Júlia; Cáceres, Cynthia; Forés, Rosa; Pera, Guillem; Dávalos, Antoni; Mataró, Maria

    2013-10-01

    Carotid atherosclerosis has emerged as a relevant contributor to cognitive impairment and dementia whereas the role of intracranial stenosis and vascular resistance in cognition remains unknown. This study aims to assess the association of asymptomatic cervicocerebral atherosclerosis and intracranial vascular resistance with cognitive performance in a large dementia-free population. The Barcelona-AsIA (Asymptomatic Intracranial Atherosclerosis) Neuropsychology Study included 747 Caucasian subjects older than 50 with a moderate-high vascular risk (assessed by REGICOR score) and without history of neither symptomatic vascular disease nor dementia. Extracranial and transcranial color-coded duplex ultrasound examination was performed to assess carotid intima-media thickness (IMT), presence of carotid plaques (ECAD group), intracranial stenosis (ICAD group), and middle cerebral artery pulsatility index (MCA-PI) as a measure of intracranial vascular resistance. Neuropsychological assessment included tests in three cognitive domains: visuospatial skills and speed, verbal memory and verbal fluency. In univariate analyses, carotid IMT, ECAD and MCA-PI were associated with lower performance in almost all cognitive domains, and ICAD was associated with poor performance in some visuospatial and verbal cognitive tests. After adjustment for age, sex, vascular risk score, years of education and depressive symptoms, ECAD remained associated with poor performance in the three cognitive domains and elevated MCA-PI with worse performance in visuospatial skills and speed. Carotid plaques and increased intracranial vascular resistance are independently associated with low cognitive functioning in Caucasian stroke and dementia-free subjects. We failed to find an independent association of intracranial large vessel stenosis with cognitive performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Need-based nutritional intervention is effective in improving handgrip strength and Barthel Index scores of older people living in a nursing home: a randomized controlled trial.

    Science.gov (United States)

    Lee, Li-Chin; Tsai, Alan C; Wang, Jiun-Yi

    2015-05-01

    Nutritional status is associated with physical functioning in older people. Protein-energy malnutrition can limit functional performance. This study examined the effectiveness of a "need-based intervention" on improving the physical functioning of older adults living in nursing homes. A 24-week randomized, double-blind, controlled trial. A privately managed geriatric nursing home in Taiwan. Ninety-two persons who were ≥65 years old, ≤25 kg/m(2), >1 month residence, non-bed-ridden, without acute infection, and able to self-feed or receive oral feeding. Qualified participants were stratified by gender and then randomly assigned to either the control group (n=45) or the intervention group (n=47). Each participant in the intervention group would receive a 50 g/day soy-protein-based nutritional supplement when he/she was rated as undernourished, defined as Mini Nutritional Assessment score ≤24 and body mass index ≤24 kg/m(2). The supplement contained 9.5 g protein, 250 kcal energy, and all essential micronutrients. The supplementation would be suspended if either one of the two "at risk" conditions was not met at the next measurement (every 4 weeks). Handgrip strength and Barthel Index were measured at baseline, mid-point (week 12), and end-point (week 24) of the trial. Results were analyzed with Student's t-test and by the Generalized Estimating Equations controlled for nutritional status. The intervention significantly improved (a) handgrip strength of the older adults at weeks 12 and 24, and (b) the overall Barthel Index at week 24 (all pintervention" can be an effective and useful strategy for improving the physical functioning of older adults living in nursing homes, without adverse effects. The results probably are the indirect results of the improved nutritional status. The study highlights the importance of routine screening and timely intervention in geriatric care. The applicability of this need-based strategy to community-living older adults is an

  18. Association between various anthropometric measures of obesity and markers of subclinical atherosclerosis.

    Science.gov (United States)

    Kommuri, Naga V A; Zalawadiya, Sandip K; Veeranna, Vikas; Kollepara, Sri Lakshmi S; Ramesh, Krithi; Briasoulis, Alexandros; Afonso, Luis

    2016-01-01

    Central obesity is a known cardiovascular risk factor and measures of visceral obesity are known to predict atherosclerosis. This study sought to explore the association between various anthropometric measures and markers of subclinical atherosclerosis (MoSCA) among low risk healthy individuals. Multi-Ethnic Study of Atherosclerosis (MESA) is a population-based study of Caucasian (38%), Afro-American (28%), Chinese (22%) and Hispanic (12%) subjects, aged 45-84 years, free from clinical cardiovascular disease. We performed a post hoc analysis of the limited access dataset of MESA subjects to evaluate the association between carotid intima media thickness and coronary artery calcium score (CACS), as MoSCA and various measures of obesity. Multivariable regression analyses adjusted for traditional cardiovascular risk factors, ethnicity and C-reactive protein were performed. Each unit increase in waist-hip ratio was strongly associated with increase in both common and internal carotid intima media thickness (beta: 0.12, 95% confidence interval (CI): 0.06 to 0.18, p < 0.001 and beta: 0.23, 95% CI: 0.03 to 0.43, p = 0.021, respectively). Measures of central obesity were superior to body mass index as demonstrated by their consistent association with each category of CACS when compared to the reference category (CACS = 0). Compared to body mass index, measures of visceral obesity were significantly associated with MoSCA in this multiethnic healthy population. Waist-hip ratio seems to be more consistent in its association with various MoSCA compared to other anthropometric measures.

  19. Polyunsaturated fats, carbohydrates and carotid disease: The Atherosclerosis Risk in Communities (ARIC) Carotid MRI study.

    Science.gov (United States)

    Dearborn, Jennifer L; Qiao, Ye; Guallar, Eliseo; Steffen, Lyn M; Gottesman, Rebecca F; Zhang, Yiyi; Wasserman, Bruce A

    2016-08-01

    Carbohydrates and fat intake have both been linked to development of atherosclerosis. We examined associations between glycemic index (GI) and fat intake with carotid atherosclerosis. The Atherosclerosis Risk in Communities (ARIC) cohort enrolled participants during the period 1987-1989 and the Carotid MRI sub-study occurred between 2004 and 2006 (1672 participants attending both visits). Measures of carbohydrate quality (usual GI), fat intake (total, polyunsaturated and saturated) and overall dietary quality index (DASH Diet Score) were derived from a 66-item food frequency questionnaire administered at baseline. Trained readers measured lipid core presence and maximum wall thickness. Using multivariate logistic regression, we determined the odds of lipid core presence by quintile (Q) of energy-adjusted dietary components. Restricted cubic spline models were used to examine non-linear associations between dietary components and maximum wall thickness. Mean daily polyunsaturated fat intake was 5 g (SD 1.4). GI and polyunsaturated fat intake had a nonlinear relationship with maximum wall thickness. Low (1-4 g) and high (6-12 g) polyunsaturated fat intake were associated with a statistically significant decreased odds of lipid core presence compared to intake in a majority of participants (OR Q5 vs. Q2-4: 0.64, 95% CI 0.42 to 0.98; OR Q1 vs. Q2-4: 0.64, 95% CI 0.42, 0.96), however, the association with lipid core was attenuated by adjustment for maximum wall thickness, hypertension, hyperlipidemia, and diabetes. GI and polyunsaturated fat intake were not associated with high-risk plaque features, such as lipid core presence, independent of traditional vascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Association of neighborhood characteristics with cardiovascular health in the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Unger, Erin; Diez-Roux, Ana V; Lloyd-Jones, Donald M; Mujahid, Mahasin S; Nettleton, Jennifer A; Bertoni, Alain; Badon, Sylvia E; Ning, Hongyan; Allen, Norrina B

    2014-07-01

    The concept of cardiovascular health (CVH) was introduced as a global measure of one's burden of cardiovsacular risk factors. Previous studies established the relationship between neighborhood characteristics and individual cardiovascular risk factors. However, the relationship between neighborhood environment and overall CVH remains unknown. We analyzed data from the Multi-Ethnic Study of Atherosclerosis baseline examination (2000–2002). Mean age was 61.6 years, and 52% were women. Ideal, intermediate, and poor categories of cholesterol, body mass index, diet, physical activity, fasting glucose, blood pressure, and smoking were defined according to the American Heart Association 2020 Strategic Goals, assigned an individual score, and summed to create an overall score. CVH scores were categorized into ideal (11–14 points), intermediate (9–10), and poor (0–8). Neighborhood exposures included favorable food store and physical activity resources densities (by 1-mile buffer), reported healthy food availability,walking/physical activity environment, safety, and social cohesion (by census tract). Multinomial logistic regression was used to determine the association of each characteristic with ideal and intermediate CVH, adjusted for demographics and neighborhood socioeconomic status. Over 20% of Multi-Ethnic Study of Atherosclerosis participants had an ideal CVH score at baseline. In fully adjusted models, favorable food stores (odds ratio=1.22; 1.06–1.40), physical activity resources(odds ratio=1.19; 1.08–1.31), walking/physical activity environment (odds ratio=1.20; 1.05–1.37), and neighborhood socioeconomic status (odds ratio=1.22; 1.11–1.33) were associated with higher odds of having an ideal CVH score. Neighborhood environment including favorable food stores, physical activity resources, walking/physical activity environment, and neighborhood socioeconomic status are associated with ideal CVH. Further research is needed to investigate the

  1. Glucose intolerance, insulin resistance and metabolic syndrome in patients with stable angina pectoris. Obesity predicts coronary atherosclerosis and dysglycemia.

    Science.gov (United States)

    Włodarczyk, Aleksander; Strojek, Krzysztof

    2008-12-01

    Disturbances of glucose regulation and other metabolic disorders, as part of metabolic syndrome, are important risk factors for atherosclerosis. Abnormal glucose metabolism is commonly observed in patients with acute coronary syndrome. However, there is no consistent evidence for subjects with stable angina. To investigate the prevalence of glucose metabolism in patients with stable coronary artery disease (CAD) documented angiographically and to assess correlations of metabolic profile and extent of atherosclerotic lesions. 100 consecutive non-diabetic patients with stable CAD referred to coronary angiography were studied. Total cholesterol and its fractions, triglycerides, uric acid and fasting insulin levels were determined. Oral glucose tolerance test (OGTT) and then coronary angiography were performed. All patients were divided into groups according to glucometabolic and coronary status and insulin resistance. The sum of all lesions in coronary vessels was calculated for each patient (CAD score). After OGTT, 44% of patients presented disturbed glucose metabolism: 9% of patients had newly diagnosed diabetes and 35% patients were in the prediabetic state. There was no correlation between glycemic status and insulin resistance, and severity of coronary heart disease. Obesity, reflected by body mass index, waist circumference and waist-to-hip ratio, was a major metabolic disorder and independent predictor of the extent of coronary atherosclerosis and glucose intolerance. Abnormal glucose regulation is very common in patients with stable CAD. Only obesity was the independent predictor of coronary atherosclerosis and dysglycemia. Other metabolic risk factors are target for prevention and treatment.

  2. Relation of Cardiorespiratory Fitness to Risk of Subclinical Atherosclerosis in Men With Cardiometabolic Syndrome.

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    Jae, Sae Young; Franklin, Barry A; Schmidt-Trucksass, Arno; Kim, Do Kyung; Choi, Yoon-Ho; Park, Jeong Bae

    2016-11-01

    We tested the hypothesis that cardiometabolic syndrome (CMS) is associated with subclinical atherosclerosis in men and that moderate-to-high levels of cardiorespiratory fitness (fitness) attenuate this relation. Our study population (n = 2,107 men) participated in a health screening program that included measures of coronary artery calcification (CAC) and carotid artery intima-media thickness (CIMT) as surrogate markers of subclinical atherosclerosis. The prevalence of subclinical atherosclerosis was defined as a CAC score >0 and a mean CIMT more than the seventy-fifth percentile. Fitness was directly measured through peak oxygen consumption during cardiopulmonary exercise testing to volitional fatigue/exhaustion. The presence of CMS was defined as having ≥3 relevant risk factors based on the Adult Treatment Panel III report (ATP-III) criteria. After adjusting for confounding variables, participants with CMS demonstrated a higher odds ratio (OR) of having a positive CAC (OR 1.41, 95% confidence interval [CI] 1.05 to 1.89) and CIMT (OR 1.70, 95% CI 1.14 to 2.52) compared with those without CMS. Upper levels of fitness were associated with a lower prevalence of CAC (OR 0.69, 95% CI 0.55 to 0.88) and CIMT (OR 0.53, 95% CI 0.40 to 0.71) compared with lower fitness. In the joint analysis, unfit participants with CMS were 1.47 times (95% CI 1.09 to 1.96 for CAC) and 2.35 times (95% CI 1.70 to 3.26 for CIMT) more likely to exhibit these indexes of subclinical atherosclerosis compared with fit participants without CMS. Fit participants with CMS had ORs for the prevalence of CAC (OR 1.12; 95% CI 0.85 to 1.47) and CIMT (OR 1.06; 95% CI 0.74 to 1.53) that were similar to those of the fit cohort without CMS. In conclusion, our findings demonstrate that CMS is associated with an increased risk of subclinical atherosclerosis but that high fitness appears to attenuate these associations in men. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Alcohol and atherosclerosis

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    Foppa Murilo

    2001-01-01

    Full Text Available Observational studies have attributed a protective effect to alcohol consumption on the development of atherosclerosis and cardiovascular morbidity and mortality. Alcohol intake in the amount of one to two drinks per day results in an estimated 20-40% reduction in cardiovascular events. An additional protective effect, according to major cohort studies, has been attributed to wine, probably due to antioxidant effects and platelet antiaggregation agents. On the other hand, the influence of different patterns of alcohol consumption and environmental factors may explain a great part of the additional effect of wine. Protection may be mediated by modulation of other risk factors, because alcohol increases HDL-C, produces a biphasic response on blood pressure, and modulates the endothelial function, while it neither increases body weight nor impairs glucose-insulin homeostasis. Alcohol may also have a direct effect on atherogenesis. Despite these favorable effects, the current evidence is not enough to justify prescribing alcohol to prevent cardiovascular disease.

  4. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

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    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  5. Cardiometabolic Risk Assessments by Body Mass Index z-Score or Waist-to-Height Ratio in a Multiethnic Sample of Sixth-Graders

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    Henry S. Kahn

    2014-01-01

    Full Text Available Convention defines pediatric adiposity by the body mass index z-score (BMIz referenced to normative growth charts. Waist-to-height ratio (WHtR does not depend on sex-and-age references. In the HEALTHY Study enrollment sample, we compared BMIz with WHtR for ability to identify adverse cardiometabolic risk. Among 5,482 sixth-grade students from 42 middle schools, we estimated explanatory variations (R2 and standardized beta coefficients of BMIz or WHtR for cardiometabolic risk factors: insulin resistance (HOMA-IR, lipids, blood pressures, and glucose. For each risk outcome variable, we prepared adjusted regression models for four subpopulations stratified by sex and high versus lower fatness. For HOMA-IR, R2 attributed to BMIz or WHtR was 19%–28% among high-fatness and 8%–13% among lower-fatness students. R2 for lipid variables was 4%–9% among high-fatness and 2%–7% among lower-fatness students. In the lower-fatness subpopulations, the standardized coefficients for total cholesterol/HDL cholesterol and triglycerides tended to be weaker for BMIz (0.13–0.20 than for WHtR (0.17–0.28. Among high-fatness students, BMIz and WHtR correlated with blood pressures for Hispanics and whites, but not black boys (systolic or girls (systolic and diastolic. In 11-12 year olds, assessments by WHtR can provide cardiometabolic risk estimates similar to conventional BMIz without requiring reference to a normative growth chart.

  6. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes.

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    Tahririan, Dana; Kaviani, Naser; Nourbakhsh, Nosrat

    2016-01-01

    This study was planned to determine the relationship between bispectoral index (BIS) during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents' written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and isoflurane (1%). For the second group, the anesthesia was preserved by a mixture of oxygen (50%), nitrous oxide (50%), and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients' vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87). Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05); however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308) and (P < 0.001, r = -0.55). The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  7. Combination of high ankle-brachial index and hard coronary heart disease Framingham Risk Score in predicting the risk of ischemic stroke in general population.

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    Yinyin Zhang

    Full Text Available Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle-brachial index (ABI, but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3 and 65 subjects were randomly selected as normal ABI group (0.9Score (FRS were compared between two groups. The results showed that the 10-year HCHD FRS of high ABI group was significantly higher than normal ABI group (7.87 ± 6.11 vs. 3.98 ± 2.90%, P<0.001. There was a positive correlation between ABI value and HCHD FRS in overweight participants (R = 0.576, P<0.01. The prevalence of ischemic stroke was higher in high ABI group than normal ABI group (21.3% vs. 6.2%, P<0.05, and it was higher in participants with HCHD FRS ≥ 6% than those with HCHD FRS<6% (19.1% vs. 6.9%, P<0.05. Moreover, the prevalence of ischemic stroke was higher in participants with high ABI and HCHD FRS ≥ 6% than those with normal ABI and HCHD FRS<6% (26.7% vs. 4.1%, P<0.05. BMI, hypertension, hsCRP and smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05. In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China.

  8. Validity of a continuous metabolic syndrome score as an index for modeling metabolic syndrome in children and adolescents: the CASPIAN-V study

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    Ramin Heshmat

    2017-11-01

    Full Text Available Abstract Background The purpose of the present study was to assess the validity of continuous metabolic syndrome score (cMetS for predicting metabolic syndrome (MetS and to determine the cutoff values in a representative sample of Iranian children and adolescents. Methods This national study was conducted among 3843 students, aged 7–18 years country during the fifth survey of a national school-based surveillance program. The cMetS was computed by standardizing the residuals of waist circumference, mean arterial blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose by regressing them according to age and sex and aggregating them. The optimal cut-off points of cMetS for predicting MetS were determined by the receiver operation characteristic (ROC curve analysis in different gender and age categories. Results Totally, 3843 students (52.3% boys with average age of 12.45 years were assessed. The mean of cMetS increased according to elevating the number of MetS components. The overall cMetS cut-off point was 1.76 (sensitivity 93% and specificity 82% in total pediatrics. The area under the ROC curve was 94%. The values for boys and girls were 1.79 and 2.72, respectively. Conclusions cMetS performed highly accurate in predicting pediatrics with MetS in all gender and age groups and it appears to be a valid index in children and adolescents.

  9. Prognostic values of pneumonia severity index, CURB-65 and expanded CURB-65 scores in community-acquired pneumonia in Zagazig University Hospitals

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    Samah M. Shehata

    2017-07-01

    Conclusions: Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.

  10. Antidepressant Use and Subclinical Measures of Atherosclerosis: The Multi-Ethnic Study of Atherosclerosis.

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    Camacho, Álvaro; McClelland, Robyn L; Delaney, Joseph A; Allison, Matthew A; Psaty, Bruce M; Rifkin, Dena E; Rapp, Stephen R; Szklo, Moyses; Stein, Murray B; Criqui, Michael H

    2016-08-01

    Antidepressants are commonly prescribed medications used in primary care. The cardiovascular safety profile of antidepressant medications, in terms of subclinical atherosclerosis, is underexamined. A total of 6814 participants in the Multi-Ethnic Study of Atherosclerosis were examined. At baseline, the mean age was 62 years with 4 race/ethnic groups represented: European Americans (38%), Hispanic Americans (23%), African Americans (28%), and Chinese Americans (11%). Antidepressants were subgrouped as serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and "other" (bupropion, nefazodone, trazodone, mirtazapine). After adjusting for potential confounders, we estimated the association between antidepressant use and the following measures of subclinical atherosclerosis: coronary artery calcium (CAC), the ankle-brachial index, and carotid intima-media thickness, both cross-sectionally and prospectively. A total of 324 participants were exposed to SSRIs, 88 to TCAs, 41 to SNRIs, and 123 to other antidepressants. For CAC incidence, the fully adjusted longitudinal analyses revealed no consistent associations with SSRIs (relative risk [RR], 0.99; 95% confidence interval [CI], 0.71-1.37), SNRIs (RR, 0.49; 95% CI, 0.13-1.86), TCAs (RR, 0.94; 95% CI, 0.50-1.77), other antidepressant (RR, 0.87; 95% CI, 0.73-1.03) exposure, and subclinical disease. Similar null results were obtained in the cross-sectional and longitudinal exposure to antidepressants with changes in baseline CAC greater than 0, ankle-brachial index, and carotid intima-media thickness. The results of the current study do not support an association between antidepressants and subclinical atherosclerosis.

  11. ABC Transporters, Atherosclerosis and Inflammation

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    Fitzgerald, Michael L.; Mujawar, Zahedi; Tamehiro, Norimasa

    2010-01-01

    Atherosclerosis, driven by inflamed lipid-laden lesions, can occlude the coronary arteries and lead to myocardial infarction. This chronic disease is a major and expensive health burden. However, the body is able to mobilize and excrete cholesterol and other lipids, thus preventing atherosclerosis by a process termed reverse cholesterol transport (RCT). Insight into the mechanism of RCT has been gained by the study of two rare syndromes caused by the mutation of ABC transporter loci. In Tangi...

  12. Genetic Risk Score Mendelian Randomization Shows that Obesity Measured as Body Mass Index, but not Waist:Hip Ratio, Is Causal for Endometrial Cancer.

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    Painter, Jodie N; O'Mara, Tracy A; Marquart, Louise; Webb, Penelope M; Attia, John; Medland, Sarah E; Cheng, Timothy; Dennis, Joe; Holliday, Elizabeth G; McEvoy, Mark; Scott, Rodney J; Ahmed, Shahana; Healey, Catherine S; Shah, Mitul; Gorman, Maggie; Martin, Lynn; Hodgson, Shirley V; Beckmann, Matthias W; Ekici, Arif B; Fasching, Peter A; Hein, Alexander; Rübner, Matthias; Czene, Kamila; Darabi, Hatef; Hall, Per; Li, Jingmei; Dörk, Thilo; Dürst, Matthias; Hillemanns, Peter; Runnebaum, Ingo B; Amant, Frederic; Annibali, Daniela; Depreeuw, Jeroen; Lambrechts, Diether; Neven, Patrick; Cunningham, Julie M; Dowdy, Sean C; Goode, Ellen L; Fridley, Brooke L; Winham, Stacey J; Njølstad, Tormund S; Salvesen, Helga B; Trovik, Jone; Werner, Henrica M J; Ashton, Katie A; Otton, Geoffrey; Proietto, Anthony; Mints, Miriam; Tham, Emma; Bolla, Manjeet K; Michailidou, Kyriaki; Wang, Qin; Tyrer, Jonathan P; Hopper, John L; Peto, Julian; Swerdlow, Anthony J; Burwinkel, Barbara; Brenner, Hermann; Meindl, Alfons; Brauch, Hiltrud; Lindblom, Annika; Chang-Claude, Jenny; Couch, Fergus J; Giles, Graham G; Kristensen, Vessela N; Cox, Angela; Pharoah, Paul D P; Tomlinson, Ian; Dunning, Alison M; Easton, Douglas F; Thompson, Deborah J; Spurdle, Amanda B

    2016-11-01

    The strongest known risk factor for endometrial cancer is obesity. To determine whether SNPs associated with increased body mass index (BMI) or waist-hip ratio (WHR) are associated with endometrial cancer risk, independent of measured BMI, we investigated relationships between 77 BMI and 47 WHR SNPs and endometrial cancer in 6,609 cases and 37,926 country-matched controls. Logistic regression analysis and fixed effects meta-analysis were used to test for associations between endometrial cancer risk and (i) individual BMI or WHR SNPs, (ii) a combined weighted genetic risk score (wGRS) for BMI or WHR. Causality of BMI for endometrial cancer was assessed using Mendelian randomization, with BMIwGRS as instrumental variable. The BMIwGRS was significantly associated with endometrial cancer risk (P = 3.4 × 10-17). Scaling the effect of the BMIwGRS on endometrial cancer risk by its effect on BMI, the endometrial cancer OR per 5 kg/m2 of genetically predicted BMI was 2.06 [95% confidence interval (CI), 1.89-2.21], larger than the observed effect of BMI on endometrial cancer risk (OR = 1.55; 95% CI, 1.44-1.68, per 5 kg/m2). The association attenuated but remained significant after adjusting for BMI (OR = 1.22; 95% CI, 1.10-1.39; P = 5.3 × 10-4). There was evidence of directional pleiotropy (P = 1.5 × 10-4). BMI SNP rs2075650 was associated with endometrial cancer at study-wide significance (P < 4.0 × 10-4), independent of BMI. Endometrial cancer was not significantly associated with individual WHR SNPs or the WHRwGRS. BMI, but not WHR, is causally associated with endometrial cancer risk, with evidence that some BMI-associated SNPs alter endometrial cancer risk via mechanisms other than measurable BMI. The causal association between BMI SNPs and endometrial cancer has possible implications for endometrial cancer risk modeling. Cancer Epidemiol Biomarkers Prev; 25(11); 1503-10. ©2016 AACR. ©2016 American Association for Cancer Research.

  13. Genetic risk score Mendelian randomization shows obesity measured as body mass index, but not waist:hip ratio, is causal for endometrial cancer

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    Painter, Jodie N; O’Mara, Tracy A; Marquart, Louise; Webb, Penelope M; Attia, John; Medland, Sarah E; Cheng, Timothy; Dennis, Joe; Holliday, Elizabeth G; McEvoy, Mark; Scott, Rodney J; Ahmed, Shahana; Healey, Catherine S; Shah, Mitul; Gorman, Maggie; Martin, Lynn; Hodgson, Shirley V; Beckmann, Matthias W; Ekici, Arif B; Fasching, Peter A; Hein, Alexander; Rübner, Matthias; Czene, Kamila; Darabi, Hatef; Hall, Per; Li, Jingmei; Dörk, Thilo; Dürst, Matthias; Hillemanns, Peter; Runnebaum, Ingo B; Amant, Frederic; Annibali, Daniela; Depreeuw, Jeroen; Lambrechts, Diether; Neven, Patrick; Cunningham, Julie M; Dowdy, Sean C; Goode, Ellen L; Fridley, Brooke L; Winham, Stacey J; Njølstad, Tormund S; Salvesen, Helga B; Trovik, Jone; Werner, Henrica MJ; Ashton, Katie A; Otton, Geoffrey; Proietto, Anthony; Mints, Miriam; Tham, Emma; Bolla, Manjeet K; Michailidou, Kyriaki; Wang, Qin; Tyrer, Jonathan P; Hopper, John L; Peto, Julian; Swerdlow, Anthony J; Burwinkel, Barbara; Brenner, Hermann; Meindl, Alfons; Brauch, Hiltrud; Lindblom, Annika; Chang-Claude, Jenny; Couch, Fergus J; Giles, Graham G; Kristensen, Vessela N; Cox, Angela; Pharoah, Paul D P; Tomlinson, Ian; Dunning, Alison M; Easton, Douglas F; Thompson, Deborah J; Spurdle, Amanda B

    2016-01-01

    Background The strongest known risk factor for endometrial cancer (EC) is obesity. To determine whether single nucleotide polymorphisms (SNPs) associated with increased body mass index (BMI) or waist-hip ratio (WHR) are associated with EC risk, independent of measured BMI, we investigated relationships between 77 BMI and 47 WHR SNPs and EC in 6,609 cases and 37,926 country-matched controls. Methods Logistic regression analysis and fixed-effects meta-analysis were used to test for associations between EC risk and (i) individual BMI or WHR SNPs, (ii) a combined weighted genetic risk score (wGRS) for BMI or WHR. Causality of BMI for EC was assessed using Mendelian randomization, with BMIwGRS as instrumental variable. Results The BMIwGRS was significantly associated with EC risk (P=3.4×10−17). Scaling the effect of the BMIwGRS on EC risk by its effect on BMI, the EC odds ratio (OR) per 5kg/m2 of genetically predicted BMI was 2.06 (95% confidence interval(CI)=1.89–2.21), larger than the observed effect of BMI on EC risk (OR=1.55, 95%CI 1.44–1.68, per 5kg/m2). The association attenuated but remained significant after adjusting for BMI (OR=1.22, 95%CI=1.10–1.39,P=5.3×10−4). There was evidence of directional pleiotropy (P=1.5×10−4). BMI SNP rs2075650 was associated with EC at study-wide significance (P<4.0×10−4), independent of BMI. EC was not significantly associated with individual WHR SNPs or the WHRwGRS. Conclusions BMI, but not WHR, is causally associated with EC risk, with evidence that some BMI-associated SNPs alter EC risk via mechanisms other than measurable BMI. Impact The causal association between BMI SNPs and EC has possible implications for EC risk modeling. PMID:27550749

  14. Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Côte d'Ivoire.

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    Rohner, Fabian; Tschannen, Andres B; Northrop-Clewes, Christine; Kouassi-Gohou, Valérie; Bosso, Patrice E; Mascie-Taylor, C G Nicholas

    2012-09-01

    To determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15-49 years; WRA) and children aged 6-59 months living in Côte d'Ivoire. Anthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition. Data were from a nationally representative survey conducted in Côte d'Ivoire in 2007. A sample of 768 WRA and 717 children aged 6-59 months was analysed. Overall, 74·9 % of children and 50·2 % of WRA were anaemic; 39·5 % of the children were stunted, 28·1 % underweight and 12·8 % wasted, while 7·4 % of WRA had BMI rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8·2 g/l and 6·5 g/l, respectively (13·9 % and 19·8 % difference in anaemia, respectively; P poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession score.

