scholarly journals Spontaneous extracranial carotid atherosclerosis evolution in asymptomatic individuals: a three-year prospective study

2004 ◽  
Vol 62 (3a) ◽  
pp. 613-617
Author(s):  
Rubens José Gagliardi ◽  
Ibsen Thadeu Damiani ◽  
Rogério Menoncello ◽  
Manoel Carlos Sampaio de Almeida Ribeiro
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Carotid Atherosclerosis ◽  
Specific Treatment ◽  
Signs And Symptoms ◽  
Asymptomatic Patients ◽  
Spontaneous Course ◽  
Atherosclerosis Risk Factors ◽  
Asymptomatic Individuals

OBJECTIVE: To evaluate the spontaneous evolution of extracranial carotid atherosclerosis in asymptomatic patients who did not present the main risk factors associated to the disease. METHOD:A prospective study including patients of both genders, age ranging from 40 to 70 years, not presenting any signs and symptoms of cerebrovascular disease and without the main atherosclerosis risk factors were included. Patients who were using or had used medication during the follow-up period that could potentially influence in the spontaneous course of atherosclerosis were excluded. The evaluation of the plaque and degree of stenosis were acquired using mode B, 7.5 MHz Doppler ultrasonography (USG). The follow-up was carried out for 36 months, with clinical, neurological, and USG exams repeated in a period of 6 to 8 months. Ninety-six individuals (48 women) completed the study with the presence of plaque, and 52 (26 women) with a degree of stenosis. RESULTS: As to the degree of stenosis, 25% of the patients had worsening, 69% remained stable and 6% improved. When only the presence or absence of plaque was considered, 20% showed worsening (plaque developed during follow-up), 7% improved (disappearance of plaque), and 73% remained stable. No differences were found between the male and female patients. CONCLUSION: These results confirm the dynamic characteristics of plaque. In asymptomatic individuals without specific treatment, spontaneous improvement may occur, however, rarely. These findings may contribute as an assessment criterion when a decision is to be made in high-risk patients.

scholarly journals Replication study reveals miR-483-5p as an important target in prevention of cardiometabolic disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Widet Gallo ◽  
Filip Ottosson ◽  
Cecilia Kennbäck ◽  
Amra Jujic ◽  
Jonathan Lou S. Esguerra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Cardiometabolic Risk ◽  
Carotid Atherosclerosis ◽  
Tissue Injury ◽  
Control Sample ◽  
Cardiometabolic Risk Factors ◽  
Cardiometabolic Disease ◽  
Micro Rnas

Abstract Background Alterations in levels of circulating micro-RNAs might reflect within organ signaling or subclinical tissue injury that is linked to risk of diabetes and cardiovascular risk. We previously found that serum levels of miR-483-5p is correlated with cardiometabolic risk factors and incidence of cardiometabolic disease in a case–control sample from the populations-based Malmö Diet and Cancer Study Cardiovascular Cohort (MDC-CC). We here aimed at replicating these findings and to test for association with carotid atherosclerosis. Methods We measured miR-483-5p in fasting serum of 1223 healthy subjects from the baseline examination of the population-based, prospective cohort study Malmö Offspring Study (MOS) and correlated miR-483-5p to cardiometabolic risk factors and to incidence of diabetes mellitus and coronary artery disease (CAD) during 3.7 (± 1.3) years of follow-up using logistic regression. In both MOS and MDC-CC we related mir-483-5p to carotid atherosclerosis measured with ultrasound. Results In cross-sectional analysis miR-483-5p was correlated with BMI, waist circumference, HDL, and sex. After adjustment for age and sex, the association remained significant for all risk factors except for HDL. Logistic regression analysis showed significant associations between miR-483-5p and new-onset diabetes (OR = 1.94, 95% CI 1.06–3.56, p = 0.032) and cardiovascular disease (OR = 1.99, 95% CI 1.06–3.75, p = 0.033) during 3.7 (± 1.3) years of follow-up. Furthermore, miR-483-5p was significantly related with maximum intima-media thickness of the carotid bulb in MDC-CC (p = 0.001), but not in MOS, whereas it was associated with increasing number of plaques in MOS (p = 0.007). Conclusion miR-483-5p is related to an unfavorable cardiometabolic risk factor profile and predicts diabetes and CAD, possibly through an effect on atherosclerosis. Our results encourage further studies of possible underlying mechanisms and means of modifying miR-483-5p as a possible interventional target in prevention of cardiometabolic disease.

