scholarly journals FEASIBILITY OF VASCULAR REMODELING PARAMETER ESTIMATION FOR ASSESSING HYPERTENSIVE PREGNANCY DISORDERS

2021 ◽  
Author(s):  
Georgios Kissas ◽  
Eileen Hwuang ◽  
Elizabeth Thompson ◽  
Nadav Schwartz ◽  
John Detre ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Ad Hoc ◽  
Disease Assessment ◽  
Patient Specific ◽  
Absolute Pressure ◽  
Cross Sectional ◽  
Arterial Network ◽  
Hypertensive Pregnancy ◽  
Value Range ◽  
Pregnancy Disorders

Hypertensive pregnancy disorders, such as preeclampsia, are leading sources of both maternal and fetal morbidity in pregnancy. Non-invasive imaging, such as ultrasound and magnetic resonance imaging (MRI), is an important tool in predicting and monitoring these high risk pregnancies. While imaging can measure hemodynamic parameters, such as uterine artery pulsatility and resistivity indices, the interpretation of such metrics for disease assessment rely on ad-hoc standards, which provide limited insight to the physical mechanisms underlying the emergence of hypertensive pregnancy disorders. To provide meaningful interpretation of measured hemodynamic data in patients, advances in computational fluid dynamics can be brought to bear. In this work, we develop a patient-specific computational framework that combines Bayesian inference with a reduced-order fluid dynamics model to infer remodeling parameters, such as vascular resistance, compliance and vessel cross-sectional area, known to be related to the development of hypertension. The proposed framework enables the prediction of hemodynamic quantities of interest, such as pressure and velocity, directly from sparse and noisy MRI measurements. We illustrate the effectiveness of this approach in two systemic arterial network geometries: an aorta with carotid and a maternal pelvic arterial network. For both cases, the model can reconstruct the provided measurements and infer parameters of interest. In the case of the maternal pelvic arteries, the model can make a distinction between the pregnancies destined to develop hypertension and those that remain normotensive, expressed through the value range of the predicted absolute pressure.

scholarly journals Maternal Hypertensive Pregnancy Disorders and Mental and Behavioral Disorders in the Offspring: a Review

2021 ◽  
Vol 23 (5) ◽  
Author(s):  
Rachel Robinson ◽  
Anna Lähdepuro ◽  
Soile Tuovinen ◽  
Polina Girchenko ◽  
Ville Rantalainen ◽  
...  
Keyword(s):  
Behavioral Disorders ◽  
Sound Studies ◽  
Original Research ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Hypertensive Pregnancy ◽  
Increased Risk ◽  
Meta Analyses ◽  
Mental And Behavioral Disorders ◽  
Pregnancy Disorders

Abstract Purpose of Review We review here recent original research and meta-analytic evidence on the associations of maternal hypertensive pregnancy disorders and mental and behavioral disorders in the offspring. Recent Findings Seven meta-analyses and 11 of 16 original research studies published since 2015 showed significant associations between maternal hypertensive pregnancy disorders and offspring mental and behavioral disorders. Evidence was most consistent in meta-analyses and high-quality cohort studies. The associations, independent of familial confounding, were observed on different mental and behavioral disorders in childhood and schizophrenia in adulthood. Preterm birth and small-for-gestational age birth emerged as possible moderators and mediators of the associations. Cross-sectional and case-control studies yielded inconsistent findings, but had lower methodological quality. Summary Accumulating evidence from methodologically sound studies shows that maternal hypertensive pregnancy disorders are associated with an increased risk of mental and behavioral disorders in the offspring in childhood. More studies on adult mental disorders are needed.

WHICH MORPHOLOGIC AND HEMODYNAMIC CHARACTERISTICS PREDICT INTRACRANIAL FUSIFORM ANEURYSMS RUPTURE? A PATIENT-SPECIFIC COMPUTATIONAL FLUID DYNAMICS STUDY

2017 ◽  
Vol 17 (03) ◽  
pp. 1750070
Author(s):  
YAN CHEN ◽  
YI-BIN FANG ◽  
PENG-FEI YANG ◽  
QING-HAI HUANG ◽  
JIAN-MIN LIU
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Cfd Simulation ◽  
Patient Specific ◽  
Parent Artery ◽  
Cross Sectional ◽  
3D Angiography ◽  
Cross Section Area ◽  
Increased Risk ◽  
Risk Of Rupture

