scholarly journals Role of pregnancy and female sex steroids on aneurysm formation, growth, and rupture: a systematic review of the literature

2019 ◽  
Vol 47 (1) ◽  
pp. E8 ◽  
Author(s):  
Milli Desai ◽  
Arvin R. Wali ◽  
Harjus S. Birk ◽  
David R. Santiago-Dieppa ◽  
Alexander A. Khalessi

OBJECTIVEWomen have been shown to have a higher risk of cerebral aneurysm formation, growth, and rupture than men. The authors present a review of the recently published neurosurgical literature that studies the role of pregnancy and female sex steroids, to provide a conceptual framework with which to understand the various risk factors associated with cerebral aneurysms in women at different stages in their lives.METHODSThe PubMed database was searched for “(“intracranial” OR “cerebral”) AND “aneurysm” AND (“pregnancy” OR “estrogen” OR “progesterone”)” between January 1980 and February 2019. A total of 392 articles were initially identified, and after applying inclusion and exclusion criteria, 20 papers were selected for review and analysis. These papers were then divided into two categories: 1) epidemiological studies about the formation, growth, rupture, and management of cerebral aneurysms in pregnancy; and 2) investigations on female sex steroids and cerebral aneurysms (animal studies and epidemiological studies).RESULTSThe 20 articles presented in this study include 7 epidemiological articles on pregnancy and cerebral aneurysms, 3 articles reporting case series of cerebral aneurysms treated by endovascular therapies in pregnancy, 3 epidemiological articles reporting the relationship between female sex steroids and cerebral aneurysms through retrospective case-control studies, and 7 experimental studies using animal and/or cell models to understand the relationship between female sex steroids and cerebral aneurysms. The studies in this review report similar risk of aneurysm rupture in pregnant women compared to the general population. Most ruptured aneurysms in pregnancy occur during the 3rd trimester, and most pregnant women who present with cerebral aneurysm have caesarean section deliveries. Endovascular treatment of cerebral aneurysms in pregnancy is shown to provide a new and safe form of therapy for these cases. Epidemiological studies of postmenopausal women show that estrogen hormone therapy and later age at menopause are associated with a lower risk of cerebral aneurysm than in matched controls. Experimental studies in animal models corroborate this epidemiological finding; estrogen deficiency causes endothelial dysfunction and inflammation, which may predispose to the formation and rupture of cerebral aneurysms, while exogenous estrogen treatment in this population may lower this risk.CONCLUSIONSThe aim of this work is to equip the neurosurgical and obstetrical/gynecological readership with the tools to better understand, critique, and apply findings from research on sex differences in cerebral aneurysms.

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Frederik Strang ◽  
Heribert Schunkert

C-reactive protein (CRP) and coronary heart disease (CHD) have been the subject of intensive investigations over the last decades. Epidemiological studies have shown an association between moderately elevated CRP levels and incident CHD whereas genetic studies have shown that polymorphisms associated with elevated CRP levels do not increase the risk of ischemic vascular disease, suggesting that CRP might be a bystander rather than a causal factor in the progress of atherosclerosis. Beside all those epidemiological and genetic studies, the experimental investigations also try to reveal the role of CRP in the progress of atherosclerosis. This review will highlight the complex results of genomic, epidemiological, and experimental studies on CRP and will show why further studies investigating the relationship between CRP and atherosclerosis might be needed.


2018 ◽  
Vol 24 (3) ◽  
pp. 341-358 ◽  
Author(s):  
Xiaotong Ji ◽  
Yingying Zhang ◽  
Guangke Li ◽  
Nan Sang

Recently, numerous studies have found that particulate matter (PM) exposure is correlated with increased hospitalization and mortality from heart failure (HF). In addition to problems with circulation, HF patients often display high expression of cytokines in the failing heart. Thus, as a recurring heart problem, HF is thought to be a disorder characterized in part by the inflammatory response. In this review, we intend to discuss the relationship between PM exposure and HF that is based on inflammatory mechanism and to provide a comprehensive, updated evaluation of the related studies. Epidemiological studies on PM-induced heart diseases are focused on high concentrations of PM, high pollutant load exposure in winter, or susceptible groups with heart diseases, etc. Furthermore, it appears that the relationship between fine or ultrafine PM and HF is stronger than that between HF and coarse PM. However, fewer studies paid attention to PM components. As for experimental studies, it is worth noting that coarse PM may indirectly promote the inflammatory response in the heart through systematic circulation of cytokines produced primarily in the lungs, while ultrafine PM and its components can enter circulation and further induce inflammation directly in the heart. In terms of PM exposure and enhanced inflammation during the pathogenesis of HF, this article reviews the following mechanisms: hemodynamics, oxidative stress, Toll-like receptors (TLRs) and epigenetic regulation. However, many problems are still unsolved, and future work will be needed to clarify the complex biologic mechanisms and to identify the specific components of PM responsible for adverse effects on heart health.


