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Sample records for cardiovascular abnormalities clinical

  1. ABNORMAL CARDIOVASCULAR REFLEXES IN PATIENTS WITH ACHALASIA

    Institute of Scientific and Technical Information of China (English)

    戈峰; 李泽坚; 柯美云

    1994-01-01

    Using 3 non-invasive tests,abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia.Abnormalities of heart rate responses to the Valsalva maneuver,deep breathing ,and standing were moted in patients with autonomic neuropathy defect.The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.

  2. Clinical Observation of Patients with Cardiovascular Medicine Sugar Metabolic Abnormality%心血管内科患者糖代谢异常的临床观察

    Institute of Scientific and Technical Information of China (English)

    高学军

    2014-01-01

    Objective To analyze the clinical study of carbohydrate metabolism in Department of internal medicine, cardiovascular abnormality. Methods 82 patients of this hospital cardiovascular department of internal medicine patients, in which 32 cases were diagnosed as diabetic patients, 50 cases of non diabetic patients, wil give a fasting blood glucose test results as the control group, wil give the oral glucose tolerance test results as the study group, recording and analysis of two groups of diagnostic rate and accuracy. Results The study group detection diagnosis rate was significantly higher than the control group, with significant dif erence ( <0.05);the study group detection accuracy higher than that of the control group, with significant dif erence ( < 0.05). Conclusion The application of oral glucose tolerance test diagnosis rate and accuracy rate of abnormal glucose metabolism is high, can avoid missed diagnosis and misdiagnosis.%目的:分析心血管内科患者糖代谢异常的临床研究。方法对本院诊治的心血管内科患者82例,其中32例被确诊为糖尿病患者,非糖尿病患者有50例,将给予空腹血糖测试结果作为对照组,将给予口服葡萄糖耐量试验测试结果作为研究组,记录并分析两组诊断确诊率和准确性情况。结果研究组检测确诊率明显高于对照组,比较差异具有统计学意义(P<0.05);研究组检测准确性比对照组高,比较差异具有统计学意义(P<0.05)。结论应用口服葡萄糖耐量试验测试糖代谢异常的确诊率和准确性均较好,能够避免漏诊和误诊。

  3. Cardiovascular abnormalities with single dose of tapentadol

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    A Vachhani

    2014-01-01

    Full Text Available This case represents the development of dizziness, palpitation, tightness in chest, flushing, and tremor on consumption of a single dose of tapentadol (100 mg for acute lower back pain. The patient was admitted in the intensive cardiac care unit for continuous monitoring. At admission, electrocardiogram showed tachycardia (140/min along with ST segment elevation in second chest lead (V 2 . The patient was monitored and advised not to take further doses of tapentadol. He was discharged after 36 hours of admission. Tapentadol should be used cautiously in patients with cardiovascular diseases and receiving sympathomimetic drugs.

  4. Cardiovascular changes in cirrhosis: Pathogenesis and clinical implications

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    Al-Hamoudi Waleed

    2010-01-01

    Full Text Available Liver cirrhosis is associated with a wide range of cardiovascular abnormalities including hyperdynamic circulation, cirrhotic cardiomyopathy, and pulmonary vascular abnormalities. The pathogenic mechanisms of these cardiovascular changes are multifactorial and include neurohumoral and vascular dysregulations. Accumulating evidence suggests that cirrhosis-related cardiovascular abnormalities play a major role in the pathogenesis of multiple life-threatening complications including hepatorenal syndrome, ascites, spontaneous bacterial peritonitis, gastroesophageal varices, and hepatopulmonary syndrome. Treatment targeting the circulatory dysfunction in these patients may improve the short-term prognosis while awaiting liver transplantation. Careful fluid management in the immediate post-transplant period is extremely important to avoid cardiac-related complications. Liver transplantation results in correction of portal hypertension and reversal of all the pathophysiological mechanisms that lead to the cardiovascular abnormalities, resulting in restoration of a normal circulation. The following is a review of the pathogenesis and clinical implications of the cardiovascular changes in cirrhosis.

  5. Clinical observation of abnormal glucose metabolism in patients with cardiovascular department of Internal Medicine%心血管内科住院患者糖代谢异常的临床观察

    Institute of Scientific and Technical Information of China (English)

    李丽

    2015-01-01

    ObjectiveTo explore cardiovascular department of internal medicine hospitalized patients with abnormal glucose metabolism,understanding of abnormal glucose metabolism oncardiovascular effects of patient health,and better treatment of patients with cardiovasculardisease.MethodsIn our hospital in 2013 June~2014 year in March treated 200 cases ofcardiovascular department of internal medicine hospitalized patients as the research object,including 50 cases with clinical diagnosed with diabetes,the remaining 150 patients,were used toobserve the cardiovascular department of internal medicine sugar glucose metabolism of patients hospitalized for observation and analysis of tolerance test and fasting blood glucose detection two experimental methods.ResultsThe two test results show,in 200 patients with fasting blood glucose detection,diagnosis of abnormal glucose metabolism in 50 patients,and oral glucose tolerance test on the remaining 150 patients,diagnosed with abnormal glucose metabolism in 100 cases(67%) of the number of sampling experiment,by comparing with the glucose tolerance,test of cardiovascular patients blood glucose were detected,the rate of missed diagnosis of patients with greatly reduced.ConclusionThe oral glucose tolerance test glucose metabolism in patients with cardiovascular disease than that of fasting blood glucose test to conifrm the diagnosis of glucose metabolism in patients with cardiovascular disease rate is high,is worth in clinicaldetection of glucose metabolism of the patients,and vigorously promote the use of.%目的:探究心血管内科住院患者的糖代谢异常,了解糖代谢异常对心血管患者身体健康的影响,从而更好的治疗患者的心血管疾病。方法选取我院2013年6月~2014年3月收治的200例心血管内科住院的患者为研究对象,其中50例经过临床各项检查确诊为糖尿病,对剩余150例患者,分别采用葡萄糖耐量试验和空腹血糖检测实验方法对患者的

  6. Abnormalities in Alternative Splicing of Apoptotic Genes and Cardiovascular Diseases

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    Zodwa Dlamini

    2015-11-01

    Full Text Available Apoptosis is required for normal heart development in the embryo, but has also been shown to be an important factor in the occurrence of heart disease. Alternative splicing of apoptotic genes is currently emerging as a diagnostic and therapeutic target for heart disease. This review addresses the involvement of abnormalities in alternative splicing of apoptotic genes in cardiac disorders including cardiomyopathy, myocardial ischemia and heart failure. Many pro-apoptotic members of the Bcl-2 family have alternatively spliced isoforms that lack important active domains. These isoforms can play a negative regulatory role by binding to and inhibiting the pro-apoptotic forms. Alternative splicing is observed to be increased in various cardiovascular diseases with the level of alternate transcripts increasing elevated in diseased hearts compared to healthy subjects. In many cases these isoforms appear to be the underlying cause of the disease, while in others they may be induced in response to cardiovascular pathologies. Regardless of this, the detection of alternate splicing events in the heart can serve as useful diagnostic or prognostic tools, while those splicing events that seem to play a causative role in cardiovascular disease make attractive future drug targets.

  7. Early cardiovascular abnormalities in newly diagnosed obstructive sleep apnea

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    Jean-Philippe Baguet

    2009-12-01

    Full Text Available Jean-Philippe Baguet1, Marie Nadra1, Gilles Barone-Rochette1, Olivier Ormezzano1, Hélène Pierre1, Jean-Louis Pépin21Department of Cardiology, University Hospital, Grenoble, France; 2Sleep Laboratory, EFCR, University Hospital, Grenoble, FranceAbstract: Obstructive sleep apnea (OSA is associated with high cardiovascular morbidity and mortality. Recent studies have shown that it is associated with atherosclerosis and left ventricular dysfunction markers. The aim of this study was to assess the cardiovascular effects of OSA depending on its severity, in patients without clinically diagnosed cardiovascular disease. One hundred thirty newly diagnosed, nondiabetic OSA patients (mean age 49 ± 10 years, without vasoactive treatment were included. They underwent clinical and ambulatory blood pressure measurements, echocardiography, carotid ultrasound examination, and a carotid–femoral pulse wave velocity (PWV measurement. Seventy-five percent of the subjects were hypertensive according to the clinical or ambulatory measurement. More patients with the most severe forms (respiratory disturbance index >37/hour had a nondipper profile (52% vs 34%; P = 0.025 and their left ventricular mass was higher (40 ± 7 vs 36 ± 8 g/m, p = 0.014. This last parameter was independently and inversely associated with mean nocturnal oxygen saturation (P = 0.004. PWV and carotid intima-media thickness did not differ between one OSA severity group to another, but the prevalence of carotid hypertrophy was higher when mean SaO2 was below 93.5% (29.5 vs 16%; P = 0.05. Our study shows that in OSA patients without clinically diagnosed cardiovascular disease, there is a significant left ventricular and arterial effect, which is even more marked when OSA is severe.Keywords: obstructive sleep apnea, hypertension, left ventricular hypertrophy, intima-media thickness, arterial stiffness

  8. CARDIOVASCULAR ABNORMALITIES IN PATIENTS WITH HIV INFECTION: A BOLT IN BLUE

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    Anita

    2015-12-01

    Full Text Available One of the consistent findings among various studies on HIV has been simultaneous multiorgan dysfunction. Cardiovascular disorders are now most common cause of mortality worldwide. With more effective and widespread treatment of HIV in resource-rich settings, morbidity and mortality from non-AIDS-related events have surpassed those from AIDS-related events with cardiovascular diseases emerging as an important cause of death in HIV-infected patients relative to the decreasing incidence of opportunistic disease. Various studies have reported a 1.5-fold increase in the rate of cardiovascular events in HIV-infected individuals compared to control populations. MATERIAL AND METHODS The aim of the study was to the find the prevalence and types of different cardiovascular abnormalities in HIV positive patients and assess their association with CD4 counts. Consecutive 82 patients, HIV positive patients fulfilling the inclusion criteria and giving informed consent were included in the study. All patients were subjected to history taking and a detailed physical examination. Blood counts, renal function tests, lipid profile and CD4 counts were estimated and patients were subjected to 12-lead ECG, chest X-ray and 2D/Colour Doppler Echocardiogram. RESULTS Of the 82 patients studied 47.46% had evidence of cardiovascular involvement, out of which 12% had clinical features of heart failure while electrocardiographic changes were seen in 35% of patients in the form of sinus tachycardia (27%, QTc prolongation (10% and left sided chamber enlargements (6%. Echocardiographic abnormalities were noted in 39 patients (47.56% including fractional shortening associated with systolic dysfunction (26.8%. The mean CD4 count in patients with echocardiographic abnormalities was found to be 58.87±29.80, whereas in patients without echocardiographic abnormalities it was 136.53±38.80 (p<0.0001. CONCLUSION High frequencies of cardiac abnormalities, both symptomatic and

  9. Cardiovascular fitness in youth: association with obesity and metabolic abnormalities

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    Jaime Guixeres

    2014-06-01

    Full Text Available Therapies currently implemented for obesity are focused on nutritional aspects and on physical activity. In order to make physical activity a positive therapy instead of triggering disabilities it is relevant to accurately assess cardiovascular fitness. Objective: To assess the cardiovascular fitness by measuring the peak oxygen consumption and to asses their relationship with classical cardiometabolic parameters. Methods: A modified Balke protocol was applied to one hundred and twenty-six Caucasians (60% males, ranging between 9 and 16 years old, who underwent an assessment of obesity. The non-obese group consisted of healthy age and sex matched subjects who were invited to participate from the general population. Results: Significant differences in consumption of oxygen peak between non-obese and obese individuals were observed. In contrast, no significant differences existed between the categories of obesity. Furthermore in obese subjects consumption of oxygen peak was inversely correlated with parameters of cardiometabolic risk, particularly insulin and HOMA index. In addition, two predictive equations of consumption of oxygen peak, with an R² of 0.74 and 0.84, respectively, have been developed. Conclusion: The consumption of oxygen peak is a relevant clinical parameter that should be included in the routine clinical assessment of obese subjects. Therefore, it is crucial to make exercise tests more affordable which can be achieved by employing predictive equations.

  10. Cardiovascular Automatic Feedback Control Instrument for Rescuing Critical Patients With Abnormal Blood Pressure

    Institute of Scientific and Technical Information of China (English)

    Ge Yuzhi; Wu Zhiting; Sheng Guotai; Li Gang

    2006-01-01

    Objectives Most medical instruments are designed for diagnosis purpose but very few for clinical treatment. Our research aim is to design and develop a cardiovascular automatic feedback control instrument (CAFCI) for rescuing the critical patients with abnormal blood pressure.Methods The CAFCI was designed on the basis of abundant clinical experiences and on successful mathematic modeling of our experimental data. The blood pressure, pulmonary capillary wedge pressure,and rates of heart beat were measured and inputted into a computer and drugs were chosen by a doctor through a user-friendly interface with the computer.The responses to medication were rapidly acquired and feed back to the computer by automatic detection system in a close-loop system. The data were refreshed every 7.5 sec in order to regulate the speed and dosage of the medications that were given. Results The experimental results with ten dogs showed that the CAFCI system took samples promptly and accurately so that the targeted blood pressure could be reached reliably based on our input parameters and our designing requirements. Conclusions Since the dependability and accuracy of the CAFCI system are much superior to that of the traditional method, its clinical application to rescue the critical patient warrants evaluation in the future.

  11. Cardiovascular fitness in youth: association with obesity and metabolic abnormalities.

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    Guixeres, Jaime; Redon, Pau; Saiz, Javier; Alvarez, Julio; Torró, Maria Isabel; Cantero, Laura; Lurbe, Empar

    2014-06-01

    Las terapias que se implantan actualmente para la obesidad se centran en los aspectos nutricionales y sobre la actividad física. Con el fin de hacer que la actividad física sea una terapia positiva en vez de un desencadenador de discapacidades, es relevante evaluar de forma precisa el entrenamiento cardiovascular. Objetivo: evaluar el entrenamiento cardiovascular midiendo el consumo máximo de oxígeno y evaluar su relación con los parámetros cardiometabólicos clásicos. Métodos: se aplicó el protocolo modificado de Balke a 126 individuos caucásicos (60 % de varones), con edades entre 9 y 16 años, que se sometieron a una evaluación de obesidad. El grupo de no obesos consistía de individuos sanos, de la población general, emparejados por edad y sexo y a los que se les invitó a participar. Resultados: se observaron diferencias significativas en el consumo máximo de oxígeno entre los indiviudos obesos y no obesos. Por contra, no existían diferencias significativas entre las categorías de obesidad. Además, en los sujetos obesos, el consumo máximo de oxígeno se correlacionó de forma inversa con los parámetros de riesgo cardiometabólico, particularmente con la insulina y el índice HOMA. Además, se han desarrollado dos ecuaciones predictivas del consumo máximo de oxígeno con una R2 de 0,74 y de 0,84, respectivamente. Conclusión: el consumo máximo de oxígeno es un parámetro clínico relevante que debería incluirse en la evaluación clínica rutinaria de los sujetos obesos. Por lo tanto, es crucial hacer que las pruebas de esfuerzo sean más asequibles, que puedan alcanzarse empleando las ecuaciones predictivas.

  12. Association of Traditional Cardiovascular Risk Factors With Development of Major and Minor Electrocardiographic Abnormalities: A Systematic Review.

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    Healy, Caroline F; Lloyd-Jones, Donald M

    2016-01-01

    Electrocardiographic (ECG) abnormalities are prevalent in middle aged and are associated with risk of adverse cardiovascular events. It is unclear whether and to what extent traditional risk factors are associated with the development of ECG abnormalities. To determine whether traditional cardiovascular risk factors are associated with the presence or development of ECG abnormalities, we performed a systematic review of the English-language literature for cross-sectional and prospective studies examining associations between traditional cardiovascular risk factors and ECG abnormalities, including major and minor ECG abnormalities, isolated nonspecific ST-segment and T-wave abnormalities, other ST-segment and T-wave abnormalities, QT interval, Q waves, and QRS duration. Of the 202 papers initially identified, 19 were eligible for inclusion. We examined data analyzing risk factor associations with ECG abnormalities in individuals free of cardiovascular disease. For composite major or minor ECG abnormalities, black race, older age, higher blood pressure, use of antihypertensive medications, higher body mass index, diabetes, smoking, and evidence of left ventricular hypertrophy or higher left ventricular mass are the factors most commonly associated with prevalence and incidence. Risk factor associations differ somewhat according to types of specific ECG abnormalities. Because major and minor ECG abnormalities have important and independent prognostic significance, understanding the groups at risk for their development may inform prevention strategies focused on modifiable risk factors to reduce the burden of ECG abnormalities, which may in turn promote CVD prevention. PMID:27054606

  13. 特纳综合征的心血管异常%Cardiovascular abnormalities in patients with Turner's syndrome

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    朱燕林; 倪超; 郭立琳

    2011-01-01

    目的 分析遗传性疾病特纳综合征(TS)合并的先天性心血管异常.方法 回顾25例女性TS患者临床特点及先天性心血管异常类型,并分析各种异常在不同核型患者中的分布情况.结果 40%TS患者合并先天性心血管异常,包括主动脉二叶瓣畸形、二尖瓣/主动脉瓣冗长或脱垂、冠状静脉窦扩张、房室增大及心肌致密化不全.45,XO型患者先天性心血管畸形显著多于嵌合型(40%vs14%,Pvs(18±2)mm/m、(28±6)mm/mvs(18±2)mm/m,P<0.001].结论 严格筛查,TS患者先天性心血管异常以及合并存在的心血管疾病危险因素有助于预测TS患者心血管死亡风险.%Objective To analyse the cardiovascular abnormalities in patients with Turner's syndrome (TS). Methods Clinical features and cardiovascular abnormalities of 25 female patients with TS were analyzed according to karyotype. Results Congenital cardiovascular mafformations were detected in 40% of TS patients, including bicuspid aortic valve, mitral/aortic lengthy or prolapse, coronary sinus dilation, cardiac chamber dilation, and noncompaction of the ventricular myocardium. The patients with monosomy X had a higher incidence of cengenital cardiovascular malformation than those with mosaicism(40% vs 14%, P <0. 01 ). Aortic size index, including root and assending aorta were significantly greater in TS than the healthy contro[ (27 ± 5 ) mm/m2 vs ( 18 ± 2 ) mm/m2, (28 ± 6) mm/rn2 vs ( 18 ±2)mm/m2, P <0. 001 ]. Conclusion Regular evaluation of congenital cardiovascular malformations and accompanied risk factors may help to predict the risk of cardiovascular death.

  14. [Clinical characteristics of pancreatitis after cardiovascular surgery].

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    Ikegami, H; Sumiyoshi, T; Ishizuka, N; Ueda, M; Inaba, T; Hosoda, S; Aomi, S; Endo, M; Hashimoto, A; Koyanagi, H

    1995-10-01

    Increases in pancreatic enzyme levels after cardiovascular surgery were studied, and their clinical characteristics evaluated. The subjects were 128 patients who had undergone cardiovascular surgery (65 patients after valve replacement, 32 after coronary bypass surgery and 31 after aortic artificial graft replacement). The pancreatic enzyme (serum amylase and lypase) levels were monitored serially before and after operation, and amylase fractions were measured at their peaks. The relationships of the peak lypase level with underlying cardiac diseases, background factors, factors related to surgery, factors related to the extracorporeal circulation, presence or absence of symptoms, and treatments were examined. The amylase level exhibited biphasic changes consisting of a peak in which salivary glands amylase (S type) was dominant and a peak in which pancreatic amylase (P type) was dominant. The second peak coincided with the peak lypase and occurred mostly 3 to 10 days after operation. The peak lypase level exceeded the normal range in 78% of all the patients. It exceeded 564 U/l, 4 times the normal value in 28% of the patients, many of whom were symptomatic. So, we recommended that these cases should be treated as "postoperative pancreatitis". A high peak lypase level showed a significant correlation with the history of gallbladder and pancreatic diseases and diabetes mellitus among the background factors and emergency operation and the use of IABP among the surgery-related factors.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Non-cardiovascular findings in clinical cardiovascular magnetic resonance imaging in children

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    Ghadimi Mahani, Maryam [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Morani, Ajaykumar C. [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Lu, Jimmy C.; Dorfman, Adam L. [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, Ann Arbor, MI (United States); Fazeli Dehkordy, Soudabeh [University of Michigan Health System, C.S. Mott Children' s Hospital, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Providence Hospital and Medical Centers, Department of Graduate Medical Education, Southfield, MI (United States); Jeph, Sunil [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Geisinger Medical Center, Department of Radiology, Danville, PA (United States); Agarwal, Prachi P. [University of Michigan Health System, Department of Radiology, Division of Cardiothoracic Radiology, Ann Arbor, MI (United States)

    2016-04-15

    With increasing use of pediatric cardiovascular MRI, it is important for all imagers to become familiar with the spectrum of non-cardiovascular imaging findings that can be encountered. This study aims to ascertain the prevalence and nature of these findings in pediatric cardiovascular MRIs performed at our institution. We retrospectively evaluated reports of all cardiovascular MRI studies performed at our institute from January 2008 to October 2012 in patients younger than18 years. Most studies (98%) were jointly interpreted by a pediatric cardiologist and a radiologist. We reviewed the electronic medical records of all cases with non-cardiovascular findings, defined as any imaging finding outside the cardiovascular system. Non-cardiovascular findings were classified into significant and non-significant, based on whether they were known at the time of imaging or they required additional workup or a change in management. In 849 consecutive studies (mean age 9.7 ± 6.3 years), 145 non-cardiovascular findings were found in 140 studies (16.5% of total studies). Overall, 51.0% (74/145) of non-cardiovascular findings were in the abdomen, 30.3% (44/145) were in the chest, and 18.6% (27/145) were in the spine. A total of 19 significant non-cardiovascular findings were observed in 19 studies in individual patients (2.2% of total studies, 47% male, mean age 5.9 ± 6.7 years). Significant non-cardiovascular findings included hepatic adenoma, arterially enhancing focal liver lesions, asplenia, solitary kidney, pelvicaliectasis, renal cystic diseases, gastric distention, adrenal hemorrhage, lung hypoplasia, air space disease, bronchial narrowing, pneumomediastinum and retained surgical sponge. Non-cardiovascular findings were seen in 16.5% of cardiovascular MRI studies in children, of which 2.2% were clinically significant findings. Prevalence and nature of these non-cardiovascular findings are different from those reported in adults. Attention to these findings is important

  16. Pharmacogenetics in Cardiovascular Disease is there clinical relevance?

    NARCIS (Netherlands)

    Maitland-Van Der Zee, A.

    2014-01-01

    • Objectives: To give an up-to-date overview of the research in pharmacogenetics of cardiovascular disease, and the clinical implications of this research. • Methods: In this lecture I will focus on these groups cardiovascular drugs where many pharmacogenetics studies have been performed (including

  17. Clinical impact of ' in-treatment' wall motion abnormalities in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Cicala, S.; Simone, G. de; Wachtell, K.;

    2008-01-01

    Objectives Left ventricular systolic wall motion abnormalities have prognostic value. Whether wall motion detected by serial echocardiographic examinations predicts prognosis in hypertensive patients with left ventricular hypertrophy ( LVH) without clinically recognized atherosclerotic disease has...... to analyze the primary composite endpoint of cardiovascular death, MI, or stroke and, separately, for fatal and nonfatal MI and hospitalized heart failure. Results During a mean follow-up of 4.8 years, an event was recorded in 67 ( 9%) patients. In Cox models after adjusting for age, gender, treatment, blood...... In hypertensive patients with LVH and no history of cardiovascular disease, ' in- treatment' left ventricular wall motion abnormalities are associated with increased likelihood of subsequent cardiovascular events independent of age, gender, blood pressure lowering, treatment modality, and in- treatment left...

  18. Early renal abnormalities as an indicator of cardiovascular risk in type 2 diabetes.

    Science.gov (United States)

    Viazzi, Francesca; Bonino, Barbara; Ratto, Elena; De Cosmo, Salvatore; Pontremoli, Roberto

    2014-12-01

    Accurate assessment of cardiovascular (CV) risk is a prerequisite for devising effective therapeutic strategies in patients with type 2 diabetes (T2DM) as it allows to refine prognosis and treatment targets as well as the cost-benefit ratio for specific pharmacological interventions. The presence of subclinical vascular organ damage plays a well known role in determining overall risk and a wider use of low cost, easy to perform diagnostic tools to stratify CV risk is very much needed. Besides their well known prognostic value for progression to end stage renal disease (ESRD), subclinical renal abnormalities such as microalbuminuria and/or a slight reduction in estimation of glomerular filtration rate (eGFR), have been shown to be powerful, independent predictors of CV diseases in patients with T2DM. Through the combined evaluation of these two biomarkers of chronic kidney disease (CKD), clinicians can usefully and reliably get a perspective on global and CV outcome of their diabetic patients.

  19. Clinical Application of Stem Cells in the Cardiovascular System

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    Stamm, Christof; Klose, Kristin; Choi, Yeong-Hoon

    Regenerative medicine encompasses "tissue engineering" - the in vitro fabrication of tissues and/or organs using scaffold material and viable cells - and "cell therapy" - the transplantation or manipulation of cells in diseased tissue in vivo. In the cardiovascular system, tissue engineering strategies are being pursued for the development of viable replacement blood vessels, heart valves, patch material, cardiac pacemakers and contractile myocardium. Anecdotal clinical applications of such vessels, valves and patches have been described, but information on systematic studies of the performance of such implants is not available, yet. Cell therapy for cardiovascular regeneration, however, has been performed in large series of patients, and numerous clinical studies have produced sometimes conflicting results. The purpose of this chapter is to summarize the clinical experience with cell therapy for diseases of the cardiovascular system, and to analyse possible factors that may influence its outcome.

  20. Cardiovascular Pharmacokinetics, Pharmacodynamics, and Pharmacogenomics for the Clinical Practitioner.

    Science.gov (United States)

    Sleder, Anna T; Kalus, James; Lanfear, David E

    2016-01-01

    Current clinical cardiovascular practice requires a clinician to have a strong foundation in multiple aspects of pharmacology. Modern cardiovascular regimens are complex, and optimal management, application of evolving guidelines, and adoption of new therapies build off a more basic understanding of pharmacokinetics and pharmacodynamics. In addition, it is likely time to add a third pillar into this discussion, the expanding field of pharmacogenomics referring to the genetic influences on drug response. This field has increasing applications in medicine and clearly holds significant promise for cardiovascular disease management. Awareness of pharmacogenomic advances and the fundamentals of pharmacokinetics and pharmacodynamics can help the clinician more easily deliver great care. Here we attempt to briefly summarize and simplify key concepts of pharmacokinetics, pharmacodynamics, and pharmacogenomics relevant to the cardiovascular disease practitioner.

  1. Rare DNA copy number variants in cardiovascular malformations with extracardiac abnormalities.

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    Lalani, Seema R; Shaw, Chad; Wang, Xueqing; Patel, Ankita; Patterson, Lance W; Kolodziejska, Katarzyna; Szafranski, Przemyslaw; Ou, Zhishuo; Tian, Qi; Kang, Sung-Hae L; Jinnah, Amina; Ali, Sophia; Malik, Aamir; Hixson, Patricia; Potocki, Lorraine; Lupski, James R; Stankiewicz, Pawel; Bacino, Carlos A; Dawson, Brian; Beaudet, Arthur L; Boricha, Fatima M; Whittaker, Runako; Li, Chumei; Ware, Stephanie M; Cheung, Sau Wai; Penny, Daniel J; Jefferies, John Lynn; Belmont, John W

    2013-02-01

    Clinically significant cardiovascular malformations (CVMs) occur in 5-8 per 1000 live births. Recurrent copy number variations (CNVs) are among the known causes of syndromic CVMs, accounting for an important fraction of cases. We hypothesized that many additional rare CNVs also cause CVMs and can be detected in patients with CVMs plus extracardiac anomalies (ECAs). Through a genome-wide survey of 203 subjects with CVMs and ECAs, we identified 55 CNVs >50 kb in length that were not present in children without known cardiovascular defects (n=872). Sixteen unique CNVs overlapping these variants were found in an independent CVM plus ECA cohort (n=511), which were not observed in 2011 controls. The study identified 12/16 (75%) novel loci including non-recurrent de novo 16q24.3 loss (4/714) and de novo 2q31.3q32.1 loss encompassing PPP1R1C and PDE1A (2/714). The study also narrowed critical intervals in three well-recognized genomic disorders of CVM, such as the cat-eye syndrome region on 22q11.1, 8p23.1 loss encompassing GATA4 and SOX7 and 17p13.3-p13.2 loss. An analysis of protein-interaction databases shows that the rare inherited and de novo CNVs detected in the combined cohort are enriched for genes encoding proteins that are direct or indirect partners of proteins known to be required for normal cardiac development. Our findings implicate rare variants such as 16q24.3 loss and 2q31.3-q32.1 loss, and delineate regions within previously reported structural variants known to cause CVMs.

  2. A CLINICAL STUDY OF ERYTHRODERMA AND CARDIOVASCULAR COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Padmaja Pinjala

    2016-06-01

    Full Text Available BACKGROUND Erythroderma is the term applied to any inflammatory skin disease which affects more than 90% of the body surface. The extensive inflammation of large areas of the skin puts a great brunt on the entire metabolism of the body. Many organ systems are involved and secondarily affected. We studied the Erythroderma and Cardiovascular complications in 25 patients at DVL Department, Osmania General Hospital, Hyderabad between January 2011 to January 2012. METHODS A total of 25 patients of Erythroderma attending the DVL OPD as well as those admitted in the ward were included in the study. Examination of other systems with special emphasis to cardiovascular system was done in all the cases. All the patients were subjected to all the routine investigations. Chest X-ray and ultrasound abdomen was done in all the cases. Cardiovascular complications were assessed by doing ECG and 2D Echo. All the patients were admitted. In suspected drug induced cases, all the non-essential drugs were stopped. All the patients were managed conservatively with specific treatment depending on the need. RESULTS Out of 25 cases studied, majority were in the age group of 41-50 years and showed male preponderance. In majority of patients, the common cause of Erythroderma was pre-existing dermatoses like Psoriasis and eczema. The next common being the drugs. Among the psoriasis, the Chronic Plaque type was the commonest progressing to erythroderma. In majority of cases, most of the body surface was involved. CONCLUSION In our study, the mean age of presentation was seen in the middle aged groups. Majority of the cases were secondary to preexisting dermatoses. Psoriasis was the single most common cause of Erythroderma. Antiepileptics were commonest cause for drug-induced erythroderma. Cardiovascular abnormalities were seen in 40% of cases of erythroderma. ECG and 2D Echo showed cardiac abnormalities in those cases of erythroderma which were mainly psoriatic induced.

  3. Abnormal Congenital Location of Stapes’ Superstructure: Clinical and Embryological Implications

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    Vânia Henriques

    2016-01-01

    Full Text Available Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes’ superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window. A stapes prosthesis was inserted and resulted in closure of the air-bone gap by 25 dB. A review of the literature was also performed using MEDLINE. Two theories diverge on the embryologic origin of the stapes. Our findings seem to be in favour of the theory that defines two different embryologic origins to the stapes.

  4. Diffusion abnormality maps in demyelinating disease: Correlations with clinical scores

    International Nuclear Information System (INIS)

    Background and purpose: Magnetic resonance imaging (MRI) has been explored as a noninvasive tool to assess pathology in multiple sclerosis (MS) patients. However, the correlation between classical MRI measures and physical disability is modest in MS. The diffusion tensor imaging (DTI) MRI technique holds particular promise in this regard. The present study shows brain regions where FA and individual diffusivities abnormalities are present and check their correlations with physical disability clinical scores. Methods: Eight patients and 12 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR-DTI acquisitions, a Genesis Signa 1.5T MR system, an EP/SE scanning sequence, 25 gradient directions were used. Results: Tract Based Spatial Statistics (TBSS) group comparisons showed reduced FA and increased individual diffusivities in several brain regions in patients. Significant correlations were found between FA and: EDSS, 9-HPT(NON)DOM and 25FW score; between λ2 and: P100 (r and l), 9-HPT(NON)DOM and 25FW; between λ3 and: 9-HPT(NON)DOM and 25FW score. Conclusions: Fractional anisotropy and individual radial diffusivities proved to be important markers of motor disabilities in MS patients when the disease duration mean and the disability scores values range are relatively high.

  5. Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem Cognitive decline, cardiovascular risk factors, and neuroimaging abnormalities

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    Tânia Corrêa de Toledo Ferraz Alves

    2005-06-01

    decline associated with cardiac diseases is characterized mainly by impairments of memory (learning and fixation, attention and information processing. In this article, we review neuroimaging abnormalities that may be found in samples of subjects presenting with cardiovascular risk factors and cognitive decline, including regional brain volumetric changes, white matter hyperintensities, silent brain infarcts, lacunars infarcts, and functional deficits in global blood flow (associated to reduced cardiac output or regional cerebral blood flow. We discuss the implications of these findings to the knowledge about the pathophysiology of cognitive deficits associated with cardiovascular risk factors, as well as their potential clinical applications. Finally, we discuss the potential use of novel imaging technologies in future studies evaluating abnormalities in brain structure and function related to cardiovascular risk factors, in large samples of elderly patients.

  6. Patient-centered clinical impact of incidentally detected abnormalities on chest CT scans

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    Sherine G. Moftah

    2014-09-01

    Conclusion: The clinically significant different incidental abnormalities on chest CT scans represented 10.4% of all incidental findings, 3.3% were due to malignancies. The clinical impact of incidental abnormalities on chest CT may be of utmost importance on patient care.

  7. Berberine: metabolic and cardiovascular effects in preclinical and clinical trials

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    Arrigo FG Cicero

    2009-09-01

    Full Text Available Arrigo FG Cicero1, Sibel Ertek21Internal Medicine, Aging and Kidney Diseases Department, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 2Ufuk University, Medical Faculty, Dr Ridvan Ege Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, TurkeyAbstract: Berberine is a plant alkaloid with numerous biological activities. A large body of preclinical in vitro and in vivo studies support different pharmacological actions of berberine that could be potentially useful in the management of metabolic diseases associated with high cardiovascular disease risk, such as mixed hyperlipidemia, insulin resistance, metabolic syndrome, and type 2 diabetes. Moreover, it seems that berberine also exerts anti-inflammatory and antiproliferative effects that could play a role in the development of atherosclerosis and its clinical consequences. Recently, the metabolic effects of berberine have been demonstrated in humans, opening new perspectives for the use of this molecule in patient therapy. Larger and longer clinical studies need to be carried out to implement the definition of the therapeutic role of berberine in humans.Keywords: berberine, cardiovascular disease, diabetes, cholesterol

  8. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

    OpenAIRE

    Rutwa J. Chavda; Hardev B. Saini

    2014-01-01

    Background: Evaluating feto-maternal outcome in pregnancies with abnormal liquor volume. Methods: 200 pregnant subjects between 20 and 42 weeks of gestation, who were clinically suspected to have an abnormal amniotic fluid volume (oligohydramnios or polyhydramnios) were subjected to ultrasonographic (USG) assessment of amniotic fluid index. The subjects were closely monitored during pregnancy, labour and puerperium. Results: Ultrasonically, abnormal liquor volume was confirmed in 90-93...

  9. A prospective clinical study of feto-maternal outcome in pregnancies with abnormal liquor volume

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    Rutwa J. Chavda

    2014-02-01

    Conclusions: A good clinical examination can pick up most subjects of abnormal liquor volume. Abnormal liquor volumes are associated with increased maternal morbidity and adverse perinatal outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 181-184

  10. INTESTINAL PSEUDO-OBSTRUCTION AND TRANSIENT CARDIOVASCULAR ABNORMALITIES IN KAWASAKI DISEASE

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    Maria L Avila-Aguero

    2005-08-01

    Full Text Available SUMMARYWe describe a 2 year-old boy with severe vasculitis who presented with a typical Kawasaki disease complicated with an intestinal pseudo-obstruction, gallbladder hydrops, myocarditis and transient coronary abnormalities despite early administration of intravenous immunoglobulin treatment.RESUMENDescribimos el caso de un niño de 2 años con vasculitis grave que presentó un cuadro típico de enfermedad de Kawasaki complicada con una pseudo-obtrucción intestinal, hidrops vesicular, miocarditis y anormalidades coronarias transitorias, a pesar de la administración temprana de tratamiento con inmunoglulina intravenosa

  11. Frequency and clinical significance of erythrocyte genetic abnormalities in Omanis.

    OpenAIRE

    White, J. M.; Christie, B S; Nam, D; S. Daar; Higgs, D R

    1993-01-01

    The frequencies of four malaria associated erythrocyte genetic abnormalities have been established in 1000 Omani subjects. They are: homozygous alpha+ thalassaemia (-alpha/-alpha) 0.45; high Hb A2 beta thalassaemia trait 0.015; sickle trait (Hb A/S) 0.061; and glucose 6 phosphate dehydrogenase deficiency (Gd-): males 0.27, females 0.11. From our data the alpha+ (-alpha/) thal gene (confirmed by Southern blotting) is pandemic in this population. Moreover, in spite of the very high frequency of...

  12. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention

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    Jesús Millán

    2009-09-01

    Full Text Available Jesús Millán1, Xavier Pintó2, Anna Muñoz3, Manuel Zúñiga4, Joan Rubiés-Prat5, Luis Felipe Pallardo6, Luis Masana7, Alipio Mangas8, Antonio Hernández-Mijares9, Pedro González-Santos10, Juan F Ascaso11, Juan Pedro-Botet121Hospital Universitario Gregorio Marañón, Madrid, Spain; 2Hospital Universitario Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain; 3Solvay Pharma, Barcelona, Spain; 4Hospital Marqués de Valdecilla, Santander, Spain; 5Hospital Vall d’Hebrón, Barcelona, Spain; 6Hospital Universitario La Paz, Madrid, Spain; 7Hospital Sant Joan, Reus, Tarragona, Spain; 8Hospital Universitario Puerta del Mar, Cádiz, Spain; 9Hospital Universitario Dr Peset, Valencia, Spain; 10Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain; 11Hospital Clínico Universitario, Valencia, Spain; 12Hospital del Mar, Barcelona, SpainAbstract: Low-density lipoprotein (LDL cholesterol concentration has been the prime index of cardiovascular disease risk and the main target for therapy. However, several lipoprotein ratios or “atherogenic indices” have been defined in an attempt to optimize the predictive capacity of the lipid profile. In this review, we summarize their pathophysiological aspects, and highlight the rationale for using these lipoprotein ratios as cardiovascular risk factors in clinical practice, specifying their cut-off risk levels and a target for lipid-lowering therapy. Total/high-density lipoprotein (HDL cholesterol and LDL/HDL cholesterol ratios are risk indicators with greater predictive value than isolated parameters used independently, particularly LDL. Future recommendations regarding the diagnosis and treatment of dyslipidemia, including instruments for calculating cardiovascular risk or action guidelines, should include the lipoprotein ratios with greater predictive power which, in view of the evidence-based results, are none other than those which include HDL cholesterol.Keywords: apolipoproteins

  13. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis

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    Rickson R Pereira

    2011-01-01

    Full Text Available Background: The association between psoriasis, diabetes, and cardiovascular disease remains largely unelucidated in the Indian population. Aims: To study the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis. Materials and Methods: Seventy-seven patients of chronic plaque psoriasis and ninety two age- and sex-matched controls were enrolled in the study over a period of one year. Clinical and biometric data were noted and fasting venous blood samples were collected. Nondiabetic patients were subjected to an oral glucose tolerance test with 75 g glucose and postprandial venous blood samples collected at 120 mins. The fasting glucose, insulin, lipid levels, postprandial glucose and postprandial insulin levels were measured in samples from nondiabetic patients whereas fasting lipid levels only were measured in diabetic patients. Results: The prevalence of impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus in psoriatics was 5.2%, 9.1%, and 32.5%, respectively, as compared to 6.5%, 3.3%, and 15.2%, respectively, in the controls. The difference was statistically significant. The odds ratio of having an abnormal glucose metabolism in psoriasis was 2.63. Smoking had a positive association with insulin resistance in psoriatic cases. The serum cholesterol levels were elevated in 29 (37.7% cases with a mean of 186.27 ± 43.18 and 34 (37% controls with a mean of 194.38 ± 57.20. The serum HDL-cholesterol levels were reduced in 50 (64.9% cases with a mean of 53.29 ± 15.90 as compared to 71 (74.7% in controls with a mean of 48.76 ± 12.85. The serum LDL-cholesterol levels were elevated in 38 (49.4% cases with a mean of 102.56 ± 44.02 and 36 controls with a mean of 115.62 ± 54.37. The serum triglyceride levels were elevated in 25 (32.5% cases with a mean of 129.99 ± 61.32 and 38 (41.3% controls with a mean of 141.04 ± 80.10. The differences

  14. [Otoneurologic and cardiovascular abnormalities associated to carbon monoxide poisoning in occupational exposed workers].

    Science.gov (United States)

    Vargas-Martínez, Alma; Reyna-López, Víctor; Rodríguez-Ortega, Francisco

    2014-01-01

    INTRODUCCIÓN: aun cuando la Ley Federal del Trabajo incluye la intoxicación por monóxido de carbono, su registro es escaso en el ámbito laboral. El objetivo de esta investigación fue determinar la relación de trastornos otoneurológicos y cardiovasculares con la intoxicación por monóxido de carbono en el ambiente de trabajo, para la adecuada fundamentación de su diagnóstico como enfermedad de trabajo. MÉTODOS: estudio transversal y analítico de un grupo de asaderos que utilizaban leña y carbón para cocinar pollo, comparados con un grupo control (n = 54). La investigación se realizó de abril a noviembre de 2012, con trabajadores de uno u otro sexo, entre los 18 y 74 años de edad; no se excluyó a quienes fumaban, pero no se incluyó a quienes manifestaron antecedente de cardiopatía isquémica Se obtuvieron niveles de carboxihemoglobina en aire espirado, audiometría tonal y electrocardiograma de 12 derivaciones.

  15. CT abnormality in multiple sclerosis analysis based on 28 probable cases and correlation with clinical manifestations

    International Nuclear Information System (INIS)

    In order to investigate the occurrence and nature of CT abnormality and its correlation with clinical manifestations in multiple sclerosis, 34 CT records obtained from 28 consecutive patients with probable multiple sclerosis were reviewed. Forty-six percent of all cases showed abnormal CT. Dilatation of cortical sulci was found in 39%; dilatation of the lateral ventricle in 36%; dilatation of prepontine or cerebello-pontine cistern and the fourth ventricle, suggesting brainstem atrophy, in 18%; dilatation of cerebellar sulci, superior cerebellar cistern and cisterna magna, suggesting cerebellar atrophy, in 11%. Low density area was found in the cerebral hemisphere in 11% of cases. Contrast enhancement, performed on 25 CT records, did not show any change. There was no correlation between CT abnormality and duration of the illness. Although abnormal CT tended to occur more frequently during exacerbations and chronic stable state than during remissions, the difference was not statistically significant. CT abnormalities suggesting brainstem atrophy, cerebellar atrophy or plaques were found exclusively during exacerbations and chronic stable state. The occurrence of CT abnormalities was not significantly different among various clinical forms which were classified based on clinically estimated sites of lesion, except that abnormal CT tended to occur less frequently in cases classified as the optic-spinal form. It is noteworthy that cerebral cortical atrophy and/or dilatation of the lateral ventricle were found in 31% of cases who did not show any clinical sign of cerebral involvement. There was a statistically significant correlation between CT abnormalities and levels of clinical disability. Eighty percent of the bedridden or severely disabled patients showed abnormal CT, in contrast with only 29% of those with moderate, slight or no disability. (author)

  16. Clinical factors associated with abnormal postures in Parkinson's disease.

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    Tomoko Oeda

    Full Text Available BACKGROUND: Abnormal posture (AP is often seen in Parkinson's disease (PD, and marked forms known as dropped head syndrome and camptocormia encumber daily living activities. Unlike other motor disabilities such as bradykinesia or muscular rigidity, AP is not always improved but rather deteriorated by PD medication. PURPOSE: To clarify factors associated with neck and thoracolumbar AP. METHODS: Neck flexion (NF and thoracolumbar (TL angles were measured in 216 consecutive PD patients and 175 elderly healthy controls. The differences in NF and TL angles between PD patients and controls were designated as ΔNFA and ΔTLA, respectively. The association of ΔNFA or ΔTLA and predictable factors such as age, sex, duration of PD, Hoehn Yahr (H-Y stage, Unified Parkinson's Disease Rating Scale Part 3 (UPDRS-3, daily dose of dopamine agonists, and comorbid orthopedic spinal lesions was investigated in PD patients. Patients were divided into quartiles according to ΔNFA or ΔTLA. The association between predictable factors and ΔNFA or ΔTLA was estimated as odds ratio (OR, comparing with the lowest quartile as the reference by multivariate regression analysis. RESULTS: Compared with controls, distributions of all three posture angles were significantly shifted rightward in PD patients. Although there were no difference in UPDRS-3 scores in the quartiles of ΔNFA, the highest quartile was associated with H-Y stage ≥3 [OR 2.99, 95% confidence interval (CI 1.33-6.70, p = 0.008] after adjustment for age, sex and comorbid orthopedic spinal lesions. The highest quartile of ΔTLA was associated with comorbid orthopedic spinal lesions [OR 5.83 (1.42-23.8, p = 0.014], and UPDRS-3 score [OR 3.04 (1.80-5.15/10 points, p<0.0001]. CONCLUSION: Thoraco-lumbar AP was associated with UPDRS-3 scores and orthopedic spinal lesions, and in contrast, neck AP was not associated with these factors, suggesting that they had different pathomechanisms.

  17. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.  ...

  18. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  19. Cardiovascular physiology at the bench for application in the clinic.

    Science.gov (United States)

    Zhang, Cuihua

    2011-02-26

    Our research focuses on microphysiological aspects of the cardiovascular system, with an emphasis on what is occurring in heart tissues, to learn more about how various diseases arise and how they can be avoided or cured. These diseases include atherosclerosis, diabetes, myocardial infarction, obesity and ischemia/reperfusion (I/R). We use animal models, particularly mice, to aid us in these studies. A key feature of our work centers on dissection of coronary arterioles and examining their functionality using drugs, electrophysiology, fluoroscopy, genomics, proteomics, and standard chemical analyses to determine their physiological status, and compare it with other treated animals. My laboratory is focusing on anti-inflammatory and antioxidative stress therapeutic effects, the roles of sodium salicylate, exercise and resveratrol in type 2 diabetes, I/R injury, obesity, and atherosclerosis. Recently, we began investigations of the effects of stem cells and gastric bypass surgery on vascular dysfunction in obesity and diabetes. Our work identifies how diet, exercise, surgical interventions and drugs can be considered to combat these diseases in a clinical setting.

  20. Fractal frontiers in cardiovascular magnetic resonance: towards clinical implementation.

    Science.gov (United States)

    Captur, Gabriella; Karperien, Audrey L; Li, Chunming; Zemrak, Filip; Tobon-Gomez, Catalina; Gao, Xuexin; Bluemke, David A; Elliott, Perry M; Petersen, Steffen E; Moon, James C

    2015-01-01

    Many of the structures and parameters that are detected, measured and reported in cardiovascular magnetic resonance (CMR) have at least some properties that are fractal, meaning complex and self-similar at different scales. To date however, there has been little use of fractal geometry in CMR; by comparison, many more applications of fractal analysis have been published in MR imaging of the brain.This review explains the fundamental principles of fractal geometry, places the fractal dimension into a meaningful context within the realms of Euclidean and topological space, and defines its role in digital image processing. It summarises the basic mathematics, highlights strengths and potential limitations of its application to biomedical imaging, shows key current examples and suggests a simple route for its successful clinical implementation by the CMR community.By simplifying some of the more abstract concepts of deterministic fractals, this review invites CMR scientists (clinicians, technologists, physicists) to experiment with fractal analysis as a means of developing the next generation of intelligent quantitative cardiac imaging tools.

  1. Potential and clinical utility of stem cells in cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Korff Krause

    2010-03-01

    Full Text Available Korff Krause, Carsten Schneider, Kai Jaquet, Karl-Heinz KuckHanseatic Heart Center Hamburg, Department of Cardiology, Asklepios Hospital St. Georg, Hamburg, GermanyAbstract: The recent identification of bone marrow-derived adult stem cells and other types of stem cells that could improve heart function after transplantation have raised high expectations. The basic mechanisms have been studied mostly in murine models. However, these experiments revealed controversial results on transdifferentiation vs transfusion of adult stem cells vs paracrine effects of these cells, which is still being debated. Moreover, the reproducibility of these results in precisely translated large animal models is still less well investigated. Despite these weaknesses results of several clinical trials including several hundreds of patients with ischemic heart disease have been published. However, there are no solid data showing that any of these approaches can regenerate human myocardium. Even the effectiveness of cell therapy in these approaches is doubtful. In future we need in this important field of regenerative medicine: i more experimental data in large animals that are closer to the anatomy and physiology of humans, including data on dose effects, comparison of different cell types and different delivery routes; ii a better understanding of the molecular mechanisms involved in the fate of transplanted cells; iii more intensive research on genuine regenerative medicine, applying genetic regulation and cell engineering.Keywords: stem cells, cardiovascular disease

  2. Current trends in the cardiovascular clinical trial arena (I

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    Pater Cornel

    2004-06-01

    Full Text Available Abstract The existence of effective therapies for most cardiovascular disease states, coupled with increased requirements that potential benefits of new drugs be evaluated on clinical rather than surrogate endpoints, makes it increasingly difficult to substantiate any incremental improvements in efficacy that these new drugs might offer. Compounding the problem is the highly controversial issue of comparing new agents with placebos rather than active pharmaceuticals in drug efficacy trials. Despite the recent consensus that placebos may be used ethically in well-defined, justifiable circumstances, the problem persists, in part because of increased scrutiny by ethics committees but also because of considerable lingering disagreement regarding the propriety and scientific value of placebo-controlled trials (and trials of antihypertensive drugs in particular. The disagreement also substantially affects the most viable alternative to placebo-controlled trials: actively controlled equivalence/noninferiority trials. To a great extent, this situation was prompted by numerous previous trials of this type that were marked by fundamental methodological flaws and consequent false claims, inconsistencies, and potential harm to patients. As the development and use of generic drugs continue to escalate, along with concurrent pressure to control medical costs by substituting less-expensive therapies for established ones, any claim that a new drug, intervention, or therapy is "equivalent" to another should not be accepted without close scrutiny. Adherence to proper methods in conducting studies of equivalence will help investigators to avoid false claims and inconsistencies. These matters will be addressed in the third article of this three-part series.

  3. Clinical significance of microembolus detection by transcranial Doppler sonography in cardiovascular clinical conditions.

    Science.gov (United States)

    Hudorović, Narcis

    2006-01-01

    Transcranial Doppler can detect microembolic signals, which are characterized by unidirectional high intensity increase, short duration, and random occurrence, producing a "whistling" sound. Microembolic signals have been proven to represent solid or gaseous particles within the blood flow. Microemboli have been detected in a number of clinical cardiovascular settings: carotid artery stenosis, aortic arch plaques, atrial fibrillation, myocardial infarction, prosthetic heart valves, patent foramen ovale, valvular stenosis, during invasive procedures (angiography, percutaneous transluminal angioplasty) and surgery (carotid, cardiopulmonary bypass). Despite numerous studies performed so far, clinical significance of microembolic signals is still unclear. This article provides an overview of the development and current state of technical and clinical aspects of microembolus detection. PMID:17462357

  4. Effect of metabolic abnormalities on cognitive performance and clinical symptoms in schizophrenia

    OpenAIRE

    Wysokiński, Adam; Dzienniak, Małgorzata; Kłoszewska, Iwona

    2013-01-01

    Aim. The objective of this study is to determine whether and how metabolic abnormalities are associated with clinical symptoms and cognitive performance in schizophrenia. Methods. 46 adult patients with schizophrenia taking first- or second generation antipsychotics were included in the study. The following data were collected: BMI, abdominal circumference, lipid panel and blood glucose, blood pressure and treatment of comorbidities. Clinical symptoms were assessed using PANSS, CDSS, CGI a...

  5. Cardiovascular safety of type 2 diabetes medications: Review of existing literature and clinical implications.

    Science.gov (United States)

    Paredes, Sílvia; Matta-Coelho, Claudia; Monteiro, Ana Margarida; Brás, Alice; Marques, Olinda; Alves, Marta; Ribeiro, Laura

    2016-04-01

    Type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and the cardiovascular effect of antidiabetic drugs are today critical medical issues, with the prevalence of T2DM in particular showing a steep increase worldwide, mainly due to unhealthy lifestyle habits. T2DM in association with obesity and other cardiovascular risk factors, results in the development of CVD, the leading cause of morbidity and mortality in patients with T2DM. Thus, treatment of T2DM is an individualized and complex challenge in which targeting cardiovascular risk factors is an important component in the decision making. Given the cardiovascular adverse events associated with rosiglitazone, both the Food and Drug Administration and the European Medicines Agency currently require the demonstration of cardiovascular safety of new antidiabetic drugs. Consequently, clinical trials to guarantee their cardiovascular safety are now obligatory. This review aims to summarize the available evidence on the cardiovascular effects and safety of the major drugs used in T2DM treatment and also to provide an overview of upcoming and ongoing clinical trials in this field. Our belief is that this review will be of substantial assistance to all medical doctors who are treating diabetic patients, namely primary care physicians, internal medicine doctors, endocrinologists, diabetologists and less well experienced personnel such as young doctors in training. PMID:27376421

  6. Effects of a training program at the crossover point on the cluster of metabolic abnormalities and cardiovascular risk factors

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    Jérémy B. Coquart

    2014-12-01

    Full Text Available The present study examined the effects of a training program at a special exercise intensity—the crossover point of substrate utilization (COP—on the metabolic abnormalities and cardiovascular risk factors in obese women with metabolic syndrome (MetS. Eighteen postmenopausal obese women with MetS (age, 54.8 ± 8.4 years; height, 160 ± 6 cm followed a 12-week training program consisting of three 45-minute sessions/wk on a cycle ergometer. The intensity imposed during the training sessions corresponded to COP. Before and after the training program, anthropometric, biological, and blood pressure data were collected and compared. After the training program, body mass (88.4 ± 12.3 kg vs. 85.7 ± 11.1 kg, fat mass (43.2 ± 4.8% vs. 41.8 ± 4.8% body mass, body mass index (34.3 ± 3.9 kg/m2 vs. 33.2 ± 3.6 kg/m2, and waist circumference (105 ± 10 cm vs. 100 ± 9 cm were significantly lower (p < 0.01. Moreover, fasting plasma glucose was significantly lower after the training program (114 ± 20 mg/dL vs. 107 ± 15 mg/dL; p = 0.02 and the quantitative insulin-sensitivity check index was significantly higher (0.58 ± 0.08 vs. 0.61 ± 0.05; p = 0.05. A significant reduction in systolic blood pressure was also observed (141 ± 15 mmHg vs. 129 ± 11 mmHg; p = 0.02. After the program, the number of patients with fasting plasma hyperglycemia and arterial hypertension was significantly decreased by 54.4% and 44.4%, respectively, and the number of patients with MetS was nonsignificantly reduced by 22.2% (p = 0.10. The present study shows that a training program at COP is an efficient means to treat MetS.

  7. Long Pentraxin 3: Experimental and Clinical Relevance in Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Fabrizia Bonacina

    2013-01-01

    Full Text Available Pentraxin 3 (PTX3 is an essential component of the humoral arm of innate immunity and belongs, together with the C-reactive protein (CRP and other acute phase proteins, to the pentraxins' superfamily: soluble, multifunctional, pattern recognition proteins. Pentraxins share a common C-terminal pentraxin domain, which in the case of PTX3 is coupled to an unrelated long N-terminal domain. PTX3 in humans, like CRP, correlates with surrogate markers of atherosclerosis and is independently associated with the risk of developing vascular events. Studies addressing the potential physiopathological role of CRP in the cardiovascular system were so far inconclusive and have been limited by the fact that the sequence and regulation have not been conserved during evolution between mouse and man. On the contrary, the conservation of sequence, gene organization, and regulation of PTX3 supports the translation of animal model findings in humans. While PTX3 deficiency is associated with increased inflammation, cardiac damage, and atherosclerosis, the overexpression limits carotid restenosis after angioplasty. These observations point to a cardiovascular protective effect of PTX3 potentially associated with the ability of tuning inflammation and favor the hypothesis that the increased levels of PTX3 in subjects with cardiovascular diseases may reflect a protective physiological mechanism, which correlates with the immunoinflammatory response observed in several cardiovascular disorders.

  8. A randomised trial of salsalate for insulin resistance and cardiovascular risk factors in persons with abnormal glucose tolerance

    Science.gov (United States)

    Goldfine, A. B.; Conlin, P. R.; Halperin, F.; Koska, J.; Permana, P.; Schwenke, D.; Shoelson, S. E.

    2016-01-01

    Aims/hypothesis Chronic sub-acute inflammation contributes to the pathogenesis of type 2 diabetes mellitus and cardiovascular disease. High doses of salicylate reduce inflammation, glucose and triacylglycerols, and may improve insulin sensitivity, suggesting therapeutic potential in impaired fasting glucose and/or impaired glucose tolerance. This trial aimed to evaluate the effect of salsalate vs placebo on insulin resistance and glycaemia in impaired fasting glucose and/or impaired glucose tolerance. Methods We conducted a 12 week, two-centre, randomised, placebo-controlled study to evaluate the effect of salsalate (up to 4 g/day) vs placebo on systemic glucose disposal. Secondary objectives included treatment effects on glycaemia, inflammation and cardiovascular risk factors. Seventy-eight participants with impaired fasting glucose and/or impaired glucose tolerance from two VA healthcare systems were enrolled. Randomisation assignment was provided by the coordinating center directly to site pharmacists, and participants and research staff were blinded to treatment assignment. Results Seventy-one individuals were randomised to placebo (n = 36) or salsalate (n = 35). Glucose disposal did not change in either group (salsalate 1% [95% CI −39%, 56%]; placebo 6% [95% CI −20%, 61%], p = 0.3 for placebo vs salsalate). Fasting glucose was reduced by 6% during the study by salsalate (p = 0.006) but did not change with placebo. Declines in glucose were accompanied by declines in fasting C-peptide with salsalate. Insulin clearance was reduced with salsalate. In the salsalate group, triacylglycerol levels were lower by 25% (p = 0.01) and adiponectin increased by 53% (p = 0.02) at the end of the study. Blood pressure, endothelial function and other inflammation markers did not differ between groups. Adipose tissue nuclear factor κB (NF-κB) activity declined in the salsalate group compared with placebo (−16% vs 42%, p = 0.005), but was not correlated with metabolic

  9. Psoriasis and cardiovascular disease: epidemiology, mechanisms, and clinical implications

    OpenAIRE

    Armstrong, April

    2012-01-01

    Kelly C Pearson1, April W Armstrong21Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 2Department of Dermatology, University of California, Davis, Sacramento, CA, USAAbstract: Psoriasis is a systemic inflammatory disorder, which has been reported to be associated with adverse cardiovascular (CV) risks. CV comorbidities, such as diabetes, dyslipidemia, hypertension, and obesity appear to be increased in psoriasis patients compared with the genera...

  10. Psoriasis and cardiovascular disease: epidemiology, mechanisms, and clinical implications

    Directory of Open Access Journals (Sweden)

    Pearson KC

    2012-01-01

    Full Text Available Kelly C Pearson1, April W Armstrong21Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, 2Department of Dermatology, University of California, Davis, Sacramento, CA, USAAbstract: Psoriasis is a systemic inflammatory disorder, which has been reported to be associated with adverse cardiovascular (CV risks. CV comorbidities, such as diabetes, dyslipidemia, hypertension, and obesity appear to be increased in psoriasis patients compared with the general population. Psoriasis may contribute independently to adverse cardiac outcomes after accounting for traditional CV risk factors. In this article, it was aimed to summarize large population studies that examine the relationship between psoriasis and CV risk factors and major adverse cardiac outcomes, and highlight proposed mechanisms for the observed epidemiologic link. Specifically, large population-based studies with over 1000 total subjects from 1975 to September 2008 in the English literature are highlighted. The relevant search terms in the Ovid Medline database were applied. The majority of the studies presented evidence for an increased incidence of CV risk factors and an increased risk for major adverse cardiac outcomes in patients with severe psoriasis. The increased risk in severe psoriasis necessitates regular screening for other comorbidities. Current guidelines for screening CV risk factors among psoriasis patients are discussed. Also reviewed is the scarce literature in therapeutic strategies to reduce CV risk factors and major adverse cardiac outcomes in psoriasis patients. Specifically, an emerging area of research on the effects of biologic agents on CV risk factors and CV adverse outcomes in psoriasis is discussed.Keywords: cardiovascular disease, cardiovascular risk factors, psoriasis, diabetes mellitus, myocardial infarction, major adverse cardiovascular events, MACE, hypertension

  11. Biomaterials in Cardiovascular Research: Applications and Clinical Implications

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    Saravana Kumar Jaganathan

    2014-01-01

    Full Text Available Cardiovascular biomaterials (CB dominate the category of biomaterials based on the demand and investments in this field. This review article classifies the CB into three major classes, namely, metals, polymers, and biological materials and collates the information about the CB. Blood compatibility is one of the major criteria which limit the use of biomaterials for cardiovascular application. Several key players are associated with blood compatibility and they are discussed in this paper. To enhance the compatibility of the CB, several surface modification strategies were in use currently. Some recent applications of surface modification technology on the materials for cardiovascular devices were also discussed for better understanding. Finally, the current trend of the CB, endothelization of the cardiac implants and utilization of induced human pluripotent stem cells (ihPSCs, is also presented in this review. The field of CB is growing constantly and many new investigators and researchers are developing interest in this domain. This review will serve as a one stop arrangement to quickly grasp the basic research in the field of CB.

  12. Effect of metabolic abnormalities on cognitive performance and clinical symptoms in schizophrenia

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    Wysokiński, Adam

    2013-12-01

    Full Text Available Aim. The objective of this study is to determine whether and how metabolic abnormalities are associated with clinical symptoms and cognitive performance in schizophrenia. Methods. 46 adult patients with schizophrenia taking first- or second generation antipsychotics were included in the study. The following data were collected: BMI, abdominal circumference, lipid panel and blood glucose, blood pressure and treatment of comorbidities. Clinical symptoms were assessed using PANSS, CDSS, CGI and SAS scales. Cognitive performance was assessed using CNS Vital Signs computerized battery of tests: Verbal Memory test, Visual Memory test, Finger Tapping Test, Symbol Digit Coding, Stroop Test, Shifting Attention Test, and Continuous Performance Test. Results. Dyslipidemia, raised LDL and raised blood glucose levels were the best predictors of more severe clinical symptoms (PANSS, PANSS P, PANSS G, CGI and lower neurocognitive index, worse cognitive flexibility, executive functions, complex attention composite memory, verbal memory, slower reaction time and worse performance in SAT, CPT, ST tests. Obesity was associated with worse results in VBM, VIM, FTT, SDC tests. Raised blood pressure was associated with improvements in all cognitive domains and better performance in SAT, CPT, ST tests. Discussion. There are several weak associations between severity of clinical symptoms and metabolic abnormalities. Most of these were for blood glucose levels and raised blood glucose. Lipids and glucose abnormalities are the best predictors of deteriorated cognitive performance. Contrary to previous observations, raised blood pressure was associated with better results in cognitive tests. Conclusions. These findings indicate that cognitive impairment and metabolic abnormalities may be linked in patients with schizophrenia

  13. Electronic Healthcare Record and Clinical Research in Cardiovascular Radiology. HL7 CDA and CDISC ODM Interoperability

    OpenAIRE

    El Fadly, A.; Daniel, C.; Bousquet, C.; Dart, T; Lastic, P-Y.; Degoulet, P.

    2007-01-01

    Integrating clinical research data entry with patient care data entry is a challenging issue. At the G. Pompidou European Hospital (HEGP), cardiovascular radiology reports are captured twice, first in the Electronic Health Record (EHR) and then in a national clinical research server. Informatics standards are different for EHR (HL7 CDA) and clinical research (CDISC ODM). The objective of this work is to feed both the EHR and a Clinical Research Data Management System (CDMS) from a single mult...

  14. Clinical Symptoms of Minor Head Trauma and Abnormal Computed Tomography Scan

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    Maghsoudi

    2015-11-01

    Full Text Available Background Minor head trauma accounts for 70% to 90% of all head traumas. Previous studies stated that minor head traumas were associated with 7% - 20% significant abnormal findings in brain computed tomography (CT-scans. Objectives The aim of this study was to reevaluate clinical criteria of taking brain CT scan in patients who suffered from minor head trauma. Patients and Methods We enrolled 680 patients presented to an academic trauma hospital with minor head trauma in a prospective manner. All participants underwent brain CT scan if they met the inclusion criteria and the results of scans were compared with clinical examination finding. Results Loss of consciousness (GCS drop or amnesia was markedly associated with abnormal brain CT scan (P < 0.05. Interestingly, we found 7 patients with normal clinical examination but significant abnormal brain CT scan. Conclusions According to the results of our study, we recommend that all patients with minor head trauma underwent brain CT scan in order not to miss any life-threatening head injuries.

  15. Matrix metalloproteinases and their inhibitors in cardiovascular pathologies: current knowledge and clinical potential

    OpenAIRE

    Johnson, Jason

    2014-01-01

    Jason Lee Johnson Laboratory of Cardiovascular Pathology, School of Clinical Sciences, University of Bristol, Bristol, UK Abstract: Matrix metalloproteinases (MMPs) constitute a family of endopeptidases that harbor matrix-degrading potential, but also modulate the proliferation, migration, and apoptosis of resident blood-vessel cells and recruited inflammatory cells. Accordingly, they are proposed to play a major regulatory role in numerous cardiovascular pathologies, including restenosis, a...

  16. Clinical values dataset processing through cluster analysis to find cardiovascular risk

    Science.gov (United States)

    Bucci, C. M.; Legnani, W. E.; Armentano, R. L.

    2016-04-01

    The scope of this work is to show another way to grouping population with clinical variables measured in health centres and to assign a cardiovascular risk indicator. To do this, two different datasets were used, one coming from France and another coming from Uruguay. The well proved Framingham index was used to validate the results. The preliminary results are very auspicious to encourage the research and get deeper knowledge of the cardiovascular risk indicators.

  17. Patients’ preferences for selection of endpoints in cardiovascular clinical trials

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    Robert D. Chow

    2014-02-01

    Full Text Available Background: To reduce the duration and overall costs of cardiovascular trials, use of the combined endpoints in trial design has become commonplace. Though this methodology may serve the needs of investigators and trial sponsors, the preferences of patients or potential trial subjects in the trial design process has not been studied. Objective: To determine the preferences of patients in the design of cardiovascular trials. Design: Participants were surveyed in a pilot study regarding preferences among various single endpoints commonly used in cardiovascular trials, preference for single vs. composite endpoints, and the likelihood of compliance with a heart medication if patients similar to them participated in the trial design process. Participants: One hundred adult English-speaking patients, 38% male, from a primary care ambulatory practice located in an urban setting. Key results: Among single endpoints, participants rated heart attack as significantly more important than death from other causes (4.53 vs. 3.69, p=0.004 on a scale of 1–6. Death from heart disease was rated as significantly more important than chest pain (4.73 vs. 2.47, p<0.001, angioplasty/PCI/CABG (4.73 vs. 2.43, p<0.001, and stroke (4.73 vs. 2.43, p<0.001. Participants also expressed a slight preference for combined endpoints over single endpoint (43% vs. 57%, incorporation of the opinions of the study patient population into the design of trials (48% vs. 41% for researchers, and a greater likelihood of medication compliance if patient preferences were considered during trial design (67% indicated a significant to major effect. Conclusions: Patients are able to make judgments and express preferences regarding trial design. They prefer that the opinions of the study population rather than the general population be incorporated into the design of the study. This novel approach to study design would not only incorporate patient preferences into medical decision making, but

  18. Association of coexisting morphological umbilical cord abnormality and clinical cord compromise with hypoxic and thrombotic placental histology.