  15. A review of plant-based compounds and medicinal plants effective on atherosclerosis

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    Mehrnoosh Sedighi

    2017-01-01

    Full Text Available Atherosclerosis is one of the most important cardiovascular diseases that involve vessels through the development of fatty streaks and plaques. Plant-based compounds can help treat or prevent atherosclerosis through affecting the involved factors. The main purpose of this review article is to investigate and introduce medicinal plants and their potential activities regarding antioxidant properties, effective on lipids level and development of plaque, atherosclerosis, and progression of atherosclerosis as well as the development of cardiovascular disease and ischemia. To search for the relevant articles indexed in Information Sciences Institute, PubMed, Scientific Information Database, IranMedex, and Scopus between 1980 and 2013, with further emphasis on those indexed from 2004 to 2015, we used these search terms: atherosclerosis, antioxidant, cholesterol, inflammation, and the medicinal plants below. Then, the articles with inclusion criteria were used in the final analysis of the findings. Plant-based active compounds, including phenols, flavonoids, and antioxidants, can be effective on atherosclerosis predisposing factors and hence in preventing this disease and associated harmful complications, especially through reducing cholesterol, preventing increase in free radicals, and ultimately decreasing vascular plaque and vascular resistance. Hence, medicinal plants can contribute to treating atherosclerosis and preventing its progression through reducing cholesterolemia, free radicals, inflammation, vascular resistance, and certain enzymes. They, alone or in combination with hypocholesterolemic drugs, can therefore be useful for patients with hyperlipidemia and its complications.

  16. A review of plant-based compounds and medicinal plants effective on atherosclerosis

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    Sedighi, Mehrnoosh; Bahmani, Mahmoud; Asgary, Sedigheh; Beyranvand, Fatemeh; Rafieian-Kopaei, Mahmoud

    2017-01-01

    Atherosclerosis is one of the most important cardiovascular diseases that involve vessels through the development of fatty streaks and plaques. Plant-based compounds can help treat or prevent atherosclerosis through affecting the involved factors. The main purpose of this review article is to investigate and introduce medicinal plants and their potential activities regarding antioxidant properties, effective on lipids level and development of plaque, atherosclerosis, and progression of atherosclerosis as well as the development of cardiovascular disease and ischemia. To search for the relevant articles indexed in Information Sciences Institute, PubMed, Scientific Information Database, IranMedex, and Scopus between 1980 and 2013, with further emphasis on those indexed from 2004 to 2015, we used these search terms: atherosclerosis, antioxidant, cholesterol, inflammation, and the medicinal plants below. Then, the articles with inclusion criteria were used in the final analysis of the findings. Plant-based active compounds, including phenols, flavonoids, and antioxidants, can be effective on atherosclerosis predisposing factors and hence in preventing this disease and associated harmful complications, especially through reducing cholesterol, preventing increase in free radicals, and ultimately decreasing vascular plaque and vascular resistance. Hence, medicinal plants can contribute to treating atherosclerosis and preventing its progression through reducing cholesterolemia, free radicals, inflammation, vascular resistance, and certain enzymes. They, alone or in combination with hypocholesterolemic drugs, can therefore be useful for patients with hyperlipidemia and its complications. PMID:28461816

  17. Metabolically healthy obesity and the risk for subclinical atherosclerosis.

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    Kim, Tae Jun; Shin, Hee-Young; Chang, Yoosoo; Kang, Mira; Jee, Jaehwan; Choi, Yoon-Ho; Ahn, Hyeon Seon; Ahn, Soo Hyun; Son, Hee Jung; Ryu, Seungho

    2017-07-01

    Although obesity and metabolic abnormalities are known risk factors for cardiovascular disease, the risk of cardiovascular disease among obese individuals without obesity-related metabolic abnormalities, referred to as metabolically healthy obese (MHO), remains unclear. We examined the association between body mass index categories and the development of subclinical carotid atherosclerosis in a cohort of metabolically healthy individuals. We conducted a cohort study of 6453 men without subclinical carotid atherosclerosis or metabolic abnormalities at baseline, who underwent repeated health check-up examinations that included carotid ultrasound. A metabolically healthy state was defined as having no metabolic syndrome components and a homeostasis model assessment of insulin resistance Subclinical carotid atherosclerosis was assessed using ultrasound. During the follow-up period of 34,797.9 person-years, subclinical carotid atherosclerosis developed in 1916 participants. Comparing overweight and obese with normal weight participants, the multivariable adjusted hazard ratios (95% confidence intervals) for incident subclinical carotid atherosclerosis were 1.24 (1.12-1.38) and 1.54 (1.38-1.72), respectively. The association persisted after further adjustment for metabolic variables. This association was also evident in MHO men without abdominal obesity (waist circumference > 90 cm) and it did not differ across any clinically relevant subgroups evaluated. In a large cohort study of strictly defined metabolically healthy participants, the MHO phenotype was associated with an increased risk of incident subclinical carotid atherosclerosis, providing evidence that the MHO phenotype is not protective from cardiovascular risk. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

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    Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

    2016-04-01

    The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

  19. Association between nonalcoholic fatty liver disease and subclinical coronary atherosclerosis: An observational cohort study.

    Science.gov (United States)

    Lee, Seung Bum; Park, Gyung-Min; Lee, Jong-Young; Lee, Byung Uk; Park, Jae Ho; Kim, Byung Gyu; Jung, Seok Won; Jeong, In Du; Bang, Sung-Jo; Shin, Jung Woo; Park, Neung Hwa; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan; Kim, Hong-Kyu; Choe, Jaewon; Lee, Han Chu

    2017-12-20

    There are limited data on the association between nonalcoholic fatty liver disease (NAFLD) and subclinical coronary atherosclerosis. This study investigated the influence of NAFLD on subclinical coronary atherosclerosis as detected by coronary computed tomographic angiography (CCTA) in an asymptomatic population. A total of 5,121 consecutive asymptomatic individuals with no prior history of coronary artery disease or significant alcohol intake voluntarily underwent abdominal ultrasonography and CCTA as part of a general health examination. Fatty liver was assessed by ultrasonography examination. The fatty liver index and NAFLD fibrosis score were also calculated. Coronary atherosclerotic plaques on CCTA were evaluated. The association between NAFLD and subclinical coronary atherosclerosis was determined by logistic regression analysis. Of the study participants, 1,979 (38.6%) had ultrasonography-diagnosed NAFLD. After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios of NAFLD for calcified plaque (1.03, 95% confidence interval [CI] 0.89-1.20, P=0.673) and mixed plaque (1.15, 95% CI 0.93-1.42, P=0.214). However, adjusted odds ratios for any atherosclerotic plaque (1.18, 95% CI 1.03-1.35, P=0.016) and non-calcified plaque (1.27, 95% CI 1.08-1.48, P=0.003) were significantly higher in NAFLD. In addition, there was a significant association of fatty liver index ≥30 with non-calcified plaque (1.37, 95% CI 1.14-1.65, P=0.001) and NAFLD fibrosis score ≥-1.455 with non-calcified plaque (1.20, 95% CI 1.08-1.42, P=0.030). In this large cross-sectional study of asymptomatic individuals undergoing CCTA, NAFLD was consistently associated with non-calcified plaque, suggesting an increased cardiovascular risk. In asymptomatic individuals, the nonalcoholic fatty liver disease (NAFLD) was an independent risk factor for non-calcified plaque, which has been known as a vulnerable plaque associated with

  20. Macrovascular disease and atherosclerosis in SSc

    NARCIS (Netherlands)

    Hettema, M. E.; Bootsma, H.; Kallenberg, C. G. M.

    Atherosclerosis is considered to be a chronic inflammatory disorder. Several autoimmune rheumatic diseases are characterized by premature and accelerated atherosclerosis in which both classical and non-classical risk factors contribute to atherogenesis. SSc is characterized by vasculopathy, and

  1. Trained innate immunity and atherosclerosis.

    Science.gov (United States)

    Bekkering, Siroon; Joosten, Leo A B; van der Meer, Jos W M; Netea, Mihai G; Riksen, Niels P

    2013-12-01

    Monocytes/macrophages play a decisive role in the development and progression of atherosclerosis. It is currently unknown what stimuli initiate and orchestrate the activation of these cells in atherogenesis. In this review, we postulate that the novel concept of 'trained immunity' modulates the development and progression of atherosclerosis. Recently, results from our laboratory challenged the current paradigm that innate immunity is static and does not have an immunological memory. Stimulation by various microbial products, including Candida albicans and bacille Calmette-Guérin, appeared to bring monocytes into a long-term enhanced functional state, showing a stronger proinflammatory response to a second stimulus. This 'trained immunity' was mediated by increased and stable histone methylation. We describe the hypothesis that this functional reprogramming of monocytes, either by microbial products or by metabolic products, contributes to atherogenesis and propose epigenetic reprogramming of monocytes as a novel pharmacological target for preventing or treating atherosclerosis in the future.

  2. Periodontal Innate Immune Mechanisms Relevant to Atherosclerosis

    OpenAIRE

    Amar, Salomon; Engelke, Marianne

    2014-01-01

    Atherosclerosis is a common cardiovascular disease in the United States. The disease is a leading cause of illness and death in the United States. Atherosclerosis is the most common cause for heart attack and stroke. Most commonly, people develop atherosclerosis as a result of diabetes, genetic risk factors, high blood pressure, a high-fat diet, obesity, high blood cholesterol levels, and smoking. However a sizable amount of patients suffering from atherosclerosis do not harbor the classical ...

  3. Fibrinogen and the Severity of Coronary Atherosclerosis among Adults with and without Statin Treatment: Lipid as a mediator.

    Science.gov (United States)

    Zhang, Yan; Zhu, Cheng-Gang; Guo, Yuan-Lin; Li, Sha; Xu, Rui-Xia; Dong, Qian; Li, Jian-Jun

    2016-06-01

    It has been proposed that plasma fibrinogen is associated with lipid levels and increased cardiovascular risk. However, the interrelationship has not been well-elucidated. We hypothesise that lipids may be potential mediators. We enrolled 4748 consecutive subjects scheduled for coronary angiography in this study. The severity of coronary atherosclerosis was assessed by Gensini score (GS). By principle component analysis, a multi-marker lipid index was extracted weighting the coefficients of six atherogenic lipid parameters: total cholesterol (TC), low-density lipoprotein-cholesterol, non-high-density lipoprotein-cholesterol (non-HDL-C), apolipoprotein (apo) B, apoB/apoA1, and TC/HDL-C ratio. Moreover, using mediation analysis, the relationship between fibrinogen and lipids with high GS was evaluated. Fibrinogen was positively associated with GS after adjustment (β=0.100, peffect of fibrinogen and concurrent elevated lipid index for high GS. The adjusted odds ratios were greater in participants who had high fibrinogen levels and also high lipid index compared to those with low lipid index [on statin: 1.725(1.258-2.364) vs. 1.261(0.962-1.652); not on statin: 2.197(1.450-3.328) vs. 1.166(0.417-3.258)]. Specifically, mediation analysis indicated that around 24% of the effect of fibrinogen on high GS was mediated by lipid index, which was attenuated to 13% by statin status. The increased risk of fibrinogen on coronary atherosclerosis appeared to be enhanced by the high atherogenic lipid levels, which mediated around 24% of this effect. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  4. Differences in gestational weight gain between pregnancies before and after maternal bariatric surgery correlate with differences in birth weight but not with scores on the body mass index in early childhood

    DEFF Research Database (Denmark)

    Berglind, D; Willmer, M; Näslund, E

    2013-01-01

    Large maternal gestational weight gain (GWG) is associated with increased birth weight and increased risk of obesity in offspring, but these associations may be confounded by genetic and environmental factors. The aim was to investigate the effects of differences in GWG in all three trimesters on...... on differences in birth weight and in body mass index (BMI) scores at 4 and 6 years of age, within siblings born before and after bariatric surgery....

  5. Long noncoding RNAs and atherosclerosis.

    Science.gov (United States)

    Zhou, Tian; Ding, Jia-wang; Wang, Xin-an; Zheng, Xia-xia

    2016-05-01

    Atherosclerosis is universally recognized as a chronic lipid-induced inflammation of the vessel wall in response to dyslipidemia and haemodynamic stress involving dysfunction and activation of resident vascular cells as well as infiltration of leukocytes. As members of nonprotein-coding RNAs, the long noncoding RNAs (lncRNAs) are implicated in various biological processes. Accumulating evidences suggest that lncRNAs regulate the function of vascular wall, activation of macrophages, lipid metabolism and immune response. Here, we review the effects of lncRNAs on the progress of atherosclerosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. The pediatric index of mortality 3 score to predict mortality in a pediatric intensive care unit in Palembang, South Sumatera, Indonesia

    Directory of Open Access Journals (Sweden)

    Destiana Sera Puspita Sari

    2017-06-01

    Conclusion In Mohammad Hoesin Hospital, Palembang, South Sumatera, the PIM 3 can be used to predict mortality in PICU patients, but the score should be multiplied by a factor of 2.24. This recalibration is needed due to the presumed lower standard of care at this hospital compared to that of the originating PIM 3 institutions in developed countries.

  7. Saturated fat intake modulates the association between an obesity genetic risk score and body mass index in two U.S. populations

    Science.gov (United States)

    Combining multiple genetic variants related to obesity into a genetic risk score (GRS) might improve identification of individuals at risk of developing obesity. Moreover, characterizing gene-diet interactions is a research challenge to establish dietary recommendations to individuals with higher pr...

  8. Muscle Fatigability During a Sustained Index Finger Abduction and Depression Scores Are Associated With Perceived Fatigue in Patients With Relapsing-Remitting Multiple Sclerosis

    NARCIS (Netherlands)

    Wolkorte, Ria; Heersema, Dorothea J.; Zijdewind, Inge

    Introduction. Fatigue is a common and debilitating symptom in patients with multiple sclerosis (MS). Self-reported levels of perceived fatigue are associated with both patient characteristics and clinical measures. Pilot analysis indicated that muscle fatigability combined with depression scores was

  9. A composite score combining waist circumference and body mass index more accurately predicts body fat percentage in 6-to 13-year-old children

    NARCIS (Netherlands)

    Aeberli, I.; Gut-Knabenhans, M.; Kusche-Ammann, R.S.; Molinari, L.; Zimmermann, M.B.

    2013-01-01

    Body mass index (BMI) and waist circumference (WC) are widely used to predict % body fat (BF) and classify degrees of pediatric adiposity. However, both measures have limitations. The aim of this study was to evaluate whether a combination of WC and BMI would more accurately predict %BF than either

  10. Kamp K’aana, a 2-week residential weight management summer camp, shows long-term improvement in body mass index z scores

    Science.gov (United States)

    Long-term effects of Kamp K'aana, a 2-week residential weight management camp, on body mass index (BMI) measures were evaluated on 71 of 108 (66%) obese youth 10 to 14 years of age. Measures were obtained at 11-month study follow-up (n=38) or extracted from medical record (n=33). Compared with basel...

  11. Among 4 Diet Quality Indexes, Only the Alternate Mediterranean Diet Score Is Associated with Better Colorectal Cancer Survival and Only in African American Women in the Multiethnic Cohort123

    Science.gov (United States)

    Jacobs, Simone; Harmon, Brook E; Ollberding, Nicholas J; Wilkens, Lynne R; Monroe, Kristine R; Kolonel, Laurence N; Le Marchand, Loic; Boushey, Carol J; Maskarinec, Gertraud

    2016-01-01

    Background: Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, with a 5-y survival rate of ∼65%. Therefore, the identification of modifiable health factors to improve CRC survival is crucial. Objective: We investigated the association of 4 prediagnostic a priori diet quality indexes with CRC-specific and all-cause mortality in the Multiethnic Cohort (MEC). Methods: The MEC included >215,000 African-American, Native Hawaiian, Japanese-American, Latino, and white adults living in Hawaii and California who completed a validated quantitative food-frequency questionnaire in 1993–1996. CRC cases and deaths were identified through linkages to cancer registries and to state and national vital registries. Sex-specific HRs and 95% CIs were estimated for the Healthy Eating Index (HEI) 2010, the Alternative HEI (AHEI) 2010, the alternate Mediterranean Diet (aMED) score, and the Dietary Approaches to Stop Hypertension (DASH) index with CRC-specific and overall mortality as the primary outcomes. Ethnicity-specific analyses were the secondary outcomes. Results: Among 4204 MEC participants diagnosed with invasive CRC through 2010, 1976 all-cause and 1095 CRC-specific deaths were identified. A higher aMED score was associated with lower CRC-specific mortality in women [HR continuous pattern score divided by its respective SD (HR1SD): 0.86; 95% CI: 0.77, 0.96] but not in men (HR1SD: 1.01; 95% CI: 0.92, 1.11). A higher aMED score was also associated with lower all-cause mortality in women (HR1SD: 0.88; 95% CI: 0.81, 0.96) but not in men (HR1SD: 1.00; 95% CI: 0.93, 1.07). The HEI-2010, AHEI-2010, and DASH index were not significantly associated with CRC-specific or with all-cause mortality. The inverse relation for the aMED score was limited to African Americans and to colon (compared with rectal) cancer. Conclusions: The aMED score was related to lower mortality only in African-American women (1 of 5 ethnic groups studied). The

  12. Preventing and arresting coronary atherosclerosis.

    Science.gov (United States)

    Roberts, W C

    1995-09-01

    The good news about coronary atherosclerosis is that it takes an awful lot of plaque before symptoms of myocardial ischemia occur. The bad news is that despite the need for large quantities of plaque for symptoms to occur, nevertheless nearly half of us in the United States eventually have the necessary quantity. Atherosclerosis is infrequently hereditary in origin. Most of us get atherosclerosis because we consume too much fat, cholesterol, and calories. The consequence is an elevated ( > 150 mg/dl) serum total cholesterol level, and the higher the number is above 150, the greater is the quantity of plaque deposited in our arteries. If the serum total cholesterol level can be prevented from rising to more than 150 mg/dl, plaques are not laid down; if elevated levels are lowered to 150 mg/dl, further plaque does not form, and parts of those present may vanish. A fruit-vegetarian-starch diet is necessary as a rule to achieve the 150 mg/dl level in most adults. Lipid-lowering drugs are required in the patients with familial hypercholesterolemia and in most patients with atherosclerotic events. The best news about atherosclerosis is that it can be prevented in those without the hereditary form, and it can be arrested by lowering elevated serum total (and LDL) cholesterol to the 150 mg/dl level.

  13. Inflammation and coagulation in atherosclerosis.

    Science.gov (United States)

    Krychtiuk, K A; Kastl, S P; Speidl, W S; Wojta, J

    2013-01-01

    Cardiovascular diseases remain to be the leading cause of death in Western societies. Despite major findings in vascular biology that lead to a better understanding of the pathomechanisms involved in atherosclerosis, treatment of the disease has only changed slightly within the last years. A big body of evidence suggests that atherosclerosis is a chronic inflammatory disease of the vessel wall. Accumulation and peroxidation of LDL-particles within the vessel wall trigger a strong inflammatory response, causing macrophage and T-cell accumulation within the vessel wall. Additionally, B-cells and specific antibodies against LDL-particles, as well as the complement system are implicated in atherogenesis. Besides data from clinical trials and autopsy studies it was the implementation of mouse models of atherosclerosis and the emerging field of direct gen-modification that lead to a thorough description of the pathophysiological mechanisms involved in the disease and created overwhelming evidence for a participation of the immune system. Recently, the cross-talk between coagulation and inflammation in atherogenesis has gained attention. Serious limitations and disparities in the pathophysiology of atherosclerosis in mice and men complicated the translation of experimental data into clinical practice. Despite these limitations, new anti-inflammatory medical therapies in cardiovascular disease are currently being tested in clinical trials.

  14. Intravital Microscopy for Atherosclerosis Research

    NARCIS (Netherlands)

    Megens, Remco T. A.; Soehnlein, Oliver

    2015-01-01

    Recruitment of leukocytes into arteries is a hallmark event throughout all stages of atherosclerosis and hence stands out as a primary therapeutic target. To understand the molecular mechanisms of arterial leukocyte subset infiltration, real-time visualization of recruitment processes of leukocyte

  15. Trained innate immunity and atherosclerosis

    NARCIS (Netherlands)

    Bekkering, S.; Joosten, L.A.B.; Meer, J.W.M. van der; Netea, M.G.; Riksen, N.P.

    2013-01-01

    PURPOSE OF REVIEW: Monocytes/macrophages play a decisive role in the development and progression of atherosclerosis. It is currently unknown what stimuli initiate and orchestrate the activation of these cells in atherogenesis. In this review, we postulate that the novel concept of 'trained immunity'

  16. Cyclodextrin promotes atherosclerosis regression via macrophage reprogramming

    DEFF Research Database (Denmark)

    2016-01-01

    Atherosclerosis is an inflammatory disease linked to elevated blood cholesterol concentrations. Despite ongoing advances in the prevention and treatment of atherosclerosis, cardiovascular disease remains the leading cause of death worldwide. Continuous retention of apolipoprotein B...... that increases cholesterol solubility in preventing and reversing atherosclerosis. We showed that CD treatment of murine atherosclerosis reduced atherosclerotic plaque size and CC load and promoted plaque regression even with a continued cholesterol-rich diet. Mechanistically, CD increased oxysterol production...... of CD as well as for augmented reverse cholesterol transport. Because CD treatment in humans is safe and CD beneficially affects key mechanisms of atherogenesis, it may therefore be used clinically to prevent or treat human atherosclerosis....

  17. Countries’ Biomedical Publications and Attraction Scores. A PubMed-based assessment [v2; ref status: indexed, http://f1000r.es/5q4

    Directory of Open Access Journals (Sweden)

    Qinyi Xu

    2015-08-01

    Full Text Available Studying publication volumes at the country level is key to understanding and improving a country’s research system. PubMed is a public search engine of publications in all life sciences areas. Here, we show how this search engine can be used to assess the outputs of life science-related research by country. We have measured the numbers of publications during different time periods based on the country of affiliation of the first authors. Moreover, we have designed scores, which we have named Attraction Scores, to appraise the relative focus either toward particular types of studies, such as clinical trials or reviews, or toward specific research areas, such as public health and pharmacogenomics, or toward specific topics, for instance embryonic stem cells; we have also investigated a possible use of these Attraction Scores in connection with regulatory policies. We have weighed the statistics against general indicators such as country populations and gross domestic products (GDP. During the 5-year period 2008-2012, the United States was the country with the highest number of publications and Denmark the one with the highest number of publications per capita. Among the 40 countries with the highest GDPs, Israel had the highest publications-to-GDP ratio. Among the 20 countries with the most publications, Japan had the highest Attraction Score for induced pluripotent stem (iPS cells and Italy the highest proportion of review publications. More than 50% of publications in English were from countries in which English is not the primary language. We show an assorted and extensive collection of rankings and charts that will inform scholars and policymakers in studying and improving the research systems both at the national and international level.

  18. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    OpenAIRE

    Tahririan, Dana; Kaviani, Naser; Nourbakhsh, Nosrat

    2016-01-01

    Background: This study was planned to determine the relationship between bispectoral index (BIS) during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining ...

  19. Does Council Tax Valuation Band (CTVB correlate with Under-Privileged Area 8 (UPA8 score and could it be a better 'Jarman Index'?

    Directory of Open Access Journals (Sweden)

    Taylor Gordon

    2001-11-01

    Full Text Available Abstract Background Widespread scepticism persists on the use of the Under-Privileged Area (UPA8 score of Jarman in distributing supplementary resources to so-attributed 'deprived' UK general practices. The search for better 'needs' markers continues. Having already shown that Council Tax Valuation Band (CTVB is a predictor of UK GP workload, we compare, here, CTVB of residence of a random sample of patients with their respective 'Jarman' scores. Methods Correlation coefficient is calculated between (i the CTVB of residence of a randomised sample of patients from an English general practice and (ii the UPA8 scores of the relevant enumeration districts in which they live. Results There is a highly significant correlation between the two measures despite modest study size of 478 patients (85% response. Conclusions The proposal that CTVB is a marker of deprivation and of clinical demand should be examined in more detail: it correlates with 'Jarman', which is already used in NHS resource allocation. But unlike 'Jarman', CTVB is simple, objective, and free of the problems of Census data. CTVB, being household-based, can be aggregated at will.

  20. Relationship of change in traditional cardiometabolic risk factors to change in coronary artery calcification among individuals with detectable subclinical atherosclerosis: the multi-ethnic study of atherosclerosis.

    Science.gov (United States)

    Arguelles, William; Llabre, Maria M; Penedo, Frank J; Daviglus, Martha L; Sacco, Ralph L; Liu, Kiang; Szklo, Moyses; Polak, Joseph F; Eng, John; Burke, Gregory L; Schneiderman, Neil

    2014-06-01

    Data describing relationships between change in risk factors and coronary artery calcification (CAC) are lacking and could inform optimal cardiovascular disease prevention and treatment strategies. This study aimed to examine how change in traditional cardiometabolic risk factors related to change in CAC among individuals with detectable subclinical atherosclerosis. Latent growth modeling was used to examine change in cardiometabolic risk factors (waist circumference, body mass index, systolic and diastolic blood pressure, high- and low-density lipoprotein cholesterol, triglycerides, and glucose) related to change in CAC up to an average 4.9-year follow-up in a multi-ethnic cohort of 3398 asymptomatic individuals (57.8% men) who had detectable CAC (score>0) at baseline, adjusting for baseline risk factor levels and CAC values, age, gender, race/ethnicity, smoking, family history of CVD, income, and use of antihypertensive, lipid-lowering, and glucose-lowering medications. Greater declines in blood pressure (systolic and diastolic) and low-density lipoprotein cholesterol at follow-up were each associated with greater CAC progression. The observed inverse associations were attributable to greater CAC progression in participants taking antihypertensive and lipid-lowering drugs who, as expected, had declines in blood pressure and lipid levels, respectively. These inverse associations did not emerge in participants not taking these medications. Among individuals with subclinical atherosclerosis, the unexpected inverse associations observed between change in blood pressure and lipid levels with CAC progression emphasize the importance of considering medication use, and, when feasible, the severity and duration of disease, in exploring associations between risk factors and CAC change. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Subclinical atherosclerosis in low Framingham risk HIV patients.

    Science.gov (United States)

    León, Rafael; Reus, Sergio; López, Nicolás; Portilla, Irene; Sánchez-Payá, José; Giner, Livia; Boix, Vicente; Merino, Esperanza; Torrús, Diego; Moreno-Pérez, Óscar; Portilla, Joaquín

    2017-08-01

    Pathogenesis of atherosclerosis is complex, and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score. Case-control study. Outpatient Infectious Diseases clinic in a university hospital. HIV-1-infected patients aged > 35 years receiving antiretroviral treatment with viral load  5 cigarettes/day; diabetes; hypertension; vascular diseases. subclinical atherosclerosis determined by ultrasonography: common carotid intima-media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin-6 (IL-6) and TNF-α. Eighty-four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm(3) . Median Framingham risk score was 1% at 10 years (percentile 25-75: 0·5-4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist-hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL-6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3-40, P = 0.02) and 9 (95% CI, 1.0-85, P = 0.04) for patients older than 44 years and IL-6 > 6·6 pg/mL, respectively. Well-controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  2. The relationship of TIMI risk index with SYNTAX and Gensini risk scores in predicting the extent and severity of coronary artery disease in patients with STEMI undergoing primary percutaneous coronary intervention.

    Science.gov (United States)

    Acet, Halit; Ertaş, Faruk; Bilik, Mehmet Zihni; Aydın, Mesut; Yüksel, Murat; Polat, Nihat; Yıldız, Abdulkadir; Özyurtlu, Ferhat; Akıl, Mehmet Ata; Çiftçi, Leyla; Özbek, Mehmet; Alan, Sait; Toprak, Nizamettin

    2015-10-01

    The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) have been reported in patients with coronary artery disease (CAD). In this study, we sought to evaluate the association between TRI and the extent and severity of CAD evaluated by SYNTAX score (SS) and Gensini score in patients with ST elevation myocardial infarction (STEMI). A total of 290 patients with STEMI were included in the study. GRS and TRI were calculated on admission using specified variables. The extent and severity of CAD were evaluated using the SS and Gensini scores. The patients were divided into low (TRI ⩽19), intermediate (TRI 19-30), and high (TRI ⩾30) risk groups. A Pearson correlation analysis was used for the relationship between TRI, GRS, Gensini score and SS. There were significant differences in the mean age (p < 0.001), admission heart rate (p < 0.001), admission systolic blood pressure (p = 0.009), SS (p < 0.001), GRS (p < 0.001) and in-hospital major adverse cardiac events (MACE) in all patients between the low, intermediate and high TRI risk groups. There was a positive significant correlation between TRI and SS (r = 0.24, p < 0.001), Gensini score (r = 0.18, p = 0.002), GRS (r = 0.74, p = 0.001) and in-hospital MACE (r = 0.29, p < 0.001). TRI is significantly related to SS and Gensini score in predicting the extent and severity of CAD in patients with STEMI. © The Author(s), 2015.

