scholarly journals Cardiovascular Health in Individuals with Exceptional Longevity Residing in Arkansas

2021 ◽  
Vol 7 ◽  
pp. 233372142110189
Author(s):  
Brandi M. Mize ◽  
Brandon Duke ◽  
Amanda K. Pangle ◽  
Jeanne Y. Wei ◽  
Gohar Azhar
Keyword(s):  
Heart Failure ◽  
Chart Review ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Retrospective Chart Review ◽  
Hdl Cholesterol ◽  
Study Cohort ◽  
Old Patients ◽  
Genetic Components ◽  
Blood Pressures

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas. Only 236 of the 291 patients in our study cohort had blood pressures recorded. Of these, 50% had systolic blood pressures ≥140 mmHg. Additionally, 77% had pulse pressures ≥50 mmHg. Of the 96 patients with BNP data, 44% had values ≥300 pg/mL. There was a slight positive correlation between aging and HDL cholesterol, while there was a negative correlation between aging and both total cholesterol and LDL cholesterol. A majority of our patients had both elevated systolic blood pressures and elevated pulse pressures. A majority also had high BNP values, indicative of some degree of heart failure. Additionally, atrial fibrillation was a common arrhythmia identified on EKG. However, these oldest of the old patients had fewer documented metabolic derangements. These findings lay important groundwork for further investigation into lifestyle and genetic components that allow them to live exceptionally long with such comorbidities.

Cholecystectomy for Biliary Hyperkinesia

2019 ◽  
Vol 85 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Joshua Gazzetta ◽  
Betty Fan ◽  
Paul Bonner ◽  
John Galante
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Chart Review ◽  
Gallbladder Disease ◽  
Retrospective Chart Review ◽  
Biliary Colic ◽  
Study Cohort ◽  
Final Pathology ◽  
Pathology Reports ◽  
Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

Abstract 3235: Low LDL is Associated with Hematoma Expansion in Chronic Daily Alcohol Users with Intracranial Hemorrhage

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Gayle R Pletsch ◽  
Christopher Burns ◽  
Karen C Albright ◽  
Amelia K Boehme ◽  
T. M Beasley ◽  
...  
Keyword(s):  
Chart Review ◽  
Ldl Cholesterol ◽  
Independent Predictor ◽  
Retrospective Chart Review ◽  
Platelet Inhibition ◽  
Demographic Variables ◽  
Hematoma Expansion ◽  
Chi Square ◽  
Alcohol Users

Background: Prior studies have reported elevated blood pressure, platelet inhibition, and low LDL cholesterol in chronic daily alcohol users (CDA). Each of these has been shown to be associated with intracerebral hemorrhage (ICH) growth. We hypothesized that CDA patients with ICH and low LDL were at higher risk for ICH growth than CDA users with high LDL. Methods: Retrospective chart review was performed on patients who presented to Tulane University from 7/1/08-12/31/10 with a spontaneous ICH. Patients who underwent hematoma evacuation were excluded. Clinical and demographic variables were abstracted. Hemorrhages volumes were calculated based on ABC/2 method. LDL was dichotomized into low (<100mg/dl) and high (≥100mg/dl) values. Comparisons were made using t-tests, Chi-square and non-parametric equivalents where appropriate. ICH growth in 24 hours and CDA use were evaluated using linear regression. Results: Of the 99 patients with spontaneous ICH, 25.3% were CDA users. No significant differences were observed when comparing baseline demographics of CDA users with LDL<100 and CDA users with LDL>=100 ( Table 1). Patients with low LDL had larger baseline ICH volumes (21.4 vs. 7.5, p=.03) and were more likely to experience ICH growth (87.5% vs. 57.1%, p=0.0002). Initial LDL was an independent predictor for 24 hour ICH growth. Every 10 points the initial LDL was below 100 predicted 1 cc of growth. LDL did not predict ICH growth in non-CDA users (p=0.9430). Discussion: Our data suggest that initial LDL level in chronic daily alcohol users can be used to predict ICH growth. The role of LDL in the importance of vessel fragility and clot stabilization needs to be further explored as this appears be important in patients who are chronic daily alcohol users.

scholarly journals Dietary Intakes and Cardiovascular Health of Healthy Adults in Short-, Medium-, and Long-Term Whole-Food Plant-Based Lifestyle Program

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 55 ◽  
Author(s):  
Boštjan Jakše ◽  
Barbara Jakše ◽  
Stanislav Pinter ◽  
Borut Jug ◽  
Uroš Godnov ◽  
...  
Keyword(s):  
Blood Lipids ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Whole Grains ◽  
Food Plant ◽  
Dietary Intakes ◽  
Lifestyle Program ◽  
Cvd Prevention