    Science.gov (United States)

    Stanek, Jerzy

    2016-06-01

    To assess the usefulness and limitations of placental histology when morphological umbilical cord (UC) abnormality coexists with clinical UC compromise, 5634 consecutive placentas were divided into four groups and statistically compared: group 1-182 placentas from pregnancies with clinical features of UC compromise (variable decelerations, UC entanglement, prolapse, or true knot at delivery); group 2-1355 placentas with abnormal UC morphology or insertion; group 3-152 placentas with at least one phenotype from group 1 and one from group 2; group 4-3945 placentas with no clinical or morphological UC-related phenotypes (control group).Differences were analyzed by ANOVA or χ (2). Of 68 phenotypes studied, 13 clinical and 18 placental phenotypes were statistically significant. In group 1, 2 phenotypes were most common (oligohydramnios and abnormal fetal heart rate tracing). In group 2, 6 phenotypes were most common, including 4 clinical (abnormal umbilical artery Dopplers, nonmacerated stillbirth, multiple pregnancy, and fetal growth restriction) and 2 placental. In group 3, 23 phenotypes were most common, including 7 clinical (gestational hypertension, polyhydramnios, induction of labor, cesarean section, macerated stillbirth, congenital malformations, and abnormal 3rd stage of labor) and 16 placental. The existence of clinical signs of UC compromise alone was associated with the absence of pathomorphological placental abnormalities. However, the coexistence of clinical and abnormal morphological UC phenotypes was statistically significantly associated with placental histological signs of decreased fetal blood flow, hypoxia (acute and chronic post uterine), shallow placental implantation, and/or amnion nodosum. Thus, confirmation of clinical UC compromise should not be expected on placental examination if no morphological UC abnormality or abnormal UC insertion has been found. PMID:26983702

  19. Abnormal Unsaturated Fatty Acid Metabolism in Cystic Fibrosis: Biochemical Mechanisms and Clinical Implications

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    Adam C. Seegmiller

    2014-09-01

    Full Text Available Cystic fibrosis is an inherited multi-organ disorder caused by mutations in the CFTR gene. Patients with this disease exhibit characteristic abnormalities in the levels of unsaturated fatty acids in blood and tissue. Recent studies have uncovered an underlying biochemical mechanism for some of these changes, namely increased expression and activity of fatty acid desaturases. Among other effects, this drives metabolism of linoeate to arachidonate. Increased desaturase expression appears to be linked to cystic fibrosis mutations via stimulation of the AMP-activated protein kinase in the absence of functional CFTR protein. There is evidence that these abnormalities may contribute to disease pathophysiology by increasing production of eicosanoids, such as prostaglandins and leukotrienes, of which arachidonate is a key substrate. Understanding these underlying mechanisms provides key insights that could potentially impact the diagnosis, clinical monitoring, nutrition, and therapy of patients suffering from this deadly disease.

  20. Effectiveness of a Pharmacist-Led Cardiovascular Risk Reduction Clinic in Rural Perry County, Alabama

    Science.gov (United States)

    Sands, Charles; Ford, Frances

    2016-01-01

    Background. The Cardiovascular Risk Reduction Clinic (CRRC) in Perry County, Alabama, provides free pharmacist-led services. Clinic goals include improving health outcomes and reducing cardiovascular risk factors. Objective. To investigate the effectiveness of the CRRC in rural Perry County, Alabama. The reduction of the modifiable cardiovascular risk factors, blood pressure and body mass index, was evaluated to measure a decrease from baseline to last clinic date. Methods. This retrospective chart review identified 130 patients with at least two blood pressure and BMI measurements from baseline to June 30, 2010. The patients' paper files were used to collect baseline data and most recent measurements, which were recorded on a data collection sheet. Results. There was a statistically significant reduction in systolic blood pressure of 4.08 mmHg, 3.25 mmHg reduction in diastolic blood pressure, and 0.42 kg/m2 reduction in mean BMI. At their last visit prior to June 30, 2010, 59% of hypertensive patients and 35% of diabetic patients were meeting their blood pressure goals. Conclusion. Pharmacist-led management of patients with cardiovascular risk factors significantly reduced blood pressure and allowed more patients to meet their hypertension treatment goals. Despite being modest, reductions in blood pressure and BMI help reduce overall cardiovascular risks. PMID:27525302

  1. An Experimental Clinical Science Fellowship in Cardiovascular-Renal

    Science.gov (United States)

    Chasis, Herbert; Campbell, Charles I.

    1974-01-01

    Describes the New York Heart Association's experimental program aimed at evaluating a method of developing physicians disciplined by research and competent both as teachers and in the care of patients (clinical scientists). (Author)

  2. Continued efforts to translate diabetes cardiovascular outcome trials into clinical practice.

    Science.gov (United States)

    Avogaro, Angelo; Fadini, Gian Paolo; Sesti, Giorgio; Bonora, Enzo; Del Prato, Stefano

    2016-01-01

    Diabetic patients suffer from a high rate of cardiovascular events and such risk increases with HbA1c. However, lowering HbA1c does not appear to yield the same benefit on macrovascular endpoints, as observed for microvascular endpoints. As the number of glucose-lowering medications increases, clinicians have to consider several open questions in the management of type 2 diabetes, one of which is the cardiovascular risk profile of each regimen. Recent placebo-controlled cardiovascular outcome trials (CVOTs) have responded to some of these questions, but careful interpretation is needed. After general disappointment around CVOTs assessing safety of DPP-4 inhibitors (SAVOR, TECOS, EXAMINE) and the GLP-1 receptor agonist lixisenatide (ELIXA), the EMPA-REG Outcome trial and the LEADER trial have shown superiority of the SGLT2-I empagliflozin and the GLP-1RA liraglutide, respectively, on the 3-point MACE outcome (cardiovascular death, non-fatal myocardial infarction or stroke) and cardiovascular, as well as all-cause mortality. While available mechanistic studies largely support a cardioprotective effect of GLP-1, the ability of SGLT2 inhibitor(s) to prevent cardiovascular death was unexpected and deserves future investigation. We herein review the results of completed CVOTs of glucose-lowering medications and suggest a possible treatment algorithm based on cardiac and renal co-morbidities to translate CVOT findings into clinical practice. PMID:27514514

  3. Alteraciones electrocardiográficas y factores de riesgo cardiovascular en pacientes con diabetes tipo 2 Electrocardiographic abnormalities and cardiovascular risk factors in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Martha Rodríguez-Morán

    1999-01-01

    Full Text Available Objetivo. Determinar cuáles son las alteraciones del ritmo y la conducción cardiaca más frecuentes en pacientes con diabetes tipo 2 sin cardiopatía previa y establecer su asociación con los factores de riesgo cardiovascular. Material y métodos. Se incluyeron pacientes con diabetes tipo 2 sin presencia o antecedentes de cardiopatía. Se determinaron los factores de riesgo cardiovascular, el índice de masa corporal y los niveles séricos de glucosa, colesterol y triglicéridos. Se registró electrocardiograma convencional en reposo. La asociación de las variables en estudio con la ocurrencia de arritmias se calculó con un modelo de análisis multivariado ajustado por sexo. Resultados. Se integraron 199 pacientes: 113 mujeres (56.8% y 86 hombres (43.2%, y se identificó algún tipo de alteración electrocardiográfica en 29.1% de los sujetos. El hemibloqueo fascicular anterior (HFA y el bloqueo completo de rama derecha del Haz de His (BRDHH, constituyeron 75.9% de las alteraciones identificadas. Los pacientes con trastornos del ritmo y la conducción tienen niveles más elevados de colesterol y triglicéridos. La aparición de arritmias se relaciona directamente con el incremento de la edad (r= 0.75, p= 0.01. En el análisis multivariado ajustado por sexo la hipercolesterolemia y la edad se asociaron significativamente con las alteraciones del ritmo y la conducción: RM 1.5, IC95% 1.1-4.6, pObjective. To determine the most frequent alterations in rhythm and cardiac conduction in patients with type 2 diabetes without previous cardiopathy, and to establish the association of this disease with cardiovascular risk factors. Material and methods. Subjects with type 2 diabetes, without cardiopathy antecedents were included in the study. Cardiovascular risk factors, body mass index and serum glucose, cholesterol and trygliceride levels were determined. A resting electrocardiogram was recorded. The association between the variables under study and

  4. [Influence of chitosan on clinical-biochemical rates and protein metabolism of patients with cardiovascular diseases].

    Science.gov (United States)

    Baĭgarin, E K; Pogozheva, A V

    2008-01-01

    The article tells about influence of combined chitosan (5 g/day) and triweekly dietotherapy on clinical-biochemical rates and nitrogen balance of patients with cardiovascular diseases. We obtained data indicating negative influence of chitosan on nitrogen balance. PMID:19227863

  5. Cardiovascular Risk of Stimulant Treatment in Pediatric Attention-Deficit/Hyperactivity Disorder: Update and Clinical Recommendations

    Science.gov (United States)

    Hammerness, Paul G.; Perrin, James M.; Shelley-Abrahamson, Rachel; Wilens, Timothy E.

    2011-01-01

    Objective: This review provides an update on the cardiovascular impact of therapeutic stimulant-class medication for children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: Relevant clinical literature was ascertained using PubMed searches limited to human studies and the English language as of May 2011. Current…

  6. [Psychocardiology: clinically relevant recommendations regarding selected cardiovascular diseases].

    Science.gov (United States)

    Albus, C; Ladwig, K-H; Herrmann-Lingen, C

    2014-03-01

    Psychosocial risk factors (work stress, low socioeconomic status, impaired social support, anger, anxiety and depression), certain personality traits (e.g. hostility) and post-traumatic stress disorders may negatively influence the incidence and course of multiple cardiovascular disease conditions. Systematic screening for these factors may help to adequately assess the psychosocial risk pattern of a given patient and may also contribute to the treatment of these patients. Recommendations for treatment are based on current guidelines. The physician-patient interaction should basically follow the principle of a patient centered communication and should gender and age specific aspects into consideration. Integrated biopsychosocial care is an effective, low threshold option to treat psycho-social risk factors and should be offered on a regular basis. Patients with high blood pressure may profit from relaxation programs and biofeedback procedures (however with moderate success). An individually adjusted multimodal treatment strategy should be offered to patients with coronary heart disease, heart failure and after heart surgery. It may incorporate educational tools, exercise therapy, motivational modules, relaxation and stress management programs. In case of affective comorbidity, psychotherapy may be indicated. Anti-depressant pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) in the first line should only be offered to patients with at least moderate severe depressive episodes. Psychotherapy and SSRIs, particularly sertraline, have been proven to be safe and effective with regard to improvements of the patient's quality of life. A prognostic benefit has not been clearly proven so far. Patients with an implanted cardioverter/defibrillator (ICD) should receive psychosocial support on a regular basis. Concomitant psychotherapy and/or psychopharmacotherapy (SSRIs) should be offered in case of a severe mental comorbidity. Generally, tricyclic

  7. Spinal Cord Injury without Radiographic Abnormality (SCIWORA) – Clinical and Radiological Aspects

    International Nuclear Information System (INIS)

    The acronym SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) was first developed and introduced by Pang and Wilberger who used it to define “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. SCIWORA is a clinical-radiological condition that mostly affects children. SCIWORA lesions are found mainly in the cervical spine but can also be seen, although much less frequently, in the thoracic or lumbar spine. Based on reports from different authors, SCIWORA is responsible for 6 to 19% and 9% to 14% of spinal injuries in children and adults, respectively. Underlying degenerative changes, including spondylosis or spinal canal stenosis, are typically present in adult patients. The level of spinal cord injury corresponds to the location of these changes. With recent advances in neuroimaging techniques, especially in magnetic resonance imaging, and with increasing availability of MRI as a diagnostic tool, the overall detection rate of SCIWORA has significantly improved

  8. Abnormal neuronal migration: radiologic-clinic study. Alteraciones en la migracion neural: estudio clinico-radiologico

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Fernandez, M.; Menor Serrano, F.; Bordon Ferre, F.; Garcia Tena, J.; Esteban Hernandez, E.; Sanguesa Nebot, C.; Marti Bonnati, L. (Hospital Infantil La Fe, Valencia (Spain))

    1994-01-01

    We present our experience in 18 pediatric patients with abnormal neuronal migration. Seven cases of heterotopia of the gray matter, 7 agyria-pachygyria complexes, 1 case of polymicrogyria, 2 cases of schizencephaly and 1 case of hemimegalencephaly were diagnosed by means of ultrasonography, computed tomography and magnetic resonance. The clinical picture was reviewed in each case, with special attention to the occurrence of convulsions, psycho motor development and visual changes. In general, the greater the morphological change, the greater the neurological involvement in these patients. However, the two cases of schizencephaly presented mild clinical expression. Magnetic resonance increases the diagnostic yield in neuronal migration disorders. Nevertheless, either ultrasonography or, especially, computed tomography is useful as a first diagnostic approach in these malformative disorders. (Author)

  9. Analysis of Factor of Abnormal Vagal Reflex after Interventional Operation Treatment for Cardiovascular Diseases%介入手术治疗心血管疾病后迷走神经异常反射的因素分析

    Institute of Scientific and Technical Information of China (English)

    张勇; 唐小霞; 曹邦明

    2015-01-01

    目的:研究分析介入手术治疗心血管疾病后迷走神经异常反射的因素。方法回顾性分析2009年1月—2013年1月于该院接受介入手术治疗的109例心血管疾病患者,其中42例发生迷走神经异常反射。对109例患者的临床资料进行单因素分析和多元Logistic回归分析,研究迷走神经异常反射的相关因素。结果对患者的性别、年龄、精神状态、术前禁食时间、穿刺途径及拔管时间等因素进行单因素分析,结果显示患者的精神状态、术前禁食时间、穿刺途径及拔管时间均是迷走神经异常反射的相关因素(P<0.05);对患者的精神状态、术前禁食时间、穿刺途径及拔管时间进行多元Logistic回归分析,P<0.05。结论介入手术治疗心血管疾病后迷走神经异常反射的相关性因素包括患者的精神状态、术前禁食时间、穿刺途径及拔管时间。%Objective To study the factors of abnormal vagal reflex after interventional operation treatment for cardiovascu-lar diseases. Methods 109 patients with cardiovascular diseases who underwent interventional operation in our hospital from January 2009 and January 2013 were retrospectively analyzed, and abnormal vagal reflex appeared in 42 of them. Univariate analysis and multivariate Logistic regression analysis were done on the clinical data of all the 109 patients to analyze the re-lated factors of abnormal vagal reflex. Results Univariate analysis on patients' gender, age, mental state, preoperative fasting time, puncturing approach and extubation time and other factors was done, and the result showed related factors of abnormal vagal reflex included patients' mental state, preoperative fasting time, puncturing approach and extubation time (P<0.05);Multivariate Logistic regression analysis was done on patients' mental state, preoperative fasting time, puncturing approach and extubation time, and the result showed that patients' mental

  10. Influencing factors of abnormal vagal reflex after treatment of cardiovascular diseases with interventional operation%介入手术治疗心血管疾病后迷走神经异常反射的影响因素

    Institute of Scientific and Technical Information of China (English)

    谭刚; 杨锴; 何中涵

    2016-01-01

    Objective To analyze the influencing factors of abnormal vagal reflex after treatment of cardiovascular diseases with interventional operation. Methods The patients (n=109, male 64, female 45, aged from 37 to 68 and average age=48.57±8.32) were chosen from 2009 to 2013. All patients were divided, according to whether or not with abnormal vagal reflex, into control group (n=67) and abnormal group (n=42). The clinical data were given single-factor analysis and Logistic regression analysis, and relevant factors of abnormal vagal reflex were analyzed in 2 groups. Results The difference in age, sex proportions, body mass index (BMI), and percentages of cases complicated by hypertension, diabetes and hyperlipidemia had no statistical significance (all P>0.05). The percentages of patients with mental stress, pre-operation fasting time>4 h, transfemoral puncture and immediate postoperation extubation increased in abnormal group compared with control group (all P4 h, transfemoral puncture and immediate postoperation extubation after treatment of cardiovascular diseases with interventional operation (all P4 h, transfemoral puncture and immediate postoperation extubation after treatment of cardiovascular diseases with interventional operation, and clinical physicians should attach importance to them.%目的:分析介入手术治疗心血管疾病后迷走神经异常反射的影响因素。方法回顾性分析2009年~2013年于武汉市中心医院接受介入手术治疗的109例心血管疾病患者,男性64例,女性45例,年龄37~68(48.57±8.32)岁。根据是否出现迷走神经异常反射分为2组:对照组67例,异常反射组42例。对两组临床资料进行单因素分析和多元Logistic回归分析,分析迷走神经异常反射的相关因素。结果两组患者年龄、性别构成比例、体质指数、合并高血压病、糖尿病、高酯血症比例比较,差异均无统计学意义(P均>0.05)。与对照组比较,异常

  11. Transitional cardiovascular physiology and comprehensive hemodynamic monitoring in the neonate: relevance to research and clinical care.

    Science.gov (United States)

    Azhibekov, Timur; Noori, Shahab; Soleymani, Sadaf; Seri, Istvan

    2014-02-01

    A thorough understanding of developmental cardiovascular physiology is essential for early recognition of cardiovascular compromise, selective screening of at-risk groups of neonates, and individualized management using pathophysiology-targeted interventions. Although we have gained a better understanding of the physiology and pathophysiology of postnatal cardiovascular transition over the past decade with the use of sophisticated methods to study neonatal hemodynamics, most aspects of neonatal hemodynamics remain incompletely understood. In addition, targeted therapeutic interventions of neonatal hemodynamic compromise have not been shown to improve mortality and clinically relevant outcomes. However, the recent development of comprehensive hemodynamic monitoring systems capable of non-invasive, continuous and simultaneous bedside assessment of cardiac output, organ blood flow, microcirculation, and tissue oxygen delivery has made sophisticated analysis of the obtained physiologic data possible and has created new research opportunities with the potential of direct implications to patient care.

  12. Clinical and cardiovascular alterations produced by scorpion envenomation in dogs

    Directory of Open Access Journals (Sweden)

    F. F. Cordeiro

    2006-01-01

    Full Text Available Scorpionism is a common problem that occurs in tropical and subtropical countries and assumes great medical-sanitary importance due to its fatal effect on sensitive individuals, being able to lead children and aged people to death. The envenomation lethal potential is responsible for the serious cardiopulmonary alterations the scorpion toxin produces in its victims. The present research evaluated the effects of Tityus serrulatus venom on dogs, using two distinct doses: a dose that simulates natural envenomation (0.4 mg/total dose, and an experimental dose (0.25 mg/kg. General clinical signs were observed at different moments after envenomation, and specific data related to the cardiopulmonary system were evaluated by systemic arterial pressure measurement, CK-MB enzymatic activity dosage, and radiographic, electrocardiographic and echocardiographic examinations. Results demonstrated that the scorpion venom, in experimental doses, was able to cause acute and reversible cardiac injury in few days, and, in the dose that simulated natural accident, it produced clinical signs of light envenomation, such as local pain, hyperesthesia, sialorrhea, vomiting, diarrhea, sneeze and prostration.

  13. Clinical, clinicopathologic, radiographic, and ultrasonographic abnormalities in dogs with fatal acute pancreatitis: 70 cases (1986-1995)

    International Nuclear Information System (INIS)

    To determine clinical, clinicopathologic, radiographic, ultrasonographic, and coagulation abnormalities in dogs in which acute pancreatitis was fatal. Retrospective study. 70 dogs. History, clinical signs, and physical examination findings at the time of initial evaluation at the veterinary teaching hospital; results of pretreatment laboratory tests, abdominal radiography, and ultrasonography; and histologic abnormalities were obtained from medical records. Clinical signs included anorexia, vomiting, Weakness, diarrhea, polyuria and polydipsia, neurologic abnormalities, melena, weight loss, hematemesis, and passage of frank blood in feces. At the time of initial examination at the veterinary teaching hospital, 68 (97%) dogs were dehydrated, 18 (26%) were icteric, 22 (32%) were febrile, 40 (58%) had signs of abdominal pain, and 30 (43%) were classified as overweight or obese. Most dogs had leukocytosis, neutrophilia with a left shift, and thrombocytopenia. Various serum biochemical abnormalities were identified, including hypoglycemia, azotemia, hypercalcemia and other electrolyte abnormalities, hypoalbuminemia, high hepatic and pancreatic enzyme activities, hypercholesterolemia, and lipemia. For 17 of 28 (61%) dogs, results of coagulation function tests were abnormal. Results of abdominal ultrasonography and radiography were consistent with a diagnosis of acute pancreatitis in 23 of 34 (68%) and 10 of 41 (24%) dogs, respectively. For 2 dogs, results of abdominal ultrasonography were not suggestive of acute pancreatitis, but results of abdominal radiography were. Clinical signs and results of clinicopathologic tests are inconsistent. Abdominal ultrasonography may be valuable in the diagnostic evaluation of dogs suspected to have acute pancreatitis

  14. Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

    Directory of Open Access Journals (Sweden)

    David Feldman

    2010-05-01

    Full Text Available David Feldman1, Terry S Elton2, Doron M Menachemi3, Randy K Wexler41Heart Failure/Transplant and VAD Programs, Minneapolis Heart Institute, Minneapolis, Minnesota, USA; 2Division of Pharmacology, College of Pharmacology, The Ohio State University, Columbus, Ohio, USA; 3Heart Failure Services, Edith Wolfson Medical Center, The Heart Institute, Sakler School of Medicine, Tel-Aviv University, Holon, Israel; 4Department of Clinical Family Medicine, The Ohio State University, Columbus, Ohio, USAAbstract: The sympathetic nervous system is involved in regulating various cardiovascular parameters including heart rate (HR and HR variability. Aberrant sympathetic nervous system expression may result in elevated HR or decreased HR variability, and both are independent risk factors for development of cardiovascular disease, including heart failure, myocardial infarction, and hypertension. Epidemiologic studies have established that impaired HR control is linked to increased cardiovascular morbidity and mortality. One successful way of decreasing HR and cardiovascular mortality has been by utilizing β-blockers, because their ability to alter cell signaling at the receptor level has been shown to mitigate the pathogenic effects of sympathetic nervous system hyperactivation. Numerous clinical studies have demonstrated that β-blocker-mediated HR control improvements are associated with decreased mortality in postinfarct and heart failure patients. Although improved HR control benefits have yet to be established in hypertension, both traditional and vasodilating β-blockers exert positive HR control effects in this patient population. However, differences exist between traditional and vasodilating β-blockers; the latter reduce peripheral vascular resistance and exert neutral or positive effects on important metabolic parameters. Clinical evidence suggests that attainment of HR control is an important treatment objective for patients with cardiovascular

  15. Cardiovascular effects of dipeptidyl peptidase-4 inhibitors: from risk factors to clinical outcomes.

    Science.gov (United States)

    Scheen, André J

    2013-05-01

    Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) are oral incretin-based glucose-lowering agents with proven efficacy and safety in the management of type 2 diabetes mellitus (T2DM). In addition, preclinical data and mechanistic studies suggest a possible additional non-glycemic beneficial action on blood vessels and the heart, via both glucagon-like peptide-1-dependent and glucagon-like peptide-1-independent effects. As a matter of fact, DPP-4 inhibitors improve several cardiovascular risk factors: they improve glucose control (mainly by reducing the risk of postprandial hyperglycemia) and are weight neutral; may lower blood pressure somewhat; improve postprandial (and even fasting) lipemia; reduce inflammatory markers; diminish oxidative stress; improve endothelial function; and reduce platelet aggregation in patients with T2DM. In addition, positive effects on the myocardium have been described in patients with ischemic heart disease. Results of post hoc analyses of phase 2/3 controlled trials suggest a possible cardioprotective effect with a trend (sometimes significant) toward lower incidence of major cardiovascular events with sitagliptin, vildagliptin, saxagliptin, linagliptin, or alogliptin compared with placebo or other active glucose-lowering agents. However, the definite relationship between DPP-4 inhibition and better cardiovascular outcomes remains to be proven. Major prospective clinical trials involving various DPP-4 inhibitors with predefined cardiovascular outcomes are under way in patients with T2DM and a high-risk cardiovascular profile: the Sitagliptin Cardiovascular Outcome Study (TECOS) on sitagliptin, the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients With Diabetes Mellitus-Thrombolysis in Myocardial Infarction (SAVOR-TIMI) 53 trial on saxagliptin, the Cardiovascular Outcomes Study of Alogliptin in Subjects With Type 2 Diabetes and Acute Coronary Syndrome (EXAMINE) trial on alogliptin, and the Cardiovascular Outcome

  16. Multi-scale Modeling of the Cardiovascular System: Disease Development, Progression, and Clinical Intervention.

    Science.gov (United States)

    Zhang, Yanhang; Barocas, Victor H; Berceli, Scott A; Clancy, Colleen E; Eckmann, David M; Garbey, Marc; Kassab, Ghassan S; Lochner, Donna R; McCulloch, Andrew D; Tran-Son-Tay, Roger; Trayanova, Natalia A

    2016-09-01

    Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications. PMID:27138523

  17. Garlic powder intake and cardiovascular risk factors: a meta-analysis of randomized controlled clinical trials

    OpenAIRE

    Kwak, Jin Sook; Kim, Ji Yeon; Paek, Ju Eun; Lee, You Jin; Kim, Haeng-Ran; Park, Dong-Sik; Kwon, Oran

    2014-01-01

    BACKGROUND/OBJECTIVES Although preclinical studies suggest that garlic has potential preventive effects on cardiovascular disease (CVD) risk factors, clinical trials and reports from systematic reviews or meta-analyses present inconsistent results. The contradiction might be attributed to variations in the manufacturing process that can markedly influence the composition of garlic products. To investigate this issue further, we performed a meta-analysis of the effects of garlic powder on CVD ...

  18. Religion, spirituality and cardiovascular disease: research, clinical implications, and opportunities in Brazil.

    Science.gov (United States)

    Lucchese, Fernando A; Koenig, Harold G

    2013-03-01

    In this paper we comprehensively review published quantitative research on the relationship between religion, spirituality (R/S), and cardiovascular (CV) disease, discuss mechanisms that help explain the associations reported, examine the clinical implications of those findings, and explore future research needed in Brazil on this topic. First, we define the terms religion, spirituality, and secular humanism. Next, we review research examining the relationships between R/S and CV risk factors (smoking, alcohol/drug use, physical inactivity, poor diet, cholesterol, obesity, diabetes, blood pressure, and psychosocial stress). We then review research on R/S, cardiovascular functions (CV reactivity, heart rate variability, etc.), and inflammatory markers (IL-6, IFN-γ, CRP, fibrinogen, IL-4, IL-10). Next we examine research on R/S and coronary artery disease, hypertension, stroke, dementia, cardiac surgery outcomes, and mortality (CV mortality in particular). We then discuss mechanisms that help explain these relationships (focusing on psychological, social, and behavioral pathways) and present a theoretical causal model based on a Western religious perspective. Next we discuss the clinical applications of the research, and make practical suggestions on how cardiologists and cardiac surgeons can sensitively and sensibly address spiritual issues in clinical practice. Finally, we explore opportunities for future research. No research on R/S and cardiovascular disease has yet been published from Brazil, despite the tremendous interest and involvement of the population in R/S, making this an area of almost unlimited possibilities for researchers in Brazil.

  19. Clinical evaluation of plasma abnormal prothrombin (PIVKA-II) in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Fujiyama, S; Morishita, T; Sagara, K; Sato, T; Motohara, K; Matsuda, I

    1986-10-01

    The clinical usefulness of plasma abnormal prothrombin, defined as a protein induced by vitamin K absence or antagonist-II: PIVKA-II, as a tumor marker for hepatocellular carcinoma (HCC), was evaluated. Plasma PIVKA-II concentration was determined by an enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody specific for PIVKA-II. Forty-one (65%) out of 63 patients with HCC had an abnormal PIVKA-II level above 0.13 arbitrary units (AU)/ml; the level was above 0.3 AU/ml in 33 patients (52%) and above 0.5 AU/ml in 27 patients (43%). On the other hand, most of the 282 patients with various liver diseases other than HCC had normal or slightly elevated levels of PIVKA-II. Their values were all below 0.5 AU/ml, with the exception of 2 patients with decompensated liver cirrhosis. The patients with PIVKA-II values above 0.5 AU/ml were strongly suspected of having HCC. Plasma PIVKA-II levels were not related to serum alpha-fetoprotein (AFP) levels, but were above 0.5 AU/ml in 14 (44%) out of the 32 patients whose serum AFP levels were below 400 ng/ml. In some patients with HCC, PIVKA-II was increased throughout the course of the disease, and in others it normalized after surgical resection of the tumor. We conclude that the plasma PIVKA-II assay by the ELISA method using a monoclonal antibody is a useful diagnostic tool for monitoring HCC, particularly in HCC patients with low AFP levels.

  20. Assessment of Inflammatory and Cardiovascular Markers in Type 2 Diabetes without Clinical Evidence of Cardiac Events

    Directory of Open Access Journals (Sweden)

    Marwan Al-Nimer

    2014-09-01

    Full Text Available Purpose: There is no doubt that several inflammatory markers were detected in type 2 diabetes (T2D. Cardiovascular events were also associated with T2D or complicated T2D. Co-existence of cardiovascular and inflammatory biomarkers in T2D patients in the absence of cardiovascular morbidity have been mentioned in a few articles. This study aimed to assess the association of C-reactive protein as inflammatory marker with serum NT-proBNP (a diagnostic marker of heart failure with nitric oxide (a marker of vascular endothelial function in T2D patients without clinical evidence of heart failure. Material and Method: A total of 75 T2D patients recruited from the Center of Diabetes and 25 healthy subjects served as controls were enrolled in the study. Patients without clinical evidence of heart failure or recent infection were included in the study. Serum C- reactive protein, NT-proBNP, and nitric oxide were determined. Results: High serum NT-proBNP levels (≥600 pg/ml indicating the presence of moderate to severe heart failure was detected in 10.7% of subjects. Serum nitric oxide levels were significantly lower (60.98±30.75 µmol compared with those in healthy subjects (120.3±12.5 µmol. Serum nitric oxide significantly and inversely correlated with serum NT-proBNP level (r=-0.228, p<0.05. Seven out of 14 patients with positive C-reactive protein had significantly high serum NT-proBNP level (≥600 pg/ml. Patients with positive C-reactive protein significantly have low serum nitric oxide level compared with those expressed negative C-reactive protein reaction. Discussion: Biomarkers of cardiovascular events in T2D patients without clinical evidence of heart failure are detected in the presence of inflammatory process. Turk Jem 2014; 18: 75-78

  1. Clinical impact of evaluation of cardiovascular control by novel methods of heart rate dynamics.

    Science.gov (United States)

    Huikuri, Heikki V; Perkiömäki, Juha S; Maestri, Roberto; Pinna, Gian Domenico

    2009-04-13

    Heart rate variability (HRV) has been conventionally analysed with time- and frequency-domain methods, which measure the overall magnitude of RR interval fluctuations around its mean value or the magnitude of fluctuations in some predetermined frequencies. Analysis of heart rate dynamics by novel methods, such as heart rate turbulence after ventricular premature beats, deceleration capacity of heart rate and methods based on chaos theory and nonlinear system theory, have gained recent interest. Recent observational studies have suggested that some indices describing nonlinear heart rate dynamics, such as fractal scaling exponents, heart rate turbulence and deceleration capacity, may provide useful prognostic information in various clinical settings and their reproducibility may be better than that of traditional indices. For example, the short-term fractal scaling exponent measured by the detrended fluctuation analysis method has been shown to predict fatal cardiovascular events in various populations. Similarly, heart rate turbulence and deceleration capacity have performed better than traditional HRV measures in predicting mortality in post-infarction patients. Approximate entropy, a nonlinear index of heart rate dynamics, which describes the complexity of RR interval behaviour, has provided information on the vulnerability to atrial fibrillation. There are many other nonlinear indices which also give information on the characteristics of heart rate dynamics, but their clinical usefulness is not as well established. Although the concepts of nonlinear dynamics, fractal mathematics and complexity measures of heart rate behaviour, heart rate turbulence, deceleration capacity in relation to cardiovascular physiology or various cardiovascular events are still far away from clinical medicine, they are a fruitful area for research to expand our knowledge concerning the behaviour of cardiovascular oscillations in normal healthy conditions as well as in disease states.

  2. Clinical features, MRI brain, and MRS abnormalities of drug-naïve neurologic Wilson′s disease

    Directory of Open Access Journals (Sweden)

    Satyabrata Pulai

    2014-01-01

    Full Text Available Background: Magnetic resonance imaging (MRI helps in the diagnosis of neurologic Wilson′s disease (WD. The literature regarding MR spectroscopy (MRS and diffusion-weighted imaging (DWI in WD is limited. Objectives: To evaluate the clinical features and neuroimaging findings in drug-naοve neurologic WD and to find correlation between clinical stage and disease duration with different imaging findings. Materials and Methods: The study subjects included consecutive and follow-up neurologic WD patients attending movement disorder clinic. The initial clinical and MRI features before commencement of chelation therapy were noted. Of 78 patients, 34 underwent DWI study and MRS was done in 38 patients and in 32 control subjects. Results: Dystonia, dysarthria, tremor, and behavioral abnormality were common presenting features. All patients had MRI abnormality with major affection of basal ganglia. The clinical severity and anatomical extent of MRI abnormalities were positively correlated (P < 0.001; r s = 0.709. Presence of diffusion restriction was inversely related to duration of disease (P < 0.001; r s = 0.760. WD patients had reduced N-acetylaspartate/creatine (Cr and choline (Cho/Cr ratio (P < 0.001 as compared with control subjects in MRS study. Conclusion: Dystonia, dysarthria and tremor are common neurological features of WD. In this study, MRI abnormalities were positively correlated with disease severity; diffusion restriction was inversely correlated with the duration of the disease process. MRS was also a sensitive tool for diagnosing patient of neurologic WD.

  3. Highly accelerated cardiovascular MR imaging using many channel technology: concepts and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Niendorf, Thoralf [RWTH Aachen, University Hospital, Department of Diagnostic Radiology, Aachen (Germany); Sodickson, Daniel K. [New York University School of Medicine, Department of Radiology, Center for Biomedical Imaging, New York, NY (United States)

    2008-01-15

    Cardiovascular magnetic resonance imaging (CVMRI) is of proven clinical value in the non-invasive imaging of cardiovascular diseases. CVMRI requires rapid image acquisition, but acquisition speed is fundamentally limited in conventional MRI. Parallel imaging provides a means for increasing acquisition speed and efficiency. However, signal-to-noise (SNR) limitations and the limited number of receiver channels available on most MR systems have in the past imposed practical constraints, which dictated the use of moderate accelerations in CVMRI. High levels of acceleration, which were unattainable previously, have become possible with many-receiver MR systems and many-element, cardiac-optimized RF-coil arrays. The resulting imaging speed improvements can be exploited in a number of ways, ranging from enhancement of spatial and temporal resolution to efficient whole heart coverage to streamlining of CVMRI work flow. In this review, examples of these strategies are provided, following an outline of the fundamentals of the highly accelerated imaging approaches employed in CVMRI. Topics discussed include basic principles of parallel imaging; key requirements for MR systems and RF-coil design; practical considerations of SNR management, supported by multi-dimensional accelerations, 3D noise averaging and high field imaging; highly accelerated clinical state-of-the art cardiovascular imaging applications spanning the range from SNR-rich to SNR-limited; and current trends and future directions. (orig.)

  4. Clinical perspectives and fundamental aspects of local cardiovascular and renal renin-angiotensin systems

    Directory of Open Access Journals (Sweden)

    Walmor eDe Mello

    2014-02-01

    Full Text Available Evidence for the potential role of organ specific cardiovascular renin-angiotensin systems (RAS has been demonstrated experimentally and clinically with respect to certain cardiovascular and renal diseases. These findings have been supported by studies involving pharmacological inhibition during ischemic heart disease, myocardial infarction, cardiac failure; hypertension associated with left ventricular (LV ischemia, myocardial fibrosis and left ventricular hypertrophy (LVH; structural and functional changes of the target organs associated with prolonged dietary salt excess; and intrarenal vascular disease associated with end-stage renal disease (ESRD. Moreover, the severe structural and functional changes induced by these pathological conditions, can be prevented and reversed by agents producing RAS inhibition (even when not necessarily coincident with alterations in arterial pressure.In this review, we discuss specific fundamental and clinical aspects and mechanisms related to the activation or inhibition of local renin angiotensin systems and their implications for cardiovascular and renal diseases. Fundamental aspects involving the role of angiotensins on cardiac and renal functions including the expression of RAS components in the heart and kidney and the controversial role of ACE2 on angiotensin peptide metabolism in humans, were discussed.

  5. Clinical predictors of abnormal computed tomography scan in minor head trauma in children under 2 years old

    Directory of Open Access Journals (Sweden)

    Sepideh Lotfi Sadigh

    2015-03-01

    Full Text Available Introduction: Minor blunt head trauma is a common reason for children to present to the emergency department (ED. Crania computed tomography (CT is the choice for evaluating children with blunt head trauma in the ED, but few shows abnormal findings. In this study, we aim to evaluate CT findings in children with blunt head trauma and clinical symptoms to identify clinical predictors of abnormal CT scans. Methods: In this prospective study, 218 children under 2 years of age (121 male and 97 female with mean age of 11.24 ± 4.31 months with compliant of minor blunt head trauma visiting the ED between April 2011 and April 2014 were included. Physical examination and clinical symptoms, as well as CT findings and patients’ outcome were evaluated. Results: Physical examinations were normal in 95.9%, and clinical symptoms were present only in 25.7% including vomiting in 16.1%, loss of consciousness (LOC in 8.3%, ear/nose bleeding in 4.1% and seizure in 5.5%. CT scan was requested in 189 cases (86.7% of which, 7.9% were abnormal including linear fracture in 5.3%, subgaleal hematoma in 1.1% and depressed fracture, subcutaneous hematoma and intracranial hemorrhage (ICH each in 0.5%. Among all cases, 89.0% were discharged from ED with no further observation, 6.0% discharged after 48 h observation and 5.0% were hospitalized. There was a significant correlation between abnormal CT findings and having any clinical symptoms, vomiting and Ear/nose bleeding. Conclusion: In children under 2 years old with minor blunt head trauma, most CT scans are unnecessary. Considering clinical symptoms as predictors of abnormal CT scans we can reduce unnecessary ones.

  6. The clinical significance of normal mammograms and normal sonograms in patients with palpable abnormalities of the breast

    International Nuclear Information System (INIS)

    We wanted to evaluate the clinical significance of normal mammograms and normal sonograms in patients with palpable abnormalities of the breast. From Apr 2003 to Feb 2005, 107 patients with 113 palpable abnormalities who had combined normal sonographic and normal mammographic findings were retrospectively studied. The evaluated parameters included age of the patients, the clinical referrals, the distribution of the locations of the palpable abnormalities, whether there was a past surgical history, the mammographic densities and the sonographic echo patterns (purely hyperechoic fibrous tissue, mixed fibroglandular breast tissue, predominantly isoechoic glandular tissue and isoechoic subcutaneous fat tissue) at the sites of clinical concern, whether there was a change in imaging and/or the physical examination results at follow-up, and whether there were biopsy results. This study period was chosen to allow a follow-up period of at least 12 months. The patients' ages ranged from 22 to 66 years (mean age: 48.8 years) and 62 (58%) of the 107 patients were between 41 and 50 years old (58%). The most common location of the palpable abnormalities was the upper outer portion of the breast (45%) and most of the mammographic densities were dense patterns (BI-RADS Type 3 or 4: 91%). Our cases showed similar distribution for all the types of sonographic echo patterns. 23 patients underwent biopsy; all the biopsy specimens were benign. For the 84 patients with 90 palpable abnormalities who were followed, there was no interval development of breast cancer in the areas of clinical concern. Our results suggest that we can follow up and prevent unnecessary biopsies in women with palpable abnormalities when both the mammography and ultrasonography show normal tissue, but this study was limited by its small sample size. Therefore, a larger study will be needed to better define the negative predictive value of combined normal sonographic and mammographic findings

  7. Gene therapy for cardiovascular disease: advances in vector development, targeting, and delivery for clinical translation.

    Science.gov (United States)

    Rincon, Melvin Y; VandenDriessche, Thierry; Chuah, Marinee K

    2015-10-01

    Gene therapy is a promising modality for the treatment of inherited and acquired cardiovascular diseases. The identification of the molecular pathways involved in the pathophysiology of heart failure and other associated cardiac diseases led to encouraging preclinical gene therapy studies in small and large animal models. However, the initial clinical results yielded only modest or no improvement in clinical endpoints. The presence of neutralizing antibodies and cellular immune responses directed against the viral vector and/or the gene-modified cells, the insufficient gene expression levels, and the limited gene transduction efficiencies accounted for the overall limited clinical improvements. Nevertheless, further improvements of the gene delivery technology and a better understanding of the underlying biology fostered renewed interest in gene therapy for heart failure. In particular, improved vectors based on emerging cardiotropic serotypes of the adeno-associated viral vector (AAV) are particularly well suited to coax expression of therapeutic genes in the heart. This led to new clinical trials based on the delivery of the sarcoplasmic reticulum Ca(2+)-ATPase protein (SERCA2a). Though the first clinical results were encouraging, a recent Phase IIb trial did not confirm the beneficial clinical outcomes that were initially reported. New approaches based on S100A1 and adenylate cyclase 6 are also being considered for clinical applications. Emerging paradigms based on the use of miRNA regulation or CRISPR/Cas9-based genome engineering open new therapeutic perspectives for treating cardiovascular diseases by gene therapy. Nevertheless, the continuous improvement of cardiac gene delivery is needed to allow the use of safer and more effective vector doses, ultimately bringing gene therapy for heart failure one step closer to reality.

  8. Clinical Significance of Abnormal Heart Rate Recovery after Treadmill Exercise Test in Patients With Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Li-feng HONG; Hao ZHANG; Ye-xin MA; He-song ZENG; Yuan WEN

    2009-01-01

    Objectives To evaluate the values of abnormal heart rate recovery (HRR) after treadmill exercise test in patients with coronary artery disease (CAD). Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test (TET) and coronary angiography (CAG) were enrolled and di-vided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results (1) The cases of smoking, diabetes mellitus (DM) and ST segment de-viation at rest in abnormal HRR group were more significantly than those in normal HRR group (all P < 0. 05). (2) The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET(P<0.01 and P<0.05, respectively), but lower level of peak heart rate attained (P<0.05) than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference (P<0.05). There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group (P<0.01). (3) The cases of negative CAG results in the group of normal and abnormal HRR group were 73 (66.97 % ) and 24 (34.78 %). Cases of significant coronary lesions (at least one major coronary vessel ≥ 50 % stenosis) a-mongst the subgroup of positive CAG were 36 (33.03 % ) and 45 (65.22 %), severe coronary lesions (three-vessel, left main or the equivalents of left main) were 10 (9.17 % ) and 17 (24.64 %) for normal and abnormal HRR respec-tively (P<0.01). Accordingly, the Gensini scores in the subunit of abnormal HRR increased. (4)Linear correlation analysis indicate there was a negative correlation between the values of HRR in

  9. Relationship Between Clinical and Immunological Features with Magnetic Resonance Imaging Abnormalities in Female Patients with Neuropsychiatric Systemic Lupus Erythematosus

    Institute of Scientific and Technical Information of China (English)

    Hai-Peng Wang; Cui-Yan Wang; Zheng-Lun Pan; Jun-Yu Zhao; Bin Zhao

    2016-01-01

    Background:Conventional magnetic resonance imaging (MRI) is the preferred neuroimaging method in the evaluation ofneuropsychiatric systemic lupus erythematosus (NPSLE).The purpose of this study was to investigate the association between clinical and immunological features with MRI abnormalities in female patients with NPSLE,to screen for the value of conventional MRI in NPSLE.Methods:A total of 59 female NPSLE patients with conventional MRI examinations were enrolled in this retrospective study.All patients were classified into different groups according to MRI abnormalities.Both clinical and immunological features were compared between MRI abnormal and normal groups.One-way analysis of variance was used to compare the systemic lupus erythematosus disease activity index (SLEDAI) score for MRI abnormalities.Multivariate logistic regression analysis investigated the correlation between immunological features,neuropsychiatric manifestations,and MRI abnormalities.Results:Thirty-six NPSLE patients (61%) showed a variety of MRI abnormalities.There were statistically significant differences in SLEDAI scores (P < 0.001),incidence of neurologic disorders (P =0.001),levels of 24-h proteinuria (P =0.001) and immunoglobulin M (P =0.004),and incidence of acute confusional state (P =0.002),cerebrovascular disease (P =0.004),and seizure disorder (P =0.028) between MRI abnormal and normal groups.In the MRI abnormal group,SLEDAI scores for cerebral atrophy (CA),cortex involvement,and restricted diffusion (RD) were much higher than in the MRI normal group (P < 0.001,P =0.002,P =0.038,respectively).Statistically significant positive correlations between seizure disorder and cortex involvement (odds ratio [OR] =14.90;95% confidence interval [CI],1.50-151.70;P =0.023) and cerebrovascular disease and infratentorial involvement (OR =10.00;95% CI,1.70-60.00;P =0.012) were found.Conclusions:MRI abnormalities in NPSLE,especially CA,cortex involvement,and RD might be markers of

  10. Cardiovascular autonomic neuropathy in diabetes

    DEFF Research Database (Denmark)

    Spallone, Vincenza; Ziegler, Dan; Freeman, Roy;

    2011-01-01

    Cardiovascular Autonomic Neuropathy (CAN) Subcommittee of Toronto Consensus Panel on Diabetic Neuropathy worked to update CAN guidelines, with regard to epidemiology, clinical impact, diagnosis, usefulness of CAN testing, and management. CAN is the impairment of cardiovascular autonomic control...... in the setting of diabetes after exclusion of other causes. The prevalence of confirmed CAN is around 20%, and increases up to 65% with age and diabetes duration. Established risk factors for CAN are glycaemic control in type 1 and a combination of hypertension, dyslipidemia, obesity and glycaemic control...... in type 2 diabetes. CAN is a risk marker of mortality and cardiovascular morbidity, and possibly a progression promoter of diabetic nephropathy. Criteria for CAN diagnosis and staging are: 1. one abnormal cardio-vagal test identifies possible or early CAN; 2. at least two abnormal cardio-vagal tests...

  11. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    International Nuclear Information System (INIS)

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84±17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78±10.36), mild defect (2 test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients

  12. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84{+-}17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78{+-}10.36), mild defect (<50MQ : n=9, MQ=66.11{+-}13.87). The degree of rCBF decrease between the two groups was evaluated by {chi}{sup 2} test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients.

  13. AB022. Harnessing big data to transform clinical care of cardiovascular diseases

    Science.gov (United States)

    Cutiongco-de la Paz, Eva Maria

    2015-01-01

    Diseases of the heart and vascular system are the leading causes of mortality worldwide. A number of risk factors have already been identified such as obesity, diabetes and smoking; in the recent years, research has shifted its focus on genetic risk factors. Discoveries on the role of genes partnered with the technological developments have enabled advances in the understanding of human genetics and its influence on disease and treatment. There are initiatives now to combine medical records and genetic and other molecular data into a single “knowledge network” to achieve these aptly known as precision medicine. With next generation sequencing readily available at a more affordable cost, it is expected that genetic information of patients will be increasingly available and can be used to guide clinical decisions. Big data generated and stored necessitates broad and extensive interpretation to be valuable in clinical care. Accumulating evidence on the use of such genetic information in the cardiovascular clinics will be presented.

  14. Dante and cardiology: Physiopathology and clinical features of cardiovascular diseases in the Middle Ages.

    Science.gov (United States)

    Riva, M A; Cambioli, L; Castagna, F; Cianci, N; Varrenti, M; Giannattasio, C; Cesana, G

    2015-02-15

    Ancient non-medical texts can unexpectedly provide useful information on the development of knowledge about the heart and its diseases throughout history. The 750th anniversary of the birth of the Italian poet Dante Alighieri (1265-1321) provides a timely opportunity to analyze medical references in his works, in particular, focusing on literary descriptions that may be attributed to cardiovascular disorders. Dante's high level of medical knowledge, probably derived from his academic studies, is testified by his affiliation to the Florentine Guild of physicians and pharmacists. In all his works, the poet shows a deep interest for the heart. However, his anatomical and physiological knowledge of the circulatory system appears to be poor, probably due to it being based on theories and concepts brought forth by Aristotle and Galen, which were taught in medieval universities. Despite this, accurate descriptions of some symptoms (emotional syncope, orthopnea, dyspnea on exertion) and signs (ascites, paleness), which may be attributed to cardiovascular disorders, can be easily found in Dante's works, particularly in his masterpiece, the Divine Comedy. The literary and historical analysis of cardiovascular signs and symptoms allows us to assume that clinical features due to alterations of heart function were probably known by medieval physicians, but their etiology and pathophysiological mechanisms were not completely understood in that period. Historians of cardiology and clinicians should consider analysis of non-medical texts (including poetry) as an opportunity to better investigate the evolution of their discipline throughout the ages. PMID:25544198

  15. Clinical value of plasma endothelin levels in children with cardiovascular diseases

    International Nuclear Information System (INIS)

    To explore the clinical value of plasma endothelin (ET-1) levels in children with cardiovascular diseases, 77 children with heart failure, obesity, hyperlipemia, fatty liver and hypertension were divided into 5 experimental groups and 21 health children with same age and gender as control group. The plasma levels of ET-1 in these children were tested by RIA. The results showed that plasma levels of ET-1 in 5 experimental groups were 112.8 ± 34.1ng/L, 57.8 ± 19.1ng/L,64.5 ± 25.3ng/L, 74.9 ± 28.4ng/L and 60.7 ± 21.6ng/L, respectively. The ET-1 levels in 5 groups were significantly higher than that in control group (P<0.01). The results indicate the higher plasma ET-1 levels in children are related with cardiovascular diseases, and it is useful in the diagnosis of children cardiovascular diseases. (authors)

  16. Clinical manifestation and humoral immuno-function of myasthenia gravis patients with abnormal and normal thymus gland

    Institute of Scientific and Technical Information of China (English)

    Fuhua Peng; Yongqiang Dai; Wei Qiu; Xueqiang Hu

    2006-01-01

    BACKGROUND: Myasthenia gravis (MG) is an autoimmune disease which mainly affects neuromuscular junctions. The ages, modified Osserman classification and clinical manifestation and humoral immunol function of MG with and without thymic abnormality are different.OBJECTIVE: To explore the clinical manifestation and humoral immuno-function of MG with abnormal and normal thymus gland.DESIGN: Contrast observation.SETTING: Department of Neurology, the Third Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: A total of 49 inpatients with MG were selected from the Third Affiliated Hospital of Sun Yat-sen University from March 2000 to August 2005. All the patients had typical clinical manifestation of MG and positive neostigmine test. All the patients knew and agreed the laboratory examinations. There were 22 males and 27 females of 2-69 years old. Chest MRI or CT scan were performed to reveal thymus gland abnormality. According to whether there was tumor in superior mediastinum, all patients were divided into 2 groups, abnormal and normal groups. Normal thymus gland group (n=30) contained 16 males and 14 famales of 6-43 years old. Abnormal thymus gland group (n=19) contained 6 male and 13 female of 2-69years old.METHODS: ① All patients were questioned about initial symptoms. Meanwhile, main clinical manifestations were recorded at hospital admission. ② 7180A automatic biochemical analyzer and automatic microplate reader were used in detecting seroimmunity index. The levels of C3, C4, IgG, IgA, IgM and CH50 in blood serum were analyzed by nephelometry. ③ Clinical classification is based on modified Osserman classification. The patients with MG were divided into six types: Ⅰ (Ocular myasthenia), Ⅱ a (Mild generalized myasthenia), Ⅱ b (Moderately severe generalized myasthenia), Ⅲ (Acute fulminating myasthenia), Ⅳ (Late severe myasthenia).MAIN OUTCOME MEASURES: ① Differences of initial symptoms and clinical manifestation of two group patients.

  17. [Clinical associations between retinal vascular diseases and cardiovascular diseases in patients with systemic atheromatosis].

    Science.gov (United States)

    Stefănescu-Dima, Alin; Bătăiosu, Constantin; Sas, Teodor; Puianu, Mihaela

    2013-01-01

    A clinical study was conducted on a sample of 48 patients examined within 3 months. Of these, 27 patients were recruited by ophtalmologic criteria and 21 recruited by cardiologic criteria, 25% of these patients coming for routine check. They were investigated by ophthalmic examination, cardiological examination, imaging and laboratory examination. Testing has shown a strong link between cardiovascular disease and the eye of the patients investigated. The study demonstrated the need for interdisciplinary consultation for patients with vascular complaints in the carotid territory and a close correlation between the vascular and ophthalmologic pathology at this level.

  18. Risk assessment models in genetics clinic for array comparative genomic hybridization: Clinical information can be used to predict the likelihood of an abnormal result in patients.

    Science.gov (United States)

    Marano, Rachel M; Mercurio, Laura; Kanter, Rebecca; Doyle, Richard; Abuelo, Dianne; Morrow, Eric M; Shur, Natasha

    2013-03-01

    Array comparative genomic hybridization (aCGH) testing can diagnose chromosomal microdeletions and duplications too small to be detected by conventional cytogenetic techniques. We need to consider which patients are more likely to receive a diagnosis from aCGH testing versus patients that have lower likelihood and may benefit from broader genome wide scanning. We retrospectively reviewed charts of a population of 200 patients, 117 boys and 83 girls, who underwent aCGH testing in Genetics Clinic at Rhode Island hospital between 1 January/2008 and 31 December 2010. Data collected included sex, age at initial clinical presentation, aCGH result, history of seizures, autism, dysmorphic features, global developmental delay/intellectual disability, hypotonia and failure to thrive. aCGH analysis revealed abnormal results in 34 (17%) and variants of unknown significance in 24 (12%). Patients with three or more clinical diagnoses had a 25.0% incidence of abnormal aCGH findings, while patients with two or fewer clinical diagnoses had a 12.5% incidence of abnormal aCGH findings. Currently, we provide families with a range of 10-30% of a diagnosis with aCGH testing. With increased clinical complexity, patients have an increased probability of having an abnormal aCGH result. With this, we can provide individualized risk estimates for each patient.

  19. Risk assessment models in genetics clinic for array comparative genomic hybridization: Clinical information can be used to predict the likelihood of an abnormal result in patients

    Science.gov (United States)

    Marano, Rachel M.; Mercurio, Laura; Kanter, Rebecca; Doyle, Richard; Abuelo, Dianne; Morrow, Eric M.; Shur, Natasha

    2013-01-01

    Array comparative genomic hybridization (aCGH) testing can diagnose chromosomal microdeletions and duplications too small to be detected by conventional cytogenetic techniques. We need to consider which patients are more likely to receive a diagnosis from aCGH testing versus patients that have lower likelihood and may benefit from broader genome wide scanning. We retrospectively reviewed charts of a population of 200 patients, 117 boys and 83 girls, who underwent aCGH testing in Genetics Clinic at Rhode Island hospital between 1 January/2008 and 31 December 2010. Data collected included sex, age at initial clinical presentation, aCGH result, history of seizures, autism, dysmorphic features, global developmental delay/intellectual disability, hypotonia and failure to thrive. aCGH analysis revealed abnormal results in 34 (17%) and variants of unknown significance in 24 (12%). Patients with three or more clinical diagnoses had a 25.0% incidence of abnormal aCGH findings, while patients with two or fewer clinical diagnoses had a 12.5% incidence of abnormal aCGH findings. Currently, we provide families with a range of 10–30% of a diagnosis with aCGH testing. With increased clinical complexity, patients have an increased probability of having an abnormal aCGH result. With this, we can provide individualized risk estimates for each patient. PMID:27625836

  20. Cardiovascular Risk Factor Analysis in Patients with a Recent Clinical Fracture at the Fracture Liaison Service

    Directory of Open Access Journals (Sweden)

    Caroline E. Wyers

    2014-01-01

    Full Text Available Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD and venous thromboembolic events (VTE. The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT, and diabetes mellitus type 2 (DM2 in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS. Out of 3057 patients aged 50–90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs. Based on medical history, 29.9% had a history of CVD (13.7%, VTE (1.7%, HT (14.9%, and DM2 (7.1% or a combination. Their prevalence increased with age (21% in patients aged 50–59 years to 48% in patients aged >80 years and was higher in men than in women (36% versus 27%, but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.

  1. Acute and chronic cardiovascular effects of hyperkalemia: new insights into prevention and clinical management.

    Science.gov (United States)

    McCullough, Peter A; Beaver, Thomas M; Bennett-Guerrero, Elliott; Emmett, Michael; Fonarow, Gregg C; Goyal, Abhinav; Herzog, Charles A; Kosiborod, Mikhail; Palmer, Biff F

    2014-01-01

    The plasma pool of potassium is a partial reflection of the overall body, transient cellular shifts, and potassium elimination regulated by the kidneys. Potassium concentrations elevating above the upper limit of normal (> 5.0 mEq/L) have become more common in cardiovascular practice due to the growing population of patients with chronic kidney disease and the broad applications of drugs that modulate potassium excretion by either reducing production of angiotensin II (angiotensin-converting enzyme inhibitors, direct renin inhibitors, beta-adrenergic receptor antagonists), blocking angiotensin II receptors (angiotensin receptor blockers), or antagonizing the action of aldosterone on mineralocorticoid receptors (mineralocorticoid receptor antagonists). In addition, acute kidney injury, critical illness, crush injuries, and massive red blood cell transfusions can result in hyperkalemia. Progressively more severe elevations in potassium are responsible for abnormalities in cardiac depolarization and repolarization and contractility. Untreated severe hyperkalemia results in sudden cardiac death. Traditional management steps have included reducing dietary potassium and discontinuing potassium supplements; withdrawal of exacerbating drugs; acute treatment with intravenous calcium gluconate, insulin, and glucose; nebulized albuterol; correction of acidosis with sodium bicarbonate for short-term shifts out of the plasma pool; and, finally, gastrointestinal ion exchange with oral sodium polystyrene sulfonate in sorbitol, which is mainly used in the hospital and is poorly tolerated due to gastrointestinal adverse effects. This review explores hyperkalemia as a complication in cardiovascular patients and highlights new acute, chronic, and preventative oral therapies (patiromer calcium, cross-linked polyelectrolyte, ZS-9) that could potentially create a greater margin of safety for vulnerable patients with combined heart and kidney disease.

  2. Ring chromosome 18 abnormality in acute myelogenous leukemia: the clinical dilemma

    Directory of Open Access Journals (Sweden)

    Malone Adriana K

    2010-07-01

    Full Text Available Abstract The ring chromosome is a circular, structural abnormality composed of either multiple chromosomes or a single chromosome with loss of genetic material at one or both ends. This chromosomal rearrangement is often unstable with frequent recombinations and may be accompanied by either loss or amplification of genetic material1. Considering that ring chromosomes are rare in acute myelogenous leukemia (AML, it is difficult to risk stratify patient prognosis, particularly when the ring chromosome occurs as the sole abnormality. Here we report a case of a ring chromosome 18 abnormality in a patient with newly diagnosed AML with monocytic differentiation. Cytogenetic analysis demonstrated 46, XY, r(18(p11q21 karyotype in 19 of 34 evaluated metaphase cells. The patient received induction chemotherapy and subsequent allogeneic cord blood transplant from a sex-matched donor, and remained in hematologic and cytogenetic remission for 120 days post transplant. Soon after, he developed post transplant lymphoproliferative disorder and died of multi-organ failure. Although r(18 chromosomal abnormalities were not classified in the recent updated evidence-and expert opinion-based recommendations for the diagnosis and management of AML (likely due to the small number of reported cases, the patient was treated as high risk with stem cell transplantation. This was based on the unstable nature of the ring chromosome and the poor outcomes described in the literature of patients with sole ring 18 abnormalities.

  3. Myelin Abnormalities in Schizophrenia: Insights from Proteomic Investigations of Post-Mortem Schizophrenia and Pre-Clinical Animal Models

    OpenAIRE

    Farrelly, Lorna

    2014-01-01

    Accumulating evidence from epidemiologic and clinical findings report that both exposure to prenatal inflammation and prenatal iron deficiency significantly increase the risk of developing Schizophrenia in the offspring. Abnormalities in myelin are the most robust neuropathological findings in post-mortem human Schizophrenia, however the exact mechanisms at the protein and pathway levels owing to the myelin deficits are largely unknown. Animal models offer a fruitful approach to study the ...

  4. Electronic Healthcare Record and clinical research in cardiovascular radiology. HL7 CDA and CDISC ODM interoperability.

    Science.gov (United States)

    El Fadly, A; Daniel, C; Bousquet, C; Dart, T; Lastic, P-Y; Degoulet, P

    2007-01-01

    Integrating clinical research data entry with patient care data entry is a challenging issue. At the G. Pompidou European Hospital (HEGP), cardiovascular radiology reports are captured twice, first in the Electronic Health Record (EHR) and then in a national clinical research server. Informatics standards are different for EHR (HL7 CDA) and clinical research (CDISC ODM). The objective of this work is to feed both the EHR and a Clinical Research Data Management System (CDMS) from a single multipurpose form. We adopted and compared two approaches. First approach consists in implementing the single "care-research" form within the EHR and aligning XML structures of HL7 CDA document and CDISC ODM message to export relevant data from EHR to CDMS. Second approach consists in displaying a single "care-research" XForms form within the EHR and generating both HL7 CDA document and CDISC message to feed both EHR and CDMS. The solution based on XForms avoids overloading both EHR and CDMS with irrelevant information. Beyond syntactic interoperability, a perspective is to address the issue of semantic interoperability between both domains. PMID:18693829

  5. Adherence of Staphylococcus aureus to Dyneema Purity® Patches and to Clinically Used Cardiovascular Prostheses.

    Science.gov (United States)

    Basir, Amir; Gründeman, Paul; Moll, Frans; van Herwaarden, Joost; Pasterkamp, Gerard; Nijland, Reindert

    2016-01-01

    Various materials that are used for vascular and heart valve prostheses carry drawbacks: some require anticoagulant drugs or have moderate durability; others are not suitable for endovascular treatment. These prostheses are associated with bacterial infections. A material potentially suitable for prostheses is Dyneema Purity®, made of ultra-high-molecular-weight polyethylene. Dyneema Purity® fibers are very thin, flexible, resistant to fatigue and abrasion, and have high strength. S. aureus adherence to Dyneema Purity® was tested and compared with currently used cardiovascular prostheses. We compared adhesion of S. aureus to Dyneema Purity® (1 membrane-based and 1 yarn-composed patch) with 5 clinically used yarn-composed polyester and membrane-based expanded polytetrafluoroethylene patches. Patches were contaminated with S. aureus bacteria and bacterial adherence was quantified. S. aureus adherence was also visualized in flow conditions. Overall, bacterial adherence was higher on yarn-composed prosthesis materials, with a rough surface, than on the membrane-based materials, with a smooth surface. Adherence to Dyneema Purity® materials was non-inferior to the currently used materials. Therefore, patches of Dyneema Purity® might be attractive for use in cardiovascular applications such as catheter-based heart valves and endovascular prostheses by their good mechanical properties combined with their noninferiority regarding bacterial adhesion. PMID:27583703

  6. Cardiovascular outcomes of sodium-glucose cotransporter 2 inhibitors: A comprehensive review of clinical and preclinical studies.

    Science.gov (United States)

    Ghosh, Raktim Kumar; Bandyopadhyay, Dhrubajyoti; Hajra, Adrija; Biswas, Monodeep; Gupta, Anjan

    2016-06-01

    Diabetes is a leading cause of morbidity and mortality worldwide. Management of diabetes is changing at a rapid pace. Three new classes of antidiabetic drugs including GLP-1 (Glucagon-like peptide 1), DPP-IV (Dipeptidyl peptidase IV) and SGLT2 (Sodium glucose cotransporter 2) inhibitors have been approved in the last few years. Treating diabetes with the antidiabetic drug does not always reduce the cardiovascular complications of diabetes. On the contrary, there was a huge controversy regarding the effect of rosiglitazone on cardiovascular risk reduction a few years ago. Since then, submission of postmarketing cardiovascular outcome study data has been mandated by US FDA and other drug regulatory agencies for newer antidiabetic medications. This is to avoid further premature claims regarding cardiovascular harm or safety of the newer classes. We already have some cardiovascular safety data available on DPP-IV and GLP-1 groups of medications. Dapagliflozin, canagliflozin, and empagliflozin are currently approved SGLT2 inhibitors. We do not have sufficient cardiovascular outcome data available for this novel class. However, this group of drugs, which act by increasing renal glucose excretion, have also shown some non-glycemic benefits including weight reduction, blood pressure control, diuretic action, renal protection, decrease in arterial stiffness and uric acid reduction. Empagliflozin, a new member of SGLT2 class, showed significant cardiovascular morbidity and mortality benefit in recently published EMPA-REG OUTCOME trial. The authors summarize all the published clinical and preclinical cardiovascular outcome data of SGLT2 inhibitors, including recently completed and ongoing major clinical trials in this comprehensive review. PMID:27017118

  7. PHOSPHODIESTERASE-5 INHIBITORS USE IN PATIENTS WITH ERECTILE DYSFUNCTION AND CARDIOVASCULAR DISEASE IN CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2016-01-01

    Full Text Available About 150 million men worldwide and about 50% of men aged 40-88 y.o. in outpatient practice suffer from erectile dysfunction (ED. There is a linear relation between the age and ED rate. The main reason of ED in the majority of men (about 80% of patients is cardiovascular diseases (atherosclerosis, hypertension, diabetes mellitus, as well as certain risk factors (smoking, alcohol abuse, physical inactivity etc.. The problem of ED in cardiac outpatients and modern pharmacotherapy is discussed. The phosphodiesterase-5 (PDE5 inhibitors increase the relaxing effect of nitric oxide and increase cyclic GMP levels during sexual arousal. It results in increase of cavernosum blood flow, contributing to the physiological erection. Three PDE5 inhibitors (sildenafil, tadalafil, vardenafil are used in clinical practice nowadays.

  8. Clinical and pathological manifestations of cardiovascular disease in rat models: the influence of acute ozone exposure

    Science.gov (United States)

    This paper shows that rat models of cardiovascular diseases have differential degrees of underlying pathologies at a young age. Rodent models of cardiovascular diseases (CVD) and metabolic disorders are used for examining susceptibility variations to environmental exposures. How...

  9. Cardiovascular and neurohumoral postural responses and baroreceptor abnormalities during a course of adjunctive vasodilator therapy with felodipine for congestive heart failure.

    Science.gov (United States)

    Kassis, E; Amtorp, O

    1987-06-01

    Studies in patients with congestive heart failure (CHF) have demonstrated an abnormal beta-adrenergic reflex vasodilation during orthostatic tilt. Baroreflex modulation of vascular resistance in patients with CHF was investigated during therapy with a vasoselective calcium antagonist, felodipine. Eight patients on conventional therapy for severe CHF were studied after a 3 week course of additional felodipine or placebo treatment under randomized, double-blind, and crossover conditions. Forearm subcutaneous vascular resistance (FSVR) was estimated with use of the local 133Xe washout. Aortic pulsatile stretch, expressed as the systolic distension in percent of diastolic diameter, was calculated from echocardiographic measurements of aortic root diameters. At 3 weeks, felodipine reduced the arterial pressure, systemic vascular resistance, and FSVR, preserved cardiac filling pressures and heart rate, and increased cardiac output, stroke volume, and aortic pulsatile stretch. Upright tilt (45 degrees) was used to study baroreflex-mediated cardiovascular responses. The unloading of cardiopulmonary baroreceptors during upright tilt was substantial and about equal during both treatment courses, but the pulse pressure was maintained during the placebo and decreased during the felodipine period. During tilt, the patients on placebo failed to increase heart rate and their FSVR, systemic vascular resistance, and arterial mean pressure were decreased, whereas during tilt after felodipine, heart rate and systemic vascular resistance increased to maintain arterial mean pressure and FSVR also tended to increase. Both the stroke volume and aortic pulsatile stretch increased during tilt in patients on placebo but they decreased in those on felodipine. The tilt caused increments in circulating norepinephrine and epinephrine levels during both treatment regimens. Regulation of FSVR during the sympathetic stimulation of orthostatic stress was further elucidated. Proximal neural blockade

  10. Clinical Observation of Kaixin Capsule (开心胶囊) in Treating Type 2 Diabetes Mellitus Complicated with Abnormal Lipidemia

    Institute of Scientific and Technical Information of China (English)

    薛军; 陈镜合

    2002-01-01

    Objective: To observe the clinical efficacy of Kaixin Capsule (KXC, 开心胶囊), a Chinese compound preparation, in treating type 2 diabetes mellitus (DM) complicated with abnormal lipidemia. Methods: Seventy-two DM inpatients were medicated on the basis of administering conventional hypoglycemics, and KXC was orally taken. They were compared with those patients only taking hypoglycemics to observe the change of blood lipid before and after treatment. Results: The total cholesterol of KXC combined with hypoglycemics group had their blood lipid lowered by 14% after treatment and triglyceride lowered by 36%, HDL-C raised by 11%, and LDL-C lowered by 24%. Compared with only hypoglycemics treatment, there was significant difference (P<0.01). Conclusion: KXC has good blood lipid regulating effect on DM complicated with abnormal lipidemia.

  11. CARDIOVASCULAR DISEASES TREATMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN CURRENT CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    I. E. Sapozhnikova

    2009-01-01

    Full Text Available Aim. To evaluate cardiovascular diseases (CVD treatment in patients with type 2 diabetes mellitus (DM 2 in current clinical practice.Material and methods. A total of 200 patients with DM 2, who consented to take part in the questionnaire, were examined. Questionnaire, clinical and laboratory examinations were conducted.Results. There was a low frequency of CVD recognized and included into clinical diagnosis – angina, history of myocardial infarction and stroke. In majority of the patients decompensated carbohydrate metabolism was observed. This was due to lack of knowledge, inadequate or absent glucose self-monitoring, low frequency of combined glucoselowering therapy. Target level of blood pressure (BP was registered in 16% of hypertensive patients only. Basic reasons of this were: frequently prescribed mono-therapy, irrational combinations, inadequate dosage and frequent omissions of antihypertensive drugs intake and not appropriate BP self-monitoring. Low frequency of statins therapy and non-targeted cholesterol levels were also revealed in examined patients.Conclusion. Improvement of diagnostic tactics in patients with DM 2 is necessary as well as therapy correction taking into account these patients co-morbidity.