  3. Microstructural Parameters of Bone Evaluated Using HR-pQCT Correlate with the DXA-Derived Cortical Index and the Trabecular Bone Score in a Cohort of Randomly Selected Premenopausal Women

    Science.gov (United States)

    Popp, Albrecht W.; Buffat, Helene; Eberli, Ursula; Lippuner, Kurt; Ernst, Manuela; Richards, R. Geoff; Stadelmann, Vincent A.; Windolf, Markus

    2014-01-01

    Background Areal bone mineral density is predictive for fracture risk. Microstructural bone parameters evaluated at the appendicular skeleton by high-resolution peripheral quantitative computed tomography (HR-pQCT) display differences between healthy patients and fracture patients. With the simple geometry of the cortex at the distal tibial diaphysis, a cortical index of the tibia combining material and mechanical properties correlated highly with bone strength ex vivo. The trabecular bone score derived from the scan of the lumbar spine by dual-energy X-ray absorptiometry (DXA) correlated ex vivo with the micro architectural parameters. It is unknown if these microstructural correlations could be made in healthy premenopausal women. Methods Randomly selected women between 20–40 years of age were examined by DXA and HR-pQCT at the standard regions of interest and at customized sub regions to focus on cortical and trabecular parameters of strength separately. For cortical strength, at the distal tibia the volumetric cortical index was calculated directly from HR-pQCT and the areal cortical index was derived from the DXA scan using a Canny threshold-based tool. For trabecular strength, the trabecular bone score was calculated based on the DXA scan of the lumbar spine and was compared with the corresponding parameters derived from the HR-pQCT measurements at radius and tibia. Results Seventy-two healthy women were included (average age 33.8 years, average BMI 23.2 kg/m2). The areal cortical index correlated highly with the volumetric cortical index at the distal tibia (R  =  0.798). The trabecular bone score correlated moderately with the microstructural parameters of the trabecular bone. Conclusion This study in randomly selected premenopausal women demonstrated that microstructural parameters of the bone evaluated by HR-pQCT correlated with the DXA derived parameters of skeletal regions containing predominantly cortical or cancellous bone. Whether these indexes

  4. Microstructural parameters of bone evaluated using HR-pQCT correlate with the DXA-derived cortical index and the trabecular bone score in a cohort of randomly selected premenopausal women.

    Directory of Open Access Journals (Sweden)

    Albrecht W Popp

    Full Text Available BACKGROUND: Areal bone mineral density is predictive for fracture risk. Microstructural bone parameters evaluated at the appendicular skeleton by high-resolution peripheral quantitative computed tomography (HR-pQCT display differences between healthy patients and fracture patients. With the simple geometry of the cortex at the distal tibial diaphysis, a cortical index of the tibia combining material and mechanical properties correlated highly with bone strength ex vivo. The trabecular bone score derived from the scan of the lumbar spine by dual-energy X-ray absorptiometry (DXA correlated ex vivo with the micro architectural parameters. It is unknown if these microstructural correlations could be made in healthy premenopausal women. METHODS: Randomly selected women between 20-40 years of age were examined by DXA and HR-pQCT at the standard regions of interest and at customized sub regions to focus on cortical and trabecular parameters of strength separately. For cortical strength, at the distal tibia the volumetric cortical index was calculated directly from HR-pQCT and the areal cortical index was derived from the DXA scan using a Canny threshold-based tool. For trabecular strength, the trabecular bone score was calculated based on the DXA scan of the lumbar spine and was compared with the corresponding parameters derived from the HR-pQCT measurements at radius and tibia. RESULTS: Seventy-two healthy women were included (average age 33.8 years, average BMI 23.2 kg/m(2. The areal cortical index correlated highly with the volumetric cortical index at the distal tibia (R  =  0.798. The trabecular bone score correlated moderately with the microstructural parameters of the trabecular bone. CONCLUSION: This study in randomly selected premenopausal women demonstrated that microstructural parameters of the bone evaluated by HR-pQCT correlated with the DXA derived parameters of skeletal regions containing predominantly cortical or cancellous bone

  5. Subclinical atherosclerosis and obesity phenotypes among Mexican Americans.

    Science.gov (United States)

    Laing, Susan T; Smulevitz, Beverly; Vatcheva, Kristina P; Rahbar, Mohammad H; Reininger, Belinda; McPherson, David D; McCormick, Joseph B; Fisher-Hoch, Susan P

    2015-03-18

    Data on the influence of obesity on atherosclerosis in Hispanics are inconsistent, possibly related to varying cardiometabolic risk among obese individuals. We aimed to determine the association of obesity and cardiometabolic risk with subclinical atherosclerosis in Mexican-Americans. Participants (n=503) were drawn from the Cameron County Hispanic Cohort. Metabolic health was defined as 5.13; or high-sensitivity C-reactive protein >3 mg/L. Carotid intima media thickness (cIMT) was measured. A high proportion of participants (77.8%) were metabolically unhealthy; they were more likely to be male, older, with fewer years of education, and less likely to meet daily recommendations regarding fruit and vegetable servings. One-third (31.8%) had abnormal carotid ultrasound findings. After adjusting for covariates, mean cIMT varied across the obesity phenotypes (P=0.0001); there was no difference among the metabolically unhealthy regardless of whether they were obese or not. In multivariable analysis, after adjusting for covariates, cardiometabolic risk (P=0.0159), but not obesity (P=0.1446), was significantly associated with subclinical atherosclerosis. In Mexican-Americans, cardiometabolic risk has a greater effect on early atherosclerosis development than body mass index. Non-obese but metabolically unhealthy participants had similar development of subclinical atherosclerosis as their obese counterparts. Interventions to maintain metabolic health among obese and non-obese patients may be a more important goal than weight loss alone. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  6. Periodontal disease and atherosclerosis

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    Jeferson Freitas Toregeani

    2014-09-01

    Full Text Available Atherosclerotic disease (AD is one of the most important causes of morbidity and mortality in the world. It expresses inflammatory markers such as C-reactive protein (CRP and can provoke arterial wall thickening, which can be evaluated using Doppler ultrasound. Risk factors associated with AD include diabetes mellitus, systemic arterial hypertension, dyslipidemia and smoking. More recently, periodontal disease (PD has been identified as a factor related to AD. Periodontal disease has a high prevalence in the global population and the inflammatory process and bacterial activity at the periodontium appear to increase the risk of AD. Encouraging good oral hygiene can reduce expression of inflammatory markers of AD. A review of literature on PD, AD and inflammatory markers and the interrelationships between the two diseases was conducted using data published in articles indexed on the PUBMED, SCIELO and BIREME databases.

  7. Diet and adipose tissue distributions: The Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Shah, R V; Murthy, V L; Allison, M A; Ding, J; Budoff, M; Frazier-Wood, A C; Lima, J A C; Steffen, L; Siscovick, D; Tucker, K L; Ouyang, P; Abbasi, S A; Danielson, K; Jerosch-Herold, M; Mozaffarian, D

    2016-03-01

    Dietary quality affects cardiometabolic risk, yet its pathways of influence on regional adipose tissue depots involved in metabolic and diabetes risk are not well established. We aimed to investigate the relationship between dietary quality and regional adiposity. We investigated 5079 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) who had food-frequency questionnaires and measurement of pericardial fat and hepatic attenuation at the baseline study visit in MESA, as well as a subgroup with imaging for visceral and subcutaneous fat (N = 1390). A dietary quality score (DietQuality) was constructed to include established food group constituents of a Mediterranean-type diet. Linear models estimated associations of dietary score as well as its constituents with regional adiposity. Baseline mean age was 61 (± 10) years, and approximately half of the participants (47%) were male. Those with a higher DietQuality score were generally older, female, with a lower body mass index, C-reactive protein, and markers of insulin resistance. After adjustment, a higher DietQuality score was associated with lower visceral fat (lowest vs. highest dietary score quartile: 523.6 vs. 460.5 cm(2)/m; P < 0.01 for trend), pericardial fat (47.5 vs. 41.3 cm(3)/m; P < 0.01 for trend), lesser hepatic steatosis (by hepatic attenuation; 58.6 vs. 60.7 Hounsfield units; P < 0.01 for trend), but not subcutaneous fat (P = 0.39). Greater fruits, vegetables, whole grains, seeds/nuts and yogurt intake were associated with decreased adiposity, while red/processed meats were associated with greater regional adiposity. A higher quality diet pattern is associated with less regional adiposity, suggesting a potential mechanism of beneficial dietary effects on diabetes, metabolic, and cardiovascular risk. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and

  8. Global DNA methylation and risk of subclinical atherosclerosis in young adults: The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study

    Science.gov (United States)

    Bressler, Jan; Shimmin, Lawrence C.; Boerwinkle, Eric; Hixson, James E.

    2011-01-01

    Objective The association between hepatic global DNA methylation measured using pyrosequencing technology and the risk of subclinical atherosclerosis was examined in the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. PDAY is a bi-racial investigation of the natural history of atherosclerosis and its risk factors involving 3013 individuals aged 15–34 years who underwent autopsy after dying of unrelated causes in 1987–1994. Methods Raised atherosclerotic lesions were defined as the sum of the percentages of intimal surface area detected in the right coronary artery and left half of the abdominal and thoracic aorta harboring fibrous plaques, complicated lesions, and calcified lesions during a postmortem pathological examination. To conduct the case–control study, 300 cases selected with the highest raised lesion scores were paired with 300 controls without raised lesions after matching for age, race, and gender. Results Global DNA methylation was not associated with disease risk in the study population considered as a whole using conditional logistic regression models to analyze matched pairs. Since the estimation of the risk of atherosclerosis associated with inter-individual variation in DNA methylation was similar if unconditional logistic regression was used, subgroup analyses were carried out after adjusting for matching variables. A modest association with methylation levels below the median value was found in white but not in African-American study participants (odds ratio = 1.59, 95% confidence interval = 1.02–2.49, p = 0.04). Conclusions Hepatic global DNA methylation does not appear to be a definitive determinant of atherosclerosis burden in a postmortem sample of young adults. PMID:22015179

  9. Innate lymphoid cells in atherosclerosis.

    Science.gov (United States)

    Engelbertsen, Daniel; Lichtman, Andrew H

    2017-12-05

    The family of innate lymphoid cells (ILCs) consisting of NK cells, lymphoid tissue inducer cells and the 'helper'-like ILC subsets ILC1, ILC2 and ILC3 have been shown to have important roles in protection against microbes, regulation of inflammatory diseases and involved in allergic reactions. ILC1s produce IFN-γ upon stimulation with IL-12 and IL-18, ILC2s produce IL-5 and IL-13 responding to IL-33 and IL-25 while ILC3s produce IL-17 and IL-22 after stimulation with IL-23 or IL-1. Although few studies have directly investigated the role for ILCs in atherosclerosis, several studies have investigated transcription factors and cytokines shared by ILCs and T helper cells. In this review we summarize our current understanding of the role of ILC in atherosclerosis and discuss future directions. Copyright © 2017. Published by Elsevier B.V.

  10. Combination of high ankle-brachial index and hard coronary heart disease Framingham Risk Score in predicting the risk of ischemic stroke in general population.

    Science.gov (United States)

    Zhang, Yinyin; Chen, Jie; Zhang, Kun; Wang, Tong; Kong, Minyi; Chen, Renhua; Liu, Yu; Chen, Jianping; Wang, Zhiyu; Wang, Jingfeng; Huang, Hui

    2014-01-01

    Our previous study showed that the patients with more metabolic risk factors had higher risk of high ankle-brachial index (ABI), but the relationship between high ABI and the risk of severe cardiovascular and cerebrovascular diseases is still under debate. This study aims to evaluate this association in the general population. 1486 subjects of South China were recruited in the study. 61 subjects were defined as high ABI group (ABI≥1.3) and 65 subjects were randomly selected as normal ABI group (0.9smoking were proved to be the independent factors and effective predictors for high ABI (P<0.05). In conclusion, high ABI combined with high HCHD FRS should be a potential predictor of ischemic stroke in the general population of South China.

  11. Insulin Resistance, Hyperglycemia, and Atherosclerosis

    OpenAIRE

    Bornfeldt, Karin E.; Tabas, Ira

    2011-01-01

    Progress in preventing atherosclerotic coronary artery disease (CAD) has been stalled by the epidemic of type 2 diabetes. Further advances in this area demand a thorough understanding of how two major features of type 2 diabetes, insulin resistance and hyperglycemia, impact atherosclerosis. Insulin resistance is associated with systemic CAD risk factors, but increasing evidence suggests that defective insulin signaling in atherosclerotic lesional cells also plays an important role. The role o...

  12. DONOR-TRANSMITTED CORONARY ATHEROSCLEROSIS

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    B. L. Mironkov

    2014-01-01

    Full Text Available Aim. To estimate opportunities, prospects and safety of using heart transplants from aged donors who are at high risk of coronary atherosclerosis.Materials and methods. Over the period from March 1987 to May 2014450 heart transplantations (HTx were performed in V.I.Shumakov Federal Research Center of Transplantology and Artifi cial Organs. During the fi rst month after HTx coronarography was made to 152 (37,8% recipients inorder to exclude/confi rm donor-transmitted coronary atherosclerosis (DTCA and to identify tactics of treatment. Coronary atherosclerosis was detected among 16 patients (3,6% of total number of HTx, 15 (93,8% men and 1 (6,2% women. Mean age of recipients with DTCA at the moment of HTx was 48,3 ± 13,1 years.Results. Hemodynamically relevant coronary atherosclerosis was not detected and percutaneous coronary intervention (PCI was not made in the group of patients with the mean age of 42,24 ± 8,91 years. Using heart transplants from aged donors is connected with increasing risk of DTCA among the recipients. DTCA-dependent PCI is not connected with coronary mortality. Actuarial survival rate of patients who underwent PCI is comparable with the same one in the total population of HTx recipients and is equal to 87,5% at 5 years and less.Conclusion. Hearts from aged donors (older than 50 years may be used for HTx with suffi cient level of safety. Due to high level of DTCA using of hearts from such donors is preferable for completing urgent HTx to recipients 1А–В UNOS.

  13. Association between ideal cardiovascular health and the atherogenic index of plasma

    Science.gov (United States)

    Shen, Shiwei; Lu, Yun; Qi, Huajin; Li, Feng; Shen, Zhenhai; Wu, Liuxin; Yang, Chengjian; Wang, Ling; Shui, Kedong; Wang, Yaping; Qiang, Dongchang; Yun, Jingting; Weng, Xiaofeng

    2016-01-01

    Abstract The American Heart Association aims to improve cardiovascular health by encouraging the general population to meet 7 cardiovascular health behaviors and factors. The atherogenic index of plasma (AIP) is an important index. Our aim is to evaluate the relationship between ideal cardiovascular health and the atherogenic index of plasma (AIP) in middle-aged Chinese men. A cross-sectional study was performed. A total of 27,824 middle-aged Chinese men were enrolled. The association between ideal cardiovascular health behaviors and factors and AIP was determined. The 7 cardiovascular health metrics were scored as follows: 0, poor; 1, general; and 2, ideal. The cardiovascular health status was classified according to the total score, as follows: 0 to 4, inadequate; 5 to 9, average; and 10 to 14, optimum. Analyses assessed the prevalence of 7 cardiovascular health metrics, its association with AIP. Logistic regression models were used to calculate odds ratios (ORs), adjusting for age. All 7 cardiovascular health metrics were shown to correlate with AIP (all P values < 0.05), and the strongest correlation existed between body mass and AIP, followed by total cholesterol and AIP. The mean AIP level increased with the decrease in the score of each of the 7 cardiovascular health metrics (all P values < 0.05). The subjects with poor cardiovascular health status had a 4.982-fold increase in the high risk of developing atherosclerosis, whereas a 1-point increase in the cardiovascular health score resulted a 0.046 reduction in AIP and a 22.3% reduction in the high-risk of developing atherosclerosis (OR = 0.777, 95% CI: 0.768–0.787). The ideal cardiovascular health score correlated significantly with AIP, and a 1-point increase in the cardiovascular health score led to a 0.046 reduction in AIP and a 22.3% reduction in the high risk of developing atherosclerosis. These validated the value of ideal cardiovascular health behaviors and factors in the prediction of high

  14. Long-term trends in tourism climate index scores for 40 stations across Iran: the role of climate change and influence on tourism sustainability.

    Science.gov (United States)

    Roshan, Gholamreza; Yousefi, Robabe; Fitchett, Jennifer M

    2016-01-01

    Tourism is a rapidly growing international sector and relies intrinsically on an amenable climate to attract visitors. Climate change is likely to influence the locations preferred by tourists and the time of year of peak travel. This study investigates the effect of climate change on the Tourism Climate Index (TCI) for Iran. The paper first calculates the monthly TCI for 40 cities across Iran for each year from 1961 to 2010. Changes in the TCI over the study period for each of the cities are then explored. Increases in TCI are observed for at least one station in each month, whilst for some months no decreases occurred. For October, the maximum of 45% of stations demonstrated significant changes in TCI, whilst for December only 10% of stations demonstrated change. The stations Kashan, Orumiyeh, Shahrekord, Tabriz, Torbat-e-Heidarieh and Zahedan experienced significant increases in TCI for over 6 months. The beginning of the change in TCI is calculated to have occurred from 1970 to 1980 for all stations. Given the economic dependence on oil exports, the development of sustainable tourism in Iran is of importance. This critically requires the identification of locations most suitable for tourism, now and in the future, to guide strategic investment.

  15. Re-operative abdominal predictive score: a prognostic model combining Acute Re-intervention Predictive Index and intra-abdominal pressure.

    Science.gov (United States)

    Soler-Morejón, Caridad de Dios; Lombardo-Vaillant, Tomás Ariel; Tamargo-Barbeito, Teddy Osmín; Wise, Robert; Malbrain, Manu L N G

    2017-11-22

    The decision to re-operate after abdominal surgery is still difficult, especially in the setting of intra-abdominal sepsis. Mathematical models provide a good aid to both diagnosis and decision-making. A prospective observational study was conducted with 300 patients consecutively admitted to the intensive care unit of an academic institution affiliated to Calixto García Medical Faculty following abdominal surgery from January 2008 to January 2010. The patients were randomly separated (2:1) into estimation and validation groups. Logistic regression analysis was used in the estimation group to develop three models for decision-making related to re-operation including related factors such as age, ARPI, IAP, type of surgery (elective or emergency), and the duration of surgery. The three models developed were validated on the other group. The acute re-operation predictive index-intra-abdominal pressure (ARPI-IAP) model was the best of the three models, with an excellent calibration, using the Hossmer-Lemeshow goodness-of-fit statistical test (C = 9.976, P = 0.267), as well as discrimination (AUC = 0.989; 95% CI: 0.976-1.000). The combination of IAP with ARPI in a mathematical model can add accuracy to the prediction of need for re-operation related to intra-abdominal infectious complications in patients following abdominal surgery. This may be useful in all medical settings, but especially those with limited resources.

  16. Non-invasive measurements of atherosclerosis (NIMA): current evidence and future perspectives.

    Science.gov (United States)

    Holewijn, S; den Heijer, M; Stalenhoef, A F H; de Graaf, J

    2010-12-01

    In clinical practice, cardiovascular (CV) risk stratification is based on the assessment of individual risk factors. Still many cardiovascular deaths occur in individuals who were not at high risk according to the current CV risk stratification models as the Systematic COronary Risk Evaluation chart (SCORE) and Framingham Risk Score. By measuring morphological and÷or functional abnormalities in the arterial wall directly, the impact of all CV risk factors together can be determined. In this review, the current status for the use of a panel of non-invasive measurements of atherosclerosis (NIMA) in CV risk prediction in clinical practice is discussed. Some of these NIMA showed predictive value for CV disease, such as intima-media thickness, pulse wave velocity, and ankle-brachial index, both in patients and in healthy and community-based populations. Recommendations have been made to include these NIMA in CV risk stratification in secondary prevention. However, the additional value of NIMA in CV risk stratification in primary prevention settings remains to be determined. Furthermore, the main determinants of NIMA are still unclear. Also the use of different combinations of NIMA should be evaluated, since different NIMA likely reflect different stages and aspects of the atherosclerotic process that leads to CV events. Future prospective studies should focus on repeated measures of NIMA to reveal the main determinants of the different NIMA and evaluate the predictive value of baseline versus repeated measurements.

  17. [Transdisciplinary Approach for Sarcopenia. Sarcopenia and atherosclerosis].

    Science.gov (United States)

    Kohara, Katsuhiko

    2014-10-01

    Risk factors for sarcopenia, including aging, inflammation, oxidative stress, and sedentary life style, are also known as risks for atherosclerosis. Sarcopenia and atherosclerosis relate each other. We found that sarcopenia, especially sarcopenic visceral obesity in male subjects, was associated with higher arterial stiffness and central blood pressure. We also observed that leptin resistance may underlie the link between sarcopenia, sarcopenic obesity and atherosclerosis. In epidemiological studies, it has been demonstrated sarcopenic indices were associated with cardiovascular death. These findings indicate that sarcopenia could be regarded as risk factor for atherosclerosis and cardiovascular events.

  18. Association of Mild-to-Moderate Reduction in Glomerular Filtration Rate with Subclinical Atherosclerosis in Postmenopausal Women.

    Science.gov (United States)

    Parv, Florina; Beceanu, Andrei; Avram, Rodica; Timar, Romulus Zorin; Timar, Bogdan; Gadalean, Florica

    2017-05-24

    Due to loss of hormonal protective effects, postmenopausal women have an increased cardiovascular (CV) risk. Chronic kidney disease (CKD) is a well-established risk factor for CV disease, but little is known whether mild-to-moderate kidney dysfunction is associated with atherosclerosis burden in the postmenopausal asymptomatic women. Subclinical atherosclerosis was evaluated in 125 postmenopausal women with no clinical form of atherosclerosis, by carotid and femoral ultrasonography, ankle-brachial index (ABI), and flow-mediated dilation (FMD). Carotid and femoral atherosclerosis were defined as increased intima-media thickness (IMT) and/or the presence of plaques. Endothelial function was assessed by endothelial dependent (flow-mediated dilation at 1 minute [FMD1]) and independent (flow-mediated dilation after nitroglycerin [FMDNTG]) vasodilation. Classical CV risk factors (age, smoking, obesity, diabetes, blood pressure, and lipids) were evaluated. Kidney function was evaluated in terms of estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI formula. Univariate linear regression and multivariate logistic regressions were used to evaluate the independent associations between kidney function and markers of subclinical atherosclerosis. In the unadjusted linear analysis, eGFR showed a significant negative association with markers of subclinical atherosclerosis: carotid IMT (R(2) = 0.305; p subclinical atherosclerosis, independent of traditional CV risk factors. It is important to detect renal function decline, even if it is mild, to improve risk stratification of subclinical atherosclerosis in postmenopausal women.

  19. Evaluating the lexico-grammatical differences in the writing of native and non-native speakers of English in peer-reviewed medical journals in the field of pediatric oncology: Creation of the genuine index scoring system.

    Science.gov (United States)

    Gayle, Alberto Alexander; Shimaoka, Motomu

    2017-01-01

    The predominance of English in scientific research has created hurdles for "non-native speakers" of English. Here we present a novel application of native language identification (NLI) for the assessment of medical-scientific writing. For this purpose, we created a novel classification system whereby scoring would be based solely on text features found to be distinctive among native English speakers (NS) within a given context. We dubbed this the "Genuine Index" (GI). This methodology was validated using a small set of journals in the field of pediatric oncology. Our dataset consisted of 5,907 abstracts, representing work from 77 countries. A support vector machine (SVM) was used to generate our model and for scoring. Accuracy, precision, and recall of the classification model were 93.3%, 93.7%, and 99.4%, respectively. Class specific F-scores were 96.5% for NS and 39.8% for our benchmark class, Japan. Overall kappa was calculated to be 37.2%. We found significant differences between countries with respect to the GI score. Significant correlation was found between GI scores and two validated objective measures of writing proficiency and readability. Two sets of key terms and phrases differentiating NS and non-native writing were identified. Our GI model was able to detect, with a high degree of reliability, subtle differences between the terms and phrasing used by native and non-native speakers in peer reviewed journals, in the field of pediatric oncology. In addition, L1 language transfer was found to be very likely to survive revision, especially in non-Western countries such as Japan. These findings show that even when the language used is technically correct, there may still be some phrasing or usage that impact quality.

  20. Mutation in KERA identified by linkage analysis and targeted resequencing in a pedigree with premature atherosclerosis.

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    Stephanie Maiwald

    Full Text Available Genetic factors explain a proportion of the inter-individual variation in the risk for atherosclerotic events, but the genetic basis of atherosclerosis and atherothrombosis in families with Mendelian forms of premature atherosclerosis is incompletely understood. We set out to unravel the molecular pathology in a large kindred with an autosomal dominant inherited form of premature atherosclerosis.Parametric linkage analysis was performed in a pedigree comprising 4 generations, of which a total of 11 members suffered from premature vascular events. A parametric LOD-score of 3.31 was observed for a 4.4 Mb interval on chromosome 12. Upon sequencing, a non-synonymous variant in KERA (c.920C>G; p.Ser307Cys was identified. The variant was absent from nearly 28,000 individuals, including 2,571 patients with premature atherosclerosis. KERA, a proteoglycan protein, was expressed in lipid-rich areas of human atherosclerotic lesions, but not in healthy arterial specimens. Moreover, KERA expression in plaques was significantly associated with plaque size in a carotid-collar Apoe-/- mice (r2 = 0.69; p<0.0001.A rare variant in KERA was identified in a large kindred with premature atherosclerosis. The identification of KERA in atherosclerotic plaque specimen in humans and mice lends support to its potential role in atherosclerosis.

  1. Monocyte angiotensin converting enzyme expression may be associated with atherosclerosis rather than arteriosclerosis in hemodialysis patients.

    Science.gov (United States)

    Ulrich, Christof; Seibert, Eric; Heine, Gunnar H; Fliser, Danilo; Girndt, Matthias

    2011-03-01

    Circulating monocytes can be divided into functionally distinct subpopulations according to their surface expression of CD14 and CD16. Monocytes with high-level expression of both antigens (CD14(++)CD16(+), Mo2 cells) are associated with cardiovascular morbidity and mortality in hemodialysis patients. These cells express angiotensin converting enzyme (ACE) on their surface. They are involved in the association of chronic inflammation and cardiovascular disease in kidney patients. Cardiovascular morbidity results from atherosclerosis (plaque-forming, vessel occluding disease) and arteriosclerosis (loss of arterial dampening function). It is unknown whether ACE-expressing proinflammatory monocytes are related to atherosclerosis, arteriosclerosis, or both. During baseline examination for a prospective study on monocyte ACE expression and mortality, 60 chronic hemodialysis patients of an academic outpatient center were screened for atherosclerosis by carotid artery ultrasound, for arteriosclerosis by pulse pressure measurement, and for ACE expression on Mo2 cells by flow cytometry. ACE expression on Mo2 monocytes was significantly higher in patients with severe compared with those with little or no carotid atherosclerosis. Mo2 ACE correlated with a score to semiquantify atherosclerosis and remained a significant predictor of carotid plaques in multivariate analysis including the other univariately associated variables of age, hemoglobin A1c, and albumin. Mo2 ACE was not related to pulse pressure. ACE expression on Mo2, although being a known predictor of mortality and cardiovascular disease in end-stage renal disease patients, may act via enhancement of atherosclerosis rather than arteriosclerosis.

  2. Asymptomatic Atherosclerosis in Egyptian Rheumatoid Arthritis Patients and Its Relation to Disease Activity

    Directory of Open Access Journals (Sweden)

    Rawhya R. Elshereef

    2015-01-01

    Full Text Available Aim. To detect the frequency of subclinical atherosclerosis in rheumatoid arthritis patients without clinically evident atherosclerosis and to correlate its presence with the disease activity. Patients and Methods. Our study includes 112 RA patients (group 1 and 40 healthy controls (group 11. All patients and controls were subjected to full history taking, clinical examination, and laboratory investigations. Carotid intima media wall thickness (IMT and carotid plaques were measured in both groups by B-mode ultrasonography; also color duplex Doppler ultrasound of the brachial artery was done to detect endothelial function. Results. There is atherosclerosis in 31.3% of asymptomatic RA patients compared with only 5% in controls P=0.003**. A significant difference was detected in patients with and without atherosclerosis regarding duration of the disease P=0.0001*** and patient’s age P=0.01*. There is highly statistical significant correlation between atherosclerosis and disease activity index. Conclusion. The frequency of subclinical atherosclerosis was high in long-term active RA patients.

  3. Hepatic artery resistive index (HARI) and non-alcoholic fatty liver disease (NAFLD) fibrosis score in NAFLD patients: cut-off suggestive of non-alcoholic steatohepatitis (NASH) evolution.

    Science.gov (United States)

    Tana, Claudio; Tana, Marco; Rossi, Stefano; Silingardi, Mauro; Schiavone, Cosima

    2016-09-01

    Conventional ultrasound (US) is reliable to reveal the presence of non-alcoholic fatty liver disease (NAFLD), but it is neither sensitive nor specific to reveal fibrosis clues, except in advanced stages where signs of cirrhosis are evident. NALFD fibrosis score is a non-invasive parameter that predicts well the presence of significant fibrosis, but correlations with US parameters are lacking. The aim of this study was, therefore, to compare resistive index of hepatic artery (HARI) of NAFLD patients with different severity degrees of diffuse fatty liver disease vs HARI of controls, and to compare HARI of NAFLD patients with different NAFLD fibrosis scores vs HARI of controls. This was a spontaneous, no-profit observational study conducted in our US department between December 2013 and July 2014. Patients with NAFLD with different severity of disease and healthy controls were included. Echogenicity and size of liver and spleen, maximum portal vein velocity, RI, peak systolic velocity (PSV), and end diastolic velocity (EDV) of splenic artery, PSV, EDV, and RI of hepatic artery, and NAFLD fibrosis score were acquired and compared between groups. HARI was significantly lower in NAFLD patients than controls (p steatohepatitis and fibrous tissue accumulation. Low values of HARI may be expression of lower risk, which does not necessitate any biopsy.

