Age dynamics of the need for outpatient medical care for conditions that determine the basic value of the need in women with the diseases of the circulatory system

INTRODUCTION: The results obtained from the analysis of age dynamics are insufficient for development a program of reducing morbidity and, ultimately, mortality, since a need of medical care already indicates a problem; so prevention and screening programs should surpass the emergence of these problems. AIM: To analyze the age dynamics of the need for outpatient medical care for conditions that determine the basic value of the need in women with diseases of the circulatory system. MATERIALS AND METHODS: We used data on 780,000 visits during one year to medical organizations that provide medical care on an outpatient basis. We studied the probability of an episode and the dynamics of the frequency of episodes depending on age in six five-year age groups: 31 to 35 years, 36 to 40 years, 41 to 45 years, 46 to 50 years, 51 to 55 years, and 56 to 60 years. The dynamics of the frequency of episodes was modeled by a mathematical function with the largest value of the approximation coefficient. The dynamics of the frequency of episodes was modeled by a mathematical function with the largest value of the approximation coefficient. RESULTS: The dynamics of the need for outpatient medical care for hypertensive diseases [Diseases characterized by high blood pressure] (I10 – I15), ischemic heart diseases (I20 – I25) and vascular diseases of the brain (I60 – I69) is characterized by an increasing trend in demand indicators throughout the studied age period. The greatest increase in indicators is observed in the age groups of 31–40 years for ischemic heart diseases and vascular diseases of the brain and 41–50 years for hypertensive conditions. The greatest increase in demand is observed for coronary heart diseases (I20 – I25). The total amount of resources required increases more than 350 times over the 30-year age period, despite the stable value of the average duration of treatment. The increase in the total amount of resources required for vascular diseases of the brain is 30 times. The lowest growth gradient is registered in relation to hypertensive conditions (10-fold growth). As a critical age period, it is most appropriate to consider the age of a woman under 35 years. CONCLUSION: Mathematical modeling is optimally performed using power functions for hypertensive conditions and vascular diseases of the brain and exponential functions for ischemic heart diseases. All the proposed models are characterized by high approximation coefficients.

Expression Profiles of Circular RNA in Aortic Vascular Tissues of Spontaneously Hypertensive Rats

Background: Circular RNAs (circRNAs), as a kind of endogenous non-coding RNA, have been implicated in ischemic heart diseases and vascular diseases. Based on theirs high stability with a closed loop structure, circRNAs function as a sponge and bind specific miRNAs to exert inhibitory effects in heart and vasculature, thereby regulating their target gene and protein expression, via competitive endogenous RNA (ceRNA) mechanism. However, the exact roles and underlying mechanisms of circRNAs in hypertension and related cardiovascular diseases remain largely unknown.Methods and Results: High-throughput RNA sequencing (RNA-seq) was used to analyze the differentially expressed (DE) circRNAs in aortic vascular tissues of spontaneously hypertensive rats (SHR). Compared with the Wistar-Kyoto (WKY) rats, there were marked increases in the levels of systolic blood pressure, diastolic blood pressure and mean blood pressure in SHR under awake conditions via the tail-cuff methodology. Totally, compared with WKY rats, 485 DE circRNAs were found in aortic vascular tissues of SHR with 279 up-regulated circRNAs and 206 down-regulated circRNAs. Furthermore, circRNA-target microRNAs (miRNAs) and the target messenger RNAs (mRNAs) of miRNAs were predicted by the miRanda and Targetscan softwares, respectively. Additionally, real-time RT-PCR analysis verified that downregulation of rno_circRNA_0009197, and upregulation of rno_circRNA_0005818, rno_circRNA_0005304, rno_circRNA_0005506, and rno_circRNA_0009301 were observed in aorta of SHR when compared with that of WKY rats. Then, the potential ceRNA regulatory mechanism was constructed via integrating 5 validated circRNAs, 31 predicted miRNAs, and 266 target mRNAs. More importantly, three hub genes (NOTCH1, FOXO3, and STAT3) were recognized according to PPI network and three promising circRNA-miRNA-mRNA regulatory axes were found in hypertensive rat aorta, including rno_circRNA_0005818/miR-615/NOTCH1, rno_circRNA_0009197/ miR-509-5p/FOXO3, and rno_circRNA_0005818/miR-10b-5p/STAT3, respectively.Conclusions: Our results demonstrated for the first time that circRNAs are expressed aberrantly in aortic vascular tissues of hypertensive rats and may serve as a sponge linking with relevant miRNAs participating in pathogenesis of hypertension and related ischemic heart diseases via the circRNA-miRNA-mRNA ceRNAnetwork mechanism.

Mortality Sensitivity of Cardiovascular, Cerebrovascular, and Respiratory Diseases to Warm Season Climate in Japanese Cities

We investigated decadal (2010–2019) cardiovascular, cerebrovascular, and respiratory mortality sensitivity to annual warm temperatures in major Japanese cities: Sapporo, Tokyo (23 wards), and Osaka. The summer mortalities (June–August) increased with the monthly mean temperature for acute myocardial infarction, other acute ischemic heart diseases, cerebral infarction, and pneumonia in the three cities. Monthly mean temperatures were an indicator of these disease mortalities in Japan. However, similar responses were not found for cardiac arrhythmia and heart failure (excluding Sapporo), subarachnoid hemorrhage, and intracerebral hemorrhage. The decadal sensitivities and risk ratios between the maximum and minimum monthly mean temperatures were calculated using a linear regression model. In Sapporo, Tokyo, and Osaka, for example, the analyses of acute myocardial infarction showed summer positive responses of 0.19–0.25, 0.13–0.18, and 0.12–0.30, respectively, as the mortality rate (per 100,000 population) per 1 °C of monthly mean temperature, which estimated increased risks (between the coolest and hottest months) of 37–65% in Sapporo, 31–42% in Tokyo, and 35–39% in Osaka.