  12. CARDIOVASCULAR DISEASES TREATMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN CURRENT CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    I. E. Sapozhnikova

    2016-01-01

    Full Text Available Aim. To evaluate cardiovascular diseases (CVD treatment in patients with type 2 diabetes mellitus (DM 2 in current clinical practice.Material and methods. A total of 200 patients with DM 2, who consented to take part in the questionnaire, were examined. Questionnaire, clinical and laboratory examinations were conducted.Results. There was a low frequency of CVD recognized and included into clinical diagnosis – angina, history of myocardial infarction and stroke. In majority of the patients decompensated carbohydrate metabolism was observed. This was due to lack of knowledge, inadequate or absent glucose self-monitoring, low frequency of combined glucoselowering therapy. Target level of blood pressure (BP was registered in 16% of hypertensive patients only. Basic reasons of this were: frequently prescribed mono-therapy, irrational combinations, inadequate dosage and frequent omissions of antihypertensive drugs intake and not appropriate BP self-monitoring. Low frequency of statins therapy and non-targeted cholesterol levels were also revealed in examined patients.Conclusion. Improvement of diagnostic tactics in patients with DM 2 is necessary as well as therapy correction taking into account these patients co-morbidity.

  13. Abnormal Unsaturated Fatty Acid Metabolism in Cystic Fibrosis: Biochemical Mechanisms and Clinical Implications

    OpenAIRE

    Seegmiller, Adam C.

    2014-01-01

    Cystic fibrosis is an inherited multi-organ disorder caused by mutations in the CFTR gene. Patients with this disease exhibit characteristic abnormalities in the levels of unsaturated fatty acids in blood and tissue. Recent studies have uncovered an underlying biochemical mechanism for some of these changes, namely increased expression and activity of fatty acid desaturases. Among other effects, this drives metabolism of linoeate to arachidonate. Increased desaturase expression appears to be ...

  14. Prevention of cardiovascular disease guided by total risk estimations - challenges and opportunities for practical implementation: highlights of a CardioVascular Clinical Trialists (CVCT) Workshop of the ESC Working Group on CardioVascular Pharmacology and Drug Therapy.

    LENUS (Irish Health Repository)

    Zannad, Faiez

    2011-11-03

    This paper presents a summary of the potential practical and economic barriers to implementation of primary prevention of cardiovascular disease guided by total cardiovascular risk estimations in the general population. It also reviews various possible solutions to overcome these barriers. The report is based on discussion among experts in the area at a special CardioVascular Clinical Trialists workshop organized by the European Society of Cardiology Working Group on Cardiovascular Pharmacology and Drug Therapy that took place in September 2009. It includes a review of the evidence in favour of the \\'treat-to-target\\' paradigm, as well as potential difficulties with this approach, including the multiple pathological processes present in high-risk patients that may not be adequately addressed by this strategy. The risk-guided therapy approach requires careful definitions of cardiovascular risk and consideration of clinical endpoints as well as the differences between trial and \\'real-world\\' populations. Cost-effectiveness presents another issue in scenarios of finite healthcare resources, as does the difficulty of documenting guideline uptake and effectiveness in the primary care setting, where early modification of risk factors may be more beneficial than later attempts to manage established disease. The key to guideline implementation is to improve the quality of risk assessment and demonstrate the association between risk factors, intervention, and reduced event rates. In the future, this may be made possible by means of automated data entry and various other measures. In conclusion, opportunities exist to increase guideline implementation in the primary care setting, with potential benefits for both the general population and healthcare resources.

  15. Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations.

    Science.gov (United States)

    Low Wang, Cecilia C; Hess, Connie N; Hiatt, William R; Goldfine, Allison B

    2016-06-14

    Cardiovascular disease remains the principal cause of death and disability among patients with diabetes mellitus. Diabetes mellitus exacerbates mechanisms underlying atherosclerosis and heart failure. Unfortunately, these mechanisms are not adequately modulated by therapeutic strategies focusing solely on optimal glycemic control with currently available drugs or approaches. In the setting of multifactorial risk reduction with statins and other lipid-lowering agents, antihypertensive therapies, and antihyperglycemic treatment strategies, cardiovascular complication rates are falling, yet remain higher for patients with diabetes mellitus than for those without. This review considers the mechanisms, history, controversies, new pharmacological agents, and recent evidence for current guidelines for cardiovascular management in the patient with diabetes mellitus to support evidence-based care in the patient with diabetes mellitus and heart disease outside of the acute care setting.

  16. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Goudis, Christos A; Konstantinidis, Athanasios K; Ntalas, Ioannis V; Korantzopoulos, Panagiotis

    2015-11-15

    Chronic obstructive pulmonary disease (COPD) is independently associated with an increased burden of cardiovascular disease. Besides coronary artery disease (CAD) and congestive heart failure (CHF), specific electrocardiographic (ECG) abnormalities and cardiac arrhythmias seem to have a significant impact on cardiovascular prognosis of COPD patients. Disturbances of heart rhythm include premature atrial contractions (PACs), premature ventricular contractions (PVCs), atrial fibrillation (AF), atrial flutter (AFL), multifocal atrial tachycardia (MAT), and ventricular tachycardia (VT). Of note, the identification of ECG abnormalities and the evaluation of the arrhythmic risk may have significant implications in the management and outcome of patients with COPD. This article provides a concise overview of the available data regarding ECG abnormalities and arrhythmias in these patients, including an elaborated description of the underlying arrhythmogenic mechanisms. The clinical impact and prognostic significance of ECG abnormalities and arrhythmias in COPD as well as the appropriate antiarrhythmic therapy and interventions in this setting are also discussed. PMID:26218181

  17. The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Lorenzo Pradelli

    2006-09-01

    Full Text Available HMGCoA-inhibitors (statins lower plasma cholesterol through interference with the rate-limiting enzyme in the endogenous synthesis process. Since their introduction in the early 90’s, the clinical attitude towards cardiovascular (cv risk reduction has evolved from the attention to single risk factors to a more comprehensive global risk evaluation, and thus the indications of statins have broadened from the secondary prevention in hypercholesterolemic patients to include primary prevention in mildly and moderately hypercholesterolemic, or even normocholesterolemic patients, provided their global cv risk is considered high (typically, an estimated major cv event probability greater than 20%. Italian drug utilization data show that a small proportion of patients who could benefit from statins do actually receive them, contributing to the persistence of the clinical and economical burden of cv disease, the leading cause of mortality; since statins have proved effective, and cost-effective, in cv prevention, a more widespread use appears desirable, but requires high investments in pharmaceutical costs. This article defines a clinical profile of lovastatin, a statin with a solid efficacy and safety record only recently introduced into the Italian market despite it has been the first to become clinically available abroad. Among available statin formulations appropriate for target cholesterol reductions up to 30%, which apply to a significant proportion of statin therapy candidates, lovastatin 20 mg is marketed at the lowest price. Although the individual response to the different statins is highly unpredictable, determining a mandatory empirical molecule- and dose-finding strategy on the single patient, from the societal point of view the choice to start with lower cost molecules, among options that on average are equally-effective, may limit initial drug investment and dampen the impact of resource waste secondary to treatment interruptions and

  18. Computer aided diagnosis of bone tumours and tumour-like skeletal abnormalities: Critical evaluation of its clinical use

    Energy Technology Data Exchange (ETDEWEB)

    Fotter, R.; Gell, G.; Melzer, G.; Kopp, W.; Lehnert, M.; Weybora, W.

    1988-05-01

    Thirty-four patients with bone tumours and tumour-like abnormalities of the skeleton, of varying ages, were examined by a computer-aided diagnostic programm; the accuracy, clinical usefullness and specific advantages and disadvantages of the programm have been evaluated. This was done by two statistical methods, both with showed high accuracy and reliability of the system (97% and 88,2%). In addition to the diagnostic results, the growth rate of the lesion could be estimated. This indicates the biological behaviour of the tumour independently of the histological diagnosis.

  19. Clinically Relevant Cardiovascular Findings Detected on Staging Computed Tomography in Patients with Several Malignancies.

    Science.gov (United States)

    Surov, Alexey; Bach, Andreas Gunter; Schramm, Dominik

    2016-08-01

    We evaluated the frequency and subtypes of clinically relevant cardiovascular (CV) findings identified on staging computed tomography (CT) in a large sample. Patients (n = 5026) with different malignant diseases were staged by CT. Clinically relevant CV findings (CRCFs) were included into the study. The CRCFs were defined as cardiac aneurysm, cardiac thrombus, venous thrombosis, arterial thrombosis, arterial dissection, pulmonary thromboembolism, arterial dissection, and dislocation of venous ports/central venous catheters. The CRCFs were identified in 342 patients (6.8% of all patients). Overall, 491 CRCFs were identified in the patients (1.4 per patient). In 203 (59.4%) patients, 1 CRCF; in 129, 2 (37.7%) CRCFs; and in 10 (2.9%) cases, 3 CRCFs were detected. There were incidental venous thrombosis (n = 298, 60.7% of all CRCFs), pulmonary thromboembolism (n = 84, 17.1%), arterial aneurysms (n = 44, 8.9%), arterial thrombosis (n = 43, 8.8%), heart thrombus (n = 15, 3.1%), arterial dissection (n = 3, 0.6%), heart aneurysms (n = 2, 0.4%), and port catheter dislocation (n = 2, 0.4%). The identified CRCF can be associated with potential hazardous complications. The CV system should be carefully evaluated in staging CT investigations. PMID:26399716

  20. Clinical significance of abnormal protein bands in multiple myeloma treated with bortezmib-based induction regimen and autologous stem cell transplantation

    Institute of Scientific and Technical Information of China (English)

    王荷花

    2013-01-01

    Objective To study the clinical significance of abnormal protein bands(APB)in multiple myeloma(MM) patients treated with bortezomib-based induction regimen and autologous stem cell transplantation(ASCT)

  1. Quantitative analysis of abnormal spontaneous behavior and clinical assessment of the stargazer rat.

    Science.gov (United States)

    Brock, J W; Truett, G E; Ross, K D; Kloster, C A

    1995-06-01

    A new mutant derived from the Zucker rat strain called stargazer (homozygous stg/stg) displays abnormal behavior that is characterized by pronounced arching of the neck ("stargazing"), rapid circling, and conspicuous hyperactivity. Results of serologic assays performed by two independent diagnostic laboratories have indicated that the abnormal behavior in the stargazer is not the result of a viral or bacterial infection. In this report, different groups of stargazer rats and their normal-behaving littermates (heterozygous stg/+) were assessed with regard to spontaneous behaviors, heart rate, blood pressure, and plasma biochemical profiles. Besides frequent stargazing, the predominant behavioral feature of the stargazers was extreme hyperactivity; they had sevenfold greater activity than the normal littermates (P stargazers had significantly greater daily calorie and water consumption, despite being significantly smaller in body weight than the littermates (P Stargazers had significantly lower total triglycerides concentration and lower aminotransferase activity than littermates (P stargazer rats are extremely hyperactive but normotensive; heterozygous littermates are behaviorally normal, despite being carriers of the stg gene; and routine diagnostic blood testing revealed no important differences between the stargazers and their unaffected littermates. PMID:7650898

  2. Clinical neurocardiology defining the value of neuroscience-based cardiovascular therapeutics.

    Science.gov (United States)

    Shivkumar, Kalyanam; Ajijola, Olujimi A; Anand, Inder; Armour, J Andrew; Chen, Peng-Sheng; Esler, Murray; De Ferrari, Gaetano M; Fishbein, Michael C; Goldberger, Jeffrey J; Harper, Ronald M; Joyner, Michael J; Khalsa, Sahib S; Kumar, Rajesh; Lane, Richard; Mahajan, Aman; Po, Sunny; Schwartz, Peter J; Somers, Virend K; Valderrabano, Miguel; Vaseghi, Marmar; Zipes, Douglas P

    2016-07-15

    The autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology of many cardiovascular diseases. As such, the value of neuroscience-based cardiovascular therapeutics is increasingly evident. This White Paper reviews the current state of understanding of human cardiac neuroanatomy, neurophysiology, pathophysiology in specific disease conditions, autonomic testing, risk stratification, and neuromodulatory strategies to mitigate the progression of cardiovascular diseases. PMID:27114333

  3. Clinical Application of Breast Fiberoptic Ductoscopy in 354 Cases with Abnormal Nipple Discharge

    Institute of Scientific and Technical Information of China (English)

    HengweiZhang; GuifenYang; HuaYang; FawenLiu; ShudeCui

    2004-01-01

    OBJECTIVE To use the breast duct endoscope for studying thepathological characteristics of breast-duct disease with nipple discharge,and offer methods that can improve diagnostic accuracy.METHODS A total of 354 patients with nipple discharge were examinedusing the fiberoptic duct endoscope (FVS-3000M). Ducts and theirbranches were investigated to define and locate the extent of intraductallesions. Core biopsies were taken of suspicious lesions and the findingswere analyzed retrospectively.RESULTS In cases of bloody and serosanguineous nipple discharge,72.3% were papilloma and papillomatosis, 5.2% duct cancer and 22.5%mammary duct ectasia and galactophoritis. In patients with watery nippledischarge, 56.0% were papilloma and papillomatosis, 8.0% were breastcancer and 5 patients without abnormal findings were regarded asnormal.CONCLUSION Fiberoptic duct endoscopy can accurately locate the siteand pathology of nipple discharge allowing the improvement in diagnosisof early breast cancer.

  4. [Clinical and therapeutic aspects of pyelo-ureteral junction abnormalities at the University Hospital of Point G].

    Science.gov (United States)

    Tembely, Aly; Kassogué, Amadou; Berthé, Honoré; Ouattara, Zanafon

    2016-01-01

    This study is meant to analyze the clinical and therapeutic aspects of abnormalities ureteropelvic junction. Cross-sectional and descriptive study on 35 cases of abnormalities of the AUPJ collected the Urology Department of the University Hospital of Point G for a period of 4 years (January 2010 to December 2014). Data were collected on the survey forms, medical records and records of the block. The socio-demographic, clinical and therapeutic data were entered into Microsoft Word 2007 and Excel 2007 and analyzed on SPSS 18.0. Between January 2010 and December 2014, 35 cases of AUPJ were collected. The average age was 29.3 years. The back pain was the most frequent reason for consultation or 40%. 20% of patients were consulting for the first time 10 years symptomatic evolution. Kidney destruction was observed in 28.6%. The association Ultrasound + IVU has established the diagnosis in 37.1%. A urinary tract infection was found in 60%. The gallstone complication was present in 17.1% of patients. 51.4% of patients received open pyeloplasty by Anderson Kuss. The anomaly of the ureteropelvic junction in our study was marked by a consultation with delay formidable complications. The open surgery has been the gold standard with satisfactory results. The endopyéloplasty, the treatment of laparoscopic minimally invasive joint surgeries are not available to us but to encourage and incorporate in the therapeutic arsenal. PMID:27516821

  5. Lessons learned from cardiovascular outcome clinical trials with dipeptidyl peptidase 4 (DPP-4) inhibitors.

    Science.gov (United States)

    Fiorentino, Teresa Vanessa; Sesti, Giorgio

    2016-08-01

    Previous trials of glucose-lowering strategies in subjects with type 2 diabetes have demonstrated a beneficial effect of intensive glycemic control on microvascular complications but failed to show a clear benefit on cardiovascular complications. The findings of meta-analyses of rosiglitazone trials suggesting that rosiglitazone might increase the risk of myocardial infarction have cast doubt on the cardiovascular safety of glucose-lowering drugs. In 2008, the US Food and Drug Administration has implemented rigorous criteria to approve new glucose-lowering drugs, requiring proof of cardiovascular safety. These regulatory requirements have led to a considerable increase in the number of cardiovascular outcome trials in type 2 diabetes to ensure that newer glucose-lowering drugs are not associated with increased cardiovascular risk. Incretin-based therapies including dipeptidyl peptidase 4 (DPP-4) inhibitors, and injectable glucagon-like peptide 1 (GLP-1) receptor agonists are novel treatment options for patients with inadequate glucose control. Although DPP-4 inhibitors have shown neutral effects on risk factors for cardiovascular diseases, it remains unclear whether treatment with these new glucose-lowering agents might be associated with a reduction in cardiovascular events. The results of the three cardiovascular outcome trials comparing DPP-4 inhibitors treatment to placebo in addition to other glucose-lowering drugs have been published. All the three DPP-4 inhibitor cardiovascular outcome trials have shown non-inferiority with regard to cardiovascular safety, compared with placebo, when added to usual care. In this review, we summarize cardiovascular outcome trials of DPP-4 inhibitors, and provide an overview of these trials and their limitations. PMID:26611248

  6. Anormalidades cardiovasculares e metabólicas em pacientes com a síndrome de Berardinelli-Seip Anormalidades cardiovasculares y metabólicas en pacientes con el síndrome de Berardinelli-Seip Cardiometabolic abnormalities in patients with berardinelli-Seip syndrome

    Directory of Open Access Journals (Sweden)

    Antonio Guedes do Rêgo

    2010-01-01

    .BACKGROUND: Berardinelli-Seip syndrome (BSS or Generalized Congenital Lipodystrophy often affects the cardiovascular system and also promotes metabolic abnormalities involving glycidic and lipid metabolisms. OBJECTIVE: To assess the prevalence of cardiometabolic abnormalities in patients with BSS. METHODS: Twenty-two patients from the state of Rio Grande do Norte, Brazil, diagnosed with BSS, underwent clinical evaluation, resting electrocardiogram, echodopplercardiogram, chest X-ray, 24-hour ambulatory electrocardiogram monitoring, exercise testing and laboratory analysis. RESULTS: The patients were predominantly young adults, most of whom women. The whole sample showed insulin resistance, acanthosis nigricans and diminished HDL-cholesterol. The presence of splenomegaly, hepatomegaly, type II diabetes and elevated triglycerides was constant. Metabolic syndrome was characterized in most patients, which were predominantly women and with a high degree of paternal consanguinity. SAH and prehypertension blood pressure were found in more than half of the patients (77.3%. The echodopplercardiogram showed the presence of CLVH (50%, eccentric left ventricular hypertrophy (4.5%, and normal left ventricular geometry (45.5%. High arrhythmia rates were observed by Holter monitoring, such as ventricular ectopic beats, supraventricular ectopic beats and sustained supraventricular tachycardia. Chronotropic incompetence (54.5% was observed during exercise testing. CONCLUSION: A high prevalence of cardiovascular and metabolic abnormalities was observed in young asymptomatic individuals with BSS. These findings point to the need for systematic cardiological follow-up and of preventive measures in this high-risk group.

  7. Validez del cuestionario cardiovascular MONICA comparado con la historia clínica Validity of the MONICA cardiovascular questionnaire compared with clinical records

    Directory of Open Access Journals (Sweden)

    José M. Baena-Díez

    2009-12-01

    Determinants in Cardiovascular Disease (MONICA compared with clinical records. Methods: A descriptive, prospective, multicenter study was performed within the framework of the Peripheral Arterial Disease Study (PERART in 3,329 persons aged >50 years old. The sample was selected by simple random sampling in 32 primary health care centers. The diagnoses included were acute myocardial infarction, angina pectoris, cerebrovascular disease, hypertension, diabetes mellitus, and hypercholesterolemia. Treatment variables were also considered (antihypertensive, lipid-lowering and hypoglycemic agents or insulin, as well as antiplatelet or anticoagulant agents. The sensitivity, specificity, predictive values, and kappa index were computed to test the validity of the MONICA questionnaire. Results: The mean age was 65 years (SD 8.9 and 54.8% were women. The sensitivity of the questionnaire was >90% for all the variables apart from angina pectoris (89.9% and cerebrovascular disease (86.5%. Specificity was also >90%, except for angina pectoris (88.3% and hypercholesterolemia (77.5%. The positive predictive value was >90% for all the treatments; >80% for angina pectoris, acute myocardial infarction and hypertension; 79.4% for cerebrovascular disease; 79.1% for hypercholesterolemia and 73.4% for diabetes mellitus. The negative predictive value was >90% for all the variables. The kappa indexes were >0.80 for all the variables apart from hypercholesterolemia (0.69 and diabetes mellitus (0.79. Conclusions: The MONICA cardiovascular questionnaire is valid in the assessment of cardiovascular disease, risk factors and treatments in patients aged >50 years old.

  8. Late gadolinium enhancement cardiovascular magnetic resonance predicts clinical worsening in patients with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Freed Benjamin H

    2012-02-01

    Full Text Available Abstract Background Late gadolinium enhancement (LGE occurs at the right ventricular (RV insertion point (RVIP in patients with pulmonary hypertension (PH and has been shown to correlate with cardiovascular magnetic resonance (CMR derived RV indices. However, the prognostic role of RVIP-LGE and other CMR-derived parameters of RV function are not well established. Our aim was to evaluate the predictive value of contrast-enhanced CMR in patients with PH. Methods RV size, ejection fraction (RVEF, and the presence of RVIP-LGE were determined in 58 patients with PH referred for CMR. All patients underwent right heart catheterization, exercise testing, and N-terminal pro-brain natriuretic peptide (NT-proBNP evaluation; results of which were included in the final analysis if performed within 4 months of the CMR study. Patients were followed for the primary endpoint of time to clinical worsening (death, decompensated right ventricular heart failure, initiation of prostacyclin, or lung transplantation. Results Overall, 40/58 (69% of patients had RVIP-LGE. Patients with RVIP- LGE had larger right ventricular volume index, lower RVEF, and higher mean pulmonary artery pressure (mPAP, all p Conclusions The presence of RVIP-LGE in patients with PH is a marker for more advanced disease and poor prognosis. In addition, this study reveals for the first time that CMR-derived RVEF is an independent non-invasive imaging predictor of adverse outcomes in this patient population.

  9. Clinical investigation study on occupational exposure of operators during cardiovascular intervention

    International Nuclear Information System (INIS)

    Objective: To investigate the personal effective dose of the operator in cardiovascular intervention. Methods: Lithium fluoride (LiF) thermoluminescent dosimeters (TLD) were used to carry out personal dose monitoring for the operator. Effective doses of the operator were evaluated in 28 clinical operations. Results: The average fluoroscopy time for 24 Coronary angiography (CA), percutaneous transluminal coronary angioplasty (PTCA) and percutaneous intracoronary arterial stenting (PICAS) procedures was 19.2±6.3 min, and the average effective dose of the operator per procedure was 4.1±0.9 μSv (under protection) and 52.2±15.5 μSv (without protection). However, for 4 PT procedures, average fluoroscopy time was 14.1±4.6 min, and the average effective dose of the operator per operation was 5.5±1.4 μSv (under protection) and 220±42 μSv (without protection). Conclusions: Reducing fluoroscopy time, femoral artery access to the patients are recommended during interventional procedures. In order to decrease the radiation risk to the lowest level, more advanced equipment should be applied and radiation protection should be fully managed. (authors)

  10. The Clinical and Nonclinical Values of Nonexercise Estimation of Cardiovascular Endurance in Young Asymptomatic Individuals

    Directory of Open Access Journals (Sweden)

    Mahmoud A. Alomari

    2012-01-01

    Full Text Available Exercise testing is associated with barriers prevent using cardiovascular (CV endurance (CVE measure frequently. A recent nonexercise model (NM is alleged to estimate CVE without exercise. This study examined CVE relationships, using the NM model, with measures of obesity, physical fitness (PF, blood glucose and lipid, and circulation in 188 asymptomatic young (18–40 years adults. Estimated CVE correlated favorably with measures of PF (r=0.4-0.5 including handgrip strength, distance in 6 munities walking test, and shoulder press, and leg extension strengths, obesity (r=0.2-0.7 including % body fat, body water content, fat mass, muscle mass, BMI, waist and hip circumferences and waist/hip ratio, and circulation (r=0.2-0.3 including blood pressures, blood flow, vascular resistance, and blood (r=0.2-0.5 profile including glucose, total cholesterol, LDL-C, HDL-C, and triglycerides. Additionally, differences (P<0.05 in examined measures were found between the high, average, and low estimated CVE groups. Obviously the majority of these measures are CV disease risk factors and metabolic syndrome components. These results enhance the NM scientific value, and thus, can be further used in clinical and nonclinical settings.

  11. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues.

    Science.gov (United States)

    Gekas, Jean; Langlois, Sylvie; Ravitsky, Vardit; Audibert, François; van den Berg, David Gradus; Haidar, Hazar; Rousseau, François

    2016-01-01

    Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening) was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. PMID:26893576

  12. Magnetic resonance imaging of sacroiliitis in early seronegative spondylarthropathy. Abnormalities correlated to clinical and laboratory findings

    DEFF Research Database (Denmark)

    Puhakka, K B; Jurik, A G; Schiøttz-Christensen, Berit;

    2004-01-01

    OBJECTIVE: To compare a new MRI scoring system of the sacroiliac joints (SIJs) in early spondylarthropathy (SpA) with clinical and laboratory parameters. METHODS: Forty-one patients (24 males, 17 females) with a median age of 26 yr and a median duration of inflammatory low back pain of 19 months...... were included. They all fulfilled the ESSG-criteria for SpA. The patients were examined by MRI of the SIJs using a new scoring system. Clinical examinations, biochemical tests, functional score (BASFI), and pain score (BASDAI) were also performed. RESULTS: 95% of the patients had inflammation and....../or destructive bone changes of the SIJs at MRI. No correlation was found between MRI pathology and clinical findings. MRI demonstrated significantly greater severity of both inflammation and destruction of the SIJs in HLA B27 positive patients than in the HLA B27 negative patients. CONCLUSIONS: In patients with...

  13. Hormones and Cardiovascular Disease: A Shift in Paradigm with Clinical Consequences?

    NARCIS (Netherlands)

    B. van Zaane; A.Q. Reuwer; H.R. Büller; J.J.P. Kastelein; V.E.A. Gerdes; M.T.B. Twickler

    2009-01-01

    Several endocrine disorders have been associated with an increased risk of cardiovascular disease (CVD) and mortality. In addition, even subtle hormonal disturbances may modulate the function of cardiovascular organs. In this article, we discuss in detail the contribution of thyroid hormones, cortis

  14. [Somatotype of the patients with obesity and associated cardio-vascular patholodgy. Clinical and anthropological bonds].

    Science.gov (United States)

    Bukavneva, N S; Pozdniakov, A L; Nikitiuk, D B

    2008-01-01

    In the article there are presented major anthropometric parameters of patients (male and female) with obesity, combined with cardiovascular pathology, before and after treatment. Constitutional predisposition to obesity is defined. Efficacy of dietary therapy is estimated and with obesity are defined on the basil of associated cardio-vascular pathology. PMID:18839806

  15. Cardiovascular Outcomes in the Outpatient Kidney Transplant Clinic: The Framingham Risk Score Revisited

    OpenAIRE

    Kiberd, Bryce; Panek, Romuald

    2008-01-01

    Background and objectives: Cardiovascular disease is an important cause of morbidity and death in kidney transplant recipients. This study examines the Framingham risk score's ability to predict cardiac and stroke events. Because cyclosporine and tacrolimus have different cardiovascular risk profiles, these agents were also examined.

  16. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar Hilmar; Charlot, Mette Gitz;

    2011-01-01

    Objective. The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. Design, setting and subjects. We conducted a cohort study of the entire Danish population aged...... with psoriasis and psoriatic arthritis. Main outcome measures. All-cause mortality, cardiovascular mortality and hospitalizations for myocardial infarction (MI), stroke and coronary revascularization were recorded. Results. A total of 34 371 patients with mild psoriasis and 2621 with severe psoriasis, including...... 607 with psoriatic arthritis, were identified and compared with 4 003 265 controls. The event rates and rate ratios (RRs) of all-cause mortality, cardiovascular death, MI, coronary revascularization, stroke and a composite of MI, stroke and cardiovascular death were increased in patients...

  17. Psoriasis is associated with clinically significant cardiovascular risk: a Danish nationwide cohort study

    DEFF Research Database (Denmark)

    Ahlehoff, O; Gislason, G H; Charlot, M;

    2011-01-01

    . The magnitude of the cardiovascular risk from psoriasis and psoriatic arthritis is debated. We therefore investigated the psoriasis-related risk of adverse cardiovascular events and mortality. Design, setting and subjects. We conducted a cohort study of the entire Danish population aged =18 years followed from...... and psoriatic arthritis. Main outcome measures. All-cause mortality, cardiovascular mortality and hospitalizations for myocardial infarction (MI), stroke and coronary revascularization were recorded. Results. A total of 34 371 patients with mild psoriasis and 2621 with severe psoriasis, including 607...... with psoriatic arthritis, were identified and compared with 4 003 265 controls. The event rates and rate ratios (RRs) of all-cause mortality, cardiovascular death, MI, coronary revascularization, stroke and a composite of MI, stroke and cardiovascular death were increased in patients with psoriasis. The rate...

  18. Chromosomal abnormalities in clinical psychiatry : a report of two older patients

    NARCIS (Netherlands)

    Verhoeven, W. M. A.; Tuerlings, J. H. A. M.; van Ravenswaay-Arts, C. M. A.; Boermans, J. A. J.; Tuinier, S.

    2007-01-01

    Background and Objectives: In clinical psychiatry genetic anomalies are infrequently part of the differential diagnosis, especially in the elderly. Two case reports are used to illustrate the relevance of a genetic workup for diagnosis, treatment and prognosis. Methods: A female and a male patient,

  19. Normal and abnormal development of pulmonary veins : State of the art and correlation with clinical entities

    NARCIS (Netherlands)

    Douglas, Yvonne L.; Jongbloed, Monique R. M.; DeRuiter, Marco C.; Gittenberger-de Groot, Adriana C.

    2011-01-01

    Interest for the pulmonary veins has increased in the past decade after the potential arrhythmogenicity of the myocardial sleeve surrounding these structures has been recognized. Furthermore, there are several clinical entities, such as anomalous connection pattern and pulmonary vein stenosis, that

  20. Clinical manifestations that predict abnormal brain computed tomography (CT in children with minor head injury

    Directory of Open Access Journals (Sweden)

    Nesrin Alharthy

    2015-01-01

    Full Text Available Background: Computed tomography (CT used in pediatric pediatrics brain injury (TBI to ascertain neurological manifestations. Nevertheless, this practice is associated with adverse effects. Reports in the literature suggest incidents of morbidity and mortality in children due to exposure to radiation. Hence, it is found imperative to search for a reliable alternative. Objectives: The aim of this study is to find a reliable clinical alternative to detect an intracranial injury without resorting to the CT. Materials and Methods: Retrospective cross-sectional study was undertaken in patients (1-14 years with blunt head injury and having a Glasgow Coma Scale (GCS of 13-15 who had CT performed on them. Using statistical analysis, the correlation between clinical examination and positive CT manifestation is analyzed for different age-groups and various mechanisms of injury. Results: No statistically significant association between parameteres such as Loss of Consciousness, ′fall′ as mechanism of injury, motor vehicle accidents (MVA, more than two discrete episodes of vomiting and the CT finding of intracranial injury could be noted. Analyzed data have led to believe that GCS of 13 at presentation is the only important clinical predictor of intracranial injury. Conclusion: Retrospective data, small sample size and limited number of factors for assessing clinical manifestation might present constraints on the predictive rule that was derived from this review. Such limitations notwithstanding, the decision to determine which patients should undergo neuroimaging is encouraged to be based on clinical judgments. Further analysis with higher sample sizes may be required to authenticate and validate findings.

  1. Electrocardiographic pattern combined with echocardiographic wall motion abnormalities in stress related cardiomyopathies: clinical and pathophysiological insights

    OpenAIRE

    Berti, Marco; Ghizzoni,Giuseppe; Gualeni,Anna; Cantamessa,Paola; Oneglia,Carlo

    2012-01-01

    We report five cases of stress related cardiomyopahies that occurred in post-menopausal women (age range from 49 to 90) consecutively admitted to our Department in the last year in different clinical settings: typical anginal pain, carotid endarterectomy, pulmonary edema, cardiogenic shock, and severe asthenia. Apical left ventricular involvement was observed in three patients in conjunction with ECG mild ST segment elevation in anterior precordial leads resembling acute anterior myocardial i...

  2. The potential for clinical use of cannabinoids in treatment of cardiovascular diseases.

    Science.gov (United States)

    Durst, Ronen; Lotan, Chaim

    2011-02-01

    Cannabinoids, the constituents of the marijuana plant and their analogs, have not only neurobehavioral but also cardiovascular effects. Great advances in the last couple of decades have led to better understanding of the physiological effects of the cannabinoids and of their role in various cardiovascular pathologies. The potential therapeutic use of cannabinoids in various cardiac diseases, such as ischemic injury, heart failure, and cardiac arrhythmias, has been studied in animal models. The purpose of this article is to review the physiological cardiovascular properties of cannabinoids and to summarize the knowledge related to their potential therapeutic use. PMID:20946323

  3. Review and Updates in Regenerative and Personalized Medicine, Preclinical Animal Models, and Clinical Care in Cardiovascular Medicine.

    Science.gov (United States)

    Barbato, Emanuele; Barton, Paul J; Bartunek, Jozef; Huber, Sally; Ibanez, Borja; Judge, Daniel P; Lara-Pezzi, Enrique; Stolen, Craig M; Taylor, Angela; Hall, Jennifer L

    2015-11-01

    The goal of this paper is to provide an updated review for scientists and clinicians on the major areas in cardiovascular medicine published in the Journal. Leading topics in regenerative and personalized medicine are presented along with a critical overview of the field. New standards in large preclinical animal models of pulmonary hypertension and left bundle branch block are highlighted. Finally, clinical care in the areas of atherosclerosis, the aortic valve, platelet biology, and myocarditis is discussed as well as autonomic modulation therapies.

  4. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

    OpenAIRE

    Okon Ekwere Essien; Joseph Andy; Victor Ansa; Akaninyene Asuquo Otu; Alphonsus Udoh

    2014-01-01

    Introduction. Death from coronary artery disease (CAD) has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD) risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6%) of 747 autopsies. They were predominantly males, urban residents, and...

  5. Current Role of Platelet Glycoprotein Ⅱ b/Ⅲ a Receptor Inhibitors in Clinic-al Trials of Cardiovascular Diseases

    Institute of Scientific and Technical Information of China (English)

    SHEN Di

    2001-01-01

    @@Thrombosis formation on disrupted atherosclerotic plaque is the most common acuse of cardiovascular dis eases, in the pathophysiology, increased platelet reactiv ity is a descriptor of the risk of cardiovascular events in healthy persons and in patients with overt coronary artery disease. Regardless of the stimulus for activation platelet-platelet interation and thrombus formation is ul timately regulated through the GP Ⅱ b/Ⅲ a receptor complex

  6. Non-invasive prenatal testing for fetal chromosome abnormalities: review of clinical and ethical issues

    Directory of Open Access Journals (Sweden)

    Gekas J

    2016-02-01

    Full Text Available Jean Gekas,1,2 Sylvie Langlois,3 Vardit Ravitsky,4 François Audibert,5 David Gradus van den Berg,6 Hazar Haidar,4 François Rousseau2,7 1Prenatal Diagnosis Unit, Department of Medical Genetics and Pediatrics, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 2Department of Medical Biology, CHU de Québec, Québec City, QC, Canada; 3Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; 4Bioethics Program, Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada; 5Department of Obstetrics and Gynecology, Hospital Sainte-Justine, Montreal, QC, Canada; 6Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; 7Department of Molecular Biology, Medical Biochemistry and Pathology, Faculty of Medicine, Université Laval, Québec City, QC, Canada Abstract: Genomics-based non-invasive prenatal screening using cell-free DNA (cfDNA screening was proposed to reduce the number of invasive procedures in current prenatal diagnosis for fetal aneuploidies. We review here the clinical and ethical issues of cfDNA screening. To date, it is not clear how cfDNA screening is going to impact the performances of clinical prenatal diagnosis and how it could be incorporated in real life. The direct marketing to users may have facilitated the early introduction of cfDNA screening into clinical practice despite limited evidence-based independent research data supporting this rapid shift. There is a need to address the most important ethical, legal, and social issues before its implementation in a mass setting. Its introduction might worsen current tendencies to neglect the reproductive autonomy of pregnant women. Keywords: prenatal diagnosis, Down syndrome, non-invasive prenatal testing, cell-free fetal DNA, informed consent, reproductive autonomy

  7. Palpable pediatric thyroid abnormalities – diagnostic pitfalls necessitate a high index of clinical suspicion: a case report

    Directory of Open Access Journals (Sweden)

    Klopper Joshua P

    2007-06-01

    Full Text Available Abstract A 12-year-old girl presented with a 4 year history of an enlarged, firm thyroid gland. On exam, her thyroid was firm and fixed and an enlarged cervical lymph node was palpable as well. Though a thyroid ultrasound prior to referral was read as thyroiditis, clinical suspicion for thyroid carcinoma mandated continued investigation. The diagnosis of papillary thyroid cancer was established and her workup revealed lymph node metastases as well as a tremendous burden of pulmonary metastases. Pediatric thyroid cancer is extremely rare, but often presents with aggressive disease. Palpable thyroid abnormalities in an individual under 20-years-old should be viewed with suspicion and should be thoroughly investigated to rule out malignancy even in the face of negative diagnostic procedures. Though pediatric papillary thyroid cancer often presents with loco-regional and even distant metastatic disease, mortality rates in follow-up for as long as 20 years are very favorable.

  8. Chest radiographs in subjects with asbestos-related abnormalities: comparison between ILO categorizations and clinical reading.

    Science.gov (United States)

    Hilt, B; Borgerson, A; Lien, J T; Langård, S

    1992-01-01

    The findings of a previous chest X-ray screening, determined without using standardized criteria, were reassessed by means of the ILO classification. Of 470 radiographs that had been determined as showing asbestos-related changes, 430 were categorized according to the ILO Classification. Small opacities with profusion greater than or equal to 1/0 were described in 39 (52%) of 75 participants who, on the original clinical reading, had been determined as having lung fibrosis, and in 45 (12.7%) of 355 who were determined as having pleural changes only. When considering circumscribed pleural thickening at the chest wall or diaphragm, as categorized by the ILO Classification, such changes were present in 401 (93.7%) of 428 subjects with pleural changes as determined on the clinical reading. In addition to the improved sensitivity and specificity achieved, the ILO Classification also allows comparison with other studies. The most apparent disadvantage of the ILO system is that it cannot firmly separate the various types of asbestos-related pleural changes. The study revealed that the previous asbestos exposure of the case subjects had occurred in many different workplaces and occupations.

  9. Renal Vein Thrombosis in a Newborn With Abnormal Factor VIII Level: Clinical Case Report.

    Science.gov (United States)

    Szafranska, Agnieszka; Pajak, Agata; Kilis-Pstrusinska, Katarzyna; Królak-Olejnik, Barbara

    2015-08-01

    Renal vein thrombosis (RVT) in neonates is a rare condition of low mortality but significant morbidity due to renal impairment.We report the case of a male term newborn with left RVT and elevated serum factor VIII (FVIII).The main symptoms of the patient and the important clinical findings: prompt diagnosis of RVT was possible because the classic clinical presentation of macroscopic hematuria, thrombocytopenia, and palpable flank mass were present in this newborn infant.The main diagnoses: finally, the reason of RVT was established when the infant was 3 months of age: the increased level of FVIII was confirmed. We discuss the diagnosis, therapy, and outcome of the patient and compare with the literature.Therapeutics interventions: however, despite anticoagulant therapy the left kidney developed areas of scarring and then atrophy.Conclusions and outcomes: Prothrombotic defects should be considered in all patients with perinatal RVT. Elevated factor VIII as a reason of RVT in neonatal period is particularly rare. Given a poor renal outcome in children associated with elevated levels of factor VIII, consideration could be given to more aggressive antithrombotic therapy in such cases.

  10. Results of the Dyslipidemia International Study (DYSIS-Middle East: clinical perspective on the prevalence and characteristics of lipid abnormalities in the setting of chronic statin treatment.

    Directory of Open Access Journals (Sweden)

    Saud N Al Sifri

    Full Text Available BACKGROUND: Therapeutic intervention with low-density lipoprotein cholesterol-lowering agents known as statins has been demonstrated to reduce cardiovascular risk. However, many patients on statin treatment have persistent dyslipidemia and remain at a high risk of cardiovascular disease. Therefore, the objective of this study was to assess the frequency of lipid abnormalities in patients receiving chronic statin treatment. METHODS: As part of an international, cross-sectional, observational study, DYSIS-Middle East enrolled 2,182 patients in the United Arab Emirates (UAE, Saudi Arabia, Lebanon and Jordan. All patients were over 45 years of age and had been on statin treatment for at least three months. Data on demographics, lipid parameters and cardiovascular risk profile were recorded. Cardiovascular risk was defined according the guidelines of the European Society of Cardiology. RESULTS: The majority of patients (82.6% were classified as being at very high risk of cardiovascular events, and 61.8% of all patients did not attain LDL-C target levels. Low high-density lipoprotein cholesterol levels and elevated triglyceride levels were noted in 55.5% and 48.5% of patients, respectively. Multivariate logistical regression modeling indicated that factors independently associated with LDL-C levels not being at goal were lifestyle choices, diabetes mellitus, ischemic heart disease, and blood pressure ≥ 140/90 mmHg. CONCLUSIONS: Almost two-thirds of statin-treated patients in the United Arab Emirates, Saudi Arabia, Lebanon and Jordan had inadequately controlled lipid levels. More comprehensive surveillance, awareness and treatment regimens, as well as modification of lifestyle choices, is necessary to halt the rise in cardiovascular disease-related mortality.

  11. Clinical and Biochemical Markers of Cardiovascular Structure and Function in Women With the Metabolic Syndrome.

    Science.gov (United States)

    Velarde, Gladys P; Sherazi, Saadia; Kraemer, Dale F; Bravo-Jaimes, Katia; Butterfield, Ryan; Amico, Tonja; Steinmetz, Sherry D; Guzman, Maricela; Martin, Dale; Dodani, Sunita; Smith, Brian H

    2015-12-01

    The pathobiological impact of individual components of the metabolic syndrome (MS) on cardiac structural and functional parameters in women with isolated MS is not known. The objectives of this study were (1) to compare biochemical (prothrombotic, lipogenic, and inflammatory) and imaging (carotid intima-media thickening and basic cardiac structural measurements) markers in women with and without MS and (2) to examine if any of these markers associated or predicted cardiac structural differences between the 2 groups. This cross-sectional pilot study included 88 women with MS and 35 women without it. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients with diagnosis of diabetes were excluded. Compared with healthy subjects, women with MS had higher levels of intercellular adhesion molecule, myeloperoxidase, C-reactive protein, plasminogen activator inhibitor-1, leptin, apolipoprotein-B, and lower levels of apolipoprotein-A1 (p <0.001 for all). They also had higher mean ventricular septum, posterior wall thickness, left ventricular (LV) mass, carotid intima-media thickness (p <0.001 for all), and left atrial diameter (p = 0.015). In multivariable regression models, waist circumference and systolic blood pressure (BP) were significant predictors of: ventricular septum (p = 0.005 and p = 0.001, respectively), posterior wall thickness (p = 0.008 and p = 0.040, respectively), and LV mass (p <0.001 and p = 0.013, respectively). Significant predictors for carotid intima-media thickness were systolic BP, glucose, and leptin (p <0.0001, p = 0.034, and p = 0.002, respectively). In conclusion, there are significant clinical, biochemical, and cardiovascular structural differences in women with isolated MS compared with those without. Waist circumference and systolic BP had the strongest association with cardiac structural differences in this group of women. PMID:26482181

  12. No association between anxiety and depression and adverse clinical outcome among patients with cardiovascular disease

    DEFF Research Database (Denmark)

    Kornerup, Henriette; Zwisler, Ann-Dorthe Olsen; Prescott, Eva

    2011-01-01

    Anxiety and depression have been linked to adverse prognostic outcome in patients with cardiovascular disease (CVD) with mixed results. The timing of anxiety and depression measurement has received little attention so far.......Anxiety and depression have been linked to adverse prognostic outcome in patients with cardiovascular disease (CVD) with mixed results. The timing of anxiety and depression measurement has received little attention so far....

  13. Potassium in hypertension and cardiovascular disease.

    Science.gov (United States)

    Castro, Hector; Raij, Leopoldo

    2013-05-01

    The increased prevalence of hypertension and cardiovascular disease in industrialized societies undoubtedly is associated with the modern high-sodium/low-potassium diet. Extensive experimental and clinical data strongly link potassium intake to cardiovascular outcome. Most studies suggest that the sodium-to-potassium intake ratio is a better predictor of cardiovascular outcome than either nutrient individually. A high-sodium/low-potassium environment results in significant abnormalities in central hemodynamics, leading to potential target organ damage. Altered renal sodium handling, impaired endothelium-dependent vasodilatation, and increased oxidative stress are important mediators of this effect. It remains of paramount importance to reinforce consumption of a low-sodium/high-potassium diet as a critical strategy for prevention and treatment of hypertension and cardiovascular disease.

  14. Chromosomal abnormalities in clinical psychiatry: a report of two older patients

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    W.M.A. Verhoeven

    2007-09-01

    Full Text Available Background and Objectives: In clinical psychiatry genetic anomalies are infrequently part of the differential diagnosis, especially in the elderly. Two case reports are used to illustrate the relevance of a genetic workup for diagnosis, treatment and prognosis. Methods: A female and a male patient, aged 81 and 68 year respectively, were admitted because of psychotic symptoms. Despite their relatively low level of intelligence together with autistic-like behaviour in the female patient and dysmorphias in the male patient, a genetic disorder was previously never considered. Results: In the female patient a balanced translocation between chromosomes X and 19 was found, while in the male patient a mosaic trisomy 8 was demonstrated. Conclusions: Genetic analysis is indicated in patients with autism, lower intelligence, unexplained somatic anomalies and dysmorphias.

  15. TO STUDY THE CLINICAL SPECTRUM AND HAEMATOLOGICAL ABNORMALITIES IN PATIENTS OF MACROCYTIC ANAEMIA

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    Daljinderjit

    2015-06-01

    Full Text Available BACKGROUND : Folate and vitamin12 deficiency have been known to cause megaloblastic anaemia. Megaloblastic anaemia is not uncommon in India , but data are insufficient regarding its prevalence , causative factors and precipitating factors. AIMS & OBJECTIVES : To evaluate the clinic o - haematological profile in patients of macrocytic anaemia. MATERIAL AND METHODS : In the present study , 50 patients of >20years of age with hemoglobin 95 fl and PBF showing macrocytosis and pancytopenia were included. Detailed history with clinical examination was performed and investigations (Bone Marrow aspiration , Serum Folate and cobalamin assays were carried out. RESULTS : The peak incidence of megaloblas tic anaemia was in the age group of 41 - 50 years (48% , with male preponderance (71% . ( The predominant symptoms were fatigue (54% followed by low grade fever (52% , breathlessness (50% , and mild jaundice (22% . ( Physicalfindingswere pallor (88 % , hepatomegaly (80% , knuckle hyperpigmentation (68% , glossitis (50% , peripheral neuropathy (28% and mild icterus was the least common finding in 22% of patients. 64% patients of macrocytic anaemia were found to be lactovegetarian. Cobalamin deficiency wa s present in maximum patients (50% , followed by combined cobalamin and folate deficiency in 34% and folate deficiency in 16% of patients. Bonemarrowsmears revealed megaloblastic picture in 58% of patients and 42% patients had non - megaloblastic bone marrow picture. C ONCLUSION : Megaloblastic anaemia must be considered in the differential diagnosis of patients presenting with pyrexia of unknown origin , mild ic terus or pancytopenia. Therefore , the early screening for cobalamin and folic acid deficiency can lead to improvement in the wellbeing and prolongs the life of people in our community.

  16. Applied Cardiovascular Physiology in Dogs with Heart Failure

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    Iván Álvarez Ramírez

    2011-06-01

    Full Text Available Congestive heart failure is related to abnormal ventricular contraction and relaxation. Recent publications show that the alteration of systolic and diastolic function coexists in most patients with heart diseases. There are currently several ambiguities in the daily use of clinical and physiological terms regarding this topic. This paper aims to review certain physiological concepts of the cardiovascular system.

  17. Diabetes Mellitus, Arterial Wall, and Cardiovascular Risk Assessment

    Science.gov (United States)

    Kozakova, Michaela; Palombo, Carlo

    2016-01-01

    Diabetes mellitus is an independent risk factor for atherothrombotic cardiovascular disease. Adults with diabetes are two to four times more likely to develop heart disease or stroke than adults without diabetes. The two major features of diabetes, i.e., hyperglycemia and insulin-resistance, trigger arterial stiffening and increase the susceptibility of the arterial wall to atherosclerosis at any given age. These pathological changes in the arterial wall may provide a functional and structural background for cardiovascular events. The present paper provides a critical overview of the clinical evidence linking diabetes-related metabolic abnormalities to cardiovascular risk, debates the pathophysiologic mechanisms through which insulin resistance and hyperglycemia may affect the arterial wall, and discusses the associations between vascular biomarkers, metabolic abnormalities and cardiovascular events. PMID:26861377

  18. Cardiovascular manifestations of phaeochromocytoma

    NARCIS (Netherlands)

    Prejbisz, A.; Lenders, J.W.M.; Eisenhofer, G.; Januszewicz, A.

    2011-01-01

    Clinical expression of phaeochromocytoma may involve numerous cardiovascular manifestations, but usually presents as sustained or paroxysmal hypertension associated with other signs and symptoms of catecholamine excess. Most of the life-threatening cardiovascular manifestations of phaeochromocytoma,

  19. Clinical Implications of Cardiovascular Outcome Trials in Type 2 Diabetes: From DCCT to EMPA-REG.

    Science.gov (United States)

    Rydén, Lars; Shahim, Bahira; Mellbin, Linda

    2016-06-01

    Cardiovascular disease is a major threat to people with diabetes. Attempts have long been made to lower cardiovascular risk by means of glucose-lowering treatment. Initially, it seemed that was an option, but subsequent trials could not verify the original observations and there was concern that some glucose-lowering drugs can actually cause cardiovascular harm. This led medical product agencies in the United States and Europe to require major outcomes trials before accepting new glucose-lowering drugs. The least requirement was noninferiority compared with existing treatment modalities. A large number of such trials have been performed or are ongoing, including >100,000 patients. The drug classes investigated are basal insulin, glucagon-like peptide-1 agonists, dipeptidyl peptidase 4 inhibitors, and sodium-glucose cotransporter-2 (SGLT2) inhibitors. This commentary discusses these trials and their outcomes, the reasons why several of them ended with neutral results (noninferiority), and that the likelihood for showing cardiovascular benefit was minor or even nonexistent. The surprising and highly rewarding impact of the SGLT2 inhibitor empagliflozin is described and potential mechanisms for cardiovascular benefits are discussed. PMID:27107734

  20. The risk factors for abnormal ankle-brachial index in type 2 diabetic patients and clinical predictive value for diabetic foot

    Institute of Scientific and Technical Information of China (English)

    张净

    2013-01-01

    Objective To investigate the prevalence of diabetic foot (DF) and the normal,high and low ankle brachial index (ABI) in type 2 diabetic patients and explore the risk factor for abnormal ABI and the clinical predictive value for DF.Methods A total of 2 681 type 2 diabetic patients who visited our hospital between January,2007and December,2009 were enrolled in the study.The clinical data were analyzed and the risk factors for abnormal ABI were determined by logistic regression analysis.Results ABI was normal (0.9-<1.3) in 2 362 cases

  1. Cardiovascular Risk Factors - Clinical and Epidemiologic profiles in the subjects of the "Atividade Física na Vila" Project

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    Eduardo Simon

    2010-11-01

    Full Text Available The group of atherothrombotic cardiovascular diseases represents one of the leading causes of death around the world. Atherosclerosis is a condition of multifactorial origin, with great genetic and familiar dependence, besides being characterized by an elevated aggravation trend related to lifestyle. Our objective was to describe the prevalence of cardiovascular risk (CVR factors and Metabolic Syndrome (MS, as well as to estimate the cardiovascular risk in the subjects of the "Atividade Física na Vila" Project. By means of a cross sectional study, 48 patients aged between 23 and 74 (41 women and 7 men were screened for the presence of sedentary lifestyle, smoking, family antecedents of Diabetes mellitus type 22 (DM or Coronary artery disease, obesity, abdominal obesity, High Blood Pressure (HBP, DM2, Impaired Fasting Glucose (IFG, Lipid abnormalities, and MS. This prevalence was compared to the available general population data. The MS definition was that of the NCEP. The CVR was estimated using the Framingham Score (FS, and compared among the groups with and without MS. 67% of the patients were 50 or older and 46% were 55 or older. There was a high prevalence of CVR factors compared to the population data, specially in the case of sedentary lifestyle (52% x 56%, NS, obesity (men 14% x 9%, NS; women 39% x 13%, P<0.05, HBP (56% x 32%, P<0.05, high total cholesterol (63% x 40%, P<0.05. The prevalence of DM2, IFG, abdominal obesity and MS was 10%, 21%, 60% and 27%, respectively. The mean FS was 5,2 ± 5,5, significantly higher in the patients with MS (9,5 ± 3,1 x 3,5 ± 5,4 p<0.05. These data indicate the high prevalence of CVR factors, and suggest its synergy in elevating the global CVR represented by the FS, as well as strongly support the need for changes in the lifestyle of these patients.

  2. Cardiovascular findings of children with Marfan syndrome

    OpenAIRE

    Yılmaz, Osman; Bilici, Meki; Ceylan, Özben; Karademir, Selmin; Örün, Utku Arman; Özgür, Senem; Keskin, Mahmut; Şenocak, Filiz

    2012-01-01

    Objectives: The aim of our study is to investigate the frequency of structural heart diseases in patients with Marfan syndrome (MS) and to reveal the importance of clinical follow-up in MS. Materials and methods: Study population consisted of 17 patients admitted to the Pediatric Cardiology department between January 2005 and March 2010 with the diagnosis of MS according to the Ghent criteria. Patients were evaluated for the eye, genetic and the cardiovascular system abnormalities. Physic...

  3. The clinical analysis on the characteristics of dyslipidemia and abnormal Hpid metabolism in different types of elderly people with hypertension%老年人群血脂紊乱特点及其与高血压关系

    Institute of Scientific and Technical Information of China (English)

    刘蕾

    2011-01-01

    目的 探讨老年人群血脂紊乱的特点及不同类型血脂代谢异常合并高血压情况。方法 对门诊老年人群查体资料进行回顾性分析。结果 老年人群中血脂紊乱者占人群总数的69.63%,其中单纯高胆固醇(HTC)者23.65%,单纯高甘油三酯(HTG)者26.71%,HTC伴HTG(混合型)19.27%;正常血脂者30.37%。正常血脂组及HTC组比较,HTG组高血压患病率较高(P<0.05)。结论 老年人群血脂紊乱的患病率高,合并高血压的患病率高。%Objective To study the clinical characteristics of abnormal lipid metabolism in different types of elderly people with hypertension.Methods The clinical data,collected from the elderly people who underwent annual physical examination,the characteristics of dyslipidemia and abnormal lipid metabolism in different types of elderly people with hypertension were analyzed retrospectively. Results The prevalence of dyslipidemia was 69. 63%, in which the prevalence of hypercholesteremia and hypertriglyceridemia was 23. 65%, and 26. 71% respectively. The prevalence of hypercholesteremia accompanied hypertriglyceridemia( mixed group) was 19. 27%, and normal group was 30. 37%. Hypertriglyceridemia group was easier to be accompanied with hypertension than normal group and HTC group(P <0. 05). The hypertriglyceridemia had higher risk of cardiovascular and cerebrovascular diseases than norral group and HTC group( P < 0. 05 ). Conclusion The elderly people had high prevalence of dyslipidemia and metabolic syndrome,and with high prevalence of hypertension, which led to higher risk of cardiovascular and cerebrovascular diseases. The hypertriglyceridemia had more strong impact on cardiovascular and cerebrovascular diseases than hypercholesteremia.

  4. CT diagnosis of abnormal transparent septum in clinical meaning%透明隔异常CT诊断的临床意义

    Institute of Scientific and Technical Information of China (English)

    曹连义; 张勇

    2003-01-01

    AIM:Abnormal transparent septum is common in clinical works but little in meaning,so some CT reports are not listed.We collected complete abnormal transparent septum cases to perform comparison analysis between CT diagnosis and clinical data.METHODS:109 abnormal transparent septum diagnosed by CT was compared with symptom of clinics.Axis scanning and no enhanced scanning were used in CT and 2 doctors in charge of sample collection.The 109 cases were excluded with abnormal transparent septum induced by secondary local cerebral atrophy and secondary perforation deformity.RESULTS:There were 15 cases with the fifth ventricle of cerebrum and 22 cases with the fifth and sixth ventricle of cerebrums,10 cases with transparent septum cyst,28 cases with translocation of transparent septum,8 cases with no crack in the forebrain,6 cases with poor development of keratoma and 20 cases of other deformity.CONCLUSION:Abnormal transparent septum cannot be omitted and should be clearly diagnosed by CT.

  5. Preliminary findings of cortical thickness abnormalities in blast injured service members and their relationship to clinical findings.

    Science.gov (United States)

    Tate, D F; York, G E; Reid, M W; Cooper, D B; Jones, L; Robin, D A; Kennedy, J E; Lewis, J

    2014-03-01

    Though cortical abnormalities have been demonstrated in moderate and severe traumatic brain injured (TBI) patients, there have been no studies examining cortical changes following blast related mild TBI (mTBI). The purpose of this study was to determine the effects and functional relevance of blast mTBI on cortical thickness in a small cohort of carefully screened blast injured US Service Members (SM). Twelve SM with mTBI acquired through blast injury were compared to 11 demographically matched control SM without TBI. Both mTBI and control participants were active duty and had completed a combat deployment. Subjects underwent MRI examination and the T1 weighted anatomic images were processed using the FreeSurfer suite of tools. Cortical thickness maps were compared between groups and examined for relationships with time since injury (TSI). Utilizing a large database of functional imaging results (BrainMap), significant regions of interest (ROI) were used to determine the behavioral profiles most consistently associated with the specific ROI. In addition, clinical variables were examined as part of post-hoc analysis of functional relevance. Group comparisons controlling for age demonstrated several significant clusters of cortical thinning for the blast injured SM. After multiple comparisons correction (False Discovery Rate (FDR)), two left hemisphere clusters remained significant (left superior temporal (STG) and frontal (SFG) gyri). No clusters were significantly correlated with TSI after FDR correction. Behavioral analysis for the STG and SFG clusters demonstrated three significant behavioral/cognitive sub-domains, each associated with audition and language. Blast injured SMs demonstrated distinct areas of cortical thinning in the STG and SFG. These areas have been previously shown to be associated with audition and language. Post-hoc analyses of clinical records demonstrated significant abnormal audiology reports for the blast injured SM suggesting that the

  6. THE ATTITUDE TOWARDS TREATMENT OF CARDIOVASCULAR DISEASES: A SURVEY OF PATIENTS OF STATE OUTPATIENT CLINICS AND PRIVATE MEDICAL CENTERS

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    O. N. Semenova

    2015-09-01

    Full Text Available Aim. To study the differences in views on treatment among patients with cardiovascular diseases in state and private outpatient clinics, as well as the motivation for choosing one of these outpatient clinics.Material and methods. Anonymous and voluntary survey of cardiology patients (n=90 in 2 state (57.7% and 3 private outpatient clinics (42.2% was conducted in Saratov.Results. 33.3% of respondents were men; the median age was 65 years. Patients of state outpatient clinics were more likely to have retirement age (p=0.0008, low income (p=0.0006, history of hypertensive crises (p=0.0129 and chronic heart failure (p=0.0001. Patients of private outpatient clinics were more likely to have mental work (p=0.0001, higher education (p=0.0001, moderate income (p=0.0006. The difference in views on the disease and the attitude towards a doctor among patients of state and private clinics was shown.Conclusion. Patients of private outpatient clinics were more active, young, aimed at continuation of life. They are more likely to have higher education, mental work and moderate income. Patients of state outpatient clinics are "infatuated with their illness"; it is their “lifestyle”. Paternalistic model of communication with doctors is expressed in all the patients.

  7. Audit of Cardiovascular Disease Risk Factors among Supported Adults with Intellectual Disability Attending an Ageing Clinic

    Science.gov (United States)

    Wallace, Robyn A.; Schluter, Philip

    2008-01-01

    Background: Little is known about the cardiovascular disease (CVD) risk factor profile for older adults with intellectual disability (ID). As many CVD risk factors are treatable by lifestyle changes, confirmation of the risk factor profile for older adults with ID could substantially impact upon preventive health practices for this group. Method:…

  8. HYPERACTIVE TISSUE RENIN-ANGIOTENSIN SYSTEMS IN CARDIOVASCULAR DYSFUNCTION - EXPERIMENTAL-EVIDENCE AND CLINICAL HYPOTHESES

    NARCIS (Netherlands)

    PINTO, YM; BUIKEMA, H; VANGILST, WH

    1995-01-01

    In this review, hypotheses are discussed with regard to the role of local, tissue renin-angiotensin systems in the progression of cardiovascular dysfunction. After local renin-anglotensin systems had been described as functionally distinct systems, recent experimental studies have suggested an assoc

  9. Cardiovascular Safety of One-Year Escitalopram Therapy in Clinically Nondepressed Patients With Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Hanash, Jamal A; Hansen, Baiba H; Hansen, Jørgen F;

    2012-01-01

    : Selective serotonin reuptake inhibitors are commonly used for treatment of depression in patients with cardiac diseases. However, evidence of cardiovascular (CV) safety from randomized trials is based on studies of no longer than 6-month duration. We examined the CV safety of 1-year treatment w...... with Selective serotonin reuptake inhibitor escitalopram compared with placebo in patients with recent acute coronary syndrome (ACS)....

  10. Editorial: cardiovascular drug therapy in paediatric age: from metabolomics to clinical practice.

    Science.gov (United States)

    Bassareo, Pier Paolo; Fanos, Vassilios

    2014-01-01

    In adult patients, cardiovascular drugs are widely administered in the treatment of numerous diseases. The indications and doses are strictly codified by international Guidelines, which are periodically updated by the American and European Societies of Cardiology. In paediatric patients, however, the situation is substantially different. The lack of large interventional studies on the use of these compounds has led to a greater uncertainty, with a less extensive administration and more limited indications. Furthermore, some important differences in therapeutic approach for the same diseases are present between the U.S. and Europe. The purpose of this Special Issue is to review the pharmacological treatment of certain heart diseases, such as heart failure, and arterial blood pressure, which can result in both adult and pediatric patients [1, 2]. Differences and similarities have been highlighted. Regarding the differences in medical treatment for the same disease in the U.S. and Europe, it has been emphasized that the regulation of drugs is largely determined not only by scientific considerations, but also by other concerns - legal, cultural - which vary in different parts of the world. Such discrepancies are found even in the informational documents provided by pharmaceutical companies (different in USA and Europe for the same drug) and drug agencies (different between FDA and equivalent agencies in Europe). In this issue of Current Medicinal Chemistry, a specific paper is dedicated to the pharmacological treatment of the patency of ductus arteriosus in neonates, which is still a controversial issue. In fact, notwithstanding ibuprofen appears to be lesser dangerous for newborns than indomethacin, with a similar efficacy in closing the ductus; in a number of countries the latter is still administered to all preterm subjects as a prophylactic tool [3]. An unusual case report is the interesting starting point to perform an extensive literature review about the new

  11. Council Clinical Perspective: Cardiovascular Health of Patients with Cancer and Cancer Survivors: A Roadmap to the Next Level

    Science.gov (United States)

    Barac, Ana; Murtagh, Gillian; Carver, Joseph R.; Chen, Ming Hui; Freeman, Andrew M.; Herrmann, Joerg; Iliescu, Cezar; Ky, Bonnie; Mayer, Erica L.; Okwuosa, Tochi M.; Plana, Juan Carlos; Ryan, Thomas D.; Rzeszut, Anne K.; Douglas, Pamela S.

    2015-01-01

    Many existing and emerging cancer therapies have significant impact on the cardiovascular (CV) health of patients with cancer and cancer survivors. This manuscript examines current aspects of interdisciplinary cardio-oncology clinical care delivery and education in the United States and outlines how these data provide a platform for future development of the field. We present the results of the nationwide survey on cardio-oncology services, practices and opinions, conducted among Chiefs of Cardiology and Program Directors, that demonstrate ranges of clinical activities and identify significant interest for increased educational opportunities and expert training of CV physicians in this field. The survey respondents recognized clinical relevance, but emphasized lack of national guidelines, lack of funds, and limited awareness and infrastructure as the main challenges for development and growth of cardio-oncology. We discuss potential solutions to unmet needs through interdisciplinary collaboration and the active roles of professional societies and other stakeholders. PMID:26112199

  12. Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes

    Directory of Open Access Journals (Sweden)

    Kones R

    2013-10-01

    would be cardioprotective. When LDL cholesterol is aggressively lowered to targets, low HDL cholesterol levels are still inversely related to MCVE. The efflux capacity, or ability to relocate cholesterol out of macrophages, is believed to be a major antiatherogenic mechanism responsible for reduction in MCVE mediated in part by healthy HDL. HDL cholesterol is a complex molecule with antioxidative, anti-inflammatory, antithrombotic, antiplatelet, and vasodilatory properties, among which is protection of LDL from oxidation. HDL-associated paraoxonase-1 has a major effect on endothelial function. Further, HDL promotes endothelial repair and progenitor cell health, and supports production of nitric oxide. HDL from patients with cardiovascular disease, diabetes, and autoimmune disease may fail to protect or even become proinflammatory or pro-oxidant. Mendelian randomization and other clinical studies in which raising HDL cholesterol has not been beneficial suggest that high plasma levels do not necessarily reduce cardiovascular risk. These data, coupled with extensive preclinical information about the functional heterogeneity of HDL, challenge the “HDL hypothesis”, ie, raising HDL cholesterol per se will reduce MCVE. After the equivocal AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome With Low HDL/High Triglycerides: Impact on Global Health Outcomes study and withdrawal of two major cholesteryl ester transfer protein compounds, one for off-target adverse effects and the other for lack of efficacy, development continues for two other agents, ie, anacetrapib and evacetrapib, both of which lower LDL cholesterol substantially. The negative but controversial HPS2-THRIVE (the Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events trial casts further doubt on the HDL cholesterol hypothesis. The growing impression that HDL functionality, rather than abundance, is clinically important is supported by experimental evidence highlighting

  13. [Pathophysiological and clinical correlations between endocrine and cardiovascular systems. An inter-systemic model of internal medicine].

    Science.gov (United States)

    Andreoli, Mario

    2006-12-01

    This review focuses on the mechanisms by which thyroid hormones affect the regulation of the cardiovascular system and the thermogenic and hemodynamic variation induced by thyroid disfunction. It is also stressed the hormonal role of the cardiac myocytes realising natriuretic peptides, involved in plasma volume homeostasis and cardiovascular remodelling; its rapid measurement is a useful clinical tool, in the diagnostic and prognostic of left ventricular dysfunction, correlating with the degree of the clinical symptoms. The endothelial layer is a receptor-effector endocrine organ that produces substances that maintain vasomotor balance and vascular-tissue homeostasis. Cardiovascular risk factors causes oxidative stress that alter endothelial function and leads to endothelial dysfunction. On the basis of the present body of evidence there is no doubt that endothelial dysfunction contributes to the initiation, and progression, of atherosclerotic disease and that it could be considered an independent vascular risk factor for the micro- and macrovascular damages in the diabetes disease. In several extrathyroidal pathological condition, as well as in heart failure, the main alteration of the thyroid function is referred to as "low T3 syndrome". This syndrome is due to an adaptative reaction of the metabolic pathway of thyroxine, producing an increased amount of rT3, metabolically inactive, thus decreasing the detrimental metabolic effects of T3, in conditions of critically impaired hemodynamic and metabolic efficiency. Preliminary clinical trials, in heart failure, suggest the prognostic value of the level of circulating T3, as well as usefulness of T3, or of thyromimetic derivatives (DITPA), in chronic treatment of the heart ventricular dysfunction.

  14. Depression as a Clinical Determinant of Dependence and Low Quality of Life in Elderly Patients with Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Giselle Helena de Paula Rodrigues

    2015-06-01

    Full Text Available Background: The aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists. Objective: Evaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life. Methods: This group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State. Results: The study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old. 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68. 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014, obesity (p < 0.001, lack of physical activity (p = 0.016, osteoarthritis (p < 0.001, cognitive impairment (p < 0.001, and major depression (p < 0.001. Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36. Conclusion: Among an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.

  15. Comparison of clinical features of left-sided infective endocarditis involving previously normal versus previously abnormal valves.

