scholarly journals Reactive Hyperemia-Triggered Wrist Pulse Analysis for Early Monitoring of Young Men with High Atherosclerotic Risk

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1918
Author(s):  
Jian-Jung Chen ◽  
Hsien-Tsai Wu ◽  
Bagus Haryadi
Keyword(s):  
At Risk ◽  
Endothelial Function ◽  
Early Identification ◽  
Risk Group ◽  
Reactive Hyperemia ◽  
Young Men ◽  
High Risk Group ◽  
Young Males ◽  
Initial Application ◽  
Group 2

The high prevalence of cardiovascular disease in young adults has raised significant concern regarding the early identification of risk factors to allow for timely intervention. This study aimed to identify young males at risk of atherosclerosis using a noninvasive instrument and an initial application percussion entropy analysis of the wrist pressure pulse (WPP). In total, 49 young males aged 18 to 28, without any known history of vascular disease, were recruited. Blood samples were obtained whereby a TC/HDL cutoff value of 4 was used to divide the young men into low-risk (Group 1, TC/HDL < 4, N = 32) and high-risk (Group 2, TC/HDL ≥ 4, N = 17) groups regarding atherosclerosis. The reactive hyperemia-triggered WPPs were measured using a modified air-pressure-sensing system (MAPSS). The dilation index (DI) of the endothelial function and percussion entropy index (PEI) of the heart rate variability (HRV) assessments, calculated using pragmatic signal-processing techniques, were compared between the two groups. The nonparametric Mann–Whitney U test showed that the DI and PEI of the two groups showed statistical differences (both p < 0.05). Not only could the MAPSS assess endothelial function and HRV in young males, but the results also showed that waist circumference and PEI may serve as indicators for the early identification of young males at risk of atherosclerosis.

scholarly journals Research of genetic predisposition to gestosis: polymorphism of genes, participating in vasoregulation of functions endothelium

2003 ◽  
Vol 52 (2) ◽  
pp. 25-34
Author(s):  
Yelena V. Mozgovaya
Keyword(s):  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Pregnant Women ◽  
Genetic Predisposition ◽  
Early Identification ◽  
Risk Group ◽  
Developmental Pathways ◽  
Multifactorial Disease ◽  
Mutant Genes ◽  
Pai 1

The polymorphism of the genes involved in the regulation of endothelial function - PLAT, PAI-1, ACE, eNOS and TNF- - was studied in 122 pregnant women with pure and concomitant preeclampsia of varying severity and in 73 healthy puerperas. It was revealed that mutant genotypes of the studied genes are associated with more pronounced clinical and laboratory indicators of the severity of preeclampsia and the greatest increase in the level of markers of endothelial dysfunction. It is noted that the frequency of mutant genes and alleles varies depending on the severity of preeclampsia and the presence of background diseases characterized by the presence of endothelial dysfunction. The data obtained confirm the opinion that gestosis is a multifactorial disease with several, possibly independent, developmental pathways. The study of the polymorphism of genes regulating endothelial function contributes to the early identification of a risk group for the development of preeclampsia.

Tetanus Prophylaxis and Accidental Wounds

1981 ◽  
Vol 26 (1) ◽  
pp. 24-26
Author(s):  
W. J. Morgan ◽  
Moira P. J. McGuigan ◽  
S. Williams ◽  
G. Solomon
Keyword(s):  
At Risk ◽  
High Risk ◽  
Tetanus Toxoid ◽  
Risk Group ◽  
High Risk Group ◽  
Human Immunoglobulin ◽  
Time Interval ◽  
Risk Patients ◽  
Tetanus Immunity

Of 400 consecutive patients who had wounds treated in the Accident Department, 200 remembered receiving either booster injections or a full course of tetanus toxoid in the last 10 years. During this period, 182 patients received their initial toxoid injection in association with treatment of a wound in an accident department. Only 71 (38%) of these patients attended for a full course of injections. From our assessment of the wounds and the patient's anti-tetanus immunity, 79 patients (20%) were considered to be at risk of developing tetanus. By further considering the time interval elapsed between injury and treatment, a ‘high risk” group of 13 patients (3%) was recognised. It is recommended that the use of human immunoglobulin shoul I be reserved for the ‘high risk’ group, and that the remainer of the ‘at-risk’ patients should receive penecillin prophylaxis only.

scholarly journals Endothelial function in men with type 2 diabetes without clinical signs of cardiovascular disease

2016 ◽  
Vol 19 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Irina Alexandrovna Khripun ◽  
Sergey Vladislavovich Vorobyev ◽  
Maxim Nikolaevich Morgunov ◽  
Michail Iosifovich Kogan
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Clinical Signs ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group 2 ◽  
Group 1