An effective lifestyle strategy to reduce cardiovascular diseases risk (CVD) factors is needed. We examined the effects of a whole-food plant-based (WFPB) lifestyle program on dietary intake and cardiovascular (CV) risk factors in 151 adults (mean 39.6 (SD 12.5) years). Adherence was categorised into short-, medium- and long-term (years: (0.5–<2), (2–<5) and (5–10)), for both genders separately. Dietary intakes were assessed, fasting blood lipids and blood pressure (BP) were measured, and % participants reaching guideline recommended targets for LDL-cholesterol, triglycerides and BP in the primary CVD prevention was assessed. There were no statistically significant differences in intakes of energy and most nutrients among participants (both genders), that were short-, medium- and long term in our program. Diet was mainly composed of unprocessed vegetables/fruits, whole grains, legumes, potatoes, and nuts/seeds. LDL-cholesterol, triglycerides, systolic and diastolic BP were within targets for: 93%, 97%, 88% and 95% participants, respectively. In females (vs. males), total- and HDL-cholesterol were higher (mean): 3.8 (SD 0.7) vs. 3.4 (SD 0.9), p = 0.002 and 1.5 (SD 0.3) vs. 1.1 (SD 0.2) mmol/L, p < 0.001), systolic BP was lower (113 (SD 11) vs. 120 (SD 10) mmHg, p = 0.001), while there was no difference in diastolic BP (71 (SD 9) vs. 72 (SD 8) mmHg, p = 0.143). More females vs. males reached target triglycerides (99% vs. 91%, p = 0.021) and systolic BP (92% vs. 79%, p = 0.046), while similar females and males reached target LDL-cholesterol (94% vs. 91%, p = 0.500) and diastolic BP (93% vs. 100%, p = 0.107). Participation in our WFPB lifestyle program is associated with favourable dietary intakes, safety markers, and CV risk factor profiles.

scholarly journals Impact of the COVID-19 Pandemic on Cystic Fibrosis Pulmonary Exacerbations

2020 ◽  
Vol 3 ◽  
Author(s):  
Shreya Patel ◽  
Misty Thompson ◽  
James Slaven ◽  
Clement Ren
Keyword(s):  
Chart Review ◽  
Viral Infections ◽  
Retrospective Chart Review ◽  
Time Interval ◽  
Study Cohort ◽  
School Closures ◽  
Respiratory Viral Infections ◽  
Potential Impact ◽  
Pulmonary Exacerbations ◽  
The Impact

​Background and Hypothesis       CF pulmonary exacerbations (PEx) are episodes of decline in respiratory function that can be triggered by a variety of mechanisms, including respiratory viral infections.  The COVID-19 pandemic resulted in school closures and home isolation policies and a potential reduction in exposure to other respiratory viruses.  The goal of this project is to study the impact of the COVID-19 pandemic on CF PEx at the Riley Hospital for Children. We hypothesize that the incidence of PEx will be lower during the period of the COVID-19 lockdown from March 1 to May 15 in 2020 compared to the same time interval in 2019.      Methods  We performed a retrospective chart review of children with CF ages 2-12 (N=80) seen at Riley in 2019 and 2020 and collected data within the following timeframes: January 1 to March 15 2019 and 2020, and March 16 to May 15 2019 and 2020.  We collected data on baseline clinical features and details of each PEx event.  Data were analyzed with parametric and non-parametric descriptive statistic tests as appropriate; significance was set at P≤0.05.     Results       The percent of PEx events in the study cohort was significantly lower in 2020 compared to 2019 for January 1 to March 15 (56% vs 42%, P=0.0116) and March 16 to May 15 (35% vs 14%, P<0.0001).  The percent of in-person PEx events was significantly lower during March 16 to May 15 in 2020 compared to 2019 (15% vs 1%, P=0.0066)    Conclusions and Potential Impact        COVID-19 restrictions were associated with a decrease PEx events.  We speculate that this reflects a reduced exposure to respiratory viral infections in general. The decrease in in-person PEx events may reflect a shift towards telehealth during the COVID-19 restrictions.  These results provide a foundation for further research into triggers and prevention of CF PEx.   