Abstract TP199: Stroke Awareness in Argentina, the Sifhon Population Survey

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Daiana E Dossi ◽  
Maximiliano A Hawkes ◽  
Mauricio F Farez ◽  
Maia M Gomez Schneider ◽  
Nicolas A Torres ◽  
...  
Keyword(s):  
Risk Factors ◽  
Distribution System ◽  
Population Survey ◽  
Large Population ◽  
Family Doctor ◽  
Specific Treatment ◽  
Signs And Symptoms ◽  
Warning Signs ◽  
Public Media ◽  
Stroke Awareness

Introduction: Stroke awareness in Latin America is scant. We conducted a large population survey in 13 provinces in Argentina to assess knowledge of cerebrovascular disease. Methods: We distributed 110,000 multiple-choice anonymous questionnaires using the house distribution system of a bottled water dispensing company, assessing information regards age, gender, educational level, general stroke information, attitude towards symptoms and treatment. Percentages of each choice were recorded for every question and a multivariate analysis was performed. Results: A total of 12,710 surveys were returned, age 51±17 years, 69% women. Almost 95% reported prior knowledge of the disease, 50% through public media, 37% through a relative/friend that had a stroke and 8% through their family doctor. The Spanish acronym for accidente cerebrovascular , ACV, was the most frequently identified name for stroke (79%), the Spanish equivalent to cerebral attack was used by 7% and 0,4% used the term “ictus”. Only 29% knew about TIA but 69% identified stroke risk factors. Although 73% recognized their signs and symptoms, 11% misinterpreted them as a heart attack and 34% ignored that stroke can present with severe headache. Although 73% considered the disease potentially disabling/fatal, 40% ignored its frequency. If symptoms, 25% would call 911 and 50% would go to an emergency room by own means. Only 63% knew the existence of a specific treatment. Lowest degree of knowledge was seen in young, single, non-university men. Conclusion: This study represents the largest general public stroke awareness survey in Spanish speaking populations. Respondents showed excellent recognition of risk factors, warning signs and need of a rapid response. The population had little knowledge of prevalence, severity, TIA, and acute treatment. Public media appear to have an essential role in education.

scholarly journals ANALYSIS OF THE ASSOCIATION OF THE METHYLATION LEVELS OF MIR10B AND MIR21 GENES IN BLOOD LEUKOCYTES WITH ADVANCED CAROTID ATHEROSCLEROSIS

2018 ◽  
Vol 33 (2) ◽  
pp. 77-82
Author(s):  
Iu. A. Koroleva ◽  
A. A. Zarubin ◽  
A. V. Markov ◽  
A. N. Kazancev ◽  
O. L. Barbarash ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dna Methylation ◽  
Methylation Level ◽  
Carotid Atherosclerosis ◽  
Gene Promoter ◽  
Control Group ◽  
Coding Region ◽  
Blood Leukocytes ◽  
Atherosclerosis Risk Factors

Complications of atherosclerosis remain the leading cause of morbidity and mortality worldwide. MiRNAs are short regulatory molecules that are involved in all processes of pathogenesis. Expression of miRNAs is regulated by DNA methylation. Methylation and/or expression of MIR10B and MIR21 genes are known to vary in atherosclerotic tissues of the arteries, but there is no data about the changes in the methylation levels of these genes in blood leukocytes and their association with atherosclerosis risk factors.Objective.To evaluate the association of methylation levels of MIR10B and MIR21 genes in the blood leukocytes with risk factors and pathogenetically significant traits of carotid atherosclerosis.Material and Methods. DNA for the study was extracted from the samples of blood leukocytes of 122 patients with advanced carotid atherosclerosis as well as from blood leukocytes of 135 individuals in the control group. The DNA methylation level was analyzed by bisulfite pyrosequencing.Results.The methylation level of the MIR10B and MIR21 genes in leukocytes of patients with atherosclerosis is higher than in the leukocytes of the control group. In leukocytes of patients with carotid atherosclerosis the methylation level of the MIR21 gene promoter was correlated with type 2 diabetes and serum cholesterol level, and the methylation level of the coding region of the MIR10B gene was correlated with smoking.Conclusions.The level of DNA methylation in the regions of MIR10B and MIR21 genes in blood leukocytes is associated with the risk of advanced atherosclerosis of the carotid arteries. 

scholarly journals Mobile educational follow-up application for patients with peripheral arterial disease

2019 ◽  
Vol 27 ◽  
Author(s):  
Cristiane Baldessar Mendez ◽  
Nádia Chiodelli Salum ◽  
Cintia Junkes ◽  
Lucia Nazareth Amante ◽  
Carlos Mauricio Lopes Mendez
Keyword(s):  
Risk Factors ◽  
Peripheral Arterial Disease ◽  
Signs And Symptoms ◽  
Arterial Disease ◽  
Pedagogical Content ◽  
Analysis And Design ◽  
Individualized Care ◽  
Technological Tool ◽  
Peripheral Arterial