Type 2 diabetes mellitus (T2DM) increases the risk of cardiovascular disease that is based on endothelial dysfunction (ED). Currently, conventional diagnostic methods are unreliable, especially at early stages of disease.Aims. The aim of this work was to assess endothelial function in men with T2DM without clinical signs of cardiovascular disease.Materials and methods. The study included 100 patients (mean age, 54.3 ± 5.3 years) with a T2DM duration of less than 10 years and without signs of cardiovascular disease. The patients were divided into two groups: group 1 consisted of 60 patients with a T2DM duration of less than five years. Group 2 included 40 men with a history of diabetes between 5 and 10 years. Endothelial function was assessed by the levels of nitric oxide (NO), endothelial NO synthase type 3 (eNOS3), ICAM-1, VCAM-1, E-selectin, P-selectin, resistin and C-reactive protein and the arterial vasoreactivity of the brachial artery (BA) using the D. Celermajer method.Results. Results revealed decreases in levels of both eNOS3 by 2.5 fold (P = 0.0005) and NO by 1.9 fold (P = 0.043) in group 2 patients, compared to those in group 1 patients. When the duration of diabetes was greater than five years, levels of VCAM-1, resistin and C-reactive protein increased by 12.1% (P = 0.048), 62% (P = 0.01) and 45.6%, respectively. Additionally, the time until maximal BA vasodilatation during reactive hyperemia was observed to be higher in group 2 [105 (90; 180) seconds] than those in group 1 [90 (60; 120) seconds].Conclusions. Biochemical and imaging signs of ED begin to appear in the first five years of T2DM, long before clinical manifestations. The earliest symptoms are decreases in eNOS3 and NO levels, increases in VCAM-1 and resistin concentrations and increased time until maximal BA vasodilatation during reactive hyperemia.

The Profile of Endothelial Function in Children with ALL Is Associated with the Risk Stratification Determining the Outcome – a Pilot Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4230-4230
Author(s):  
Ewa Niedzielska ◽  
Adrian Doroszko ◽  
Alicja Chybicka ◽  
Andrzej Szuba
Keyword(s):  
Lipid Peroxidation ◽  
High Risk ◽  
Risk Stratification ◽  
Endothelial Function ◽  
Risk Group ◽  
High Risk Group ◽  
No Bioavailability ◽  
Anti Inflammatory ◽  
Standard Risk ◽  
Pai 1

Abstract Abstract 4230 Background: Endothelial dysfunction (ED) is characterized by impaired balance between pro- and anti-aggregatory, pro- and anti-inflammatory factors as well as vasodilative and vasoconstrictive action of numerous metabolic and signaling pathways. ED is an important factor worsening the outcome in severe diseases. The aim of this study was to assess if the profile of endothelial function during the treatment of ALL might be associated with the risk stratification and with the outcome. Material and Methods: N=18 children at age of 4–18 years with ALL, treated with the ALLIC- BFM 2002 protocol were investigated. Plasma levels of the NO pathway metabolites (L-Arginine, ADMA – an endogenous competive eNOS inhibitor), markers of endothelial inflammatory and aggregatory function (VCAM-1, ICAM-1, E-selectin, P-selectin and PAI-1), lipid peroxidation (MDA – malonyldialdehyde) were analyzed at baseline, then during the 33rd and 78th day of treatment. Results were compared between three subgroups: standard risk, intermediate risk and high risk. Results: Subjects in the high risk groups were characterized by increased baseline lipid peroxidation, as assessed by the MDA levels in comparison to those in the standard risk group (8.56±2.14U/ml vs. 3.57±0.81U/ml, respectively, p<0.05). In the high risk group low E-selectin levels at baseline (32.1±6.1ng/ml vs. 101.3±11.8ng/ml in the standard risk group, respectively, p<0.05), as well as high NO production at the beginning of the M protocol, assessed by the L-Arg/ADMA ratio (88.6±11.6ng/ml vs. 41.7±6.4ng/ml, respectively, p<0.05) were observed. Moreover, increase in the PAI-1 level during the therapy was associated with smaller risk for poor outcome. Conclusions: Increased lipid peroxidation, low E-selectin at baseline, as well as increased NO bioavailability, decreased PAI-1 levels at the beginning of the M protocol are common feature in children classified to the high risk group. Low NO bioavailability at baseline and high at the beginning of the M protocol as well as decreased anti-inflammatory and antiaggregatory function of endothelium at the beginning of the M protocol are associated with higher risk for poor prognosis. Disclosures: No relevant conflicts of interest to declare.