    Science.gov (United States)

    Olmos, Carmen; Vilacosta, Isidre; Fernández, Cristina; Sarriá, Cristina; López, Javier; Del Trigo, María; Ferrera, Carlos; Vivas, David; Maroto, Luis; Hernández, Miguel; Rodríguez, Enrique; San Román, José Alberto

    2014-07-15

    Native valve infective endocarditis (IE) in patients with normal valves has increased in the last decades. Whether patients with normal valves present a similar prognosis to those with pathologic valves is unresolved. Our aim is to describe epidemiologic and clinical differences between patients with left-sided IE and normal valves and those with native pathologic valves. We analyzed 945 consecutive episodes of IE, 435 of which involved left-sided nonprosthetic IE. They were classified into 2 groups: episodes in normal valves (normal group, n=173) and episodes in pathologic valves (abnormal group, n=262). Patients in the normal group were younger, Staphylococcus aureus and Streptococcus bovis were more frequently isolated, and vegetations were more frequently found. Heart failure, septic shock, and the need for surgery or death were more common. Multivariate analysis identified the following as factors independently associated with normal valve IE: agevalve IE, patients with IE on normal valves were younger, had a more virulent microbiological profile, developed heart failure and septic shock more frequently, needed more surgical procedures, and had worse prognosis.

  16. The changes of serum ferritin and β2-microglobulin in the cardiovascular and cerebrovascular diseases and their clinical significance

    International Nuclear Information System (INIS)

    To study the changes of serum ferritin (SF) and β2-microglobulin (β2-MG) in the cardiovascular and cerebrovascular diseases and their clinical significance, serum SF and β2-MG in 22 patients with coronary cardiopathy, 46 patients with hypertension and 21 patients with cerebral infarction were tested by RIA and compared with control group. The results showed that serum SF and β2-MG in patients with the above-mentioned diseases were significantly higher than those in control group (P2-MG participate in the pathophysiological processes, so that they may be used as references to therapeutic effectiveness and prognosis

  17. Clinical and prognostic significance of bone marrow abnormalities in the appendicular skeleton detected by low-dose whole-body multidetector computed tomography in patients with multiple myeloma

    International Nuclear Information System (INIS)

    Clinical significance of medullary abnormalities in the appendicular skeleton (AS) detected by low-dose whole-body multidetector computed tomography (MDCT) in patients with multiple myeloma (MM) was investigated. A total of 172 patients with monoclonal gammopathy of undetermined significance (MGUS) (n=17), smoldering MM (n=47) and symptomatic MM (n=108) underwent low-dose MDCT. CT values (CTv) of medullary density of AS⩾0 Hounsfield unit (HU) was considered as abnormal. Percentage of medullary abnormalities and the mean CTv of AS in patients with MGUS, smoldering MM and symptomatic MM were 18, 55 and 62% and −44.5 , −20.3 and 11.2 HU, respectively (P<0.001 and P<0.001). Disease progression of MM was independently associated with high CTv on multivariate analysis. In symptomatic MM, the presence of abnormal medullary lesions was associated with increased incidence of high-risk cytogenetic abnormalities (34.4% vs 7.7% P=0.002) and extramedullary disease (10.4% vs 0% P=0.032). It was also an independent poor prognostic predictor (hazard ratio 3.546, P=0.04). This study showed that CTv of AS by MDCT is correlated with disease progression of MM, and the presence of abnormal medullary lesions is a predictor for poor survival

  18. The clinical significances of the abnormal expressions of Piwil1 and Piwil2 in colonic adenoma and adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Wang HL

    2015-05-01

    Full Text Available Hai-Ling Wang,1 Bei-Bei Chen,1 Xin-Guang Cao,1 Jin Wang,2 Xiu-Feng Hu,1 Xiao-Qian Mu,1 Xiao-Bing Chen1 1The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, People’s Republic of China; 2The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China Objective: The objective of the present investigation was to study the clinical significances of the abnormal expressions of Piwil1 and Piwil2 protein in colonic adenoma and adenocarcinoma.Methods: This study had applied immunohistochemical method to detect 45 cases of tissues adjacent to carcinoma (distance to cancerous tissue was above 5 cm, 41 cases of colonic adenoma and 92 cases of colon cancer tissues, and their Piwil1 and Piwil2 protein expression levels.Analysis: The correlation of both expression and its relationship with clinicopathological features of colon cancer was analyzed.Results: Positive expression rates of Piwil1 in tissues adjacent to carcinoma, colonic adenoma, and colon cancer were 11.1% (5/45, 53.7% (22/41, and 80.4% (74/92, respectively; the expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05. In each group, the positive expression rates of Piwil2 were 24.4% (11/45 cases, 75.6% (31/41 cases, and 92.4% (85/92 cases; expression rates increased, and the comparisons between each two groups were statistically significant (P<0.05. Piwil1 expression and the correlation of the degree of differentiation, TNM stage, and lymph node metastasis were statistically significant (P<0.05. Piwil2 expression and the correlation of the degree of differentiation, tumor node metastasis (TNM stage, and lymph node metastasis had no statistical significance (P>0.05. In colon cancer tissue, Piwil1 and Piwil2 expressions were positively correlated (r=0.262, P<0.05.Conclusion: The results showed that the abnormal expression of Piwil1 and Piwil2 might play an important role in

  19. Biologic function and clinical potential of telomerase and associated proteins in cardiovascular tissue repair and regeneration

    OpenAIRE

    Madonna, Rosalinda; De Caterina, Raffaele; Willerson, James T.; Geng, Yong-Jian

    2010-01-01

    Telomeres comprise long tracts of double-stranded TTAGGG repeats that extend for 9–15 kb in humans. Telomere length is maintained by telomerase, a specialized ribonucleoprotein that prevents the natural ends of linear chromosomes from undergoing inappropriate repair, which could otherwise lead to deleterious chromosomal fusions. During the development of cardiovascular tissues, telomerase activity is strong but diminishes with age in adult hearts. Dysfunction of telomerase is associated with ...

  20. SUPPRESSION OF RENIN-ANGIOTENSIN SYSTEM TO PREVENT COMPLICATIONS OF CARDIOVASCULAR DISEASES: CURRENT "ROLES" DISTRIBUTION FROM CLINICAL PHARMACOLOGIST’S POINT OF VIEW

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevskiy

    2016-01-01

    Full Text Available A role of angiotensin-converting enzyme (ACE inhibitors in cardiovascular diseases treatment and prevention is discussed. Some large randomized clinical trials are analyzed. Physical and chemical properties of drugs and its evidence base are considered among possible factors of ACE inhibitors choice. A problem of ACE inhibitor choice is also discussed in context of secondary prevention of cardiovascular complications in arterial hypertension and after myocardial infarction. It is concluded that the choice of any drug for cardiovascular disease treatment is mainly determined by its evidence base.

  1. SUPPRESSION OF RENIN-ANGIOTENSIN SYSTEM TO PREVENT COMPLICATIONS OF CARDIOVASCULAR DISEASES: CURRENT "ROLES" DISTRIBUTION FROM CLINICAL PHARMACOLOGIST’S POINT OF VIEW

    Directory of Open Access Journals (Sweden)

    S. R. Gilyarevskiy

    2011-01-01

    Full Text Available A role of angiotensin-converting enzyme (ACE inhibitors in cardiovascular diseases treatment and prevention is discussed. Some large randomized clinical trials are analyzed. Physical and chemical properties of drugs and its evidence base are considered among possible factors of ACE inhibitors choice. A problem of ACE inhibitor choice is also discussed in context of secondary prevention of cardiovascular complications in arterial hypertension and after myocardial infarction. It is concluded that the choice of any drug for cardiovascular disease treatment is mainly determined by its evidence base.

  2. Neuropatia autonômica cardiovascular diabética: fatores de risco, impacto clínico e diagnóstico precoce Diabetic cardiovascular autonomic neuropathy: risk factors, clinical impact and early diagnosis

    Directory of Open Access Journals (Sweden)

    Luiz Clemente de Souza Pereira Rolim

    2008-04-01

    Full Text Available A neuropatia autonômica cardiovascular (NAC constitui uma das complicações de maior repercussão clínica do diabete melito (DM e, ao mesmo tempo, está entre as menos diagnosticadas. Nesta revisão, são discutidos os principais fatores de risco para o desenvolvimento e a progressão da NAC nos pacientes com DM, a história natural da neuropatia autonômica e seu impacto na doença cardiovascular do DM, bem como os testes para o diagnóstico precoce e o estadiamento da NAC na prática clínica. A pesquisa bibliográfica teve como base dois bancos de dados: Medline e Tripdatabase, com os seguintes descritores: diabetic cardiovascular autonomic neuropathy e cardiovascular autonomic neuropathy and diabetes. Os artigos de 1998 a 2007 em inglês e alemão foram selecionados. A NAC em estágios iniciais (precoce e intermediária pode ser diagnosticada e revertida, porém, nos casos avançados (estágio grave, resta apenas o tratamento sintomático. A NAC está associada a um maior índice de morbidade e mortalidade cardiovasculares e pior qualidade de vida nos indivíduos diabéticosCardiovascular autonomic neuropathy (CAN is one of the most clinically significant complications of diabetes mellitus (DM, but one of the least frequently diagnosed. In this review, we discuss the major risk factors for the development and progression of CAN in patients with DM, the natural history of autonomic neuropathy and its impact on cardiovascular disease in DM, as well as the tests for the early diagnosis and staging of CAN in the clinical practice. The bibliographic research was based on two databases: Medline and Tripdatabase, with the following descriptors: diabetic cardiovascular autonomic neuropathy and cardiovascular autonomic neuropathy and diabetes. We selected English and German articles, written between 1998 and 2007. In its initial stages (early and intermediate, CAN may be diagnosed and reversed. However, in advanced cases (severe stage, the only

  3. Statins: Cardiovascular Risk Reduction in Percutaneous Coronary Intervention—Basic and Clinical Evidence of Hyperacute Use of Statins

    Directory of Open Access Journals (Sweden)

    Enrique C. Morales-Villegas

    2011-01-01

    Full Text Available Reduction of LDL-cholesterol concentration in serum, blocking the isoprenylation of GTPases and the activation of myocyte-protective enzyme systems are three mechanisms that currently explain the lipid and non-lipid effects of statins. However, the decrease of LDL-cholesterol, the reduction of inflammation biomarkers and even the atheroregresion, as surrogate effects to the mechanisms of action of statins would be irrelevant if not accompanied by a significant decrease in the incidence of cardiovascular events. Statins like no other pharmacological group have proven to reduce the incidence of cardiovascular events and prolong life in any clinical scenario. This article review the basic and clinical evidence that support a new indication for HMG-CoA reductase inhibitors “pharmacological myocardial preconditioning before anticipated ischemia” or hyperacute use of statins in subjects with any coronary syndrome eligible for elective, semi-urgent or primary percutaneous coronary intervention: ARMYDA-Original, NAPLES I-II, ARMYDA-ACS, ARMYDA-RECAPTURE, Non-STEMI-Korean, Korean-STEMI trials.

  4. Lifetime opiate exposure as an independent and interactive cardiovascular risk factor in males: a cross-sectional clinical study

    Directory of Open Access Journals (Sweden)

    Reece AS

    2013-10-01

    Full Text Available Albert S Reece, Gary K HulseSchool of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, AustraliaIntroduction: While several studies have identified an increased incidence of cardiovascular disorders in opiate dependence, neither opiates as a cardiovascular risk factor nor their effect on central arterial function has been considered.Methods: Pulse wave analysis (SphygmoCor, AtCorMedical Pty Limited, Sydney, NSW, Australia was undertaken on a cohort of controls and opiate dependent patients and the results compared to their lifetime opiate exposure.Results: Controls (N = 401 were compared with 465 opiate dependent men. The mean (log ages were different and were found to be 28.80 ± 0.49 years versus 35.02 ± 0.39 years (P < 0.0001, respectively. Of the opiate dependent group, 87.7% were treated with buprenorphine, 8.8% with methadone, and 3.4% with naltrexone. Multiple regression analysis was used to adjust for chronologic age (CA. At CA of 60 years, the modeled age in the controls was 66.40 years, and that in the addicted group was 73.11 years, an advancement of 6.71 years, or 10.10%. Exacerbations of age dependent changes in central arterial stiffness, central pressures, pulse rate, ejection duration, diastolic duration, and subendocardial perfusion ratio by opiate dependence were all noted (P < 0.05. Current heroin dose, heroin duration, and the dose duration interaction were all significantly related to the vascular (or “reference” age (RA/CA ratio (all P < 0.006. After multivariate adjustment, the opiate dose duration was independently predictive of RA (P < 0.02. Opiate dose and/or duration were included in a further 25 terms.Conclusion: These data show that opiate use is not benign for the male cardiovascular system, but has a dose response relationship to central arterial stiffness and thus cardiovascular aging, acting independently and interactively with established cardiovascular risk factors

  5. [Cardiovascular outcome clinical trials in type 2 diabetes mellitus: what are the epidemiological and methodological evidence and the first evaluations to date?].

    Science.gov (United States)

    Fiorentino, Teresa Vanessa; Sesti, Giorgio

    2016-03-01

    Clinical trials of glucose-lowering strategies in patients with type 2 diabetes mellitus (T2DM) have shown a favorable effect of intensive glycemic control on microvascular complications but failed to show a clear benefit on cardiovascular events. In 2008, the US Food and Drug Administration (FDA) and European Medicines Agency (EMA) have required stringent criteria to approve new glucose-lowering drugs, demanding proof of cardiovascular safety. As a result of these regulatory requirements, a number of cardiovascular outcome trials in T2DM have been conducted examining the cardiovascular safety of novel glucose-lowering drugs. Dipeptidyl peptidase 4 (DPP4) inhibitors, analogs of glucagon-like peptide 1 (GLP-1), and inhibitors of the renal sodium-glucose linked transporter-2 (SGLT2) are new classes of glucose-lowering drugs for subjects with T2DM. The results of the cardiovascular outcome trials comparing the DPP4 inhibitors saxagliptin, alogliptin, and sitagliptin or the GLP-1 analog lixisenatide to placebo have demonstrated that these drugs are safe. The results of a cardiovascular outcome trial comparing the SGLT2 inhibitor empagliflozin to placebo have been published. Notably, empagliflozin treatment has been associated with a significant reduction in the primary composite cardiovascular outcome. Although the question regarding the positive effect of glycemic control on cardiovascular risk is still unanswered, current evidence suggests that a multifactorial approach aimed at treating not only hyperglycemia but also classical cardiovascular risk factors is necessary in order to reduce the risk of cardiovascular events in patients with T2DM. PMID:27030121

  6. A comparison of cardiovascular risk factors for ten antipsychotic drugs in clinical practice

    Directory of Open Access Journals (Sweden)

    Bodén R

    2013-03-01

    Full Text Available Robert Bodén,1,2 Gunnar Edman,3,4 Johan Reutfors,2 Claes-Göran Östenson,3 Urban Ösby3,4 1Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden; 2Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden; 3Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; 4Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden Abstract: It is well known that abdominal obesity, dyslipidemia, and insulin resistance are highly prevalent in patients receiving maintenance treatment with antipsychotics, but there is limited knowledge about the association between cardiovascular risk factors and treatment with antipsychotic drugs. In this naturalistic study we investigated a sample of 809 antipsychotic-treated patients from Swedish psychosis outpatient teams. Cardiovascular risk factors (eg, metabolic syndrome, homeostasis model assessment of insulin resistance, and low-density lipoprotein values were measured, and their associations to current antipsychotic pharmacotherapy were studied. Ten antipsychotic drugs were compared in a stepwise logistic regression model. For the patients, the presence of the components of metabolic syndrome ranged from 35% for hyperglycemia to 64% for elevated waist circumference. Hypertriglyceridemia was associated with clozapine (odds ratio [OR] = 1.81, 95% confidence interval [CI] 1.08–3.04, reduced high-density lipoprotein with both clozapine and olanzapine (OR = 1.73, 95% CI 1.01–2.97; and OR = 2.03, 95% CI 1.32–3.13, hypertension with perphenazine (OR = 2.00, 95% CI 1.21–3.59, and hyperglycemia inversely with ziprasidone (OR = 0.21, 95% CI 0.05–0.89 and positively with haloperidol (OR = 2.02, 95% CI 1.18–3.48. There were no significant relationships between any of the antipsychotic drugs and increased waist circumference, homeostasis model assessment of insulin resistance, or low-density lipoprotein levels. In

  7. Cardiovascular autonomic neuropathy in the diabetic patients.

    Directory of Open Access Journals (Sweden)

    Maria Eugenia Niño Mantilla

    2007-11-01

    Full Text Available the dysfunction of the autonomic nervous system is a serious problem in diabetic patients. The cardiovacular autonomic neuropathy is the most important autonomic dysfuntion for it´s implication in the increasesof the mortality rate in diabetis patients. tis ethiopatogenesis is the result of a multifactorial process caused by chronic hyperglycemia, ending up in damage of the autonomic fibers thet innervate the heart and blood vessels, leading to dysfuntional hearth rate control and abnormal vascular dynamics. the associated clinical manifestations include orthotatic hypotension, excecise intolerance, intraoperative cardiovascular liability and silent myocardial ischemia. Being important its recognition, quantitative test to evaluate the cardiovascular funtion, to value its evolution and the effects of the treatment ahould be done, being the most used, the hearth rate response to standing test, and teh valsalva maneuver. the handling of this entity is done improving control of glucose blood levels its the most effective way to prevent the cardiovascular autonomic neuropathy in the diabetic patients.

  8. Clinical cardiovascular experiences with iopamidol: a new non-ionic contrast medium.

    Science.gov (United States)

    Partridge, J B; Robinson, P J; Turnbull, C M; Stoker, J B; Boyle, R M; Morrison, G W

    1981-07-01

    Iopamidol, a new non-ionic water-soluble contrast medium, has been compared with standard ionic media in a number of cardiovascular applications. It is stable in aqueous solution, is much less viscous and only slightly more osmolar than metrizamide. Compared to sodium meglumine diatrizoate in a series of 40 coronary arteriograms, it produced a consistent and highly significant decrease in the incidence and severity of hypotension and bradycardia following intracoronary injection. In the same group and in 62 children undergoing ventricular or great vessel angiocardiography, a subjective assessment of patient reaction showed that iopamidol was better tolerated than the ionic medium. There was a very strong patient preference for iopamidol in a group of 20 of the adult patients who had also consented to femoral artery injections of both media. Throughout these series there was no detectable difference in arterial image quality between the media. Venous phase opacification during arterioportography was assessed in 11 cases comparing iopamidol with sodium meglumine iothalamate. No significant difference was found. We conclude that iopamidol is clearly preferable to ionic media for routine cardiovascular applications.

  9. Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

    Energy Technology Data Exchange (ETDEWEB)

    Merlini, Laura; Borzani, Irene Maria Olivia; Anooshiravani, Mehrak; Hanquinet, Sylviane [University of Geneva Children' s Hospital, Paediatric Radiology Unit, Geneva (Switzerland); Rochat, Isabelle [University of Geneva Children' s Hospital, Paediatric Pneumology Unit, Geneva (Switzerland); Ozsahin, Ayse Hulya [University of Geneva Children' s Hospital, Paediatric Oncology Unit, Geneva (Switzerland)

    2008-11-15

    Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established. To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD). A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD. Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT. The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data. (orig.)

  10. Heart failure as an endpoint in heart failure and non-heart failure cardiovascular clinical trials: the need for a consensus definition

    DEFF Research Database (Denmark)

    Zannad, F.; Stough, W.G.; Pitt, B.;

    2008-01-01

    Specific criteria have been established to define the occurrence of myocardial infarction (MI) and stroke in cardiovascular clinical trials, but there is not a consistent definition for heart failure. Heart failure events appear to occur at a rate that is similar to stroke and MI in trials...... of hypertension, hyperlipidaemia, diabetes, and coronary heart disease, yet a consistent approach to defining heart failure events has not yet been realized. The wide range of definitions used in clinical trials makes it difficult to interpret new data in the context of existing literature. This inconsistency has...... led to challenges in determining the incidence of heart failure in cardiovascular studies and the effects of interventions on these endpoints. This paper examines issues related to defining heart failure events in cardiovascular clinical trials and presents a definition to formally address this issue...

  11. Investigation and Analysis on Cardiovascular System Abnormality Caused by Combined Exposure to Noise and Heat%噪声高温联合环境致心血管系统异常的调查与分析

    Institute of Scientific and Technical Information of China (English)

    王革; 何颖

    2011-01-01

    [Objective] To understand the combined effect of noise and heat on steel workers'health, through investigation and anal-ysis on the cardiovascular diseases of workers in a steel plant, and explore the effective ways to reduce occupational damage on work-ers. [Methods]The stratified random sampling method was adopted to investigate 186 workers only exposed to heat, only exposed to noise, exposed to noise and heat, without exposure to noise and heat. Their abnormalities of cardiovascular system were investigated. [Results]The abnormal rates of cardiovascular system were significantly different between workers only exposed to heat, only ex-posed to noise, exposed to noise and heat, without exposure to noise and heat. The abnormal rates of ECG and blood pressure of worker only exposed to heat, only exposed to noise, exposed to noise and heat, without exposure to noise and heat were 30. 8% , 33.3% ; 32.2% , 35.6% ;50.0% , 46.6% ; 22.0% , 23.6% ; respectively, the differences were significant (P <0.05), the high-est abnormal rates were detected in workers with exposure to noise and heat. The difference of ECG abnormal rate was significant be-tween workers with different length of service, it increased with the extending length of service.. [ Conclusion] Noise and heat expo-sure causes significant damage on the cardiovascular system of workers which increases with the extending length of service, com-bined noise and heat causes even more serious injuries. Therefore, labor protection measures must be taken to reduce occupational injury on operating workers,.%目的 通过对某钢厂工人心血管系统疾病的调查与分析,了解噪声与高温联合环境对作业工人的危害情况,探讨减少工人职业伤害的有效途径.方法采用分层随机抽样的方法,抽取纯高温环境,纯噪声环境,噪声与高温联合环境及无噪声、高温环境工人186人,调查其心血管系统异常状况.结果纯高温环境,纯噪声环境,噪声与高温联

  12. Peptide mimotopes of malondialdehyde epitopes for clinical applications in cardiovascular disease

    DEFF Research Database (Denmark)

    Amir, Shahzada; Hartvigsen, Karsten; Gonen, Ayelet;

    2012-01-01

    Autoantibodies specific for malondialdehyde-modified LDL (MDA-LDL) represent potential biomarkers to predict cardiovascular risk. However, MDA-LDL is a high variability antigen with limited reproducibility. To identify peptide mimotopes of MDA-LDL, phage display libraries were screened with the MDA-LDL...... subjects and patients with myocardial infarction and stable angina pectoris undergoing percutaneous coronary intervention, and the titers of autoAbs correlated significantly with respective Ab titers against MDA-LDL. In conclusion, we identified specific peptides that are immunological mimotopes of MDA....... Furthermore, MDA mimotopes were found to mimic MDA epitopes on the surface of apoptotic cells. Immunization of mice with P2 resulted in the induction of MDA-LDL-specific Abs, which strongly immunostained human atherosclerotic lesions. We detected IgG and IgM autoAbs to both MDA mimotopes in sera of healthy...

  13. Adapting existing natural language processing resources for cardiovascular risk factors identification in clinical notes.

    Science.gov (United States)

    Khalifa, Abdulrahman; Meystre, Stéphane

    2015-12-01

    The 2014 i2b2 natural language processing shared task focused on identifying cardiovascular risk factors such as high blood pressure, high cholesterol levels, obesity and smoking status among other factors found in health records of diabetic patients. In addition, the task involved detecting medications, and time information associated with the extracted data. This paper presents the development and evaluation of a natural language processing (NLP) application conceived for this i2b2 shared task. For increased efficiency, the application main components were adapted from two existing NLP tools implemented in the Apache UIMA framework: Textractor (for dictionary-based lookup) and cTAKES (for preprocessing and smoking status detection). The application achieved a final (micro-averaged) F1-measure of 87.5% on the final evaluation test set. Our attempt was mostly based on existing tools adapted with minimal changes and allowed for satisfying performance with limited development efforts.

  14. Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant- induced and other chronic health problems.

    Science.gov (United States)

    Crinnion, Walter J

    2011-09-01

    Sauna therapy has been used for hundreds of years in the Scandinavian region as a standard health activity. Studies document the effectiveness of sauna therapy for persons with hypertension, congestive heart failure, and for post-myocardial infarction care. Some individuals with chronic obstructive pulmonary disease (COPD), chronic fatigue, chronic pain, or addictions also find benefit. Existing evidence supports the use of saunas as a component of depuration (purification or cleansing) protocols for environmentally-induced illness. While far-infrared saunas have been used in many cardiovascular studies, all studies applying sauna for depuration have utilized saunas with radiant heating units. Overall, regular sauna therapy (either radiant heat or far-infrared units) appears to be safe and offers multiple health benefits to regular users. One potential area of concern is sauna use in early pregnancy because of evidence suggesting that hyperthermia might be teratogenic.

  15. Psoriasis and the Risk of Major Cardiovascular Events: Cohort Study Using the Clinical Practice Research Datalink.

    Science.gov (United States)

    Parisi, Rosa; Rutter, Martin K; Lunt, Mark; Young, Helen S; Symmons, Deborah P M; Griffiths, Christopher E M; Ashcroft, Darren M

    2015-09-01

    The association between psoriasis and risk of major cardiovascular (CV) events (myocardial infarction, acute coronary syndrome, unstable angina, and stroke) is unclear. A cohort study with 48,523 patients with psoriasis and 208,187 controls was conducted. During a median follow-up of 5.2 years, 1,257 patients with psoriasis (2.59%) had a major CV event, compared with 4,784 controls (2.30%). In the multivariable analysis, inflammatory arthritis hazard ratio (HR) 1.36 (1.18-1.58), diabetes HR 1.18 (1.06-1.31), chronic kidney disease HR 1.18 (1.07-1.31), hypertension HR 1.37 (1.29-1.45), transient ischemic attack HR 2.74 (2.41-3.12), atrial fibrillation HR 1.54 (1.36-1.73), valvular heart disease HR 1.23 (1.05-1.44), thromboembolism 1.32 (1.17-1.49), congestive heart failure HR 1.57 (1.39-1.78), depression HR 1.16 (1.01-1.34), current smoker HR 2.18 (2.03-2.33), age (year) HR 1.07 (1.07-1.07), and male gender HR 1.83 (1.69-1.98) were statistically significant for the risk of major CV events. The age- and gender-adjusted HRs of a major CV event for psoriasis were 1.10 (1.04-1.17) and for severe psoriasis 1.40 (1.07-1.84), whereas the fully adjusted HRs were attenuated to 1.02 (0.95-1.08) and 1.28 (0.96-1.69). In conclusion, neither psoriasis nor severe psoriasis were associated with the short-to-medium term (over 3-5 years) risk of major CV events after adjusting for known cardiovascular disease risk factors.

  16. Free Levels of Selected Organic Solutes and Cardiovascular Morbidity and Mortality in Hemodialysis Patients: Results from the Retained Organic Solutes and Clinical Outcomes (ROSCO Investigators.

    Directory of Open Access Journals (Sweden)

    Tariq Shafi

    Full Text Available Numerous substances accumulate in the body in uremia but those contributing to cardiovascular morbidity and mortality in dialysis patients are still undefined. We examined the association of baseline free levels of four organic solutes that are secreted in the native kidney - p-cresol sulfate, indoxyl sulfate, hippurate and phenylacetylglutamine - with outcomes in hemodialysis patients.We measured these solutes in stored specimens from 394 participants of a US national prospective cohort study of incident dialysis patients. We examined the relation of each solute and a combined solute index to cardiovascular mortality and morbidity (first cardiovascular event using Cox proportional hazards regression adjusted for demographics, comorbidities, clinical factors and laboratory tests including Kt/VUREA.Mean age of the patients was 57 years, 65% were white and 55% were male. In fully adjusted models, a higher p-cresol sulfate level was associated with a greater risk (HR per SD increase; 95% CI of cardiovascular mortality (1.62; 1.17-2.25; p=0.004 and first cardiovascular event (1.60; 1.23-2.08; p<0.001. A higher phenylacetylglutamine level was associated with a greater risk of first cardiovascular event (1.37; 1.18-1.58; p<0.001. Patients in the highest quintile of the combined solute index had a 96% greater risk of cardiovascular mortality (1.96; 1.05-3.68; p=0.04 and 62% greater risk of first cardiovascular event (1.62; 1.12-2.35; p=0.01 compared with patients in the lowest quintile. Results were robust in sensitivity analyses.Free levels of uremic solutes that are secreted by the native kidney are associated with a higher risk of cardiovascular morbidity and mortality in incident hemodialysis patients.

  17. Event Rates in Randomized Clinical Trials Evaluating Cardiovascular Interventions and Devices

    NARCIS (Netherlands)

    Mahmoud, Karim D.; Lennon, Ryan J.; Holmes, David R.

    2015-01-01

    Randomized clinical trials (RCTs) are considered the gold standard for evidence-based medicine. However, an accurate estimation of the event rate is crucial for their ability to test clinical hypotheses. Overestimation of event rates reduces the required sample size but can compromise the statistica

  18. PPAR Genomics and Pharmacogenomics: Implications for Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Sharon Cresci

    2008-03-01

    Full Text Available The peroxisome proliferator-activated receptors (PPARs consist of three related transcription factors that serve to regulate a number of cellular processes that are central to cardiovascular health and disease. Numerous pharmacologic studies have assessed the effects of specific PPAR agonists in clinical trials and have provided insight into the clinical effects of these genes while genetic studies have demonstrated clinical associations between PPAR polymorphisms and abnormal cardiovascular phenotypes. With the abundance of data available from these studies as a background, PPAR pharmacogenetics has become a promising and rapidly advancing field. This review focuses on summarizing the current state of understanding of PPAR genetics and pharmacogenetics and the important implications for the individualization of therapy for patients with cardiovascular diseases.

  19. PRACTICE OF PRESCRIBING BETA-BLOCKERS AND ITS COMPLIANCE WITH CLINICAL GUIDELINES ACCORDING TO TWO REGISTERS OF CARDIOVASCULAR DISEASES

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    S. Yu. Martsevich

    2016-01-01

    Full Text Available  Aim. To assess real clinical practice of prescribing beta-blockers (BB and its compliance with updated guidelines, using data from outpatient registers that are carried out in medical institutions of different levels. Material and methods. We analyzed data from two outpatient registries - RECVASA and PROFILE. RECVASA register included patients aged ≥18 years with arterial hypertension (HT, ischemic heart disease (IHD, chronic heart failure (CHF and atrial fibrillation (AF that consulted in 3 outpatient clinics of Ryazan city in 2012-2013 (n=3690. PROFILE register included patients aged ≥18 years with HT, IHD, CHF, AF that consulted in specialized cardiac unit of the State Research Center for Preventive Medicine in 2011-2015 (n=1531. Results. There were differences in the basic characteristics of the registers: in the RECVASA register average age of patients was higher, HT, IHD and CHF were more frequent; PROFILE register included more patients with the history of myocardial infarction. In the RECVASA register 41.5% (n=1533 of patients received BB, and in the PROFILE register – 47.7% (n=731. The most frequently prescribed BB was bisoprolol in all cardiovascular diseases. Conclusion. In a specialized medical institution BB used more often under the conditions where they are necessary. The choice of a specific BB inside the pharmacological group, even in a specialized medical institution does not always correspond to clinical guidelines and evidence-based medicine.

  20. A COMPARATIVE STUDY OF CLINICAL EXAMINATION, ULTRASOUND FINDINGS, DIAGNOSTIC HYSTEROSCOPY WITH HISTOPATHOLOGICAL EXAMINATION REPORT OF ENDOMETRIUM IN PATIENTS WITH ABNORMAL UTERINE BLEEDING

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    Sathenahalli Devegowda Prathibha

    2016-08-01

    Full Text Available BACKGROUND AND OBJECTIVES Abnormal Uterine Bleeding (AUB is a very frequent gynaecological complaint and occurs across the entire age spectrum, approximately 75000 hysterectomies are carried out each year with 30% of these for menstrual problems alone. These menstrual aberrations occur more commonly at extremes of reproductive life. The introduction of hysteroscopy has opened a new dimension in evaluation of patient with AUB replacing the blind technique of Dilatation and Curettage. The present study was undertaken to know the accuracy of various tests with Histopathology. MATERIALS AND METHODS The present prospective study was carried out on 100 patients from reproductive, perimenopausal and postmenopausal age group with abnormal uterine bleeding in Dr. B. R. Ambedkar Medical College and Hospital. RESULTS In the present study, in relation to histopathological examination, clinical findings and hysteroscopy had better accuracy (72% as compared to ultrasound findings (41% in diagnosis of abnormal uterine bleeding. CONCLUSION Hysteroscopy guided biopsy and histopathology complements each other in the evaluation of patient with abnormal uterine bleeding for accurate diagnosis and further treatment.

  1. Maintenance of improved lipid levels following attendance at a cardiovascular risk reduction clinic: a 10-year experience

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    Glen J Pearson

    2008-08-01

    Full Text Available Glen J Pearson1,5, Kari L Olson6, Nicole E Panich1, Sumit R Majumdar2,5, Ross T Tsuyuki1,4, Dawna M Gilchrist2,5, Ali Damani4, Gordon A Francis3,5The MILLARR Study (Maintenance of Improved Lipid Levels Following Attendance at a Cardiovascular Risk Reduction Clinic 1Department of Medicine, Divisions of Cardiology; 2General Internal Medicine; 3Endocrinology and Metabolism; Faculty of Pharmacy and Pharmaceutical Sciences; 4University of Alberta, Edmonton, Alberta, Canada; 5Cardiovascular Risk Reduction Clinic (CRRC, University of Alberta Hospital, Edmonton, Alberta, Canada; 6University of Colorado Health Sciences Center, Denver, Colorado, USA; 7Family Medicine (Private Practice, Calgary, Alberta, CanadaBackground: Specialty cardiovascular risk reduction clinics (CRRC increase the proportion of patients attaining recommended lipid targets; however, it is not known if the benefits are sustained after discharge. We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge.Methods: The medical records of consecutive dyslipidemic patients discharged >6 months from a tertiary hospital CRRC from January 1991 to January 2001 were retrospectively reviewed. The primary outcome was the change in patients’ lipid levels between the final CRRC visit and the most recent primary care follow-up. A worst-case analysis was conducted to evaluate the potential impact of the patients in whom the follow-up lipid profiles post-discharge from the CRRC were not obtained.Results: Within the CRRC (median follow-up = 1.28 years in 1064 patients, we observed statistically significant improvements in all lipid parameters. In the 411 patients for whom post-discharge lipid profiles were available (median follow-up = 2.41 years, there were no significant differences observed in low-density lipoprotein-cholesterol, total cholesterol (TC, or triglycerides since CRRC discharge; however, there

  2. Religion, spirituality and cardiovascular disease: research, clinical implications, and opportunities in Brazil Religião, espiritualidade e doença cardiovascular: pesquisa, implicações clínicas e oportunidades no Brasil

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    Fernando A. Lucchese

    2013-03-01

    Full Text Available In this paper we comprehensively review published quantitative research on the relationship between religion, spirituality (R/S, and cardiovascular (CV disease, discuss mechanisms that help explain the associations reported, examine the clinical implications of those findings, and explore future research needed in Brazil on this topic. First, we define the terms religion, spirituality, and secular humanism. Next, we review research examining the relationships between R/S and CV risk factors (smoking, alcohol/drug use, physical inactivity, poor diet, cholesterol, obesity, diabetes, blood pressure, and psychosocial stress. We then review research on R/S, cardiovascular functions (CV reactivity, heart rate variability, etc., and inflammatory markers (IL-6, IFN-γ, CRP, fibrinogen, IL-4, IL-10. Next we examine research on R/S and coronary artery disease, hypertension, stroke, dementia, cardiac surgery outcomes, and mortality (CV mortality in particular. We then discuss mechanisms that help explain these relationships (focusing on psychological, social, and behavioral pathways and present a theoretical causal model based on a Western religious perspective. Next we discuss the clinical applications of the research, and make practical suggestions on how cardiologists and cardiac surgeons can sensitively and sensibly address spiritual issues in clinical practice. Finally, we explore opportunities for future research. No research on R/S and cardiovascular disease has yet been published from Brazil, despite the tremendous interest and involvement of the population in R/S, making this an area of almost unlimited possibilities for researchers in Brazil.

  3. Alterations in left ventricular, left atrial, and right ventricular structure and function to cardiovascular risk factors in adolescents with type 2 diabetes participating in the TODAY clinical trial

    Science.gov (United States)

    Data on cardiovascular disease (CVD) risk in adolescents with type 2 diabetes (T2D) are limited. Echocardiography was performed in the last year of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial (median 4.5 yr from diagnosis of T2D, average age 18 yr), incl...

  4. External model validation of binary clinical risk prediction models in cardiovascular and thoracic surgery.

    Science.gov (United States)

    Hickey, Graeme L; Blackstone, Eugene H

    2016-08-01

    Clinical risk-prediction models serve an important role in healthcare. They are used for clinical decision-making and measuring the performance of healthcare providers. To establish confidence in a model, external model validation is imperative. When designing such an external model validation study, thought must be given to patient selection, risk factor and outcome definitions, missing data, and the transparent reporting of the analysis. In addition, there are a number of statistical methods available for external model validation. Execution of a rigorous external validation study rests in proper study design, application of suitable statistical methods, and transparent reporting.

  5. Clinical utility of rosuvastatin and other statins for cardiovascular risk reduction among the elderly

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    Roger S Blumenthal

    2010-12-01

    Full Text Available Sydney B Long, Michael J Blaha, Roger S Blumenthal, Erin D MichosJohns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USAAbstract: Age is one of the strongest predictors of cardiovascular disease (CVD risk. Treatment with statins can significantly reduce CVD events and mortality in both primary and secondary prevention. Yet despite the high CVD risk among the elderly, there is underutilization of statins in this population (ie, the treatment-risk paradox. Few studies have investigated the use of statins in the elderly, particularly for primary prevention and, as a result, guidelines for treating the elderly are limited. This is likely due to: uncertainties of risk assessment in older individuals where the predictive value of individual risk factors is decreased; the need to balance the benefits of primary prevention with the risks of polypharmacy, health care costs, and adverse medication effects in a population with decreased life expectancy; the complexity of treating patients with many other comorbidities; and increasingly difficult social and economic concerns. As life expectancy increases and the total elderly population grows, these issues become increasingly important. JUPITER (Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin is the largest primary prevention statin trial to date and enrolled a substantial number of elderly adults. Among the 5695 JUPITER participants ≥70 years of age, the absolute CVD risk reduction associated with rosuvastatin was actually greater than for younger participants. The implications of this JUPITER subanalysis and the broader role of statins among older adults is the subject of this review.Keywords: JUPITER, rosuvastatin, elderly, risk

  6. Resveratrol Supplementation in Schizophrenia Patients: A Randomized Clinical Trial Evaluating Serum Glucose and Cardiovascular Risk Factors

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    Karine Zortea

    2016-01-01

    Full Text Available Background: Patients with schizophrenia (SZ are generally overweight or obese and have several metabolic disorders. Additionally, such patients have a lower life expectancy and the main cause of their increased mortality is cardiovascular disease (CVD. The objective of this study was to determine the efficacy of resveratrol supplementation on serum glucose and CVD risk factors in individuals with SZ. Methods and Results: This is a four-week randomized, double-blind controlled trial (registration No.: NCT 02062190 in which 19 men with a diagnosis of SZ, aged 18 to 65, were assigned to either a resveratrol supplement group (200 mg/day or a placebo group (200 mg/day. In short, we did not observe significant changes after resveratrol supplementation. In the placebo group, we found a significant increase in total cholesterol levels (p = 0.024 and in LDL-cholesterol (p = 0.002, as well as a decrease in body fat percentage (p = 0.038. The placebo group also showed an increase in triglycerides (9.19% and a reduction in HDL-cholesterol (4.88%. In the resveratrol group, triglycerides decreased (7.64%. Conclusion: In summary, oral resveratrol in reasonably low dosages (200 mg daily brought no differences to body weight, waist circumference, glucose, and total cholesterol. It was possible to note that the lipid profile in the placebo group worsened and, although no significant differences were found, we can assume that resveratrol might prevent lipid profile damage and that the intervention affected the lipoprotein metabolism at various levels.

  7. MITRAL ANNULAR CALCIFICATION IN ELDERLY PATIENTS: RELATIONSHIP WITH CLINICAL MANIFESTATIONS AND RISK FACTORS OF CARDIOVASCULAR DISEASES CAUSED BY ATHEROSCLEROSIS

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    G. M. Urvacheva

    2011-01-01

    Full Text Available The aim – to study the association of the mitral annular calcification (MAC with traditional risk factors and clinical manifestations of atherosclerosisin patients aged over 65 years without diabetes.Materials and methods. The prospective study included 100 patients over 65 years with MAC consistently identified among 910 ambulatory patients after transthoracic Doppler echocardiography in relation to the symptoms of cardiovascular disease. The comparison group consisted of 65 consecutively examined patients aged over 65 with no MAC.Results. When comparing risk factors in patients with and without MAC, MAC statistically significant differences was found with age (72,4 ± 5,4 and 70,2 ± 4,3 years, respectively; p = 0,006, the incidence of hypertension of moderate and severe degree (99 % and 90.8 % of patients, p = 0.012, levels of total cholesterol – TC (6,91 ± 0,92 and 6,2 ± 0,90 mmol / l, p = 0.0008 and lipoproteinlow density (3,57 ± 0,95 and 2,96 ± 0,96 mmol / l, p = 0.004 in subgroups of patients aged 65 to 70 years. In multivariate analysis remained statistically significant association of MAC only with age (p = 0,025, β = 0,173 and total cholesterol levels (p = 0,040; β = 0,160. Averages of the coefficient of atherogenicity of blood lipids, systolic and diastolic blood pressure, C-reactive protein, body mass index, waist circumference, the frequency of smoking, and risk assessment on a scale of SCORE in groups of patients with and without MAC did not differ significantly. In patients with MAC was higher incidence of myocardial infarction (p = 0.024 and more often than in patients without MAC, diagnosed coronary heart disease (p = 0.029. In the multivariate analysis adjusted for age and total cholesterol level is set significantly associated with the presence and extent of MAC with symptomatic atherosclerotic peripheral arterial disease (p < 0,00001; β = 0,410.Conclusion. In patients with MAC older than 65 years without diabetes

  8. Analysis of imaging findings and clinical abnormalities in patients with lymphoma; Analise de achados de imagem e alteracoes clinicas em pacientes com linfoma

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    Caldas, Flavio Augusto Ataliba; Montomiya, Carolina Tsumori [Faculdade de Medicina de Marilia, SP (Brazil)]. E-mail: flavio_caldas@hotmail.com; Silva, Helena Cristina da [Faculdade de Medicina de Marilia, SP (Brazil). Hospital de Clinicas

    2002-04-01

    Computed tomography is currently the method of choice for the diagnostic and staging of lymphomas. Computed tomography enables accurate measurements of both tumor extent and volume and provides information that can be used to plan an appropriate strategy for the treatment. The purpose of the present article is to describe and analyze the chest and abdomen computed tomography and ultrasound findings in HIV-negative patients with lymphoma. Clinical abnormalities, such as the reason the patient sought medical assistance already showing evidence of lymphocytic disease (not yet diagnosed at this point) and the physical examination abnormalities seen on the first consultation were also studied. This study comprised 30 patients: 40% with non-Hodgkin lymphoma, 46,6% with Hodgkin lymphoma, 10% with Burkitt's lymphoma and 3,3% with lymphoblastic lymphoma. (author)

  9. Coronary Artery Disease and the Profile of Cardiovascular Risk Factors in South South Nigeria: A Clinical and Autopsy Study

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    Okon Ekwere Essien

    2014-01-01

    Full Text Available Introduction. Death from coronary artery disease (CAD has been until recently considered rare in Nigeria. We present a report of a study of CAD with its predisposing cardiovascular (CVD risk factors in South South Nigeria. Methods. We examined the autopsy reports of 747 coroner cases and 41 consecutive clinically diagnosed cases of ischemic heart disease seen in South South Nigeria. Results. CAD was diagnosed in 13 (1.6% of 747 autopsies. They were predominantly males, urban residents, and of high social class with combination of CVD risk factors of hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activities, and obesity. The mean serum cholesterol of the clinical subjects was 4.7±1.57 mmol/L and 5.07±1.94 mmol/L for angina and myocardial infarction, respectively, which was higher than the mean total cholesterol for locality of 3.1 mmol/L. Conclusion. CAD and its risk factors are contributing to mortality and morbidity in South South Nigeria. These risk factors include hypertension, alcohol use, diabetes mellitus, cigarette smoking, poor physical activity, and obesity. Nigerians in this locality with CAD have raised serum lipids.

  10. "Beauty is a light in the heart": the transformative potential of optogenetics for clinical applications in cardiovascular medicine.

    Science.gov (United States)

    Boyle, Patrick M; Karathanos, Thomas V; Trayanova, Natalia A

    2015-02-01

    Optogenetics is an exciting new technology in which viral gene or cell delivery is used to inscribe light sensitivity in excitable tissue to enable optical control of bioelectric behavior. Initial progress in the fledgling domain of cardiac optogenetics has included in vitro expression of various light-sensitive proteins in cell monolayers and transgenic animals to demonstrate an array of potentially useful applications, including light-based pacing, silencing of spontaneous activity, and spiral wave termination. In parallel to these developments, the cardiac modeling community has developed a versatile computational framework capable of realistically simulating optogenetics in biophysically detailed, patient-specific representations of the human heart, enabling the exploration of potential clinical applications in a predictive virtual platform. Toward the ultimate goal of assessing the feasibility and potential impact of optogenetics-based therapies in cardiovascular medicine, this review provides (1) a detailed synopsis of in vivo, in vitro, and in silico developments in the field and (2) a critical assessment of how existing clinical technology for gene/cell delivery and intra-cardiac illumination could be harnessed to achieve such lofty goals as light-based arrhythmia termination.

  11. Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

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    Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-08-15

    Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

  12. Evaluation of malposition of the branch pulmonary arteries using cardiovascular computed tomography angiography

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    Liu, Hui [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States); Juan, Yu-Hsiang [Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States); Chang Gung Memorial Hospital, Linkou and Chang Gung University, Department of Medical Imaging and Intervention, Taoyuan (China); Wang, Qiushi; Huang, Hongfei; Yang, Lin [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Xie, Zhaofeng [Guangdong Academy of Medical Sciences, Department of Pediatric Cardiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Chen, Jimei; Zhang, Xiaoshen [Guangdong Academy of Medical Sciences, Department of Cardiovascular Surgery, Guangdong General Hospital, GuangZhou, GuangDong (China); Liang, Changhong [Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, GuangZhou, GuangDong (China); Guangdong Academy of Medical Sciences, Department of Radiology, Guangdong General Hospital, Guangzhou (China); Chung, Taylor [Children' s Hospital and Research Center Oakland, Department of Diagnostic Imaging, Oakland, CA (United States); Kwong, Raymond Y.; Saboo, Sachin S. [Brigham and Women' s Hospital, Harvard Medical School, Cardiovascular Imaging Program, Department of Medicine (Division of Cardiovascular Medicine) and Radiology, Boston, MA (United States)

    2014-12-15

    To analyze 15 cases of malposition of branch pulmonary arteries (MBPA) for the hospital-based prevalence, clinical information, surgical outcome, imaging findings, associated cardiovascular and airway abnormalities on cardiovascular computed tomography angiography (CCTA). We retrospectively searched for patients with MBPA from our database consisting of patients referred for CCTA due to known or suspected congenital heart disease and also from all patients receiving chest computed tomography (CT) during the same time period. We analyzed the hospital-based prevalence, image findings, associated cardiovascular anomalies, airway compression, and recorded the clinical information and surgical outcome. Our study showed 15 patients with MBPA (hospital-based prevalence: 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving chest CT or CCTA). Classic type was more common than lesser type (67 % versus 33 %). All patients had associated cardiovascular anomalies, including aortic arch abnormalities (80 %) and secondary airway compression (33 %). Surgery was performed in 67 % of cardiovascular anomalies and 60 % of airway stenoses. MBPA has a hospital-based prevalence of 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving either chest CT or CCTA. CCTA can delineate the anatomy of MBPA, associated cardiovascular and airway abnormalities for preoperative evaluation. (orig.)

  13. Evaluation of malposition of the branch pulmonary arteries using cardiovascular computed tomography angiography

    International Nuclear Information System (INIS)

    To analyze 15 cases of malposition of branch pulmonary arteries (MBPA) for the hospital-based prevalence, clinical information, surgical outcome, imaging findings, associated cardiovascular and airway abnormalities on cardiovascular computed tomography angiography (CCTA). We retrospectively searched for patients with MBPA from our database consisting of patients referred for CCTA due to known or suspected congenital heart disease and also from all patients receiving chest computed tomography (CT) during the same time period. We analyzed the hospital-based prevalence, image findings, associated cardiovascular anomalies, airway compression, and recorded the clinical information and surgical outcome. Our study showed 15 patients with MBPA (hospital-based prevalence: 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving chest CT or CCTA). Classic type was more common than lesser type (67 % versus 33 %). All patients had associated cardiovascular anomalies, including aortic arch abnormalities (80 %) and secondary airway compression (33 %). Surgery was performed in 67 % of cardiovascular anomalies and 60 % of airway stenoses. MBPA has a hospital-based prevalence of 0.33 % among patients with congenital heart disease and 0.06 % in all patients receiving either chest CT or CCTA. CCTA can delineate the anatomy of MBPA, associated cardiovascular and airway abnormalities for preoperative evaluation. (orig.)

  14. Crossed pulmonary arteries: a report on 20 cases with an emphasis on the clinical features and the genetic and cardiac abnormalities.

    Science.gov (United States)

    Babaoğlu, Kadir; Altun, Gürkan; Binnetoğlu, Köksal; Dönmez, Muhammed; Kayabey, Özlem; Anık, Yonca

    2013-01-01

    Crossed pulmonary arteries (CPAs) are a rare abnormality in which the ostium of the left pulmonary artery originates superior to the right pulmonary artery and to its right. Recognition of this rare pathology is important because it generally is accompanied by other congenital heart defects, extracardiac anomalies, and certain genetic problems. To date, only a few cases have been reported, and most of these cases have been associated with complex cardiac abnormalities. The authors detected 20 cases of CPA between June 2009 and November 2012 through their increasing awareness of this anomaly. Approximately 9,250 echocardiograms were performed during this period, and all of them also were checked for this anomaly. This report describes 20 cases of this CPA, with an emphasis on the clinical features and the genetic and cardiac abnormalities. The patients ranged in age from 1 day to 13 years at the time of the initial diagnosis. Four patients had complex cardiac pathologies such as tetralogy of Fallot, truncus arteriosus, transposition of the great arteries, and complete atrioventricular septal defect. Of the 20 patients, 11 had ventricular septal defects, and 12 had atrial septal defects. Pulmonary artery stenosis was detected in 12 (55 %) of the 20 patients. Aortic arch abnormalities such as interrupted aortic arch, right aortic arch, and coarctation of the aorta were detected in six patients. One patient had a left persistent superior vena cava. In 45 % of the cases, an associated genetic syndrome (DiGeorge-, Noonan-, Holt-Oram syndromes, vertebral, anal, cardiac, tracheal, esophageal, renal, limb anomalies [VACTERL] anomalies) was present. These syndromes were diagnosed based on their clinical features. Karyotype and fluorescent in situ hybridization (FISH) analyses for a 22q11 deletion were performed for 11 patients, with 10 patients found to have normal karyotype and FISH results. Only one patient had a 22q11 deletion. Six patients underwent successful operations

  15. Cardiovascular abnormalities with single dose of tapentadol

    OpenAIRE

    A Vachhani; M Barvaliya; V. Naik; Tripathi, C.B.

    2014-01-01

    This case represents the development of dizziness, palpitation, tightness in chest, flushing, and tremor on consumption of a single dose of tapentadol (100 mg) for acute lower back pain. The patient was admitted in the intensive cardiac care unit for continuous monitoring. At admission, electrocardiogram showed tachycardia (140/min) along with ST segment elevation in second chest lead (V 2 ). The patient was monitored and advised not to take further doses of tapentadol. He was discharged afte...

  16. Spectral analysis of systemic and cerebral cardiovascular variabilities in preterm infants: relationship with clinical risk index for babies (CRIB)

    International Nuclear Information System (INIS)

    Frequency spectrum analysis of circulatory signals has been proposed as a potential method for clinical risk assessment of preterm infants by previous studies. In this study, we examined the relationships between various spectral measures derived from systemic and cerebral cardiovascular variabilities and the clinical risk index for babies (CRIB II). Physiological data collected from 17 early low birth weight infants within 1–3 h after birth were analysed. Spectral and cross-spectral analyses were performed on heart rate variability, blood pressure variability and cerebral near-infrared spectroscopy measures such as oxygenated and deoxygenated haemoglobins (HbO2 and HHb) and tissue oxygenation index (TOI). In addition, indices related to cardiac baroreflex sensitivity and cerebral autoregulation were derived from the very low, low- and mid-frequency ranges (VLF, LF and MF). Moderate correlations with CRIB II were identified from mean arterial pressure (MAP) normalized MF power (r = 0.61, P = 0.009), LF MAP–HHb coherence (r = 0.64, P = 0.006), TOI VLF percentage power (r = 0.55, P = 0.023) and LF baroreflex gain (r = −0.61, P = 0.01 after logarithmic transformation), with the latter two parameters also highly correlated with gestational age (r = −0.75, P = 0.0005 and r = 0.70, P = 0.002, respectively). The relationships between CRIB II and various spectral measures of arterial baroreflex and cerebral autoregulation functions have provided further justification for these measures as possible markers of clinical risks and predictors of adverse outcome in preterm infants

  17. The clinical impact of late gadolinium enhancement in Takotsubo cardiomyopathy: serial analysis of cardiovascular magnetic resonance images

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    Katoh Hideki

    2011-10-01

    Full Text Available Abstract Background Our study aimed to investigate both the clinical implications of late gadolinium enhancement (LGE by cardiovascular magnetic resonance (CMR and the relation of LGE to clinical findings in patients with Takotsubo cardiomyopathy (TTC. Methods We evaluated 20 consecutive patients (2 men, 18 women; median age, 77 years; interquartile range [IQR] 67-82 years who were admitted to our hospital with the diagnosis of TTC. CMR was performed within 1 week after admission, and follow-up studies were conducted 1.5 and 6 months later. Results In 8 patients, CMR imaging during the sub-acute phase revealed LGE in the area matched with wall motion impairment. Cardiogenic shock was more frequently observed in patients with LGE than in those without LGE (38% vs 0%, p = 0.049. The patients with LGE needed a longer duration for ECG normalization and recovery of wall motion than did those without LGE (median 205 days, IQR [152-363] vs 68 days, [43-145], p = 0.005; 15 days, [10-185] vs 7 days, [4-13], p = 0.030, respectively. In 5 of these 8 patients, LGE disappeared within 45-180 days (170, IQR [56-180] of onset. The patients with LGE remaining in the chronic phase had higher peak creatine kinase levels than did those without LGE (median 307 IU/L, IQR [264-460] vs 202 IU/L, [120-218], p = 0.017. Conclusion LGE by CMR in the sub-acute phase may be associated with the severity and prolonged recovery to normal of clinical findings in TTC.

  18. Neonatal disruption of serine racemase causes schizophrenia-like behavioral abnormalities in adulthood: clinical rescue by d-serine.

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    Hiroko Hagiwara

    Full Text Available BACKGROUND: D-Serine, an endogenous co-agonist of the N-methyl-D-aspartate (NMDA receptor, is synthesized from L-serine by serine racemase (SRR. Given the role of D-serine in both neurodevelopment and the pathophysiology of schizophrenia, we examined whether neonatal disruption of D-serine synthesis by SRR inhibition could induce behavioral abnormalities relevant to schizophrenia, in later life. METHODOLOGY/PRINCIPAL FINDINGS: Neonatal mice (7-9 days were injected with vehicle or phenazine methosulfate (Met-Phen: 3 mg/kg/day, an SRR inhibitor. Behavioral evaluations, such as spontaneous locomotion, novel object recognition test (NORT, and prepulse inhibition (PPI were performed at juvenile (5-6 weeks old and adult (10-12 weeks old stages. In addition, we tested the effects of D-serine on PPI deficits in adult mice after neonatal Met-Phen exposure. Finally, we assessed whether D-serine could prevent the onset of schizophrenia-like behavior in these mice. Neonatal Met-Phen treatment reduced D-serine levels in the brain, 24 hours after the final dose. Additionally, this treatment caused behavioral abnormalities relevant to prodromal symptoms in juveniles and to schizophrenia in adults. A single dose of D-serine improved PPI deficits in adult mice. Interestingly, chronic administration of D-serine (900 mg/kg/day from P35 to P70 significantly prevented the onset of PPI deficits after neonatal Met-Phen exposure. CONCLUSIONS/SIGNIFICANCE: This study shows that disruption of D-serine synthesis during developmental stages leads to behavioral abnormalities relevant to prodromal symptoms and schizophrenia, in later life. Furthermore, early pharmacological intervention with D-serine may prevent the onset of psychosis in adult.

  19. Dyslipidemia and cardiovascular disease risk profiles of patients attending an HIV treatment clinic in Harare, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Zhou DT

    2015-05-01

    Full Text Available Danai Tavonga Zhou,1,2 Vitaris Kodogo,1 Kudzai Fortunate Vongai Chokuona,1 Exnevia Gomo,1 Olav Oektedalen,3 Babill Stray-Pedersen21Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Avondale, Zimbabwe; 2Institute of Clinical Medicine, University in Oslo, Oslo University Hospital, Oslo, Norway; 3Department of Infectious Diseases, Oslo University Hospital, Oslo, NorwayAbstract: The chronic inflammation induced by human immunodeficiency virus (HIV contributes to increased risk of coronary heart disease (CHD in HIV-infected individuals. HIV-infected patients generally benefit from being treated with antiretroviral drugs, but some antiretroviral agents have side effects, such as dyslipidemia and hyperglycemia. There is general consensus that antiretroviral drugs induce a long-term risk of CHD, although the levels of that risk are somewhat controversial. The intention of this cross-sectional study was to describe the lipid profile and the long-term risk of CHD among HIV-positive outpatients at an HIV treatment clinic in Harare, Zimbabwe. Two hundred and fifteen patients were investigated (females n=165, mean age 39.8 years; males n=50; mean age 42.0 years. Thirty of the individuals were antiretroviral-naïve and 185 had been on antiretroviral therapy (ART for a mean 3.9±3.4 years. All participants had average lipid and glucose values within normal ranges, but there was a small difference between the ART and ART- for total cholesterol (TC and high-density lipoprotein (HDL.Those on a combination of D4T or ZDV/NVP/3TC and PI-based ART were on average oldest and had the highest TC levels. Framingham risk showed 1.4% prevalence of high CHD risk within the next ten years. After univariate analysis age, sex, TC/HDL ratio, HDL, economic earnings and systolic BP were associated with medium to high risk of CHD. After multivariate regression analysis and adjusting for age or sex only age, sex and economic earnings

  20. Epigenetic Changes in Diabetes and Cardiovascular Risk.

    Science.gov (United States)

    Keating, Samuel T; Plutzky, Jorge; El-Osta, Assam

    2016-05-27

    Cardiovascular complications remain the leading causes of morbidity and premature mortality in patients with diabetes mellitus. Studies in humans and preclinical models demonstrate lasting gene expression changes in the vasculopathies initiated by previous exposure to high glucose concentrations and the associated overproduction of reactive oxygen species. The molecular signatures of chromatin architectures that sensitize the genome to these and other cardiometabolic risk factors of the diabetic milieu are increasingly implicated in the biological memory underlying cardiovascular complications and now widely considered as promising therapeutic targets. Atherosclerosis is a complex heterocellular disease where the contributing cell types possess distinct epigenomes shaping diverse gene expression. Although the extent that pathological chromatin changes can be manipulated in human cardiovascular disease remains to be established, the clinical applicability of epigenetic interventions will be greatly advanced by a deeper understanding of the cell type-specific roles played by writers, erasers, and readers of chromatin modifications in the diabetic vasculature. This review details a current perspective of epigenetic mechanisms of macrovascular disease in diabetes mellitus and highlights recent key descriptions of chromatinized changes associated with persistent gene expression in endothelial, smooth muscle, and circulating immune cells relevant to atherosclerosis. Furthermore, we discuss the challenges associated with pharmacological targeting of epigenetic networks to correct abnormal or deregulated gene expression as a strategy to alleviate the clinical burden of diabetic cardiovascular disease. PMID:27230637

  1. Arsenic and cardiovascular diseases

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    Bianchi F.

    2013-04-01

    Full Text Available A growing body of epidemiologic, experimental and clinical evidence shows that arsenic may exert relevant cardiovascular effects with early damage such as endothelial dysfunction. Early biomarkers of cardiovascular damage together with markers of exposure, genetic and epigenetic effects, DNA damage, apoptosis, oxidative stress remain unexplored and a study is ongoing in Italy.

  2. Development of a decision support tool to facilitate primary care management of patients with abnormal liver function tests without clinically apparent liver disease [HTA03/38/02]. Abnormal Liver Function Investigations Evaluation (ALFIE

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    Sullivan Frank M

    2007-04-01

    Full Text Available Abstract Background Liver function tests (LFTs are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF test in primary care and with no obvious liver disease. Further investigations may be dangerous for the patient and expensive for Health Services. The aims of this study are to determine the natural history of abnormalities in LFTs before overt liver disease presents in the population and identify those who require minimal further investigations with the potential for reduction in NHS costs. Methods/Design A population-based retrospective cohort study will follow up all those who have had an incident liver function test (LFT in primary care to subsequent liver disease or mortality over a period of 15 years (approx. 2.3 million tests in 99,000 people. The study is set in Primary Care in the region of Tayside, Scotland (pop approx. 429,000 between 1989 and 2003. The target population consists of patients with no recorded clinical signs or symptoms of liver disease and registered with a GP. The health technologies being assessed are LFTs, viral and auto-antibody tests, ultrasound, CT, MRI and liver biopsy. The study will utilise the Epidemiology of Liver Disease In Tayside (ELDIT database to determine the outcomes of liver disease. These are based on hospital admission data (Scottish Morbidity Record 1, dispensed medication records, death certificates, and examination of medical records from Tayside hospitals. A sample of patients (n = 150 with recent initial ALF tests or invitation to biopsy will complete questionnaires to obtain quality of life data and anxiety measures. Cost-effectiveness and cost utility Markov model analyses will be performed from health service and patient perspectives using standard NHS costs. The findings will also be used to develop a computerised clinical decision

  3. Cardiovascular Safety Assessment in Early-Phase Clinical Studies: A Meta-Analytical Comparison of Exposure-Response Models.

    Science.gov (United States)

    Conrado, D J; Chen, D; Denney, W S

    2016-06-01

    Exposure-response analysis of QT interval in clinical studies has been proposed as a thorough QT study alternative. Many exposure-response model structures have been proposed for cardiovascular (CV) safety markers, but few studies have compared models across multiple drugs. To recommend preferred drug-effect exposure-response models on vital signs and electrocardiogram (ECG) intervals, an individual-level model-based meta-analysis (39 studies and 1,291 subjects) compared 90 model structures. Models were selected to describe the data and cross-validate studies on the same drug. The most commonly selected baseline model was an unstructured model (estimation of a value at each study nominal time) for all measures but blood pressure. The unstructured model estimated a better cross-validated drug-effect when considering all markers. A linear model was the most commonly selected to characterize drug-effect on all markers. We propose these models as a starting point assisting with CV safety exposure-response assessment in nondedicated small studies with healthy subjects. PMID:27318037

  4. Clinical implications of microvascular obstruction and intramyocardial haemorrhage in acute myocardial infarction using cardiovascular magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bekkers, Sebastiaan C.A.M.; Smulders, Martijn W.; Waltenberger, Johannes; Gorgels, Anton P.M.; Schalla, Simon [Maastricht University Medical Center, Department of Cardiology, Maastricht (Netherlands); Passos, Valeria Lima [Maastricht University Medical Center, Department of Methodology and Statistics, Maastricht (Netherlands); Leiner, Tim [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands)

    2010-11-15

    To investigate the clinical implications of microvascular obstruction (MVO) and intramyocardial haemorrhage (IMH) in acute myocardial infarction (AMI). Ninety patients with a first AMI undergoing primary percutaneous coronary intervention (PCI) were studied. T2-weighted, cine and late gadolinium-enhanced cardiovascular magnetic resonance imaging was performed at 5 {+-} 2 and 103 {+-} 11 days. Patients were categorised into three groups based on the presence or absence of MVO and IMH. MVO was observed in 54% and IMH in 43% of patients, and correlated significantly (r = 0.8, p < 0.001). Pre-PCI thrombolysis in myocardial infarction 3 flow was only observed in MVO(-)/IMH(-) patients. Infarct size and impairment of systolic function were largest in MVO(+)/IMH(+) patients (n = 39, 23 {+-} 9% and 47 {+-} 7%), smallest in MVO(-)/IMH(-) patients (n = 41, 8 {+-} 8% and 55 {+-} 8%) and intermediate in MVO(+)/IMH(-) patients (n = 10, 16 {+-} 7% and 51 {+-} 6%, p < 0.001). LVEF increased in all three subgroups at follow-up, but remained intermediate in MVO(+)/IMH(-) and was lowest in MVO(+)/IMH(+) patients. Using random intercept model analysis, only infarct size was an independent predictor for adverse LV remodelling. Intramyocardial haemorrhage and microvascular obstruction are strongly related. Pre-PCI TIMI 3 flow is less frequently observed in patients with MVO and IMH. Only infarct size was an independent predictor of LV remodelling. (orig.)

  5. A Follow-Up Study of Medical Students' Biomedical Understanding and Clinical Reasoning Concerning the Cardiovascular System

    Science.gov (United States)

    Ahopelto, Ilona; Mikkila-Erdmann, Mirjamaija; Olkinuora, Erkki; Kaapa, Pekka

    2011-01-01

    Novice medical students usually hold initial conceptions concerning medical domains, such as the cardiovascular system, which may contradict scientific explanations and thus hinder learning. The purpose of this study was to investigate which kinds of biomedical representations medical students constructed of the central cardiovascular system in…

  6. Alterações metabólicas, terapia antirretroviral e doença cardiovascular em idosos portadores de HIV Alteraciones metabólicas, terapia antirretroviral y enfermedad cardiovascular en adultos mayores portadores de VIH Metabolic abnormalities, antiretroviral therapy and cardiovascular disease in elderly patients with HIV

    Directory of Open Access Journals (Sweden)

    Andréa Sebben Kramer

    2009-11-01

    Full Text Available Um dos fenômenos mais atuais da síndrome da imunodeficiência adquirida (AIDS é o surgimento de uma nova população vulnerável: os idosos. Um dos fatores responsáveis por este aumento é o desenvolvimento da terapia antirretroviral combinada (TARV, que tem proporcionado uma melhor qualidade e expectativa de vida do portador de HIV. Entretanto, a TARV está associada a efeitos adversos como dislipidemia, diabete melito e resistência à insulina, os quais se constituem como fatores de risco para doença cardiovascular. Com o impacto da TARV no metabolismo glicídico e lipídico, surgiram muitos estudos associando a infecção pelo HIV e a doença cardiovascular, assim como, os seus fatores de risco e a utilização da TARV, porém, poucos deles relatam sobre a cardiotoxicidade desta Terapia em idosos. Este artigo tem o objetivo de revisar as principais alterações metabólicas causadas pelo uso da terapia antirretroviral e o seu impacto no aumento do risco de doenças cardiovasculares nos idosos portadores de HIV.Uno de los fenómenos más actuales del síndrome de la inmunodeficiencia adquirida (SIDA es el surgimiento de una nueva población vulnerable: los adultos mayores. Uno de los factores responsables de este incremento es el desarrollo de la terapia antirretroviral combinada (TARV, que ha proporcionado una mejor calidad y expectativa de vida del portador de VIH. Sin embargo, la TARV está asociada a efectos adversos como dislipidemia, diabetes melito y resistencia a la insulina, los que se constituyen como factores de enfermedad para riesgo cardiovascular. Con el impacto de la TARV en el metabolismo glucídico y lipídico, surgieron muchos estudios asociando la infección por el riesgo y la enfermedad cardiovascular, así como, sus factores de VIH y la utilización de la TARV, sin embargo, pocos de ellos relatan sobre la cardiotoxicidad de esta terapia en adultos mayores. Este artículo tiene por objeto revisar las principales

  7. Clinical Preventive Services for Patients at Risk for Cardiovascular Disease, National Ambulatory Medical Care Survey, 2005-2006

    Directory of Open Access Journals (Sweden)

    Paula W. Yoon, ScD, MPH

    2011-03-01

    Full Text Available IntroductionClinical preventive services can detect diseases early, when they are most treatable, but these services may not be provided as recommended. Assessing the provision of services to patients at risk for cardiovascular disease (CVD could help identify disparities and areas for improvement.MethodsWe used data on patient visits (n = 21,261 from the National Ambulatory Medical Care Survey, 2005-2006, and classified patients with hypertension, hyperlipidemia, obesity, or diabetes as being at risk for CVD. We assessed differences in the provision of preventive services offered to patients who were and who were not at risk for CVD. Further, for those at risk, we compared the demographic characteristics of those who had and who had not been offered services.ResultsPatients at risk for CVD received significantly more preventive services compared with those not at risk. For patients at risk for CVD, aspirin therapy was more likely to be recommended to those aged 65 years or older than those aged 45 to 64 years and to men than women. Cholesterol screening was more likely for men and was less likely for patients with Medicare/Medicaid or no insurance than for patients who were insured. Rates of counseling for diet and nutrition, weight reduction, and exercise were low overall, but younger patients received these services more than older patients did.ConclusionPatients at risk for CVD are not all receiving the same level of preventive care, suggesting the need to clarify clinical practice guidelines and provide clinicians with education and support for more effective lifestyle counseling.