To identify hemodynamic and morphological parameters leading to increased risk of intracranial fusiform aneurysms (IFA) rupture using computational fluid dynamics (CFDs). A total of 24 patient-specific fusiform aneurysms models on vertebral artery were reconstructed from 3D angiography images. 11 ruptured cases and 13 unruptured cases were included. Morphologic parameters were measured and CFD parameters were calculated using CFD simulation. The length of the aneurysm is significantly shorter in ruptured group than in unruptured group. The ratio of the width to the length of an aneurysm (WLR) and the ratio of the cross-section area to the length of an aneurysm (ALR) to the averaged cross sectional areas of the inlet and outlet of the parent artery (ALaR) were significantly higher in ruptured group compared with unruptured group. Wall shear stress (WSS) of the aneurysm was normalized to the WSS of the parent artery. Hemodynamically, only low WSS was associated with higher risk of rupture. Ruptured IFAs are shorter, have bigger WLR, ALaR, and lower WSS, compared with unruptured IFAs.

scholarly journals Functional assessment of the stenotic carotid artery by CFD-based pressure gradient evaluation

2016 ◽  
Vol 311 (3) ◽  
pp. H645-H653 ◽  
Author(s):  
Xin Liu ◽  
Heye Zhang ◽  
Lijie Ren ◽  
Huahua Xiong ◽  
Zhifan Gao ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Carotid Artery ◽  
Pressure Gradient ◽  
Carotid Stenosis ◽  
Functional Assessment ◽  
Image Data ◽  
Internal Carotid Artery Stenosis ◽  
Patient Specific ◽  
Severe Stenosis ◽  
Cross Sectional

The functional assessment of a hemodynamic significant stenosis base on blood pressure variation has been applied for evaluation of the myocardial ischemic event. This functional assessment shows great potential for improving the accuracy of the classification of the severity of carotid stenosis. To explore the value of grading the stenosis using a pressure gradient (PG)—we had reconstructed patient-specific carotid geometries based on MRI images—computational fluid dynamics were performed to analyze the PG in their stenotic arteries. Doppler ultrasound image data and the corresponding MRI image data of 19 patients with carotid stenosis were collected. Based on these, 31 stenotic carotid arterial geometries were reconstructed. A combinatorial boundary condition method was implemented for steady-state computer fluid dynamics simulations. Anatomic parameters, including tortuosity (T), the angle of bifurcation, and the cross-sectional area of the remaining lumen, were collected to investigate the effect on the pressure distribution. The PG is highly correlated with the severe stenosis ( r = 0.902), whereas generally, the T and the angle of the bifurcation negatively correlate to the pressure drop of the internal carotid artery stenosis. The calculation required <10 min/case, which made it prepared for the fast diagnosis of the severe stenosis. According to the results, we had proposed a potential threshold value for distinguishing severe stenosis from mild-moderate stenosis (PG = 0.88). In conclusion, the PG could serve as the additional factor for improving the accuracy of grading the severity of the stenosis.

scholarly journals GAD-7 and PHQ-9 measurement of perinatal anxiety and depression in women with hypertensive disorders of pregnancy in Yaounde, Cameroon

2018 ◽  
Vol 7 (6) ◽  
pp. 2069
Author(s):  
Felix Essiben ◽  
Esther Meka Ngo Um ◽  
Samuel Ojong ◽  
Felix Gimnwi ◽  
Kamga Olen ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Perinatal Period ◽  
Anxiety And Depression ◽  
Hypertensive Disorder ◽  
Cross Sectional ◽  
Hypertensive Pregnancy ◽  
Validated Questionnaire ◽  
Perinatal Anxiety ◽  
Patient Health ◽  
Pregnancy Disorders