Anxiety during Pregnancy at the Time of the Gulf War: Comparison of Anxiety of Israeli Women with Normal Pregnancies and Those with “At-Risk” Pregnancies

1993 ◽  
Vol 72 (2) ◽  
pp. 600-602 ◽  
Author(s):  
Deborah Lieberman ◽  
Shaul Harel
Keyword(s):  
At Risk ◽  
High Risk ◽  
Pregnant Women ◽  
Risk Group ◽  
Gulf War ◽  
High Risk Group

81 pregnant women were interviewed at the time of the Gulf War. One group was interviewed before the missile attacks began in Israel, and the second group during the period of the attacks. Of the women interviewed, 53 women had “high-risk” pregnancies and 28 had normal pregnancies. Despite the hypothesis that women with “at-risk” pregnancies would report a greater rise in anxiety during the missile attacks, it was found that the women with normal pregnancies reported a significantly greater rise in anxiety during missile attacks. It is suggested that the already-stressed “high-risk” group “shut out” the additional anxiety generated by the dangers from the missile attacks.

scholarly journals Assessment of vascular endothelial function in COVID-19 patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Mejia-Renteria ◽  
A Travieso ◽  
A Sagir ◽  
E Martinez-Gomez ◽  
A Carrascosa-Granada ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Augmentation Index ◽  
Reactive Hyperemia ◽  
Vascular Complications ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Past Infection ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) receptor as a means to enter the host. High density of ACE2 receptor in vascular endothelial cells may explain why vascular complications related to endothelial dysfunction occur in COVID-19. However, in vivo assessment of vascular endothelial function during COVID-19 has not been reported. Objective To investigate the vascular endothelial function and its temporal changes in COVID-19 patients. Methods In this prospective blinded study, systemic endothelial function was assessed using plethysmography-derived peripheral arterial tonometry (PAT). The reactive hyperemia index (LnRHI), a measure of endothelium-mediated hyperaemia, and the augmentation index, a measure of arterial vascular stiffness, were measured in 102 individuals across three study groups using PAT: group 1 (active infection), constituted by 20 patients hospitalised due to acute COVID-19; group 2 (past infection), constituted by 52 patients who had recovered from COVID-19; and group 3 (controls), constituted by 30 healthcare workers not infected by SARS-CoV-2. Additionally, among group 1, PAT assessment was repeated in 14 patients several weeks after recovery from acute COVID-19. PAT studies were analysed at a blinded fashion with respect to the assigned study group. Results Lower resting PAT amplitude was found in acute COVID-19 patients compared to the other groups (ratio of arterial tone signal between hyperemia to resting condition was 1.5 [interquartile range, 1.1] in group 1, 1.3 [0.3] in group 2 and 1.2 [0.3] in group 3, p=0.041). On the contrary, no significant differences between groups were found with respect to the hyperemic PAT amplitude (867.9 [486.1] in group 1, 944.7 [748.1] in group 2 and 819.3 [639.6] in group 3, p=0.444). Due to the lower resting PAT amplitude, there was a paradoxically significantly increased LnRHI during acute COVID-19 compared to past infection and controls (0.73 [0.32] vs. 0.53 [0.31] vs. 0.44 [0.23], respectively; p=0.013) (Figure A). Furthermore, among group 1 patients, LnRHI normalised markedly from acute COVID-19 to past infection stage (0.73 [0.32] vs. 0.49 [0.28], respectively; p=0.005) (Figure B). Augmentation index was significantly higher during acute COVID-19 compared to past COVID-19 and controls (9.6 [19.1] in group 1, 6.97 [18.6] in group 2 and −0.35 [20.53] in group 3; p=0.045 for COVID groups vs. controls). Conclusions Non-invasive assessment of systemic vascular endothelial function with PAT revealed significant differences between subjects with acute COVID-19, past COVID-19 and controls. Lower baseline PAT amplitude and high augmentation index suggest vasoconstriction at rest during the acute phase of COVID-19. These findings open new research opportunities to investigate the prognostic value of PAT in COVID-19 patients. FUNDunding Acknowledgement Type of funding sources: None.

Evaluation of a medication intensity screening tool used in malignant hematology and bone marrow transplant services to identify patients at risk for medication-related problems

2017 ◽  
Vol 24 (4) ◽  
pp. 243-252 ◽  
Author(s):  
Mariana Lucena ◽  
Carolyn Bondarenka ◽  
Genevieve Luehrs-Hayes ◽  
Andy Perez
Keyword(s):  
At Risk ◽  
Bone Marrow ◽  
High Risk ◽  
Hospital Stay ◽  
Bone Marrow Transplant ◽  
Screening Tool ◽  
Risk Group ◽  
Anticoagulation Therapy ◽  
Marrow Transplant ◽  
High Risk Group