  8. Integrated Genomic Analysis Identifies Clinically Relevant Subtypes of Glioblastoma Characterized by Abnormalities in PDGFRA, IDH1, EGFR, and NF1

    Energy Technology Data Exchange (ETDEWEB)

    Verhaak, Roel GW; Hoadley, Katherine A; Purdom, Elizabeth; Wang, Victoria; Qi, Yuan; Wilkerson, Matthew D; Miller, C Ryan; Ding, Li; Golub, Todd; Mesirov, Jill P; Alexe, Gabriele; Lawrence, Michael; O' Kelly, Michael; Tamayo, Pablo; Weir, Barbara A; Gabriel, Stacey; Winckler, Wendy; Gupta, Supriya; Jakkula, Lakshmi; Feiler, Heidi S; Hodgson, J Graeme; James, C David; Sarkaria, Jann N; Brennan, Cameron; Kahn, Ari; Spellman, Paul T; Wilson, Richard K; Speed, Terence P; Gray, Joe W; Meyerson, Matthew; Getz, Gad; Perou, Charles M; Hayes, D Neil; Network, The Cancer Genome Atlas Research

    2009-09-03

    The Cancer Genome Atlas Network recently cataloged recurrent genomic abnormalities in glioblastoma multiforme (GBM). We describe a robust gene expression-based molecular classification of GBM into Proneural, Neural, Classical, and Mesenchymal subtypes and integrate multidimensional genomic data to establish patterns of somatic mutations and DNA copy number. Aberrations and gene expression of EGFR, NF1, and PDGFRA/IDH1 each define the Classical, Mesenchymal, and Proneural subtypes, respectively. Gene signatures of normal brain cell types show a strong relationship between subtypes and different neural lineages. Additionally, response to aggressive therapy differs by subtype, with the greatest benefit in the Classical subtype and no benefit in the Proneural subtype. We provide a framework that unifies transcriptomic and genomic dimensions for GBM molecular stratification with important implications for future studies.

  9. Characterisation of liver chemistry abnormalities associated with pazopanib monotherapy: a systematic review and meta-analysis of clinical trials in advanced cancer patients.

    Science.gov (United States)

    Powles, Thomas; Bracarda, Sergio; Chen, Mei; Norry, Elliot; Compton, Natalie; Heise, Mark; Hutson, Thomas; Harter, Philipp; Carpenter, Christopher; Pandite, Lini; Kaplowitz, Neil

    2015-07-01

    Drug-induced liver chemistry abnormalities, primarily transaminase elevations, are commonly observed in pazopanib-treated patients. This meta-analysis characterises liver chemistry abnormalities associated with pazopanib. Data of pazopanib-treated patients from nine prospective trials were integrated (N=2080). Laboratory datasets were used to characterise the incidence, timing, recovery and patterns of liver events, and subsequent rechallenge with pazopanib. Severe cases of liver chemistry abnormalities were clinically reviewed. Multivariate analyses identified predisposing factors. Twenty percent of patients developed elevated alanine aminotransferase (ALT) >3×ULN. Incidence of peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN was 8%, 5%, 5% and 1%, respectively. Median time to onset for all events was 42days; 91% of events were observed within 18weeks. Recovery rates based on peak ALT >3-5×ULN, >5-8×ULN, >8-20×ULN and >20×ULN were 91%, 90%, 90% and 64%, respectively. Median time from onset to recovery was 30days, but longer in patients without dose interruption. Based on clinical review, no deaths were associated with drug-induced liver injury. Overall, 38% of rechallenged patients had ALT elevation recurrence, with 9-day median time to recurrence. Multivariate analysis showed that older age was associated with development of ALT >8×ULN. There was no correlation between hypertension and transaminitis. Our data support the current guidelines on regular liver chemistry tests after initiation of pazopanib, especially during the first 9 or 10weeks, and also demonstrate the safety of rechallenge with pazopanib.

  10. Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations

    Directory of Open Access Journals (Sweden)

    Longwen Chen

    2014-01-01

    Full Text Available The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap interpretations of atypical endometrial cells (AEMs or AGC favor endometrial origin (AGC-EM. More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05% were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7. On follow-up histology, 27 (20.3% had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal, 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial

  11. 胎儿染色体核型异常的临床分析%Clinical analysis of fetal chromosomes karyotype abnormalities

    Institute of Scientific and Technical Information of China (English)

    林晓娟; 孙庆梅; 何晓春; 吴菊; 葛婷婷; 代维斯

    2016-01-01

    Objective To study the indications of prenatal diagnosis of fetal chromosome karyotype abnormalities,and provide the basis for prenatal diagnosis and clinical genetic counseling. Methods From October 2010 to April 2014,a total of 5 655 cases of pregnant women who received prenatal diagnosis of fetal karyotype analysis in Prenatal Diagnosis Center,Gansu Provincial Maternity and Child-care Hospital were selected as research subjects.The indications of prenatal diagnosis of the 5 655 cases of pregnant women contained high-risk indications of antenatal serological screening,such as trisomy 21 syndrome risk≥1/270 or trisomy 18 syndrome risk≥1/350 (2 482 cases),age ≥35 years old (1 889 cases),adverse pregnancy history (675 cases),chromosomal abnormalities of one of the couple (49 cases),prenatal ultrasound abnormalities (465 cases),and exposure to the poisonous and harmful substance,drugs that may cause teratogenicity and radical line (95 cases ).All the indications of prenatal diagnosis were uncrossed.Fetal chromosome karyotype abnormalities were diagnosed by amniocentesis. Different kinds of fetal chromosomes karyotype abnormalities, the number and detection rate,the relationship between fetal chromosome karyotype abnormalities and prenatal ultrasound abnormalities were analyzed by retrospective method.And the fetal chromosomes karyotype abnormalities detection rates of different indications of prenatal diagnosis were analyzed by statistical methods.The study protocol was approved by the Ethical Review Board of Investigation in Gansu Provincial Maternity and Child-care Hospital.Informed consent was obtained from each patient before receiving invasive prenatal diagnosis.Results ①Among the 5 655 cases of pregnant women who received invasive prenatal diagnosis,124 cases were detected as fetal chromosomal karyotype abnormalities,and the detection rate was 2.2%.Among 2 482 cases of pregnant women with high-risk indications,1 889 cases with age ≥ 35 years old,675

  12. A literature review on cardiovascular risk in human immunodeficiency virus-infected patients: implications for clinical management

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    Mansueto Gomes Neto

    2013-12-01

    Full Text Available INTRODUCTION: In recent years, there has been growing concern about an increasing rate of cardiovascular diseases in human immunodeficiency virus-infected patients, which could be associated with side effects of highly active antiretroviral therapy. It is likely that the metabolic disorders related to anti-human immunodeficiency virus treatment will eventually translate into a increased cardiovascular risk in patients submitted to such regimens. OBJECTIVE: To evaluate if human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy are at higher risk of cardiovascular diseases than human immunodeficiency virus infected patients not receiving highly active antiretroviral therapy, or the general population. RESEARCH DESIGN AND METHODS: We conducted a computer-based search in representative databases, and also performed manual tracking of citations in selected articles. RESULT: The available evidence suggests an excess risk of cardiovascular events in human immunodeficiency virus-infected persons compared to non-human immunodeficiency virus infected individuals. The use of highly active antiretroviral therapy is associated with increased levels of total cholesterol, triglycerides, low-density lipoprotein and morphological signs of cardiovascular diseases. Some evidence suggested that human immunodeficiency virus-infected individuals on highly active antiretroviral therapy regimens are at increased risk of dyslipidemia, ischemic heart disease, and myocardial infarction, particularly if the highly active antiretroviral therapy regimen contains a protease inhibitor. CONCLUSION: Physicians must weigh the cardiovascular risk against potential benefits when prescribing highly active antiretroviral therapy. Careful cardiac screening is warranted for patients who are being evaluated for, or who are receiving highly active antiretroviral therapy regimens, particularly for those with known underlying cardiovascular risk

  13. EVALUATION OF THE CONFORMITY OF CARDIOVASCULAR THERAPY TO CURRENT CLINICAL GUIDELINES IN THE IMPROVEMENT OF OUTCOMES IN PATIENTS AFTER STROKE (ACCORDING TO THE LIS-2 REGISTER

    Directory of Open Access Journals (Sweden)

    A. Yu. Suvorov

    2015-01-01

    Full Text Available Aim. To study the conformity of preventative therapy prescribed to patients during a hospital stay and at a discharge to clinical guidelines using a special algorithm, and to assess the impact of the results on a long-term mortality based on the LIS-2 register (Lyubertsy study of mortality in patients after cerebral stroke.Material and methods. The scales to assess the quality of cardiovascular care for the prevention of recurrent stroke along with the prevention of recurrent ischemic attacks index (PRIA index for this assessment were developed according to current clinical guidelines. Analysis of the therapy was performed using PRIA index on survived hospital patients from LIS-2 register (N=753. The impact of PRIA index results on a long-term mortality (Me=2.3 years was studied.Results. Based upon the results of the assessment obtained with PRIA index, higher treatment conformity to clinical guidelines resulted in a significantly better long-term survival. Non-conformity to clinical guidelines was due to the lack of prescription of drugs with proven efficacy and irrational choice of preventive therapy. Median of treatment quality assessment was 44.4% (22.2; 44.4.Conclusion. Low conformity of preventive therapy to clinical guidelines is found in the LIS-2 register. The algorithm for the assessment of preventive cardiovascular therapy quality allows identifying limitations in the prevention of recurrent stroke, and can serve as an example of implementation of evidence-based medicine in clinical practice.

  14. A Global View of the Relationships between the Main Behavioural and Clinical Cardiovascular Risk Factors in the GAZEL Prospective Cohort

    Science.gov (United States)

    Meneton, Pierre; Lemogne, Cédric; Herquelot, Eléonore; Bonenfant, Sébastien; Larson, Martin G.; Vasan, Ramachandran S.; Ménard, Joël; Goldberg, Marcel; Zins, Marie

    2016-01-01

    Although it has been recognized for a long time that the predisposition to cardiovascular diseases (CVD) is determined by many risk factors and despite the common use of algorithms incorporating several of these factors to predict the overall risk, there has yet been no global description of the complex way in which CVD risk factors interact with each other. This is the aim of the present study which investigated all existing relationships between the main CVD risk factors in a well-characterized occupational cohort. Prospective associations between 12 behavioural and clinical risk factors (gender, age, parental history of CVD, non-moderate alcohol consumption, smoking, physical inactivity, obesity, hypertension, dyslipidemia, diabetes, sleep disorder, depression) were systematically tested using Cox regression in 10,736 middle-aged individuals free of CVD at baseline and followed over 20 years. In addition to independently predicting CVD risk (HRs from 1.18 to 1.97 in multivariable models), these factors form a vast network of associations where each factor predicts, and/or is predicted by, several other factors (n = 47 with p<0.05, n = 37 with p<0.01, n = 28 with p<0.001, n = 22 with p<0.0001). Both the number of factors associated with a given factor (1 to 9) and the strength of the associations (HRs from 1.10 to 6.12 in multivariable models) are very variable, suggesting that all the factors do not have the same influence within this network. These results show that there is a remarkably extensive network of relationships between the main CVD risk factors which may have not been sufficiently taken into account, notably in preventive strategies aiming to lower CVD risk. PMID:27598908

  15. Effectiveness of personalized face-to-face and telephone nursing counseling interventions for cardiovascular risk factors: a controlled clinical trial 1

    Science.gov (United States)

    Vílchez Barboza, Vivian; Klijn, Tatiana Paravic; Salazar Molina, Alide; Sáez Carrillo, Katia Lorena

    2016-01-01

    Abstract Objective: to evaluate the effect and gender differences of an innovative intervention involving in-person and telephone nursing counseling to control cardiovascular risk factors (arterial hypertension, dyslipidemia, and overweight), improve health-related quality of life and strengthen self-efficacy and social support in persons using the municipal health centers' cardiovascular health program. Method: a randomized controlled clinical trial involving participants randomized into the intervention group who received traditional consultation plus personalized and telephone nursing counseling for 7 months (n = 53) and the control group (n = 56). The study followed the Consolidated Standards of Reporting Trials Statement. Results: women in the intervention group presented a significant increase in the physical and mental health components compared to the control group, with decreases in weight, abdominal circumference, total cholesterol, low-density lipoprotein cholesterol, and the atherogenic index. The effects attributable to the intervention in the men in the intervention group were increased physical and emotional roles and decreased systolic and diastolic pressure, waist circumference, total cholesterol, low-density lipoprotein cholesterol, atherogenic index, cardiovascular risk factor, and 10-year coronary risk. Conclusion: this intervention is an effective strategy for the control of three cardiovascular risk factors and the improvement of health-related quality of life. PMID:27508917

  16. Diffuse white matter tract abnormalities in clinically normal ageing retired athletes with a history of sports-related concussions.

    Science.gov (United States)

    Tremblay, Sebastien; Henry, Luke C; Bedetti, Christophe; Larson-Dupuis, Camille; Gagnon, Jean-François; Evans, Alan C; Théoret, Hugo; Lassonde, Maryse; De Beaumont, Louis

    2014-11-01

    Sports-related concussions have been shown to lead to persistent subclinical anomalies of the motor and cognitive systems in young asymptomatic athletes. In advancing age, these latent alterations correlate with detectable motor and cognitive function decline. Until now, the interacting effects of concussions and the normal ageing process on white matter tract integrity remain unknown. Here we used a tract-based spatial statistical method to uncover potential white matter tissue damage in 15 retired athletes with a history of concussions, free of comorbid medical conditions. We also investigated potential associations between white matter integrity and declines in cognitive and motor functions. Compared to an age- and education-matched control group of 15 retired athletes without concussions, former athletes with concussions exhibited widespread white matter anomalies along many major association, interhemispheric, and projection tracts. Group contrasts revealed decreases in fractional anisotropy, as well as increases in mean and radial diffusivity measures in the concussed group. These differences were primarily apparent in fronto-parietal networks as well as in the frontal aspect of the corpus callosum. The white matter anomalies uncovered in concussed athletes were significantly associated with a decline in episodic memory and lateral ventricle expansion. Finally, the expected association between frontal white matter integrity and motor learning found in former non-concussed athletes was absent in concussed participants. Together, these results show that advancing age in retired athletes presenting with a history of sports-related concussions is linked to diffuse white matter abnormalities that are consistent with the effects of traumatic axonal injury and exacerbated demyelination. These changes in white matter integrity might explain the cognitive and motor function declines documented in this population.

  17. Topographic abnormalities of proinsulin to insulin conversion in functioning human insulinomas. Comparison of immunoelectron microscopic and clinical data.

    OpenAIRE

    Roth, J; Komminoth, P; Heitz, P. U.

    1995-01-01

    It has been proposed that the major defect in human insulinomas is a decreased hormone storage capacity resulting in uncontrolled release of proinsulin and insulin. By immunoelectron microscopy with monoclonal antibodies we studied the subcellular distribution of proinsulin and insulin in benign and malignant functioning insulinomas of different histology and compared the findings with various clinical and pathohistological parameters. We found that, in contrast to normal B cells, the proinsu...

  18. Frequency of Cardiovascular Involvement in Familial Amyloidotic Polyneuropathy in Brazilian Patients

    Directory of Open Access Journals (Sweden)

    Márcia Cavalcanti de Campos Queiroz

    2015-11-01

    Full Text Available Background:Familial amyloidotic polyneuropathy (FAP is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown.Objective:Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND score.Methods:In a national reference center, 51 patients were evaluated with clinical examination, electrocardiography (ECG, echocardiography (ECHO, and 24-hour Holter. Patients were classified according to the modified PND score and divided into groups: PND 0, PND I, PND II, and PND > II (which included PND IIIa, IIIb, and IV. We chose the classification tree as the statistical method to analyze the association between findings in cardiac tests with the neurological classification (PND.Results:ECG abnormalities were present in almost 2/3 of the FAP patients, whereas ECHO abnormalities occurred in around 1/3 of them. All patients with abnormal ECHO also had abnormal ECG, but the opposite did not apply. The classification tree identified ECG and ECHO as relevant variables (p < 0.001 and p = 0.08, respectively. The probability of a patient to be allocated to the PND 0 group when having a normal ECG was over 80%. When both ECG and ECHO were abnormal, this probability was null.Conclusions:Brazilian patients with FAP have frequent ECG abnormalities. ECG is an appropriate test to discriminate asymptomatic carriers of the mutation from those who develop the disease, whereas ECHO contributes to this discrimination.

  19. Correlations between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases : Are there differences between male populations from primary healthcare and urology clinics? A review of the current knowledge

    NARCIS (Netherlands)

    Bouwman, Inge I.; Van der Heide, Wouter K.; Van der Meer, Klaas; Nijman, Rien

    2009-01-01

    Objective: To evaluate the correlation between lower urinary tract symptoms, erectile dysfunction, and cardiovascular diseases in different male populations. Methods: Data sources: PubMed (Medline), clinical evidence, Embase, Cochrane reviews, and articles from reference lists. Selection criteria: S

  20. Clinical evaluation of cardiovascular devices: principles, problems, and proposals for European regulatory reform. Report of a policy conference of the European Society of Cardiology.

    Science.gov (United States)

    Fraser, Alan G; Daubert, Jean-Claude; Van de Werf, Frans; Estes, N A Mark; Smith, Sidney C; Krucoff, Mitchell W; Vardas, Panos E; Komajda, Michel

    2011-07-01

    The European Commission announced in 2008 that a fundamental revision of the medical device directives is being considered in order to clarify and strengthen the current legal framework. The system for testing and approving devices in Europe was established >20 years ago as a 'New Approach' to a previously little-regulated industry. It is recognized by many that the regulatory system has not kept pace with technological advances and changing patterns of medical practice. New legislation will be drafted during 2011, but medical experts have been little involved in this important process. This context makes it an opportune time for a professional association to advise from both clinical and academic perspectives about changes which should be made to improve the safety and efficacy of devices used in clinical practice and to develop more appropriate systems for their clinical evaluation and post-marketing surveillance. This report summarizes how medical devices are regulated and it reviews some serious clinical problems that have occurred with cardiovascular devices. Finally, it presents the main recommendations from a Policy Conference on the Clinical Evaluation of Cardiovascular Devices that was held at the European Heart House in January 2011.

  1. 临床药师指导心血管科药物治疗的体会%Experience of clinical pharmacist guiding in medication of cardiovascular department

    Institute of Scientific and Technical Information of China (English)

    栗云明

    2013-01-01

    Objective To explore the effect of clinical pharmacists in clinical therapy.Methods The drug problems solved by clinical pharmacist in the cardiovascular department were summarized,and the process and methods of clinical pharmacist guiding in medication were described.Results The medication programs were improved through pharmaceutical guidance on doctors' drug treatment,the drug obedience and security were improved by pharmaceutical care for patients.Conclusion Participation of clinical pharmacists in cardiovascular department could improve the treatment effect,and protect the patients.%目的 探讨临床药师在临床治疗过程中的作用.方法 总结临床药师在心血管科遇到的用药问题,介绍临床药师指导药物治疗的过程与方法.结果 临床药师通过对医生的药学指导,完善了药物治疗方案;通过对患者的药学监护,提高了药物治疗依从性和安全性.结论 临床药师的参与对提高临床医疗水平、保障患者的生命安全具有重大意义.

  2. Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight.

    Science.gov (United States)

    Skranes, J; Vangberg, T R; Kulseng, S; Indredavik, M S; Evensen, K A I; Martinussen, M; Dale, A M; Haraldseth, O; Brubakk, A-M

    2007-03-01

    Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight children semistructured interview, the Autism Spectrum Screening Questionnaire and attention deficit hyperactivity disorder (ADHD) rating scale IV. Overall functioning was scored on the children's global assessment scale. DTI scans were performed for calculation of FA maps and areas of significant differences in mean FA values between subjects and controls were compared with their clinical data. The VLBW children had reduced FA values in the internal and external capsule, corpus callosum and superior, middle superior and inferior fasciculus. Within this group of children, visual motor and visual perceptual deficits were associated with low FA values in the external capsule, posterior part of the internal capsule and in the inferior fasciculus. Children with low IQ had low FA values in the external capsule and inferior and middle superior fasciculus. Fine motor impairment was related to low FA values in the internal and external capsule and superior fasciculus. Eight VLBW children with inattention symptoms or a diagnosis of ADHD had significantly lower FA values in several areas. Mild social deficits correlated with reduced FA values in the external capsule and superior fasciculus. We conclude that DTI was able to detect differences in FA between VLBW adolescents and controls in several white matter areas at risk of periventricular leucomalacia in VLBW newborns. Our results show that low FA values in these areas were associated with perceptual, cognitive, motor and mental health impairments. These conclusions indicate that perinatal injury of white matter tracts persist with clinical significance in

  3. Echocardiographic abnormalities in the assessment of cardiac organ damage in never-treated hypertensive patients.

    Science.gov (United States)

    Milan, Alberto; Avenatti, Eleonora; Puglisi, Elisabetta; Abram, Sara; Magnino, Corrado; Naso, Diego; Tosello, Francesco; Fabbri, Ambra; Vairo, Alessandro; Mulatero, Paolo; Rabbia, Franco; Veglio, Franco

    2012-01-01

    Hypertension-related cardiac organ damage, other than left ventricular (LV) hypertrophy (LVH), has been described: in particular, concentric remodeling, LV diastolic dysfunction (DD), and left atrial (LA) enlargement are significantly associated with cardiovascular morbility and mortality in different populations. This study evaluated the prevalence of these latter morphofunctional abnormalities, in never-treated essential hypertensive patients and the role of such a serial assessment of hypertensive cardiac damage in improving cardiovascular risk stratification in these patients. A total of 100 never-treated essential hypertensive subjects underwent a complete clinical and echocardiographic evaluation. Left ventricular morphology, systolic and diastolic function, and LA dimension (linear and volume) were evaluated by echocardiography. Left ventricular hypertrophy was present in 14% of the patients, whereas concentric remodeling was present in 25% of the subjects. Among patients free from LV morphology abnormalities, the most frequent abnormality was LA enlargement (global prevalence 57%); the percentage of patients with at least one parameter consistent with DD was 22% in the entire population, but DD was present as the only cardiac abnormality in 1% of our patient. Left atrial volume indexed for body surface area was the most sensitive parameter in identifying hypertension-related cardiac modification. The global prevalence of cardiac alteration reached 73% in never-treated hypertensive patients. Left ventricular remodeling and LA enlargement evaluation may grant a better assessment of cardiac organ damage and cardiovascular risk stratification of hypertensive patients without evidence of LVH after routine examination. PMID:22738434

  4. The influence of Multiwave Locked System (MLS) laser therapy on clinical features, microcirculatory abnormalities and selected modulators of angiogenesis in patients with Raynaud's phenomenon.

    Science.gov (United States)

    Kuryliszyn-Moskal, Anna; Kita, Jacek; Dakowicz, Agnieszka; Chwieśko-Minarowska, Sylwia; Moskal, Diana; Kosztyła-Hojna, Bożena; Jabłońska, Ewa; Klimiuk, Piotr Adrian

    2015-03-01

    The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud's phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud's attack and pain intensity in RP patients was observed. After MLS laser therapy in 65% of patients with primary and in 35% with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.

  5. Retrospective database analysis of clinical outcomes and costs for treatment of abnormal uterine bleeding among women enrolled in US Medicaid programs

    Directory of Open Access Journals (Sweden)

    Bonafede MM

    2014-10-01

    Full Text Available Machaon M Bonafede,1 Jeffrey D Miller,1 Shannon K Laughlin-Tommaso,2 Andrea S Lukes,3 Nicole M Meyer,1 Gregory M Lenhart1 1Truven Health Analytics, Cambridge MA, 2Mayo Clinic, Department of Obstetrics and Gynecology, Rochester, MN, 3Women's Wellness Clinic and Research Center, Durham, NC, USA Background: Women with abnormal uterine bleeding (AUB may be treated surgically with hysterectomy or global endometrial ablation (GEA, an outpatient procedure. We compared the costs and clinical outcomes of these surgical procedures for AUB among women in Medicaid programs.Methods: The Truven Health MarketScan® Medicaid Multi-State Database was used to identify Medicaid women aged 30–55 years with AUB who newly initiated GEA or hysterectomy (index event during 2006–2010. Patients were required to have 12 months of continuous enrollment pre-index and post-index. Baseline characteristics were assessed in the pre-index period; health care utilization and costs (2011 USD, treatment complications, and reinterventions were assessed in the post-index period.Results: Of 1,880 women who met the study criteria (mean age 40.7 years, 53.4% were Caucasian, 33.1% were African-American, and 2.3% were Hispanic; many (42.8% received their Medicaid eligibility due to disability. Similar proportions received GEA (50.9% or hysterectomy (49.1%. At baseline, both groups also had similar Deyo-Charlson Comorbidity scores (0.65, and use of antibiotics (69.4%, nonsteroidal anti-inflammatory drugs (56.3%, and oral contraceptives (5.3%. More hysterectomy patients than GEA patients had a treatment-related complication (52% versus 36%, respectively, P<0.001. Initial treatment costs were higher for hysterectomy ($11,270 than for GEA ($3,958, P<0.001; monthly gynecology-related costs in the remainder of the year were not significantly different for hysterectomy ($63 and GEA ($16, P=0.11.Conclusion: Hysterectomy was nearly three times more costly than GEA for initial treatment of AUB

  6. Acute and chronic psychological stress as risk factors for cardiovascular disease: Insights gained from epidemiological, clinical and experimental studies.

    Science.gov (United States)

    Lagraauw, H Maxime; Kuiper, Johan; Bot, Ilze

    2015-11-01

    Cardiovascular disease (CVD) remains a leading cause of death worldwide and identification and therapeutic modulation of all its risk factors is necessary to ensure a lower burden on the patient and on society. The physiological response to acute and chronic stress exposure has long been recognized as a potent modulator of immune, endocrine and metabolic pathways, however its direct implications for cardiovascular disease development, progression and as a therapeutic target are not completely understood. More and more attention is given to the bidirectional interaction between psychological and physical health in relation to cardiovascular disease. With atherosclerosis being a chronic disease starting already at an early age the contribution of adverse early life events in affecting adult health risk behavior, health status and disease development is receiving increased attention. In addition, experimental research into the biological pathways involved in stress-induced cardiovascular complications show important roles for metabolic and immunologic maladaptation, resulting in increased disease development and progression. Here we provide a concise overview of human and experimental animal data linking chronic and acute stress to CVD risk and increased progression of the underlying disease atherosclerosis. PMID:26256574

  7. Clinical implications of the Women's Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes.

    Science.gov (United States)

    Handberg, Eileen M; Eastwood, Jo-Ann; Eteiba, Wafia; Johnson, B Delia; Krantz, David S; Thompson, Diane V; Vaccarino, Viola; Bittner, Vera; Sopko, George; Pepine, Carl J; Merz, Noel Bairey; Rutledge, Thomas R

    2013-09-01

    Cardiovascular disease remains the leading cause of death in the USA and is associated with several modifiable (hypertension, diabetes, high cholesterol, tobacco use, physical inactivity, obesity and unhealthy diet) and nonmodifiable (age, gender and family history) risk factors. The role of psychosocial risk factors in the development of cardiovascular disease has a growing body of literature, and differences in men and women have been identified. The Women's Ischemia Syndrome Evaluation provides insight into psychosocial risk factors in a cohort of women presenting with chest pain who had a comprehensive battery of psychosocial assessments and long-term follow-up. This review focuses on symptom presentation for chest pain and its relationship to cardiovascular disease morbidity and mortality, quality of life, healthcare costs and psychosocial predictor variables, including anxiety, depression, hostility and social networks. In the Women's Ischemia Syndrome Evaluation, persistent chest pain was associated with an increased rate of adverse events and relatively high rates of depression and anxiety, with reduced functional capacity and impaired quality of life, over a median of 6 years of follow-up. More research is needed to better understand the relationships between symptoms and negative emotions and to determine whether psychological (pharmacologic and/or cognitive) interventions might impact both psychological and cardiovascular outcomes.

  8. Abnormal expression of vascular endothelial growth factor (VEGF) and its clinical features in tissues of human lung cancer

    Institute of Scientific and Technical Information of China (English)

    Xinhua Wu; Dengfu Yao; Gongshen Shi; Liwei Qiu; Wei Wu; Songshi Ni; Xueguang Zhang

    2005-01-01

    Objective: Angiogennesis, the formation of new blood vessels from the existing vascular bed, is essential step for growth and invasion of primary tumor. Vascular endothelial growth-factor (VEGF) is known to play crucial role in tumor angiogenesis. In the present study, we investigate the expression of VEGF and VEGF-mRNA in the angiogennesis, metastasis and prognosis of lung cancer.Methods: The VEGF cellular distributions and expression in 38 specimens of patients with lung cancer were investigated with immunohistochemistry stain technology. The total RNAs in 38 tissues of lung cancer was measured, then the levels of VEGF-mRNA expression were analyzed by a reverse-transcription polymerase chain reaction (RT-PCR) assay. The levels of VEGF in sera of patients with lung cancer, benign lung diseases and healthy controls were detected through Enzyme linked immunosorbent assay (ELISA) method. Results: The VEGF positive stain was 76% in 38 cases of lung cancer specimens. The 89% rate of VEGF stain was found for clinical stage Ⅲ cases and 92%for stage Ⅳ lung cancers. The significantly higher expression of VEGF was evidenced in patients with lymph node metastasis (84 % ), distant metastasis (90%), and lung cancers with lower histological differentiation (89%), respectively. The expression level of total RNA was significantly higher in patients with lung cancers than that in their paracancerous or distant lung tissues. The VEGF expressions were tightly correlated with total RNA concentration of lung carcinoma ( P < 0.01 ). The predominant expressions of VEGF121 and VEGF165 gene fragments were found in lung cancer specimens by RT-PCR analysis. No significant difference of serum VEGF levels was detected between cases with lung cancer and patients with benign diseases. However, the VEGF level of cases with benign diseases was decreased significantly after patients with anti-inflammation medication. Conclusion: The present data suggested that the tumor tissue VEGF

  9. 临床综合分析及治疗儿童多瞬症%Clinical comprehensive analysis and treatment of children abnormal blinking

    Institute of Scientific and Technical Information of China (English)

    宿可昕; 王兴民; 马娟; 姜红; 魏秀华; 徐晶

    2015-01-01

    Objective To study the curative effect of integrated Chinese and Western medicines treatment by clinical practical observation, visual function training, drug therapy and psychological guidance in the treatment of children abnormal blinking.Methods Treatment was given according to pathogenesis of 168 children abnormal blinking cases by detailed inquiry, visual function examination and eye examination. Visual function training, drug therapy and psychological guidance were given as integrated Chinese and Western treatment.Results After receiving treatment, there were 126 cured cases in 1 course, accounting for 75.0% and 41 cured cases in 2 courses, accounting for 24.4%, while only 1 case with relieved symptoms (psychological factors).Conclusion Therapies of integrated Chinese and Western medicines can effectively treat children abnormal blinking by visual function training, lysine alkamine vitamin B12, Stulln, Gegenshumu decoction, and psychological guidance.%目的:探讨通过临床实践观察、视功能训练、药物及心理辅导等中西医结合方法治疗儿童多瞬症的疗效。方法通过详尽问诊、视功能检查及眼部检查了解明确168例儿童多瞬症发生的病因,按因施治,然后通过视功能训练、药物及心理辅导等中西医结合方法治疗儿童多瞬症。结果经治疗,1个疗程治愈者126例,占总人数的75.0%;2个疗程治愈者41例,占总人数的24.4%,只有1例患儿(心理因素)症状缓解。结论视功能训练、赖氨基醇维生素B12、施图伦、葛根舒目汤、心理辅导等中西医方法相结合可有效的治疗儿童多瞬症。

  10. Clinical experience for treating senile cardiovascular diseases inTCM differientiation%中医辨治老年心血管病的临床体会

    Institute of Scientific and Technical Information of China (English)

    曾浪泉

    2014-01-01

    Objective: To investigate clinical effects of TCM differentiation for cardiovascular disease in the elderly. Methods: 208 hospitalized patients and outpatient were classified for scientific classification and investigation. Results: TCM treatment for different types of cardiovascular disease in elderly have a significant effect. Conclusion: TCM for cardiovascular disease in elderly is efficient, safe and has less side effects characteristic.%目的:探讨中医对老年心血管病的治疗效果,为临床用药提供依据。方法:对我院2008年3月-2010年3月收治的208名住院和门诊患者进行病例科学分类和治疗效果调查。结果:中医治疗对于不同类型的老年心血管病均有显著疗效。结论:中医治疗老年心血管病有高效、安全和低副作用的特点。

  11. Final infarct size measured by cardiovascular magnetic resonance in patients with ST elevation myocardial infarction predicts long-term clinical outcome

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Vejlstrup, Niels Grove; Kelbæk, Henning Skov;

    2013-01-01

    prognostic evaluation. To evaluate the prognostic importance of the final infarct size measured by cardiovascular magnetic resonance (CMR) in patients with STEMI. METHODS AND RESULTS: In an observational study the final infarct size was measured by late gadolinium enhancement CMR 3 months after initial...... admission in 309 patients with STEMI. The clinical endpoint was a composite of all-cause mortality and admission for heart failure. During the follow-up period of median 807 days (IQR: 669-1117) 35 events (5 non-cardiac deaths, 3 cardiac deaths, and 27 admissions for heart failure) were recorded. Patients...

  12. Salud Para Su Corazon (health for your heart) community health worker model: community and clinical approaches for addressing cardiovascular disease risk reduction in Hispanics/Latinos.

    Science.gov (United States)

    Balcazar, H; Alvarado, M; Ortiz, G

    2011-01-01

    This article describes 6 Salud Para Su Corazon (SPSC) family of programs that have addressed cardiovascular disease risk reduction in Hispanic communities facilitated by community health workers (CHWs) or Promotores de Salud (PS). A synopsis of the programs illustrates the designs and methodological approaches that combine community-based participatory research for 2 types of settings: community and clinical. Examples are provided as to how CHWs can serve as agents of change in these settings. A description is presented of a sustainability framework for the SPSC family of programs. Finally, implications are summarized for utilizing the SPSC CHW/PS model to inform ambulatory care management and policy.

  13. Clinical implications of adipocytokines and newly emerging metabolic factors with relation to insulin resistance and cardiovascular health

    Directory of Open Access Journals (Sweden)

    Sung Hee eChoi

    2013-08-01

    Full Text Available Adipose tissue is known to secrete hormones actively and produces many biologically active proteins called adipocytokines. Typically, obesity is followed by low-grade inflammation, which is characterized by increased circulating levels of pro-inflammatory cytokines. Macrophages play a role in the inflammatory process by secreting many cytokines such as tumour necrosis factor-alpha, interleukin-6, resistin and retinol binding protein-4. These cytokines and chemokines participate in low grade pro-inflammatory processes leading to insulin resistance, metabolic impairment and cardiovascular diseases. More metabolic regulators, such as fibroblast growth factor (FGF21, FGF19, FGF1, vaspin and visfatin have now been discovered but their exact roles in human diseases are still unclear. This review focuses on recent research regarding the role of adipokines and new metabolic factors in metabolic derangement or cardiovascular disease.

  14. Is there something special about cardiovascular abnormalities and sudden unexpected death in epilepsy among patients with chronic renal insufficiency in regular hemodialysis program? Existe algo de especial a respeito das anormalidades cardíacas e morte súbita e inesperada na epilepsia nos pacientes com insuficiência renal crônica no programa regular de hemodiálise?

    Directory of Open Access Journals (Sweden)

    Rui A. Gomes

    2009-06-01

    Full Text Available Of the many risk factors suggested for sudden unexpected death in epilepsy (SUDEP, higher frequency of seizures is a very consistent issue. Following this reasoning, it has been established that hemodialysis-associated seizure is a complication of dialysis procedure. Based on these facts, this study investigated a possible association between cardiovascular abnormalities and SUDEP among patients with chronic renal insufficiency in regular hemodialysis program. For that, a retrospective medical history of 209 patients was reviewed to investigate the occurrence of convulsive seizures and EKG abnormalities during dialytic program. Three patients presented generalized tonic-clonic seizures, one had partial seizure with secondary generalization, and one presented unclassified seizure. Any EKG abnormalities and SUDEP event were found in all patients evaluated. In conclusion, the present findings demonstrated uncommon the occurrence of seizures and also SUDEP. Probably, the main justification to not allow us to demonstrated a direct relation between SUDEP and cardiovascular diseases in hemodialysis are the reduced number of cases examined.Um dos principais fatores de risco para a morte súbita e inesperada na epilepsia (SUDEP é a alta freqüência de crises epilépticas. Seguindo este raciocínio, tem sido estabelecido que as crises epilépticas associadas à hemodiálise seja uma complicação do procedimento dialítico. Baseado neste fato, este estudo investigou uma possível associação entre anormalidades cardiovasculares e SUDEP nos pacientes com insuficiência renal crônica em um programa regular de hemodiálise. Para isto, um histórico médico retrospectivo de 209 pacientes foi revisado para avaliar a ocorrência de crises epilépticas e possíveis anormalidades no ECG durante o programa de diálise. Três pacientes apresentaram crises tônico-clonica generalizadas, um apresentou crise parcial com generalização secundária e um apresentou

  15. The Protective Role of Positive Well-Being in Cardiovascular Disease: Review of Current Evidence, Mechanisms, and Clinical Implications.

    Science.gov (United States)

    Sin, Nancy L

    2016-11-01

    Positive psychological aspects of well-being-including positive emotions, optimism, and life satisfaction-are increasingly considered to have protective roles for cardiovascular disease (CVD) and longevity. A rapidly-growing body of literature has linked positive well-being with better cardiovascular health, lower incidence of CVD in healthy populations, and reduced risk of adverse outcomes in patients with existing CVD. This review first examines evidence on the associations of positive well-being with CVD and mortality, focusing on recent epidemiological research as well as inconsistent findings. Next, an overview is provided of putative biological, behavioral, and stress-buffering mechanisms that may underlie the relationship between positive well-being and cardiovascular health. Key areas for future inquiry are discussed, in addition to emerging developments that capitalize on technological and methodological advancements. Promising initial results from randomized controlled trials suggest that efforts to target positive well-being may serve as valuable components of broader CVD management programs. PMID:27612475

  16. Risco cardiovascular: marcadores antropométricos, clínicos e dietéticos em indivíduos infectados pelo vírus HIV Cardiovascular risk: anthropometric, clinical and dietary markers in HIV-infected persons

    Directory of Open Access Journals (Sweden)

    Luísa Helena Maia Leite

    2011-02-01

    Full Text Available OBJETIVO: Descrever marcadores antropométricos, clínicos e dietéticos associados ao risco cardiovascular em indivíduos infectados pelo vírus HIV. MÉTODOS: Realizou-se um estudo transversal com 100 indivíduos, adultos, com HIV/Aids, da cidade do Rio de Janeiro. O risco cardiovascular foi estimado pelo escore de risco de Framingham. O consumo alimentar foi avaliado por meio de um recordatório de 24 horas e de uma lista de frequência de consumo de alimentos. Para comparar variáveis, foram utilizados o teste t de Student e o teste Qui-quadrado. RESULTADOS: Dentre os indivíduos avaliados, 63% eram homens, com idade média de 41,8, DP=9,6 anos, 77% faziam uso de antirretrovirais. Escore de risco de Framingham >10% foi identificado em 53% dos indivíduos. Os principais fatores de risco cardiovascular potencialmente modificáveis identificados foram: lipoproteína de alta densidade baixo (70%, hipercolesterolemia (35%, hipertensão arterial (35%, seguidos de tabagismo (23% e glicose alta (21%. Indivíduos com escore de risco de Framingham >10% apresentavam uma tendência para consumir dietas mais ricas em colesterol (p=0,720, em sódio (p=0,898, em açúcares/doces (p=0,032 e pobres em fibras (p=0,273, associadas a um maior consumo de bebidas alcoólicas (p=0,053. A avaliação dos hábitos de vida revelou maior prevalência de tabagismo e maior nível de sedentarismo no grupo com escore de risco de Framingham >10, porém não significativos. CONCLUSÃO: Os resultados deste estudo mostram que pacientes com HIV/Aids sob terapia Highly Active Antiretroviral Therapy e com mais altos escore de risco de Framingham não seguem as medidas preventivas contra doenças cardiovasculares e devem ser permanentemente encorajados a fazer escolhas alimentares saudáveis, parar de fumar e aumentar a atividade física.OBJECTIVE: This study described the anthropometric, clinical and dietary markers associated with cardiovascular risk in HIV-infected persons

  17. Randomised clinical trial of an intensive intervention in the primary care setting of patients with high plasma fibrinogen in the primary prevention of cardiovascular disease

    Directory of Open Access Journals (Sweden)

    José Rodríguez Cristóbal Juan

    2012-03-01

    Full Text Available Abstract Background We have studied the possible effects of an intensive lifestyle change program on plasma fibrinogen levels, in patients with no cardiovascular disease, with elevated levels of fibrinogen, normal cholesterol levels, and a moderate estimated risk of coronary heart disease (CHD and we have also analysed whether the effect on fibrinogen is independent of the effect on lipids. Results This clinical trial was controlled, unblinded and randomized, with parallel groups, done in 13 Basic Health Areas (BHA in l'Hospitalet de Llobregat (Barcelona and Barcelona city. The study included 436 patients, aged between 35 and 75 years, with no cardiovascular disease, elevated levels of fibrinogen (> 300 mg/dl, cholesterol The evaluation of the baseline characteristics of the patients showed that both groups were homogenous. Obesity and hypertension were the most prevalent risk factors. After 24 months of the study, statistically significant changes were seen between the adjusted means of the two groups, for the following parameters: fibrinogen, plasma cholesterol, systolic and diastolic blood pressure and body mass index. Conclusion Intensive intervention to achieve lifestyle changes has shown to be effective in reducing some of the estimated CHD factors. However, the effect of intensive intervention on plasma fibrinogen levels did not correlate with the variations in cholesterol. Trial Registration ClinicalTrials.gov: NCT01089530

  18. Clinical usefulness of myocardial iodine-123-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid distribution abnormality in patients with mitochondrial encephalomyopathy based on normal data file in bull`s-eye polar map

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobukazu; Mitani, Isao; Sumita, Shinichi [Yokohama City Univ. (Japan). School of Medicine] [and others

    1998-01-01

    Visual interpretation of iodine-123-beta-15-(p-iodophenyl)-3(R,S)-methyl-pentadecanoic acid ({sup 123}I-BMIPP) myocardial images cannot easily detect mild reduction in tracer uptake. Objective assessment of myocardial {sup 123}I-BMIPP maldistributions at rest was attempted using a bull`s-eye map and its normal data file for detecting myocardial damage in patients with mitochondrial encephalomyopathy. Six patients, two with Kearns-Sayre syndrome and four with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS), and 10 normal subjects were studied. Fractional myocardial uptake of 1{sup 23}I-BMIPP was also measured by dynamic static imaging to assess the global myocardial free fatty acid. These data were compared with the cardiothoracic ratio measured by chest radiography and left ventricular ejection fraction assessed by echocardiography. Abnormal cardiothoracic ratio and lower ejection fraction were detected in only one patient with Kearns-Sayre syndrome. Abnormal fractional myocardial uptake was detected in two patients (1.61%, 1.91%), whereas abnormal regional {sup 123}I-BMIPP uptake assessed by the bull`s-eye map was detected in five patients (83%). All patients showed abnormal uptake in the anterior portion, and one showed progressive atrioventricular conduction abnormality and systolic dysfunction with extended {sup 123}I-BMIPP abnormal uptake. The results suggest that assessment based on the normal data file in a bull`s-eye polar map is clinically useful for detection of myocardial damage in patients with mitochondrial encephalomyopathy. (author)

  19. Down Syndrome: A Cardiovascular Perspective

    Science.gov (United States)

    Vis, J. C.; Duffels, M. G. J.; Winter, M. M.; Weijerman, M. E.; Cobben, J. M.; Huisman, S. A.; Mulder, B. J. M.

    2009-01-01

    This review focuses on the heart and vascular system in patients with Down syndrome. A clear knowledge on the wide spectrum of various abnormalities associated with this syndrome is essential for skillful management of cardiac problems in patients with Down syndrome. Epidemiology of congenital heart defects, cardiovascular aspects and…

  20. Clinical use of quantitative cardiac perfusion PET: rationale, modalities and possible indications. Position paper of the Cardiovascular Committee of the European Association of Nuclear Medicine (EANM).

    Science.gov (United States)

    Sciagrà, Roberto; Passeri, Alessandro; Bucerius, Jan; Verberne, Hein J; Slart, Riemer H J A; Lindner, Oliver; Gimelli, Alessia; Hyafil, Fabien; Agostini, Denis; Übleis, Christopher; Hacker, Marcus

    2016-07-01

    Until recently, PET was regarded as a luxurious way of performing myocardial perfusion scintigraphy, with excellent image quality and diagnostic capabilities that hardly justified the additional cost and procedural effort. Quantitative perfusion PET was considered a major improvement over standard qualitative imaging, because it allows the measurement of parameters not otherwise available, but for many years its use was confined to academic and research settings. In recent years, however, several factors have contributed to the renewal of interest in quantitative perfusion PET, which has become a much more readily accessible technique due to progress in hardware and the availability of dedicated and user-friendly platforms and programs. In spite of this evolution and of the growing evidence that quantitative perfusion PET can play a role in the clinical setting, there are not yet clear indications for its clinical use. Therefore, the Cardiovascular Committee of the European Association of Nuclear Medicine, starting from the experience of its members, decided to examine the current literature on quantitative perfusion PET to (1) evaluate the rationale for its clinical use, (2) identify the main methodological requirements, (3) identify the remaining technical difficulties, (4) define the most reliable interpretation criteria, and finally (5) tentatively delineate currently acceptable and possibly appropriate clinical indications. The present position paper must be considered as a starting point aiming to promote a wider use of quantitative perfusion PET and to encourage the conception and execution of the studies needed to definitely establish its role in clinical practice.

  1. Periodontal treatment effects on endothelial function and cardiovascular disease biomarkers in subjects with chronic periodontitis: protocol for a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Arce Roger M

    2011-02-01

    Full Text Available Abstract Background Periodontal disease (PD is an infectious clinical entity characterized by the destruction of supporting tissues of the teeth as the result of a chronic inflammatory response in a susceptible host. It has been proposed that PD as subclinical infection may contribute to the etiology and to the pathogenesis of several systemic diseases including Atherosclerosis. A number of epidemiological studies link periodontal disease/edentulism as independent risk factor for acute myocardial infarction, peripheral vascular disease, and cerebrovascular disease. Moreover, new randomized controlled clinical trials have shown an improvement on cardiovascular surrogate markers (endothelial function, sICAM, hsPCR level, fibrinogen after periodontal treatment. Nonetheless, such trials are still limited in terms of external validity, periodontal treatment strategies, CONSORT-based design and results consistency/extrapolation. The current study is designed to evaluate if periodontal treatment with scaling and root planning plus local delivered chlorhexidine improves endothelial function and other biomarkers of cardiovascular disease in subjects with moderate to severe periodontitis. Methods/Design This randomized, single-blind clinical trial will be performed at two health centers and will include two periodontal treatment strategies. After medical/periodontal screening, a baseline endothelium-dependent brachial artery flow-mediated dilatation (FMD and other systemic surrogate markers will be obtained from all recruited subjects. Patients then will be randomized to receive either supragingival/subgingival plaque cleaning and calculus removal plus chlorhexidine (treatment group or supragingival plaque removal only (control group. A second and third FMD will be obtained after 24 hours and 12 weeks in both treatment arms. Each group will consist of 49 patients (n = 98 and all patients will be followed-up for secondary outcomes and will be monitored

  2. Racionalidade e métodos: registro da prática clínica em pacientes de alto risco cardiovascular Racionalidad y métodos: registro de la práctica clínica en pacientes de alto riesgo cardiovascular Rationality and methods: registry of clinical practice in high-risk cardiovascular patients

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Piva e Mattos

    2011-07-01

    ón a la atención de pacientes de alto riesgo cardiovascular en una representativa y amplia muestra de centros investigadores, incluyendo hospitales públicos y privados en un ámbito nacional. Siendo así, este estudio permitirá identificar los vacíos existentes en la incorporación de intervenciones con el beneficio comprobado en nuestro medio. OBJETIVO: Elaborar un registro que evalúe la práctica clínica brasileña en lo que se refiere a la atención del paciente cardiovascular clasificado como de alto riesgo. MÉTODOS: Estudio observacional del tipo registro, prospectivo, con el objetivo de documentar la práctica clínica actual aplicada a un nivel ambulatorial para pacientes de alto riesgo cardiovascular, clasificados cuando se les diagnostica una de estas variables: evidencia de enfermedad arterial coronaria, enfermedad cerebrovascular, vascular periférica, en diabéticos o no diabéticos; o en presencia de por lo menos tres de los siguientes factores de riesgo cardiovascular: hipertensión arterial sistémica, tabaquismo activo, dislipidemia, edad superior a los 70 años, nefropatía crónica, historia familiar de enfermedad arterial coronaria y/o enfermedad carotídea asintomática. Los pacientes serán seleccionados en 43 centros de todas las regiones brasileñas, incluyendo hospitales públicos y privados, como también en unidades básicas de atención a la salud y seguidos clínicamente hasta un año después de su inclusión en el estudio. RESULTADOS: Los resultados se presentarán un año después del inicio de la selección (setiembre de 2011 y consolidados, después de la reunión de la población y de los objetivos deseados a posteriori. CONCLUSIÓN: El análisis de este registro multicéntrico permitirá proyectar una perspectiva horizontal del tratamiento de los pacientes afectados con la enfermedad cardiovascular en Brasil.BACKGROUND: To date, no Brazilian registry has been designed to document the clinical practice regarding assistance to

  3. Clinical use and rational management of homocysteine, folic acid, and B vitamins in cardiovascular and thrombotic diseases.

    Science.gov (United States)

    Stanger, O; Herrmann, W; Pietrzik, K; Fowler, B; Geisel, J; Dierkes, J; Weger, M

    2004-06-01

    About half of all deaths are due to cardiovascular disease and its complications. The economic burden on society and the healthcare system from cardiovascular disability, complications, and treatments is huge and becoming larger in the rapidly aging populations of developed countries. As conventional risk factors fail to account for part of the cases, homocysteine, a "new" risk factor, is being viewed with mounting interest. Homocysteine is a sulfur-containing intermediate product in the normal metabolism of methionine, an essential amino acid. Folic acid, vitamin B(12), and vitamin B(6) deficiency and reduced enzyme activities inhibit the breakdown of homocysteine, thus increasing the intracellular homocysteine concentration. Numerous retrospective and prospective studies have consistently found an independent relationship between mild hyperhomocysteinemia and cardiovascular disease or all-cause mortality. Starting at a plasma homocysteine concentration of approximately 10 micromol/l, the risk increase follows a linear dose-response relationship with no specific threshold level. Hyperhomocysteinemia as an independent risk factor for cardiovascular disease is thought to be responsible for about 10 percent of total risk. Elevated plasma homocysteine levels (> 12 micromol/l; moderate hyperhomocysteinemia) are considered cytotoxic and are found in 5 to 10 percent of the general population and in up to 40 percent of patients with vascular disease. Additional risk factors (smoking, arterial hypertension, diabetes, and hyperlipidemia) may additively or, by interacting with homocysteine, synergistically (and hence overproportionally) increase overall risk. Hyperhomocysteinemia is associated with alterations in vascular morphology, loss of endothelial antithrombotic function, and induction of a procoagulant environment. Most known forms of damage or injury are due to homocysteine-mediated oxidative stresses. Especially when acting as direct or indirect antagonists of

  4. Prevalence and prognostic significance of ECG abnormalities in HIV-infected patients: results from the Strategies for Management of Antiretroviral Therapy study

    DEFF Research Database (Denmark)

    Soliman, Elsayed Z; Prineas, Ronald J; Roediger, Mollie P;

    2011-01-01

    BACKGROUND: It remains debated whether to include resting electrocardiogram (ECG) in the routine care of human immunodeficiency virus (HIV)-infected patients. METHODS: This analysis included 4518 HIV-infected patients (28% women and 29% blacks) from the Strategies for Management of Antiretroviral...... Therapy study, a clinical trial aimed to compare 2 HIV treatment strategies. ECG abnormalities were classified using the Minnesota Code. Cox proportional hazards analysis was used to examine the association between baseline ECG abnormalities and incident cardiovascular disease (CVD). RESULTS: More than...... half of the participants (n = 2325, or 51.5%) had either minor or major ECG abnormalities. Minor ECG abnormalities (48.6%) were more common than major ECG abnormalities (7.7%). During a median follow-up of 28.7 months, 155 participants (3.4%) developed incident CVD. After adjusting for the study...

  5. Ultrasonography of splenic abnormalities

    Institute of Scientific and Technical Information of China (English)

    Ming-Jen Chen; Ming-Jer Huang; Wen-Hsiung Chang; Tsang-En Wang; Horng-Yuan Wang; Cheng-Hsin Chu; Shee-Chan Lin; Shou-Chuan Shih

    2005-01-01

    AIM: This report gives a comprehensive overview of ultrasonography of splenic abnormalities. Certain ultrasonic features are also discussed with pathologic correlation.METHODS: We review the typical ultrasonic characteristics of a wide range of splenic lesions, illustrating them with images obtained in our institution from 2000 to 2003.One hundred and three patients (47 men, 56 women),with a mean age of 54 years (range 9-92 years), were found to have an abnormal ultrasonic pattern of spleen.RESULTS: We describe the ultrasonic features of various splenic lesions such as accessory spleen, splenomegaly,cysts, cavernous hemangiomas, lymphomas, abscesses,metastatic tumors, splenic infarctions, hematomas, and rupture, based on traditional gray-scale and color Doppler sonography.CONCLUSION: Ultrasound is a widely available, noninvasive,and useful means of diagnosing splenic abnormalities. A combination of ultrasonic characteristics and clinical data may provide an accurate diagnosis. If the US appearance alone is not enough, US may also be used to guide biopsy of suspicious lesions.

  6. [Risk management of cardiovascular disease through milk enriched with sterols in a young-adult population; randomized controlled clinical trial].

    Science.gov (United States)

    San Mauro Martín, Ismael; Collado Yurrita, Luis; Ciudad Cabañas, María José; Cuadrado Cenzual, María Ángeles; Hernández Cabria, Marta; Calle Purón, María Elisa

    2014-10-01

    Introducción: La hipercolesterolemia es uno de los factores de riesgo relevantes en la enfermedad cardiovascular, siendo el uso de esteroles vegetales una de las estrategias con mayor evidencia. Objetivos: Determinar la eficacia de una leche enriquecida en fitoesteroles para la disminución de marcadores de enfermedad cardiovascular en población joven adulta. Métodos: Ensayo clínico, controlado, aletorizado, doble ciego y cruzado. Los esteroles (2,24 g diarios) fueron ingeridos a través de una leche comercial, administrada en dos fases de 3 semanas respectivamente y separadas por un periodo de lavado de 2 semanas, para aquellos sujetos durante la fase de “leche de estudio”, y la misma cantidad de leche desnatada, sin esteroles, para el placebo. Al inicio y al final de cada fase se realizaron extracciones de sangre. Se recopilaron datos antropométricos, hábitos de salud y marcadores analíticos sanguíneos: perfil lipídico, hematológico, inflamación, etc. Resultados: Diecinueve personas culminaron el estudio de con una edad media de 34,68 años (±6,91). La diferencia entre los marcadores basales y finales para el colesterol- LDL, el Colesterol total y Triglicéridos fueron de 19,47 (±29,10) mg/dl, 24,47 (±30,68) mg/dl, 14,36 (±44,16) mg/dl, respectivamente. Sin cambios considerables en las fracciones de colesterol-HDL. Existen diferencias significativas, entre el placebo y la leche con esteroles para colesterol-LDL (p=0,009) y Colesterol total (p=0,003). Conclusiones: Los esteroles vegetales suministrados en un alimento de consumo habitual, como la leche, pueden ser una estrategia terapéutica no farmacológica de la hipoercolesterolemia y, por ello, una herramienta en la prevención del riesgo cardiovascular a nivel global.

  7. Prognostic value of cardiovascular MRI in diabetics

    International Nuclear Information System (INIS)

    Despite an increased cardiovascular risk in patients with diabetes mellitus they are a heterogeneous population with very different individual manifestation of diseases; therefore, a profound stratification is recommended. Clinical examinations and blood biomarkers are typically used in diabetic patients to determine the risk for developing cardio-cerebrovascular events. Cardiac as well as whole-body magnetic resonance imaging (MRI) including cardiovascular sequences are established methods for clinical diagnostics. Their significance in predicting the outcome and the corresponding risk stratification for patients with diabetes is becoming increasingly more important based on recent study results. Late gadolinium enhancement (LGE) in cardiac MRI detects silent myocardial ischemia in up to 30 % of diabetic patients, which is associated with a hazard ratio of 3-6 for cardiovascular events. Regional left ventricular wall motion abnormalities and decreased ejection fraction also have a prognostic value in diabetics. Based on whole-body MRI, the vessel score as well as carotid artery stenosis have been evaluated as additional predictors for cardio-cerebrovascular events. The MRI-based predictors have independent and incremental prognostic value beyond traditional risk stratification for cardio-cerebrovascular events; however, only the comprehensive assessment of whole-body MRI including angiography allows the identification of patients who remain free of cardio-cerebrovascular events over a period of 6 years. Cardiac MRI, particularly the detection of LGE, can be recommended for risk stratification of patients with diabetes mellitus. The clinical relevance of the added prognostic value of whole-body MRI needs to be clarified in further studies. (orig.)

  8. Vitamins D and K as pleiotropic nutrients: clinical importance to the skeletal and cardiovascular systems and preliminary evidence for synergy.

    Science.gov (United States)

    Kidd, Parris M

    2010-09-01

    Vitamins D and K are lipid-phase nutrients that are pleiotropic - endowed with versatile homeostatic capacities at the organ, tissue, and cellular levels. Their metabolic and physiologic roles overlap considerably, as evidenced in the bone and cardiovascular systems. Vitamin D₃ (cholecalciferol, D₃) is the prehormone for the vitamin D endocrine system. Vitamin D₃ undergoes initial enzymatic conversion to 25-hydroxyvitamin D (25D, calcidiol), then to the seco-steroid hormone 1alpha, 25-dihydroxyvitamin D (1,25D, calcitriol). Beyond its endocrine roles in calcium homeostasis, 1,25D likely has autocrine, paracrine, and intracrine effects. At least 17 tissues likely synthesize 1,25D, and 35 carry the vitamin D receptor (VDR). Vitamin D functional deficiency is widespread in human populations. Vitamin K₁ (phylloquinone) is more abundant in foods but less bioactive than the vitamin K₂ menaquinones (especially MK-4, menatetrenone). Menadione (vitamin K₃) has minimal K activity. Vitamin K compounds undergo oxidation-reduction cycling within the endoplasmic reticulum membrane, donating electrons to activate specific proteins via enzymatic gamma-carboxylation of glutamate groups before being enzymatically re-reduced. Warfarin inhibits this vitamin K reduction, necessitating K supplementation during anticoagulation therapy. Along with coagulation factors (II, VII, IX, X, and prothrombin), protein C and protein S, osteocalcin (OC), matrix Gla protein (MGP), periostin, Gas6, and other vitamin K-dependent (VKD) proteins support calcium homeostasis, facilitate bone mineralization, inhibit vessel wall calcification, support endothelial integrity, are involved in cell growth control and tissue renewal, and have numerous other effects. This review updates vitamin D and K skeletal and cardiovascular benefits and evidence for their synergy of action. PMID:21155624

  9. [Present Execution of and Problems with Clinical Lipid Examination and Application of "the Japan Atherosclerotic Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2012"].

    Science.gov (United States)

    Igarashi, Masahiko; Tanji, Yasuhiro; Nomura, Takashi; Yamaguchi, Hiroshi

    2014-09-01

    It is well known that dyslipidemia is one of the most crucial risk factors for atherosclerosis, including cardiovascular diseases (ASCVD). In order to prevent the onset of ASCVD, the Japan Atherosclerotic Society (JAS) published the JAS Guidelines in 2012 for appropriate lipid examination and treatment. However, it is unknown how the guidelines are practically used by Japanese clinicians. Therefore, we conducted a questionnaire survey to assess the present execution of and problems with clinical lipid examination and the application of the JAS Guidelines by doctors working in hospitals and clinics of Yamagata district in Japan. We found that 16% of doctors carried out clinical lipid examination every time, but some did not examine lipids at all. Fasting blood sampling for lipid examination was performed by 44% of doctors, and the items of triglycerides, HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C) were measured by more than 95%. Regarding problems with clinical lipid examination, more than 40% of doctors requested the early achievement of the standardization of LDL-C. The JAS Guidelines in 2012 were unfortunately recognized by only 55% of doctors. In addition, the rate of the clinical application of the guidelines, including the absolute risk, the flowchart of LDL-C, and non-HDL-C, was less than 30%, and more than half of the doctors measured LDL-C with the direct method, but did not use the "recommended" Friedewald method. In contrast, the cardiologists and endocrinologists generally accepted the guidelines, and their clinical application rate was higher than in other doctors. Through the questionnaire survey, it was revealed that doctors in various fields have not properly accepted the use and significance of lipid examination and the JAS Guidelines, and so further educational activities are necessary. PMID:27526534

  10. 高血压住院患者合并不同代谢异常与心血管疾病发病情况分析%Analysis of the incidence of different metabolic abnormalities and cardiovascular in hospitalized hypertension patients

    Institute of Scientific and Technical Information of China (English)

    李园春; 杨冬

    2013-01-01

    目的 探讨高血压住院患者合并不同代谢异常与心血管疾病的流行特征.方法 选取诊断为高血压患者1843例,其中合并代谢综合征患者327例作为研究对象,进行代谢综合征的不同年龄、性别、异常组分流行现状分析.结果 327例患者中超重、血脂紊乱、高血糖、心血管病的阳性率分别为42.20%、37.92%、35.17%、71.25%,其中阳性率最高者为心血管病,显著高于其他三者(x2=56.22、73.28、85.51,均P<0.05).超重率男性与女性差异无统计学意义(x2=0.42,P>0.05);血脂紊乱及高血糖发生率女性显著高于男性(x2 =5.73、6.47,均P<0.05);心血管病发病率男性高于女性(x2=24.66,P<0.05).结论 预防不同代谢异常需根据年龄性别采取不同措施;控制体质量、血脂和血糖是预防心血管病的关键.%Objective To investigate the epidemiological characteristics of hospitalized hypertension patients with different metabolic abnormalities associated with cardiovascular disease.Methods 1 843 patients with diagnosis of hypertension were selected,including 327 patients with metabolic syndrome as the research object.Metabolic syndrome of different age,gender,abnormal components epidemic status were analyzed.Results Positive rates of overweight,dyslipidemia,hyperglycemia,cardiovascular disease in 327 patients were 42.20%,37.92%,35.17%,71.25%,the highest positive rate for cardiovascular disease was significantly higher than the other three indexs(x2 =56.22,73.28,85.51,all P < 0.05).There was no significant differences in the rates of overweight between men and women (x2 =0.42,P > 0.05).Dyslipidemia and hyperglycemia incidence of women were significantly more than those of men,there was statistically significant difference (x2 =5.73,6.47,all P < 0.05).The incidence of cardiovascular disease in males was high than that in females (x2 =24.66,P < 0.05).Conclusion Preventive different metabolic abnormalities

  11. The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial and Hurricane Katrina: lessons for managing clinical trials during and after a natural disaster.

    Science.gov (United States)

    McDuffie, Roberta; Summerson, John; Reilly, Patricia; Blackwell, Caroline; Goff, David; Kimel, Angela R; Crago, Lenore; Fonseca, Vivian

    2008-09-01

    Hurricane Katrina was one of the most catastrophic natural disasters to hit the United States. It had a major impact on health care in New Orleans, LA and the surrounding region, not only in relation to acute illness but also chronic disease. When Hurricane Katrina struck New Orleans on August 29, 2005, there were 193 participants being followed in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial at Tulane University Health Sciences Center. In the immediate aftermath of the storm, the Tulane University ACCORD Study site, in collaboration with the Study Coordinating Center and the Southeast Clinical Center Network office of the trial at Wake Forest University Health Sciences in North Carolina, took several actions in order to locate the participants, ensure their safety, and maintain the scientific integrity of the trial. We describe the actions taken and the relative success/failure of such actions. PMID:18577469

  12. Joint Effect of Early Microvascular Damage in the Eye & Kidney on Risk of Cardiovascular Events

    Science.gov (United States)

    Yip, Wanfen; Sabanayagam, Charumathi; Ong, Peng Guan; Patel, Uptal D; Chow, Khuan Yew; Tai, E Shyong; Ling, Lieng H; Wong, Tien Yin; Cheung, Carol Yim-lui

    2016-01-01

    Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD), but not all individuals require treatment. Retinal microvascular abnormalities and microalbuminuria reflect early systemic microvascular changes. We examined the joint effect of retinal abnormalities and microalbuminuria on CVD risk in an Asian cohort. We conducted a prospective, population-based study. Retinal abnormalities were defined as presence of retinopathy and/or retinal venular widening. Microalbuminuria was defined as urinary albumin: creatinine ratio between 30–300 mg/g. Incident CVD was defined as newly diagnosed clinical stroke, acute myocardial infarction or CVD death. Cox regression models were performed to determine the associations between retinal abnormalities and microalbuminuria with risk of CVD, while controlling for established risk factors. 3,496 participants (aged ≥ 40) were free of prevalent CVD. During the follow-up (5.8 years), 126 (3.60%) participants developed CVD. Persons presenting with both retinal abnormalities and microalbuminuria were 6.71 times (95% CI, 2.68, 16.79) as likely to have incident CVD compared with those without either abnormalities. There was a significant interaction effect between retinal abnormalities and microalbuminuria on incident CVD. Assessment of retinal abnormalities in patients with microalbuminuria may provide additional value in identifying persons at risk of developing CVD. PMID:27273133

  13. EVALUATION OF CARDIOVASCULAR RISK FACTORS PREVALENCE AND EFFICACY OF THEIR CORRECTION IN PHYSICIANS. ESTIMATION OF PHYSICIANS’ EXPERTISE IN UP-TO-DATE CLINICAL GUIDELINES. RESULTS OF THE “PHYSICIAN’S HEALTH AND EDUCATION” STUDY

    Directory of Open Access Journals (Sweden)

    L. Y. Drozdova

    2016-01-01

    Full Text Available Aim. To evaluate cardiovascular risk factors prevalence among physicians of therapeutic profile (cardiology , internal medicine, neurology , endocrinology etc, to estimate awareness of physicians about their own cardiovascular risk, and to simultaneously assess their expertise in up-to-date clinical guidelines. Material and methods. A total of 638 physicians working in out-patient and in-patient clinics of Moscow, Moscow region, St-Petersburg, Nizhniy Novgorod, Vladivostok, Irkutsk, Krasnoyarsk, Krasnodar and Perm were included into the study. The mean age of participants was 46 years. The mean professional experience – 20.4 years. We made an assessment of main cardiovascular risk factors, and conducted interactive inquiry , which included questions about preventive and treatment measures for cardiovascular diseases. Results. Arterial hypertension (HT was revealed for the first time in 178 physicians, 150 physicians indicated HT in anamnesis. Only 64 physicians had target levels of blood pressure. Hypercholesterolemia rate was 45%. The prevalence of obesity and overweight were 22% and 39%, respectively. Inquiry showed that 53% of physicians primarily use clinical guidelines to choose treatment options. 76% and 88% of physicians considered it possible to achieve target levels of blood pressure and of low-density lipoprotein-cholesterol, respectively. Conclusion. Prevalence of main risk factors among physicians was similar to that in the total population; correction of those risk factors was not satisfactory. Knowledge of cardiovascular risk problems and necessity of their correction was adequate in the whole; however physicians often failed to apply their knowledge to practice.