  4. Long-term exposure to ambient particulate matter and prevalence of subclinical atherosclerosis in the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Diez Roux, Ana V; Auchincloss, Amy H; Franklin, Tracy Green; Raghunathan, Trivellore; Barr, R Graham; Kaufman, Joel; Astor, Brad; Keeler, Jerry

    2008-03-15

    Exposure to airborne particulate matter has been linked to cardiovascular events. Whether this finding reflects an effect of particulate matter exposure on the triggering of events or development of atherosclerosis remains unknown. Using data from the Multi-Ethnic Study of Atherosclerosis collected at baseline (2000-2002), the authors investigated associations of 20-year exposures to particulate matter with measures of subclinical disease (coronary calcium, common carotid intimal-medial thickness, and ankle-brachial index) in 5,172 US adults without clinical cardiovascular disease. Particulate matter exposures for the 20 years prior to assessment of subclinical disease were obtained from a space-time model of Environmental Protection Agency monitor data linked to residential history data for each participant. Intimal-medial thickness was weakly, positively associated with exposures to particulate matter aerodynamic diameter and aerodynamic diameter after controlling for age, sex, race/ethnicity, socioeconomic factors, diet, smoking, physical activity, blood lipids, diabetes, hypertension, and body mass index (1-4% increase per 21-microg/m(3) increase in particulate matter aerodynamic diameter or a 12.5-microg/m(3) increase in particulate matter aerodynamic diameter). No consistent associations with other measures of atherosclerosis were observed. There was no evidence of effect modification by sociodemographic factors, lipid status, smoking, diabetes, body mass index, or site. Results are compatible with some effect of particulate matter exposures on development of carotid atherosclerosis.

  5. Oxyradical Stress, Endocannabinoids, and Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Anberitha T. Matthews

    2015-12-01

    Full Text Available Atherosclerosis is responsible for most cardiovascular disease (CVD and is caused by several factors including hypertension, hypercholesterolemia, and chronic inflammation. Oxidants and electrophiles have roles in the pathophysiology of atherosclerosis and the concentrations of these reactive molecules are an important factor in disease initiation and progression. Overactive NADPH oxidase (Nox produces excess superoxide resulting in oxidized macromolecules, which is an important factor in atherogenesis. Although superoxide and reactive oxygen species (ROS have obvious toxic properties, they also have fundamental roles in signaling pathways that enable cells to adapt to stress. In addition to inflammation and ROS, the endocannabinoid system (eCB is also important in atherogenesis. Linkages have been postulated between the eCB system, Nox, oxidative stress, and atherosclerosis. For instance, CB2 receptor-evoked signaling has been shown to upregulate anti-inflammatory and anti-oxidative pathways, whereas CB1 signaling appears to induce opposite effects. The second messenger lipid molecule diacylglycerol is implicated in the regulation of Nox activity and diacylglycerol lipase β (DAGLβ is a key biosynthetic enzyme in the biosynthesis eCB ligand 2-arachidonylglycerol (2-AG. Furthermore, Nrf2 is a vital transcription factor that protects against the cytotoxic effects of both oxidant and electrophile stress. This review will highlight the role of reactive oxygen species (ROS in intracellular signaling and the impact of deregulated ROS-mediated signaling in atherogenesis. In addition, there is also emerging knowledge that the eCB system has an important role in atherogenesis. We will attempt to integrate oxidative stress and the eCB system into a conceptual framework that provides insights into this pathology.

  6. Insulin Resistance, Hyperglycemia, and Atherosclerosis

    Science.gov (United States)

    Bornfeldt, Karin E.; Tabas, Ira

    2011-01-01

    Progress in preventing atherosclerotic coronary artery disease (CAD) has been stalled by the epidemic of type 2 diabetes. Further advances in this area demand a thorough understanding of how two major features of type 2 diabetes, insulin resistance and hyperglycemia, impact atherosclerosis. Insulin resistance is associated with systemic CAD risk factors, but increasing evidence suggests that defective insulin signaling in atherosclerotic lesional cells also plays an important role. The role of hyperglycemia in CAD associated with type 2 diabetes is less clear. Understanding the mechanisms whereby type 2 diabetes exacerbates CAD offers hope for new therapeutic strategies to prevent and treat atherosclerotic vascular disease. PMID:22055501

  7. ABC transporters, atherosclerosis and inflammation.

    Science.gov (United States)

    Fitzgerald, Michael L; Mujawar, Zahedi; Tamehiro, Norimasa

    2010-08-01

    Atherosclerosis, driven by inflamed lipid-laden lesions, can occlude the coronary arteries and lead to myocardial infarction. This chronic disease is a major and expensive health burden. However, the body is able to mobilize and excrete cholesterol and other lipids, thus preventing atherosclerosis by a process termed reverse cholesterol transport (RCT). Insight into the mechanism of RCT has been gained by the study of two rare syndromes caused by the mutation of ABC transporter loci. In Tangier disease, loss of ABCA1 prevents cells from exporting cholesterol and phospholipid, thus resulting in the build-up of cholesterol in the peripheral tissues and a loss of circulating HDL. Consistent with HDL being an athero-protective particle, Tangier patients are more prone to develop atherosclerosis. Likewise, sitosterolemia is another inherited syndrome associated with premature atherosclerosis. Here mutations in either the ABCG5 or G8 loci, prevents hepatocytes and enterocytes from excreting cholesterol and plant sterols, including sitosterol, into the bile and intestinal lumen. Thus, ABCG5 and G8, which from a heterodimer, constitute a transporter that excretes cholesterol and dietary sterols back into the gut, while ABCA1 functions to export excess cell cholesterol and phospholipid during the biogenesis of HDL. Interestingly, a third protein, ABCG1, that has been shown to have anti-atherosclerotic activity in mice, may also act to transfer cholesterol to mature HDL particles. Here we review the relationship between the lipid transport activities of these proteins and their anti-atherosclerotic effect, particularly how they may reduce inflammatory signaling pathways. Of particular interest are recent reports that indicate both ABCA1 and ABCG1 modulate cell surface cholesterol levels and inhibit its partitioning into lipid rafts. Given lipid rafts may provide platforms for innate immune receptors to respond to inflammatory signals, it follows that loss of ABCA1 and ABCG1

  8. Differential associations of renal function with coronary and peripheral atherosclerosis.

    Science.gov (United States)

    Stamatelopoulos, Kimon S; Lekakis, John P; Tseke, Paraskevi; Ikonomidis, Ignatios; Kollias, George E; Alevizaki, Maria; Kanakakis, Ioannis; Voidonikola, Paraskevi; Zakopoulos, Nikolaos; Papamichael, Christos M

    2009-06-26

    The aim of this study was to examine the impact of renal dysfunction on both coronary and peripheral atherosclerosis in patients with coronary artery disease (CAD) without severe renal impairment. One hundred and eighty-seven consecutive patients referred for elective coronary angiography were enrolled. Mean IMT and the presence of plaques were measured in the carotid and femoral arteries prior to angiography as markers of subclinical peripheral atherosclerosis. The severity of CAD was evaluated by the Gensini score. Glomerular filtration rate (GFR) was estimated by the MDRD formula. Significant CAD (>50% stenosis) was identified in 139 patients. GFR independently correlated with the presence and severity of CAD with incremental value over that of IMT. Renal function was significantly but not independently correlated with carotid IMT in CAD patients. Femoral IMT and the presence of plaques did not show any significant correlations with GFR in patients with or without CAD. Renal function is an important predictor of the presence and severity of angiographic CAD in patients without severe renal impairment with incremental value over traditional risk factors for CAD and IMT. The contrasting weak or no associations of GFR with IMT and the presence of plaques suggest that renal dysfunction may exert differential effects on the development of coronary and peripheral atherosclerosis.

  9. Association of obstructive sleep apnoea with subclinical coronary atherosclerosis.

    Science.gov (United States)

    Weinreich, Gerhard; Wessendorf, Thomas E; Erdmann, Timo; Moebus, Susanne; Dragano, Nico; Lehmann, Nils; Stang, Andreas; Roggenbuck, Ulla; Bauer, Marcus; Jöckel, Karl-Heinz; Erbel, Raimund; Teschler, Helmut; Möhlenkamp, Stefan

    2013-12-01

    Accumulating evidence suggests a role of obstructive sleep apnoea (OSA) as a risk factor for coronary atherosclerosis. This study aimed i) to assess the prevalence of OSA in the general population and ii) to analyse the association of this disorder with traditional cardiovascular disease risk factors and subclinical coronary atherosclerosis. In a cross-sectional analysis of the Heinz Nixdorf Recall study a subgroup of 1604 subjects (791 men, age 50-80 years) underwent OSA screening. Furthermore, coronary artery calcium (CAC) was measured. OSA was defined as apnoea-hypopnoea index (AHI) ≥ 15/h. OSA was observed in 29.1% of men and 15.6% of women. In a multiple linear regression analysis adjusted for risk factors AHI was associated with CAC in men aged ≤65 years (estimated log-transformed increase of CAC = 0.25, 95% confidence interval (CI) = -0.001-0.50, p = 0.051) and in women of any age (estimated log-transformed increase = 0.23, 95% CI = 0.04-0.41, p = 0.02). Doubling of the AHI was associated with a 19% increase of CAC in men aged ≤65 years and with a 17% increase in women of any age. In the general population aged ≥50 years OSA is associated with subclinical atherosclerosis in men aged ≤65 years and in women of any age, independent of traditional cardiovascular risk factors. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Influence of chronic exercise on carotid atherosclerosis in marathon runners.

    Science.gov (United States)

    Taylor, Beth A; Zaleski, Amanda L; Capizzi, Jeffrey A; Ballard, Kevin D; Troyanos, Christopher; Baggish, Aaron L; D'Hemecourt, Pierre A; Dada, Marcin R; Thompson, Paul D

    2014-02-14

    The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis. field study at Boston Marathon. 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women). We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT. Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p0.31) and were associated with age (all r≥0.41; p0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model. Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors.

  11. Therapeutic approaches to drug targets in atherosclerosis.

    Science.gov (United States)

    Jamkhande, Prasad G; Chandak, Prakash G; Dhawale, Shashikant C; Barde, Sonal R; Tidke, Priti S; Sakhare, Ram S

    2014-07-01

    Non-communicable diseases such as cancer, atherosclerosis and diabetes are responsible for major social and health burden as millions of people are dying every year. Out of which, atherosclerosis is the leading cause of deaths worldwide. The lipid abnormality is one of the major modifiable risk factors for atherosclerosis. Both genetic and environmental components are associated with the development of atherosclerotic plaques. Immune and inflammatory mediators have a complex role in the initiation and progression of atherosclerosis. Understanding of all these processes will help to invent a range of new biomarkers and novel treatment modalities targeting various cellular events in acute and chronic inflammation that are accountable for atherosclerosis. Several biochemical pathways, receptors and enzymes are involved in the development of atherosclerosis that would be possible targets for improving strategies for disease diagnosis and management. Earlier anti-inflammatory or lipid-lowering treatments could be useful for alleviating morbidity and mortality of atherosclerotic cardiovascular diseases. However, novel drug targets like endoglin receptor, PPARα, squalene synthase, thyroid hormone analogues, scavenger receptor and thyroid hormone analogues are more powerful to control the process of atherosclerosis. Therefore, the review briefly focuses on different novel targets that act at the starting stage of the plaque form to the thrombus formation in the atherosclerosis.

  12. Cytokines in atherosclerosis: an intricate balance

    NARCIS (Netherlands)

    Boshuizen, M.C.S.

    2016-01-01

    Atherosclerosis is the underlying pathology in the majority of clinical manifestations of cardiovascular diseases, which are nowadays the main global cause of mortality. Atherosclerosis is a lipid-driven chronic inflammatory disease of the arterial wall. This inflammatory response, with cytokines as

  13. Measurement of blood pressure, ankle blood pressure and calculation of ankle brachial index in general practice

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Damsbo, Bent; Lund, Jens Otto

    2012-01-01

    BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values......BACKGROUND: Low ankle brachial index (ABI) is a sensitive measure of 'burden' of atherosclerosis, indicating cardiovascular risk of the asymptomatic patient. Conventionally, ABI values...

  14. Aging, progenitor cell exhaustion, and atherosclerosis.

    Science.gov (United States)

    Rauscher, Frederick M; Goldschmidt-Clermont, Pascal J; Davis, Bryce H; Wang, Tao; Gregg, David; Ramaswami, Priya; Pippen, Anne M; Annex, Brian H; Dong, Chunming; Taylor, Doris A

    2003-07-29

    Atherosclerosis is largely attributed to chronic vascular injury, as occurs with excess cholesterol; however, the effect of concomitant vascular aging remains unexplained. We hypothesize that the effect of time in atherosclerosis progression is related to obsolescence of endogenous progenitor cells that normally repair and rejuvenate the arteries. Here we show that chronic treatment with bone marrow-derived progenitor cells from young nonatherosclerotic ApoE-/- mice prevents atherosclerosis progression in ApoE-/- recipients despite persistent hypercholesterolemia. In contrast, treatment with bone marrow cells from older ApoE-/- mice with atherosclerosis is much less effective. Cells with vascular progenitor potential are decreased in the bone marrow of aging ApoE-/- mice, but cells injected from donor mice engraft on recipient arteries in areas at risk for atherosclerotic injury. Our data indicate that progressive progenitor cell deficits may contribute to the development of atherosclerosis.

  15. Differences in atherosclerosis according to area level socioeconomic deprivation: cross sectional, population based study

    NARCIS (Netherlands)

    Deans, Kevin A.; Bezlyak, Vladimir; Ford, Ian; Batty, G. David; Burns, Harry; Cavanagh, Jonathan; de Groot, Eric; McGinty, Agnes; Millar, Keith; Shiels, Paul G.; Tannahill, Carol; Velupillai, Yoga N.; Sattar, Naveed; Packard, Chris J.

    2009-01-01

    To examine the relation between area level social deprivation and ultrasound markers of atherosclerosis (common carotid intima-media thickness and plaque score), and to determine whether any differences can be explained by "classic" (currently recognised) or "emerging" (novel) cardiovascular risk

  16. Synergy of circulating miR-212 with markers for cardiovascular risks to enhance estimation of atherosclerosis presence

    Science.gov (United States)

    Lee, Seo Hyun; Hwang, Junha; Shin, Jong Wook; Song, Kyu Sang; Lee, Sukhoon

    2017-01-01

    Synergy of specific microRNAs (miRNAs) with cardiovascular risk factors to estimate atherosclerosis presence in ischemic stroke patients has not been investigated. The present study aimed to identify atherosclerosis-related circulating miRNAs and to evaluate interaction with other cardiovascular markers to improve the estimation of atherosclerosis presence. We performed a miRNA profiling study using serum of 15 patients with acute ischemic stroke who were classified by the presence of no (n = 8) or severe (n = 7) stenosis on intracranial and extracranial vessels, which identified miR-212, -372, -454, and -744 as miRNAs related with atherosclerosis presence. Of the 4 miRNAs, only miR-212 showed a significant increase in expression in atherosclerosis patients in a validation study (atherosclerotic patients, n = 32, non-atherosclerotic patients, n = 33). Hemoglobin A1c, a high-density lipoprotein cholesterol, and lipoprotein(a), both established risk markers, were independently related with atherosclerosis presence in the validation population. miR-212 enhanced the accuracy of atherosclerosis presence by the three existing markers (three markers, 78.5%; three markers+miR-212, 84.6%, P<0.05) and significantly added to the area under the receiver operating characteristic curve (three markers, 0.8258; three markers+miR-212, 0.8646, P<0.05). The inclusion of miR-212 increased the reclassification index calculated using net reclassification improvement (0.4527, P<0.05) and integrated discrimination improvement (0.0737, P<0.05). We identified circulating miR-212 as a novel marker of atherosclerosis. miR-212 enhanced the estimation of atherosclerosis presence in combination with hemoglobin A1c, high-density lipoprotein cholesterol, and lipoprotein(a). Thus, miR-212 is expected to improve the estimation of atherosclerosis using peripheral blood of patients. PMID:28557988

  17. Apgar Scores

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Apgar Scores Page Content Article Body As soon as ... baby's general condition at birth. What Does the Apgar Test Measure? The test measures your baby's: Heart ...

  18. Atherosclerosis

    Science.gov (United States)

    ... State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) Tiếng Việt (Vietnamese) Healthy Living for Heart.org ... and Live Our Interactive Cardiovascular Library has detailed animations and illustrations to help you learn about conditions, ...

  19. Clinical nutrition scores are superior for the prognosis of haemodialysis patients compared to lab markers and bioelectrical impedance.

    Science.gov (United States)

    Fiedler, Roman; Jehle, Peter M; Osten, Bernd; Dorligschaw, Otgontogoo; Girndt, Matthias

    2009-12-01

    Malnutrition is closely related to inflammation and atherosclerosis in uraemic patients. There is still debate on how to quantify nutritional status in order to achieve the best prediction of mortality and hospitalization. Different methods to detect malnutrition were prospectively investigated for their prognostic impact on mortality and hospitalization of haemodialysis (HD) patients. We compared clinical nutrition scores (body mass index, BMI; subjective global assessment, SGA; malnutrition inflammation score, MIS; and nutritional risk screening, NRS) to lab parameters of protein and lipid metabolism, or bioelectrical impedance analysis (BIA) in 90 HD patients. Over a 3-year follow-up, all-cause mortality and hospitalization were evaluated using a Cox regression model. The scores SGA, NRS, MIS, serum albumin, prealbumin, transferrin and BIA were predictive of both mortality and hospitalization. Elevated CRP predicted only a significantly higher mortality. After adjustment for age, gender, dialysis vintage and diabetes status, the best prognostic parameters for mortality were the clinical nutrition scores, MIS-Index > or = 10 [HR 6.25 (2.82-13.87), P clinical nutrition scores are superior compared to lab markers and BIA. To confirm malnutrition, we propose using clinical nutrition score generally or at least in the case of two malnutrition-positive parameters (lab, BIA, BMI).

  20. The role of atherosclerosis imaging in redefining normal and abnormal cholesterol values, and risk reduction in primary prevention statin trials.

    Science.gov (United States)

    Hecht, Harvey S

    2011-10-01

    The emergence of atherosclerosis imaging, using coronary calcium scanning (CAC) and carotid intima media thickness (CIMT) and plaque as stronger predictors of cardiovascular events than risk factors of atherosclerosis, has created a paradigm shift in the primary prevention of cardiovascular disease. Rather than population-derived indices to define normal or abnormal low-density lipoprotein (or other lipid values) in the untreated individual patient, it is more appropriate to define "normal" as "cholesterol values at which level there is no subclinical atherosclerosis" and "abnormal" as "cholesterol values at which level there is subclinical atherosclerosis," with the severity of "abnormal" depending on the degree of subclinical atherosclerosis. Similarly, the low-density lipoprotein treatment goal is the level at which atherosclerosis progression is halted. Extension of the subclinical atherosclerosis risk-based paradigms to primary prevention trials dramatically changes the manner in which trials should be conducted in the future, as well as the results of trials already performed. For example, asymptomatic patients with a CAC score of 0 have an extraordinarily low event rate but have been included in primary prevention statin trials even though their risk without treatment is very small. Reanalysis of the statin primary prevention trials after excluding the percentage (40%) of patients who would be expected to have a CAC score of 0 yields an absolute risk increase of 60% in both the placebo group (from 5.4% to 8.5%), and the statin group (from 3.0% to 4.8%). Absolute risk reduction increased by 58% (from 2.4% to 3.8%). Relative risk reduction of 44% was unchanged. In conclusion, 1) the presence or absence of atherosclerosis as measured by CAC redefines normal or abnormal lipid levels in an individual patient; 2) statin absolute risk reduction is significantly greater than previously appreciated; and 3) patients with a CAC score of 0 should be excluded from

  1. Skin autofluorescence, a non-invasive marker for AGE accumulation, is associated with the degree of atherosclerosis.

    Directory of Open Access Journals (Sweden)

    Martijn A M den Dekker

    Full Text Available INTRODUCTION: Advanced glycation endproducts (AGEs may be involved in the development of atherosclerosis, beyond diabetes and renal disease. Skin autofluorescence (AF is a non-invasive marker for AGEs. We examined whether skin AF is increased in (subclinical atherosclerosis and associated with the degree of atherosclerosis independent of diabetes and renal function. METHODS: A cross-sectional study of 223 patients referred for primary (n = 163 or secondary (n = 60 prevention between 2006 and 2012 was performed. Skin AF was measured using the AGE-Reader. Ultrasonography was used to assess plaques in carotid and femoral arteries and computed tomography for the calculation of the coronary artery calcium score (CACS; in primary prevention only. Primary prevention patients were divided into a group with subclinical atherosclerosis defined as >1 plaque or CACS>100 (n = 67; age 53 year [interquartile range 48-56]; 49% male and without (controls; 96; 43 [38-51]; 55%. Secondary prevention were patients with peripheral arterial disease (60; 64 [58-70]; 73%. RESULTS: Skin AF was higher in subclinical and clinical atherosclerosis compared with controls (skin AF 2.11 [interquartile range 1.83-2.46] and 2.71 [2.15-3.27] vs. 1.87 [1.68-2.12] respectively; P = 0.005 and <0.001. In a multivariate analysis, the association of skin AF with the atherosclerosis categories was independent of age, sex, diabetes, presence of the metabolic syndrome, Framingham Risk Score, and renal function. Skin AF correlated with most cardiovascular risk factors, Framingham risk score, and IMT and CACS. CONCLUSIONS: Skin AF is increased in documented subclinical and clinical atherosclerosis, independent of known risk factors such as diabetes and renal disease. These data suggest that AGEs may be associated with the burden of atherosclerosis and warrant a prospective study to investigate its clinical usability as a risk assessment tool for primary prevention.

  2. Determination of the Oswestry Disability Index score equivalent to a "satisfactory symptom state" in patients undergoing surgery for degenerative disorders of the lumbar spine-a Spine Tango registry-based study.

    Science.gov (United States)

    van Hooff, Miranda L; Mannion, Anne F; Staub, Lukas P; Ostelo, Raymond W J G; Fairbank, Jeremy C T

    2016-10-01

    The achievement of a given change score on a valid outcome instrument is commonly used to indicate whether a clinically relevant change has occurred after spine surgery. However, the achievement of such a change score can be dependent on baseline values and does not necessarily indicate whether the patient is satisfied with the current state. The achievement of an absolute score equivalent to a patient acceptable symptom state (PASS) may be a more stringent measure to indicate treatment success. This study aimed to estimate the score on the Oswestry Disability Index (ODI, version 2.1a; 0-100) corresponding to a PASS in patients who had undergone surgery for degenerative disorders of the lumbar spine. This is a cross-sectional study of diagnostic accuracy using follow-up data from an international spine surgery registry. The sample includes 1,288 patients with degenerative lumbar spine disorders who had undergone elective spine surgery, registered in the EUROSPINE Spine Tango Spine Surgery Registry. The main outcome measure was the ODI (version 2.1a). Surgical data and data from the ODI and Core Outcome Measures Index (COMI) were included to determine the ODI threshold equivalent to PASS at 1 year (±1.5 months; n=780) and 2 years (±2 months; n=508) postoperatively. The symptom-specific well-being item of the COMI was used as the external criterion in the receiver operating characteristic (ROC) analysis to determine the ODI threshold equivalent to PASS. Separate sensitivity analyses were performed based on the different definitions of an "acceptable state" and for subgroups of patients. JF is a copyright holder of the ODI. The ODI threshold for PASS was 22, irrespective of the time of follow-up (area under the curve [AUC]: 0.89 [sensitivity {Se}: 78.3%, specificity {Sp}: 82.1%] and AUC: 0.91 [Se: 80.7%, Sp: 85.6] for the 1- and 2-year follow-ups, respectively). Sensitivity analyses showed that the absolute ODI-22 threshold for the two follow-up time-points were

  3. The run-off resistance (ROR) assessed on MR angiograms may serve as a valid scoring system in patients with symptomatic peripheral arterial disease (PAD) and correlates with the ankle-brachial pressure index (ABI).

    Science.gov (United States)

    Gorny, O; Santner, W; Fraedrich, G; Jaschke, W; Greiner, A; Schocke, M F

    2012-06-01

    To investigate the correlation between the hemodynamic parameter ankle-brachial pressure index (ABI) and the run-off resistance (ROR) assessed on MR angiograms (MRA) in patients with peripheral arterial disease (PAD) Fontaine Stage I and II and its potential as reliable reporting system in clinical routine. Contrast-enhanced MRA was performed in 321 PAD patients using a 1.5T MR scanner with moving bed technique. The ROR and resting ABI were determined in each patient's leg and correlation analysis was performed using the Pearson test. A significant negative correlation (r = -.513; pROR (mean 11.03±5.42) and resting ABI (mean .81±.26) was identified. An even more pronounced correlation was found in patients younger than median age who had higher ABI values (r = -.608; pROR scoring system evaluated in this series correlates better with the ABI than previously published scoring systems and could be suggested as reporting system for routine MRA evaluation. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. Changes in parent motivation predicts changes in body mass index z-score (zBMI) and dietary intake among preschoolers enrolled in a family-based obesity intervention.

    Science.gov (United States)

    Van Allen, Jason; Kuhl, Elizabeth S; Filigno, Stephanie S; Clifford, Lisa M; Connor, Jared M; Stark, Lori J

    2014-10-01

    To examine whether changes in parent motivation over the course of a pediatric obesity intervention are significantly associated with long-term changes in treatment outcomes.   Study hypotheses were tested with a secondary data analysis of a randomized controlled trial (N = 42). Study analyses tested whether baseline to posttreatment change in total score for a self-report parent motivation measure (Parent Motivation Inventory [PMI]) was significantly associated with baseline to 6-month follow-up changes in body mass index z-score (zBMI), dietary variables, and physical activity.   Increases in PMI were significantly associated with decreased zBMI, decreased consumption of sugar-sweetened beverages and sweets, and increased consumption of artificially sweetened beverages.   Given that increases in parent motivation were associated with some treatment benefits, future research should evaluate the impact of directly assessing and targeting parent motivation on weight outcomes for preschoolers participating in a weight management program. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Can total cardiac calcium predict the coronary calcium score?

    Science.gov (United States)

    Pressman, Gregg S; Crudu, Vitalie; Parameswaran-Chandrika, Anoop; Romero-Corral, Abel; Purushottam, Bhaskar; Figueredo, Vincent M

    2011-01-21

    Mitral annular calcification (MAC) shares the same risk factors as atherosclerosis and is associated with coronary artery disease as well as cardiovascular events. However, sensitivity and positive predictive value are low. We hypothesized that a global echocardiographic calcium score would better predict coronary atherosclerotic burden, as assessed by coronary artery calcium score (CAC), than MAC alone. An echocardiographic score was devised to measure global cardiac calcification in a semi-quantitative manner; this included calcification in the aortic valve and root, the mitral valve and annulus, and the sub-mitral apparatus. This score, and a simplified version, were compared with a similar calcification score by CT scan, as well as the CAC. There was a good correlation between the two global calcification scores; the echocardiographic score also correlated with CAC. Using CAC >400 as a measure of severe coronary atherosclerosis, an echocardiographic score ≥5 had a positive predictive value of 60%. Importantly, the simplified score performed equally well (≥3 had a positive predictive value of 62%). Global cardiac calcification, assessed by CT scan or echocardiography, correlates with the extent of coronary calcium. A semi-quantitative calcium score can be easily applied during routine echocardiographic interpretation and can alert the reader to the possibility of severe coronary atherosclerosis. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  6. Association Between Change in Body Mass Index, Unified Parkinson's Disease Rating Scale Scores, and Survival Among Persons With Parkinson Disease: Secondary Analysis of Longitudinal Data From NINDS Exploratory Trials in Parkinson Disease Long-term Study 1.

    Science.gov (United States)

    Wills, Anne-Marie A; Pérez, Adriana; Wang, Jue; Su, Xiao; Morgan, John; Rajan, Suja S; Leehey, Maureen A; Pontone, Gregory M; Chou, Kelvin L; Umeh, Chizoba; Mari, Zoltan; Boyd, James

    2016-03-01

    Greater body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) is associated with improved survival among persons with Huntington disease or amyotrophic lateral sclerosis. Weight loss is common among persons with Parkinson disease (PD) and is associated with worse quality of life. To explore the association between change in BMI, Unified Parkinson's Disease Rating Scale (UPDRS) motor and total scores, and survival among persons with PD and to test whether there is a positive association between BMI at randomization and survival. Secondary analysis (from May 27, 2014, to October 13, 2015) of longitudinal data (3-6 years) from 1673 participants who started the National Institute of Neurological Disorders and Stroke Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1). This was a double-blind randomized placebo-controlled clinical trial of creatine monohydrate (10 g/d) that was performed at 45 sites throughout the United States and Canada. Participants with early (within 5 years of diagnosis) and treated (receiving dopaminergic therapy) PD were enrolled from March 2007 to May 2010 and followed up until September 2013. Change across time in motor UPDRS score, change across time in total UPDRS score, and time to death. Generalized linear mixed models were used to estimate the effect of BMI on the change in motor and total UPDRS scores after controlling for covariates. Survival was analyzed using Cox proportional hazards models of time to death. A participant's BMI was measured at randomization, and BMI trajectory groups were classified according to whether participants experienced weight loss ("decreasing BMI"), weight stability ("stable BMI"), or weight gain ("increasing BMI") during the study. Of the 1673 participants (mean [SD] age, 61.7 [9.6] years; 1074 [64.2%] were male), 158 (9.4%) experienced weight loss (decreasing BMI), whereas 233 (13.9%) experienced weight gain (increasing BMI). After adjusting for covariates, we

  7. Index blood tests and national early warning scores within 24 hours of emergency admission can predict the risk of in-hospital mortality: a model development and validation study.