Outcomes of a Pharmacist-Managed Heart Failure Medication Titration Assistance Clinic

2018 ◽  
Vol 52 (8) ◽  
pp. 724-732 ◽  
Author(s):  
Shubha Bhat ◽  
Mayank Kansal ◽  
George T. Kondos ◽  
Vicki Groo
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Ace Inhibitors ◽  
Chart Review ◽  
Ace Inhibitor ◽  
Angiotensin Receptor Blockers ◽  
Retrospective Chart Review ◽  
National Guidelines ◽  
Reduced Ejection Fraction ◽  
Receptor Blockers

Background: National guidelines recommend angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs) and β-blockers (BBs) at target doses for morbidity and mortality benefits in heart failure with reduced ejection fraction (HFrEF); regardless, titration of these therapies in practice remains suboptimal. We implemented an outpatient pharmacist-managed HFrEF medication titration assistance clinic (MTAC) at one institution to improve titration for general cardiology (GC) patients. Objective: To evaluate MTAC impact by determining the proportion of patients on target or maximum tolerated ACE inhibitor/ARB and BB doses. Methods: A retrospective chart review of adult patients with documented ejection fraction ≤40% managed in the MTAC or GC from 2011 to 2013 was conducted. HFrEF medication regimens were collected at initial visit and months 1, 2, 3, 6, 9, and 12 to assess titration. Target doses were defined per guideline or dose at which ejection fraction recovered during the study. Maximum tolerated doses were defined as the highest dose patients tolerated without physiological limitations. Results: Of 148 patients, the MTAC managed 51 and GC managed 97. At baseline, 90% of MTAC versus 82% of GC patients were prescribed ACE inhibitors/ARBs and BBs. In the MTAC, 4% were at target or maximum tolerated doses compared with 32% of GC patients ( P < 0.001). At 12 months, 95% of patients in the MTAC and 87% in GC were prescribed ACE inhibitors/ARBs and BBs. Of those prescribed ACE inhibitors/ARBs and BBs, 64% in the MTAC versus 40% in GC reached target or maximum tolerated doses ( P = 0.01). Conclusions: The pharmacist-managed MTAC increased the proportion of patients on optimal HFrEF therapies and are a resource for GC patients.

Incidence and predictors of ophthalmic artery occlusion in intra-arterial chemotherapy for retinoblastoma

2020 ◽  
pp. neurintsurg-2020-016759
Author(s):  
Ahmad Sweid ◽  
Kareem El Naamani ◽  
Kalyan Chekravarthy Sajja ◽  
Batoul Hammoud ◽  
Michael D Knapp ◽  
...  
Keyword(s):  
Ophthalmic Artery ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Artery Occlusion ◽  
Study Cohort ◽  
Related Factors ◽  
Artery Thrombosis ◽  
Total Incidence ◽  
Chemotherapy Infusion ◽  
Intraocular Retinoblastoma

BackgroundRetinoblastoma is the most common primary intraocular malignancy in children.ObjectiveTo determine the incidence of ophthalmic artery (OA) occlusion in patients treated with selective ophthalmic artery catheterization (OAC) for chemotherapy infusion for retinoblastoma. Also, to evaluate technical, anatomical, tumorous, and patient-related factors that are predictors of OA occlusion.MethodsA retrospective chart review was performed for patients diagnosed with intraocular retinoblastoma and managed with intra-arterial chemotherapy (IAC).ResultsThe total study cohort included 208 retinoblastoma tumors of 208 eyes in 197 consecutive patients who underwent 688 attempted IAC infusions overall with a total of 624 successful OAC infusions. The total incidence of ophthalmic artery thrombosis was 11.1% (23/208). The numbers of successful OAC procedures before diagnosing OA occlusion were one OAC in six cases (27.3%), two in seven cases (31.8%), three in four cases (18.2%), four in one case (4.5%), five in two cases (9.1%), and six in one case (4.5%).ConclusionsLocal factors relating to the chemotherapy and selective microcatheterization of the OA are essential factors in the development of OA thrombosis, as seen by the association of OA thrombosis with the frequency of IAC.

scholarly journals Dose-dependent effects of docosahexaenoic acid-rich fish oil on erythrocyte docosahexaenoic acid and blood lipid levels

2008 ◽  
Vol 99 (5) ◽  
pp. 1083-1088 ◽  
Author(s):  
Catherine M. Milte ◽  
Alison M. Coates ◽  
Jonathan D. Buckley ◽  
Alison M. Hill ◽  
Peter R. C. Howe
Keyword(s):  
Docosahexaenoic Acid ◽  
Fish Oil ◽  
Cardiovascular Health ◽  
Ldl Cholesterol ◽  
Close Association ◽  
Hdl Cholesterol ◽  
Blood Lipid ◽  
Erythrocyte Membranes ◽  
Double Blind ◽  
The Relationship