  14. EVALUATION OF CARDIOVASCULAR RISK FACTORS PREVALENCE AND EFFICACY OF THEIR CORRECTION IN PHYSICIANS. ESTIMATION OF PHYSICIANS’ EXPERTISE IN UP-TO-DATE CLINICAL GUIDELINES. RESULTS OF THE “PHYSICIAN’S HEALTH AND EDUCATION” STUDY

    Directory of Open Access Journals (Sweden)

    L. Y. Drozdova

    2011-01-01

    Full Text Available Aim. To evaluate cardiovascular risk factors prevalence among physicians of therapeutic profile (cardiology , internal medicine, neurology , endocrinology etc, to estimate awareness of physicians about their own cardiovascular risk, and to simultaneously assess their expertise in up-to-date clinical guidelines. Material and methods. A total of 638 physicians working in out-patient and in-patient clinics of Moscow, Moscow region, St-Petersburg, Nizhniy Novgorod, Vladivostok, Irkutsk, Krasnoyarsk, Krasnodar and Perm were included into the study. The mean age of participants was 46 years. The mean professional experience – 20.4 years. We made an assessment of main cardiovascular risk factors, and conducted interactive inquiry , which included questions about preventive and treatment measures for cardiovascular diseases. Results. Arterial hypertension (HT was revealed for the first time in 178 physicians, 150 physicians indicated HT in anamnesis. Only 64 physicians had target levels of blood pressure. Hypercholesterolemia rate was 45%. The prevalence of obesity and overweight were 22% and 39%, respectively. Inquiry showed that 53% of physicians primarily use clinical guidelines to choose treatment options. 76% and 88% of physicians considered it possible to achieve target levels of blood pressure and of low-density lipoprotein-cholesterol, respectively. Conclusion. Prevalence of main risk factors among physicians was similar to that in the total population; correction of those risk factors was not satisfactory. Knowledge of cardiovascular risk problems and necessity of their correction was adequate in the whole; however physicians often failed to apply their knowledge to practice.

  15. 心血管疾病合并心理障碍的临床治疗效果%Cardiovascular Disease Combined Clinical Effect of the Psychological Barriers

    Institute of Scientific and Technical Information of China (English)

    赵鹏; 王艳娉

    2013-01-01

      目的探讨常规药物加心理治疗药物治疗心血管疾病合并心理障碍的应有及临床效果。方法选取我院2009年1月至2012年1月在我院接受心血管疾病合并心理障碍的患者105例,其中高血压患者64例,冠心病患者41例。采用高血压和冠心病的常规药物加心理治疗的药物(焦虑患者服用阿普唑仑、氯硝安定和舒乐安定;抑郁患者服用阿米替林、马普替林和多虑平;强迫症者服用氯丙咪嗪)进行综合治疗心血管疾病合并心理障碍疾病。结果经过常规药物和抗心理障碍的药物治疗,两种心血管疾病合并心理障碍的治疗均得到有效控制,治疗后与前一次治疗分别进行评价数据差异均有统计学意义 P <0.05,治疗前和治疗8周以后的相比 P <0.05。结论用氯硝安定等心理治疗药物治疗心血管疾病合并心理障碍具有明显的临床效果,且常规用药无严重不良反应和较好的安全性。%  Objective To investigate the conventional drug plus psychotherapy drug treatment of cardiovascular diseases combined psychological barriers should and clinical effects. Methods Our hospital from January 2009 to January 2012 in our hospital cardiovascular disease merger of mental disorders in 105 patients, including 64 cases of patients with hypertension, coronary heart disease 41 patients. Conventional drugs for high blood pressure and coronary heart disease drugs plus psychotherapy (anxiety patients taking alprazolam, clonazepam and estazolam; depression patients taking amitriptyline, maprotiline and doxepin; obsessive-compulsive disorder taking clomipramine) comprehensive treatment of cardiovascular diseases combined psychological disorders. Results After conventional drugs and anti-drug treatment of the mental disorder, two types of cardiovascular disease combined treatment of psychological disorders has been effectively controlled after treatment with the previous

  16. Validation of the Ability of SYNTAX and Clinical SYNTAX Scores to Predict Adverse Cardiovascular Events After Stent Implantation: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Chen, JiaYuan; Tang, Buzhou; Lin, YongQing; Ru, Ying; Wu, MaoXiong; Wang, Xiaolong; Chen, Qingcai; Chen, YangXin; Wang, JingFeng

    2016-10-01

    To compare the predicative ability of SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) and clinical SYNTAX scores for major adverse cardiac events (MACEs) after stent implantation in patients with coronary artery disease (CAD). Studies were identified by electronic and manual searches. Twenty-six studies were included in the meta-analysis. The pooled C-statistics of SYNTAX score for 1- and 5-year all-cause mortality (ACM) were 0.65 (95% confidence interval [CI]: 0.61-0.68) and 0.62 (95% CI: 0.59-0.65), respectively, with weak heterogeneity. The 1- and 5-year ACM pooled C-statistics for clinical SYNTAX scores were significantly higher at 0.77 and 0.71, respectively (Ps SYNTAX score for predicting 1-year ACM per unit was 1.04 (95% CI: 1.03-1.05). Calibration analysis indicated SYNTAX scores overestimated the risk of major adverse cardiac and cerebrovascular events in each risk stratum. The SYNTAX score demonstrated minimal discrimination in predicting 1- or 5-year adverse cardiovascular events after percutaneous coronary intervention in patients with CAD. The clinical SYNTAX score could further improve the predictive capability for ACM but not MACE.

  17. A cluster-randomised clinical trial comparing two cardiovascular health education strategies in a child population: the Savinghearts project

    Directory of Open Access Journals (Sweden)

    Sánchez-Gómez Luis

    2012-11-01

    Full Text Available Abstract Background This paper describes a methodology for comparing the effects of an eduentertainment strategy involving a music concert, and a participatory class experience involving the description and making of a healthy breakfast, as educational vehicles for delivering obesity-preventing/cardiovascular health messages to children aged 7–8 years. Methods/design This study will involve a cluster-randomised trial with blinded assessment. The study subjects will be children aged 7–8 years of both sexes attending public primary schools in the Madrid Region. The participating schools (n=30 will be randomly assigned to one of two groups: 1 Group MC, in which the children will attend a music concert that delivers obesity-preventing/cardiovascular health messages, or 2 Group HB, in which the children will attend a participatory class providing the same information but involving the description and making of a healthy breakfast. The main outcome measured will be the increase in the number of correct answers scored on a knowledge questionnaire and in an attitudes test administered before and after the above interventions. The secondary outcome recorded will be the reduction in BMI percentile among children deemed overweight/obese prior to the interventions. The required sample size (number of children was calculated for a comparison of proportions with an α of 0.05 and a β of 0.20, assuming that the Group MC subjects would show values for the measured variables at least 10% higher than those recorded for the subjects of Group HB. Corrections were made for the design effect and assuming a loss to follow-up of 10%. The maximum sample size required will be 2107 children. Data will be analysed using summary measurements for each cluster, both for making estimates and for hypothesis testing. All analyses will be made on an intention-to-treat basis. Discussion The intervention providing the best results could be recommended as part of health

  18. Transcranial Doppler ultrasonography predicts cardiovascular events after TIA

    International Nuclear Information System (INIS)

    Transient ischemic attack (TIA) patients are at high vascular risk. We assessed the value of extracranial (ECD) and transcranial (TCD) Doppler and duplex ultrasonography to predict clinical outcome after TIA. 176 consecutive TIA patients admitted to the Stroke Unit were recruited in the study. All patients received diffusion-weighted imaging, standardized ECD and TCD. At a median follow-up of 27 months, new vascular events were recorded. 22 (13.8%) patients experienced an ischemic stroke or TIA, 5 (3.1%) a myocardial infarction or acute coronary syndrome, and 5 (3.1%) underwent arterial revascularization. ECD revealed extracranial ≥ 50% stenosis or occlusions in 34 (19.3%) patients, TCD showed intracranial stenosis in 15 (9.2%) and collateral flow patterns due to extracranial stenosis in 5 (3.1%) cases. Multivariate analysis identified these abnormal ECD and TCD findings as predictors of new cerebral ischemic events (ECD: hazard ratio (HR) 4.30, 95% confidence interval (CI) 1.75 to 10.57, P = 0.01; TCD: HR 4.73, 95% CI 1.86 to 12.04, P = 0.01). Abnormal TCD findings were also predictive of cardiovascular ischemic events (HR 18.51, 95% CI 3.49 to 98.24, P = 0.001). TIA patients with abnormal TCD findings are at high risk to develop further cerebral and cardiovascular ischemic events

  19. Pharmacogenomics and cardiovascular disease

    DEFF Research Database (Denmark)

    Weeke, Peter; Roden, Dan M

    2013-01-01

    Variability in drug responsiveness is a sine qua non of modern therapeutics, and the contribution of genomic variation is increasingly recognized. Investigating the genomic basis for variable responses to cardiovascular therapies has been a model for pharmacogenomics in general and has established...... resulted in changes to the product labels but also have led to development of initial clinical guidelines that consider how to facilitate incorporating genetic information to the bedside. This review summarizes the state of knowledge in cardiovascular pharmacogenomics and considers how variants described...

  20. Advancing cardiovascular tissue engineering

    Science.gov (United States)

    Truskey, George A.

    2016-01-01

    Cardiovascular tissue engineering offers the promise of biologically based repair of injured and damaged blood vessels, valves, and cardiac tissue. Major advances in cardiovascular tissue engineering over the past few years involve improved methods to promote the establishment and differentiation of induced pluripotent stem cells (iPSCs), scaffolds from decellularized tissue that may produce more highly differentiated tissues and advance clinical translation, improved methods to promote vascularization, and novel in vitro microphysiological systems to model normal and diseased tissue function. iPSC technology holds great promise, but robust methods are needed to further promote differentiation. Differentiation can be further enhanced with chemical, electrical, or mechanical stimuli. PMID:27303643

  1. Cardiovascular effects of gliptins.

    Science.gov (United States)

    Scheen, André J

    2013-02-01

    Dipeptidyl peptidase 4 (DPP-4) inhibitors (commonly referred to as gliptins) are a novel class of oral antihyperglycaemic agents with demonstrated efficacy in the treatment of type 2 diabetes mellitus (T2DM). Preclinical data and mechanistic studies have indicated a possible beneficial action on blood vessels and the heart, via both glucagon-like peptide 1 (GLP-1)-dependent and GLP-1-independent effects. DPP-4 inhibition increases the concentration of many peptides with potential vasoactive and cardioprotective effects. Clinically, DPP-4 inhibitors improve several risk factors in patients with T2DM. They improve blood glucose control (mainly by reducing postprandial glycaemia), are weight neutral (or even induce modest weight loss), lower blood pressure, improve postprandial lipaemia, reduce inflammatory markers, diminish oxidative stress, and improve endothelial function. Some positive effects on the heart have also been described in patients with ischaemic heart disease or congestive heart failure, although their clinical relevance requires further investigation. Post-hoc analyses of phase II-III, controlled trials suggest a possible cardioprotective effect with a trend for a lower incidence of major cardiovascular events with gliptins than with placebo or active agents. However, the actual relationship between DPP-4 inhibition and cardiovascular outcomes remains to be proven. Major prospective clinical trials with predefined cardiovascular outcomes and involving various DPP-4 inhibitors are now underway in patients with T2DM and a high-risk cardiovascular profile.

  2. Fish cardiovascular physiology and disease.

    Science.gov (United States)

    Sherrill, Johanna; Weber, E Scott; Marty, Gary D; Hernandez-Divers, Stephen

    2009-01-01

    Fish patients with cardiovascular disorders present a challenge in terms of diagnostic evaluation and therapeutic options. Veterinarians can approach these cases in fish using methods similar to those employed for other companion animals. Clinicians who evaluate and treat fish in private, aquarium, zoologic, or aquaculture settings need to rely on sound clinical judgment after thorough historical and physical evaluation. Pharmacokinetic data and treatments specific to cardiovascular disease in fish are limited; thus, drug types and dosages used in fish are largely empiric. Fish cardiovascular anatomy, physiology, diagnostic evaluation, monitoring, common diseases, cardiac pathologic conditions, formulary options, and comprehensive references are presented with the goal of providing fish veterinarians with clinically relevant tools.

  3. Patient beliefs about medicines and quality of life after a clinical medication review and follow-up by a pharmaceutical care plan: A study in elderly polypharmacy patients with a cardiovascular disorder

    NARCIS (Netherlands)

    Geurts, Marlies M.E.; Stewart, Roy E.; Brouwers, Jacobus R.B.J.; de Graeff, Pieter A.; de Gier, Johan J.

    2015-01-01

    Objective: To determine the effect of a clinical medication review, followed up by a pharmaceutical care plan, on the beliefs about medicines and quality of life (QoL) of older patients with polypharmacy and a cardiovascular disorder. Methods: Patients were randomly assigned to an intervention or co

  4. Innovative pharmaceutical interventions in cardiovascular disease: Focusing on the contribution of non-HDL-C/LDL-C-lowering versus HDL-C-raisingA systematic review and meta-analysis of relevant preclinical studies and clinical trials

    NARCIS (Netherlands)

    Kühnast, S.; Fiocco, M.; Hoorn, J.W.A. van der; Princen, H.M.G.; Jukema, J.W.

    2015-01-01

    Non-HDL-cholesterol is well recognised as a primary causal risk factor in cardiovascular disease. However, despite consistent epidemiological evidence for an inverse association between HDL-C and coronary heart disease, clinical trials aimed at raising HDL-C (AIM-HIGH, HPS2-THRIVE, dal-OUTCOMES) fai

  5. Metabolic syndrome and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Abdullah M Alshehri

    2010-11-01

    Full Text Available The constellation of dyslipidemia (hypertriglyceridemia and low levels of high-density lipoprotein cholesterol, elevated blood pressure, impaired glucose tolerance, and central obesity is now classified as metabolic syndrome, also called syndrome X. In the past few years, several expert groups have attempted to set forth simple diagnostic criteria for use in clinical practice to identify patients who manifest the multiple components of the metabolic syndrome. These criteria have varied somewhat in specific elements, but in general, they include a combination of multiple and metabolic risk factors. The most widely recognized of the metabolic risk factors are atherogenic dyslipidemia, elevated blood pressure, and elevated plasma glucose. Individuals with these characteristics, commonly manifest a prothrombotic state as well as and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities including elevated serum triglyceride and apolipoprotein B (apoB, increased small LDL particles, and a reduced level of HDL cholesterol (HDL-C. The metabolic syndrome is often referred to as if it were a discrete entity with a single cause. Available data suggest that it truly is a syndrome, ie, a grouping of atherosclerotic cardiovascular disease (ASCVD risk factors, that probably has more than one cause. Regardless of cause, the syndrome identifies individuals at an elevated risk for ASCVD. The magnitude of the increased risk can vary according to the components of the syndrome present as well as the other, non-metabolic syndrome risk factors in a particular person.

  6. [Cardiovascular disease in pregnancy].

    Science.gov (United States)

    Hilfiker-Kleiner, Denise; Bauersachs, Johann

    2016-01-01

    Cardiovascular diseases are among the most frequent complications in pregnancies. Among them preexisting heart diseases including congenital heart disease, genetic cardiomyopathies, myocardial infarction and chemotherapy-induced cardiomyopathies display a special challenge for the mother and her physicians. Moreover, the incidence of cardiovascular disease induced by or associated with pregnancy, i.e. hypertensive disorders and peripartum cardiomyopathies, has increased over the past decades. In the present overview we explain why pregnancy is a stress model for the maternal heart and summarize the current knowledge on the influence of pregnancy on preexisting cardiomyopathies. We highlight recent advances in research with regard to hypertensive complications in pregnancy and peripartum cardiomyopathy (PPCM). Moreover, we summarize etiologies, risk factors, pathomechanisms, diagnosis, treatment, management and prognosis. Finally, interdisciplinarity between different clinical fields and basic science is a key requirement to avoid longterm damage to the cardiovascular system induced by pregnancy associated impacts and with this improve women's health in general. PMID:26800071

  7. Triglycerides and cardiovascular disease

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Varbo, Anette

    2014-01-01

    After the introduction of statins, clinical emphasis first focussed on LDL cholesterol-lowering, then on the potential for raising HDL cholesterol, with less focus on lowering triglycerides. However, the understanding from genetic studies and negative results from randomised trials that low HDL...... cholesterol might not cause cardiovascular disease as originally thought has now generated renewed interest in raised concentrations of triglycerides. This renewed interest has also been driven by epidemiological and genetic evidence supporting raised triglycerides, remnant cholesterol, or triglyceride......-rich lipoproteins as an additional cause of cardiovascular disease and all-cause mortality. Triglycerides can be measured in the non-fasting or fasting states, with concentrations of 2-10 mmol/L conferring increased risk of cardiovascular disease, and concentrations greater than 10 mmol/L conferring increased risk...

  8. Vitamin D and Risk of Neuroimaging Abnormalities.

    Science.gov (United States)

    Littlejohns, Thomas J; Kos, Katarina; Henley, William E; Lang, Iain A; Annweiler, Cedric; Beauchet, Olivier; Chaves, Paulo H M; Kestenbaum, Bryan R; Kuller, Lewis H; Langa, Kenneth M; Lopez, Oscar L; Llewellyn, David J

    2016-01-01

    Vitamin D deficiency has been linked with an increased risk of incident all-cause dementia and Alzheimer's disease. The aim of the current study was to explore the potential mechanisms underlying these associations by determining whether low vitamin D concentrations are associated with the development of incident cerebrovascular and neurodegenerative neuroimaging abnormalities. The population consisted of 1,658 participants aged ≥65 years from the US-based Cardiovascular Health Study who were free from prevalent cardiovascular disease, stroke and dementia at baseline in 1992-93. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected at baseline. The first MRI scan was conducted between 1991-1994 and the second MRI scan was conducted between 1997-1999. Change in white matter grade, ventricular grade and presence of infarcts between MRI scan one and two were used to define neuroimaging abnormalities. During a mean follow-up of 5.0 years, serum 25(OH)D status was not significantly associated with the development of any neuroimaging abnormalities. Using logistic regression models, the multivariate adjusted odds ratios (95% confidence interval) for worsening white matter grade in participants who were severely 25(OH)D deficient (vitamin D concentrations could not be shown to be associated with the development of cerebrovascular or neurodegenerative neuroimaging abnormalities in Cardiovascular Health Study participants. PMID:27166613

  9. Do diet, folic acid, and vitamins matter? What did we learn from the Women's Health Initiative, the Women's Health Study, the Women's Antioxidant and Folic Acid Cardiovascular Study, and other clinical trials?

    Science.gov (United States)

    Wenger, Nanette K

    2007-01-01

    Data from recent randomized clinical trials have contributed substantially to our understanding of appropriate interventions for coronary heart disease in women. Addressed in this monograph are issues of diet, folic acid, and antioxidant vitamins. Importantly, these randomized clinical trials have helped to clarify conflicting information from observational data, and to aid clinicians and their women patients in making appropriate choices of coronary and cardiovascular preventive therapy.

  10. Clinical effect of increasing doses of lenalidomide in high-risk myelodysplastic syndrome and acute myeloid leukemia with chromosome 5 abnormalities

    DEFF Research Database (Denmark)

    Möllgård, Lars; Saft, Leonie; Treppendahl, Marianne Bach;

    2011-01-01

    Patients with chromosome 5 abnormalities and high-risk myelodysplastic syndromes or acute myeloid leukemia have a poor outcome. We hypothesized that increasing doses of lenalidomide may benefit this group of patients by inhibiting the tumor clone, as assessed by fluorescence in situ hybridization...

  11. Various distinctive cytogenetic abnormalities in patients with acute myeloid leukaemia aged 60 years and older express adverse prognostic value : results from a prospective clinical trial

    NARCIS (Netherlands)

    van der Holt, Bronno; Breems, Dimitri A.; Beverloo, H. Berna; van den Berg, Eva; Burnett, Alan K.; Sonneveld, Pieter; Lowenberg, Bob

    2007-01-01

    Diagnostic cytogenetic abnormalities are considered important prognostic factors in patients with acute myeloid leukaemia (AML). However, the prognostic assessments have mainly been derived from patients with AML aged <60 years. Two recent studies of AML patients of 60 years and older proposed progn

  12. Clinical effect of increasing doses of lenalidomide in high-risk myelodysplastic syndrome and acute myeloid leukemia with chromosome 5 abnormalities

    DEFF Research Database (Denmark)

    Möllgård, Lars; Saft, Leonie; Treppendahl, Marianne Bach;

    2011-01-01

    Background Patients with chromosome 5 abnormalities and high-risk myelodysplastic syndromes or acute myeloid leukemia have a poor outcome. We hypothesized that increasing doses of lenalidomide may benefit this group of patients by inhibiting the tumor clone, as assessed by fluorescence in situ hy...

  13. “Beauty is a Light in the Heart”1: The Transformative Potential of Optogenetics for Clinical Applications in Cardiovascular Medicine

    Science.gov (United States)

    Boyle, Patrick M.; Karathanos, Thomas V.; Trayanova, Natalia A.

    2014-01-01

    Optogenetics is an exciting new technology in which viral gene or cell delivery is used to inscribe light sensitivity in excitable tissue to enable optical control of bioelectric behavior. Initial progress in the fledgling domain of cardiac optogenetics has included in vitro expression of various light-sensitive proteins in cell monolayers and transgenic animals to demonstrate an array of potentially useful applications, including light-based pacing, silencing of spontaneous activity, and spiral wave termination. In parallel to these developments, the cardiac modeling community has developed a versatile computational framework capable of realistically simulating optogenetics in biophysically detailed, patient-specific representations of the human heart, enabling the exploration of potential clinical applications in a predictive virtual platform. Towards the ultimate goal of assessing the feasibility and potential impact of optogenetics-based therapies in cardiovascular medicine, this review provides (1) a detailed synopsis of in vivo, in vitro, and in silico developments in the field and (2) a critical assessment of how existing clinical technology for gene/cell delivery and intra-cardiac illumination could be harnessed to achieve such lofty goals as light-based arrhythmia termination. PMID:25453984

  14. 临床心血管护理与合理用药%Rational Use of Cardiovascular Drugs in Clinical Nursing

    Institute of Scientific and Technical Information of China (English)

    朱玲玲; 周权

    2001-01-01

    Experience in use of cardiovascular drugs in clinical nursingwere introduced and discussed.Nurse should enhance learning knowledge of clinical pharmacy,including generic names and new forms of durgs,drug interaction,infusion compatiblity,chronopharmacology,etc.Nurse' observation play an important role in detection of untoward reactions.When doctors having different habits of prescribing alternated,nurse should pay more attention to carry out the orders.%调查了中心血管药物的使用情况,并总结了用药体会。提出护士应加强心血管药物通用名、新剂型、输液配伍化学、时辰药理学知识的学习。应充分发挥护士观察力在药物不良反应发现中的价值。和不同用药习惯的医生交接班时,尤应注意医嘱的正确执行。

  15. Prothrombin fragment 1+2 is associated with carotid intima-media thickness in subjects free of clinical cardiovascular disease

    OpenAIRE

    Paramo, J. A.; Orbe, J.; Beloqui, O. (Óscar); Benito, A.; Colina, I. (Inmaculada); Martinez-Vila, E; Diez, J.

    2004-01-01

    BACKGROUND AND PURPOSE: Thrombin, a central enzyme in the clotting cascade, plays a role not only in thrombosis but also in the progression of atherosclerosis. We studied the relationship between prothrombin fragment 1+2 (F1+2), a specific marker of thrombin generation in vivo, and carotid intima-media thickness (IMT), an index of subclinical atherosclerosis. METHODS: We examined 181 asymptomatic middle-aged subjects (mean age 55.6 years, 76.7% men) free of overt clinical atherosclerotic ...

  16. Conceptual framework for research and clinical practice concerning cardiovascular health-related behaviors Modelo conceptual para la investigación y la práctica clínica en los cambios de comportamiento en salud cardiovascular Estrutura conceitual para pesquisa e prática clínica na mudança de comportamentos em saúde cardiovascular

    Directory of Open Access Journals (Sweden)

    Maria Cecília Bueno Jayme Gallani

    2013-02-01

    Full Text Available OBJECTIVE: To present a conceptual framework based on the PRECEDE model conceived to guide research and the clinical practice of nurses in the clinical follow-up of patients with cardiovascular diseases. METHOD: The conceptual bases as well as the study designs used in the framework are discussed. The contextualization of the proposed structure is presented in the clinical follow-up of hypertensive patients. Examples of the intervention planning steps according to the intervention mapping protocol are provided. RESULTS: This conceptual framework coherently and rationally guided the diagnostic steps related to excessive salt intake among hypertensive individuals, as well as the development and assessment of specific interventions designed to change this eating behavior. CONCLUSION: The use of this conceptual framework enables a greater understanding of health-related behaviors implied in the development and progression of cardiovascular risk factors and is useful in proposing nursing interventions with a greater chance of success. This model is a feasible strategy to improve the cardiovascular health of patients cared for by the Brazilian Unified Health System.OBJETIVO: presentar el marco conceptual basado en el modelo PRECEDE, concebido para orientar la investigación y la práctica clínica de las enfermeras para el seguimiento clínico de pacientes cardíacos. MÉTODO: La base conceptual, así como los diseños metodológicos de los estudios implicados en el marco conceptual son discutidos. Además, la contextualización del modelo se ilustra en el seguimiento clínico de los pacientes hipertensos. Ejemplos de las etapas de planificación de la intervención de acuerdo con el protocolo intervention mapping son proporcionados. RESULTADOS: Se observó que la utilización del marco conceptual permitió guiar coherentemente y racionalmente los pasos de diagnóstico relacionados con el consumo excesivo de sal entre hipertensos, así como el

  17. Knee loading for abnormal gait

    OpenAIRE

    Hutchison, J.; Madsen, D.; Norman, T. L.; -Blaha, J. D.

    2014-01-01

    The purpose of the study was to develop a mathematical model for determining knee loads for abnormal gait. Abnormal gait was defined as a person with varus, i.e. “bowleggedness”, or a person who had an external rotation of the femur (or the inability to internally rotate the femur) which caused an indirect varus in the forward positions of gait. Conditions such as these have been observed clinically to result in increased wear on the medial condyle of total knee replacements. This problem was...

  18. Prevalence and predictors of an abnormal stress myocardial perfusion study in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Kharagjitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands); Dibbets-Schneider, Petra; Stokkel, Marcel P. [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands)

    2009-04-15

    The purpose of this study was to evaluate the prevalence of an abnormal stress myocardial perfusion study in a cohort of truly asymptomatic patients with type 2 diabetes mellitus using myocardial perfusion imaging by means of single photon emission computed tomography (SPECT). Secondly, we determined which clinical characteristics may predict an abnormal stress myocardial perfusion study in this population. A total of 120 asymptomatic patients (mean age 53{+-}10 years) with type 2 diabetes mellitus and one or more risk factors for coronary artery disease were prospectively recruited from an outpatient diabetes clinic. All patients underwent myocardial perfusion imaging by means of adenosine {sup 99m}Tc sestamibi SPECT. Images were evaluated for the presence of perfusion abnormalities as well as other nonperfusion abnormalities that may indicate extensive ischaemia, including left ventricular dysfunction (defined as a left ventricular ejection fraction <45%), transient ischaemic dilatation and adenosine-induced ST segment depression. Multivariable analysis was performed using a backward selection strategy to identify potential predictors for an abnormal stress myocardial perfusion study. Finally, all patients were followed up for 12 months to determine the occurrence of cardiovascular events: (1) cardiac death, (2) nonfatal myocardial infarction, (3) unstable angina requiring hospitalization, (4) revascularization, or (5) stroke. Of the 120 patients, 40 (33%) had an abnormal stress study, including myocardial perfusion abnormalities in 30 patients (25%). In 10 patients (8%), indicators of extensive (possibly balanced ischaemia) were observed in the absence of abnormal perfusion. The multivariable analysis identified current smoking, duration of diabetes and the cholesterol/high-density lipoprotein (HDL) ratio as independent predictors of an abnormal stress study. During a follow-up period of 12 months six patients (5%) had a cardiovascular event. The current study

  19. Clinical study on the mechanism of abnormal accumulation in lung scanning with N-isopropyl-p-123I-iodoamphetamine (123I-IMP)

    International Nuclear Information System (INIS)

    Sixty-three cases with gross abnormalities on chest radiograms were studied by lung scanning with 123I-IMP. Abnormal accumulation in comparison with the normal lung field was detected in all patients 24 hours after the intravenous injection of 123I-IMP and these sites were seen within hypoperfusion areas observed by lung scanning using 99mTc-MAA. However, no intratumoral accumulation was detected in the patients with tumor. Comparison between the image obtained after the initial distribution of 123I-IMP and that obtained 24 hours later showed that during this period, 123I-IMP accumulated in the area of decreased or no distribution of 123I-IMP. It was speculated that the area of low pulmonary blood flow showed abnormal accumulation, because even in a low blood flow, 123I-IMP reached the sites of receptor, and the wash-out from these sites was delayed. These findings indicate the possibility that lung scanning with 123I-IMP is a useful agent as assessing pulmonary blood flow. (author)

  20. Kinase-SUMO networks in diabetes-mediated cardiovascular disease.

    Science.gov (United States)

    Chang, Eugene; Abe, Jun-Ichi

    2016-05-01

    Type II diabetes mellitus (DM) is a common comorbidity in patients with cardiovascular disease (CVD). Epidemiological studies including the Framingham, UKPDS, and MRFIT studies have shown diabetes to be an independent risk factor for cardiovascular disease associated with increased incidence of morbidity and mortality. However, major randomized controlled clinical trials including ADVANCE, VAD, and ACCORD have failed to demonstrate a significant reduction in CVD complications from longstanding DM with strict glycemic control. This suggests that despite the strong clinical correlation between DM and CVD, the precise mechanisms of DM-mediated CVD pathogenesis remain unclear. Signal transduction investigations have shed some light on this question with numerous studies demonstrating the role of kinase pathways in facilitating DM and CVD pathology. Abnormalities in endothelial, vascular smooth muscle, and myocardial function from the pathological insults of hyperglycemia and oxidative stress in diabetes are thought to accelerate the development of cardiovascular disease. Extensive interplay between kinase pathways that regulate the complex pathology of DM-mediated CVD is heavily regulated by a number of post-translational modifications (PTMs). In this review, we focus on the role of a dynamic PTM known as SUMOylation and its role in regulating these kinase networks to provide a mechanistic link between DM and CVD. PMID:27085771

  1. Cardiovascular effects of basal insulins

    Directory of Open Access Journals (Sweden)

    Mannucci E

    2015-07-01

    Full Text Available Edoardo Mannucci,1 Stefano Giannini,2 Ilaria Dicembrini1 1Diabetes Agency, Careggi Teaching Hospital, Florence, 2Section of Endocrinology, Department of Biomedical Clinical and Experimental Sciences, University of Florence and Careggi University Hospital, Florence, Italy Abstract: Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane and basal insulin analogs (glargine, detemir, and the more recent degludec differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with

  2. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  3. The Effect of Antihypertensive Treatment on Cardiovascular Events——A Meta-Analysis of Four Clinical Trials in China

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective The pooled results of four large-scale clinical trials of antihypertensive treatments carried out in China were assessed, with an overall study population of 10,457 patients. Methods The fixed effect model was used for data analysis. Results A pooled analysis at the individual level showed that the average time of treatment was 3.4 years, after which an average reduction in blood pressure of 9/4 mmHg was found. The meta-analysis showed that stroke was reduced by 36% (95% CI 25%-46%, P0.05), whereas the significant reduction in stroke was epidemiologically expected. Conclusion The benefit of antihypertensive treatment obtained was mostly due to a reduction in the incidence of stroke.

  4. Ensayo clínico aleatorizado con una galleta enriquecida en inulina en el patrón de riesgo cardiovascular de pacientes obesos Randomized clinical trial with a inulin enriched cookie on risk cardiovascular factor in obese patients

    OpenAIRE

    D. A. De Luis; B. de la Fuente; O. Izaola; Conde, R.; S. Gutiérrez; Morillo, M.; C. Teba Torres

    2010-01-01

    Introducción: La inulina es un prebiótico con potenciales efectos beneficiosos a nivel cardiovascular. El objetivo de nuestro trabajo es evaluar la respuesta del perfil de riesgo cardiovascular en pacientes obesos tras la inclusión en la dieta de una galleta enriquecida en inulina. Material y métodos: Un total de 34 pacientes fueron randomizados a una de las siguientes ramas: galleta I (enriquecida con inulina, ver tabla I) y galleta II (galleta control, ver tabla I) (Gullón SL). Cada pacient...

  5. Abnormal Vasomotor System Function in Idiopathic Generalized Epileptic Patients

    Directory of Open Access Journals (Sweden)

    Mehdi Maghbooli

    2014-12-01

    Full Text Available OBJECTIVE: Autonomic dysfunction is widely recognized in both partial and generalized epilepsies. The aim of this study was to evaluate the vasomotor response in patients with generalized idiopathic epilepsy by the clinical autonomic function tests. METHODS: 124 consecutive subjects including 62 idiopathic generalized epileptic patients diagnosed for more than 3 months receiving monotherapy and 62 matched for sex and age healthy controls were assessed in this case-control study. The evaluation of the vasomotor system was made using a questionnaire and autonomic function tests including Cold pressor, Valsalva maneuver, mental arithmetic and hand-grip tests. RESULTS: Abnormal score of the Cold pressor test was seen in 59.7%, Valsalva maneuver in 64.5% and 33.9% in mental arithmetic test of epileptic patients. These results were different significantly in comparison to control group. If abnormal hand grip test was defined as an increase less than 11 mmHg in diastolic pressure, there was found no significant difference between two groups of case and control, also a few people in control group was reported normal. While defining abnormal test was interpreted by increase in only one parameter or none of systolic blood pressure, diastolic blood pressure or heart rate, 43.5% in case group versus 14.5% in controls had abnormal results with significantly difference. CONCLUSION: Vasomotor dysfunction evaluated by cardiovascular tests was present commonly in the patients with generalized epilepsy. Further confirmation requires detailed reviewing of central and peripheral limbs to the breakdown of the system to be felt.

  6. 冠心病糖代谢异常患者血浆Ghrelin水平及临床意义%Plasma ghrelin level in patients with coronary heart disease with abnormal glucose metabolism and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    庞军刚; 徐新; 唐良秋; 张社兵; 江志平

    2012-01-01

    目的:探讨冠心病糖代谢异常患者血浆胃饥饿素(Ghrelin)水平及其相关临床意义.方法:将纳入研究对象依据相关检验及检查结果分为正常对照组、冠心病组(冠心病糖代谢正常组和冠心病糖代谢异常组)、单纯糖代谢异常组.收集所有入选对象人院第2天清晨空腹血样,采用ELISA方法同批检测血浆Ghrelin水平.结果:①冠心病组及单纯糖代谢异常组血浆Ghrelin水平均显著低于正常对照组.②冠心病糖代谢异常组血浆Ghrelin水平显著低于冠心病糖代谢正常组及单纯糖代谢异常组.③析因分析结果显示:冠心病与糖代谢异常在对血浆Ghrelin水平影响方面不存在交互作用.然而,糖代谢异常比冠心病对血浆Ghrelin水平的影响更明显.结论:冠心病糖代谢异常患者血浆Ghrelin水平显著下降,且糖代谢异常对Ghrelin的影响更明显.%AIM: To study plasma ghrelin level distribution in patients with coronary heart disease (CHD) with abnormal glucose metabolism and to discuss its clinical significance. METHODS; According to laboratory examination results, subjects were divided into control group, coronary heart disease with normal glucose metabolism group, coronary heart disease with abnormal glucose metabolism group and abnormal glucose metabolism group. Fasting blood samples were collected the morning after admission with EDTA-2K anticoagulation tubes. Blood samples were then transferred to centrifuge tubes containing aprotinin and were centrifuged to extract plasma for cryopreservation. All blood plasma ghrelin levels were tested with ELISA. RESULTS: Compared with those in control group, ghrelin levels were significantly reduced in the group with CHD with normal glucose metabolism, group of CHD with abnormal glucose metabolism and group with abnormal glucose metabolism. Compared with those in the group of CHD with normal glucose metabolism, levels of ghrelin were significantly reduced in patients with

  7. Analysis of clinical outcomes for prenatal diagnosis of occurrence of chromosomal abnormalities for new babies%产前诊断中胎儿新发生染色体异常的临床结局分析

    Institute of Scientific and Technical Information of China (English)

    郭化山; 陈曼萍; 吴来春

    2012-01-01

    OBJECTIVE To analyze the clinical outcomes for prenatal diagnosis of occurrence of chromosomal abnormalities for new babies. METHODS 6 cases of chromosomal abnormalities were found in the 1 346 cases of prenatal diagnosis of chromosomal karyotype from January 2007 to December 2009. Observed the cytogenetic result of fetal chromosomal abnormalities, prenatal ultrasound findings and pregnancy outcome were taken for analysis in the 6 new cases. RESULTS There were 4 cases with unbalanced sex chromosome abnormalities, accounting for 66.7%. There were 2 cases of balanced chromosomal abnormalities, accounting for 33.3%. There were 2 cases of terminal pregnancy through induced abortion in the 4 cases of unbalanced chromosome abnormalities, among whom 1 case of term delivery, 1 case of losing follow-up, the former was found with delayed development in language. 2 cases of balanced chromosomal abnormalities had term delivery, in follow-up after birth, there were no abnormalities. CONCLUSION The fetal phenotype of new chromosomal abnormalities can be predicted by analysis of detailed karyorype and further molecular cytogenetic detection of chromosome composition provided by the structural abnormalities. The prenatal ultrasound examination can provide a strong reference basis for the assessment of pregnancy outcomes.%目的 分析产前诊断中胎儿新发生染色体异常的临床结局.方法 对某院1997年1月-2009年12月1346例产前诊断细胞染色体核型分析发现的6例新发生的胎儿染色体异常病例进行分析,观察6例新发生的胎儿染色体异常病例的细胞遗传学检测结果、产前超声检查结果及妊娠结局.结果 6例新发生染色体异常的胎儿中,非平衡性染色体异常4例,占66.7%:2例平衡性染色体异常,占33.3%;4例非平衡染色体异常的胎儿中有2例选择引产终止妊娠,有1例足月分娩,1例出生后失访.足月分娩者随访至2周岁发现语言功能发育迟缓.2例平衡性染

  8. Metabolic Syndrome and Short-Term and Long-Term Heart Rate Variability in Elderly Free of Clinical Cardiovascular Disease : The PROOF Study

    NARCIS (Netherlands)

    Assoumou, H. G. Ntougou; Pichot, V.; Barthelemy, J. C.; Dauphinot, V.; Celle, S.; Gosse, P.; Kossovsky, M.; Gaspoz, J. M.; Roche, F.

    2010-01-01

    Objective: Autonomic nervous system (ANS) activity decrease has been associated with a higher risk of sudden cardiovascular and cerebrovascular disease. Thus, we explored the relationship between ANS control of the cardiovascular system and metabolic syndrome. Methods: We analyzed the relationship w

  9. EFFECT OF THERAPEUTIC TRAINING AND ACTIVE OUTPATIENT MANAGEMENT ON CLINICAL STATE AND CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH CHRONIC HEART FAILURE (THREE YEAR FOLLOW-UP

    Directory of Open Access Journals (Sweden)

    A. P. Rebrov

    2011-01-01

    Full Text Available Aim.  To  evaluate  effect  of  therapeutic  training  and  active  outpatient management  on  clinical  state  and  cardiovascular  complications  (CVC  in  patients with  chronic  heart  failure  (CHF  during  three year follow-up. Material and methods. A total of 211 patients with CHF experienced Q-wave myocardial infarction were enrolled in the study. At admission to the hospital all patients were randomized into two groups. Patients of the first group (group 1; n=106 were managed actively after discharge from the hospital, patients of the second group (group 2; n=105 - managed conventionally after discharge from the hospital. In the hospital patients of the both groups were therapeutically trained and treated according to contemporary guidelines. Patients were observed for three years.  Results. Over three year follow-up actively managed patients demonstrated significant (p<0.05 decrease in systolic and diastolic blood pressure, heart rate, blood serum levels of total cholesterol and N-terminal prohormone of brain natriuretic peptide (NT-proBNP, augmentation of 6-minute walk-test distance, deceleration of heart remodeling and left ventricle ejection fraction reduction as compared to those who were conventionally managed. Kaplan-Meier curves revealed that risk of CHF decompensation (р=0.001, mortality (р=0.04, and total number of CVC (р=0.04 was significantly lower in the first group than this in the second one. Conclusion. Therapeutic training and active outpatient management in patients with CHF improves patient compliance to pharmacotherapy , their clinical state and outcomes.

  10. Type 2 diabetes and pre-diabetic abnormalities in patients with bipolar disorders

    DEFF Research Database (Denmark)

    Leopold, Karolina; Reif, Andreas; Haack, Sarah;

    2016-01-01

    -diabetic abnormalities, however, is not clear. METHODS: 85 euthymic outpatients with bipolar disorders from two university hospitals in Germany underwent an oral glucose tolerance test, laboratory screening and clinical measurements. Socio-demographic data, medication, severity of illness, global functioning and life...... metabolism and this was associated with impaired global functioning and lower quality of life. Early detection and intervention strategies fitting the needs of patient with bipolar disorder are needed to improve both physical and mental health.......BACKGROUND: Abnormalities in the glucose metabolism cause nervous and organic damage and are a cardiovascular risk factor. They could be a main cause for the increased morbidity and mortality rates found in patients with bipolar disorders. The exact prevalence of diabetes and pre...

  11. Localization of microfibrillar-associated protein 4 (MFAP4 in human tissues: clinical evaluation of serum MFAP4 and its association with various cardiovascular conditions.

    Directory of Open Access Journals (Sweden)

    Helle Wulf-Johansson

    Full Text Available Microfibrillar-associated protein 4 (MFAP4 is located in the extracellular matrix (ECM. We sought to identify tissues with high levels of MFAP4 mRNA and MFAP4 protein expression. Moreover, we aimed to evaluate the significance of MFAP4 as a marker of cardiovascular disease (CVD and to correlate MFAP4 with other known ECM markers, such as fibulin-1, osteoprotegerin (OPG, and osteopontin (OPN. Quantitative real-time PCR demonstrated that MFAP4 mRNA was more highly expressed in the heart, lung, and intestine than in other elastic tissues. Immunohistochemical studies demonstrated high levels of MFAP4 protein mainly at sites rich in elastic fibers and within blood vessels in all tissues investigated. The AlphaLISA technique was used to determine serum MFAP4 levels in a clinical cohort of 172 patients consisting of 5 matched groups with varying degrees of CVD: 1: patients with ST elevation myocardial infarction (STEMI, 2: patients with non-STEMI, 3: patients destined for vascular surgery because of various atherosclerotic diseases (stable atherosclerotic disease, 4: apparently healthy individuals with documented coronary artery calcification (CAC-positive, and 5: apparently healthy individuals without signs of coronary artery calcification (CAC-negative. Serum MFAP4 levels were significantly lower in patients with stable atherosclerotic disease than CAC-negative individuals (p<0.05. Furthermore, lower serum MFAP4 levels were present in patients with stable atherosclerotic disease compared with STEMI and non-STEMI patients (p<0.05. In patients with stable atherosclerotic disease, positive correlations between MFAP4 and both fibulin-1 (ρ = 0.50; p = 0.0244 and OPG (ρ = 0.62; p = 0.0014 were found. Together, these results indicate that MFAP4 is mainly located in elastic fibers and is highly expressed in blood vessels. The present study suggests that serum MFAP4 varies in groups of patients with different cardiovascular conditions

  12. Nail abnormalities in patients with vitiligo*

    Science.gov (United States)

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  13. Thyroid abnormality in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Prasanna Byna

    2015-11-01

    Full Text Available Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women's health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4% were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42% women, 6 (31.57% had polymenorrhagia, 5 (26.31% had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women was heavy menstrual bleeding in 5 (41.6% women, 3 (25% had oligomennorhoea, 4 (33.3% had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57% had oligomenorrhoea, 3 (42.8% had heavy menstrual bleeding, 2 (28.57% had polymenorrhagia. In a total of 55 patients with AUB, 11 (20% had structural abnormalities in uterus and ovaries. 5 (9% had adenomyosis, 3 (5.4% had ovarian cysts, 3 (5.4% had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery. [Int J Res Med Sci 2015; 3(11.000: 3250-3253

  14. Residual generator for cardiovascular anomalies detection

    KAUST Repository

    Belkhatir, Zehor

    2014-06-01

    This paper discusses the possibility of using observer-based approaches for cardiovascular anomalies detection and isolation. We consider a lumped parameter model of the cardiovascular system that can be written in a form of nonlinear state-space representation. We show that residuals that are sensitive to variations in some cardiovascular parameters and to abnormal opening and closure of the valves, can be generated. Since the whole state is not easily available for measurement, we propose to associate the residual generator to a robust extended kalman filter. Numerical results performed on synthetic data are provided.

  15. Effect of garlic on cardiovascular disorders: a review

    OpenAIRE

    Maulik Subir; Banerjee Sanjay

    2002-01-01

    Abstract Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number...

  16. Radiological appearances of sinonasal abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    El-Beltagi, A.H.; Sobeih, A.A.; Valvoda, M.; Dahniya, M.H.; Badr, S.S

    2002-08-01

    The aim of this pictorial review is to present a variety of abnormalities of the sinonasal cavities to emphasize the diversity of lesions occurring in this region. These include congenital, neoplastic and granulomatous disorders and some allergic and inflammatory lesions with uncommon radiological appearances, as well as expanding lesions of the facial bones or of dental origin with secondary involvement of the related sinus(es). El-Beltagi, A.H. et al. (2002). Clinical Radiology 57, 702-718.

  17. Cardiovascular complications in acromegaly.

    Science.gov (United States)

    Vitale, G; Pivonello, R; Lombardi, G; Colao, A

    2004-09-01

    Cardiovascular morbidity and mortality are increased in acromegaly. In fact, GH and IGF-I excess induces a specific cardiomyopathy. The early stage of acromegaly is characterized by the hyperkinetic syndrome (high heart rate and increased systolic output). Frequently, concentric biventricular hypertrophy and diastolic dysfunction occur in acromegaly, leading to an impaired systolic function ending in heart failure if the disease is untreated or unsuccessfully untreated. Besides, abnormalities of cardiac rhythm and of valves have been also described in acromegaly. The coexistence of other complications, such as arterial hypertension and diabetes, aggravates the acromegalic cardiomyopathy. The suppression of GH/IGF-I following an efficacious therapy could decrease left ventricular mass and improve cardiac function. In conclusion, a careful evaluation of cardiac function, morphology and activity seems to be mandatory in acromegaly.

  18. ICU患儿发生心理异常反应的临床表现及应对措施%Clinical Presentation of Abnormal Psychological Reaction of ICU Children and Corresponding Intervention

    Institute of Scientific and Technical Information of China (English)

    李颖; 胡凤华; 曲东; 任晓旭; 郭琳瑛; 王贺茹

    2011-01-01

    Objective To investigate clinical presentation of abnormal psychological reaction of PICU children and corresponding intervention. Methods 146 patients were admitted to PICU from October 2009 to October 2010 (above 1 year of age with more than 3-day hospitalization). We investigated these children' s verbal behavior change in recovery period after quitting depressants and revealed that 25 out of 146 children developed abnormal psychological reaction. We also carried out 6-month followed up with the 10 children after discharge to learn their psychological outcome based on parents' feedback. Analyses were made regarding clinical presentation of abnormal psychological reaction as well as effectiveness of psychological intervention. Result Clinical presentation of abnormal psychological reaction of PICU children include: some mild symptoms,fear, nightmare, insensitivity, unusual obedience, oppositional defiant, aggressive behavior, language regression and even arrhythmia. These conditions might be relieved through psychological intervention by both medical practitioners and parents. Strategies of corresponding intervention include enhanced psychological care, prompt psychological consultation, early transfer to chaperon ward, and even psychological rehabilitation if necessary. Most of the children had recovered through psychological intervention. Conclusion There are a variety of clinical presentations of abnormal psychological reaction. Medical practitioners should raise the awareness of and identify the development of abnormal psychological reaction and provide timely intervention, by which psychological recovery of these children will be improved.%目的 探讨ICU患儿发生心理异常反应的临床表现及应对措施.方法 2009年10月至2010年10月ICU收治146 例患儿(年龄大于1岁,住院超过3天),当患儿进入恢复期,并停止药物镇静后,医务人员观察其语言行为,发现有25例患儿出现心理异常反应.在出院后追踪6个

  19. Medpor义眼座植入术矫正眼窝凹陷畸形临床观察%Clinical observation of Medpor ocular prosthesis implantation to correct sunken socket abnormality

    Institute of Scientific and Technical Information of China (English)

    杜刚; 李贵刚; 谈清明

    2011-01-01

    Objective To discuss clinical effect observation of porous polythene ocular prosthesis ( Medpor ) implantation to correct sunken socket abnormality. Methods Optionality conduct Medpor or HA ocular prosthesis implantation to 55 cases of patients without eyeball or contracted eyeball or anophthalmia or eyeball atrophy resulting in socket sinking deformity. After postoperative follow-up over 6 months, Both of the clinical effectiveness in all cases were analyzed from complications, such as extrusion, migration or infection of the implant, etc. Results Both of the therapeutic effect of the ocular prosthesis implantation to correct sunken socket abnormality is good, but Medpor has less complications. Conclusion The overall of therapeutic effect of Medpor implantation to treat sunken Socket abnormality is better. Medpor is shown to be biocompatible and an ideal material for socket sinking defomity.%目的 探讨多孔聚乙烯义眼座(Medpor)植入矫正眼窝凹陷畸形手术效果.方法 55例(55只眼)包括眼球萎缩、眼球摘除术后、眼内容摘除术后及合并结膜囊狭窄的患者,随机植入Medpor义眼座或羟基磷灰石义眼座,随访观察术后义眼座暴露、感染等并发症情况,比较手术疗效.结果 Medpor义眼座与羟基磷灰石义眼座能取得相同的良好的治疗效果,但前者并发症更少.结论 Medpor义眼座植入术疗效可靠,Medpor具有良好的组织相容性,是矫正眼窝凹陷畸形的理想材料.

  20. Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

    Directory of Open Access Journals (Sweden)

    Daniela Luisa Maggi

    2014-04-01

    Full Text Available Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI. This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease. A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial. A total of 115 patients were included, most were females (57.4%, aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%, physical inactivity (48.7% and family history (58.3%. The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

  1. Functional and morphological parameters with tissue characterization of cardiovascular magnetic imaging in clinically verified ''infarct-like myocarditis''

    International Nuclear Information System (INIS)

    Cardiac magnetic resonance (CMR) has increasingly proved to be a valuable diagnostic tool for evaluating patients with suspected myocarditis. The objective of this study was to evaluate the diagnostic value of functional and morphological parameters including tissue characterization in patients with ''infarct-like myocarditis''. 43 patients with clinically verified cases of ''infarct-like myocarditis'' (median time to MRI scanning after admission for acute symptoms 3 days) and 35 control patients matched by age and sex were included in this retrospective case control study. In this study we used a 1.5 T MRI scanner conducting steady-state-free-precession sequences, T2-weighted imaging, T1-weighted imaging before and after contrast administration and late gadolinium enhancement sequences. According to the recommendations for CMR diagnosis of myocarditis (Lake Louise consensus criteria), a scan was positive for acute myocarditis if 2 of 3 CMR criteria were present. 30 % of the patients with ''infarct-like myocarditis'' had a reduced left ventricular ejection fraction, 11 % had an increased LV end-diastolic volume index and 35 % had an increased LV mass index. The sensitivity of wall motion abnormalities was 63 % with a regional distribution in 49 %. In 47 % of cases regional wall motion abnormalities were present in the lateral left ventricular segments. Pericardial effusions were discovered in 65 % of cases with a circular appearance in 21 % and focal manifestation in 44 %. The diagnostic sensitivity, specificity, and accuracy of CMR in patients with ''infarct-like myocarditis'' were 67 %, 100 % and 82 %, respectively. The LGE alone was the most sensitive test parameter with 86 %, providing a specificity of 100 % and accuracy of 92 %. Our study results can be applied to the subgroup of patients with ''infarct-like myocarditis'', where we found that LGE alone was the

  2. Functional and morphological parameters with tissue characterization of cardiovascular magnetic imaging in clinically verified ''infarct-like myocarditis''

    Energy Technology Data Exchange (ETDEWEB)

    Schwab, Johannes [Paracelsus Medical Univ., General Hospital Nuremberg (Germany). Dept. of Cardiology and Radiology; Rogg, H.J.; Pauschinger, M.; Fessele, K. [Paracelsus Medical Univ., General Hospital Nuremberg (Germany). Dept. of Cardiology; Bareiter, T.; Baer, I. [Paracelsus Medical Univ., General Hospital Nuremberg (Germany). Dept. of Cardiology and Neuroradiology; Loose, R. [Paracelsus Medical Univ., General Hospital Nuremberg (Germany). Dept. of Radiology

    2016-04-15

    Cardiac magnetic resonance (CMR) has increasingly proved to be a valuable diagnostic tool for evaluating patients with suspected myocarditis. The objective of this study was to evaluate the diagnostic value of functional and morphological parameters including tissue characterization in patients with ''infarct-like myocarditis''. 43 patients with clinically verified cases of ''infarct-like myocarditis'' (median time to MRI scanning after admission for acute symptoms 3 days) and 35 control patients matched by age and sex were included in this retrospective case control study. In this study we used a 1.5 T MRI scanner conducting steady-state-free-precession sequences, T2-weighted imaging, T1-weighted imaging before and after contrast administration and late gadolinium enhancement sequences. According to the recommendations for CMR diagnosis of myocarditis (Lake Louise consensus criteria), a scan was positive for acute myocarditis if 2 of 3 CMR criteria were present. 30 % of the patients with ''infarct-like myocarditis'' had a reduced left ventricular ejection fraction, 11 % had an increased LV end-diastolic volume index and 35 % had an increased LV mass index. The sensitivity of wall motion abnormalities was 63 % with a regional distribution in 49 %. In 47 % of cases regional wall motion abnormalities were present in the lateral left ventricular segments. Pericardial effusions were discovered in 65 % of cases with a circular appearance in 21 % and focal manifestation in 44 %. The diagnostic sensitivity, specificity, and accuracy of CMR in patients with ''infarct-like myocarditis'' were 67 %, 100 % and 82 %, respectively. The LGE alone was the most sensitive test parameter with 86 %, providing a specificity of 100 % and accuracy of 92 %. Our study results can be applied to the subgroup of patients with ''infarct-like myocarditis'', where we found that LGE alone was the

  3. Urotensin II in cardiovascular regulation

    Directory of Open Access Journals (Sweden)

    Fraser D Russell

    2008-08-01

    Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension

  4. Urotensin II in cardiovascular regulation

    Directory of Open Access Journals (Sweden)

    Fraser D Russell

    2008-09-01

    Full Text Available Fraser D RussellSchool of Health and Sport Sciences, Faculty of Science, Health and Education, University of the Sunshine Coast, Sippy Downs, Queensland, AustraliaAbstract: Cardiovascular function is modulated by neuronal transmitters, circulating hormones, and factors that are released locally from tissues. Urotensin II (UII is an 11 amino acid peptide that stimulates its’ obligatory G protein coupled urotensin II receptors (UT to modulate cardiovascular function in humans and in other animal species, and has been implicated in both vasculoprotective and vasculopathic effects. For example, tissue and circulating concentrations of UII have been reported to increase in some studies involving patients with atherosclerosis, heart failure, hypertension, preeclampsia, diabetes, renal disease and liver disease, raising the possibility that the UT receptor system is involved in the development and/or progression of these conditions. Consistent with this hypothesis, administration of UT receptor antagonists to animal models of cardiovascular disease have revealed improvements in cardiovascular remodelling and hemodynamics. However, recent studies have questioned this contributory role of UII in disease, and have instead postulated a protective effect on the cardiovascular system. For example, high concentrations of circulating UII correlated with improved clinical outcomes in patients with renal disease or myocardial infarction. The purpose of this review is to consider the regulation of the cardiovascular system by UII, giving consideration to methodologies for measurement of plasma concentrations, sites of synthesis and triggers for release.Keywords: urotensin II, cardiovascular disease, heart failure, hypertension

  5. Analysis the risk factors of coronary heart disease and clinical characters of coronary angiography in patients with abnormal glucose metabolism%冠心病合并糖代谢异常冠脉病变特点及其危险因素分析

    Institute of Scientific and Technical Information of China (English)

    费利霞; 陈洁; 田刚

    2012-01-01

    目的:探讨糖代谢异常冠状动脉病变特点和冠心病的危险因素.方法:74例拟诊冠心病患者行冠脉造影(CAG),57例空腹血糖正常者行口服葡萄糖耐量试验(OGTT)检查.根据CAG结果分冠心病组(CAD)、非冠心病组(非CAD),分析危险因素的差异;冠心病组分为糖尿病组(DM)、糖调节受损组(IGR)、正常血糖组(NGT),观察冠状动脉病变的特点.结果:糖代谢异常在冠心病与非冠心病差异有统计学意义(χ2值为6.14,P<0.05).冠心病IGR组和DM组多支病变患病率,分别75%和50%,NGT组单支病变患病率55.6%,重度病变患病率DM组80%,NGT组77.8%.男性、DM、IGR、吸烟、危险因素累计数在CAD组与非CAD组差异有统计学意义(P<0.01).结论:冠心病合并糖代谢异常患病率高,48.6%通过OGTT诊断,OGTT应列为心血管病的常规检查;冠心病合并糖尿病和糖调节受损病变以多支病变为主,病变重而弥漫,正常血糖以单支病变多见,病变重而局限.%Objective: To analysis the risk factors of coronary heart disease and the clinical characters of coronary angiography in the patients who suffered with abnormal glucose metabolism. .Methods: 74 cases of patients who were preliminary diagnosed to coronary heart disease accepted coronary angiography (CAG),57 of them with normal fast blood glucose accepted the oral glucose tolerance test (OGTT). All the patients were divided into the CAD group and without CAD group according to the results of CAG. The CAD divided into three groups (DM, IGR and NGT) was compared with the difference of the clinical characters of coronary lesions. Results: The prevalence of abnormal glucose metabolism was 64% in patient with CAD.The prevalence of abnormal glucose metabolism in CAD was significantly higher than that of without CAD(was 6. 14,P<0. 05)). The coronary multivessel changes were more frequent in the IGR group and in the DM group than the NGT group (75%, 50% vs. 16.7%). The cor onary single

  6. Vitamin D and cardiovascular disease.

    Science.gov (United States)

    Norman, P E; Powell, J T

    2014-01-17

    Vitamin D plays a classical hormonal role in skeletal health by regulating calcium and phosphorus metabolism. Vitamin D metabolites also have physiological functions in nonskeletal tissues, where local synthesis influences regulatory pathways via paracrine and autocrine mechanisms. The active metabolite of vitamin D, 1α,25-dihydroxyvitamin D, binds to the vitamin D receptor that regulates numerous genes involved in fundamental processes of potential relevance to cardiovascular disease, including cell proliferation and differentiation, apoptosis, oxidative stress, membrane transport, matrix homeostasis, and cell adhesion. Vitamin D receptors have been found in all the major cardiovascular cell types including cardiomyocytes, arterial wall cells, and immune cells. Experimental studies have established a role for vitamin D metabolites in pathways that are integral to cardiovascular function and disease, including inflammation, thrombosis, and the renin-angiotensin system. Clinical studies have generally demonstrated an independent association between vitamin D deficiency and various manifestations of degenerative cardiovascular disease including vascular calcification. However, the role of vitamin D supplementation in the management of cardiovascular disease remains to be established. This review summarizes the clinical studies showing associations between vitamin D status and cardiovascular disease and the experimental studies that explore the mechanistic basis for these associations.

  7. Children's chromosome with abnormal karyotypes and clinical analysis in Huzhou city%湖州地区遗传咨询儿童染色体异常核型及临床分析

    Institute of Scientific and Technical Information of China (English)

    翁学军; 沈国松

    2012-01-01

    Objective: Through the study of genetic counseling children's chromosome with abnormal karyotypes characteristics, in order to provide a scientific basis for reducing the birth rate of children with chromosome disease of the region and improving population quality. Method; To analyze the chromosome karyotype of peripheral blood of the children who have the clinical manifestations of mental retardation, growth retardation, congenital malformation. Result: 93 cases were found abnormal chromosome karyotype, abnormal detection rate 38. 43% ; 80 cases were autosomal abnormal karyotype, accounting for the total number of checks of 33. 06% , accounting for abnormal number of 86. 02% , 13 cases were abnormal of the sex chromosome karyotype, accounting for the total number of checks of 5. 37% , accounting for the number of abnormal of 13. 98%. Conclusion; Chromosomal abnormalities is one important cause leading to children's mental retardation, growth retardation, congenital malformations, or even death, strengthen health education and genetic counseling during pregnancy, further increase the intensity of prenatal screening and prenatal diagnosis, and continuously improve the diagnostic accuracy of chromosomal diseases, is an effective means to reduce the birth rate of chromosomal sick children and improve the quality of birth.%目的 通过探讨我院遗传咨询儿童染色体异常核型特点,为降低本地区染色体病患儿的出生率、提高出生人口素质提供科学依据.方法 对临床表现为智能低下、生长发育迟缓、先天畸形、特殊表型等儿童进行外周血染色体核型分析.结果 发现染色体异常核型93例,异常检出率为38.43%;其中常染色体异常核型80例,占总检查数的33.06%,占异常数的86.02%,性染色体异常核型13例,占总检查数的5.37%,占异常数的13.98%.结论 染色体异常是导致儿童智能低下、生长发育迟缓、先天畸形、甚至死亡的重要病因之一,

  8. Marathon run: cardiovascular adaptation and cardiovascular risk.

    Science.gov (United States)

    Predel, Hans-Georg

    2014-11-21

    The first marathon run as an athletic event took place in the context of the Olympic Games in 1896 in Athens, Greece. Today, participation in a 'marathon run' has become a global phenomenon attracting young professional athletes as well as millions of mainly middle-aged amateur athletes worldwide each year. One of the main motives for these amateur marathon runners is the expectation that endurance exercise (EE) delivers profound beneficial health effects. However, with respect to the cardiovascular system, a controversial debate has emerged whether the marathon run itself is healthy or potentially harmful to the cardiovascular system, especially in middle-aged non-elite male amateur runners. In this cohort, exercise-induced increases in cardiac biomarkers-troponin and brain natriuretic peptide-and acute functional cardiac alterations have been observed and interpreted as potential cardiac damage. Furthermore, in the cohort of 40- to 65-year-old males engaged in intensive EE, a significant risk for the development of atrial fibrillation has been identified. Fortunately, recent studies demonstrated a normalization of the cardiac biomarkers and the functional alterations within a short time frame. Therefore, these alterations may be perceived as physiological myocardial reactions to the strenuous exercise and the term 'cardiac fatigue' has been coined. This interpretation is supported by a recent analysis of 10.9 million marathon runners demonstrating that there was no significantly increased overall risk of cardiac arrest during long-distance running races. In conclusion, intensive and long-lasting EE, e.g. running a full-distance Marathon, results in high cardiovascular strain whose clinical relevance especially for middle-aged and older athletes is unclear and remains a matter of controversy. Furthermore, there is a need for evidence-based recommendations with respect to medical screening and training strategies especially in male amateur runners over the age of

  9. Interventional cardiovascular magnetic resonance: still tantalizing

    OpenAIRE

    Saikus Christina E; Kocaturk Ozgur; Guttman Michael A; Faranesh Anthony Z; Ratnayaka Kanishka; Lederman Robert J

    2008-01-01

    Abstract The often touted advantages of MR guidance remain largely unrealized for cardiovascular interventional procedures in patients. Many procedures have been simulated in animal models. We argue these opportunities for clinical interventional MR will be met in the near future. This paper reviews technical and clinical considerations and offers advice on how to implement a clinical-grade interventional cardiovascular MR (iCMR) laboratory. We caution that this reflects our personal view of ...

  10. Abnormal immune parameters in HIV-seronegative haemophilic patients

    NARCIS (Netherlands)

    Allersma, DP; Smid, WM; Briet, E

    1996-01-01

    In HIV-seronegative haemophiliac patients abnormal immune parameters have been demonstrated. In this review data on these abnormalities, their aetiology and clinical consequences are summarized and discussed. The data reviewed show abnormalities at different levels of the adaptive immune system. Mos

  11. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    International Nuclear Information System (INIS)

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  12. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2011-04-15

    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  13. Ensayo clínico aleatorizado con una galleta enriquecida en inulina en el patrón de riesgo cardiovascular de pacientes obesos Randomized clinical trial with a inulin enriched cookie on risk cardiovascular factor in obese patients

    Directory of Open Access Journals (Sweden)

    D. A. de Luis

    2010-02-01

    Full Text Available Introducción: La inulina es un prebiótico con potenciales efectos beneficiosos a nivel cardiovascular. El objetivo de nuestro trabajo es evaluar la respuesta del perfil de riesgo cardiovascular en pacientes obesos tras la inclusión en la dieta de una galleta enriquecida en inulina. Material y métodos: Un total de 34 pacientes fueron randomizados a una de las siguientes ramas: galleta I (enriquecida con inulina, ver tabla I y galleta II (galleta control, ver tabla I (Gullón SL. Cada paciente recibió un total de 8 galletas al día (total de 68 gramos de producto. Antes de iniciar el tratamiento y al mes se realizóuna valoración nutricional y analítica. Resultados: Finalizaron un total de 15 pacientes en cada grupo. En el grupo I se produjo un aumento significativo en la ingesta de fibra soluble (inulina. Se detectó en los pacientes con las galletas enriquecidas en inulina una disminución significativa de los niveles de colesterol total (223,1 ± 45,3 mg/dl vs 208,8 ± 33,1 mg/dl; p Introduction: Inulin is a prebiotic with potential benefit in cardiovascular risk factors. The aim of our work is to evaluate in obese patients the effect of a inulin enriched cookie on cardiovascular risk factors. Material and methods: 34 patients were randomized in both branches: group I (inulin enriched cookie Gullon SL® and group II (control cookie. Previous and after 1 month of the treatment, a nutritional and biochemical study was realized. Results: 15 patients finished the procotol in each group. In group I, an increase in soluble fiber intake (inulin was detected. In this group a significant decrease of total cholesterol (223.1 ± 45.3 mg/dl vs 208.8 ± 33.1 mg/dl; p < 0.05 and LDL cholesterol (142.9 ± 39.2 mg/dl vs 131.4 ± 28.6 mg/dl; p < 0.05 was reached. A non significant improvement in insulin levels and HOMA was detected in inulin-enriched cookie group, too. Anthropometric parameters did not change in both groups. The increase in soluble fiber

  14. Clinical Effect of Statins Combined With Cardiovascular Drugs for Coronary Heart Disease%他汀类联合心血管药物治疗冠心病的临床效果

    Institute of Scientific and Technical Information of China (English)

    马晶

    2015-01-01

    Objective To investigate clinical effect of statins combined cardiovascular drugs for coronary heart disease. Methods 60 patients with cardiovascular diseases from 2010 to 2013 in our hospital were selected into control group and observation group. The control group patients received cardiovascular medications,the observation group received cardiovascular drugs and statins treatment,the clinical effects between the two groups were compared. Results The clinical effective rate of observation group was higher than control group significantly(P<0.05). The lever of total cholesterol,HDL cholesterol,LDL cholesterol and triglycerides in the observation group were better than control group significantly(P< 0.05). Conclusion The clinical treatment effect of statins combined cardiovascular drugs for coronary heart disease is good,the patient's blood lipids is improved.%目的:探讨他汀类药物和心血管药物联合使用治疗冠心病的临床效果。方法对2010~2013年我院接收的60例心血管患者进行研究分析,将这些患者分为对照组和观察组,对照组患者使用心血管药物治疗,观察组患者使用心血管药物和他汀类药物治疗,对两组的临床治疗效果进行对比分析。结果临床治疗后,观察组患者的临床治疗有效率比对照组高,两组结果存在统计学差异性,P<0.05。两组患者的总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯等指标结果为观察组较好,两组具有统计学差异性,P<0.05。结论他汀类药物和心血管药物对冠心病患者的临床治疗效果好,患者的血脂得到了改善。

  15. ED 07-4 IS EXERCISE-INDUCED HYPERTENSION ASSOCIATED WITH ADVERSE CARDIOVASCULAR OUTCOMES?

    Science.gov (United States)

    Sharman, James

    2016-09-01

    Millions of clinical exercise stress tests are conducted annually worldwide. The fundamental rationale underlying the conduct of these tests is that cardiovascular irregularities may be revealed during an exercise bout that would otherwise remain unnoticed if testing was only conducted under resting conditions. In order to reveal electrocardiographic abnormalities indicative of cardiac disease, maximal intensity exercise may need to be undertaken, whereas the presence of hypertension can be revealed by the blood pressure response at low to moderate intensity exercise. Therefore, exercise blood pressure measured carefully under standardised conditions should be a useful tool to identify individuals at increased cardiovascular risk. Independent investigators have consistently shown that exercise blood pressure at low to moderate intensities predicts adverse cardiovascular outcomes independent from resting blood pressure and conventional cardiovascular risk factors. This talk will present evidence in support of exercise-induced hypertension as a clinical observation requiring additional follow up care. Future needs in terms of better understanding the mechanisms of exercise hypertension and determination of exercise hypertension thresholds will also be detailed. PMID:27642909

  16. Relationship between pulmonary and cardiac abnormalities in sickle cell disease: implications for the management of patients

    Directory of Open Access Journals (Sweden)

    Maria Christina Paixão Maioli

    2016-02-01

    Full Text Available ABSTRACT Objective: To evaluate the association between clinical, pulmonary, and cardiovascular findings in patients with sickle cell disease and, secondarily, to compare these findings between sickle cell anemia patients and those with other sickle cell diseases. Methods: Fifty-nine adults were included in this cross-sectional study; 47 had sickle cell anemia, and 12 had other sickle cell diseases. All patients underwent pulmonary function tests, chest computed tomography, and echocardiography. Results: Abnormalities on computed tomography, echocardiography, and pulmonary function tests were observed in 93.5%, 75.0%; and 70.2% of patients, respectively. A higher frequency of restrictive abnormalities was observed in patients with a history of acute chest syndrome (85% vs. 21.6%; p-value < 0.0001 and among patients with increased left ventricle size (48.2% vs. 22.2%; p-value = 0.036, and a higher frequency of reduced respiratory muscle strength was observed in patients with a ground-glass pattern (33.3% vs. 4.3%; p-value = 0.016. Moreover, a higher frequency of mosaic attenuation was observed in patients with elevated tricuspid regurgitation velocity (61.1% vs. 24%; p-value = 0.014. Compared to patients with other sickle cell diseases, sickle cell anemia patients had suffered increased frequencies of acute pain episodes, and acute chest syndrome, and exhibited mosaic attenuation on computed tomography, and abnormalities on echocardiography. Conclusion: A significant interrelation between abnormalities of the pulmonary and cardiovascular systems was observed in sickle cell disease patients. Furthermore, the severity of the cardiopulmonary parameters among patients with sickle cell anemia was greater than that of patients with other sickle cell diseases.