    Directory of Open Access Journals (Sweden)

    Mohammed A Mohammed

    Full Text Available BACKGROUND: We explored the use of routine blood tests and national early warning scores (NEWS reported within ±24 hours of admission to predict in-hospital mortality in emergency admissions, using empirical decision Tree models because they are intuitive and may ultimately be used to support clinical decision making. METHODOLOGY: A retrospective analysis of adult emergency admissions to a large acute hospital during April 2009 to March 2010 in the West Midlands, England, with a full set of index blood tests results (albumin, creatinine, haemoglobin, potassium, sodium, urea, white cell count and an index NEWS undertaken within ±24 hours of admission. We developed a Tree model by randomly splitting the admissions into a training (50% and validation dataset (50% and assessed its accuracy using the concordance (c- statistic. Emergency admissions (about 30% did not have a full set of index blood tests and/or NEWS and so were not included in our analysis. RESULTS: There were 23248 emergency admissions with a full set of blood tests and NEWS with an in-hospital mortality of 5.69%. The Tree model identified age, NEWS, albumin, sodium, white cell count and urea as significant (p<0.001 predictors of death, which described 17 homogeneous subgroups of admissions with mortality ranging from 0.2% to 60%. The c-statistic for the training model was 0.864 (95%CI 0.852 to 0.87 and when applied to the testing data set this was 0.853 (95%CI 0.840 to 0.866. CONCLUSIONS: An easy to interpret validated risk adjustment Tree model using blood test and NEWS taken within ±24 hours of admission provides good discrimination and offers a novel approach to risk adjustment which may potentially support clinical decision making. Given the nature of the clinical data, the results are likely to be generalisable but further research is required to investigate this promising approach.

  8. Index blood tests and national early warning scores within 24 hours of emergency admission can predict the risk of in-hospital mortality: a model development and validation study.

    Science.gov (United States)

    Mohammed, Mohammed A; Rudge, Gavin; Watson, Duncan; Wood, Gordon; Smith, Gary B; Prytherch, David R; Girling, Alan; Stevens, Andrew

    2013-01-01

    We explored the use of routine blood tests and national early warning scores (NEWS) reported within ±24 hours of admission to predict in-hospital mortality in emergency admissions, using empirical decision Tree models because they are intuitive and may ultimately be used to support clinical decision making. A retrospective analysis of adult emergency admissions to a large acute hospital during April 2009 to March 2010 in the West Midlands, England, with a full set of index blood tests results (albumin, creatinine, haemoglobin, potassium, sodium, urea, white cell count and an index NEWS undertaken within ±24 hours of admission). We developed a Tree model by randomly splitting the admissions into a training (50%) and validation dataset (50%) and assessed its accuracy using the concordance (c-) statistic. Emergency admissions (about 30%) did not have a full set of index blood tests and/or NEWS and so were not included in our analysis. There were 23248 emergency admissions with a full set of blood tests and NEWS with an in-hospital mortality of 5.69%. The Tree model identified age, NEWS, albumin, sodium, white cell count and urea as significant (p<0.001) predictors of death, which described 17 homogeneous subgroups of admissions with mortality ranging from 0.2% to 60%. The c-statistic for the training model was 0.864 (95%CI 0.852 to 0.87) and when applied to the testing data set this was 0.853 (95%CI 0.840 to 0.866). An easy to interpret validated risk adjustment Tree model using blood test and NEWS taken within ±24 hours of admission provides good discrimination and offers a novel approach to risk adjustment which may potentially support clinical decision making. Given the nature of the clinical data, the results are likely to be generalisable but further research is required to investigate this promising approach.

  9. Platelets and the complement cascade in atherosclerosis.

    Science.gov (United States)

    Patzelt, Johannes; Verschoor, Admar; Langer, Harald F

    2015-01-01

    Atherosclerosis and its late sequels are still the number one cause of death in western societies. Platelets are a driving force not only during the genesis of atherosclerosis, but especially in its late stages, as evidenced by complications such as arterial thrombosis, myocardial infarction, and ischemic stroke. Atherosclerosis is increasingly recognized as an inflammatory disease, influenced by various immune mechanisms. The complement system is part of our innate immune system, and its diverse roles in atherosclerosis have become evident over the past years. In this review we identify points of intersection between platelets and the complement system and discuss their relevance for atherosclerosis. Specifically, we will focus on roles for platelets in the onset as well as progression of the disease, a possible dual role for complement in the genesis and development of atherosclerosis, and review emerging literature revealing previously unrecognized cross-talk between platelets and the complement system and discuss its possible impact for atherosclerosis. Finally, we identify limitations of current research approaches and discuss perspectives of complement modulation in the control of the disease.

  10. Plasma metabolomics reveals biomarkers of the atherosclerosis.

    Science.gov (United States)

    Chen, Xi; Liu, Lian; Palacios, Gustavo; Gao, Jie; Zhang, Ning; Li, Guang; Lu, Juan; Song, Ting; Zhang, Yingzhi; Lv, Haitao

    2010-09-01

    Atherosclerotic cardiovascular disease remains the leading cause of morbidity and mortality in industrialized societies. The lack of metabolite biomarkers has impeded the clinical diagnosis of atherosclerosis so far. In this study, stable atherosclerosis patients (n=16) and age- and sex-matched non-atherosclerosis healthy subjects (n=28) were recruited from the local community (Harbin, P. R. China). The plasma was collected from each study subject and was subjected to metabolomics analysis by GC/MS. Pattern recognition analyses (principal components analysis, orthogonal partial least-squares discriminate analysis, and hierarchical clustering analysis) commonly demonstrated plasma metabolome, which was significantly different from atherosclerotic and non-atherosclerotic subjects. The development of atherosclerosis-induced metabolic perturbations of fatty acids, such as palmitate, stearate, and 1-monolinoleoylglycerol, was confirmed consistent with previous publication, showing that palmitate significantly contributes to atherosclerosis development via targeting apoptosis and inflammation pathways. Altogether, this study demonstrated that the development of atherosclerosis directly perturbed fatty acid metabolism, especially that of palmitate, which was confirmed as a phenotypic biomarker for clinical diagnosis of atherosclerosis.

  11. The Progression and Early detection of Subclinical Atherosclerosis (PESA) study

    DEFF Research Database (Denmark)

    Fernández-Ortiz, Antonio; Jiménez-Borreguero, L Jesús; Peñalvo, José L

    2013-01-01

    The presence of subclinical atherosclerosis is a likely predictor of cardiovascular events; however, factors associated with the early stages and progression of atherosclerosis are poorly defined.......The presence of subclinical atherosclerosis is a likely predictor of cardiovascular events; however, factors associated with the early stages and progression of atherosclerosis are poorly defined....

  12. Subclinical Atherosclerosis in Patients with Rheumatoid Arthritis and Low Cardiovascular Risk: The Role of von Willebrand Factor Activity.

    Science.gov (United States)

    Ristić, Gorica G; Subota, Vesna; Lepić, Toplica; Stanisavljević, Dejana; Glišić, Branislava; Ristić, Arsen D; Petronijević, Milan; Stefanović, Dušan Z

    2015-01-01

    To evaluate association between von Willebrand factor (vWF) activity, inflammation markers, disease activity, and subclinical atherosclerosis in patients with rheumatoid arthritis (RA) and low cardiovascular risk. Above mentioned parameters were determined in blood samples of 74 non-diabetic, normotensive, female subjects, with no dyslipidemia(42 patients, 32 matched healthy controls, age 45.3±10.0 vs. 45.2±9.8 years). Intima-media thickness (IMT) was measured bilaterally, at common carotid, bifurcation, and internal carotid arteries. Subclinical atherosclerosis was defined as IMT>IMTmean+2SD in controlsat each carotid level and atherosclerotic plaque as IMT>1.5 mm. Majority of RA patients were on methotrexate (83.3%), none on steroids >10 mg/day or biologic drugs. All findings were analysed in the entire study population and in RA group separately. RA patients with subclinical atherosclerosis had higher vWF activity than those without (133.5±69.3% vs. 95.3±36.8%, psubclinical atherosclerosis was confirmed by logistic regression. vWF activity correlated significantly with erythrocyte sedimentation rate, fibrinogen, modified disease activity scores (mDAS28-ESR, mDAS28-CRP), modified Health Assessment Questionnaire (psubclinical atherosclerosis (130±68% vs. 97±38%, psubclinical atherosclerosis in low-risk RA patients as well as its correlation with inflammation markers, all parameters of disease activity, and seropositivity. Therefore, vWF might be a valuable marker of early atherosclerosis in RA patients.

  13. Regulatory T Cell Immunity in Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Hilman Zulkifli Amin

    2017-04-01

    Full Text Available Atherosclerosis is a chronic inflammatory disorder involving innate and adaptive immunity process. Effector T cell (Teff responses promote atherosclerotic disease, whereas regulatory T cells (Tregs have been shown to play a protective role against atherosclerosis by down-regulating inflammatory responses which include multiple mechanisms. Compelling experimental data suggest that shifting the Treg/Teff balance toward Tregs may be a possible therapeutic approach for atherosclerotic disease, although the role of Tregs in human atherosclerotic disease has not been fully elucidated. In this review, we discuss recent advances in our understanding of the roles of Tregs and Teffs in experimental atherosclerosis, as well as human coronary artery disease.

  14. Obesity, Insulin Resistance, and Incident Small Vessel Disease on Magnetic Resonance Imaging: Atherosclerosis Risk in Communities Study.

    Science.gov (United States)

    Dearborn, Jennifer L; Schneider, Andrea L C; Sharrett, A Richey; Mosley, Thomas H; Bezerra, Daniel C; Knopman, David S; Selvin, Elizabeth; Jack, Clifford R; Coker, Laura H; Alonso, Alvaro; Wagenknecht, Lynne E; Windham, Beverly G; Gottesman, Rebecca F

    2015-11-01

    The term metabolic syndrome describes the clustering of risk factors found in many individuals with obesity. Because of their pathophysiology, we hypothesized that 2 features of metabolic syndrome, central obesity and insulin resistance (IR), would be associated with cerebrovascular changes on magnetic resonance imaging, and specifically with incident lacunar disease and not white matter hyperintensity (WMH) progression. Risk factors were defined at study baseline in 934 participants in the Atherosclerosis Risk in Communities (ARIC) study, who completed 2 brain magnetic resonance imagings≈10 years apart. WMH progression and incident lacunes between the 2 magnetic resonance imagings were determined. An IR score for each participant was created using principal component analysis of 11 risk factors, including (among others): insulin, homeostatic model assessment-IR, body mass index, and waist circumference. Metabolic syndrome (presence/absence), using standard clinical definitions, and IR score at the first magnetic resonance imaging, were independent variables, evaluated in multivariate logistic regression to determine odds of WMH progression (Q5 versus Q1-Q4) and incident lacunes. Metabolic syndrome (adjusted odds ratio, 1.98; 95% confidence interval, 1.28-3.05) and IR score (adjusted odds ratio per 1-SD increase, 1.33; 95% confidence interval, 1.05-1.68) were associated with incident lacunes but not with WMH progression. Insulin, homeostatic model assessment-IR, and body mass index were not associated with incident lacunes or WMH progression in separate models. The IR score and central obesity are associated with incident lacunar disease but not WMH progression in individuals. Central obesity and IR may be important risk factors to target to prevent lacunar disease. © 2015 American Heart Association, Inc.

  15. Perivascular spaces are associated with atherosclerosis: an insight from the Northern Manhattan Study.

    Science.gov (United States)

    Gutierrez, J; Rundek, T; Ekind, M S V; Sacco, R L; Wright, C B

    2013-09-01

    Perivascular spaces are potential spaces found between brain blood vessels and surrounding leptomeninges that have been associated with cardiovascular risk factors and dementia, but less is known about their relationship to atherosclerosis. We tested the hypothesis that perivascular spaces are associated with atherosclerosis. Participants from the Northern Manhattan Study who remained stroke-free were invited to participate in an MR imaging substudy. Parenchymal hypointensities of spaces. A semiquantitative score was created to express the degree of brain involvement. Generalized linear models were used to assess statistical associations with carotid plaque as a surrogate marker of atherosclerosis. The studied sample included 706 participants (mean age, 72.6 ± 8.0 years; 60% women, 61% Hispanic, 68% with hypertension, 19% with diabetes, and 57% with high cholesterol). The perivascular spaces score ranged from 0 to 19 with 52% of the sample having a perivascular spaces score of ≤4. In unadjusted analysis, perivascular spaces were associated with age (β = 0.01 per year, P = spaces. Perivascular spaces were more frequently found in older participants, in those with hypertension, and in the presence of carotid plaque. These results suggest that mechanisms leading to atherosclerosis might also lead to an increased number of perivascular spaces. These results need confirmation in prospective studies.

  16. The relationship between epicardial adipose tissue and malnutrition, inflammation, atherosclerosis/calcification syndrome in ESRD patients.

    Science.gov (United States)

    Turkmen, Kultigin; Kayikcioglu, Hatice; Ozbek, Orhan; Solak, Yalcin; Kayrak, Mehmet; Samur, Cigdem; Anil, Melih; Zeki Tonbul, Halil

    2011-08-01

    Malnutrition, inflammation, atherosclerosis/calcification (MIAC) and endothelial dysfunction are the most commonly encountered risk factors in the pathogenesis of cardiovascular disease in ESRD patients. Epicardial adipose tissue (EAT) is the true visceral fat depot of the heart. The relationship between CAD and EAT was shown in patients with high risk of coronary artery disease. In this study, we aimed to investigate the relationship between EAT and MIAC syndrome in ESRD patients. Eighty ESRD patients and 27 healthy subjects enrolled in this cross-sectional study. EAT and coronary artery calcification score were measured by a multidetector computed tomography (MDCT) scanner. Patients with serum albumin 10 ng/dl (normal range, 0-5 ng/dl) had inflammation; and those with CACS >10 had atheroscleosis/calcification. Total CACS and EAT measurements were significantly higher in ESRD patients when compared with healthy subjects. There was a statistically significant relationship between EAT and CACS in ESRD patients (r = 0.48). EAT measurements were higher in PD patients than HD patients. Twenty-four of the patients had no component, 31 had one component, 17 had two components, and nine had all of the MIAC components. EAT was found to be significantly increased when the presence of MIAC components increased. EAT was positively correlated with age, body mass index, and presence of MIAC. These parameters were also found as independent predictors of increased EAT. We found a relationship between EAT and components of MIAC syndrome in ESRD patients.

  17. How Can Atherosclerosis Be Prevented or Delayed?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  18. Who Is at Risk for Atherosclerosis?

    Science.gov (United States)

    ... disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease ... This may be an early sign of CHD. Stress Testing During stress testing , you exercise to make ...

  19. Accelerated atherosclerosis in patients with Wegener's granulomatosis

    NARCIS (Netherlands)

    de Leeuw, K; Sanders, J-S; Stegeman, C; Smit, A.; Kallenberg, C G; Bijl, M

    2005-01-01

    BACKGROUND: Several autoimmune disorders are complicated by excess cardiovascular disease. In addition to traditional risk factors, non-traditional risk factors such as endothelial activation and excessive vascular remodelling might be determinants of the progression of atherosclerosis in patients

  20. Characterization of intravascular cellular activation in relationship to subclinical atherosclerosis in postmenopausal women.

    Science.gov (United States)

    Jayachandran, Muthuvel; Garovic, Vesna D; Mielke, Michelle M; Bailey, Kent R; Lahr, Brian D; Miller, Virginia M

    2017-01-01

    Mechanisms and interactions among intravascular cells contributing to development of subclinical atherosclerosis are poorly understood. In women, both menopausal status and pregnancy history influence progression of atherosclerosis. This study examined activation and interactions among blood elements with subclinical atherosclerosis in menopausal women with known pregnancy histories. Carotid intima-media thickness (CIMT), as a marker of subclinical atherosclerosis, was measured using B-mode ultrasound in age- and parity-matched women [40 with and 40 without a history of preeclampsia] 35 years after the index pregnancy. Interactions among intravascular cells (38 parameters) were measured by flow cytometry in venous blood. Data analysis was by principal component which retained 7 independent dimensions accounting for 63% of the variability among 38 parameters. CIMT was significantly greater in women with a history of preeclampsia (P = 0.004). Platelet aggregation and platelet interactions with granulocytes and monocytes positively associated with CIMT in postmenopausal women independent of their pregnancy history (ρ = 0.258, Psubclinical atherosclerosis differ in women depending upon their pregnancy histories.

  1. Correlation between vascular endothelial growth factor and subclinical atherosclerosis in patients with psoriasis.

    Science.gov (United States)

    Shahidi-Dadras, Mohammad; Haghighatkhah, Hamid Reza; Abdollahimajd, Fahimeh; Younespour, Shima; Partovi Kia, Masoud; Zargari, Omid

    2016-01-01

    Psoriasis is associated with increased risk of atherosclerotic disorders. Vascular endothelial growth factor (VEGF) is an angiogenic factor that was overexpressed in both psoriatic and atherosclerotic lesions. In a prospective controlled study, we investigated the correlation between serum levels of VEGF and subclinical atherosclerosis in patients with moderate to severe psoriasis. Sixty patients with moderate to severe psoriasis and 60 age- and gender-matched healthy controls were recruited to the study. Mean intima-media thickness of the common carotid artery (MIMT-CCA) and serum VEGF levels of all subjects were measured. Subclinical atherosclerosis was defined as having an MIMT-CCA ≥0.8 mm. Serum VEGF levels in psoriatic patients were significantly higher compared with healthy controls (P subclinical atherosclerosis (P subclinical atherosclerosis was significantly associated with serum VEGF levels, age, disease duration, and psoriasis area and severity index (PASI). This study supported the possible role of VEGF in the pathogenesis of subclinical atherosclerosis in psoriatic patients. © 2015 The International Society of Dermatology.

  2. Osteoprotegerin as a marker of atherosclerosis

    DEFF Research Database (Denmark)

    Hosbond, Susanne Elisabeth; Poulsen, Tina Svenstrup; Diederichsen, Axel Cosmus Pyndt

    2012-01-01

    Abstract Objective: Osteoprotegerin (OPG) may be involved in development of atherosclerosis. To evaluate plasma concentrations of OPG in individuals with stable coronary artery disease (CAD), acute coronary syndrome (ACS), peripheral artery disease (PAD) and cerebrovascular disease (CBVD) a syste......Abstract Objective: Osteoprotegerin (OPG) may be involved in development of atherosclerosis. To evaluate plasma concentrations of OPG in individuals with stable coronary artery disease (CAD), acute coronary syndrome (ACS), peripheral artery disease (PAD) and cerebrovascular disease (CBVD...

  3. Secondary Retroperitoneal Fibrosis Associated with Generalized Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Barbullushi Myftar

    1999-01-01

    Full Text Available Retroperitoneal fibrosis is an uncommon disease that often presents in a subtle manner. Only a few cases of the combined association of generalized atherosclerosis and retroperitoneal fibrosis are reported in the recent literature, supporting the view that the condition is probably an autoimmune periaortitis. We describe a typical case of retroperitoneal fibrosis associated with generalized atherosclerosis with clinical presentation of progressive renal insufficiency, and claudication from arterial compromise.

  4. Secondary retroperitoneal fibrosis associated with generalized atherosclerosis.

    Science.gov (United States)

    Barbullushi, M; Pasko, N; Bezhani, E; Duraku, A; Rusi, R; Hoti, K; Bakalli, V; Idrizi, A

    1999-01-01

    Retroperitoneal fibrosis is an uncommon disease that often presents in a subtle manner. Only a few cases of the combined association of generalized atherosclerosis and retroperitoneal fibrosis are reported in the recent literature, supporting the view that the condition is probably an autoimmune periaortitis. We describe a typical case of retroperitoneal fibrosis associated with generalized atherosclerosis with clinical presentation of progressive renal insufficiency, and claudication from arterial compromise.

  5. Associations of atherosclerosis in the descending thoracic aorta on CTA with arterial stiffness and chronic kidney disease in asymptomatic patients with diabetes mellitus.

    Science.gov (United States)

    Roos, Cornelis J; Delgado, V; de Koning, Eelco J; Rabelink, Ton J; Jukema, J Wouter; Bax, Jeroen J; Scholte, Arthur J

    2014-08-01

    The relation between atherosclerosis in the descending thoracic aortic (DTA), arterial stiffness and chronic kidney disease (CKD) in patients with diabetes mellitus (DM) remains unclear. The current aim was to evaluate associations of DTA atherosclerosis with arterial stiffness and parameters of CKD in asymptomatic patients with DM. A total of 213 asymptomatic patients with diabetes (mean age 52 years, 56% men) underwent cardiovascular risk assessment including multi-slice computed tomography (for non-invasive coronary angiography, from which DTA atherosclerosis can be derived), non-invasive assessment of arterial stiffness with applanation tonometry and assessment of renal function. Measurements of DTA atherosclerosis included assessment of DTA thickening and calcium score. Arterial stiffness was determined by the carotid-femoral pulse wave velocity (PWV), parameters of CKD included estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (UACR). DTA atherosclerosis was present in 180 (84%) patients. Patients with DTA atherosclerosis had increased arterial stiffness, lower eGFR and higher UACR values. After multivariate correction, DTA calcium score was independently associated with PWV (β = 0.18, p = 0.04). Furthermore, both DTA maximal wall thickness and DTA calcium score were independently associated with eGFR (β = -7.37, p < 0.001 and β = -1.99, p < 0.003, respectively), but not with UACR. The increase in arterial stiffness by atherosclerosis seemed to be mediated by arterial calcification, while the DTA calcium score was independently associated with arterial stiffness, but not DTA maximal wall thickness. Furthermore, parameters of CKD in patients with DM had a distinct relationship with DTA atherosclerosis: DTA atherosclerosis was associated with eGFR but not with UACR.

  6. Validating the role of the Australian National University Alzheimer's Disease Risk Index (ANU-ADRI) and a genetic risk score in progression to cognitive impairment in a population-based cohort of older adults followed for 12 years.

    Science.gov (United States)

    Andrews, Shea J; Eramudugolla, Ranmalee; Velez, Jorge I; Cherbuin, Nicolas; Easteal, Simon; Anstey, Kaarin J

    2017-03-04

    The number of people living with dementia is expected to exceed 130 million by 2050, which will have serious personal, social and economic implications. Employing successful intervention and treatment strategies focused on disease prevention is currently the only available approach that can have an impact on the projected rates of dementia, with risk assessment being a key component of population-based risk reduction for identification of at-risk individuals. We evaluated a risk index comprising lifestyle, medical and demographic factors (the Australian National University Alzheimer's Disease Risk Index [ANU-ADRI]), as well as a genetic risk score (GRS), for assessment of the risk of progression to mild cognitive impairment (MCI). The ANU-ADRI was computed for the baseline assessment of 2078 participants in the Personality and Total Health (PATH) Through Life project. GRSs were constructed on the basis of 25 single-nucleotide polymorphisms previously associated with Alzheimer's disease (AD). Participants were assessed for clinically diagnosed MCI and dementia as well as psychometric test-based MCI (MCI-TB) at 12 years of follow-up. Multi-state models were used to estimate the odds of transitioning from cognitively normal (CN) to MCI, dementia and MCI-TB over 12 years according to baseline ANU-ADRI and GRS. A higher ANU-ADRI score was associated with increased risk of progressing from CN to both MCI and MCI-TB (HR 1.07 [95% CI 1.04-1.11]; 1.07 [1.04-1.09]). The GRS was associated with transitions from CN to dementia (HR 4.19 [95% CI 1.72-10.20), but not to MCI or MCI-TB (HR 1.05 [95% CI 0.86-1.29]; 1.03 [0.87-1.21]). Limitations of our study include that the ethnicity of participants in the PATH project is predominately Caucasian, potentially limiting the generalisability of the results of this study to people of other ethnicities. Biomarkers of AD were not available to define MCI attributable to AD. Not all the predictive variables for the ANU-ADRI were available

  7. Vinpocetine attenuates lipid accumulation and atherosclerosis formation

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Yujun [Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642 (United States); Li, Jian-Dong [Center for Inflammation, Immunity and Infection, and Department of Biology, Georgia State University, Atlanta, GA 30303 (United States); Yan, Chen, E-mail: Chen_Yan@urmc.rochester.edu [Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642 (United States)

    2013-05-10

    Highlights: •Vinpocetine attenuates hyperlipidemia-induced atherosclerosis in a mouse model. •Vinpocetine antagonizes ox-LDL uptake and accumulation in macrophages. •Vinpocetine blocks the induction of ox-LDL receptor LOX-1 in vitro and in vivo. -- Abstract: Atherosclerosis, the major cause of myocardial infarction and stroke, is a chronic arterial disease characterized by lipid deposition and inflammation in the vessel wall. Cholesterol, in low-density lipoprotein (LDL), plays a critical role in the pathogenesis of atherosclerosis. Vinpocetine, a derivative of the alkaloid vincamine, has long been used as a cerebral blood flow enhancer for treating cognitive impairment. Recent study indicated that vinpocetine is a potent anti-inflammatory agent. However, its role in the pathogenesis of atherosclerosis remains unexplored. In the present study, we show that vinpocetine significantly reduced atherosclerotic lesion formation in ApoE knockout mice fed with a high-fat diet. In cultured murine macrophage RAW264.7 cells, vinpocetine markedly attenuated oxidized LDL (ox-LDL) uptake and foam cell formation. Moreover, vinpocetine greatly blocked the induction of ox-LDL receptor 1 (LOX-1) in cultured macrophages as well as in the LOX-1 level in atherosclerotic lesions. Taken together, our data reveal a novel role of vinpocetine in reduction of pathogenesis of atherosclerosis, at least partially through suppressing LOX-1 signaling pathway. Given the excellent safety profile of vinpocetine, this study suggests vinpocetine may be a therapeutic candidate for treating atherosclerosis.

  8. Angiotensin converting enzyme 2 and atherosclerosis.

    Science.gov (United States)

    Wang, Yutang; Tikellis, Chris; Thomas, Merlin C; Golledge, Jonathan

    2013-01-01

    Angiotensin converting enzyme 2 (ACE2) is a homolog of angiotensin converting enzyme (ACE) which generates angiotensin II from angiotensin I. ACE, its product angiotensin II and the downstream angiotensin type I receptor are important components of the renin-angiotensin system (RAS). Angiotensin II, the most important component of the RAS, promotes the development of atherosclerosis. The identification of ACE2 in 2000 opened a new chapter of research on the regulation of the RAS. ACE2 degrades pro-atherosclerotic angiotensin II and generates anti-atherosclerotic angiotensin 1-7. In this review, we explored the importance of ACE2 in protecting experimental animals from developing atherosclerosis and its involvement in human atherosclerosis. We also examined the published evidence assessing the importance of ACE2 in different cell types relevant to atherosclerosis and putative underlying cellular and molecular mechanisms linking ACE2 with protection from atherosclerosis. ACE2 shifts the balance from angiotensin II to angiotensin 1-7 inhibiting the progression of atherosclerosis in animal models. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Periodontal innate immune mechanisms relevant to atherosclerosis.

    Science.gov (United States)

    Amar, S; Engelke, M

    2015-06-01

    Atherosclerosis is a common cardiovascular disease in the USA where it is a leading cause of illness and death. Atherosclerosis is the most common cause for heart attack and stroke. Most commonly, people develop atherosclerosis as a result of diabetes, genetic risk factors, high blood pressure, a high-fat diet, obesity, high blood cholesterol levels, and smoking. However, a sizable number of patients suffering from atherosclerosis do not harbor the classical risk factors. Ongoing infections have been suggested to play a role in this process. Periodontal disease is perhaps the most common chronic infection in adults with a wide range of clinical variability and severity. Research in the past decade has shed substantial light on both the initiating infectious agents and host immunological responses in periodontal disease. Up to 46% of the general population harbors the microorganism(s) associated with periodontal disease, although many are able to limit the progression of periodontal disease or even clear the organism(s) if infected. In the last decade, several epidemiological studies have found an association between periodontal infection and atherosclerosis. This review focuses on exploring the molecular consequences of infection by pathogens that exacerbate atherosclerosis, with the focus on infections by the periodontal bacterium Porphyromonas gingivalis as a running example. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Does elevated body mass modify the influence of postmenopausal estrogen replacement on atherosclerosis progression: results from the estrogen in the prevention of atherosclerosis trial.

    Science.gov (United States)

    Mack, Wendy J; Hameed, Afshan B; Xiang, Min; Roy, Subir; Slater, Cristin C; Stanczyk, Frank Z; Lobo, Rogerio A; Liu, Chao-ran; Liu, Ci-hua; Hodis, Howard N

    2003-05-01

    To determine whether the estrogen-related reduction in atherosclerosis progression demonstrated in the estrogen in the prevention of atherosclerosis trial (EPAT) is modified by body mass index (BMI). Subgroup analyses were performed using data from EPAT, a randomized, double-blind, placebo-controlled trial designed to determine whether unopposed 17beta-estradiol administered for a 2-year treatment period reduces the progression of subclinical atherosclerosis in healthy postmenopausal women. The primary trial endpoint was the rate of change of common carotid artery intima-media thickness (IMT). In this subgroup analysis, the sample was divided into 122 women with BMIwomen with BMI> or =30 kg/m(2). Statistical analysis was performed using mixed general linear models to evaluate whether the treatment effects on IMT progression rates differed in the two BMI groups. There was no significant difference in the estradiol treatment effect on IMT progression rates between postmenopausal women with BMI or =30 kg/m(2) (P=0.52). In the 77 subjects who did not use lipid-lowering therapy, there was significant improvement in IMT with estradiol treatment that was evident in both BMI groups (P=0.48 for differences between BMI groups). In contrast to the epidemiological observation that obese postmenopausal women do not derive benefit from estrogen replacement therapy, results of this study indicate that estradiol treatment is beneficial in preventing progression of atherosclerosis regardless of initial BMI. Estradiol treatment is beneficial in preventing progression of atherosclerosis in postmenopausal women not receiving lipid-lowering therapy, regardless of their initial body mass index.