Consumption of long-chainn-3 PUFA, particularly DHA, has been shown to improve cardiovascular risk factors but the intake required to achieve benefits is unclear. We sought to determine the relationship between DHA intake, increases in erythrocyte DHA content and changes in blood lipids. A total of sixty-seven subjects (thirty-six male, thirty-one female, mean age 53 years) with fasting serum TAG ≥ 1·1 mmol/l and BMI>25 kg/m2completed a 12-week, randomized, double-blind, placebo-controlled parallel intervention. Subjects consumed 2, 4 or 6 g/d of DHA-rich fish oil (26 % DHA, 6 % EPA) or a placebo (Sunola oil). Fasting blood lipid concentrations and fatty acid profiles in erythrocyte membranes were assessed at baseline and after 6 and 12 weeks. For every 1 g/d increase in DHA intake, there was a 23 % reduction in TAG (mean baseline concentration 1·9 (sem0·1) mmol/l), 4·4 % increase in HDL-cholesterol and 7·1 % increase in LDL-cholesterol. Erythrocyte DHA content increased in proportion to the dose of DHA consumed (r0·72,P < 0·001) and the increase after 12 weeks was linearly related to reductions in TAG (r− 0·38,P < 0·01) and increases in total cholesterol (r0·39,P < 0·01), LDL-cholesterol (r0·33,P < 0·01) and HDL-cholesterol (r0·30,P = 0·02). The close association between incorporation of DHA in erythrocytes and its effects on serum lipids highlights the importance of erythrocyte DHA as an indicator of cardiovascular health status.

scholarly journals Selenium supplementation lowers insulin resistance and markers of cardio-metabolic risk in patients with congestive heart failure: a randomised, double-blind, placebo-controlled trial

2018 ◽  
Vol 120 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Fariba Raygan ◽  
Milad Behnejad ◽  
Vahidreza Ostadmohammadi ◽  
Fereshteh Bahmani ◽  
Mohammad A. Mansournia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Insulin Resistance ◽  
Ldl Cholesterol ◽  
Controlled Trial ◽  
Hdl Cholesterol ◽  
Metabolic Profiles ◽  
Metabolic Risk ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Hs Crp

AbstractThis study was carried out to evaluate the effects of Se supplementation on metabolic profiles in patients with congestive heart failure (CHF). This randomised double-blind, placebo-controlled trial was performed among fifty-three subjects with CHF, aged 45–85 years old. Subjects were randomly allocated into two groups to take either 200 µg/d of Se as Se yeast (n 26) or placebo (n 27) for 12 weeks. Metabolic profiles were assessed at baseline and at the end of trial. Compared with the placebo, Se supplementation led to significant reductions in serum insulin (−18·41 (sd 27·53) v. +13·73 (sd 23·63) pmol/l, P<0·001), homoeostatic model of assessment for insulin resistance (−1·01 (sd 1·61) v. +0·55 (sd 1·20), P<0·001) and a significant increase in quantitative insulin sensitivity check index (QUICKI) (+0·007 (sd 0·03) v. −0·01 (sd 0·01), P=0·007). In addition, Se supplementation significantly decreased LDL-cholesterol (−0·23 (sd 0·29) v. −0·04 (sd 0·28) mmol/l, P=0·03) and total-:HDL-cholesterol ratio (−0·47 (sd 0·31) v. −0·06 (sd 0·42), P<0·001), and significantly increased HDL-cholesterol levels (+0·18 (sd 0·19) v. +0·02 (sd 0·13) mmol/l, P=0·001) compared with the placebo. In addition, taking Se supplements was associated with a significant reduction in high-sensitivity C-reactive protein (hs-CRP) (−1880·8 (sd 3437·5) v. +415·3 (sd 2116·5) ng/ml, P=0·01), and a significant elevation in plasma total antioxidant capacity (TAC) (+30·9 (sd 118·0) v. −187·9 (sd 412·7) mmol/l, P=0·004) and total glutathione levels (+33·7 (sd 130·4) v. −39·2 (sd 132·8) µmol/l, P=0·003) compared with the placebo. When we applied Bonferroni correction for multiple outcome testing, QUICKI (P=0·11), LDL-cholesterol (P=0·51), hs-CRP (P=0·17), TAC (P=0·06) and GSH (P=0·05) became non-significant, and other metabolic profiles did not alter. Overall, our study supported that Se supplementation for 12 weeks to patients with CHF had beneficial effects on insulin metabolism and few markers of cardio-metabolic risk.

scholarly journals Obesity and Heart Failure as Predictors of Failure in Outpatient Skin and Soft Tissue Infections