2021 ◽  
Vol 10 (3) ◽  
pp. 448
Author(s):  
Federica Piani ◽  
Arrigo F. G. Cicero ◽  
Claudio Borghi

The relationship between serum uric acid (SUA) and hypertension has been a subject of increasing interest since the 1870 discovery by Frederick Akbar Mahomed. Several epidemiological studies have shown a strong association between high SUA levels and the presence or the development of hypertension. Genetic analyses have found that xanthine oxidoreductase (XOR) genetic polymorphisms are associated with hypertension. However, genetic studies on urate transporters and Mendelian randomization studies failed to demonstrate a causal relationship between SUA and hypertension. Results from clinical trials on the role of urate-lowering therapy in the management of patients with hypertension are not uniform. Our study sought to analyze the prognostic and therapeutic role of SUA in the hypertensive disease, from uric acid (UA) biology to clinical trials on urate-lowering therapies.


2010 ◽  
Vol 54 (5) ◽  
pp. 488-497 ◽  
Author(s):  
Arnaldo Schainberg ◽  
Antônio Ribeiro-Oliveira Jr. ◽  
José Marcio Ribeiro

It has been well documented that there is an increased prevalence of standard cardiovascular (CV) risk factors in association with diabetes and with diabetes-related abnormalities. Hyperglycemia, in particular, also plays an important role. Heart failure (HF) has become a frequent manifestation of cardiovascular disease (CVD) among individuals with diabetes mellitus. Epidemiological studies suggest that the effect of hyperglycemia on HF risk is independent of other known risk factors. Analysis of datasets from populations including individuals with dysglycemia suggests the pathogenic role of hyperglycemia on left ventricular function and on the natural history of HF. Despite substantial epidemiological evidence of the relationship between diabetes and HF, data from available interventional trials assessing the effect of a glucose-lowering strategy on CV outcomes are limited. To provide some insight into these issues, we describe in this review the recent important data to understand the natural course of CV disease in diabetic individuals and the role of hyperglycemia at different times in the progression of HF.


2019 ◽  
Vol 73 (6) ◽  
pp. 483-488 ◽  
Author(s):  
Sarah G Howard

This narrative review summarises recently published epidemiological and in vivo experimental studies on exposure to environmental chemicals and their potential role in the development of type 1 diabetes mellitus (T1DM). These studies focus on a variety of environmental chemical exposures, including to air pollution, arsenic, some persistent organic pollutants, pesticides, bisphenol A and phthalates. Of the 15 epidemiological studies identified, 14 include measurements of exposures during childhood, 2 include prenatal exposures and 1 includes adults over age 21. Together, they illustrate that the role of chemicals in T1DM may be complex and may depend on a variety of factors, such as exposure level, timing of exposure, nutritional status and chemical metabolism. While the evidence that these exposures may increase the risk of T1DM is still preliminary, it is critical to investigate this possibility further as a means of preventing T1DM.


2020 ◽  
pp. 008124632096153
Author(s):  
Sadi Cordelia Bambo ◽  
Solomon Mashegoane

The study investigated the mediator role of death obsession in the relationship between pregnancy-related anxiety and prenatal obsessive-compulsive disorder among pregnant women in the Capricorn district, South Africa. Two hundred and six conveniently selected respondents completed questionnaires individually. Statistically significant associations were found between pregnancy-related anxiety and death obsession, death obsession and prenatal obsessive-compulsive disorder, and pregnancy-related anxiety and prenatal obsessive-compulsive disorder ( ps ⩽ .05). Analysis further showed that death obsession mediates the relationship between pregnancy-related anxiety and both composite scores of a prenatal obsessive-compulsive disorder measure (Obsessive-Compulsive Inventory–Revised) and most of its components. The findings suggest that death obsession is a likely mediator that has to be studied further.


Urban Studies ◽  
2016 ◽  
Vol 55 (2) ◽  
pp. 406-426 ◽  
Author(s):  
Martin Lux ◽  
Tomáš Samec ◽  
Vojtech Bartos ◽  
Petr Sunega ◽  
Jan Palguta ◽  
...  