  11. Heart disease risk factors in midlife predict subclinical coronary atherosclerosis more than 25 years later in survivors without clinical heart disease: the Rancho Bernardo Study.

    Science.gov (United States)

    Barrett-Connor, Elizabeth; Bergstrom, Jacqueline; Wright, Michael; Kramer, Caroline K

    2009-06-01

    To determine which of the classic modifiable coronary heart disease (CHD) risk factors, measured in midlife, are associated with subclinical coronary atherosclerosis in older age. Prospective study. Community based. Participants were 400 community-dwelling middle-aged adults who had no history of CHD at baseline (1972-1974), when CHD risk factors were measured, and who were still free of known CHD in 2000 to 2002. Coronary artery plaque burden was assessed according to coronary artery calcium (CAC) score using computed tomography in 2000 to 2002. Ordinal logistic regression analysis was used to compare baseline risk factors with severity of CAC. Mean age was 42 at baseline and 69 at the time of CAC assessment; 46.5% were male. In analyses adjusted for age, sex, and all other risk factors, one standard deviation increase in body mass index (odds ratio (OR)=1.24, 95%confidence interval (CI)=1.02-1.51; P=.03), cholesterol (OR=1.28, 95% CI=1.03-1.58; P=.020, pulse pressure (OR=1.24, 95% CI=1.03-1.50; P=.03), and log triglycerides (OR=1.22, 95% CI=0.99-1.50; P=.06) each independently predicted the presence and severity of coronary artery atherosclerosis. Modifiable risk factors measured more than 25 years earlier influence plaque burden in elderly survivors without clinical heart disease.

  12. Biochemical markers identify influences on bone and cartilage degradation in osteoarthritis - the effect of sex, Kellgren-Lawrence (KL score, Body Mass Index (BMI, oral salmon calcitonin (sCT treatment and diurnal variation

    Directory of Open Access Journals (Sweden)

    Henriksen K

    2010-06-01

    Full Text Available Abstract Background Osteoarthritis (OA involves changes in both bone and cartilage. These processes might be associated under some circumstances. This study investigated correlations between bone and cartilage degradation in patients with OA as a function of sex, Kellgren-Lawrence (KL score, Body Mass Index (BMI, oral salmon calcitonin (sCT treatment and diurnal variation. Methods This study was a 2-week, double-blind, double-dummy, randomized study including 37 postmenopausal women and 36 men, aged 57-75 years, with painful knee OA, and a KL-score of I - III. Subjects were allocated to one of three treatment arms: 0.6 mg or 0.8 mg oral sCT, or placebo given twice-daily for 14 days. Correlations between gender, KL score, or BMI and the bone resorption marker, serum C-terminal telopeptide of collagen type I (CTX-I, or the cartilage degradation marker, urine C-terminal telopeptide of collagen type II (CTX-II were investigated. Results At baseline, biomarkers indicated women with OA experienced higher bone and cartilage degradation than men. CTX-I levels were significantly higher, and CTX-II levels only marginally higher, in women than in men (p = 0.04 and p = 0.06, respectively. Increasing KL score was not correlated with bone resorption, but was significantly associated with the cartilage degradation CTX-II marker in both men and women (p = 0.007. BMI was significantly and negatively correlated to the bone resorption marker CTX-I, r = -0.40 (p = 0.002, but showed only a borderline positive correlation to CTX-II, r = 0.25 (p = 0.12. Before morning treatments on days 1 and 14, no correlation was seen between CTX-I and CTX-II in either the sCT or placebo group. However, oral sCT and food intake induced a clear correlation between these bone and cartilage degradation markers. Four hours after the first sCT dose on treatment days 1 and 14, a significant correlation (r = 0.71, p p = 0.02, but not on day 14. Conclusion Bone resorption was higher in

  13. Carotid plaque burden as a measure of subclinical atherosclerosis

    DEFF Research Database (Denmark)

    Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram

    2012-01-01

    The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease.......The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease....

  14. Noninvasive assessment of preclinical atherosclerosis

    Directory of Open Access Journals (Sweden)

    Helen A Lane

    2006-03-01

    Full Text Available Helen A Lane, Jamie C Smith, J Stephen DaviesDepartment of Endocrinology, University of Wales College of Medicine, Heath Park, Cardiff, Wales, UKAbstract: Initially considered as a semipermeable barrier separating lumen from vessel wall, the endothelium is now recognised as a complex endocrine organ responsible for a variety of physiological processes vital for vascular homeostasis. These include the regulation of vascular tone, luminal diameter, and blood flow; hemostasis and thrombolysis; platelet and leucocyte vessel-wall interactions; the regulation of vascular permeability; and tissue growth and remodelling. The endothelium modulates arterial stiffness, which precedes overt atherosclerosis and is an independent predictor of cardiovascular events. Unsurprisingly, dysfunction of the endothelium may be considered as an early and potentially reversible step in the process of atherogenesis and numerous methods have been developed to assess endothelial status and large artery stiffness. Methodology includes flow-mediated dilatation of the brachial artery, assessment of coronary flow reserve, carotid intimamedia thickness, pulse wave analysis, pulse wave velocity, and plethysmography. This review outlines the various modalities, indications, and limitations of available methods to assess arterial dysfunction and vascular risk.Keywords: endothelial function, vascular risk, vascular stiffness

  15. Microalbuminuria and its Association with Subclinical Atherosclerosis in the Mexican Mestizo population: the GEA study.

    Science.gov (United States)

    Medina-Urrutia, Aida; Juárez-Rojas, Juan Gabriel; Posadas-Sánchez, Rosalinda; Jorge-Galarza, Esteban; Cardoso-Saldaña, Guillermo; Vargas-Alarcón, Gilberto; Martínez-Alvarado, Rocío; Posadas-Romero, Carlos

    2016-01-01

    Microalbuminuria is an early marker of atherosclerosis. Ethnic differences for both conditions have been reported. We studied microalbuminuria prevalence and its association with coronary artery calcification as an early atherosclerosis marker in a Mexican-Mestizo population free of diabetes and hypertension (healthy), as well as in hypertensive and diabetic subjects. In 1,472 adults (53.3 ± 9.4 years old, 50.3% women), anthropometric measurements, fasting blood glucose, and lipid profile were determined. A spot urine sample was used to quantify the albumin-to-creatinine ratio and to define microalbuminuria (20-200 mg/g in men, and 30-300 mg/g in women). A coronary artery calcification score was obtained by electron-beam computed tomography and subclinical atherosclerosis was defined as a score > 0. Overall microalbuminuria prevalence was 9.3% (5.4% in healthy, 11.6% in obese, 12% in hypertensive, and 25% in diabetic subjects). Compared to "healthy" subjects without microalbuminuria, those with microalbuminuria had a ∼3-fold higher prevalence of coronary artery calcification > 0, while normal-high albumin-to-creatinine ratio (OR: 1.8; p 0 only among diabetic subjects. Microalbuminuria and high-normal albumin-to-creatinine ratio were independently associated with subclinical atherosclerosis, suggesting that they may confer a higher risk of future cardiovascular events.

  16. Incidental paranasal sinusitis on routine brain magnetic resonance scans: association with atherosclerosis.

    Science.gov (United States)

    Rosenthal, Peter A; Lundy, Katherine C; Massoglia, Dino P; Payne, Elizabeth H; Gilbert, Gregory; Gebregziabher, Mulugeta

    2016-12-01

    Incidental paranasal sinusitis (IPS) is common on imaging for non-sinusitis disorders, usually without symptoms or obstructive features, and possibly arising from periodontitis (PD). PD associations with atherosclerosis have been widely reported. We test if IPS may also be associated with atherosclerosis. IPS was scored retrospectively in a random sample of 180 magnetic resonance (MR) brain scans and compared with chart review for atherosclerosis (all subtypes), rhinosinusitis, and related factors (smoking, asthma, and relevant surgery). IPS was scored out of 30, from all sinuses, with maxillary sinuses weighted double volumetrically. Significant IPS (Sig IPS) was designated as 6 or more out of 30. Bivariate logistic regression was used to test for associations of Sig IPS to the clinical data, with multivariate analysis then testing for potential confounders. A total of 173 subjects were analyzed (7 exclusions). MR indications included suspected acute/prior stroke (22.0%). Sig IPS found in 20 (11.6%). Positive histories for atherosclerosis were cerebral, 57 (32.9%); coronary, 48 (27.7%); and peripheral arterial disease, 14 (8.1%). IPS ≥6 was strongly associated with cerebrovascular disease (odds ratio [OR] 6.0, p Sig IPS to cerebrovascular disease persisted (modified OR 5.2, p = 0.002). Significant incidental sinusitis, which is mostly subclinical sinusitis, is associated with cerebrovascular disease but not other atheroscleroses. This suggests possible common causation of both by PD. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  17. 25-Hydroxyvitamin D Concentration and Sleep Duration and Continuity: Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Bertisch, Suzanne M; Sillau, Stefan; de Boer, Ian H; Szklo, Moyses; Redline, Susan

    2015-08-01

    To determine the associations of 25-hydroxyvitamin D (25(OH)D) concentration with sleep continuity, quality, and symptoms, and to explore race/ethnic variation. Cross-sectional study. Multi-Ethnic Study of Atherosclerosis (MESA). There were 1,721 adults. Sleep outcomes were measured by polysomnography, actigraphy, and questionnaires. Serum 25(OH)D concentration was expressed by clinical thresholds (sleep duration, efficiency, and symptoms, and assessed race/ethnic variation. Mean age was 68.2 ± 9.1 y, and 37.2% were white, 27.7% African American, 11.9% Chinese Americans, and 23.2% Hispanic. Mean 25(OH)D concentration was 25.4 ± 10.5 ng/mL. 25(OH)D deficient participants had the shortest sleep duration, lowest sleep efficiency, and highest sleepiness scores. After adjusting for demographics, obesity, and health habits, deficient individuals slept an average of 13.0 min (95% confidence interval, -22.8, -3.2) shorter than sufficient individuals. Race/ethnic-stratified analyses indicated that the strongest associations were in African Americans, in whom adjusted sleep duration was 25.6 ± 11.7 min shorter in deficient versus sufficient individuals (P = 0.04), and in Chinese Americans, adjusted apnea-hypopnea index (AHI) was 7.5 ± 3.3 events/h higher in deficient versus sufficient individuals. Overall, there were modest associations between 25-hydroxyvitamin D (25(OH)D) concentration and sleep traits. However, race-stratified analyses suggested the association between 25(OH)D concentration and sleep traits varied by race/ethnicity. Vitamin D deficiency was most strongly associated with short sleep duration in African Americans and with elevated apnea-hypopnea index in Chinese Americans, suggesting that race/ethnicity may modify these associations. © 2015 Associated Professional Sleep Societies, LLC.

  18. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. 17-β Estradiol reduces atherosclerosis without exacerbating lupus in ovariectomized systemic lupus erythematosus-susceptible LDLr(-/-) mice.

    Science.gov (United States)

    Shelton, K A; Cline, J M; Cann, J A

    2013-04-01

    To test the hypothesis that estrogen treatment in a radiation chimera mouse model of systemic lupus erythematosus (SLE) and atherosclerosis will increase SLE-associated atherosclerosis by increasing autoantibody production and inflammation. We used a radiation chimera mouse model in which bone marrow from the polygenic B6.Sle1.2.3 model of SLE was transferred to the low density lipoprotein receptor knock out (LDLr(-/-)) model of atherosclerosis on a C57BL/6 background (Sle/LDLr(-/-)). Ovariectomized chimeric mice were treated for 10 weeks with either 5.6 μg/day of 17β-estradiol or placebo; outcomes included atherosclerosis plaque size, anti-dsDNA autoantibody production and renal pathology. Mean atherosclerosis plaque size was 67.4 ± 7.6% smaller in the estrogen treated group (p atherosclerosis lesion size and either the renal histology score or UP:UC ratio in Sle/LDLr(-/-) mice. These results indicate that 17β-estradiol is atheroprotective within the context of murine SLE independent of changes in serum cholesterol concentration, autoantibody concentration, or renal pathology. The SLE phenotype in Sle/LDLr(-/-) mice is not exacerbated by exogenous 17β-estradiol administration, and the reduced UP:UC ratio suggests a protective effect against lupus nephritis. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  20. Cyanotic congenital heart disease and atherosclerosis.

    Science.gov (United States)

    Tarp, Julie Bjerre; Jensen, Annette Schophuus; Engstrøm, Thomas; Holstein-Rathlou, Niels-Henrik; Søndergaard, Lars

    2017-06-01

    Improved treatment options in paediatric cardiology and congenital heart surgery have resulted in an ageing population of patients with cyanotic congenital heart disease (CCHD). The risk of acquired heart disease such as atherosclerosis increases with age.Previous studies have speculated whether patients with CCHD are protected against atherosclerosis. Results have shown that the coronary arteries of patients with CCHD are free from plaques and stenosis. Decreased carotid intima-media thickness and low total plasma cholesterol may indicate a reduced risk of later development of atherosclerosis. However, the evidence is still sparse and questionable, and a reasonable explanation for the decreased risk of developing atherosclerosis in patients with CCHD is still missing.This review provides an overview of what is known about the prevalence and potential causes of the reduced risk of atherosclerosis in patients with CCHD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  1. Genetic predisposition to obesity and risk of subclinical atherosclerosis.

    Science.gov (United States)

    Shi, Juan; Hong, Jie; Qi, Lu; Cui, Bin; Gu, Weiqiong; Zhang, Yifei; Li, Lijuan; Miao, Lin; Wang, Rui; Wang, Weiqing; Ning, Guang

    2014-10-10

    Obesity has been associated with increased common carotid artery (CCA) intima-media thickness (IMT), a measure of subclinical atherosclerosis. We assessed the association between genetic predisposition to obesity and CCA IMT. The study included 428 young Chinese adults with CCA IMT measured using a high-resolution B-mode tomographic ultrasound system. We created a genetic risk score (GRS) by summing the risk alleles of 6 obesity-associated genetic variants confirmed in our previous analyses. The GRS was significantly associated with greater CCA IMT (pobesity status, but remained significant (p=0.009). In addition, we found that blood pressure significantly modified the association between the GRS and CCA IMT (p for interaction=0.001). The associations between the GRS and CCA IMT were stronger in participants with systolic blood pressure (SBP) ≥120 mmHg and/or diastolic blood pressure (DBP) ≥80 mmHg (per 2 allele increment of the GRS relating to 0.028 mm greater CCA IMT, p for trendobesity and development of subclinical atherosclerosis. Elevated blood pressure might amplify the adverse effect of obesity on cardiovascular risk. Copyright © 2014 Elsevier B.V. All rights reserved.

  2. Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients With Coronary Computed Tomographic Angiography.

    Science.gov (United States)

    Nakanishi, Rine; Baskaran, Lohendran; Gransar, Heidi; Budoff, Matthew J; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Cury, Ricardo; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Kaufmann, Philipp A; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J; Villines, Todd C; Dunning, Allison; Marques, Hugo; Pontone, Gianluca; Andreini, Daniele; Rubinshtein, Ronen; Bax, Jeroen; Jones, Erica; Hindoyan, Niree; Gomez, Millie; Lin, Fay Y; Min, James K; Berman, Daniel S

    2017-08-01

    Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events. © 2017 American Heart Association, Inc.

  3. Association of Serum Vitamin D Level and Carotid Atherosclerosis: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Chen, Fu-Hua; Liu, Tian; Xu, Lei; Zhang, Lei; Zhou, Xiao-Bo

    2017-11-24

    Vitamin D deficiency is associated with an increased risk of subclinical atherosclerosis. To explore the potential link of the serum vitamin D level with carotid atherosclerosis, this meta-analysis assessed the correlation between vitamin D and carotid intima-media thickness as well as carotid atherosclerotic plaque. PubMed, Embase, Web of Science, and Cochrane Library databases were searched until the end of March 2017. Clinical studies investigating the relationship between vitamin D and carotid atherosclerosis were included. The outcome data were extracted according to the inclusion criteria and pooled for an effect estimate by a random-effects model. Of the 506 initially retrieved studies, 11 studies involving a total of 16,434 participants were included in the meta-analysis. Newcastle-Ottawa Quality Assessment Scale scores suggested that the included studies were of high quality. The pooled effects estimate showed that the serum vitamin D level was negatively associated with carotid atherosclerosis (odds ratio, 0.95; 95% confidence interval [CI], 0.93-0.96), with substantial heterogeneity among the individual studies (I2  = 54%). Furthermore, a subgroup analysis suggested that hypovitaminosis D was associated with an 0.85-fold decrease in the odds of having a higher carotid intima-media thickness (95% CI, 0.76-0.96; P D level was a protective factor against increased carotid plaque (odds ratio, 0.95; 95% CI, 0.93-0.97; P D deficiency and carotid atherosclerosis. Patients with hypovitaminosis D might have extra requirements for preventive and therapeutic measures against early atherosclerosis, thus reducing the cardiovascular disease risk in the long term. © 2017 by the American Institute of Ultrasound in Medicine.

  4. INDEXING AND INDEX FUNDS

    Directory of Open Access Journals (Sweden)

    HAKAN SARITAŞ

    2013-06-01

    Full Text Available Proponents of the efficient market hypothesis believe that active portfolio management is largely wasted effort and unlikely to justify the expenses incurred. Therefore, they advocate a passive investment strategy that makes no attempt to outsmart the market. One common strategy for passive management is indexing where a fund is designed to replicate the performance of a broad-based index of stocks and bonds. Traditionally, indexing was used by institutional investors, but today, the use of index funds proliferated among individual investors. Over the years, both international and domestic index funds have disproportionately outperformed the market more than the actively managed funds have.

  5. The role of carotid ultrasound in assessing carotid atherosclerosis in individuals at low-to-intermediate cardiovascular risk.

    Science.gov (United States)

    Coll, Blai; Betriu, Angels; Feinstein, Steve B; Valdivielso, Jose M; Zamorano, Jose L; Fernández, Elvira

    2013-12-01

    Detection of carotid atherosclerosis might help to better identify individuals susceptible to cardiovascular events. We aimed to quantify the number of participants with carotid atherosclerosis and low-to-intermediate cardiovascular risk according to the traditional risk factor scoring, and therefore with an elevated risk of cardiovascular events. Cross-sectional, observational study performed during a cardiovascular screening program. From a total of 3778 volunteers, low-to-intermediate cardiovascular risk individuals (N=2354) were identified and studied. Physical examination, blood test, and carotid ultrasound followed standard procedures. Common, bulb, and internal carotid arteries were examined and common carotid intima-media thickness was measured. SCORE risk value was calculated for all participants. Univariate and multivariate statistical analysis was performed. Mean age of participants was 58.9 (15) years, 43.8% were men, 23.7% had hypertension, and 20.5% had hypercholesterolemia. The mean SCORE value was 1.47 (1.4). Both carotid intima-media thickness and the prevalence of carotid plaques increased steadily and significantly (P<.005) as advanced decades of life were analyzed. Variables significantly related with the presence of carotid atherosclerosis were age, male sex, and systolic blood pressure. Interestingly, 592 (25.1%) individuals were reclassified to a higher risk due to the presence of carotid atherosclerosis. There was a clear dissociation between cardiovascular risk scoring and the presence of atherosclerosis, because 1 of 4 study participants at low-to-intermediate cardiovascular risk had carotid atherosclerosis. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  6. Multiethnic Exome-Wide Association Study of Subclinical Atherosclerosis

    NARCIS (Netherlands)

    Natarajan, Pradeep; Bis, Joshua C; Bielak, Lawrence F; Cox, Amanda J; Dörr, Marcus; Feitosa, Mary F; Franceschini, Nora; Guo, Xiuqing; Hwang, Shih-Jen; Isaacs, Aaron; Jhun, Min A; Kavousi, Maryam; Li-Gao, Ruifang; Lyytikäinen, Leo-Pekka; Marioni, Riccardo E; Schminke, Ulf; Stitziel, Nathan O; Tada, Hayato; van Setten, Jessica|info:eu-repo/dai/nl/345493990; Smith, Albert V; Vojinovic, Dina; Yanek, Lisa R; Yao, Jie; Yerges-Armstrong, Laura M; Amin, Najaf; Baber, Usman; Borecki, Ingrid B; Carr, J Jeffrey; Chen, Yii-Der Ida; Cupples, L Adrienne; de Jong, Pim A|info:eu-repo/dai/nl/287955672; de Koning, Harry; de Vos, Bob D|info:eu-repo/dai/nl/413986004; Demirkan, Ayse; Fuster, Valentin; Franco, Oscar H; Goodarzi, Mark O; Harris, Tamara B; Heckbert, Susan R; Heiss, Gerardo; Hoffmann, Udo; Hofman, Albert; Išgum, Ivana|info:eu-repo/dai/nl/31484984X; Jukema, J Wouter; Kähönen, Mika; Kardia, Sharon L R; Kral, Brian G; Launer, Lenore J; Massaro, Joseph; Mehran, Roxana; Mitchell, Braxton D; Mosley, Thomas H; de Mutsert, Renée; Newman, Anne B; Nguyen, Khanh-Dung; North, Kari E; O'Connell, Jeffrey R; Oudkerk, Matthijs; Pankow, James S; Peloso, Gina M; Post, Wendy; Province, Michael A; Raffield, Laura M; Raitakari, Olli T; Reilly, Dermot F; Rivadeneira, Fernando; Rosendaal, Frits; Sartori, Samantha; Taylor, Kent D; Teumer, Alexander; Trompet, Stella; Turner, Stephen T; Uitterlinden, André G; Vaidya, Dhananjay; van der Lugt, Aad; Völker, Uwe; Wardlaw, Joanna M; Wassel, Christina L; Weiss, Stefan; Wojczynski, Mary K; Becker, Diane M; Becker, Lewis C; Boerwinkle, Eric; Bowden, Donald W; Deary, Ian J; Dehghan, Abbas; Felix, Stephan B; Gudnason, Vilmundur; Lehtimäki, Terho; Mathias, Rasika; Mook-Kanamori, Dennis O; Psaty, Bruce M; Rader, Daniel J; Rotter, Jerome I; Wilson, James G; van Duijn, Cornelia M; Völzke, Henry; Kathiresan, Sekar; Peyser, Patricia A; O'Donnell, Christopher J

    2016-01-01

    BACKGROUND: -The burden of subclinical atherosclerosis in asymptomatic individuals is heritable and associated with elevated risk of developing clinical coronary heart disease (CHD). We sought to identify genetic variants in protein-coding regions associated with subclinical atherosclerosis and the

  7. Subclinical Measures of Atherosclerosis: Genetics and Cardiovascular Risk Prediction

    NARCIS (Netherlands)

    M. Kavousi (Maryam)

    2013-01-01

    markdownabstract__Abstract__ Atherosclerosis is a chronic, progressive, systematic condition with a long asymptomatic phase. Atherosclerosis develops gradually as a subclinical condition over the life course and eventually becomes clinically apparent as ischemic heart disease,

  8. Oral microbiota in patients with atherosclerosis

    DEFF Research Database (Denmark)

    Fåk, Frida; Tremaroli, Valentina; Bergström, Göran

    2015-01-01

    to increase the systemic inflammatory level of the host, which may in turn influence plaque composition and rupture. We previously showed that bacteria from the oral cavity and the gut could be found in atherosclerotic plaques. METHODS: To elucidate whether the oral microbiota composition differed between......BACKGROUND AND AIMS: Recent evidence suggests that the microbiota may be considered as an environmental factor that contributes to the development of atherosclerosis. Periodontal disease has been associated with cardio- and cerebrovascular events, and inflammation in the periodontium is suggested...... patients with asymptomatic and symptomatic atherosclerosis we performed pyrosequencing of the oral microbiota of 92 individuals including patients with asymptomatic and symptomatic atherosclerosis and control individuals without carotid plaques or previous stroke or myocardial infarction. RESULTS...

  9. Macrophages, Dendritic Cells, and Regression of Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Jonathan E. Feig

    2012-07-01

    Full Text Available Atherosclerosis is the number one cause of death in the Western world. It results from the interaction between modified lipoproteins and monocyte-derived cells such as macrophages, dendritic cells, T cells, and other cellular elements of the arterial wall. This inflammatory process can ultimately lead to the development of complex lesions, or plaques, that protrude into the arterial lumen. Ultimately, plaque rupture and thrombosis can occur leading to the clinical complications of myocardial infarction or stroke. Although each of the cell types plays roles in the pathogenesis of atherosclerosis, in this review, the focus will be primarily on the monocyte derived cells- macrophages and dendritic cells. The roles of these cell types in atherogenesis will be highlighted. Finally, the mechanisms of atherosclerosis regression as it relates to these cells will be discussed.

  10. Myocardin: A novel player in atherosclerosis.

    Science.gov (United States)

    Xia, Xiao-Dan; Zhou, Zhen; Yu, Xiao-Hua; Zheng, Xi-Long; Tang, Chao-Ke

    2017-02-01

    Myocardin (MYOCD) the most important coactivator of serum response factor (SRF), plays a critical role specifically in the development of cardiac myocytes and vascular smooth muscle cells (VSMCs). Binding of Myocardin to the SRF on the CArG box-containing target genes can transcriptionally activate a variety of downstream muscle-specific genes, such as Sm22α, Acta2, Myh11, and several other signaling pathways. Myocardin expression represents a contractile and differentiated SMC phenotype. Loss of Myocardin, however, represents a synthetic and dedifferentiated phenotype, a hallmark in atherosclerosis. Growing evidence shows that Myocardin is involved in lipid metabolism and vascular inflammation, the primary pathogenesis of atherosclerosis. Moreover, Myocardin expression level is altered in atherosclerotic patients and animal models, suggesting more extensive and important roles for Myocardin in atherosclerosis. In the current review, we summarized recent progress on the regulation and signaling of Myocardin, and highlighted its impacts on atherosclerotic disease. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Sleep Disturbances and Depression in the Multi-Ethnic Study of Atherosclerosis

    Science.gov (United States)

    Alcántara, Carmela; Biggs, Mary L.; Davidson, Karina W.; Delaney, Joseph A.; Jackson, Chandra L.; Zee, Phyllis C.; Shea, Steven J.C.; Redline, Susan

    2016-01-01

    Study Objectives: We examined the association of objectively and subjectively measured sleep disturbances with depression, and explored if race/ethnicity, socioeconomic status, and sex modified these associations. Methods: We used data from the cross-sectional Multi-Ethnic Study of Atherosclerosis Sleep Study. Participants included 1,784 adults (ages 54–93 y), 36.8% non-Hispanic Whites, 28.0% African Americans, 23.7% Hispanics, 11.5% Chinese, and 46.0% males. Sleep was assessed with actigraphy, polysomnography, and self-report. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. We used relative risk regression to evaluate the association of sleep measures and depression (CES-D score ≥ 16) adjusting for site, sociodemographics, and behavioral and medical risk factors. Results: Overall, 14.5% had depression, 29.3% had insomnia symptoms, 14.1% had excessive daytime sleepiness (EDS), 15.1% had apnea-hypopnea index (AHI) ≥ 30, and 30.4% experienced short sleep (Depression was associated with short sleep duration (adjusted prevalence ratio [PR] = 1.47, 95% confidence interval [CI] = 1.11, 1.94), sleep (PR = 1.57, 95% CI = 1.08, 2.27), ≥ 25% REM sleep (PR = 1.42, 95% CI = 1.03, 1.95), insomnia (PR = 1.83, 95% CI = 1.39, 2.40), excessive daytime sleepiness (EDS) (PR = 1.61, 95% CI = 1.19, 2.18), and AHI > 15 + EDS (PR = 1.55, 95% CI = 1.01, 2.39). Short sleep duration was associated with depression among those with high school education or beyond, but not among those with less education. Insomnia was more strongly associated with depression among men than women. Conclusions: Sleep disturbances are associated with depression among middle-aged and older adults; these associations may be modified by education and sex. Future research should further test these hypotheses, evaluate whether early detection or treatment of sleep disturbances ameliorate depression, and explore subpopulation differences. Citation: Alc

  12. Serum cystatin C is associated with subclinical atherosclerosis in patients with type 2 diabetes: A retrospective study.

    Science.gov (United States)

    Chung, Yu Kyung; Lee, Young Ju; Kim, Kye Whon; Cho, Ryu Kyoung; Chung, Seung Min; Moon, Jun Sung; Yoon, Ji Sung; Won, Kyu Chang; Lee, Hyoung Woo

    2018-01-01

    The aim of this study was to investigate the association between the serum cystatin C level and cardiovascular disease risk in patients with type 2 diabetes mellitus. We studied 523 patients with type 2 diabetes mellitus and calculated estimated 10-year risk of atherosclerotic cardiovascular disease (%). Subclinical atherosclerosis was defined as brachial-ankle pulse wave velocity ⩾1700 ms, indicating the presence of arterial stiffness. Cystatin C level was significantly higher in the subclinical atherosclerosis group (brachial-ankle pulse wave velocity ⩾ 1700 ms) than in the non-subclinical atherosclerosis group (brachial-ankle pulse wave velocity diabetes and cystatin C level, but not by serum creatinine, 10-year risk of atherosclerotic cardiovascular disease score and estimated glomerular filtration rate in the multiple linear regression analysis. In addition, an increase in cystatin C level was independently associated with the risk of subclinical atherosclerosis after adjusting for age, sex, duration of diabetes, smoking, hypertension, 10-year risk of atherosclerotic cardiovascular disease risk score, serum creatinine level, total cholesterol, high-density lipoprotein cholesterol and haemoglobin A1c (odds ratio = 1.200, 95% confidence interval: 1.04-1.38, p = 0.011). Serum cystatin C level was significantly associated with subclinical atherosclerosis. This result suggests that an increase in cystatin C level could be a valuable surrogate marker for the risk of cardiovascular disease in patients with type 2 diabetes mellitus.