Background: The aim of the study was to determine the prevalence of perinatal anxiety and depression in women with hypertensive diseases during pregnancy in Yaounde.Methods: Authors carried out a cross-sectional descriptive study over nine months from October 2015 to May 2016, amongst pregnant women with hypertensive pregnancy disorders followed up in three tertiary care centers in Yaounde. Authors collected information from the medical files of selected patients by using a pre-tested and validated questionnaire in the perinatal period. We classified blood pressure values as per the JNC 7 recommendations. Anxiety and mental depression were evaluated for using the Generalized Anxiety Disorder 7-item and the Patient Health Questionnaires-9 respectively. Data analysis was done using CSPro version 6.2 and SPSS version 20.0 software.Results: Authors included 202 patients during the study period. The mean age stood at 25.9± 6.4years (extremes 13-43years). Amongst these, 47.5% were single while 97.5% (197/202) had received at least primary education. Students represented 45.5% (92/202) of women while 102 (50.5%) of them had some form of employment in the public, private or informal sectors. Severe preeclampsia was the most prevalent hypertensive disorder in these women, with 69 (34.2%) developing eclampsia. We found that 79% (161/202) of these patients suffered from anxiety, 67.3% (136/202) were depressive while 61.3% (124/202) had both anxiety and depression.Conclusions: The prevalence of perinatal anxiety and depression in women with hypertensive pregnancy disorders is high. Associated factors must be looked out in order to prevent these situations.

scholarly journals The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Assessment ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Disease Community

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

scholarly journals Morphological and Hemodynamic Changes during Cerebral Aneurysm Growth

2021 ◽  
Vol 11 (4) ◽  
pp. 520
Author(s):  
Emily R. Nordahl ◽  
Susheil Uthamaraj ◽  
Kendall D. Dennis ◽  
Alena Sejkorová ◽  
Aleš Hejčl ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Kinetic Energy ◽  
Swirling Flow ◽  
Morphological Changes ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Aneurysm Wall ◽  
Aneurysm Growth ◽  
Computational Fluid Dynamics Cfd

Computational fluid dynamics (CFD) has grown as a tool to help understand the hemodynamic properties related to the rupture of cerebral aneurysms. Few of these studies deal specifically with aneurysm growth and most only use a single time instance within the aneurysm growth history. The present retrospective study investigated four patient-specific aneurysms, once at initial diagnosis and then at follow-up, to analyze hemodynamic and morphological changes. Aneurysm geometries were segmented via the medical image processing software Mimics. The geometries were meshed and a computational fluid dynamics (CFD) analysis was performed using ANSYS. Results showed that major geometry bulk growth occurred in areas of low wall shear stress (WSS). Wall shape remodeling near neck impingement regions occurred in areas with large gradients of WSS and oscillatory shear index. This study found that growth occurred in areas where low WSS was accompanied by high velocity gradients between the aneurysm wall and large swirling flow structures. A new finding was that all cases showed an increase in kinetic energy from the first time point to the second, and this change in kinetic energy seems correlated to the change in aneurysm volume.

scholarly journals Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Study Data ◽  
Patient Specific ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medications

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

scholarly journals Prevalence of SARS-CoV-2 Infection at the University of Barcelona during the Third COVID-19 Pandemic Wave in Spain

2021 ◽  
Vol 18 (12) ◽  
pp. 6526
Author(s):  
Sebastián Videla ◽  
Aurema Otero ◽  
Sara Martí ◽  
M. Ángeles Domínguez ◽  
Nuria Fabrellas ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Venous Blood ◽  
Herd Immunity ◽  
Cross Sectional Study ◽  
Rt Pcr ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Total Prevalence ◽  
The University ◽  
The Impact

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic started in December 2019 and still is a major global health challenge. Lockdown measures and social distancing sparked a global shift towards online learning, which deeply impacted universities’ daily life, and the University of Barcelona (UB) was not an exception. Accordingly, we aimed to determine the impact of the SARS-CoV-2 pandemic at the UB. To that end, we performed a cross-sectional study on a sample of 2784 UB members (n = 52,529). Participants answered a brief, ad hoc, online epidemiological questionnaire and provided a nasal swab for reverse transcription polymerase chain reaction (RT-PCR) SARS-CoV-2 analysis and a venous blood sample for SARS-CoV-2 IgG antibody assay. Total prevalence of SARS-CoV-2 infection (positive RT-PCR or positive IgG) was 14.9% (95%CI 13.3 to 17.0%). Forty-four participants (1.6%, 95%CI: 1.2–2.1%) were positive for SARS-CoV-2 RT-PCR. IgG against SARS-CoV-2 was observed in 12.8% (95%CI: 11.6–14.1%) of participants. Overall, while waiting for population vaccination and/or increased herd immunity, we should concentrate on identifying and isolating new cases and their contacts.

Sign in / Sign up

Export Citation Format

Share Document