  17. The clinical significance analysis of the cytogentic abnormality in the infertile males%男性不育症患者外周血染色体核型分析的临床意义

    Institute of Scientific and Technical Information of China (English)

    陈亮; 鞠慧岩; 薛晴; 左文莉; 徐阳; 杨慧霞; 付杰; 于丽; 齐雯; 马京梅; 潘虹; 陈菲; 张娜; 王晟

    2014-01-01

    Objective To investigate the clinical significance of the cytogenetic abnormality in the infertile males. Methods Cytogenetics of patients was examined by culturing peripheral-blood lymphocyte and G-banding technology, and karyotyping analysis technique were used to study the abnormality and the polymorphism of chromosomes. Results Of 813 infertile men, 55 (6.76%) were detected to have chromosomal abnormalities in chromosomal analysis, including 36 cases with the numeric abnormality (4.43%), 17 cases with chrom osomal rearrangement (2.09%). In 55 cases with chromosomal abnormalities, the constituted ratios of numeric aberration and the rearrangement were 65.4%and 30.91%respectively. Two cases of male pseudohermaphroditism were detected. Klinefelter syndrome and balanced reciprocal translocations were the most common aberration of the chromosomal abnormalities. In addition, 44 cases were detected to have polymorphic variations (5.41%,44/813), including 11 cases with the somatic chromosomal polymorphic variations (1.35%,11/813), 21 cases with the big Y(2.58%,21/813) and 12 cases with bit Y chromosomal(1.48%,12/813). The somatic chromosomal polymorphism included secondary constriction increases, satellite increases in the D/G group. Y chromosomal polymorphism was the most common chromosomal polymorphism. The main clinical features of the male infertility attributing to the chromosomal abnormality and polymorphism were azoospermia, abnormal spermatozoa (oligozoospermia, asthenospermia and teratozoospermia). Conclusion Chromosome and abnormality polymorphisms showed negative effects on the male fertile function. The infertile males with chromosomal abnormality or polymorphisms definitely had an increasing risk in heredity. Karyotype testing screening is necessary for the infertile males, and PGD is helpful to decrease the genetic risk.%目的:基于外周血染色体核型分析,探讨男性不育症患者染色体核型异常的特点及临床意义。方法回顾

  18. Clinical significant evaluation of the inversion abnormality of chromosome on the fertile dysfunction%生育障碍患者中染色体倒位核型的特点及临床分析

    Institute of Scientific and Technical Information of China (English)

    陈亮; 鞠慧岩; 薛晴; 左文莉; 徐阳; 付杰; 贺占举; 于丽; 齐雯; 潘虹; 陈菲; 张娜; 王玲

    2014-01-01

    Objectives:To analyze the clinical significance of the inversion abnormality of chromosome on the adverse pregnancy events.Methods:Cytogenetics of patients was examined by culturing peripheral-blood lym-phocyte and G-banding technology,and karyotyping analysis technique was used to study the relationship between the chromosomal inversion abnormality and the fertile dysfunction in 1408 couples with adverse pregnancy outcome. Results:Among 2816 cases with adverse pregnancy events,31cases (16 male and 15 female)were found with chromosomal inversion abnormality,and the abnormal rate was 1.10%.There was no significant difference in the abnormal rate of chromosomal inversion between the different genders (male:1.13%,female:1.06%,P>0.05). 25 cases with inv (9)were detected and the detectable rate was 0.89%(25/2816).The other types of inversion abnormality included:one case with inv (6)(q11q21),one case inv (7)(p15q36),one case with inv (18) (p11q21),one case with inv (1)(q34q22),one case with inv(X)(p22q26)and one case with inv (10) (q12q22).The clinical symptoms of inversion abnormality were miscarriage,embryonic diapause,fetal anomalies and et al.Conclusion:During the inversion abnormality related to the fertile dysfunction couples,inv (9 )is the most common type.Inv (9)maybe have some potential effect on the adverse pregnancy events.There is no signifi-cant difference of the detectable rate of inversion abnormality between the different genders.Therefore,the couples with adverse pregnancy outcome should both receive cytogenetically examination at the same time.Possibly,the PGD and ICSI may be helpful to the patients with the inversion abnormality,but the detailed issues need to be fur-ther investigated.%目的:分析及总结生育障碍患者中染色体倒位核型的特点及临床意义。方法:临床分析不良妊娠结局夫妇双方的外周血染色体核型,对男方及女方不同性别间染色体异常的检出率进行比较并进

  19. 14 CFR 67.211 - Cardiovascular.

    Science.gov (United States)

    2010-01-01

    ... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN MEDICAL STANDARDS AND CERTIFICATION Second-Class Airman Medical Certificate § 67.211 Cardiovascular. Cardiovascular standards for a second-class medical certificate are no established medical history or clinical diagnosis...

  20. Cardiovascular group

    Science.gov (United States)

    Blomqvist, Gunnar

    1989-01-01

    As a starting point, the group defined a primary goal of maintaining in flight a level of systemic oxygen transport capacity comparable to each individual's preflight upright baseline. The goal of maintaining capacity at preflight levels would seem to be a reasonable objective for several different reasons, including the maintenance of good health in general and the preservation of sufficient cardiovascular reserve capacity to meet operational demands. It is also important not to introduce confounding variables in whatever other physiological studies are being performed. A change in the level of fitness is likely to be a significant confounding variable in the study of many organ systems. The principal component of the in-flight cardiovascular exercise program should be large-muscle activity such as treadmill exercise. It is desirable that at least one session per week be monitored to assure maintenance of proper functional levels and to provide guidance for any adjustments of the exercise prescription. Appropriate measurements include evaluation of the heart-rate/workload or the heart-rate/oxygen-uptake relationship. Respiratory gas analysis is helpful by providing better opportunities to document relative workload levels from analysis of the interrelationships among VO2, VCO2, and ventilation. The committee felt that there is no clear evidence that any particular in-flight exercise regimen is protective against orthostatic hypotension during the early readaptation phase. Some group members suggested that maintenance of the lower body muscle mass and muscle tone may be helpful. There is also evidence that late in-flight interventions to reexpand blood volume to preflight levels are helpful in preventing or minimizing postflight orthostatic hypotension.

  1. Cardiovascular Disease

    Directory of Open Access Journals (Sweden)

    Cheung Angela

    2004-08-01

    Full Text Available Abstract Health Issue Cardiovascular disease (CVD is the leading cause of death in Canadian women and men. In general, women present with a wider range of symptoms, are more likely to delay seeking medial care and are less likely to be investigated and treated with evidence-based medications, angioplasty or coronary artery bypass graft than men. Key Findings In 1998, 78,964 Canadians died from CVD, almost half (39,197 were women. Acute myocardial infarction, which increases significantly after menopause, was the leading cause of death among women. Cardiovascular disease accounted for 21% of all hospital admissions for Canadian women over age 50 in 1999. Admissions to hospital for ischemic heart disease were more frequent for men, but the mean length of hospital stay was longer for women. Mean blood pressure increases with age in both men and women. After age 65, however, high blood pressure is more common among Canadian women. More than one-third of postmenopausal Canadian women have hypertension. Diabetes increases the mortality and morbidity associated with CVD in women more than it does in men. Depression also contributes to the incidence and recovery from CVD, particularly for women who experience twice the rate of depression as men. Data Gaps and Recommendations CVD needs to be recognized as a woman's health issue given Canadian mortality projections (particularly heart failure. Health professionals should be trained to screen, track, and address CVD risk factors among women, including hypertension, elevated lipid levels, smoking, physical inactivity, depression, diabetes and low socio-economic status.

  2. Cardiovascular System

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008515 Clinical effect of coronary artery stenting on 12 patients with coronary artery stenosis and spasm.CHU Guang(储光),et al.Dept Cardiol,Shanghai Jiaotong Univ,1st People’s,Shanghai 20008. Chin Cir J 2008;23(5):347-349. Objective To evaluate the clinical effect of stenting on drug refractory variant angina

  3. Four small supernumerary marker chromosomes derived from chromosomes 6, 8, 11 and 12 in a patient with minimal clinical abnormalities: a case report

    Directory of Open Access Journals (Sweden)

    Hamid Ahmed B

    2010-08-01

    Full Text Available Abstract Introduction Small supernumerary marker chromosomes are still a problem in cytogenetic diagnostic and genetic counseling. This holds especially true for the rare cases with multiple small supernumerary marker chromosomes. Most such cases are reported to be clinically severely affected due to the chromosomal imbalances induced by the presence of small supernumerary marker chromosomes. Here we report the first case of a patient having four different small supernumerary marker chromosomes which, apart from slight developmental retardation in youth and non-malignant hyperpigmentation, presented no other clinical signs. Case presentation Our patient was a 30-year-old Caucasian man, delivered by caesarean section because of macrosomy. At birth he presented with bilateral cryptorchidism but no other birth defects. At age of around two years he showed psychomotor delay and a bilateral convergent strabismus. Later he had slight learning difficulties, with normal social behavior and now lives an independent life as an adult. Apart from hypogenitalism, he has multiple hyperpigmented nevi all over his body, short feet with pes cavus and claw toes. At age of 30 years, cytogenetic and molecular cytogenetic analysis revealed a karyotype of 50,XY,+min(6(:p11.1-> q11.1:,+min(8(:p11.1->q11.1:,+min(11(:p11.11->q11:,+min(12(:p11.2~12->q10:, leading overall to a small partial trisomy in 12p11.1~12.1. Conclusions Including this case, four single case reports are available in the literature with a karyotype 50,XN,+4mar. For prenatally detected multiple small supernumerary marker chromosomes in particular we learn from this case that such a cytogenetic condition may be correlated with a positive clinical outcome.

  4. Síndrome pulmonar e cardiovascular por Hantavirus: aspectos epidemiológicos, clínicos, do diagnóstico laboratorial e do tratamento Hantavirus pulmonary and cardiovascular syndrome: epidemiology, clinical presentation, laboratory diagnosis and management aspects

    Directory of Open Access Journals (Sweden)

    Luiz Tadeu M. Figueiredo

    2001-02-01

    Full Text Available A síndrome pulmonar e cardiovascular por Hantavirus (SPCVH, é doença emergente com descrição crescente de casos no Brasil. Neste trabalho, estudou-se 8 casos confirmados da doença. Todos apresentaram febre e dispnéia. Taquicardia, astenia, hipotensão e estertoração pulmonar ocorreram em 75 a 87,5% dos casos. Plaquetopenia e hipoxemia ocorreram em 100% dos casos, hemoconcentração, leucocitose com desvio à esquerda e elevação de uréia e creatinina séricas em 75 a 87,5%. Assistência respiratória, hidratação endovenosa e utilização de aminas vasoativas foram as medidas utilizadas nos pacientes. Ressalta-se que o suporte ventilatório e cardiovascular deve ser precocemente instituído, preferencialmente em unidades de terapia intensiva, com precauções universais e respiratórias de isolamento. Deve-se ter cuidados com infusão excessiva de líquidos para não agravar o edema pulmonar. A mortalidade observada, de 50%, é elevada, deveu-se à gravidade da doença e ao comparecimento tardio para tratamento intensivo. Deve-se informar sobre a SPCVH aos profissionais de saúde, considerando que casos de SPCVH, provavelmente, vêm passando desapercebidos.The Hantavirus pulmonary and cardiovascular syndrome (HPCVS is an emerging disease in Brazil. In this study, eight confirmed cases of HPCVS were studied. All the patients presented fever and dyspnea as well as thrombocytopenia and hypoxemia. Tachycardia, malaise, hypotension and lung rales occurred in 75 to 87.5% of the cases. Hemoconcentration, blood cell count increased and immature neutrophils, and high levels of creatinine were observed in 75 to 87.5%. Intravenous liquid infusion, the use of drugs for increasing systemic vascular resistance and inotropism, and mechanic ventilation were used for the patients. Mechanical ventilation and volume administration should be started precociously, preferable in intensive care units employing recommended universal and respiratory

  5. Free and Cued Memory in relation to Biomarker-Defined Abnormalities in Clinically Normal Older Adults and Those at Risk for Alzheimer’s Disease

    Science.gov (United States)

    Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically

  6. Cardiovascular effects of basal insulins.

    Science.gov (United States)

    Mannucci, Edoardo; Giannini, Stefano; Dicembrini, Ilaria

    2015-01-01

    Basal insulin is an important component of treatment for both type 1 and type 2 diabetes. One of the principal aims of treatment in patients with diabetes is the prevention of diabetic complications, including cardiovascular disease. There is some evidence, although controversial, that attainment of good glycemic control reduces long-term cardiovascular risk in both type 1 and type 2 diabetes. The aim of this review is to provide an overview of the potential cardiovascular safety of the different available preparations of basal insulin. Current basal insulin (neutral protamine Hagedorn [NPH], or isophane) and basal insulin analogs (glargine, detemir, and the more recent degludec) differ essentially by various measures of pharmacokinetic and pharmacodynamic effects in the bloodstream, presence and persistence of peak action, and within-subject variability in the glucose-lowering response. The currently available data show that basal insulin analogs have a lower risk of hypoglycemia than NPH human insulin, in both type 1 and type 2 diabetes, then excluding additional harmful effects on the cardiovascular system mediated by activation of the adrenergic system. Given that no biological rationale for a possible difference in cardiovascular effect of basal insulins has been proposed so far, available meta-analyses of publicly disclosed randomized controlled trials do not show any signal of increased risk of major cardiovascular events between the different basal insulin analogs. However, the number of available cardiovascular events in these trials is very small, preventing any clear-cut conclusion. The results of an ongoing clinical trial comparing glargine and degludec with regard to cardiovascular safety will provide definitive evidence. PMID:26203281

  7. Stress and atherosclerotic cardiovascular disease.

    Science.gov (United States)

    Inoue, Nobutaka

    2014-01-01

    Recent major advances in medical science have introduced a wide variety of treatments against atherosclerosis-based cardiovascular diseases, which has led to a significant reduction in mortality associated with these diseases. However, atherosclerosis-based cardiovascular disease remains a leading cause of death. Furthermore, progress in medical science has demonstrated the pathogenesis of cardiovascular disease to be complicated, with a wide variety of underlying factors. Among these factors, stress is thought to be pivotal. Several types of stress are involved in the development of cardiovascular disease, including oxidative stress, mental stress, hemodynamic stress and social stress. Accumulating evidence indicates that traditional risk factors for atherosclerosis, including diabetes, hyperlipidemia, hypertension and smoking, induce oxidative stress in the vasculature. Oxidative stress is implicated in the pathogenesis of endothelial dysfunction, atherogenesis, hypertension and remodeling of blood vessels. Meanwhile, mental stress is a well-known major contributor to the development of cardiovascular disease. The cardiovascular system is constantly exposed to hemodynamic stress by the blood flow and/or pulsation, and hemodynamic stress exerts profound effects on the biology of vascular cells and cardiomyocytes. In addition, social stress, such as that due to a lack of social support, poverty or living alone, has a negative impact on the incidence of cardiovascular disease. Furthermore, there are interactions between mental, oxidative and hemodynamic stress. The production of reactive oxygen species is increased under high levels of mental stress in close association with oxidative stress. These stress responses and their interactions play central roles in the pathogenesis of atherosclerosis-based cardiovascular disease. Accordingly, the pathophysiological and clinical implications of stress are discussed in this article.

  8. Significance of Cardiac Rehabilitation on Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Krutika Gajjar

    2012-06-01

    Full Text Available Considering the high mortality and morbidity rate associated with cardiovascular diseases, Cardiacrehabilitation (CR is regarded for prevention and management of cardiovascular diseases. CR servicesare generally provided in an outpatient as comprehensive, long-term programs involving medicalevaluation, prescribed exercise, cardiac risk factor modification, education and counseling. This includesnutritional therapies, weight loss program management of lipid abnormalities with diet and medication,blood pressure control, diabetes management and stress management. The exercise component of a totalapproach to rehabilitation helps to overcome the fears and anxieties that so many people experience aftera heart attack. Aerobic exercise training program improves cardiovascular fitness in both healthyindividual and cardiac patients. Cardiac rehabilitation prevents and treat cardiovascular disease, reducescardiac risk factors, improving patient’s exercise capacity and enhancing quality of life. Aerobicexercise with intensity of approximately 60 to 70% of the maximal heart rate for 30 to 60 minutes, 3 to 4times a week, for 4 to 6 weeks enhances exercise capacity.

  9. Síndrome pulmonar e cardiovascular por Hantavirus: aspectos epidemiológicos, clínicos, do diagnóstico laboratorial e do tratamento Hantavirus pulmonary and cardiovascular syndrome: epidemiology, clinical presentation, laboratory diagnosis and management aspects

    OpenAIRE

    Luiz Tadeu M. FIGUEIREDO; Gelse Mazzoni Campos; Fernando Bellissimo Rodrigues

    2001-01-01

    A síndrome pulmonar e cardiovascular por Hantavirus (SPCVH), é doença emergente com descrição crescente de casos no Brasil. Neste trabalho, estudou-se 8 casos confirmados da doença. Todos apresentaram febre e dispnéia. Taquicardia, astenia, hipotensão e estertoração pulmonar ocorreram em 75 a 87,5% dos casos. Plaquetopenia e hipoxemia ocorreram em 100% dos casos, hemoconcentração, leucocitose com desvio à esquerda e elevação de uréia e creatinina séricas em 75 a 87,5%. Assistência respiratóri...

  10. Positive Cardiovascular Health: A Timely Convergence.

    Science.gov (United States)

    Labarthe, Darwin R; Kubzansky, Laura D; Boehm, Julia K; Lloyd-Jones, Donald M; Berry, Jarett D; Seligman, Martin E P

    2016-08-23

    Two concepts, positive health and cardiovascular health, have emerged recently from the respective fields of positive psychology and preventive cardiology. These parallel constructs are converging to foster positive cardiovascular health and a growing collaboration between psychologists and cardiovascular scientists to achieve significant improvements in both individual and population cardiovascular health. We explore these 2 concepts and note close similarities in the measures that define them, the health states that they aim to produce, and their intended long-term clinical and public health outcomes. We especially examine subjective health assets, such as optimism, that are a core focus of positive psychology, but have largely been neglected in preventive cardiology. We identify research to date on positive cardiovascular health, discuss its strengths and limitations thus far, and outline directions for further engagement of cardiovascular scientists with colleagues in positive psychology to advance this new field.

  11. Positive Cardiovascular Health: A Timely Convergence.

    Science.gov (United States)

    Labarthe, Darwin R; Kubzansky, Laura D; Boehm, Julia K; Lloyd-Jones, Donald M; Berry, Jarett D; Seligman, Martin E P

    2016-08-23

    Two concepts, positive health and cardiovascular health, have emerged recently from the respective fields of positive psychology and preventive cardiology. These parallel constructs are converging to foster positive cardiovascular health and a growing collaboration between psychologists and cardiovascular scientists to achieve significant improvements in both individual and population cardiovascular health. We explore these 2 concepts and note close similarities in the measures that define them, the health states that they aim to produce, and their intended long-term clinical and public health outcomes. We especially examine subjective health assets, such as optimism, that are a core focus of positive psychology, but have largely been neglected in preventive cardiology. We identify research to date on positive cardiovascular health, discuss its strengths and limitations thus far, and outline directions for further engagement of cardiovascular scientists with colleagues in positive psychology to advance this new field. PMID:27539179

  12. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  13. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  14. Clinical applications of basic research that shows reducing skin tension could prevent and treat abnormal scarring: the importance of fascial/subcutaneous tensile reduction sutures and flap surgery for keloid and hypertrophic scar reconstruction.

    Science.gov (United States)

    Ogawa, Rei; Akaishi, Satoshi; Huang, Chenyu; Dohi, Teruyuki; Aoki, Masayo; Omori, Yasutaka; Koike, Sachiko; Kobe, Kyoko; Akimoto, Masataka; Hyakusoku, Hiko

    2011-01-01

    We use evidence-based algorithms to treat abnormal scarring, including keloids and hypertrophic scars (HSs). This involves a multimodal approach that employs traditional methods such as surgical removal, postoperative radiotherapy, corticosteroid injection, laser, and silicone gel sheets. As a result, the rate of abnormal scarring recurrence has decreased dramatically over the past 10 years. However, several problems remain to be solved. First, despite the optimization of a radiotherapy protocol, over 10% of cases who are treated with surgery and postoperative radiotherapy still recur in our facility. Second, the treatment options for cases with huge keloids are very limited. To address these problems, we performed basic research on the mechanisms that drive the formation of keloids and HSs. Extrapolation of these research observations to the clinic has led to the development of two treatment strategies that have reduced the rate of abnormal scar recurrence further and provided a means to remove large scars. Our finite element analysis of the mechanical force distribution around keloids revealed high skin tension at the keloid edges and lower tension in the keloid center. Moreover, when a sophisticated servo-controlled device was used to stretch wounded murine dorsal skin, it was observed that the stretched samples exhibited upregulated epidermal proliferation and angiogenesis, which are also observed in keloids and HSs. Real-time RT-PCR also revealed that growth factors and neuropeptides are more strongly expressed in cyclically stretched skin than in statically stretched skin. These findings support the well-established notion that mechanical forces on the skin strongly influence the cellular behavior that leads to scarring. These observations led us to focus on the importance of reducing skin tension when keloids/HSs are surgically removed to prevent their recurrence. Clinical trials revealed that subcutaneous/fascial tensile reduction sutures, which apply

  15. High-resolution computed tomography in patients with atypical 'cardiac' chest pain: a study investigating patients at 10-year cardiovascular risks defined by the Framingham and PROCAM scores

    Institute of Scientific and Technical Information of China (English)

    Choon Kiat ANG; Kui Hian SIM; Alan Yean Yip FONG; Sze Piaw CHIN; Tiong Kiam ONG; Seyfarth M Tobias; Wei Ling CHAN; Chee Khoon LIEW; Rapaee ANNUAR; Houng Bang LIEW

    2006-01-01

    Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score >400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores.

  16. Effect of aleglitazar on cardiovascular outcomes after acute coronary syndrome in patients with type 2 diabetes mellitus: the AleCardio randomized clinical trial

    NARCIS (Netherlands)

    Lincoff, A.M.; Tardif, J.C.; Schwartz, G.G.; Nicholls, S.J.; Ryden, L.; Neal, B.; Malmberg, K.; Wedel, H.; Buse, J.B.; Henry, R.R.; Weichert, A.; Cannata, R.; Svensson, A.; Volz, D.; Grobbee, D.E.; AleCardio, I.; Graaf, J. de

    2014-01-01

    IMPORTANCE: No therapy directed against diabetes has been shown to unequivocally reduce the excess risk of cardiovascular complications. Aleglitazar is a dual agonist of peroxisome proliferator-activated receptors with insulin-sensitizing and glucose-lowering actions and favorable effects on lipid p

  17. Abnormal protein aggregationand neurodegenerativediseases

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Abnormal protein aggregation or amyloid is the major cause ofmany neurodegenerative disorders. The present review focuses on the correlation between sequence and structure features of proteins related to the diseases and abnormal protein aggregation. Recent progress has improved our knowledge on understand-ing the mechanism of amyloid formation. We suggest a nucleation model for ordered protein aggregation, which can also explain pathogenesis mechanisms of these neurodegenerative diseases in vivo.

  18. Cardiovascular Risk and Mineral Bone Disorder in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Hagen Staude

    2013-03-01

    Full Text Available The term chronic kidney disease-mineral bone disorder has been coined recently to highlight that the disturbed mineral and bone metabolism is a major contributor to vascular calcification and finally cardiovascular disease. This syndrome is characterized by clinical, biochemical and/or histological findings, i.e. i biochemical alterations in the homeostasis of calcium, phosphate and their key player parathyroid hormone (PTH, Fibroblast growth factor-23 (FGF-23, klotho and vitamin-D, ii the occurrence of vascular and/or soft tissue calcification, and iii an abnormal bone structure and/or turnover. Apart from the combined and synergistic action of "traditional" and uremia-related risk factors, promoters and inhibitors of calcification have to be considered as well. This review will focus on the disturbed mineral metabolism as the triggering force behind distortion of vascular integrity and cardiovascular malfunction in CKD patients.

  19. Cardiovascular risk and mineral bone disorder in patients with chronic kidney disease.

    Science.gov (United States)

    Staude, Hagen; Jeske, Susann; Schmitz, Karin; Warncke, Gert; Fischer, Dagmar-Christiane

    2013-01-01

    The term chronic kidney disease-mineral bone disorder has been coined recently to highlight that the disturbed mineral and bone metabolism is a major contributor to vascular calcification and finally cardiovascular disease. This syndrome is characterized by clinical, biochemical and/or histological findings, i.e. i) biochemical alterations in the homeostasis of calcium, phosphate and their key player parathyroid hormone (PTH), Fibroblast growth factor-23 (FGF-23), klotho and vitamin-D, ii) the occurrence of vascular and/or soft tissue calcification, and iii) an abnormal bone structure and/or turnover. Apart from the combined and synergistic action of "traditional" and uremia-related risk factors, promoters and inhibitors of calcification have to be considered as well. This review will focus on the disturbed mineral metabolism as the triggering force behind distortion of vascular integrity and cardiovascular malfunction in CKD patients.

  20. Resveratrol and Cardiovascular Diseases

    Directory of Open Access Journals (Sweden)

    Dominique Bonnefont-Rousselot

    2016-05-01

    Full Text Available The increased incidence of cardiovascular diseases (CVDs has stimulated research for substances that could improve cardiovascular health. Among them, resveratrol (RES, a polyphenolic compound notably present in grapes and red wine, has been involved in the “French paradox”. RES is known for its antioxidant and anti-inflammatory properties and for its ability to upregulate endothelial NO synthase (eNOS. RES was able to scavenge •OH/O2•− and peroxyl radicals, which can limit the lipid peroxidation processes. Moreover, in bovine aortic endothelial cells (BAEC under glucose-induced oxidative stress, RES restored the activity of dimethylargininedimethylaminohydrolase (DDAH, an enzyme that degrades an endogenous inhibitor of eNOS named asymmetric dimethylarginine (ADMA. Thus, RES could improve •NO availability and decrease the endothelial dysfunction observed in diabetes. Preclinical studies have made it possible to identify molecular targets (SIRT-1, AMPK, Nrf2, NFκB…; however, there are limited human clinical trials, and difficulties in the interpretation of results arise from the use of high-dose RES supplements in research studies, whereas low RES concentrations are present in red wine. The discussions on potential beneficial effects of RES in CVDs (atherosclerosis, hypertension, stroke, myocardial infarction, heart failure should compare the results of preclinical studies with those of clinical trials.

  1. 鼻咽癌染色体1p末端结构异常及其临床意义的初步研究%Structural abnormalities of chromosome 1p termination in nasopharyngeal carcinoma and its clinical implications

    Institute of Scientific and Technical Information of China (English)

    黄铁军; 黄必军; 张林杰; 黄楚文; 梁启万; 方嬿

    2004-01-01

    BACKGROUND:Correlations between the structural abnormalities of chromosome 1pter in nasopharyngeal carcinoma(NPC) and its tumorigenesis and clinical significance are still unclear. OBJECTIVE: To investigate the correlations between the structural abnormalities of chromosome 1pter in NPC and the tumorigenesis of NPC. DESIGN:A retrospective study was performed to the control group according to the diagnosis. SETTING and PARTICIPANTS: The experiment was collected and completed in Reaearch Department of Sun Yat-Sen Cancer Center.Biopsy specimens from the nasopharynx of 65 cases of pathologically confirmed primary NPC without any therapy in the Sun Yat-Sen Univrsity Cancer Center were collected between the year 1998 and 2000 to survey. INTERVENTION: After the purification of cancerous cells from NPC biopsies with many noncancerous lymphocytes, interphase fluorescent in situ hybridization(FISH) and PCR-LOH/MI analysis of the somatic alterations of chromosomes 1pter in 65 cases of NPC biopsies were performed by using 1pter-related probe, TelVysion 1p, and telomere-linked microsatellite polymorphism site, D1S243,respectively. MAIN TOUCOME MEASURES: The abnormalities such as chromosome deletion, amplification and microsatellite instabilities(MI) and their clinical implications were examined and investigated. RESULTS:The somatic alterations of chromosome 1pter of NPC were detected in 20 of 65 cases with NPC, 8 of which showed allelic deletion,7 amplification and 5 both simultaneously.In available 44 patients with clinical stages, 2 of the 4 NPC cases in the early clinical stage were proved to be aberrations in chromosome 1pter, whereas 30.0% (12/40) of NPC patients in advanced clinical stage showed somatic structural aberrations of chromosome 1pter(χ 2=0.0655,P >0.05).PCR-LOH/MI analysis indicated that, out of the matched 31 NPC biopsies,16 had detectable aberrations, including 13 microsatellite instability(MI),2 homozygous deletion(HD) and 1 loss of heterozygosity

  2. The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines for Cardiopulmonary Bypass—Temperature Management during Cardiopulmonary Bypass

    Science.gov (United States)

    Engelman, Richard; Baker, Robert A.; Likosky, Donald S.; Grigore, Alina; Dickinson, Timothy A.; Shore-Lesserson, Linda; Hammon, John W.

    2015-01-01

    Abstract: To improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate. Authors adopted the American College of Cardiology/American Heart Association method for development clinical practice guidelines, and arrived at the following recommendation. PMID:26543248

  3. Clinical analysis of thyroid abnormalities in 55 children with Turner syndrome%55例Turner综合征患儿甲状腺异常临床分析

    Institute of Scientific and Technical Information of China (English)

    陈瑞敏; 张莹; 杨晓红; 林祥泉

    2013-01-01

    Objective Turner syndrome (TS) is characterized with reduced adult height and gonadal dysgenesis and associated with a number of complications including thyroid disease.The purpose of this study was to investigate the prevalence of thyroid diseases and the association between thyroid autoantibodies (TAA) and thyroid dysfunction,age,and karyotype.Methods Fifty-five girls with TS were diagnosed by chromosome analyses and were divided into 2 groups according to whether there was TAA-positive or not:TAA-positive group and TAA-negative group.Thyroid autoantibodies (antithyroglobulin antibody,thyroperoxidase antibody),thyroid function (free T3,free T4,and TSH) were determined with immunochemiluminescent.Ultrasound was applied in TAA-positive group.Results Thyroid functions in 34 TAA-negative girls were normal.Of the 21 TAA-positive girls (21/55,38.2%),7 girls suffered from hypothyroidism and 3 girls had hyperthyroidism.All of 21 TAA-positive girls were diagnosed as cases of Hashimoto's thyroiditis.As compared with the girls in TAA-negative group,the age of girls in TAA-positive group was significantly higher [(12.16 ± 2.55 vs 9.95 ± 4.50) years,P<0.05].6 cases under 5 years old were TAA-negative.31.3 % (5/16) of patients aged 5-10 years old,48.1% (13/27) aged 10-15 years old and 50.0% (3/6) above the age of 15 were TAA-positive.There were no significant differences in the numbers of TAApositive cases among different karyotypes (P > 0.05).Thyroid ultrasound in girls with positive-TAA showed the abnormal echogenicity in bilateral lobus lateralis of thyroid.Conclusion Patients with TS are prone to suffer from Hashimoto's thyroiditis leading to thyroid dysfunction,when they are older than 5 years.Thyroid function should be evaluated yearly in girls with TS after 5 years old.There is no specific association between the incidence of autoimmune thyroid disease and certain karyotypes.%目的 观察Turner综合征(TS)患儿甲状腺异常的发生率、甲状腺

  4. Clinical study in diagnosis placental implantation abnormality with Transvaginal Doppler ul-trasound%经腹彩超诊断胎盘植入的临床研究

    Institute of Scientific and Technical Information of China (English)

    卜凡文; 沈树娜

    2015-01-01

    Objective To evaluate the ultra sonographic charateristics and the diagnostic value in placental implanta-tion abnormality ( PIA) with transvaginal Doppler ultrasound, improve the rate of diagnosis accuracy in the prenatal and postnatal of PIA with transvaginal Doppler ultrasound, for early diagnosis and treatment,to avoid hysterectomy beacuse of fatally and heavy bleeding. Method There were 61 cases complicated with PIA by operation and patho-logically confirmed in our hospital. 33 cases were Prenatal PIA, 28 cases were postnatal PIA. To discuss sonograph-ic charateristics, and analysis the Sensitivity and missed diagnosis of transvaginal Doppler ultrasound contrasted with surgery pathology. Result Muscular layer of the placenta has abundant signals of blood flow, this was major sono-graphic performance in prenatal PIA, incidence rate was 85. 7%, followed by whirlpool in placenta and plancental invasion;placental remnants was major sonographic performance in postpartum PIA, incidence rate was 100%, fol-lowed by abundant signals of blood flow in muscular layer of the placenta and boundary was disappear between mus-cular layer and placenta. There were 14 cases by transvaginal Doppler ultrasound diagnosed prenatal PIA accurate-ly, sensitivity was 42. 4%, false negative rate was 57. 6%. There were 21 cases by transvaginal Doppler ultrasound diagnosed postnatal PIA accurately, sensitivity was 75. 0%, false negative rate was 25. 0%. Conclusion Specificity is low in Prenatal PIA by transvaginal Doppler ultrasound, false negative rate is higher. if necessary,to improve the diagnostic accuracy combination with MRI. Specificity is higher in postnatal PIA, false negative rate is low. The Ul-trasonography of PIA has certain characteristics, strengthen the consciousness of the diagnosis in PIA, especially in the prenatal, To do a good job of auxiliary diagnosis in PIA.%目的:探讨经腹彩超诊断胎盘植入的声像图特点和诊断价值,提高经腹彩超在产前

  5. Nanomedicine: Addressing Cardiovascular Disease and Cardiovascular Tissue Regeneration

    Science.gov (United States)

    Botchwey, Edward A.

    2016-01-01

    Cardiovascular disease is becoming an increasingly significant problem. In attempts to overcome many of the traditional hurdles of cardiovascular disease treatment, therapeutic approaches have been gradually moving beyond an exclusive focus on orally delivered drugs towards the development of nanoscale applications. These technologies exploit molecular scale events to improve drug and gene delivery applications, enhance preventative medicine and diagnostic strategies, and create biomimicking substrates for vascular tissue engineering. As nanoscale treatments enter the arena of clinical medicine, new ways of thinking about and routes for applying nanomedicine to cardiovascular health issues are emerging. With focuses on drug delivery, gene therapy, and biomimetics, this article will provide a comprehensive review of various nanomedicine applications for combating atherosclerosis and for improving upon current vascular tissue engineering designs.

  6. Abnormal Blood Glucose as a Prognostic Factor for Adverse Clinical Outcome in Children Admitted to the Paediatric Emergency Unit at Komfo Anokye Teaching Hospital, Kumasi, Ghana

    Directory of Open Access Journals (Sweden)

    Emmanuel Ameyaw

    2014-01-01

    Full Text Available Dysglycaemia (hyper- or hypoglycaemia in critically ill children has been associated with poor outcome. We compared the clinical outcomes in children admitted to Pediatric Emergency Unit (PEU at Komfo Anokye Teaching Hospital (KATH for acute medical conditions and presenting with euglycaemia or dysglycaemia. This is a prospective case matching cohort study. Eight hundred subjects aged between 3 and 144 months were screened out of whom 430 (215 with euglycaemia and 215 with dysglycaemia were enrolled. The median age was 24 months (range: 3–144 months. In the dysglycaemia group, 28 (13% subjects had hypoglycemia and 187 (87% had hyperglycemia. Overall, there were 128 complications in 116 subjects. The number of subjects with complications was significantly higher in dysglycaemia group (n=99, 46% compared to euglycaemia group (n=17, 8% (P<0.001. Forty subjects died out of whom 30 had dysglycaemia (P=0.001. Subjects with dysglycaemia were 3 times (95% CI: 1.5–6.0 more likely to die and 4.8 times (95% CI: 3.1–7.5 more likely to develop complications (P=0.001. Dysglycaemia is associated with increased morbidity and mortality in children with acute medical conditions and should lead to intensive management of the underlying condition.

  7. Cardiovascular System

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    2009428 Association between smoking status at follow-up and clinical outcomes in patients undergoing successful percutaneous coronary intervention. ZHU Zhongyu,et al.Dept Cardiol,Henan Prov People’s Hosp,Zhengzhou 450003.Chin J Cardiol 2009;37(9):777-780. Objective To assess the association between smoking

  8. CARDIOVASCULAR SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    2004474 Clinical efficacy and safety of torasemide in congestive heart failure patients. Li Yishi (李一石), et al. Dept Clin Pharmacol, Cardiovasc Instit & Fuwai Hosp, CAMS & PUMC,Beijing 100037. Chin Cir J 2004;19(4):290-293.

  9. Cardiovascular System

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    6.1.Heart failure2005329 Early impairment of renal function inchronic heart failure and its clinical significance.JINZhengming(金争鸣),et al.Dept Cardiol,The 1st AffiliHosp,Med Coll,Zhejiang Univ,Hangzhou 310003.Chin J Intern Med 2005;44(4):262-264

  10. Cardiovascular System

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010416 The clinical characteristics and prognosis of non-ST segment elevation acute coronary syndrome in different genders.SHAO Chunli(邵春丽),et al.Fuwai Hosp, Beijing 100037.Chin J Intern Med 2010;49(9):754-757. Objective To determine gender differences in base-line

  11. CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (the CORDIOPREV study): Rationale, methods, and baseline characteristics: A clinical trial comparing the efficacy of a Mediterranean diet rich in olive oil versus a low-fat diet on cardiovascular disease in coronary patients.

    Science.gov (United States)

    Delgado-Lista, Javier; Perez-Martinez, Pablo; Garcia-Rios, Antonio; Alcala-Diaz, Juan F; Perez-Caballero, Ana I; Gomez-Delgado, Francisco; Fuentes, Francisco; Quintana-Navarro, Gracia; Lopez-Segura, Fernando; Ortiz-Morales, Ana M; Delgado-Casado, Nieves; Yubero-Serrano, Elena M; Camargo, Antonio; Marin, Carmen; Rodriguez-Cantalejo, Fernando; Gomez-Luna, Purificacion; Ordovas, Jose M; Lopez-Miranda, Jose; Perez-Jimenez, Francisco

    2016-07-01

    Coronary heart disease (CHD) represents a major global health burden. However, despite the well-known influence that dietary habits exert over the progression of this disease, there are no well-established and scientifically sound dietary approaches to prevent the onset of clinical outcomes in secondary prevention. The objective of the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study, clinical trials number NCT00924937) is to compare the ability of a Mediterranean diet rich in virgin olive oil versus a low-fat diet to influence the composite incidence of cardiovascular events after 7 years in subjects with documented CHD at baseline. For this purpose, we enrolled 1,002 coronary patients from Spain. Baseline assessment (2009-2012) included detailed interviews and measurements to assess dietary, social, and biological variables. Results of baseline characteristics: The CORDIOPREV study in Spain describes a population with a high body mass index (37.2% overweight and 56.3% obesity) and with a median of low-density lipoprotein cholesterol of 88.5 mg/dL (70.6% of the patients having Mediterranean diet rich in extra virgin olive oil as compared with a low-fat diet on the incidence of CHD recurrence in a long-term follow-up study. PMID:27297848

  12. CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (the CORDIOPREV study): Rationale, methods, and baseline characteristics: A clinical trial comparing the efficacy of a Mediterranean diet rich in olive oil versus a low-fat diet on cardiovascular disease in coronary patients.

    Science.gov (United States)

    Delgado-Lista, Javier; Perez-Martinez, Pablo; Garcia-Rios, Antonio; Alcala-Diaz, Juan F; Perez-Caballero, Ana I; Gomez-Delgado, Francisco; Fuentes, Francisco; Quintana-Navarro, Gracia; Lopez-Segura, Fernando; Ortiz-Morales, Ana M; Delgado-Casado, Nieves; Yubero-Serrano, Elena M; Camargo, Antonio; Marin, Carmen; Rodriguez-Cantalejo, Fernando; Gomez-Luna, Purificacion; Ordovas, Jose M; Lopez-Miranda, Jose; Perez-Jimenez, Francisco

    2016-07-01

    Coronary heart disease (CHD) represents a major global health burden. However, despite the well-known influence that dietary habits exert over the progression of this disease, there are no well-established and scientifically sound dietary approaches to prevent the onset of clinical outcomes in secondary prevention. The objective of the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study, clinical trials number NCT00924937) is to compare the ability of a Mediterranean diet rich in virgin olive oil versus a low-fat diet to influence the composite incidence of cardiovascular events after 7 years in subjects with documented CHD at baseline. For this purpose, we enrolled 1,002 coronary patients from Spain. Baseline assessment (2009-2012) included detailed interviews and measurements to assess dietary, social, and biological variables. Results of baseline characteristics: The CORDIOPREV study in Spain describes a population with a high body mass index (37.2% overweight and 56.3% obesity) and with a median of low-density lipoprotein cholesterol of 88.5 mg/dL (70.6% of the patients having oil as compared with a low-fat diet on the incidence of CHD recurrence in a long-term follow-up study.

  13. Cardiovascular side effects of psychopharmacologic therapy.

    Science.gov (United States)

    Potočnjak, Ines; Degoricija, Vesna; Vukičević Baudoin, Dina; Čulig, Josip; Jakovljević, Miro

    2016-09-15

    WHO defined in 1976 psychopharmaca as drugs affecting psychological functions, behaviour and self-perception. Psychopharmacology is the study of pharmacological agents that affect mental and emotional functions. Creative approach to psychopharmacotherapy reflects a transdisciplinary, integrative and person-centered psychiatry. Psychiatric disorders often occur in cardiac patients and can affect the clinical presentation and morbidity. Cardiovascular (CV) side effects (SE) caused by psychopharmaceutic agents require comprehensive attention. Therapeutic approach can increase placebo and decrease nocebo reactions. The main purpose of this review is to comprehend CV SE of psychotropic drugs (PD). Critical overview of CV SE of PD will be presented in this review. Search was directed but not limited to CV effects of psychopharmacological substances, namely antipsychotics, anxiolytics, hypnotics, sedatives, antidepressants and stimulants. Literature review was performed and data identified by searches of Medline and PubMed for period from 2004 to 2015. Only full articles and abstracts published in English were included. SE of PD are organized according to the following types of CV effects: cardiac and circulatory effects, abnormalities of cardiac repolarisation and arrhythmias and heart muscle disease. There is wide spectrum and various CV effects of PD. Results of this review are based on literature research. The reviewed data came largely from prevalence studies, case reports, and cross-sectional studies. Psychopharmacotherapy of psychiatric disorders is complex and when concomitantly present with CV disease, presentation of drug SEs can significantly contribute to illness course. Further development of creative psychopharmacotherapy is required to deal with CV effects of PD. PMID:27352209

  14. Clinical predictors of abnormal esophageal pH monitoring in preterm infants Preditores clínicos para pHmetria esofágica anormal em prematuros

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Mezzacappa

    2008-09-01

    Full Text Available BACKGROUND: Risk factors for gastroesophageal reflux disease in preterm neonates have not been yet clearly defined. AIM: To identify factors associated with increased esophageal acid exposition in preterm infants during the stay in the neonatal unit. METHODS: A case-control study in preterm infants who had undergone prolonged monitoring of distal esophageal pH, following clinical indication. Eighty-seven preterms with reflux index (percentage of total time of esophageal pHmetry >10% (cases and 87 unpaired preterms were selected with reflux index 10% in preterms were: vomiting, regurgitation, Apnea, female gender. The variables that were associated with a lower frequency of increased reflux index were: volume of enteral intake at the onset of symptoms >147 mL/kg/day, and postnatal corticoid use. CONCLUSIONS: Vomiting, regurgitation, apnea, female gender and acute respiratory distress during the first week of life were variables predictive of increased esophageal acid exposition in preterm infants with birthweight 10%.RACIONAL: Os fatores de risco para a doença pelo refluxo gastroesofágico em recém-nascidos prematuros não foram, até momento, claramente estabelecidos. OBJETIVO: Identificar fatores associados ao aumento da exposição ácida intra-esofágica em prematuros durante o período de internação em unidade neonatal. MÉTODOS: Realizou-se estudo de caso controle com prematuros que realizaram monitorização prolongada do pH esofágico por suspeita clínica de doença do refluxo. Foram selecionados 87 recém-nascidos com valor do índice de refluxo (percentual do tempo total do exame com pH abaixo de 4 >10% (casos e 87 recém-nascidos com índice de refluxo 10% foram: vômitos, regurgitações, apnéia, sexo feminino e insuficiência respiratória na 1ª semana de vida. As variáveis que se associaram a menor freqüência de índice de refluxo 147mL/kg/d e uso de corticóide pós-natal. CONCLUSÕES: Vômitos, regurgitações, apn

  15. THE ACTION TO CONTROL CARDIOVASCULAR RISK IN DIABETES (ACCORD) TRIAL AND HURRICANE KATRINA: LESSONS FOR MANAGING CLINICAL TRIALS DURING AND AFTER A NATURAL DISASTER

    OpenAIRE

    McDuffie, Roberta; Summerson, John; Reilly, Patricia; Blackwell, Caroline; Goff, David; Kimel, Angela R.; Crago, Lenore; Fonseca, Vivian

    2008-01-01

    Hurricane Katrina was one of the most catastrophic natural disasters to hit the United States. It had a major impact on health care in New Orleans, LA and the surrounding region, not only in relation to acute illness but also chronic disease. When Hurricane Katrina struck New Orleans on August 29, 2005, there were 193 participants being followed in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial at Tulane University Health Sciences Center. In the immediate aftermath of th...

  16. Nuclear imaging of cardiovascular disease

    International Nuclear Information System (INIS)

    Nuclear imaging methods provide noninvasive indexes of myocardial function, perfusion, and metabolism and are well accepted in clinical cardiology. Advances in prevention and treatment of cardiac disease have resulted in decreasing cardiovascular mortality in industrialized nations. The improvement in therapeutic options has increased the demand for diagnostic tests that might guide clinical decision making. Information beyond the pure anatomic characterization of coronary stenoses is required. Nuclear imaging can be used for early detection and monitoring of the severity and extent of disease. The prognostic potential of such functional testing is being increasingly appreciated and used to guide therapy, thereby resulting in improvement of the quality and cost-effectiveness of the workup of patients with cardiovascular disease. Extensive clinical validation has resulted in growing acceptance of these techniques. Furthermore, ongoing improvement of imaging techniques and development of new radiopharmaceuticals will pave the way for disease-specific, molecular-targeted cardiac imaging in the future. (orig.)

  17. Rho kinases in cardiovascular physiology and pathophysiology.

    Science.gov (United States)

    Loirand, Gervaise; Guérin, Patrice; Pacaud, Pierre

    2006-02-17

    Rho kinases (ROCKs) are the first and the best-characterized effectors of the small G-protein RhoA. In addition to their effect on actin organization, or through this effect, ROCKs have been found to regulate a wide range of fundamental cell functions such as contraction, motility, proliferation, and apoptosis. Abnormal activation of the RhoA/ROCK pathway has been observed in major cardiovascular disorders such as atherosclerosis, restenosis, hypertension, pulmonary hypertension, and cardiac hypertrophy. This review, based on recent molecular, cellular, and animal studies, focuses on the current understanding of ROCK signaling and its roles in cardiovascular physiology and pathophysiology.

  18. Covert hypothyroidism presenting as a cardiovascular event.

    Science.gov (United States)

    LeMar, H J; West, S G; Garrett, C R; Hofeldt, F D

    1991-11-01

    Hypothyroidism presenting with classic signs and symptoms is generally easily recognized. Less often, patients with hypothyroidism may present with symptoms and laboratory abnormalities suggestive of cardiovascular disease. In this article, we describe six such patients. Hypothyroidism was suspected when creatine phosphokinase (CPK) levels were persistently elevated. The diagnosis was confirmed by thyroid function tests, and thyroid hormone therapy resulted in resolution of symptoms and CPK elevations. Persistently elevated CPK levels associated with cardiovascular symptoms but without demonstrable myocardial damage should prompt consideration of covert hypothyroidism. PMID:1951418

  19. Hyperhomocysteinemia and Cardiovascular Disease: A Transitory Glance

    Directory of Open Access Journals (Sweden)

    Rohilla Ankur

    2012-06-01

    Full Text Available Hyperhomocysteinemia (Hhcy is a medical condition characterized by abnormally large levels of homocysteine in blood. The involvement of homocysteine (Hcy in various biochemical reactions causes deficiencies of the vitamins like pyridoxine (B6, folic acid (B9, or B12 leading to higher Hcy levels. Hhcy has been considered as an independent risk factor for various cardiovascular diseases like endothelial dysfunction, vascular inflammation, atherosclerosis, hypertension, cardiac hypertrophy and heart failure. The review article critically explains about the mechanisms involved in the Hhcy-induced development and progression of various cardiovascular disorders

  20. Double blind randomized clinical trial controlled by placebo with a FOS enriched cookie on saciety and cardiovascular risk factors in obese patients

    Directory of Open Access Journals (Sweden)

    D. A. de Luis

    2013-02-01

    Full Text Available Introduction: It is essential to determine which snack foods are most affective for appetite control. The objective of the current study was to assess the responses of two different cookies on satiety and cardiovascular risk factors. Material and Methods: 38 patients were randomized: group I (FOS enriched cookie, n=19 and group II (control cookie, n=19. Previous and after 1 month , the subjects rated their feelings of satiety/hunger with a test meal of 5 cookies. Results: After the test meal, the basal area under curve of the first hunger/satiety score was higher with satiety cookie than with control cookie, the data after 1 month of treatment was higher with satiety cookie than with control cookie, too. The score was higher than the fasting level for 20 minutes with satiety cookie and for 40 minutes with the same cookie, too. In satiety group, these scores (20 min and 40 min were higher than control group before and after 1 month of treatment. The results were in the same way with the 100 mm 5-point visual satiety scale. Cardiovascular risk factors and dietary intake remained unchanged after dietary intervention. Conclusion: A FOS enriched cookie produced greater ratings of satiety than a control cookie, without effects on cardiovascular risk factors or dietary intakes.

  1. Prevalence of asymptomatic urinary abnormalities among adolescents

    Directory of Open Access Journals (Sweden)

    Mohamed Fouad

    2016-01-01

    Full Text Available To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1% individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8% at the second screening, (P <0.001. Hematuria was the most common urinary abnormalities detected in 245 (9.8% adolescents who had persistent urine abnormalities; 228 (9.1% individuals had non glomerular hematuria. The hematuria was isolated in 150 (6% individuals, combined with leukocyturia in 83 (3.3% individuals, and combined with proteinuria in 12 (0.5% individuals. Leukocyturia was detected in 150 (6% of all studied adolescents; it was isolated in 39 (1.6% individuals and combined with proteinuria in 28 (1.1% of them. Asymp- tomatic bacteriuria was detected in 23 (0.9% of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6% of all the studied adolescents; 45 (1.8% indivi- duals had <0.5 g/day and twenty (0.8% individuals had 0.5-3 g/day. Asymptomatic urinary abnormalities were more common in males than females and adolescents from rural than urban areas (P <0.01 and (P <0.001, respectively. The present study found a high prevalence of asymptomatic urinary abnormalities among adolescents in our population.

  2. [Future directions of cardiovascular surgery in China].

    Science.gov (United States)

    Hu, S S

    2016-08-01

    The cardiovascular surgery in China has achieved great progress both on scale and technology though development over the past thirty years. However, the technical predominance of cardiovascular surgery in therapies for some diseases has been weakened, along with developments of new drugs and interventional technology. Besides, the change of doctor-patient relationship result from internet medical information service and less attraction of cardiovascular surgery discipline to talents bring certain challenge to the development of cardiovascular surgery. Currently, cardiovascular surgeons should practice the "patient first" principle, carry out individual customized treatment and precision therapy, absorb the advantages of other subjects like intervention and imaging in order to achieve technological breakthroughs, create new treatment technologies and models with smaller trauma and better outcome, establish heart team to provide patient oriented treatment. Besides, cardiovascular surgeons should improve knowledge system by learning related technology and science, become hybrid doctors of research. Cardiovascular surgeons should pay high attention to critical effect of research on the disciplinary development, carry out question and demand oriented clinical studies, change the medical practice by virtue of research achievements, direct the treatment for cardiovascular diseases, and finally provide better health service and rebuild the predominance of cardiovascular surgery. PMID:27502127

  3. [Hair shaft abnormalities].

    Science.gov (United States)

    Itin, P H; Düggelin, M

    2002-05-01

    Hair shaft disorders may lead to brittleness and uncombable hair. In general the hair feels dry and lusterless. Hair shaft abnormalities may occur as localized or generalized disorders. Genetic predisposition or exogenous factors are able to produce and maintain hair shaft abnormalities. In addition to an extensive history and physical examination the most important diagnostic examination to analyze a hair shaft problem is light microscopy. Therapy of hair shaft disorders should focus to the cause. In addition, minimizing traumatic influences to hair shafts, such as dry hair with an electric dryer, permanent waves and dyes is important. A short hair style is more suitable for such patients with hair shaft disorders.

  4. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje;

    2014-01-01

    was performed. MRI assessment included age-related white matter changes (ARWMC) grading (mild, moderate, severe according to the Fazekas' scale), count of lacunar and non-lacunar infarcts, and global atrophy rating. Of the 633 (out of the 639 enrolled) patients with follow-up information (mean age 74.1 ± 5......, presence and number of neurological examination abnormalities predicted global functional decline independent of MRI lesions typical of the aging brain and other determinants of disability in the elderly. Systematically checking for neurological examination abnormalities in older patients may be cost...

  5. Clinical application of safflower yellow in treatment of cardiovascular and cerebral vessels diseases%红花黄色素在心脑血管系统疾病治疗中的应用进展

    Institute of Scientific and Technical Information of China (English)

    袁靖(综述); 陈卫东(审校)

    2015-01-01

    红花黄色素是中药红花中的主要活性成分,具有活血化瘀的功效,临床研究发现其对心脑血管疾病有显著疗效。文中对近年红花黄色素在临床治疗心绞痛、高血脂、脑梗死、椎动脉型颈椎病方面的应用进行了综述,为临床应用红花黄色素治疗心脑血管疾病提供参考。%Safflower Yellow is the essential component of Chinese traditional medicine Carthamus tinctorius with the effect of promoting blood circulation and removing blood stasis .Clinical studies have found its obvious curative effect in cardiovascular and cere -bral vascular diseases .Clinical treatment of angina , hyperlipidemia , cerebral infraction and arterial type cervical spondylosis in recent years was reviewed , which can provide references for treatment of cardiovascular diseases with Safflower Yellow .

  6. Chromosomal abnormalities in patients with sperm disorders

    Directory of Open Access Journals (Sweden)

    L. Y. Pylyp

    2013-02-01

    Full Text Available Chromosomal abnormalities are among the most common genetic causes of spermatogenic disruptions. Carriers of chromosomal abnormalities are at increased risk of infertility, miscarriage or birth of a child with unbalanced karyotype due to the production of unbalanced gametes. The natural selection against chromosomally abnormal sperm usually prevents fertilization with sperm barring in cases of serious chromosomal abnormalities. However, assisted reproductive technologies in general and intracytoplasmic sperm injection in particular, enable the transmission of chromosomal abnormalities to the progeny. Therefore, cytogenetic studies are important in patients with male factor infertility before assisted reproduction treatment. The purpose of the current study was to investigate the types and frequencies of chromosomal abnormalities in 724 patients with infertility and to estimate the risk of chromosomal abnormalities detection in subgroups of patients depending on the severity of spermatogenic disruption, aiming at identifying groups of patients in need of cytogenetic studies. Karyotype analysis was performed in 724 blood samples of men attending infertility clinic. Chromosomal preparation was performed by standard techniques. At least 20 GTG-banded metaphase plates with the resolution from 450 to 750 bands per haploid set were analysed in each case. When chromosomal mosaicism was suspected, this number was increased to 50. Abnormal karyotypes were observed in 48 (6.6% patients, including 67% of autosomal abnormalities and 33% of gonosomal abnormalities. Autosomal abnormalities were represented by structural rearrangements. Reciprocal translocations were the most common type of structural chromosomal abnormalities in the studied group, detected with the frequency of 2.6% (n = 19, followed by Robertsonian translocation, observed with the frequency of 1.2% (n = 9. The frequency of inversions was 0.6% (n = 4. Gonosomal abnormalities included 14 cases

  7. Cardiovascular consequences of diabetes mellitus

    NARCIS (Netherlands)

    C.A. Baan (Caroline)

    1999-01-01

    textabstractDiabetes mellitus comprises a clinically and genetically heterogeneous group of disorders that have one common feature: abnormally high levels of glucose in the blood. The most common form is non-insulin dependent diabetes mellitus (NlDDM); about 80-90% of all diabetic patients has NlDDM

  8. A型肉毒毒素注射除皱致面部表情异常的临床研究%Clinical research of facial abnormal expressions caused by Botulinum toxin A injection

    Institute of Scientific and Technical Information of China (English)

    孙瑛; 孙玉萍; 于波; 白秀文

    2012-01-01

    Objective Observing characteristics of facial abnormal expressions caused by Botulinum toxin A injection. Through communication skills, injection drug selection, injection skills to avoid or reduce the adverse events, reduce the incidence of the medical disputes . Methods The patients were divided into crow's-feet groups,Look-up wrinkle groups, glabellum wrinkle groups , Respectively observed the chara-cteristics of abnormal expressions.according to the results, selecting clinical skills.Results To reduce the incidence of the medical disputes,it is necessary that fully communication before injection , legal botulinum toxin , clinical skills and remedial measure after injection. Conclusion Although botulinum toxin injection is simple to implement and effective, the aesthetic doctor must pay attention to the selection of preoperative indication , good communication skills in injection, summarizing experience.%目的:观察A型肉毒毒素注射除皱致面部表情异常的发生特点,从沟通技巧、注射药物选择、注射技巧等方面避免或减轻该不良反应的发生,减少由此而引起的医疗纠纷.方法:将接受注射除皱治疗的患者分为鱼尾纹组、眉间纹组、额纹组,分别观察各组出现表情异常的特点,有针对地运用临床技巧.结果:注射前充分沟通、使用正规合法的肉毒毒素制品、注射部位与剂量的巧妙结合及注射后及时采取有效的补救措施,可大大降低注射后表情异常的发生.结论:A型肉毒毒素注射美容操作简单,效果立竿见影,但美容主诊医生切不可麻痹大意,应注意术前适应证的严格选择及良好沟通,在注射技巧上总结经验,方能将注射后表情异常的不良反应降到最低.

  9. Cannabinoids as therapeutic agents in cardiovascular disease: a tale of passions and illusions.

    Science.gov (United States)

    Mendizábal, V E; Adler-Graschinsky, E

    2007-06-01

    In addition to their classical known effects, such as analgesia, impairment of cognition and learning and appetite enhancement, cannabinoids have also been related to the regulation of cardiovascular responses and implicated in cardiovascular pathology. Elevated levels of endocannabinoids have been related to the extreme hypotension associated with various forms of shock as well as to the cardiovascular abnormalities that accompany cirrhosis. In contrast, cannabinoids have also been associated with beneficial effects on the cardiovascular system, such as a protective role in atherosclerosis progression and in cerebral and myocardial ischaemia. In addition, it has also been suggested that the pharmacological manipulation of the endocannabinoid system may offer a novel approach to antihypertensive therapy. During the last decades, the tremendous increase in the understanding of the molecular basis of cannabinoid activity has encouraged many pharmaceutical companies to develop more potent synthetic cannabinoid analogues and antagonists, leading to an explosion of basic research and clinical trials. Consequently. not only the synthetic THC dronabinol (Marinol) and the synthetic THC analogue nabilone (Cesamet) have been approved in the United States, but also the standardized cannabis extract (Sativex) in Canada. At least three strategies can be foreseen in the future clinical use of cannabinoid-based drugs: (a) the use of CB(1) receptor antagonists, such as the recently approved rimonabant (b) the use of CB(2)-selective agonists, and (c) the use of inhibitors of endocannabinoid degradation. In this context, the present review examines the effects of cannabinoids and of the pharmacological manipulation of the endocannabinoid system, in cardiovascular pathophysiology. PMID:17450170

  10. Vitamin D and Risk of Neuroimaging Abnormalities.

    Directory of Open Access Journals (Sweden)

    Thomas J Littlejohns

    Full Text Available Vitamin D deficiency has been linked with an increased risk of incident all-cause dementia and Alzheimer's disease. The aim of the current study was to explore the potential mechanisms underlying these associations by determining whether low vitamin D concentrations are associated with the development of incident cerebrovascular and neurodegenerative neuroimaging abnormalities. The population consisted of 1,658 participants aged ≥65 years from the US-based Cardiovascular Health Study who were free from prevalent cardiovascular disease, stroke and dementia at baseline in 1992-93. Serum 25-hydroxyvitamin D (25(OHD concentrations were determined by liquid chromatography-tandem mass spectrometry from blood samples collected at baseline. The first MRI scan was conducted between 1991-1994 and the second MRI scan was conducted between 1997-1999. Change in white matter grade, ventricular grade and presence of infarcts between MRI scan one and two were used to define neuroimaging abnormalities. During a mean follow-up of 5.0 years, serum 25(OHD status was not significantly associated with the development of any neuroimaging abnormalities. Using logistic regression models, the multivariate adjusted odds ratios (95% confidence interval for worsening white matter grade in participants who were severely 25(OHD deficient (<25 nmol/L and deficient (≥25-50 nmol/L were 0.76 (0.35-1.66 and 1.09 (0.76-1.55 compared to participants with sufficient concentrations (≥50 nmol/L. The multivariate adjusted odds ratios for ventricular grade in participants who were severely 25(OHD deficient and deficient were 0.49 (0.20-1.19 and 1.12 (0.79-1.59 compared to those sufficient. The multivariate adjusted odds ratios for incident infarcts in participants who were severely 25(OHD deficient and deficient were 1.95 (0.84-4.54 and 0.73 (0.47-1.95 compared to those sufficient. Overall, serum vitamin D concentrations could not be shown to be associated with the development of

  11. Family history of vascular disease and the risk of cardiovascular events

    NARCIS (Netherlands)

    Weijmans, M.

    2015-01-01

    A positive family history of cardiovascular disease is an established risk factor for the development of cardiovascular disease. In clinical practice, this evident relation between the presence of cardiovascular disease in families and first cardiovascular events has resulted in family history being

  12. Semen abnormalities :Clinical investigation(Ⅱ)

    Institute of Scientific and Technical Information of China (English)

    Edson Gurfinkel; Agnaldo P. Cedenho; Ysao Yamamura; Miguel Srougi

    2004-01-01

    @@ ◆ Results All patients completed the treatment, indicating a good patient tolerance to the procedure. However, statistical analysis was performed with 8 patients in the Study Group. One was excluded on account of incomplete seminal data.

  13. Cardiovascular Response to High Altitude Hypoxia

    OpenAIRE

    Manchanda, S C

    1984-01-01

    Normal and abnormal cardiovascular response to high altitude (HA) hypoxia were studied in 98 healthy subjects and in 15 patients with HA pulmonary oedema (HAPO) and acute mountain sickness (AMS) at an altitudeof 3,658 m. The healthy sea level (SL) residents showed marked blood volume changes during the first week with pulmonary hypotension and depression of left ventricular (LV) performance and physical work capacity (PWC). The HA natives, however, had better LV performance and PWC indicating...

  14. Clinical observation of MTA applied to the preventive pulp capping of premolar abnormal central cusp%MTA在前磨牙畸形中央尖预防性盖髓术中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵献平; 徐芳

    2015-01-01

    Objective To observe the clinical effect of MTA applied to preventive pulp capping of prenmolar abnormal central cusp.Methods 78 unifected premolar steep abnormal central cusp teeth collected from 66 case were treated in our department of our hospital during June in 2011 to June in 2013.They were randomly divided into two groups .MTA was used in preventive pulp capping in the experimental group while Dycal was applied in the control group.At each (3、6、12months and two group),the teeth were assessed dimically to evaluate clinical effect.Results After three months ,the treatment success rate of the MTA group was 97% and the treatment success rate of the Dycal group was 95%.There was no statistically significant difference at the shot term clinical effect between the two groups(P>0.05).After two years ,the treatment success rate of the MTA group was 95% and the treatment success rate of the Dycal group was 72% ,The long term clinical effect of the treatment with MTA was better than Dycal in preventive pulp capping(P<0.05). Conclusion MTA applied to the preventive pulp capping of central cusp deformity is a better way.%目的:观察MTA在前磨牙畸形中央尖预防性盖髓术中的疗效。方法选择2011年7月~2013年7月在我科就诊的未感染前磨牙高陡畸形中央尖患者66例牙齿78颗,随机分为两组,分别用MTA和氢氧化钙进行预防性盖髓,术后3、6、12个月及2年后复查,观察疗效,评价疗效。结果术后3个月复查,MTA组成功率为97%,Dycal组成功率为95%,比较两组近期疗效,差异无统计学意义(P>0.05),术后2年复查, MTA组成功率为95%,Dycal组为72%,比较两组之间远期疗效,MTA组明显高于Dycal组,差异有统计学意义(P<0.05)。结论应用MTA行前磨牙畸形中央尖预防性盖髓术是一种较好的治疗方法。

  15. Cardiovascular Disease and Diabetes

    Science.gov (United States)

    ... Blood Pressure Tools & Resources Stroke More Cardiovascular Disease & Diabetes Updated:Mar 23,2016 The following statistics speak ... disease. This content was last reviewed August 2015. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  16. Prevalence of asymptomatic urinary abnormalities among adolescents.

    Science.gov (United States)

    Fouad, Mohamed; Boraie, Maher

    2016-05-01

    To determine the prevalence of asymptomatic urinary abnormalities in adolescents, first morning clean mid-stream urine specimens were obtained from 2500 individuals and examined by dipstick and light microscopy. Adolescents with abnormal screening results were reexamined after two weeks and those who had abnormal results twice were subjected to systemic clinical examination and further clinical and laboratory investigations. Eight hundred and three (32.1%) individuals had urinary abnormalities at the first screening, which significantly decreased to 345 (13.8%) at the second screening, (P adolescents who had persistent urine abnormalities; 228 (9.1%) individuals had non glomerular hematuria. The hematuria was isolated in 150 (6%) individuals, combined with leukocyturia in 83 (3.3%) individuals, and combined with proteinuria in 12 (0.5%) individuals. Leukocyturia was detected in 150 (6%) of all studied adolescents; it was isolated in 39 (1.6%) individuals and combined with proteinuria in 28 (1.1%) of them. Asymptomatic bacteriuria was detected in 23 (0.9%) of all studied adolescents; all the cases were females. Proteinuria was detected in 65 (2.6%) of all the studied adolescents; 45 (1.8%) individuals had adolescents from rural than urban areas (P adolescents in our population.