2017 ◽  
Vol 61 (3) ◽  
Author(s):  
Erin L. Conway ◽  
John A. Sellick ◽  
Kari Kurtzhalts ◽  
Kari A. Mergenhagen
Keyword(s):  
Heart Failure ◽  
Chart Review ◽  
Primary Outcome ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Skin Infections ◽  
Unit Increase ◽  
Classification Of Diseases ◽  
International Statistical Classification

ABSTRACT The purpose of this study was to evaluate risk factors for failure of antibiotic treatment within 30 days for uncomplicated skin infections of outpatients treated in a Veterans Affairs hospital. A retrospective chart review of outpatients between January 2006 and July 2015 with an ICD-9 (International Statistical Classification of Diseases and Related Health Problems) code of cellulitis or abscess was included in the analysis. The primary outcome was success versus failure of the antibiotic, with failure defined as another antibiotic prescribed or hospitalization within 30 days for the original indication. A total of 293 patients were included in the final analysis, 24% of whom failed within 30 days. Obesity/overweight (body mass index [BMI] of >25 kg/m2) was identified in 83% of the overall population, with 16% of that population having a BMI greater than 40 kg/m2. An elevated mean BMI of 34.2 kg/m2 (P = 0.0098) was found in the subset of patients who failed oral antibiotics compared to a BMI of 31.32 kg/m2 in patients who were treated successfully. Additionally, the patients who failed had an increased prevalence of heart failure at 16% (P = 0.027). Using multivariate logistic regression, BMI and heart failure were determined to be significant predictors of antibiotic prescription failure. Each 10-kg/m2 unit increase in BMI was associated with a 1.62-fold-greater odds of failure. A diagnosis of heart failure increased the odds of failure by 2.6-fold (range, 1.1- to 5.8-fold). Outpatients with uncomplicated skin infections with an elevated BMI and heart failure were found to have increased odds of failure, defined as hospitalization or additional antibiotics within 30 days.

scholarly journals Smoking increases the risk of COVID-19 positivity, while Never-smoking reduces the risk

2020 ◽  
Author(s):  
Samson Barasa ◽  
Josephine Kiage-Mokaya ◽  
Katya Cruz-Madrid ◽  
Michael Friedlander
Keyword(s):  
Heart Failure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Lower Risk ◽  
Smoking Status ◽  
Retrospective Chart Review ◽  
Chronic Obstructive ◽  
Old Patients ◽  
Former Smokers ◽  
Never Smokers

IntroductionDoes smoking decrease the risk of testing positive for COVID-19 because the never-smokers (84%) prevalence is high and the current-smokers prevalence is low among COVID-19 positive patients? 1,2,3,4,5,6 We sought to determine whether never smoking increases the risk of COVID-19 positivity among the 50 to 69-year old patients because they are more likely to test positive for COVID-19.7MethodWe conducted a retrospective chart review of COVID-19 Polymerase chain reaction, in-hospital tested ≥18-year-old patients. A Poisson regression analysis stratified into never-smokers and history of smoking (current + former smokers) was conducted.Results277 COVID-19 negative and 117 COVID-19 positive patients’ charts with a never-smokers prevalence of 42.32% and 54% respectively were analyzed. The never-smokers prevalence was 54%, 20-39-years; 61 %, 40 -49-years; 41%, 50 – 69-years; and 43%, 70 – 100-years.The 40-49-year-old current and former smokers were more likely to test positive for COVID-19 [1.309 (1.047 - 1.635)], unlike the 40-49-year-old never-smokers [0.976 (0.890-1.071)] who had a lower risk.Regardless of their smoking status, males [1.084(1.021 - 1.151)] and the 50-69-year-old patients [1.082 (1.014 -1.154)] were more likely to test positive for COVID-19, while end stage renal disease [0.908(0.843-0.978)] and non-COVID-19 respiratory viral illness [0.907 (0.863 - 0.953)] patients had a lower risk of COVID-19 positivity.Heart failure [0.907 (0.830 - 0.991)], chronic obstructive pulmonary disease (COPD) [0.842 (0.745 - 0.952)] and Parkinson’s disease [0.823 (0.708 - 0.957)] never-smokers were less likely to test positive for COVID-19.ConclusionThis is the first study to show that smoking increases the risk of COVID-19 positivity among the 40-49-year-old patients, while not smoking reduces the risk of COVID-19 positivity among the heart failure, COPD and Parkinson’s disease patients. This study emphasizes that COVID-19 positivity risk is not reduced by smoking and not increased by not smoking.

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