ABSTRACT Objective: to describe the development of a prototype mobile educational application for nursing follow-up aimed at patients diagnosed with peripheral arterial disease. Method: a prototype-based technological production study. The construction followed the contextualized instructional design model using two steps: analysis and design and development. Results: the pedagogical content of the application was based on a survey of needs of patients with Peripheral Arterial Disease and treatments recommended in the literature. The prototype developed contained concepts, risk factors, signs and symptoms, treatment, importance of medications and their side effects, frequent doubts, necessary health care, and follow-up of patients by monitoring the evolution of the cicatricial process of lesions and possible complications, clarification of doubts and stimulus for continuation of treatment. Conclusion: the use of health applications is a technological tool with the potential to improve the follow-up of patients regarding the progress of the disease and self-care, monitoring of risk factors, co-participation of the patient in the treatment, family participation, as well as planning of individualized care, and cost reduction for the health system.

scholarly journals Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Wang ◽  
Anhua Huang ◽  
Min Jiang ◽  
Haidong Li ◽  
Wenqing Bao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Prospective Study ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Gallbladder Wall ◽  
Postoperative Recurrence ◽  
Factors Associated ◽  
History Of

Objective: For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones.Methods: The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression.Results: In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones (P < 0.05).Conclusion: The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

scholarly journals Zdravljenje glavkoma in suho oko

2016 ◽  
Vol 85 (4) ◽  
Author(s):  
Barbara Cvenkel
Keyword(s):  
Ocular Surface ◽  
Clinical Signs ◽  
Tear Film ◽  
Signs And Symptoms ◽  
Surface Damage ◽  
Eye Drops ◽  
Film Instability ◽  
Asymptomatic Patients

Patients with glaucoma have increased prevalence of dry eye (DE) compared to age-matched population without glaucoma. Clinical presentation of DE varies among individuals and may significantly reduce quality of life. The onset and deterioration of DE is caused by the toxic-inflammatory effects of preservatives in eye drops, active substance itself, and added, pharmacologically inactive substances or excipients. Ocular surface changes most frequently include superficial punctate keratitis, tear film instability, and allergic reactions. Despite the lack of symptoms, clinical signs may indicate ocular surface damage. Discordance between signs and symptoms is partly caused by decreased corneal sensitivity induced by neurotoxicity of the preservative benzalkonium chloride (BAK). Therefore, it is important to evaluate ocular surface before initiating glaucoma therapy and during follow-up also in asymptomatic patients. Preservative-free and/or BAK-free therapy is indicated in patients with severe DE and allergy to preservatives, and recommended in patients with DE of moderate severity, blepharitis, in symptomatic patients, before filtering surgery to reduce preoperative inflammation, in those with moderate fluorescein staining of grade 2 on Oxford scheme, and reduced tear film break-up time.

scholarly journals Carotid Geometry and Wall Shear Stress Independently Predict Increased Wall Thickness—A Longitudinal 3D MRI Study in High-Risk Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Christoph Strecker ◽  
Axel Joachim Krafft ◽  
Lilli Kaufhold ◽  
Markus Hüllebrandt ◽  
Martin Treppner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wall Thickness ◽  
Carotid Atherosclerosis ◽  
Bifurcation Angle ◽  
Independent Risk Factors ◽  
Carotid Wall ◽  
Group 2 ◽  
Ica Stenosis ◽  
Group 1

Introduction: Carotid geometry and wall shear stress (WSS) have been proposed as independent risk factors for the progression of carotid atherosclerosis, but this has not yet been demonstrated in larger longitudinal studies. Therefore, we investigated the impact of these biomarkers on carotid wall thickness in patients with high cardiovascular risk.Methods: Ninety-seven consecutive patients with hypertension, at least one additional cardiovascular risk factor and internal carotid artery (ICA) plaques (wall thickness ≥ 1.5 mm and degree of stenosis ≤ 50%) were prospectively included. They underwent high-resolution 3D multi-contrast and 4D flow MRI at 3 Tesla both at baseline and follow-up. Geometry (ICA/common carotid artery (CCA)-diameter ratio, bifurcation angle, tortuosity and wall thickness) and hemodynamics [WSS, oscillatory shear index (OSI)] of both carotid bifurcations were measured at baseline. Their predictive value for changes of wall thickness 12 months later was calculated using linear regression analysis for the entire study cohort (group 1, 97 patients) and after excluding patients with ICA stenosis ≥10% to rule out relevant inward remodeling (group 2, 61 patients).Results: In group 1, only tortuosity at baseline was independently associated with carotid wall thickness at follow-up (regression coefficient = −0.52, p < 0.001). However, after excluding patients with ICA stenosis ≥10% in group 2, both ICA/CCA-ratio (0.49, p < 0.001), bifurcation angle (0.04, p = 0.001), tortuosity (−0.30, p = 0.040), and WSS (−0.03, p = 0.010) at baseline were independently associated with changes of carotid wall thickness at follow-up.Conclusions: A large ICA bulb and bifurcation angle and low WSS seem to be independent risk factors for the progression of carotid atherosclerosis in the absence of ICA stenosis. By contrast, a high carotid tortuosity seems to be protective both in patients without and with ICA stenosis. These biomarkers may be helpful for the identification of patients who are at particular risk of wall thickness progression and who may benefit from intensified monitoring and treatment.