  13. Relationship of lipid oxidation with subclinical atherosclerosis and 10-year coronary events in general population.

    Science.gov (United States)

    Gómez, Miquel; Vila, Joan; Elosua, Roberto; Molina, Lluís; Bruguera, Jordi; Sala, Joan; Masià, Rafel; Covas, Maria Isabel; Marrugat, Jaume; Fitó, Montserrat

    2014-01-01

    To assess 1) the association of lipid oxidation biomarkers with 10-year coronary artery disease (CAD) events and subclinical atherosclerosis, and 2) the reclassification capacity of these biomarkers over Framingham-derived CAD risk functions, in a general population. Within the framework of the REGICOR study, 4782 individuals aged between 25 and 74 years were recruited in a population-based cohort study. Follow-up of the 4042 who met the eligibility criteria was carried out. Plasma, circulating oxidized low-density lipoprotein (oxLDL) and oxLDL antibodies (OLAB) were measured in a random sample of 2793 participants. End-points included fatal and non-fatal acute myocardial infarction (AMI) and angina. Carotid intima-media thickness (IMT) in the highest quintile and ankle-brachial index subclinical atherosclerosis. Mean age was 50.0 (13.4) years, and 52.4% were women. There were 103 CAD events (34 myocardial infarction, 43 angina, 26 coronary deaths), and 306 subclinical atherosclerosis cases. Oxidized LDL was independently associated with higher incidence of CAD events (HR = 1.70; 95% Confidence Interval: 1.02-2.84), but not with subclinical atherosclerosis. The net classification index of the Framingham-derived CAD risk function was significantly improved when ox-LDL was included (NRI = 14.67% [4.90; 24.45], P = 0.003). No associations were found between OLAB and clinical or subclinical events. The reference values for oxLDL and OLAB are also provided (percentiles). OxLDL was independently associated with 10-year CAD events but not subclinical atherosclerosis in a general population, and improved the reclassification capacity of Framingham-derived CAD risk functions. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Frequency of Nonalcoholic Fatty Liver Disease and Subclinical Atherosclerosis Among Young Mexican Americans.

    Science.gov (United States)

    Gill, Clarence; Vatcheva, Kristina P; Pan, Jen-Jung; Smulevitz, Beverly; McPherson, David D; Fallon, Michael; McCormick, Joseph B; Fisher-Hoch, Susan P; Laing, Susan T

    2017-06-01

    Nonalcoholic fatty liver disease (NAFLD) is considered as the hepatic manifestation of the metabolic syndrome, whose criteria are risk factors for atherosclerotic cardiovascular disease. We aimed to evaluate the prevalence of NAFLD, its association with subclinical atherosclerosis, and factors that may account for this association in Mexican Americans. In a population-based cross-sectional sample drawn from the Cameron County Hispanic Cohort in Texas, carotid intima media thickness (cIMT), an indicator of subclinical atherosclerosis, was measured. Abnormal carotid ultrasound study was defined as mean cIMT >75th percentile for age and gender and/or plaque presence. NAFLD was defined as steatosis by ultrasound in the absence of other causes of liver disease. Multivariable weighted regression analyses were performed to evaluate associations between NAFLD and cIMT. Mean age was 50.4 ± 1.2 years with 58.3% women. Mean body mass index was 31.0 ± 0.4 kg/m(2), and 54.0% had the metabolic syndrome. NAFLD was highly prevalent (48.80%); subjects with NAFLD had greater body mass index, central obesity, fasting glucose levels, and dyslipidemia and were more likely to have the metabolic syndrome. Nearly 1/3 of subjects with NAFLD also had evidence of subclinical atherosclerosis (31.2%). After adjusting for covariates, there was an independent association between NAFLD and increased cIMT only in younger subjects subclinical atherosclerosis among younger subjects; clustering of diabetes, obesity, and metabolic syndrome in this health disparity cohort increases the risk of both liver disease and early atherosclerosis in young adults. Published by Elsevier Inc.

  15. 學術論文被引用次數之分析研究:以Science Citation Index Expanded及Scopus為例 An Analytical Study of Citedness Score on Scholarly Literatures: Based on Science Citation Index Expanded and Scopus

    Directory of Open Access Journals (Sweden)

    Chiu-hsia Shih

    2006-09-01

    Full Text Available 論文被引用次數常被用為評估學術研究成果的指標,其對學術界的重要性不言可喻。為求公允,引用次數的運算宜力求正確,然而,由於提供查詢論文被引用次數之系統,因發展背景不同,系統的資料處理程序與原則有別,使得各篇論文的被引用次數在不同系統之檢索結果因而產生差異。本研究除藉由文獻探討外,選擇淡江大學工學院獲得校內研究獎助之學術論文372篇,以Science Citation Index Expanded(簡稱SCIE)與Scopus為對象,透過實際檢索,比較分析兩者計算論文被引用次數存在的現象與問題,以歸納影響因素。研究結果發現在比較SCIE與Scopus兩者的收錄範圍時,除資料種數外,應一併考量其收錄的資料類型與政策等面向。此外,其著錄參考文獻的規範不一,書目記錄品質的控管、引用與被引用文獻連結的處理機制等亦存在相異的作法,因而影響同一篇文獻卻有不同的被引用次數之檢索結果。由此可知,系統收錄資料的範圍、參考文獻著錄之完整性、書目記錄的品質以及文獻連結機制等情況,都是影響論文被引用次數計算之因素。Citedness score is a widely accepted metric for the quality of scholarly literatures, therefore, the forming calculation and corresponsive consequence of citation counts becomes of importance for academic researchers, especially for the research assessment. However, the distinction of citedness score exists in heterogeneous information systems resulted from considerations for system construction and development, such as purpose, procedure and policy of data processing, and that would bring various meanings and impacts for citedness score. This paper aims to examine the distinctive factors and results on calculation of citedness score of scholarly literatures between Science Citation Index Expanded and Scopus by adoption of

  16. Development of an animal model of selective coronary atherosclerosis

    NARCIS (Netherlands)

    Mihaylov, D; van Luyn, MJA; Rakhorst, G

    Background Atherosclerosis causes over 40% of all deaths in the USA and Western Europe. Although several hypotheses have been proposed, the etiology and pathogenesis of the atherosclerosis remain unknown. Objective To develop a model of selective coronary atherosclerosis in pigs. Design An animal

  17. Microparticle-Induced Coagulation Relates to Coronary Artery Atherosclerosis in Severe Aortic Valve Stenosis.

    Directory of Open Access Journals (Sweden)

    Patrick Horn

    Full Text Available Circulating microparticles (MPs derived from endothelial cells and blood cells bear procoagulant activity and promote thrombin generation. Thrombin exerts proinflammatory effects mediating the progression of atherosclerosis. Aortic valve stenosis may represent an atherosclerosis-like process involving both the aortic valve and the vascular system. The aim of this study was to investigate whether MP-induced thrombin generation is related to coronary atherosclerosis and aortic valve calcification.In a cross-sectional study of 55 patients with severe aortic valve stenosis, we assessed the coronary calcification score (CAC as indicator of total coronary atherosclerosis burden, and aortic valve calcification (AVC by computed tomography. Thrombin-antithrombin complex (TATc levels were measured as a marker for thrombin formation. Circulating MPs were characterized by flow cytometry according to the expression of established surface antigens and by measuring MP-induced thrombin generation.Patients with CAC score below the median were classified as patients with low CAC, patients with CAC Score above the median as high CAC. In patients with high CAC compared to patients with low CAC we detected higher levels of TATc, platelet-derived MPs (PMPs, endothelial-derived MPs (EMPs and MP-induced thrombin generation. Increased level of PMPs and MP-induced thrombin generation were independent predictors for the severity of CAC. In contrast, AVC Score did not differ between patients with high and low CAC and did neither correlate with MPs levels nor with MP-induced thrombin generation.In patients with severe aortic valve stenosis MP-induced thrombin generation was independently associated with the severity of CAC but not AVC indicating different pathomechanisms involved in coronary artery and aortic valve calcification.

  18. Evaluation of Selected Atherosclerosis Risk Factors in Women with Subclinical Hypothyroidism Treated with L-Thyroxine.

    Science.gov (United States)

    Adamarczuk-Janczyszyn, Maria; Zdrojowy-Wełna, Aleksandra; Rogala, Natalia; Zatońska, Katarzyna; Bednarek-Tupikowska, Grażyna

    2016-01-01

    Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors. The study group consisted of 187 obese women aged between 50 and 70 years: 100 women with SCH, 45 women with overt hypothyroidism and 42 women with TSH level in reference ranges. Anthropometric parameters were evaluated. Laboratory tests included thyroid hormones concentrations, lipid profile with apolipoproteins, CRP, homocysteine. Atherosclerotic indexes were calculated: LDL C/HDL C ratio, apoA1/apoB ratio and Castelli risk index. Women with hypothyroidism were given L-thyroxine treatment and after 6 months in euthyroidism the evaluation was repeated. Total cholesterol, LDL-cholesterol and triglycerides concentrations as well as LDL-C/HDL-C ratio and Castelli index were higher in SCH than in controls and decreased after L-thyroxin substitution. All of the calculated atherosclerosis indexes showed significant positive correlations with TSH concentration in SCH group. Also in this group the systolic and diastolic blood pressure decreased significantly after treatment. Dyslipidemia in obese SCH women is not severe, but if untreated for many years, it may lead to atherosclerosis. Substitution therapy improves the lipid profile, changing the relations between protective and proatherogenic fractions of serum lipids, and optimises blood pressure.

  19. Cardiovascular Event Prediction by Machine Learning: The Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ambale-Venkatesh, Bharath; Yang, Xiaoying; Wu, Colin O; Liu, Kiang; Hundley, W Gregory; McClelland, Robyn; Gomes, Antoinette S; Folsom, Aaron R; Shea, Steven; Guallar, Eliseo; Bluemke, David A; Lima, João A C

    2017-10-13

    Machine learning may be useful to characterize cardiovascular risk, predict outcomes, and identify biomarkers in population studies. To test the ability of random survival forests, a machine learning technique, to predict 6 cardiovascular outcomes in comparison to standard cardiovascular risk scores. We included participants from the MESA (Multi-Ethnic Study of Atherosclerosis). Baseline measurements were used to predict cardiovascular outcomes over 12 years of follow-up. MESA was designed to study progression of subclinical disease to cardiovascular events where participants were initially free of cardiovascular disease. All 6814 participants from MESA, aged 45 to 84 years, from 4 ethnicities, and 6 centers across the United States were included. Seven-hundred thirty-five variables from imaging and noninvasive tests, questionnaires, and biomarker panels were obtained. We used the random survival forests technique to identify the top-20 predictors of each outcome. Imaging, electrocardiography, and serum biomarkers featured heavily on the top-20 lists as opposed to traditional cardiovascular risk factors. Age was the most important predictor for all-cause mortality. Fasting glucose levels and carotid ultrasonography measures were important predictors of stroke. Coronary Artery Calcium score was the most important predictor of coronary heart disease and all atherosclerotic cardiovascular disease combined outcomes. Left ventricular structure and function and cardiac troponin-T were among the top predictors for incident heart failure. Creatinine, age, and ankle-brachial index were among the top predictors of atrial fibrillation. TNF-α (tissue necrosis factor-α) and IL (interleukin)-2 soluble receptors and NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) levels were important across all outcomes. The random survival forests technique performed better than established risk scores with increased prediction accuracy (decreased Brier score by 10%-25%). Machine

  20. Individual pathogens, pathogen burden, and markers of subclinical atherosclerosis: the Multi-Ethnic Study of Atherosclerosis

    Science.gov (United States)

    Szklo, Moyses; Ding, Jingzhong; Tsai, Michael Y.; Cushman, Mary; Polak, Joseph F.; Lima, João; Barr, R. Graham; Sharrett, A. Richey

    2009-01-01

    We examined the cross-sectional relationships of subclinical atherosclerosis – expressed by carotid intimal–medial thickness and coronary calcification – with antibodies to Chlamydia pneumoniae, Helicobacter pylori, cytomegalovirus, herpes simplex virus, hepatitis A virus, and pathogen burden (number of positive pathogens). A random sample of 1056 individuals chosen from 5030 Multi-Ethnic Study of Atherosclerosis cohort participants were included. After multiple adjustment, no associations were found between atherosclerosis measures and either individual pathogens or pathogen burden. Interactions with inflammatory and endothelial function markers, demographic factors, BMI, high-density lipoprotein, diabetes, and smoking were also explored. The only interaction that was large, qualitative, statistically significant (P subclinical atherosclerosis. However, the study’s limitations, which include its cross-sectional design and insufficient statistical power, suggest that inferences from its findings should be made cautiously. PMID:19444130

  1. Aspirin and the risk of cardiovascular events in atherosclerosis patients with and without prior ischemic events.

    Science.gov (United States)

    Bavry, Anthony A; Elgendy, Islam Y; Elbez, Yedid; Mahmoud, Ahmed N; Sorbets, Emmanuel; Steg, Philippe Gabriel; Bhatt, Deepak L

    2017-09-01

    The benefit of aspirin among patients with stable atherosclerosis without a prior ischemic event is not well defined. Aspirin would be of benefit in outpatients with atherosclerosis with prior ischemic events, but not in those without ischemic events. Subjects from the Reduction of Atherothrombosis for Continued Health registry were divided according to prior ischemic event (n =21 724) vs stable atherosclerosis, but no prior ischemic event (n = 11 872). Analyses were propensity score matched. Aspirin use was updated at each clinic visit and considered as a time-varying covariate. The primary outcome was the first occurrence of cardiovascular death, myocardial infarction, or stroke. In the group with a prior ischemic event, aspirin use was associated with a marginally lower risk of the primary outcome at a median of 41 months (hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.65-1.01, P = 0.06). In the group without a prior ischemic event, aspirin use was not associated with a lower risk of the primary outcome at a median of 36 months (HR: 1.03, 95% CI: 0.73-1.45, P = 0.86). In this observational analysis of outpatients with stable atherosclerosis, aspirin was marginally beneficial among patients with a prior ischemic event; however, there was no apparent benefit among those with no prior ischemic event. © 2017 Wiley Periodicals, Inc.

  2. Evaluation of carotid intima-media thickness in children with migraine: a marker of subclinical atherosclerosis.

    Science.gov (United States)

    Poyrazoglu, Hatice Gamze; Vurdem, Umit Erkan; Arslan, Alev; Uytun, Salih

    2016-10-01

    Migraine is a commonly seen neurovascular disorder during childhood. Inflammation induced by the activation of cytokines and neuropeptides is implied in its pathophysiology. There is an association between inflammation and atherosclerosis in patients with migraine. In addition, there is a strong correlation between early atherosclerotic wall lesions and carotid intima-media thickness (CIMT). The study population consisted of 57 migraine patients aged 5-17 years, as well as 47 healthy children who served as the control group. Those migraine patients who were not receiving any medications at the interictal period were compared to healthy controls in terms of their measured lipid levels, thyroid function, vitamin B12 levels, serum iron levels, iron binding capacity, complete blood count, C-reactive protein (CRP) levels, and carotid intima-media thickness (CIMT) scores, which may comprise risk factors for atherosclerosis. When children in the migraine and control groups were compared in terms of those risk factors that are known to be related to vascular changes, no significant differences were found. However, a significant difference was detected in CIMT values (P Atherosclerosis commences in childhood, and there is a long period of time before the onset of ischemic symptoms occurs. In children with migraine, an evaluation of CIMT can be used as a non-invasive imaging modality to detect atherosclerosis, which develops in the context of chronic inflammation. In this way, measures to reduce morbidity and mortality, which may result from cardiovascular diseases, can be implemented.

  3. A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity.

    Science.gov (United States)

    Boesen, Mari E; Singh, Dilip; Menon, Bijoy K; Frayne, Richard

    2015-11-01

    This systematic literature review sought to determine the effects of carotid atherosclerotic plaque on local arterial stiffness. MedLine, EMBASE, and grey literature were searched with the following term: ("atherosclerosis" or "carotid atherosclerosis" or "carotid artery disease" or "carotid plaque") AND ("distensibility" or "elasticity" or "stiffness" or "compliance") NOT ("pulse wave velocity" or "PWV" or "carotid-ankle" or "ankle-brachial" or "augmentation index" or "cardio-ankle" or "CAVI" or "flow mediated dilation" or "FMD"). Results were restricted to English language articles reporting local arterial stiffness in human subjects with carotid atherosclerosis. Of the 1466 search results, 1085 abstracts were screened and 191 full-text articles were reviewed for relevance. The results of the 50 studies that assessed some measure of carotid arterial elasticity or stiffness in patients with carotid plaque were synthesized and reviewed. A number of different measures of carotid elasticity were found in the literature. Regardless of which metric was used, the majority of studies found increased carotid stiffness (or decreased distensibility) to be associated with carotid plaque presence, the degree of atherosclerosis, and incident stroke. Carotid artery mechanics are influenced by the presence of atherosclerotic plaque. The clinical applicability of carotid elasticity measures may be limited by the lack of reference values and standardized techniques. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. On epigenetic regulation in atherosclerosis pathology

    NARCIS (Netherlands)

    Wierda, Rutger Jeen

    2015-01-01

    Atherosclerosis is one of the primary causes of cardiovascular disease; the number one cause of death in the western society. Atherosclerotic plaque formation is a dynamic multi-cellular process where regulation of different genes essentially determines the activity of the different cell types

  5. Inherited disorders of HDL metabolism and atherosclerosis

    NARCIS (Netherlands)

    Hovingh, G Kees; de Groot, E.P.; van der Steeg, Wim; Boekholdt, S Matthijs; Hutten, Barbara A; Kuivenhoven, J.A.; Kastelein, John J P

    PURPOSE OF REVIEW: Genetic disorders of HDL metabolism are rare and, as a result, the assessment of atherosclerosis risk in individuals suffering from these disorders has been difficult. Ultrasound imaging of carotid arteries has provided a tool to assess the risk in hereditary hypo and

  6. Effects of apolipoprotein M in uremic atherosclerosis

    DEFF Research Database (Denmark)

    Bosteen, Markus Høybye; Madsen Svarrer, Eva Martha; Bisgaard, Line Stattau

    2017-01-01

    BACKGROUND AND AIMS: Chronic kidney disease is characterized by uremia and causes premature death, partly due to accelerated atherosclerosis. Apolipoprotein (apo) M is a plasma carrier protein for the lipid sphingosine-1-phosphate (S1P). The Apom-S1P complex associates with HDL, and may contribute...

  7. Crosstalk between apoptosis and inflammation in atherosclerosis

    NARCIS (Netherlands)

    Westra, Marijke Marianne

    2010-01-01

    In this thesis the role of several apoptosis regulating proteins in the development of atherosclerosis and atherosclerotic plaque stability is investigated. Apoptosis of different cell types in atherosclerotic plaques, such as macrophages and smooth muscle cells may inhibit or promote plaque

  8. Cyanotic congenital heart disease and atherosclerosis

    DEFF Research Database (Denmark)

    Tarp, Julie Bjerre; Jensen, Annette Schophuus; Engstrøm, Thomas

    2017-01-01

    Improved treatment options in paediatric cardiology and congenital heart surgery have resulted in an ageing population of patients with cyanotic congenital heart disease (CCHD). The risk of acquired heart disease such as atherosclerosis increases with age.Previous studies have speculated whether...

  9. Cytokines and Immune Responses in Murine Atherosclerosis

    NARCIS (Netherlands)

    Kusters, Pascal J. H.; Lutgens, Esther

    2015-01-01

    Atherosclerosis is an inflammatory disease of the vessel wall characterized by activation of the innate immune system, with macrophages as the main players, as well as the adaptive immune system, characterized by a Th1-dominant immune response. Cytokines play a major role in the initiation and

  10. Subclinical cardiovascular disease assessment and its relationship with cardiovascular risk SCORE in a healthy adult population: A cross-sectional community-based study.

    Science.gov (United States)

    Mitu, Ovidiu; Roca, Mihai; Floria, Mariana; Petris, Antoniu Octavian; Graur, Mariana; Mitu, Florin

    The aim of this study is to evaluate the relationship and the accuracy of SCORE (Systematic Coronary Risk Evaluation Project) risk correlated to multiple methods for determining subclinical cardiovascular disease (CVD) in a healthy population. This cross-sectional study included 120 completely asymptomatic subjects, with an age range 35-75 years, and randomly selected from the general population. The individuals were evaluated clinically and biochemical, and the SCORE risk was computed. Subclinical atherosclerosis was assessed by various methods: carotid ultrasound for intima-media thickness (cIMT) and plaque detection; aortic pulse wave velocity (aPWV); echocardiography - left ventricular mass index (LVMI) and aortic atheromatosis (AA); ankle-brachial index (ABI). SCORE mean value was 2.95±2.71, with 76% of subjects having SCORE <5. Sixty-four percent of all subjects have had increased subclinical CVD changes, and SCORE risk score was correlated positively with all markers, except for ABI. In the multivariate analysis, increased cIMT and aPWV were significantly associated with high value of SCORE risk (OR 4.14, 95% CI: 1.42-12.15, p=0.009; respectively OR 1.41, 95% CI: 1.01-1.96, p=0.039). A positive linear relationship was observed between 3 territories of subclinical CVD (cIMT, LVMI, aPWV) and SCORE risk (p<0.0001). There was evidence of subclinical CVD in 60% of subjects with a SCORE value <5. As most subjects with a SCORE value <5 have subclinical CVD abnormalities, a more tailored subclinical CVD primary prevention program should be encouraged. Copyright © 2016 Sociedad Española de Arteriosclerosis. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Atherogenic index of plasma as useful predictor of cardiovascular ...

    African Journals Online (AJOL)

    as the duration of menopause increased. Conclusion: Menopause, no doubt alters lipid profile. A triglyceride based index (AIP) can significantly add value when assessing the risk of developing atherosclerosis in Nigeria. Key Words: Lipid profile, atherogenic index of plasma (AIP), postmenopausal women, dyslipidaemia, ...

  12. Metabolic syndrome: the danger signal in atherosclerosis

    Directory of Open Access Journals (Sweden)

    Patrick Mathieu

    2006-09-01

    Full Text Available Patrick Mathieu1, Philippe Pibarot2, Jean-Pierre Després31Department of Surgery, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, Canada; 2Department of Medicine, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, Canada; 3Department of Social and Preventive Medicine, Centre de Recherche de l’Hôpital Laval/Institut de Cardiologie de Québec, Québec, CanadaAbstract: Atherosclerosis is a chronic inflammatory disease characterized by infiltration of blood vessels by lipids and leukocytes. There is a growing body of evidence that among risk factors that promote atherosclerosis, the metabolic syndrome is a powerful and prevalent predictor of cardiovascular events. The systemic inflammatory process associated with the metabolic syndrome has numerous deleterious effects that promote plaque activation, which is responsible for clinical events. Interactions between the innate immune system with lipidderived products seem to play a major role in the pathophysiology of atherosclerosis in relation with the metabolic syndrome. The multiple links among adipose tissue, the vascular wall, and the immune system are the topics of this review, which examines the roles of oxidized low density lipoprotein, inflammatory cytokines, and adipokines in triggering and perpetuating a danger signal response that promotes the development of atherosclerosis. Furthermore, therapeutic options that specifically target the metabolic syndrome components are reviewed in light of recent developments. Keywords: atherosclerosis, inflammation, metabolic syndrome, innate immune system, danger signal theory

  13. Is Lipoprotein-Associated Phospholipase A2 a Link between Inflammation and Subclinical Atherosclerosis in Rheumatoid Arthritis?

    Directory of Open Access Journals (Sweden)

    Anna Södergren

    2015-01-01

    Full Text Available Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2, a marker of vascular inflammation, is associated with cardiovascular disease. This prospective study of an inception cohort aimed to investigate whether the level of Lp-PLA2 is associated with subclinical atherosclerosis in patients with rheumatoid arthritis (RA. Methods. Patients from northern Sweden diagnosed with early RA were consecutively recruited into an ongoing prospective study. From these, all patients ≤60 years (n=71 were included for measurements of subclinical atherosclerosis at inclusion (T0 and five years later (T5. Forty age- and sex-matched controls were included. The patients were clinically assessed, SCORE, Reynolds Risk Score, and Larsen score were calculated, and blood samples were drawn from all individuals at T0 and T5. Results. There was no significant difference in the level of Lp-PLA2 between patients with RA and controls (p>0.05. In simple linear regression models among patients with RA, Lp-PLA2 at T0 was significantly associated with intima media thickness (IMT at T0 and T5, flow mediated dilation (FMD at T0 and T5, ever smoking, male sex, HDL-cholesterol (inversely, non-HDL-cholesterol, SCORE, Reynolds Risk Score, and Larsen score (p<0.05. Conclusion. In this cohort of patients with early RA, the concentration of Lp-PLA2 was associated with both subclinical atherosclerosis and disease severity.

  14. Significance of good collateral compensation in symptomatic intracranial atherosclerosis.

    Science.gov (United States)

    Lau, Alexander Y L; Wong, Edward H C; Wong, Adrian; Mok, Vincent C T; Leung, Thomas W; Wong, Ka-sing Lawrence

    2012-01-01

    Collateral circulation stabilizes cerebral blood flow in patients with acute occlusion, but its prognostic role is less studied in intracranial atherosclerosis and appears different in moderate to severe stenosis. We aimed to study the associations between antegrade flow across stenosis, collateral flow via leptomeningeal anastomosis, and the neurological outcome and recurrence risk in patients with symptomatic intracranial stenosis. We examined a cohort of consecutive patients admitted for stroke or transient ischemic attack (TIA) with symptomatic intracranial stenosis confirmed by digital subtraction angiography in a single-center retrospective study. Angiograms were graded systematically in a blinded fashion for antegrade and collateral flow, using Thrombolysis in Cerebral Infarction (TICI) and American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading, respectively, and integrated to a simple composite circulation score. Demographic and clinical variables, modified Rankin Scale (mRS) scores at 3 months, recurrent stroke or TIA in 12 months were collected. Uni- and multivariate analyses were performed to identify independent predictors of good outcome (mRS 0-2) and recurrence in a logistic regression model. Among 69 patients with pure intracranial atherosclerosis ≥ 50%, compromised antegrade flow (TICI 0-2a) was observed in 26 (36%) patients and was associated with more severe arterial stenosis (mean 86 vs. 74%, p = 0.001). Poor collateral compensation resulting in a poor composite circulation score was observed in 8 (12%) patients. Patients with a good circulation score (n = 61, 88%) had preserved flow, which was associated with more favorable outcome (OR 7.50, 95% CI 1.11-50.7, p = 0.04) and less recurrent TIA or stroke (OR 0.18, 95% CI 0.04-0.96, p = 0.04). Prognosis was not significantly associated with antegrade or collateral grade per se. Good collateral compensations are more important in

  15. Relationship Between Lifelong Exercise Volume and Coronary Atherosclerosis in Athletes.

    Science.gov (United States)

    Aengevaeren, Vincent L; Mosterd, Arend; Braber, Thijs L; Prakken, Niek H J; Doevendans, Pieter A; Grobbee, Diederick E; Thompson, Paul D; Eijsvogels, Thijs M H; Velthuis, Birgitta K

    2017-07-11

    Higher levels of physical activity are associated with a lower risk of cardiovascular events. Nevertheless, there is debate on the dose-response relationship of exercise and cardiovascular disease outcomes and whether high volumes of exercise may accelerate coronary atherosclerosis. We aimed to determine the relationship between lifelong exercise volumes and coronary atherosclerosis. Middle-aged men engaged in competitive or recreational leisure sports underwent a noncontrast and contrast-enhanced computed tomography scan to assess coronary artery calcification (CAC) and plaque characteristics. Participants reported lifelong exercise history patterns. Exercise volumes were multiplied by metabolic equivalent of task (MET) scores to calculate MET-minutes per week. Participants' activity was categorized as 2000 MET-min/wk. A total of 284 men (age, 55±7 years) were included. CAC was present in 150 of 284 participants (53%) with a median CAC score of 35.8 (interquartile range, 9.3-145.8). Athletes with a lifelong exercise volume >2000 MET-min/wk (n=75) had a significantly higher CAC score (9.4 [interquartile range, 0-60.9] versus 0 [interquartile range, 0-43.5]; P=0.02) and prevalence of CAC (68%; adjusted odds ratio [ORadjusted]=3.2; 95% confidence interval [CI], 1.6-6.6) and plaque (77%; ORadjusted=3.3; 95% CI, 1.6-7.1) compared with exercise (≥9 MET) was associated with CAC (ORadjusted=1.47; 95% CI, 1.14-1.91) and plaque (ORadjusted=1.56; 95% CI, 1.17-2.08). Among participants with CAC>0, there was no difference in CAC score (P=0.20), area (P=0.21), density (P=0.25), and regions of interest (P=0.20) across exercise volume groups. Among participants with plaque, the most active group (>2000 MET-min/wk) had a lower prevalence of mixed plaques (48% versus 69%; ORadjusted=0.35; 95% CI, 0.15-0.85) and more often had only calcified plaques (38% versus 16%; ORadjusted=3.57; 95% CI, 1.28-9.97) compared with the least active group (2000 MET-min/wk group had a higher

  16. Age-Related Effects of Bariatric Surgery on Early Atherosclerosis and Cardiovascular Risk Reduction.

    Science.gov (United States)

    Jonker, Frederik H W; van Houten, Vera A A; Wijngaarden, Leontine H; Klaassen, René A; de Smet, André A E A; Niezen, André; Schelfhout, Lodewijk J D M; Bruning, Tobias A; van der Harst, Erwin

    2017-10-17

    Carotid intima-media thickness (CIMT) is increasingly used as a prognostic indicator for early atherosclerosis and the development of cardiovascular disease. The objective of this study is to assess the exact effects of bariatric surgery on CIMT reduction in different age groups. CIMT was measured just proximal to the bifurcation of the carotid artery in 166 patients with mean body mass index of 43.4 kg/m2 before and at 6 and 12 months after bariatric surgery. Preoperative CIMT and Framingham Risk Score (FRS) were compared to measurements at 6 and 12 months, postoperatively. Impact of age on CIMT change and cardiovascular risk reduction was analyzed. Median follow-up was 12 months; 12% were lost to follow-up. Mean CIMT values at 12 months after bariatric surgery were significantly lower compared to baseline (0.619 vs. 0.587 mm, p = 0.005 in women and 0.675 vs. 0.622 mm, p = 0.037 in men, respectively), and these effects were statistically significant in all age groups. The mean reduction of CIMT for patients bariatric surgery, FRS had decreased with 52% in patients Bariatric surgery resulted in a significant CIMT decrease in patients with morbid obesity in all evaluated age categories. These beneficial effects of bariatric surgery were more pronounced in younger patients, while cardiovascular risk reduction by bariatric surgery appeared inferior in patients of 50 years and older.