Background In 2014, a screening tool was implemented at Medical University of South Carolina (MUSC) Health to identify patients who are at risk for medication-related events. Patients are classified as high-risk if they meet one of the following criteria: receiving anticoagulation therapy, taking more than 10 scheduled medications upon admission, or readmission within the past 30 days. The goal of this study was to determine risk criteria specific to the malignant hematology (MH) and bone marrow transplant (BMT) patients. Methods A retrospective chart review of 114 patients admitted and discharged from the MH/BMT services between 1 September 2015 and 31 October 2015 was performed. A pharmacist-conducted medication history was completed and documented, and all interventions at admission and throughout hospitalization were categorized by severity and by value of service. The primary objective was to evaluate if patients in the MH/BMT services have more medication-related interventions documented upon admission compared with patients who are not screened as high risk. The secondary objectives were to evaluate the different types and severities of interventions made by pharmacists during the entire hospital stay, and to determine if there are certain characteristics that can help identify hematology/oncology high-risk patients. Results More interventions documented upon admission in the high-risk group as a whole when compared with the not high-risk group (73 vs. 31), but when normalized per patients in each group, there was an equal number of interventions (1.0). The most common interventions were to modify regimen (36%) and discontinue therapy (16%). The patient characteristics associated with high-risk included neutropenia, lower average platelet counts on admission, and longer length of stay. Conclusion The screening tool does not further differentiate an already complex MH/BMT patient population. Pharmacists may be more useful at capturing errors or changes during a patient’s hospital stay instead of upon admission. Thrombocytopenia, neutropenia, and active infections may correlate with higher-risk status.

Preeclampsia and Baby Complications Correlated to High-Risk Score for Obstructive Sleep Apnea Screen by STOPBang Questionnaire

2021 ◽  
Vol 104 (6) ◽  
pp. 927-933
Keyword(s):  
At Risk ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Low Risk ◽  
Maternal Complications ◽  
Neonatal Complications ◽  
Obstructive Sleep

Background: Obstructive sleep apnea (OSA) has been postulated as a risk factor for adverse maternal-fetal outcomes, especially preeclampsia. The physiological changes during pregnancy predispose a woman “at risk” towards developing OSA. Therefore, incidence of OSA may increase among pregnant population. STOP-Bang has been postulated as an acceptable screening tool for OSA in obstetric population. Objective: To identify the correlation between preeclampsia and patients who were at risk of OSA, based on STOP-Bang, Berlin, and Epworth sleepiness scale. Materials and Methods: A diagnostic prediction research was conducted using cross-sectional approach. Patients, who have STOP-Bang score of 3 or more and less than 3, were categorized as high-risk and low-risk for OSA, respectively. The relationship between high-risk OSA patients and preeclampsia were evaluated using logistic regression. Results: Seven hundred and three patients were included, and 47 patients (6.7%) were diagnosed preeclampsia. Six hundred fifty and 53 patients were classified as low-risk and high-risk for OSA, respectively. Fifty percent of the high-risk group were complicated with preeclampsia compared with 2.8% in low-risk group. The odd ratio (OR) of having preeclampsia in high-risk group was 32.6 (95% CI 16.1 to 66.1). The pregnant women, classified as high-risk, were associated with neonatal complications by OR 3.4 (95% CI 1.4 to 8.2) but not maternal complications. Conclusion: Among pregnant population, a STOP-Bang score of 3 or more is associated with the occurrence of preeclampsia and neonatal complications. Keywords: STOP-Bang questionnaire; Obstructive sleep apnea; Pregnancy; Preeclampsia

Early Identification of Youth at Risk for Suicidal Behavior

Crisis ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 326-332
Author(s):  
Ivonne Andrea Florez ◽  
Devon LoParo ◽  
Nakia Valentine ◽  
Dorian A. Lamis
Keyword(s):  
At Risk ◽  
Early Identification ◽  
Suicide Risk ◽  
Psychiatric Symptoms ◽  
Demographic Factors ◽  
Health Centers ◽  
Lack Of Information ◽  
Youth At Risk ◽  
Logistic Regressions ◽  
Lethal Means

Abstract. Background: Early identification and appropriate referral services are priorities to prevent suicide. Aims: The aim of this study was to describe patterns of identification and referrals among three behavioral health centers and determine whether youth demographic factors and type of training received by providers were associated with identification and referral patterns. Method: The Early Identification Referral Forms were used to gather the data of interest among 820 youth aged 10–24 years who were screened for suicide risk (females = 53.8%). Descriptive statistics and binary logistic regressions were conducted to examine significant associations. Results: Significant associations between gender, race, and age and screening positive for suicide were found. Age and race were significantly associated with different patterns of referrals and/or services received by youths. For providers, being trained in Counseling on Access to Lethal Means was positively associated with number of referrals to inpatient services. Limitations: The correlational nature of the study and lack of information about suicide risk and comorbidity of psychiatric symptoms limit the implications of the findings. Conclusion: The results highlight the importance of considering demographic factors when identifying and referring youth at risk to ensure standard yet culturally appropriate procedures to prevent suicide.

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