  17. Biomarkers of cardiovascular stress in obstructive sleep apnea.

    Science.gov (United States)

    Maeder, Micha T; Mueller, Christian; Schoch, Otto D; Ammann, Peter; Rickli, Hans

    2016-09-01

    Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder associated with "cardiovascular stress", i.e. cardiovascular risk factors, cardiovascular diseases, and an increased risk of heart failure, stroke, and death. Experimental and clinical studies have characterized potential underlying mechanisms including biventricular dysfunction, atherosclerosis, and arrhythmia. Assessment of these cardiovascular features of OSA requires a spectrum of clinical tools including ECG, echocardiography, exercise testing, and angiography. In contrast to many cardiovascular diseases, the role of blood biomarkers to characterize cardiovascular function and cardiovascular risk in OSA is poorly defined. In the present review we summarize the available data on biomarkers potentially providing information on cardiovascular features in OSA patients without overt cardiovascular disease. The vast majority of studies on biomarkers of cardiovascular stress in OSA evaluated B-type natriuretic peptide (BNP)/N-terminal-B-type natriuretic peptide (NT-proBNP), and cardiac troponins (cTn). Although some studies found significant associations between these cardiac biomarkers and the presence and severity of OSA, data remain conflicting. Also, the detailed pathophysiological mechanisms underlying the link between OSA and hemodynamic cardiac stress (BNP/NT-proBNP) and cardiomyocyte damage (cTn) are poorly understood. Major research efforts are required to establish the clinical role of cardiovascular biomarkers in patients with OSA. PMID:27380998

  18. Heterotaxy syndromes and abnormal bowel rotation

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Beverley [Stanford University, Lucile Packard Children' s Hospital, Department of Radiology, Stanford, CA (United States); Koppolu, Raji; Sylvester, Karl [Lucile Packard Children' s Hospital at Stanford, Department of Surgery, Stanford, CA (United States); Murphy, Daniel [Lucile Packard Children' s Hospital at Stanford, Department of Cardiology, Stanford, CA (United States)

    2014-05-15

    Bowel rotation abnormalities in heterotaxy are common. As more children survive cardiac surgery, the management of gastrointestinal abnormalities has become controversial. To evaluate imaging of malrotation in heterotaxy with surgical correlation and provide an algorithm for management. Imaging reports of heterotaxic children with upper gastrointestinal (UGI) and/or small bowel follow-through (SBFT) were reviewed. Subsequently, fluoroscopic images were re-reviewed in conjunction with CT/MR studies. The original reports and re-reviewed images were compared and correlated with surgical findings. Nineteen of 34 children with heterotaxy underwent UGI, 13/19 also had SBFT. In 15/19 reports, bowel rotation was called abnormal: 11 malrotation, 4 non-rotation, no cases of volvulus. Re-review, including CT (10/19) and MR (2/19), designated 17/19 (90%) as abnormal, 10 malrotation (abnormal bowel arrangement, narrow or uncertain length of mesentery) and 7 non-rotation (small bowel and colon on opposite sides plus low cecum with probable broad mesentery). The most useful CT/MR findings were absence of retroperitoneal duodenum in most abnormal cases and location of bowel, especially cecum. Abnormal orientation of mesenteric vessels suggested malrotation but was not universal. Nine children had elective bowel surgery; non-rotation was found in 4/9 and malrotation was found in 5/9, with discrepancies (non-rotation at surgery, malrotation on imaging) with 4 original interpretations and 1 re-review. We recommend routine, early UGI and SBFT studies once other, urgent clinical concerns have been stabilized, with elective laparoscopic surgery in abnormal or equivocal cases. Cross-sectional imaging, usually obtained for other reasons, can contribute diagnostically. Attempting to assess mesenteric width is important in differentiating non-rotation from malrotation and more accurately identifies appropriate surgical candidates. (orig.)

  19. Chromosomal phenotypes and submicroscopic abnormalities

    Directory of Open Access Journals (Sweden)

    Devriendt Koen

    2004-01-01

    Full Text Available Abstract The finding, during the last decade, that several common, clinically delineated syndromes are caused by submicroscopic deletions or, more rarely, by duplications, has provided a powerful tool in the annotation of the human genome. Since most microdeletion/microduplication syndromes are defined by a common deleted/duplicated region, abnormal dosage of genes located within these regions can explain the phenotypic similarities among individuals with a specific syndrome. As such, they provide a unique resource towards the genetic dissection of complex phenotypes such as congenital heart defects, mental and growth retardation and abnormal behaviour. In addition, the study of phenotypic differences in individuals with the same microdeletion syndrome may also become a treasury for the identification of modifying factors for complex phenotypes. The molecular analysis of these chromosomal anomalies has led to a growing understanding of their mechanisms of origin. Novel tools to uncover additional submicroscopic chromosomal anomalies at a higher resolution and higher speed, as well as the novel tools at hand for deciphering the modifying factors and epistatic interactors, are 'on the doorstep' and will, besides their obvious diagnostic role, play a pivotal role in the genetic dissection of complex phenotypes.

  20. [Cardiovascular disease prevention and life style modifications].

    Science.gov (United States)

    Baudet, M; Daugareil, C; Ferrieres, J

    2012-04-01

    Cardiovascular diseases are mainly caused by atherosclerosis, the development of which is highly dependent on our Western lifestyle. Slowing this pathology depends on the reduction of risk factors such as hypercholesterolemia, high blood pressure, smoking, lack of physical activity, excess weight and diabetes. Drug treatment exists and is very effective, but too often they treat the immediate abnormality such as diabetes, high blood pressure and hypercholesterolemia and not the underlying causes: poor eating habits, lack of physical activity and excess weight. These have a negative impact on endothelial function, oxidative stress, and can trigger inflammation, arrythmias and thrombosis. Cardiovascular prevention must therefore target sedentary lifestyle, excess weight, and favor low-calorie, low-salt food and Mediterranean diet. The way this diet works begins to be understood and goes beyond simple cardiovascular prevention. Therapeutic education holds a growing and complementary role in the Public Health system which should call upon the strengths of all healthcare professionals.

  1. Cardiovascular System

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    7.1 Heart failure2007175 Effects of recombinant human brain natriuretic peptide on aldosterone and endothelin-1 in treatment of heart failure. FU Yao(付尧),et al. Dept Cardiol, 1st Affili Hosp, China Med Univ, Shenyang 110001. Chin Cir J 2007;22(1):35-37. Obiective To study the efficacy and the effects of recombinant human brain natriuretic peptide(rhBNP) on aldosterone and endothelin-1 in the treatment of congestive heart failure(CHF).Methods A randomized, open, controlled clinical trial was conducted in 35 patients with CHF. Eighteen received rhBNP and 17 were treated with nitroglycerin as controls. The changes hemodynamic indexes, the plasma concentrations of K+, Na+, aldo-sterone(ALD) and endothelin-1 (ET-1) in order to examine the efficacy and mechanism of rhBNP. Results Between experiment and control groups significant differences were found in the decreasing of PCWP, PAP and plasma concentration of Na+, ALD, ET-1, and in the increasing of plasma concentration of K+ (P<0.05~0.01). Conclusion The mechanism of rhBNP may be associated with the overactivation of renin-angiotension-aldosterone system, and the inhibited production of endothelin-1.

  2. Abnormal ionization in sonoluminescence

    Institute of Scientific and Technical Information of China (English)

    张文娟; 安宇

    2015-01-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%–70%as the bubble flashes, which is difficult to explain by using previous models.

  3. Metabolic Syndrome, Chronic Kidney, and Cardiovascular Diseases: Role of Adipokines

    OpenAIRE

    Manfredi Tesauro; Maria Paola Canale; Giuseppe Rodia; Nicola Di Daniele; Davide Lauro; Angelo Scuteri; Carmine Cardillo

    2011-01-01

    Obesity is a chronic disease, whose incidence is alarmingly growing. It is associated with metabolic abnormalities and cardiovascular complications. These complications are clustered in the metabolic syndrome (MetS) leading to high cardiovascular morbidity and mortality. Obesity predisposes to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis and represents an independent risk factor for the development and progression of chronic kidney disease ...

  4. Imaging of cardiovascular risk in patients with Turner's syndrome

    OpenAIRE

    Marin, A.; Weir-McCall, J.R.; Webb, D J; van Beek, E J R; Mirsadraee, S.

    2015-01-01

    Turner's syndrome is a disorder defined by an absent or structurally abnormal second X chromosome and affects around 1 in 2000 newborn females. The standardised mortality ratio in Turner's syndrome is around three-times higher than in the general female population, mainly as a result of cardiovascular disorders. Most striking is the early age at which Turner's syndrome patients develop the life-threatening complications of cardiovascular disorders compared to the general population. The cardi...

  5. Cell Therapy for Cardiovascular Regeneration

    OpenAIRE

    Takehara, Naofumi

    2013-01-01

    A great numbers of cardiovascular disease patients all over the world are suffering in the poor outcomes. Under this situation, cardiac regeneration therapy to reorganize the postnatal heart that is defined as a terminal differentiated-organ is a very important theme and mission for human beings. However, the temporary success of several clinical trials using usual cell types with uncertain cell numbers has provided the transient effect of cell therapy to these patients. We therefore should r...

  6. Vitamin D and cardiovascular disease prevention.

    Science.gov (United States)

    Pilz, Stefan; Verheyen, Nicolas; Grübler, Martin R; Tomaschitz, Andreas; März, Winfried

    2016-07-01

    Vitamin D is a precursor of the steroid hormone calcitriol that is crucial for bone and mineral metabolism. Both the high prevalence of vitamin D deficiency in the general population and the identification of the vitamin D receptor in the heart and blood vessels raised interest in the potential cardiovascular effects of vitamin D. Experimental studies have demonstrated various cardiovascular protective actions of vitamin D, but vitamin D intoxication in animals is known to induce vascular calcification. In meta-analyses of epidemiological studies, vitamin D deficiency is associated with an increased cardiovascular risk. Findings from Mendelian randomization studies and randomized, controlled trials (RCTs) do not indicate significant effects of a general vitamin D supplementation on cardiovascular outcomes. Previous RCTs, however, were not adequately designed to address extraskeletal events, and did not focus on vitamin D-deficient individuals. Therefore, currently available evidence does not support cardiovascular benefits or harms of vitamin D supplementation with the commonly used doses, and whether vitamin D has cardiovascular effects in individuals with overt vitamin D deficiency remains to be evaluated. Here, we provide an update on clinical studies on vitamin D and cardiovascular risk, discuss ongoing vitamin D research, and consider the management of vitamin D deficiency from a cardiovascular health perspective. PMID:27150190

  7. Cocoa, blood pressure, and cardiovascular health.

    Science.gov (United States)

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  8. Cardiovascular magnetic resonance in systemic hypertension

    Directory of Open Access Journals (Sweden)

    Maceira Alicia M

    2012-06-01

    Full Text Available Abstract Systemic hypertension is a highly prevalent potentially modifiable cardiovascular risk factor. Imaging plays an important role in the diagnosis of underlying causes for hypertension, in assessing cardiovascular complications of hypertension, and in understanding the pathophysiology of the disease process. Cardiovascular magnetic resonance (CMR provides accurate and reproducible measures of ventricular volumes, mass, function and haemodynamics as well as uniquely allowing tissue characterization of diffuse and focal fibrosis. In addition, CMR is well suited for exclusion of common secondary causes for hypertension. We review the current and emerging clinical and research applications of CMR in hypertension.

  9. Current Clinical Studies of Metabolic Syndrome with the Main Features of Abnormal Lipid Composition%血脂组分异常为主的代谢综合征临床研究现状

    Institute of Scientific and Technical Information of China (English)

    车慧

    2012-01-01

    Dyslipidemia is an independent risk factor that causes atherosclerosis, which can also increase cardiovascular morbidity in insulin resistance environment. Dyslipidemia has a high proportion in metabolic syn-dromes,the diagnostic criteria for which all include lipid composition. Here is to make a summary of interaction among lipotoxicity and insulin resistance, glucose toxicity, and atherosclerosis of metabolic syndrome, as well as the comprehensive treatment of dyslipidemia based the premise of lipid adjustment as the main approach,providing new clinical strategies for researching on metabolic syndrome from one component.%血脂代谢异常是致动脉粥样硬化的独立危险因素,在胰岛素抵抗的环境下更增加了心脑血管疾病的发病率.血脂异常在代谢综合征中占有较高比例,众多代谢综合征诊断标准中均涉及此组分.现从血脂异常产生的脂毒性与代谢综合征胰岛素抵抗、糖毒性、动脉硬化等因素的相互影响以及在调脂为主的前提下对代谢综合征的整体治疗的研究等角度作一总结,为从单一组分入手研究代谢综合征提供了新的临床思路.

  10. Repurposing of approved cardiovascular drugs.

    Science.gov (United States)

    Ishida, Junichi; Konishi, Masaaki; Ebner, Nicole; Springer, Jochen

    2016-09-20

    Research and development of new drugs requires both long time and high costs, whereas safety and tolerability profiles make the success rate of approval very low. Drug repurposing, applying known drugs and compounds to new indications, has been noted recently as a cost-effective and time-unconsuming way in developing new drugs, because they have already been proven safe in humans. In this review, we discuss drug repurposing of approved cardiovascular drugs, such as aspirin, beta-blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, cardiac glycosides and statins. Regarding anti-tumor activities of these agents, a number of experimental studies have demonstrated promising pleiotropic properties, whereas all clinical trials have not shown expected results. In pathological conditions other than cancer, repurposing of cardiovascular drugs is also expanding. Numerous experimental studies have reported possibilities of drug repurposing in this field and some of them have been tried for new indications ('bench to bedside'), while unexpected results of clinical studies have given hints for drug repurposing and some unknown mechanisms of action have been demonstrated by experimental studies ('bedside to bench'). The future perspective of experimental and clinical studies using cardiovascular drugs are also discussed.

  11. Cardiovascular risk factors encountered during medical examination in athletic children.

    Science.gov (United States)

    Cis Spoturno, Adela C; Paz-Sauquillo, María T; López-Zea, Matilde; Fernández-Rostello, Eduardo A

    2013-12-01

    Cardiovascular risk factors can predispose to cardiovascular disease in adults or lead to cardiovascular events while practicing sports. The objectives of this study were: 1) to estimate the distribution of individual cardiovascular risk factors; 2) to establish a relationship between cardiovascular risk factors in parents or grandparents and the children's clinical condition. This was a retrospective study to assess overweight, obesity and hypertension in 1021 child athletes. The family history of obesity, type 2 diabetes, ischemic heart disease, and stroke was studied. Out of the studied children, 22.1% (n= 226) were obese and 2.1% (n= 21) had hypertension. Obesity was the most common family risk factor (30%).

  12. Cardiovascular risk factors in a population of Brazilian schoolchildren

    Directory of Open Access Journals (Sweden)

    A.N. Rodrigues

    2006-12-01

    Full Text Available Epidemiological and clinical evidence suggests that a judicious diet, regular physical activity and blood pressure (BP monitoring must start in early childhood to minimize the impact of modifiable cardiovascular risk factors. This study was designed to evaluate BP and metabolic parameters of schoolchildren from Vitória, Espírito Santo State, Brazil, and correlate them with cardiovascular risk factors. The study was conducted on 380 students aged 10-14 years (177 boys, 203 girls enrolled in public schools. Baseline measurements included body mass index, BP and heart rate. The students were submitted to exercise spirometry on a treadmill. VO2max was obtained from exercise testing to voluntary exhaustion. Fasting serum total cholesterol (TC, LDL-C, HDL-C, triglycerides (TG, and glucose were measured. Nine point nine percent of the boys and 11.7% of the girls were hypertensive or had pre-hypertensive levels. There was no significant correlation between VO2max and TC, LDL-C, or TG in prepubertal children, but a slight negative correlation was detected in post-pubertal boys for HDL-C and TG. In addition, children with hypertension (3.4% or pre-hypertensive levels (6.6% also had comorbidity for overweight and blood lipid abnormalities (14% for triglycerides, 44.7% for TC, 25.9% for LDL-C, 52% for low HDL-C. The present study shows for the first time high correlations between prehypertensive blood pressure levels and the cardiovascular risk factors high TC, high LDL-C, low HDL-C in schoolchildren. These are important for the formulation of public health policies and strategies.

  13. Oxidative stress and cardiovascular complications in polycystic ovarian syndrome.

    Science.gov (United States)

    Hyderali, Barkath Nisha; Mala, Kanchana

    2015-08-01

    Polycystic ovarian syndrome (PCOS) is a complex endocrine condition which is associated with metabolic and cardiovascular complications. It is elevated to a metabolic disorder with significant long term health ramification due to the high prevalence of insulin resistance (IR), impaired glucose tolerance, type 2 diabetes (T2D), dyslipidemia and numerous cardiovascular risk factors in PCOS women. This article concentrates on the recent developments in the regulation of oxidative stress (OS) in PCOS and on the association between PCOS and CVD outcomes. The prognostic events that define the severity of PCOS and involvement of cardiovascular risk in PCOS include endothelial dysfunction (ED) and impaired cardiac structure. Fact is that, in PCOS women, the circulating biomarkers of OS are in abnormal levels that are independent of overweight, which depicts the participation of OS in the pathophysiology of this common derangement. In addition, hyperglycemia (HG) per se, promotes reactive oxygen species (ROS) generation in PCOS. When the destructive ROS outbalances the concentration of physiological antioxidants, OS occurs. The resultant OS, directly stimulates hyperandrogenism and causes extensive cellular injury, DNA damage and/or cell apoptosis. To further the burden, the total serum antioxidant level in PCOS women is compromised, which diminishes the body's defense against an oxidative milieu. Thus, it is evident that OS regulates several cellular mechanisms in PCOS. Improving our understanding about the regulation of OS, critical role of ROS and protein biomarkers in PCOS should lead to novel therapeutic strategies in addressing PCOS-induced CVD. Besides, it is possible that the beneficial effects of dietary or therapeutic antioxidants have significant clinical relevance in PCOS.

  14. Fibrillin abnormalities and prognosis in Marfan syndrome and related disorders

    Energy Technology Data Exchange (ETDEWEB)

    Aoyama, T.; Furthmayr, H.; Francke, U.; Gasner, C. [Stanford Univ. Medical Center, CA (United States)

    1995-08-28

    Marfan syndrome (MFS), a multisystem autosomal-dominant disorder, is characterized by mutations of the fibrillin-1 (FBN1) gene and by abnormal patterns of synthesis, secretion, and matrix deposition of the fibrillin protein. To determine the sensitivity and specificity of fibrillin protein abnormalities in the diagnosis of MFS, we studied dermal fibroblasts from 57 patients with classical MFS, 15 with equivocal MFS, 8 with single-organ manifestations, and 16 with other connective tissue disorders including homocystinuria and Ehlers-Danlos syndrome. Abnormal fibrillin metabolism was identified in 70 samples that were classified into four different groups based on quantitation of fibrillin synthesis and matrix deposition. Significant correlations were found for phenotypic features including arachnodactyly, striae distensae, cardiovascular manifestations, and fibrillin groups II and IV, which included 70% of the MFS patients. In addition, these two groups were associated with shortened {open_quotes}event-free{close_quotes} survival and more severe cardiovascular complications than groups I and III. The latter included most of the equivocal MFS/single manifestation patients with fibrillin abnormalities. Our results indicate that fibrillin defects at the protein level per se are not specific for MFS, but that the drastically reduced fibrillin deposition, caused by a dominant-negative effect of abnormal fibrillin molecules in individuals defined as groups II and IV, is of prognostic and possibly diagnostic significance. 25 refs., 3 figs., 6 tabs.

  15. Effects of Soy Flour Fortified Bread Consumption on Cardiovascular Risk Factors According to APOE Genotypes in Overweight and Obese Adult Women: A Cross-over Randomized Controlled Clinical Trial

    Science.gov (United States)

    Sharifi-Zahabi, Elham; Maracy, Mohammad R

    2015-01-01

    Recent studies suggest that inclusion of soy product in the diet may have favorable effects on relief of cardiovascular diseases (CVDs) and risk factors. These effects might be associated with the presence of specific polymorphism in gene. The aim of this study was to examine the effects of consumption of soy flour fortified bread on cardiovascular risk factors in overweight and obese women according to APOE genotype. In a randomized cross-over clinical trial 30 overweight and obese women received a mild weight loss diet and assigned to a regular diet and a soy bread diet, each for 6 weeks and a washout period for 20 days. Subjects in the soy bread diet were asked to replace 120 grams of their daily usual bread intake with equal amount of soy bread. No significant effects of soy bread on serum lipid, systolic blood pressure and anthropometric indices were observed compared to the regular diet (p > 0.05). For diastolic blood pressure (DBP), comparison of mean differences between two groups showed a marginally significant effect of soy bread (p = 0.06). Compared to regular diet, soy bread had a significant effect on DBP in E2 genotype group (ε2/ε2) (p = 0.03). Having ε2 allele may influences responses of CVD risk factor to soy bread consumption. However more nutrigenetic studies are required. PMID:26566517

  16. Craniofacial abnormalities among patients with Edwards Syndrome

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano M. Rosa

    2013-09-01

    Full Text Available OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES. METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%. Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%, abnormalities of the ear helix/dysplastic ears (70%, prominent occiput (52%, posteriorly rotated (46% and low set ears (44%, and short palpebral fissures/blepharophimosis (46%. Other uncommon - but relevant - abnormalities included: microtia (18%, orofacial clefts (12%, preauricular tags (10%, facial palsy (4%, encephalocele (4%, absence of external auditory canal (2% and asymmetric face (2%. One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature.

  17. May the best friend be an enemy if not recognized early: possible role of omega-3 against cardiovascular abnormalities due antipsychotics in the treatment of autism Pode um melhor amigo ser um inimigo se não reconhecido a tempo: possível papel do ômega-3 nos efeitos cardiovasculares secundários ao tratamento antipsicótico de pacientes com autismo

    Directory of Open Access Journals (Sweden)

    Roberta M. Cysneiros

    2009-09-01

    Full Text Available Autism spectrum disorders (ASD are neurodevelopment disorders that cause severe and pervasive impairment in socialization, communication, and behavior. Although the availability of antipsychotic treatment in ASD has expanded, we will be very careful with side effects of these pharmacological agents. Following this reasoning, emerging data indicate that some antipsychotics may be associated with cardiovascular adverse events (e.g., QT interval prolongation, suggesting that this could be correlated to sudden death. Quite interesting, substantial evidence from epidemiological and case-control studies indicates that omega-3 reduces the risk of cardiovascular mortality, particularly sudden cardiac death. In accordance to the above mentioned findings, as omega-3 fatty acids per se have a direct cardiovascular protective role, our paper hypothesized that omega-3 fatty acids supplementation in ASD patients treated with atypical antipsychotic drugs may reduce cardiac arrhythmias and hence sudden cardiac death.As desordens do espectro autista (DEA são um grupo de doenças do desenvolvimento que causam um grave comprometimento na socialização, comunicação e comportamento. Embora o tratamento na DEA com drogas antipsicóticas tenha se expandido, é necessária a observação cuidadosa de efeitos colaterais destes fármacos. Nesta linha, dados recentes têm associado o uso de antipsicóticos com efeitos adversos cardiovasculares (como prolongamento do intervalo QT, sugerindo que possa haver uma correlação com morte súbita. Evidências originadas em dados epidemiológicos e estudos de caso-controle indicam que o Omega-3 reduz o risco de mortalidade por causa cardiovascular, particularmente a morte súbita de origem cardíaca. Concordante com estes achados, como o Omega-3 per se tem um papel protetor cardiovascular direto, nosso artigo levanta a hipótese que a suplementação de ácidos graxos Omega-3 em pacientes com DEA tratados com drogas antipsic

  18. 除湿液化汤联合前列安栓治疗精液液化异常的临床观察%Clinical Observation of Abnormal Sperm Liquefaction Treated with Chushi Yehua Tang and Qianlieanshuan

    Institute of Scientific and Technical Information of China (English)

    王旭初; 郑加涛

    2013-01-01

    Objective To observe the clinical efficacy on abnormal sperm liqueiaction treated with chushi yehua tang and qianlieanshuan. Methods One hundred and twenty patients of abnormal sperm liqueiaction were randomized into a treatment group( 60 cases )and a control group( 60 cases ). They were treated with the allied therapy of chushi yehua tang and qianlieanshuan and single application of qianlieanshuan respectively. One session of treatment was 30 days. The two sessions were observed continuously. The sperm liquefaction time and the other parameters were recorded. Results After two sessions of treatment, 11 cases were cured,27 cases effective remarkably, 16 cases effective and 6 cases failed in the treatment group;4 cases were cured, 12 cases effective remarkably, 14 cases effective and 30 cases failed in the control group. The difference in the total effective rate was significant statistically between the two groups( P 0. 05 ). Conclusion The allied therapy of chushi yehua tang and qianlieanshuan shortens significantly sperm liquefaction time. It achieves the significant, safe and reliable effects on abnormal sperm liquefaction.%目的 观察除湿液化汤联合前列安栓治疗精液液化异常的临床疗效.方法 将120例精液液化异常的患者,随机分为治疗组60例,对照组60例,分别选用除湿液化汤联合前列安栓和单独应用前列安栓作为治疗方法,30 d为1个疗程,连续观察2个疗程,记录精液液化时间及其他参数变化情况.结果 2个疗程后,治疗组痊愈11例,显效27例,有效16例,无效6例;对照组痊愈4例,显效12例,有效14例,无效30例,两组总有效率比较,差异有统计学意义(P<0.01).治疗组精液密度、精子活力、液化时间与治疗前比较差异有统计学意义(P<0.05);治疗组明显优于对照组,各项指标差异均有统计学意义(P<0.01);治疗后两组EPS中WBC含量比较治疗组优于对照组,差异有统计学意义(P<0.05).治疗后两

  19. [Cardiovascular safety of antidiabetics].

    Science.gov (United States)

    Aline Roth, Pressl-Wenger; Jornayvaz, François R

    2016-06-01

    Type 2 diabetes is characterized by a high risk of micro- and macro-vascular complications. Cardiovascular diseases are the leading cause of death of diabetic patients. In this context, the search for molecules decreasing cardiovascular mortality makes sense. Until the EMPA-REG OUTCOME study published late 2015, showing a reduction of cardiovascular mortality of patients treated with empagliflozin, an SGLT2 inhibitor, there was no molecule known to decrease cardiovascular mortality. The purpose of this article is to review the various existing antidiabetic molecules and their impact (positive/neutral/negative) on cardiovascular mortality. PMID:27487675

  20. Elevated stress-hemoconcentration in major depression is normalized by antidepressant treatment: secondary analysis from a randomized, double-blind clinical trial and relevance to cardiovascular disease risk.

    Directory of Open Access Journals (Sweden)

    Ma-Li Wong

    Full Text Available BACKGROUND: Major depressive disorder (MDD is an independent risk factor for cardiovascular disease (CVD; the presence of MDD symptoms in patients with CVD is associated with a higher incidence of cardiac complications following acute myocardial infarction (MI. Stress-hemoconcentration, a result of psychological stress that might be a risk factor for the pathogenesis of CVD, has been studied in stress-challenge paradigms but has not been systematically studied in MDD. METHODS: Secondary analysis of stress hemoconcentration was performed on data from controls and subjects with mild to moderate MDD participating in an ongoing pharmacogenetic study of antidepressant treatment response to desipramine or fluoxetine. Hematologic and hemorheologic measures of stress-hemoconcentration included blood cell counts, hematocrit, hemoglobin, total serum protein, and albumin, and whole blood viscosity. FINDINGS: Subjects with mild to moderate MDD had significantly increased hemorheologic measures of stress-hemoconcentration and blood viscosity when compared to controls; these measures were correlated with depression severity. Measures of stress-hemoconcentration improved significantly after 8 weeks of antidepressant treatment. Improvements in white blood cell count, red blood cell measures and plasma volume were correlated with decreased severity of depression. CONCLUSIONS: Our secondary data analyses support that stress-hemoconcentration, possibly caused by decrements in plasma volume during psychological stress, is present in Mexican-American subjects with mild to moderate MDD at non-challenged baseline conditions. We also found that after antidepressant treatment hemorheologic measures of stress-hemoconcentration are improved and are correlated with improvement of depressive symptoms. These findings suggest that antidepressant treatment may have a positive impact in CVD by ameliorating increased blood viscosity. Physicians should be aware of the potential

  1. The clinical performance of an office-based risk scoring system for fatal cardiovascular diseases in North-East of Iran.

    Directory of Open Access Journals (Sweden)

    Sadaf G Sepanlou

    Full Text Available Cardiovascular diseases (CVD are becoming major causes of death in developing countries. Risk scoring systems for CVD are needed to prioritize allocation of limited resources. Most of these risk score algorithms have been based on a long array of risk factors including blood markers of lipids. However, risk scoring systems that solely use office-based data, not including laboratory markers, may be advantageous. In the current analysis, we validated the office-based Framingham risk scoring system in Iran.The study used data from the Golestan Cohort in North-East of Iran. The following risk factors were used in the development of the risk scoring method: sex, age, body mass index, systolic blood pressure, hypertension treatment, current smoking, and diabetes. Cardiovascular risk functions for prediction of 10-year risk of fatal CVDs were developed.A total of 46,674 participants free of CVD at baseline were included. Predictive value of estimated risks was examined. The resulting Area Under the ROC Curve (AUC was 0.774 (95% CI: 0.762-0.787 in all participants, 0.772 (95% CI: 0.753-0.791 in women, and 0.763 (95% CI: 0.747-0.779 in men. AUC was higher in urban areas (0.790, 95% CI: 0.766-0.815. The predicted and observed risks of fatal CVD were similar in women. However, in men, predicted probabilities were higher than observed.The AUC in the current study is comparable to results of previous studies while lipid profile was replaced by body mass index to develop an office-based scoring system. This scoring algorithm is capable of discriminating individuals at high risk versus low risk of fatal CVD.

  2. Clinical relationship of myocardial sympathetic nervous activity to cardiovascular functions in chronic heart failure: assessment by myocardial scintigraphy with 123I-metaiodobenzylguanidine.

    Science.gov (United States)

    Wada, Yukoh; Miura, Masaetsu; Fujiwara, Satomi; Mori, Shunpei; Seiji, Kazumasa; Kimura, Tokihisa

    2003-12-01

    The aim of this study was to clarify the relationship between cardiac sympathetic nervous activity (SNA) assessed by radioiodinated metaiodobenzylguanidine (123I-MIBG), an analogue of norepinephrine and cardiovascular functions in patients with chronic heart failure (CHF). Subjects were 17 patients with CHF. A dose of 111 MBq of 123I-MIBG was administered intravenously, and 5-minute anterior planar images were obtained 15 minutes (early image) and 3 hours (delayed image) after the injection. The heart/mediastinum (H/M) count ratio was defined to quantify cardiac 123I-MIBG uptake. The washout ratio (WR) of 123I-MIBG from the heart was calculated as follows: (early counts-delayed counts)/early counts x 100 (%). Echocardiography was performed on all patients within 1 week of 123I-MIBG scintigraphy to measure stroke volume index (SVI). Blood pressure and heart rate (HR) in the resting state were also recorded to calculate cardiovascular functions including cardiac output, pulse pressure (PP), and mean blood pressure. Significant linear correlations were found between the early H/M ratio of 123I-MIBG and SVI, and between the delayed H/M ratio of 123I-MIBG and SVI, respectively. WR of 123I-MIBG was correlated with HR, and was inversely correlated with SVI and with PP, respectively. It is likely that a decrease in SVI is associated with enhanced cardiac SNA in severe CHF. 123I-MIBG scintigraphy is effective in assessing the cardiac functional status and SNA in patients with CHF in vivo. Moreover, changes in PP and HR indicate well alteration in SNA. PMID:14690018

  3. Laser therapy in cardiovascular disease

    Science.gov (United States)

    Rindge, David

    2009-02-01

    Cardiovascular disease is the number one cause of death worldwide. It is broadly defined to include anything which adversely affects the heart or blood vessels. One-third of Americans have one or more forms of it. By one estimate, average human life expectancy would increase by seven years if it were eliminated. The mainstream medical model seeks mostly to "manage" cardiovascular disease with pharmaceuticals or to surgically bypass or reopen blocked vessels via angioplasty. These methods have proven highly useful and saved countless lives. Yet drug therapy may be costly and ongoing, and it carries the risk of side effects while often doing little or nothing to improve underlying health concerns. Similarly, angioplasty or surgery are invasive methods which entail risk. Laser therapy1 regenerates tissue, stimulates biological function, reduces inflammation and alleviates pain. Its efficacy and safety have been increasingly well documented in cardiovascular disease of many kinds. In this article we will explore the effects of laser therapy in angina, atherosclerosis, coronary artery disease, hypertension, hyperlipidemia, myocardial infarction, stroke and other conditions. The clinical application of various methods of laser therapy, including laserpuncture and transcutaneous, supravascular and intravenous irradiation of blood will be discussed. Implementing laser therapy in the treatment of cardiovascular disease offers the possibility of increasing the health and wellbeing of patients while reducing the costs and enhancing safety of medical care.

  4. Ring Chromosome 4 in a Child with Multiple Congenital Abnormalities: A Case Report and Review of the Literature

    Science.gov (United States)

    Saman Kumara, L. P. C.

    2016-01-01

    A female child born preterm with intrauterine growth retardation and presenting with facial dysmorphism with clefts, microcephaly, limb deformities, and congenital abnormalities involving cardiovascular and urinary systems is described. Chromosomal analysis showed a de novo 46,XX,r(4)(p15.3q35) karyotype. The clinical features of the patient were compared with the phenotypic characteristics of 17 previously reported cases with ring chromosome 4 and those with Wolf-Hirschhorn syndrome (4p-). Clinical features observed in this case are consistent with the consensus phenotype in ring chromosome 4. Patent ductus arteriosus and bilateral talipes equinovarus observed in this baby widen the phenotypic spectrum associated with ring chromosome 4. PMID:27610251

  5. Ring Chromosome 4 in a Child with Multiple Congenital Abnormalities: A Case Report and Review of the Literature.

    Science.gov (United States)

    Paththinige, C S; Sirisena, N D; Kariyawasam, U G I U; Saman Kumara, L P C; Dissanayake, V H W

    2016-01-01

    A female child born preterm with intrauterine growth retardation and presenting with facial dysmorphism with clefts, microcephaly, limb deformities, and congenital abnormalities involving cardiovascular and urinary systems is described. Chromosomal analysis showed a de novo 46,XX,r(4)(p15.3q35) karyotype. The clinical features of the patient were compared with the phenotypic characteristics of 17 previously reported cases with ring chromosome 4 and those with Wolf-Hirschhorn syndrome (4p-). Clinical features observed in this case are consistent with the consensus phenotype in ring chromosome 4. Patent ductus arteriosus and bilateral talipes equinovarus observed in this baby widen the phenotypic spectrum associated with ring chromosome 4. PMID:27610251

  6. Advances in understanding paternally transmitted Chromosomal Abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Marchetti, F; Sloter, E; Wyrobek, A J

    2001-03-01

    Multicolor FISH has been adapted for detecting the major types of chromosomal abnormalities in human sperm including aneuploidies for clinically-relevant chromosomes, chromosomal aberrations including breaks and rearrangements, and other numerical abnormalities. The various sperm FISH assays have been used to evaluate healthy men, men of advanced age, and men who have received mutagenic cancer therapy. The mouse has also been used as a model to investigate the mechanism of paternally transmitted genetic damage. Sperm FISH for the mouse has been used to detect chromosomally abnormal mouse sperm, while the PAINT/DAPI analysis of mouse zygotes has been used to evaluate the types of chromosomal defects that can be paternally transmitted to the embryo and their effects on embryonic development.

  7. Alterações eletrocardiográficas e sua relação com os fatores de risco para doença isquêmica do coração em população da área metropolitana de São Paulo Electrocardiographic abnormalities and cardiovascular risk factors for ischemic heart disease in an adult population from São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    ELISABETH CARDOSO

    2002-09-01

    sobrepeso ou obesidade (³25 Kg/m2,relação cintura/quadril alterada correlacionaram-se positivamente com ARV. O sexo masculino, diabetes, hipertensão arterial e o tabagismo foram correlacionados positivamente com SVE. Na presença de ARV no ECG encontramos uma razão de chance de 3,54 para a ocorrência do diagnóstico de hipertensão sistólica e de 1,83 para colesterol total ³ a 200 mg/dl. Na presença de SVE no ECG, a razão de chance para a ocorrência do diagnóstico de hipertensão sistólica observada foi de 5,92. Dos três fatores de risco correlacionados às alterações eletrocardiográficas associadas à isquemia miocárdia, dois são controláveis e ligados a condições nutricionais (hipertensão e colesterol ³ a 200 mg/dl, o que demonstra a importância da sua detecção precoce. Em estudos epidemiológicos e de intervenção nutricional, o eletrocardiograma, método simples e de baixo custo, pode auxiliar na identificação de fatores de risco cardiovascular. Seria importante que estas informações fossem confirmadas por estudos prospectivos que incluíssem a determinação dos valores preditivos do ECG nesta situação.OBJETIVE: Ischemic heart disease is associated with high rates of mortality and it is the most prevalent among cardiovascular diseases. It is a multifactorial disease, and its prevention depends on control of risk factors. Resting electrocardiogram can be used to detect manifestations of ischemic heart disease, since some electrocardiographic abnormalities are indicative of coronary disease in asymptomatic subjects. The aim of the study was to analyze the relationship between electrocardiographic abnormalities and risk factors for ischemic heart disease in an adult population from the metropolitan area of São Paulo. METHODS: A cross-sectional study was carried out in an adult population (age 20 years and over from Cotia, near São Paulo, southeastern of Brazil. The study population comprised 1067 subjects. The subjects were interviewed

  8. Abnormal ionization in sonoluminescence

    Science.gov (United States)

    Zhang, Wen-Juan; An, Yu

    2015-04-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%-70% as the bubble flashes, which is difficult to explain by using previous models. Project supported by the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120002110031) and the National Natural Science Foundation of China (Grant No. 11334005).

  9. Imaging of cardiovascular risk in patients with Turner's syndrome.

    Science.gov (United States)

    Marin, A; Weir-McCall, J R; Webb, D J; van Beek, E J R; Mirsadraee, S

    2015-08-01

    Turner's syndrome is a disorder defined by an absent or structurally abnormal second X chromosome and affects around 1 in 2000 newborn females. The standardised mortality ratio in Turner's syndrome is around three-times higher than in the general female population, mainly as a result of cardiovascular disorders. Most striking is the early age at which Turner's syndrome patients develop the life-threatening complications of cardiovascular disorders compared to the general population. The cardiovascular risk stratification in Turner's syndrome is challenging and imaging is not systematically used. The aim of this article is to review cardiovascular risks in this group of patients and discuss a systematic imaging approach for early identification of cardiovascular disorders in these patients. PMID:25917542

  10. TYPES OF TREMOR IN PATIENTS WITH CEREBROVASCULAR DISEASES AND CARDIOVASCULAR EVENTS

    OpenAIRE

    Petrov Igor; Mulic Mersudin; Antonio Georgiev

    2016-01-01

    Introduction: Tremor can occur as a part of the clinical feature of cerebrovascular diseases. Many patients with cerebral stroke have cardiovascular diseases as a comorbidity or complication of stroke; sometimes cardiovascular events can lead to embolic stroke. Aim: To present types of tremor in patients with cerebrovascular diseases and cardiovascular events and diabetes mellitus type 2, clinical characteristics of tremor and investigations used. Materia...

  11. Cardiovascular MRI with ferumoxytol.

    Science.gov (United States)

    Finn, J P; Nguyen, K-L; Han, F; Zhou, Z; Salusky, I; Ayad, I; Hu, P

    2016-08-01

    The practice of contrast-enhanced magnetic resonance angiography (CEMRA) has changed significantly in the span of a decade. Concerns regarding gadolinium (Gd)-associated nephrogenic systemic fibrosis in those with severely impaired renal function spurred developments in low-dose CEMRA and non-contrast MRA as well as efforts to seek alternative MR contrast agents. Originally developed for MR imaging use, ferumoxytol (an ultra-small superparamagnetic iron oxide nanoparticle), is currently approved by the US Food and Drug Administration for the treatment of iron deficiency anaemia in adults with renal disease. Since its clinical availability in 2009, there has been rising interest in the scientific and clinical use of ferumoxytol as an MR contrast agent. The unique physicochemical and pharmacokinetic properties of ferumoxytol, including its long intravascular half-life and high r1 relaxivity, support a spectrum of MRI applications beyond the scope of Gd-based contrast agents. Moreover, whereas Gd is not found in biological systems, iron is essential for normal metabolism, and nutritional iron deficiency poses major public health challenges worldwide. Once the carbohydrate shell of ferumoxytol is degraded, the elemental iron at its core is incorporated into the reticuloendothelial system. These considerations position ferumoxytol as a potential game changer in the field of CEMRA and MRI. In this paper, we aim to summarise our experience with the cardiovascular applications of ferumoxytol and provide a brief synopsis of ongoing investigations on ferumoxytol-enhanced MR applications. PMID:27221526

  12. Carbamazepine for acute psychosis with eeg abnormalities

    Directory of Open Access Journals (Sweden)

    Ivković Maja

    2004-01-01

    Full Text Available Aim. To investigate the efficacy of carbamazepine as adjuvant drug therapy in acute paranoid psychosis with associated EEG abnormalities, compared to sole antipsychotic treatment. Methods. Eleven medication-naive patients diagnosed with acute paranoid psychosis with associated EEG abnormalities were divided into two treatment groups: sole fluphenazine group, with flexible dosing of 5-10 mg/day (n=6, and carbamazepine group (n=5 with the addition of carbamazepine (600 mg/day to fluphenazine treatment. Clinical Global Impression (CGI, Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and EEG were assessed on the baseline and after 6 weeks of treatment. Paired and two-tailed t-tests were used for statistical significance. Results. All the patients showed significant improvement of mental state after 6 weeks of treatment with no significant differences in CGI, BPRS, and total SANS scores in relation to the therapy with carbamazepine. Nevertheless, after 6 weeks of the treatment, EEG findings were significantly better in carbamazepine group, in relation to the findings from the onset of the treatment, as well as in comparison to sole fluphenazine group. Conclusion. Although carbamazepine stabilized abnormal brain electrical activities it seemed that the associated EEG abnormalities were not significant for acute psychosis observed. These preliminary results suggested that there was no convincing evidence that carbamazepine was efficient as the augmentation of antipsychotic treatment for patients with both acute paranoid psychosis and EEG abnormalities.

  13. Clinical features and Y chromosomal abnormalities in patients with karyotype chimerism of 45, XO/46, XY%染色体核型45,XO/46,XY患者的临床特点和Y染色体异常

    Institute of Scientific and Technical Information of China (English)

    茅江峰; 张红; 徐洪丽; 伍学焱; 柴晓峰; 黄炳昆; 聂敏; 王晓晶; 田丹

    2014-01-01

    目的 对染色体核型45,XO/46,XY患者的临床特点和Y染色体异常进行总结分析,以提高对此病的认识和诊疗水平.方法 对确诊患者的临床表现、性激素水平、治疗和随访、外周血淋巴细胞核型分析和Y染色体异常进行详细描述和总结.结果 (1)在2008年1月至2013年1月期间,有7例确诊为45,XO/46,XY的患者在本科就诊.社会性别男性3例,女性4例;初诊年龄(14±3)岁(11 ~ 20岁).(2)患者均为身材矮小,伴多种特纳综合征的体征.(3)完全男性外生殖器1例,尿道下裂2例,女性阴蒂增大伴阴道尿道共同开口1例,完全女性外阴3例;通过查体和超声检查,有3例患者存在睾丸,1例同时存在睾丸和卵巢样性腺,1例为卵巢样性腺,2例未发现性腺.(4)有4例患者Y染色体存在明显的异常,其中例1经多重PCR技术和多重连接探针扩增技术,证实存在AZFb和AZFc片段缺失.(5)有4例患者接受人重组生长激素(rhGH)治疗.例1行右侧隐睾牵引固定术,例4行腹腔镜探查,找到并切除性腺组织,病理可见卵巢样成分.有3例患者接受性激素替代治疗.结论 45,XO/46,XY患者,具有矮小和其他特纳综合征的体征;半数患者存在睾丸而出现不同程度男性化.Y染色体异常,可能是导致嵌合体发生和生精障碍的重要原因.应用rhGH有助于身高增加,切除隐睾和无功能性腺组织,可能降低将来的生殖细胞肿瘤风险.%Objective To increase the knowledge of clinical features and Y chromosomal abnormalities in patients with mosaic karyotype 45,XO/46,XY.Methods The clinical features,peripheral lymphocyte karyotype,sex hormones,treatment,and follow-up information were retrospectively reviewed.Results (1) 7 patients with 45,XO/46,XY were included.Their social gender was 3 male and 4 female,and the age by diagnosis was (14 ± 3) years (range 11-20 years).(2) Patients presented with short stature (n =7) and other specific somatic signs similar to Turner

  14. Rivaroxaban: An Evaluation of its Cardiovascular Benefit–Risk Profile Across Indications Based on Numbers Needed to Treat or Harm, and on Clinically Meaningful Endpoint Comparisons

    OpenAIRE

    Ageno, Walter

    2015-01-01

    The decision to prescribe anticoagulant therapy must consider the balance between reducing the risk of thromboembolic events and increasing the risk of bleeding. Although assessments of net clinical outcomes with oral anticoagulants are not new, this article presents an evaluation of benefit–risk by considering only events of substantial and comparable clinical relevance (i.e., events with serious long-term sequelae likely to have irreversible consequences, including death). This is based on ...

  15. Sex steroids and cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Bu Beng Yeap

    2014-04-01

    Full Text Available As men grow older, testosterone (T levels decline and the significance of this change is debated. The evidence supporting a causal role for lower circulating T, or its metabolites dihydrotestosterone (DHT and estradiol, in the genesis of atherosclerosis and cardiovascular disease (CVD in men is limited. Observational studies associate low baseline T levels with carotid atherosclerosis, aortic and peripheral vascular disease, and with the incidence of cardiovascular events and mortality. Studies using mass spectrometry suggest that when total T is assayed optimally, calculation of free T might not necessarily improve risk stratification. There is limited evidence to support an association of estradiol with CVD. Interventional studies of T therapy in men with coronary artery disease have shown beneficial effects on exercise-induced myocardial ischemia. However, placebo-controlled, randomized clinical trials (RCTs of T therapy in men with the prespecified outcomes of cardiovascular events or deaths are lacking. Meta-analyses of randomized controlled trials of T published up to 2010 found no increase in cardiovascular events, mortality, or prostate cancer with therapy. Recently, in a trial of older men with mobility limitations, men randomized to receive a substantial dose of T reported cardiovascular adverse effects. This phenomenon was not reported from a comparable trial where men received a more conservative dose of T, suggesting a prudent approach should be adopted when considering therapy in frail older men with existing CVD. Adequately powered RCTs of T in middle-aged and older men are needed to clarify whether or not hormonal intervention would reduce the incidence of CVD.

  16. [Renal abnormalities in ankylosing spondylitis].

    Science.gov (United States)

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. PMID:22520483

  17. Cardiovascular Safety of Oral p-Synephrine (Bitter Orange) in Healthy Subjects: A Randomized Placebo-Controlled Cross-over Clinical Trial.

    Science.gov (United States)

    Shara, Mohd; Stohs, Sidney J; Mukattash, Tareq L

    2016-05-01

    Bitter orange (Citrus aurantium) extract and its primary protoalkaloid p-synephrine are widely consumed in combination with multiple herbal ingredients for weight management and sports performance. p-Synephrine is also present in juices and foods derived from a variety of Citrus species. Questions exist regarding the safety of p-synephrine because of structural similarities with other biogenic amines. This study assessed the cardiovascular (stimulatory) effects of bitter orange extract (49-mg p-synephrine) given to 18 healthy subjects (nine men and nine women) in a double-blinded, placebo-controlled cross-over study. Heart rates, blood pressures, and electrocardiograms were determined at baseline, 30, 60, 90 min, 2, 4 , 6, and 8 h. Blood samples were drawn at baseline, 2 h and 8 h for serum chemistries, blood cell counts, and p-synephrine and caffeine levels. No significant changes occurred in electrocardiograms, heart rates, systolic blood pressure, blood chemistries, or blood cell counts at any time point in either control or p-synephrine treated group. A small (4.5 mmHg) decrease in diastolic blood pressure occurred in the p-synephrine treated group at 60 min. No adverse effects were reported. Caffeine ingestion varied markedly among the participants. p-Synephrine does not act as a stimulant at the dose used. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26948284

  18. The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension.

    Science.gov (United States)

    Chrysant, S G

    2016-01-01

    Complementary and alternative medicine (CAM) is widely used by people in the United States and other countries for the treatment of health conditions that include hypertension (HTN), cardiovascular disease (CVD), heart failure, hyperlipidemia and other condtions. The visits to CAM practitioners result in significant out-of-pocket expenses, as CAM is not covered by health insurance in the majority of cases. The reasons for this are that the products used are not closely regulated by governmental regulatory agencies and lack scientific evidence about their effectiveness and safety. The people regard these products as being 'natural' and, consequently, safe. However, there is evidence that these products can be contaminated and adulterated with other substances and could cause harm to the persons who take them. The responsibility falls on the health professionals, who should become familiar with the various CAM products, inquire their patients whether they taking any of these products and advise them accordingly. This review is based on a recent statement issued by the American Medical for the use of CAM for the treatment of HTN. For its preparation, a Medline search of the English language literature was performed between 2010 and 2014 restricted in the use of CAM for CVD and HTN, and from the 88 abstracts reviewed, 23 pertinent papers were selected. These papers together with collateral literature will be discussed in this review regarding CAM and CAM products on their effectiveness and safety for the treatment of CVD and HTN.

  19. The Effect of Dietary Supplementation of Green Tea Catechins on Cardiovascular Disease Risk Markers in Humans: A Systematic Review of Clinical Trials

    Directory of Open Access Journals (Sweden)

    Sarah O. Lau

    2016-06-01

    Full Text Available Green tea catechins (GTCs are secondary plant metabolites that have been associated with health benefits in human trials. As such, they have the potential to reduce cardiovascular disease (CVD risk; however, results are not consistent. This systematic review of the published data assessed the putative effect of GTCs supplementation on anthropometric, blood pressure, and biochemical measures associated with CVD risk. It was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines exploring four major electronic databases (MEDLINE, Cochrane Library, Web of Science, and Scopus. Studies were included if they were published in peer-reviewed journals in English from 1990 until October 2015, and were human double-blind randomized and placebo-controlled trials (RCTs. From 122,428 articles initially identified, after two levels of screening, seven studies met the inclusion criteria. The review revealed consistent and significant (p ≤ 0.05 reductions in body mass index (BMI, blood pressure and plasma lipids; however, this effect would have been less if between-group effects had been considered. The current evidence base also has considerable methodological limitations due to suboptimal statistical methods used in data analyses. Future research efforts must aim to rectify this paucity of evidence with well-designed and well-reported prospective studies.

  20. Cardiovascular Prevention of Cognitive Decline

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Monsuez

    2011-01-01

    Full Text Available Midlife cardiovascular risk factors, including diabetes, hypertension, dyslipemia, and an unhealthy lifestyle, have been linked to subsequent incidence, delay of onset, and progression rate of Alzheimer disease and vascular dementia. Conversely, optimal treatment of cardiovascular risk factors prevents and slows down age-related cognitive disorders. The impact of antihypertensive therapy on cognitive outcome in patients with hypertension was assessed in large trials which demonstrated a reduction in progression of MRI white matter hyperintensities, in cognitive decline and in incidence of dementia. Large-scale database correlated statin use and reduction in the incidence of dementia, mainly in patients with documented atherosclerosis, but clinical trials failed to reach similar conclusions. Whether a multitargeted intervention would substantially improve protection, quality of life, and reduce medical cost expenditures in patients with lower risk profile has not been ascertained. This would require appropriately designed trials targeting large populations and focusing on cognitive decline as a primary outcome endpoint.

  1. Cardiovascular Disease and Thyroid Function

    DEFF Research Database (Denmark)

    Faber, Jens; Selmer, Christian

    2014-01-01

    Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones......, a progressively increased risk in people with different levels of reduced TSH to a physiologically 'dose-dependent' effect of thyroid hormones on the heart in overt hyperthyroidism. Heart failure represents an intriguing clinical situation in which triiodothyronine treatment might be beneficial. In conclusion...

  2. Cannabinoids as therapeutic agents in cardiovascular disease: a tale of passions and illusions

    OpenAIRE

    Mendizábal, V E; Adler-Graschinsky, E

    2007-01-01

    In addition to their classical known effects, such as analgesia, impairment of cognition and learning and appetite enhancement, cannabinoids have also been related to the regulation of cardiovascular responses and implicated in cardiovascular pathology. Elevated levels of endocannabinoids have been related to the extreme hypotension associated with various forms of shock as well as to the cardiovascular abnormalities that accompany cirrhosis. In contrast, cannabinoids have also been associate...

  3. Autophagy in cardiovascular biology

    OpenAIRE

    Lavandero, Sergio; Chiong, Mario; Rothermel, Beverly A.; Hill, Joseph A.

    2015-01-01

    Cardiovascular disease is the leading cause of death worldwide. As such, there is great interest in identifying novel mechanisms that govern the cardiovascular response to disease-related stress. First described in failing hearts, autophagy within the cardiovascular system has been widely characterized in cardiomyocytes, cardiac fibroblasts, endothelial cells, vascular smooth muscle cells, and macrophages. In all cases, a window of optimal autophagic activity appears to be critical to the mai...

  4. Cardiovascular molecular MR imaging

    OpenAIRE

    Lamb, H J; van der Meer, R. W.; Roos, A. (Anna); Bax, J J

    2007-01-01

    Introduction Cardiovascular molecular imaging is a rapidly evolving field of research, aiming to image and quantify molecular and cellular targets in vivo. MR imaging has some inherent properties that make it very suitable for cardiovascular molecular imaging. Until now, only a limited number of studies have been published on cardiovascular molecular imaging using MR imaging. Review In the current review, MR techniques that have already shown potential are discussed. Metabolic MR imaging can ...

  5. A Rare Stapes Abnormality

    Directory of Open Access Journals (Sweden)

    Hala Kanona

    2015-01-01

    Full Text Available The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively.

  6. Cardiovascular and cerebrovascular complications and clinical characteristics of Cushing's disease patients with a normal kalemic level or hypokalemia%正常血钾和伴低血钾库欣病患者心脑血管并发症和临床特点的比较

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

    Objective To compare the cardiovascular and cerebrovascular complications and clinical characteristics of Cushing's disease patients with different serum potassium levels. Methods Clinical data about 187 adult Cushing's disease patients admitted to our hospital from 1991 to 2011 were retrospectively analyzed. The patients were divided into two groups according to their serum potassium level. Their cardiovascular and cerebrovascular complications and clinical characteristics were compared. Results The average age of the patients was 20-76 years (mean 38.8±11.3 years). Of the 187 patients, 43.3%(81/187) were diagnosed with hypokalemia. The number of males was greater than that of females, the course of disease was shorter, the blood pressure and blood lipid level and the incidence of striae, ecchymoses and edema of lower limbs were higher in patients with hypokalemia than in those with a normal serum potassium level(P0.05). Conclusion Hypokalemia usually occurs in males. Its course is shorter, its signs are more significant, the abnormal metabolism is severer, the hormone level is higher, and the incidence of vascular complications is higher in hypokalemia patients, especially in those with arrhythmia and proteinuria.%  目的比较不同血钾水平库欣病患者心脑血管并发症和临床特点。方法回顾性分析1991-2011年在我院诊治的187例成年库欣病患者临床资料,根据血钾正常与否分组,比较两组心脑血管并发症和临床特点。结果患者平均年龄20~76(38.8±11.3)岁,43.3%(81/187)伴有低血钾。与血钾正常组比较,低血钾组男性比例高于女性(P<0.01)、病程更短(P<0.01)、血压和血脂水平更高(P<0.05);低血钾组紫纹、瘀斑和下肢水肿发生率更高(P<0.05),更易发生碱中毒(P<0.01);低血钾组血清ACTH、F和24 h UFC均显著高于血钾正常组(P<0.01),大剂量地塞米松抑制试验阴性率更高(37.1%vs 9.4%, P=0.00);低血钾组

  7. [Final results from four clinical studies in the field of cardiovascular diseases integrated in the "Mattoni del SSN - Mattone Outcome" Project].

    Science.gov (United States)

    D'Errigo, Paola; Seccareccia, Fulvia; Rosato, Stefano; Maraschini, Alice; Badoni, Gabriella; Perucci, Carlo Alberto; Fusco, Danilo; D'Ovidio, Mariangela; Stafoggia, Massimo; Barone, Anna Patrizia

    2011-12-01

    Observational outcome studies represent a valid approach to evaluating comparative treatment effectiveness in real populations. The main objective of outcome research is to underline what works and what does not work in the field of health assistance. In 2004 the Italian Ministry of Health launched the Project "Mattone Misura dell'Outcome" aimed at assessing the introduction of procedures and methods for the systematic evaluation of outcomes in the national health system. A new experience, the PROGRESSI program (PROGRamma ESiti per SIVeAS e LEA), started in 2008 with the aim to further develop the methodologies for outcome evaluation. In this Supplement the final results from four clinical studies named "Sperimentazioni dell'area cardiovascolare del Progetto Mattoni" are presented. These studies started between 2005 and 2007 and their main objectives were to evaluate: --the contribution of information from current informative systems and clinical studies in risk-adjustment methodologies; --the advisability of introducing some clinical items in current informative systems to improve outcome estimates; --the goodness of follow-up procedures from current informative systems; and --the role of disease registries in the validation of comparative evaluation measures. The four studies were designed as voluntary prospective multicentre studies. Results concerning the characteristics of the enrolled populations as well as the risk-adjustment models built using information from current informative systems and/or clinical information are presented. As expected, each study produced specific remarks both in terms of clinical findings and contribution of different informative systems to the risk-adjustment models. In general, models built with information from both current informative systems and clinical information show the best performance. Findings from these analyses will provide the public health system with suitable indications to improve statistical methodologies for

  8. 老年咬合异常患者咬合重建修复的临床研究%Clinical study on occlusal rehabilitation in elderly patients with abnormal occlusion

    Institute of Scientific and Technical Information of China (English)

    李玉民; 高平; 殷恺; 李长义

    2009-01-01

    Objective To evaluate the clinical effects and clinical classification of occlusal rehabilitation in elderly patients with abnormal occlusion, and to discuss the diagnosis principles and the practical techniques of the dental prosthesis for occlusal rehabilitation. Methods Forty two elderly patients with abnormal occlusion were treated with occlusal rehabilitation with fixed dentures, fixed-removable dentures and removable partial dentures. Eight patients among them simultaneously had temporomandibular joint(TMJ) disorder. After the clinical procedures including examination, diagnosis, prosthesis design, manufacture, application of occlusal rehabilitation and post-treatment evaluation, the using condition of dentures, patients' satisfaction ratings, TMJ functions and abutment teeth healthy status were examined before and after treatment. Results All the patients were satisfied with their dentures' general functions 1 year after treatment. Compared with the removable partial dentures, the other two types of prosthesis showed better clinical outcomes (χ2=4.15,P<0.05) and compacts on phonation of the dentures (χ2=4.71,P<0.05). In the 8 patients with TMJ disorder, 7 cases were cured completely. The treatment effects of TMJ pain (χ2=0.031, P<0.05)and TMJ click (χ2=0.038, P<0.05)had statistical differences. 30 teeth of the 203 abutment teeth (14.8%) had the problems of periodontal diseases and secondary caries and the incidences of these problems were higher in using removable partial dentures treatment than in the other two methods. Conclusions After the systematic diagnosis and the prosthesis design procedures of occlusal rehabilitation, it is important to choose a proper prostheses for the elderly patients according to their physical and psychological features, which may give the patients satisfactory results.%目的 评价不同种类咬合重建修复的临床效果,探讨老年咬合异常患者咬合重建的临床分类、诊断

  9. Carotenoids as signaling molecules in cardiovascular biology

    Directory of Open Access Journals (Sweden)

    Abolfazl Barzegari

    2014-09-01

    Full Text Available Oxidative stress and inflammation play important roles in the etiology of cardiovascular disease (CVD. Thus, natural antioxidant carotenoids existing in fruits and vegetables could have a significant role in the prevention of CVD. Nevertheless,clinical data are conflicting about the positive effect of some antioxidant carotenoids in reducing cardiovascular morbidity and mortality. Many biological actions of carotenoids have been attributed to their antioxidant effect; however, the precise mechanism by which carotenoids produce their beneficial effects is still under discussion. They might modulate molecular pathways involved in cell proliferation, acting at Akt, tyrosine kinases, mitogen activated protein kinase (MAP kinase and growth factor signaling cascades. Screening for a promising cardiovascular protective carotenoids therefore might be performed in vitro and in vivo with caution in cross-interaction with other molecules involved in signaling pathways especially those affecting microRNAs, performing a role in molecular modulation of cardiovascular cells.

  10. Cardiovascular Risk in Patients with Psoriatic Arthritis

    Directory of Open Access Journals (Sweden)

    Tracy Y. Zhu

    2012-01-01

    Full Text Available Psoriatic arthritis (PsA is an inflammatory arthritis associated with psoriasis. In addition to skin and joint involvement, there is increasing evidence suggesting that patients with PsA also have an increase in risk of clinical and subclinical cardiovascular diseases, mostly due to accelerating atherosclerosis. Both conventional and nonconventional cardiovascular risk factors contribute to the increased cardiovascular risk in PsA. Chronic inflammation plays a pivotal role in the pathogenesis of atherosclerosis in PsA, acting independently and/or synergistically with the conventional risk factors. In this paper, we discuss the current literature indicating that patients with PsA are at risk of cardiovascular diseases.

  11. Migraine and structural abnormalities in the brain

    DEFF Research Database (Denmark)

    Hougaard, Anders; Amin, Faisal Mohammad; Ashina, Messoud

    2014-01-01

    PURPOSE OF REVIEW: The aim is to provide an overview of recent studies of structural brain abnormalities in migraine and to discuss the potential clinical significance of their findings. RECENT FINDINGS: Brain structure continues to be a topic of extensive research in migraine. Despite advances...... in neuroimaging techniques, it is not yet clear if migraine is associated with grey matter changes. Recent large population-based studies sustain the notion of increased prevalence of white matter abnormalities in migraine, and possibly of silent infarct-like lesions. The clinical relevance of this association...... is not clear. Structural changes are not related to cognitive decline, but a link to an increased risk of stroke, especially in patients with aura, cannot be ruled out. SUMMARY: Migraine may be a risk factor for structural changes in the brain. It is not yet clear how factors such as migraine sub-type, attack...

  12. Cardiovascular Risk Factors - Clinical and Epidemiologic profiles in the subjects of the "Atividade Física na Vila" Project Fatores de risco cardiovascular - Perfil clínico e epidemiológico dos participantes do projeto Atividade Física na Vila

    Directory of Open Access Journals (Sweden)

    Eduardo Simon

    2010-11-01

    Full Text Available

    The group of atherothrombotic cardiovascular diseases represents one of the leading causes of death around the world. Atherosclerosis is a condition of multifactorial origin, with great genetic and familiar dependence, besides being characterized by an elevated aggravation trend related to lifestyle. Our objective was to describe the prevalence of cardiovascular risk (CVR factors and Metabolic Syndrome (MS, as well as to estimate the cardiovascular risk in the subjects of the "Atividade Física na Vila" Project. By means of a cross sectional study, 48 patients aged between 23 and 74 (41 women and 7 men were screened for the presence of sedentary lifestyle, smoking, family antecedents of Diabetes mellitus type 22 (DM or Coronary artery disease, obesity, abdominal obesity, High Blood Pressure (HBP, DM2, Impaired Fasting Glucose (IFG, Lipid abnormalities, and MS. This prevalence was compared to the available general population data. The MS definition was that of the NCEP. The CVR was estimated using the Framingham Score (FS, and compared among the groups with and without MS. 67% of the patients were 50 or older and 46% were 55 or older. There was a high prevalence of CVR factors compared to the population data, specially in the case of sedentary lifestyle (52% x 56%, NS, obesity (men 14% x 9%, NS; women 39% x 13%, P<0.05, HBP (56% x 32%, P<0.05, high total cholesterol (63% x 40%, P<0.05. The prevalence of DM2, IFG, abdominal obesity and MS was 10%, 21%, 60% and 27%, respectively. The mean FS was 5,2 ± 5,5, significantly higher in the patients with MS (9,5 ± 3,1 x 3,5 ± 5,4 p<0.05. These data indicate the high prevalence of CVR factors, and suggest its synergy in elevating the global CVR represented by the FS, as well as strongly support the need for changes in the lifestyle of these patients.

    As doenças cardiovasculares aterotrombóticas representam uma das principais causas de morte no mundo. A aterosclerose é uma patologia de origem

  13. Circadian Rhythm Abnormalities

    OpenAIRE

    Zee, Phyllis C.; Attarian, Hrayr; Videnovic, Aleksandar

    2013-01-01

    Purpose: This article reviews the recent advances in understanding of the fundamental properties of circadian rhythms and discusses the clinical features, diagnosis, and treatment of circadian rhythm sleep disorders (CRSDs).

  14. 心脑血管疾病患者血清同型半胱氨酸检测的临床意义%Clinical significance of serum homocysteine test in patients with cerebro- and cardiovascular diseases

    Institute of Scientific and Technical Information of China (English)

    刘启波; 李蔼文; 谭俊青; 邓超

    2016-01-01

    Objective:To investigate the clinical significance of serum homocysteine( HCY)test in clinical diagnosis and treatment of cardiovascular diseases. Methods:A total of 100 patients treated in Guangdong Second Provincial Hospital for cerebro-and cardiovascular diseases( 50 cases of cerebral infarction,50 cases of coronary heart disease)and 50 healthy volunteers( control group)were randomly recruited between March 2013 and March 2014. For these three groups of patients,we detection serum levels of HCY and lipids. Results:Before treatment,patients with coronary heart disease( CHD ) and patients with cerebral infarction had significantly higher serum levels of HCY,TG,TC,HDL-C and LDL-C compared with the controls(P0.05). After treatment,patients with CHD and those with cerebral infarction showed significant improvement in serum HCY,TG,TC,HDL-C and LDL-C levels compared with baseline values(P0. 05 ). Conclusion:Elevation in serum HCY level is an important risk factor for development and progression of cerebro-and cardiovascular diseases,and may also induce dyslipidemia. Timely determination of serum HCY level is the key to start management and improve outcomes of cerebro-and cardiovascular diseases.%目的:探讨血清同型半胱氨酸( HCY)水平检测对于心脑血管疾病临床诊疗的意义。方法:随机选取2013年3月至2015年3月广东省第二中医院收治的100例心脑血管疾病患者(脑梗塞50例、冠心病50例)与50例健康体检者(对照组)作为研究对象,检测3组患者HCY水平和血脂水平。结果:冠心病组和脑梗死组治疗前HCY、TG、TC、HDL-C、LDL-C水平均明显高于对照组(P<0.05),且冠心病组与脑梗死组间比较,差异无统计学意义( P>0.05)。冠心病组和脑梗死组治疗后HCY、TG、TC、HDL-C、LDL-C水平均较各自治疗前明显改善(P<0.05),且冠心病组与脑梗死组间比较,差异无统计学意义(P>0.05)。结论

  15. How Should We Treat Depression in Patients with Cardiovascular Disease?

    OpenAIRE

    Kronish, Ian M.; Krupka, David J.; Davidson, Karina W.

    2012-01-01

    Among patients with cardiovascular disease (CVD), depression is highly prevalent and is associated with worse cardiovascular prognosis and lower quality of life. Treatments for depression in CVD patients produce modest, but clinically significant reductions in depressive symptoms and show promise for improving cardiovascular prognosis. While tricyclics should generally be avoided, antidepressants from multiple other classes appear to be safe in cardiac patients. A strategy of engaging patient...

  16. Cardiovascular risk factors in patients with severe mental illness

    OpenAIRE

    2008-01-01

    Individuals with severe mental illness have much higher mortality rates from somatic diseases than the general population. Cardiovascular disease is the leading cause of death, and, contrary to the general population, cardiovascular mortality in psychiatric patients has not declined over the last decades. The main aim of the clinical studies performed in this thesis in psychiatry was to gain more knowledge about the prevalence and causes of cardiovascular risk factors in patients with severe ...

  17. Arterial stiffness, central hemodynamics, and cardiovascular risk in hypertension

    Directory of Open Access Journals (Sweden)

    Palatini P

    2011-12-01

    reduction. Although many methodological problems still hinder the wide clinical application of parameters of arterial stiffness, these will likely contribute to cardiovascular assessment and management in future clinical practice. Each of the abovementioned parameters reflects a different characteristic of the atherosclerotic process, involving functional and/or morphological changes in the vessel wall. Therefore, acquiring simultaneous measurements of different parameters of vascular function and structure could theoretically enhance the power to improve risk stratification. Continuous technological effort is necessary to refine our methods of investigation in order to detect early arterial abnormalities. Arterial stiffness and its consequences represent the great challenge of the twenty-first century for affluent countries, and “de-stiffening” will be the goal of the next decades.Keywords: arterial elasticity, stiffness, compliance, central blood pressure, pulse wave velocity

  18. Investigation on clinical outcomes of reproductive abnormalities with secondary constric﹣ tion increase polymorphism of chromosome long arm%染色体多态性qh+与临床生殖异常关系的探讨

    Institute of Scientific and Technical Information of China (English)

    王桂玲; 任春娥; 姜爱芳

    2015-01-01

    目的::目的:分析染色体长臂次缢痕增加( qh+)与生殖异常的临床效应关系。方法:对2080例不孕不育患者进行常规外周血染色体核型分析。结果:2080例不孕不育患者共检出染色体多态性208例,检出率为10.0%,其中qh+患者88例,占42.31%。88例qh+患者中,男性72例,女性16例。1 qh+22例;9 qh+17例;16 qh+14例;Yqh+(46,XY,大Y)29例;46,XY,Yqh+,9qh+5例;46,XY,Yqh+,16qh+患者1例。72例男性患者中存在精子质量问题者60例,占83.33%。配偶有胚胎停育史者共12例,占16.7%,其中2次以上胚胎停育史者共8例,占11.11%;配偶有畸形儿生育史者3例。16例女性患者中有胚胎停育史者7例(43.12%),其中2次以上胚胎停育史者5例(31.25%)。结论:染色体qh+与不孕不育、复发性流产、生育畸形儿等