  17. The Effect of Weight History on Glucose and Lipids: The Atherosclerosis Risk in Communities Study

    OpenAIRE

    Truesdale, Kimberly P.; STEVENS, JUNE; Cai, JianWen

    2005-01-01

    Few studies have examined the impact of weight history. Extant data from the Atherosclerosis Risk in Communities Study were used to compare risk factors for normal-weight (body mass index: 18.5–24.9 kg/m2) adults with a history of weight loss (n = 775) with those for persons with a history of weight maintenance (n = 5,164). In this 1987–1998 US study, the authors also compared risk factors for preobese (body mass index: 25.0–29.9 kg/m2) adults with a history of weight gain (n = 1,296) versus ...

  18. Markers of subclinical atherosclerosis in patients with aortic valve sclerosis: A meta-analysis of literature studies.

    Science.gov (United States)

    Di Minno, Matteo Nicola Dario; Di Minno, Alessandro; Songia, Paola; Ambrosino, Pasquale; Gripari, Paola; Ravani, Alessio; Pepi, Mauro; Rubba, Paolo Osvaldo; Medda, Emanuela; Tremoli, Elena; Baldassarre, Damiano; Poggio, Paolo

    2016-11-15

    Growing evidence suggested an association between aortic valve sclerosis (AVSc) and cardiovascular (CV) events. However, little is known about the association of AVSc with major markers of subclinical atherosclerosis. We performed a meta-analysis of literature studies to address this issue. Studies on the relationship between AVSc and common carotid artery intima-media thickness (IMT), prevalence of carotid plaques (CPs), flow-mediated dilation (FMD), aortic pulse wave velocity (PWV) and augmentation index (AIx) were systematically searched in electronic databases. Thirteen studies enrolling 1086 AVSc patients and 2124 controls were included. Compared to controls, AVSc patients showed higher IMT (MD: 0.32mm; 95%CI: 0.07, 0.58; p=0.014), and higher prevalence of CPs (OR: 4.06; 95%CI: 2.38, 6.93; psubclinical atherosclerosis, thus supporting the concept that AVSc and atherosclerosis share common etiopathological mechanism and/or risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. The Neighborhood Social Environment and Objective Measures of Sleep in the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Johnson, Dayna A; Simonelli, Guido; Moore, Kari; Billings, Martha; Mujahid, Mahasin S; Rueschman, Michael; Kawachi, Ichiro; Redline, Susan; Diez Roux, Ana V; Patel, Sanjay R

    2017-01-01

    To investigate cross-sectional associations of neighborhood social environment (social cohesion, safety) with objective measures of sleep duration, timing, and disturbances. A racially/ethnically diverse population of men and women (N = 1949) aged 54 to 93 years participating in the Multi-Ethnic Study of Atherosclerosis Sleep and Neighborhood Ancillary studies. Participants underwent 1-week actigraphy between 2010 and 2013. Measures of sleep duration, timing, and disruption were averaged over all days. Neighborhood characteristics were assessed via questionnaires administered to participants and an independent sample within the same neighborhood and aggregated at the neighborhood (census tract, N = 783) level using empirical Bayes estimation. Multilevel linear regression models were used to assess the association between the neighborhood social environment and each sleep outcome. Neighborhood social environment characterized by higher levels of social cohesion and safety were associated with longer sleep duration and earlier sleep midpoint. Each 1 standard deviation higher neighborhood social environment score was associated with 6.1 minutes longer [95% confidence interval (CI): 2.0, 10.2] sleep duration and 6.4 minutes earlier (CI: 2.2, 10.6) sleep midpoint after adjustment for age, sex, race, socioeconomic status, and marital status. These associations persisted after adjustment for other risk factors. Neighborhood social factors were not associated with sleep efficiency or sleep fragmentation index. A more favorable neighborhood social environment is associated with longer objectively measured sleep duration and earlier sleep timing. Intervening on the neighborhood environment may improve sleep and subsequent health outcomes.

  20. Lower zinc bioavailability may be related to higher risk of subclinical atherosclerosis in Korean adults.

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    Su Kyoung Jung

    Full Text Available BACKGROUND: There is a proposed link between dietary zinc intake and atherosclerosis, but this relationship remains unclear. Phytate may contribute to this relationship by influencing zinc bioavailability. OBJECTIVE: The aim of this study is to examine the relationship between zinc bioavailability and subclinical atherosclerosis in healthy Korean adults. MATERIALS AND METHODS: The present cross-sectional analysis used baseline data from the Korean multi-Rural Communities Cohort Study (MRCohort, which is a part of The Korean Genome Epidemiology Study (KoGES. A total of 5,532 subjects (2,116 men and 3,416 women aged 40 years and older were recruited from rural communities in South Korea between 2005 and 2010. Phytate:zinc molar ratio, estimated from a food-based food frequency questionnaire (FFQ of 106 food items, was used to determine zinc bioavailability, and carotid intima media thickness (cIMT and pulse wave velocity (PWV were measured to calculate the subclinical atherosclerotic index. RESULTS: We found that phytate:zinc molar ratio is positively related to cIMT in men. A higher phytate:zinc molar ratio was significantly related to an increased risk of atherosclerosis in men, defined as the 80(th percentile value of cIMT (5(th vs. 1(st quintile, OR = 2.11, 95% CI 1.42-3.15, P for trend = 0.0009, and especially in elderly men (5(th vs. 1(st quintile, OR = 2.58, 95% CI 1.52-4.37, P for trend = 0.0021. We found a positive relationship between phytate:zinc molar ratio and atherosclerosis risk among women aged 65 years or younger. Phytate:zinc molar ratio was not found to be related to PWV. CONCLUSIONS: Lower zinc bioavailability may be related to higher atherosclerosis risk.

  1. Rationale and protocol of a trial for prevention of diabetic atherosclerosis by using antiplatelet drugs: study of Diabetic Atherosclerosis Prevention by Cilostazol (DAPC study

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    Kawamori Ryuzo

    2006-08-01

    Full Text Available Abstract Background Secondary treatment of arteriosclerosis may be applicable for the primary prevention of atherosclerosis in diabetic patients. This prospective, 2-year follow-up study was designed to determine the efficacy and safety of antiplatelet therapy in the prevention of atherosclerosis of diabetic subjects. Methods Patients with type 2 diabetes and arteriosclerosis obliterans from the Eastern Asian countries were registered online and randomly assigned either to the aspirin group (81–100 mg/day or the cilostazol group (100–200 mg/day in this international, 2-year, prospective follow-up interventional study. Results The primary study endpoint was changes in right and left maximum intima-media thickness of the common carotid artery. Secondary endpoints include changes in right and left maximum intima-media thickness of the internal carotid artery; semiquantitative evaluation of cerebral infarction by magnetic resonance imaging; cardiovascular events including sudden death, stroke, transient cerebral ischemic attacks, acute myocardial infarction, angina, and progression of arteriosclerosis obliterans; overall death; withdrawal; and change in ankle-brachial pressure index. Conclusion This is the first study to use an online system that was developed in Asian countries for pooling data from an international clinical trial. These findings are expected to help in the prevention of diabetic atherosclerosis and subsequent cardiovascular and cerebrovascular disease.

  2. 17-β Estradiol reduces atherosclerosis without exacerbating lupus in ovariectomized systemic lupus erythematosus-susceptible LDLr−/− mice

    Science.gov (United States)

    Shelton, KA; Cline, JM; Cann, JA

    2013-01-01

    Objective To test the hypothesis that estrogen treatment in a radiation chimera mouse model of systemic lupus erythematosus (SLE) and atherosclerosis will increase SLE-associated atherosclerosis by increasing autoantibody production and inflammation. Methods We used a radiation chimera mouse model in which bone marrow from the polygenic B6.Sle1.2.3 model of SLE was transferred to the low density lipoprotein receptor knock out (LDLr−/−) model of atherosclerosis on a C57BL/6 background (Sle/LDLr−/−). Ovariectomized chimeric mice were treated for 10 weeks with either 5.6 ug/day of 17β-estradiol or placebo; outcomes included atherosclerosis plaque size, anti-dsDNA autoantibody production and renal pathology. Results Mean atherosclerosis plaque size was 67.4 ± 7.6% smaller in the estrogen treated group (patherosclerosis lesion size and either the renal histology score or UP:UC ratio in Sle/LDLr−/− mice. Conclusion These results indicate that 17β-estradiol is atheroprotective within the context of murine SLE independent of changes in serum cholesterol concentration, autoantibody concentration, or renal pathology. The SLE phenotype in Sle/LDLr−/− mice is not exacerbated by exogenous 17β-estradiol administration, and the reduced UP:UC ratio suggests a protective effect against lupus nephritis. PMID:23395521

  3. Longitudinal association between toenail selenium levels and measures of subclinical atherosclerosis: the CARDIA trace element study

    Science.gov (United States)

    Xun, Pengcheng; Liu, Kiang; Morris, J Steven; Daviglus, Martha L; He, Ka

    2010-01-01

    Objectives To examine the longitudinal association between toenail selenium levels and sub-clinical atherosclerosis over an 18-year period. Methods Toenail selenium concentrations were examined among 3112 Americans age 20–32 years in 1987 and measured by instrumental neutron-activation analysis. Subclinical atherosclerosis, including common, bulb and internal carotid intima-media thickness (CIMT), was measured in 2005 and coronary artery calcium (CAC) score in 2000 and 2005. General linear regression was developed examining the relation between toenail selenium levels and CIMTs, and logistic regression for repeated outcomes was employed estimating the risk of having CAC>0. Results After adjustment for potential confounders, no associations were observed between toenail selenium levels and CIMTs as well as CAC score. Comparing participants in the highest with the lowest quintile of selenium, the CIMT was 0.005mm (SE=0.008mm, Ptrend=0.39), 0.018mm (SE=0.019mm, Ptrend=0.49), and 0.017mm (SE=0.014mm, Ptrend=0.21) thicker measured in common, bulb and internal carotid, respectively. The adjusted odds ratio of having CAC>0 was 0.95 (95%CI: 0.67–1.35; Ptrend=0.999). Conclusions No associations were observed between toenail selenium and measures of subclinical atherosclerosis among American young adults. This study does not support an atherosclerotic mechanism of selenium for risk reduction of cardiovascular disease. PMID:20138620

  4. Conventional, emerging, heredity, lifestyle, and psychosocial coronary risk factors: relationships to subclinical atherosclerosis.

    Science.gov (United States)

    Taylor, Allen J; Arora, Navin S; Bindeman, Jody; Bhattari, Saroj; Feuerstein, Irwin M; O'malley, Patrick G

    2006-01-01

    The authors examined the relationship between calcified coronary atherosclerosis and an array of cardiovascular risk factors in sequential logistic models to determine the extent to which these markers overlap in their identification of patients at risk for developing coronary heart disease. The prevalence of coronary artery calcium using electron beam computed tomography was 19.4% in this cross-sectional study of a prospective, consecutive, screening cohort of 1999 healthy United States Army personnel (aged 39-50 years). The proportion of the total variance of coronary artery calcium explained by sequential logistic models incorporating conventional, emerging, hereditary, lifestyle, and psychosocial cardiovascular risk variables increased progressively from 9.7% to 14.5%. The best-fit logistic model for the prediction of coronary artery calcium identified age, male gender, Framingham risk score, total cholesterol, high-density lipoprotein cholesterol, triglycerides, smoking, a family history of coronary heart disease, white race, physical inactivity, and lower depression scores as significant independent correlates of coronary artery calcium. These data indicate that the explanatory power of models for atherosclerosis can be significantly improved with the use of emerging, heredity, lifestyle, and psychosocial factors. The large residual variance, however, supports the potential of atherosclerosis imaging to incrementally and independently identify coronary heart disease risk.

  5. Antiatherosclerotic and Cardioprotective Potential of Acacia senegal Seeds in Diet-Induced Atherosclerosis in Rabbits

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    Heera Ram

    2014-01-01

    Full Text Available Acacia senegal L. (Fabaceae seeds are essential ingredient of “Pachkutta,” a specific Rajasthani traditional food. The present study explored antiatherosclerotic and cardioprotective potential of Acacia senegal seed extract, if any, in hypercholesterolemic diet-induced atherosclerosis in rabbits. Atherosclerosis in rabbits was induced by feeding normal diet supplemented with oral administration of cholesterol (500 mg/kg body weight/day mixed with coconut oil for 15 days. Circulating total cholesterol (TC, HDL-cholesterol (HDL-C, LDL-cholesterol (LDL-C, triglycerides, and VLDL-cholesterol (VLDL-C levels; atherogenic index (AI; cardiac lipid peroxidation (LPO; planimetric studies of aortal wall; and histopathological studies of heart, aorta, kidney, and liver were performed. Apart from reduced atherosclerotic plaques in aorta (6.34±0.72 and increased lumen volume (51.65±3.66, administration with ethanolic extract of Acacia senegal seeds (500 mg/kg/day, p.o. for 45 days to atherosclerotic rabbits significantly lowered serum TC, LDL-C, triglyceride, and VLDL-C levels and atherogenic index as compared to control. Atherogenic diet-induced cardiac LPO and histopathological abnormalities in aorta wall, heart, kidney, and liver were reverted to normalcy by Acacia senegal seed extract administration. The findings of the present study reveal that Acacia senegal seed extract ameliorated diet-induced atherosclerosis and could be considered as lead in the development of novel therapeutics.

  6. Correlation of serum homocysteine levels with nerve injury and atherosclerosis in patients with stroke

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    Gai-Zhuang Liu

    2017-07-01

    Full Text Available Objective: To study the correlation of serum homocysteine levels with nerve injury and atherosclerosis in patients with stroke. Methods: Patients who were diagnosed with ischemic stroke in our hospital between January 2014 and December 2016 were selected and then divided into moderate-severe stenosis group (C group, mild stenosis group (B group and no stenosis group (A group according to carotid artery ultrasonography; healthy volunteers who received physical examination during the same period were chosen as control group. The serum levels of homocysteine, nerve injury indexes and atherosclerosis indexes were detected. Results: Serum Hcy, S100B, NSE, UCH-L1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels of C group, B group and A group were significantly higher than those of control group, and the severer the carotid stenosis, the higher the serum S100B, NSE, UCHL1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels; serum S100B, NSE, UCHL1, GFAP, FGF23, CD36, ox-LDL, MMP8 and MMP9 levels in stoke patients with high Hcy were significantly higher than those of patients with normal Hcy. Conclusions: Serum homocysteine levels increase in patients with stroke and are closely related to the nerve injury and atherosclerosis.

  7. Traumatic brain injury, coronary atherosclerosis and cardiovascular mortality.

    Science.gov (United States)

    Ahmadi, Naser; Hajsadeghi, Fereshteh; Yehuda, Rachel; Anderson, Nils; Garfield, David; Ludmer, Charles; Vaidya, Nutan

    2015-01-01

    Traumatic-brain-injury (TBI) is a devastating-condition resulting in cerebral edema and ischemia. This study investigates the association of mild-TBI (mTBI) to sub-clinical atherosclerosis and cardiovascular (CV) mortality. Five hundred and forty-three veterans without known coronary artery disease or diagnosed mental disorder, who underwent coronary artery calcium (CAC) scanning for clinical indications, were followed for a median of 4-years. Veterans' medical diagnoses and neuropsychiatric health status (mTBI vs non-mTBI) were evaluated using VA electronic medical records. CAC was defined as 0, 1-100, 101-400 and 400+. CAC was higher in mTBI, compared to without-mTBI (p mortality rate was 25% in mTBI and 10.5% in without-mTBI (p = 0.0001). Multivariable survival regression analyses revealed a significant-association between mTBI and CAC, with increased-risk of CV mortality (p mortality was 5.25 in mTBI & CAC > 0, compared to without-mTBI & CAC = 0 (p mortality was 2.25 for mTBI & CAC = 1-100, 4.93 for mTBI & CAC = 101-400 and 7.06 for mTBI & CAC ≥ 400, compared to matched CAC-categories without-mTBI (p mortality was 0.64 for mTBI, 0.69 for mTBI & PTSD, 0.85 for mTBI & CAC > 0 and 0.92 for the combination. The prognostication of mTBI to predict CV mortality is superior to the Framingham risk score. Also the combination of mTBI & PTSD provided incremental prognostic values to predict CV mortality (p atherosclerosis and independently predicts CV mortality.

  8. Role of gut microbiota in atherosclerosis

    DEFF Research Database (Denmark)

    Jonsson, Annika Lindskog; Bäckhed, Gert Fredrik

    2017-01-01

    describe three pathways by which microbiota might affect atherogenesis. First, local or distant infections might cause a harmful inflammatory response that aggravates plaque development or triggers plaque rupture. Second, metabolism of cholesterol and lipids by gut microbiota can affect the development...... of atherosclerotic plaques. Third, diet and specific components that are metabolized by gut microbiota can have various effects on atherosclerosis; for example, dietary fibre is beneficial, whereas the bacterial metabolite trimethylamine-N-oxide is considered harmful. Although specific bacterial taxa have been......Infections have been linked to the development of cardiovascular disease and atherosclerosis. Findings from the past decade have identified microbial ecosystems residing in different habitats of the human body that contribute to metabolic and cardiovascular-related disorders. In this Review, we...

  9. Prevention and Regression of Atherosclerosis: Emerging Treatments

    Directory of Open Access Journals (Sweden)

    Aliosvi Rodríguez Rodríguez

    2014-06-01

    Full Text Available Occlusive vascular diseases such as acute coronary syndrome, cerebral stroke, and peripheral arterial disease, represent a serious health problem worldwide. In recent decades, there has been significant progress in the diagnosis and treatment of atherosclerosis. Intravascular ultrasound imaging provides detailed information on the anatomy of the plaque and it has been used in several studies to evaluate the results. Atherosclerosis destabilizes the normal protective mechanism provided by the endothelium and this mechanism has been involved in the pathophysiology of acute coronary disease and brain stroke. Main efforts focus on prevention, especially at early ages. This paper is a review of 68 updated bibliographic citations in order to show the current options available for the prevention and reversal of the atherosclerotic process.

  10. Coronary atherosclerosis: Significance of autophagic armour.

    Science.gov (United States)

    Arora, Mansi; Kaul, Deepak

    2012-09-26

    Autophagy is a lysosomal degradation pathway of cellular components such as organelles and long-lived proteins. Though a protective role for autophagy has been established in various patho-physiologic conditions such as cancer, neurodegeneration, aging and heart failure, a growing body of evidence now reveals a protective role for autophagy in atherosclerosis, mainly by removing oxidatively damaged organelles and proteins and also by promoting cholesterol egress from the lipid-laden cells. Recent studies by Razani et al and Liao et al unravel novel pathways that might be involved in autophagic protection and in this commentary we highlight the importance of autophagy in atherosclerosis in the light of these two recent papers.

  11. THE GEOGRAPHIC PATHOLOGY OF CORONARY ATHEROSCLEROSIS.

    Science.gov (United States)

    SCOTT, R F; DAOUD, A S; LEE, K T

    1964-02-08

    The purpose of these studies was to find large groups with significantly less coronary atherosclerosis than New Yorkers and to investigate the possible reasons for these differences. Direct comparison of hearts and measurements of coronary artery wall thickness, autopsy series, and clinical diagnoses of outpatients and hospital admissions revealed that the amount of coronary atherosclerosis and the number of myocardial infarcts is significantly less in East and West Africans compared to New Yorkers matched for age and sex. The factors producing these differences are apparently operative in childhood. East Africans were found to have a shorter blood clot-lysis time, fewer venous (and arterial) thromboemboli and lower serum lipid levels, with a lower relative percentage of serum linoleates, than age-matched New Yorkers.

  12. Atherosclerosis and Nanotechnology: Diagnostic and Therapeutic Applications.

    Science.gov (United States)

    Kratz, Jeremy D; Chaddha, Ashish; Bhattacharjee, Somnath; Goonewardena, Sascha N

    2016-02-01

    Over the past several decades, tremendous advances have been made in the understanding, diagnosis, and treatment of coronary artery disease (CAD). However, with shifting demographics and evolving risk factors we now face new challenges that must be met in order to further advance are management of patients with CAD. In parallel with advances in our mechanistic appreciation of CAD and atherosclerosis, nanotechnology approaches have greatly expanded, offering the potential for significant improvements in our diagnostic and therapeutic management of CAD. To realize this potential we must go beyond to recognize new frontiers including knowledge gaps between understanding atherosclerosis to the translation of targeted molecular tools. This review highlights nanotechnology applications for imaging and therapeutic advancements in CAD.

  13. Dietary micronutrient intake and atherosclerosis in systemic lupus erythematosus.

    Science.gov (United States)

    Lourdudoss, C; Elkan, A-C; Hafström, I; Jogestrand, T; Gustafsson, T; van Vollenhoven, R; Frostegård, J

    2016-12-01

    The aim of this study was to investigate the role of dietary micronutrient intake in systemic lupus erythematosus (SLE). This study included 111 SLE patients and 118 age and gender-matched controls. Data on diet (food frequency questionnaires) were linked with data on Systemic Lupus Activity Measure, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and carotid atherosclerotic/echolucent plaque (B-mode ultrasound). Dietary micronutrient intake were compared between SLE patients and controls and in relation to lupus activity and atherosclerosis in SLE. Associations between micronutrient intake and plaque were analyzed through logistic regression, adjusted for potential confounders. Micronutrient intake did not differ between patients and controls, and between lower and higher lupus activity, apart from the fact that phosphorus was associated with SLEDAI > 6. In SLE patients, some micronutrients were associated with atherosclerotic plaque, left side. Lower intake of riboflavin and phosphorus was associated with atherosclerotic plaque, left side (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.12-8.40 and OR 4.36, 95% CI 1.53-12.39, respectively). Higher intake of selenium and thiamin was inversely associated with atherosclerotic plaque, left side (OR 0.28, 95% CI 0.09-0.89 and OR 0.26, 95% CI 0.08-0.80, respectively). In addition, higher intake of thiamin was inversely associated with echolucent plaque, left side (OR 0.22, 95% CI 0.06-0.84). Lower intake of folate was inversely associated with bilateral echolucent plaque (OR 0.36, 95% CI 0.13-0.99). SLE patients did not have different dietary micronutrient intake compared to controls. Phosphorus was associated with lupus activity. Riboflavin, phosphorus, selenium and thiamin were inversely associated with atherosclerotic plaque, left side in SLE patients, but not in controls. Dietary micronutrients may play a role in atherosclerosis in SLE. © The Author(s) 2016.

  14. The role of dysfunctional HDL in atherosclerosis.

    Science.gov (United States)

    Navab, Mohamad; Reddy, Srinivasa T; Van Lenten, Brian J; Anantharamaiah, G M; Fogelman, Alan M

    2009-04-01

    This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.

  15. The role of dysfunctional HDL in atherosclerosis

    OpenAIRE

    Navab, Mohamad; Reddy, Srinivasa T.; Van Lenten, Brian J.; Anantharamaiah, G. M.; Fogelman, Alan M.

    2009-01-01

    This review focuses on HDL function in modulating LDL oxidation and LDL-induced inflammation. Dysfunctional HDL has been identified in animal models and humans with chronic inflammatory diseases including atherosclerosis. The loss of antiinflammatory function correlated with a loss of function in reverse cholesterol transport. In animal models and perhaps in humans, dysfunctional HDL can be improved by apoA-I mimetic peptides that bind oxidized lipids with high affinity.

  16. [Enterosorbents in the treatment of atherosclerosis].

    Science.gov (United States)

    Piskun, R P; Pentiuk, A A; Serkova, V K; Polesia, T L; Savitskaia, E A

    1998-01-01

    The article lists, characterizes, and discusses the mechanism of the action of endosorbents possessing hypocholesteremic and hypolipidemic effects. Among them are natural endosorbents--food fibers (cellulose, hemicellulose, pectins, gum, mucus, lignin and chitin compounds, etc.); artificial specific affinin and nonspecific carbonic enterosorbents (carbonitrate family, granulated, fibrous), as well as silica (aerosil, polysorb). The effectiveness and pathogenetic expediency of correcting disorders of lipid metabolism in atherosclerosis with enterosorbents is substantiated.

  17. Functional promoter variant in zinc finger protein 202 predicts severe atherosclerosis and ischemic heart disease

    DEFF Research Database (Denmark)

    Frikke-Schmidt, R.; Nordestgaard, Børge; Grande, Peer

    2008-01-01

    association with IHD in 10,431 individuals from the Danish general population, the CCHS ( Copenhagen City Heart Study), including 1,511 incident IHD events during 28 years of follow-up. Results were verified in 2 independent case-control studies including, respectively, 942 and 1,549 cases with IHD and 8......Objectives This study was designed to test the hypotheses that single nucleotide polymorphisms ( SNPs), in zinc finger protein 202 ( ZNF202), predict severe atherosclerosis and ischemic heart disease ( IHD). Background ZNF202 is a transcriptional repressor controlling promoter elements in genes...... involved in vascular maintenance and lipid metabolism. Methods We first determined genotype association for 9 ZNF202 SNPs with severe atherosclerosis ( ankle brachial index >0.7 vs.

  18. Decreased natural killer cell activity is associated with atherosclerosis in elderly humans

    DEFF Research Database (Denmark)

    Bruunsgaard, H.; Pedersen, Agnes Nadelmann; Schroll, M.

    2001-01-01

    of elderly humans. It was tested if the potential of natural cytotoxicity in the blood (evaluated as an index including cytotoxicity per NK cell and the number of circulating NK cells) was preserved in 174 81-yearold humans versus 91 young controls and if NK cell mediated immunity was associated with age......-related inflammatory diseases such as atherosclerosis. Elderly people had decreased cytotoxicity per NK cell in short-term but not in long-term assays. Ca2+ independent cytotoxicity was unaltered, and NK cells maintained their cytotoxic responses to interleukin-2 and interferon-alpha signals. The decreased...... cytotoxicity per NK cell was not completely counteracted by increased circulating numbers of NK cells in the blood. Elderly people with severe medical disorders had low numbers of circulating NK cells. Furthermore, elderly people with atherosclerosis had low cytotoxicity per NK cell and a high number...

  19. Doinseunggitang Ameliorates Endothelial Dysfunction in Diabetic Atherosclerosis

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    Jung Joo Yoon

    2013-01-01

    Full Text Available Atherosclerosis, a chronic and progressive disease characterized by vascular inflammation, is a leading cause of death in diabetes patients. Doinseunggitang (DYSGT, traditional prescription, has been used for promoting blood circulation to remove blood stasis. The aim of this study was to investigate the beneficial effects of DYSGT on endothelial dysfunction in diabetic atherosclerosis animal model. Apolipoprotein E knockout (ApoE KO mice fed on a Western diet were treated with DYSGT (200 mg/kg/day. DYSGT significantly lowered blood glucose level and glucose tolerance as well as systolic blood pressure. Metabolic parameter showed that DYSGT markedly decreased triglyceride and LDL-cholesterol levels. In the thoracic aorta, the impairment of vasorelaxation response to acetylcholine and atherosclerotic lesion was attenuated by DYSGT. Furthermore, DYSGT restored the reduction of endothelial nitric oxide synthase (eNOS expression, leading to the inhibition of intracellular adhesion molecule-1 (ICAM-1 and endothelin-1 (ET-1 expression. In conclusion, DYSGT improved the development of diabetic atherosclerosis via attenuation of the endothelial dysfunction, possibly by inhibiting ET-1, cell adhesion molecules, and lesion formation. Therefore, these results suggest that Korean traditional prescription Doinseunggitang may be useful in the treatment and prevention of diabetic vascular complications.

  20. Gout in Older Adults: The Atherosclerosis Risk in Communities Study

    Science.gov (United States)

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Grams, Morgan; Baer, Alan N.; Coresh, Josef

    2016-01-01

    Background: It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age. Methods: We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population–based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model. Results: The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63–6.63) increased gout risk in older age. Conclusions: These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age. PMID:26714568