We focus on the role of within-family socialisation and the relationship between socialisation and resource transfers in the intergenerational transmission of housing preferences, the formation of familial housing attitudes and thus the reproduction of a normative housing tenure ladder across generations in Czech society. We show that resource transfers and the within-family socialisation of housing preferences, including preferences concerning housing tenure, are closely interconnected. In other words, parental influence on decision to buy own housing (and on housing preferences in general) of their adult children through socialisation is stronger if there is an (actual or assumed) intergenerational resource transfer. This has several implications for how housing markets and systems work. The paper draws on findings from qualitative, quantitative and experimental studies.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Betty N. Wu ◽  
Anthony J. O'Sullivan

Women have a higher proportion of body fat compared to men. However, women consume fewer kilojoules per kilogram lean mass and burn fat more preferentially during exercise compared with men. During gestation, women store even greater amounts of fat that cannot be solely attributed to increased energy intake. These observations suggest that the relationship between kilojoules consumed and kilojoules utilised is different in men and women. The reason for these sex differences in energy metabolism is not known; however, it may relate to sex steroids, differences in insulin resistance, or metabolic effects of other hormones such as leptin. When considering lifestyle modifications, sex differences in energy metabolism should be considered. Moreover, elucidating the regulatory role of hormones in energy homeostasis is important for understanding the pathogenesis of obesity and perhaps in the future may lead to ways to reduce body fat with less energy restriction.


2015 ◽  
Vol 125 (2) ◽  
pp. 87-89
Author(s):  
Dorota Robak-Chołubek ◽  
Gustaw Chołubek ◽  
Ewa Piróg

Abstract Introduction. Pregnant women often create their own image of a child. The ultrasound is able to model and modify this picture. The image of the unborn child develops along with the process of creating the space for the baby on the psychological and emotional level and is continued after the delivery. Aim. The authors of the study made an attempt to evaluate the influence of fetal sex determination during ultrasound in pregnancy on emotional and ‘practical’ experiencing late pregnancy - after the 28th week of its duration. Material and methods. The study included 200 pregnant women. Qualification criteria for the research was the declared awareness of fetal sex confirmed by ultrasound. Among others, factors influencing decision to determine fetal sex, emotional bond with the unborn child after identifying the sex, as well as preparation for birth regarding prognosticated sex were assessed. Results. Nearly all pregnant women wanted to find out the fetal sex, usually claiming that they did so out of curiosity. After they did it, about 2/3 of them stated that the emotional bond with the baby increased and the vast majority of women started preparing layettes for their future babies. Conclusions. Determination of fetal sex during ultrasound improves the relationship between the mother and her future baby. It also enables the woman to prepare for childbirth considering its sex by the purchase of clothes, pram and preparation of layette or baby’s room


2018 ◽  
Vol 24 (2) ◽  
pp. 227-238 ◽  
Author(s):  
Vanessa Castelli ◽  
Davide Grassi ◽  
Raffaella Bocale ◽  
Michele d'Angelo ◽  
Andrea Antonosante ◽  
...  

Background: The aging of western societies is leading to a dramatic increase in the prevalence of chronic conditions, threatening the health status and then the sustainability of our healthcare systems. In particular, dementia is being increasingly recognized as a public health priority, given its enormous socioeconomic burdens further amplified by the absence of treatments really effective in improving the clinical course of the disease. Methods: The question of whether some degree of cognitive deterioration is an inevitable part of aging or should be considered as a pathological pre-stage of dementia is currently debated. This is a field in need of research because accelerated brain aging as well as further decline in cognition might be preventable in the early stages of cognitive impairment. Herein, we discuss evidence from clinical and experimental studies on the role of polyphenols in preserving cognitive performance across life. Results: In recent years, the possibility of favorably influencing the cognitive trajectory through promotion of lifestyle modifications has been increasingly investigated. In particular, the relationship between nutritional habits and brain health has attracted special attention. Dietary polyphenols exhibit a strong potential to promote brain due to their efficacy in protecting neurons against oxidative stress-induced injury, suppressing neuroinflammation and in ameliorating cardiovascular risk factor control and cardiovascular function thus counteracting neurotoxicity and neurodegeneration. Conclusion: Emerging evidence suggest that dietary polyphenols, in particular flavonoids, may exert beneficial effects on the central nervous system thus representing a potential tool to preserve cognitive performance throught senescence.


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