scholarly journals Long-Term Prognosis of Febrile Individuals with Right Precordial Coved-Type ST-Segment Elevation Brugada Pattern: A 10-Year Prospective Follow-Up Study

2021 ◽  
Vol 10 (21) ◽  
pp. 4997
Author(s):  
Chin-Feng Tsai ◽  
Yao-Tsung Chuang ◽  
Jing-Yang Huang ◽  
Kwo-Chang Ueng
Keyword(s):  
Family History ◽  
Sudden Death ◽  
Previous History ◽  
Asymptomatic Patients ◽  
Arrhythmic Event ◽  
History Of ◽  
Asymptomatic Individuals

A febrile state may provoke a Brugada electrocardiogram (ECG) pattern and trigger ventricular tachyarrhythmias in susceptible individuals. However, the prognostic value of fever-induced Brugada ECG pattern remains unclear. We analyzed the clinical and extended long-term follow-up data of consecutive febrile patients with a type 1 Brugada ECG presented to the emergency department. A total of 21 individuals (18 males; mean age, 43.7 ± 18.6 years at diagnosis) were divided into symptomatic (resuscitated cardiac arrest in one, syncope in two) and asymptomatic (18, 86%) groups. Sustained polymorphic ventricular tachycardias were inducible in two patients with previous syncope. All 18 asymptomatic patients had no spontaneous type 1 Brugada ECG recorded at second intercostal space and no family history of sudden death. Among asymptomatic individuals, 4 had a total 12 of repeated non-arrhythmogenic febrile episodes all with recurrent type 1 Brugada ECGs, and none had a ventricular arrhythmic event during 116 ± 19 months of follow-up. In the symptomatic group, two had defibrillator shocks for a new arrhythmic event at 31- and 49 months follow-up, respectively, and one without defibrillator therapy died suddenly at 8 months follow-up. A previous history of aborted sudden death or syncope was significantly associated with adverse outcomes in symptomatic compared with asymptomatic individuals (log-rank p < 0.0001). In conclusion, clinical presentation or history of syncope is the most important parameter in the risk stratification of febrile patients with type 1 Brugada ECG. Asymptomatic individuals with a negative family history of sudden death and without spontaneous type 1 Brugada ECG, have an exceptionally low future risk of arrhythmic events. Careful follow-up with timely and aggressive control of fever is an appropriate management option.

scholarly journals Cumulative Effects of Hypertension, Dyslipidemia, and Chronic Kidney Disease on Carotid Atherosclerosis in Chinese Patients with Type 2 Diabetes Mellitus

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Chuang Yuan ◽  
Christopher W. K. Lai ◽  
Lawrence W. C. Chan ◽  
Meyrick Chow ◽  
Helen K. W. Law ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Odds Ratio ◽  
Carotid Plaque ◽  
Carotid Atherosclerosis ◽  
Chinese Patients ◽  
Plaque Score ◽  
Atherosclerosis Risk ◽  
Atherosclerosis Risk Factors

Aims. The aim of this study is to determine the extent of carotid atherosclerosis in Chinese patients with type 2 diabetes in relation to the cumulative atherosclerosis risk factors using ultrasonography.Methods.The presence of hypertension, dyslipidemia, and chronic kidney disease (CKD) was documented in 106 Chinese subjects with type 2 diabetes. Subjects with 0, 1, and ≥2 additional atherosclerosis risk factors were assigned into groups 1, 2, and 3, respectively (n=17, 49, and 40, resp.). Using ultrasound, the carotid arteries were assessed for the presence of carotid plaque, plaque score, intima-media thickness (IMT), and carotid arterial stiffness.Results.With the adjustment for age and gender, the presence of plaque and plaque score were significantly higher in groups with more atherosclerosis risk factors (P<0.05). In addition, age > 60 years old (odds ratio = 2.75; 95% CI: 1.26–6.0) and the presence of hypertension (odds ratio = 2.48; 95% CI: 1.11–5.58), dyslipidemia (odds ratio = 2.41; 95% CI: 1.05–5.51), and CKD (odds ratio = 7.80; 95% CI: 1.46–41.72) could independently predict higher plaque score (P<0.05).Conclusions.Hypertension, dyslipidemia, and CKD in Chinese patients with type 2 diabetes have cumulative effects on the burden of carotid plaque.

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