mtDNA in the Pathogenesis of Cardiovascular Diseases

The incidence rate of cardiovascular disease (CVD) has been increasing year by year and has become the main cause for the increase of mortality. Mitochondrial DNA (mtDNA) plays a crucial role in the pathogenesis of CVD, especially in heart failure and ischemic heart diseases. With the deepening of research, more and more evidence showed that mtDNA is related to the occurrence and development of CVD. Current studies mainly focus on how mtDNA copy number, an indirect biomarker of mitochondrial function, contributes to CVD and its underlying mechanisms including mtDNA autophagy, the effect of mtDNA on cardiac inflammation, and related metabolic functions. However, no relevant studies have been conducted yet. In this paper, we combed the current research status of the mechanism related to the influence of mtDNA on the occurrence, development, and prognosis of CVD, so as to find whether these mechanisms have something in common, or is there a correlation between each mechanism for the development of CVD?

Frequency of Covid Outcome in Covid Patients with Pre-Existing Different Co-Morbid Conditions

Background: Unexpectedly and unfortunately the end of the year 2019 has proved to be the start of a deadliest era of Coronavirus disease 19. Spread of this lethal disease has remained uninhibited so far. How rapidly it has wrapped up the whole world is dangerously alarming. Aim: To determine frequency of Covid outcome in Covid patients with preexisting different co-morbid conditions. Methods: This descriptive study was conducted from July 2020 to January 2021 in two tertiary care hospital i.e. Services hospital, Lahore (Punjab) and hospital, Quetta (Baluchistan). After ethical approval and informed consent from the patients, data from PCR positive patients was recorded. The demographic parameters, travel or exposure history, duration of stay in the hospital and co morbidities including diabetes, hypertension, stroke and ischemic heart diseases of the patients were collected. Results: In our study, total 124 patients including 84(67.7%) male and 40(32.3%) female. The mean ages was 41.29±20.21 years, mean weight and height 83.46±15.1, 174.2±8.31. 82%patients were discharged, and 42%patients suffered death. Among the patients included in this study, 51(%) patients presented with diabetes, 55(%) patients presented with hypertension, 52% had ischemic heart diseases and 1.6% had stroke. Conclusion: The conclusion of this study, there is a significant impact of pre-existing co-morbidities on Covid outcomes. Thus, it can be inferred that by modifying the comorbidities, positive outcome can be observed Keywords: COVID-19, Risk factors, Outcome, Mortality

Anti-obesity and hypolipidemic effects of Morus alba- A review

The prevalence of obesity was worldwide increase in the last 60 years. Obesity represented one of the public health problems, it markedly increased the incidence of many diseases: fatty liver, type 2 diabetes, hypertension, ischemic heart diseases, sleep apnea, osteoporosis, dementia, tumors and many other disorders. Recent reviews showed that many medicinal plants possesses anti-obesity effect. In the current review, PubMed, Web Science, Science Direct, Research gate, Academia.edu and Scopus were searched to verify the hypolipidemic and anti-obesity activities of Morus alba.

Incidence of Atrial Fibrillation in Haemodialysis Patients

Background Chronic kidney disease patients usually experience several comorbid conditions including cardiovascular disorders and at final end-stage renal disease (ESRD) stage, cardiovascular mortality accounts for about 50% of total mortality. End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. Aim of the Work To detect the incidence of AF in hemodialysis patients during six months. Patients and Methods The study was a prospective cohort study for six months included 250 adult patients with end stage renal diseases on regular hemodialysis sessions in National Institute of Urology and Nephrology in CAIRO, EGYPT for at least six months with no past history suggestive of any arrhythmias and normal holter ECG at the start of the study. Results The study includes 250 patients from whom 37 patients refuse follow up after 6 months and 18 patients was died before our follow up holter ECG so mortality rate 14.4% .1n our study population there were 102 male patients (52.3%) and 93 female patients (47.7%) with mean age 54.39 ± 9.98 (19:73) and BMI 29.01±1.28 (24.5:34). In study population 96 patients were diabetic (49.2%), 84 patients were hypertensive (43.1%), 100patients were with ischemic heart diseases (51.3%) with median renal replacement duration 4 (3 — 6) with range (1 — 13). The main etiological causes of dialysis were diabetes mellitus, hypertension and analgesic nephropathy and other different causes of dialysis 35 patients (45%).The study showed association between incidence of AF in hemodialysis patients and different factors as increased BMI (0.006), prolonged duration of renal replacement therapy (0.017), diabetes mellitus (0.005), hypertension (0.000), ischemic heart diseases (0.02) and left atrium dilation (0.000). Conclusion The incidence of AF in patients with ESRD is 16.4%. The risk factors for increased incidence of AF in hemodialysis are; increased BMI, increased duration of renal replacement therapy, hypertension, diabetes mellitus, ischemic heart diseases and left atrium dilation by echocardiography.

Death of an offspring and parental risk of ischemic heart diseases: A population-based cohort study

Background The death of a child is an extreme life event with potentially long-term health consequences. Knowledge about its association with ischemic heart diseases (IHDs) and acute myocardial infarction (AMI), however, is very limited. We investigated whether the death of an offspring is associated with the risk of IHD and AMI. Methods and findings We studied parents of live-born children recorded in the Danish (1973 to 2016) and the Swedish (1973 to 2014) Medical Birth Registers (n = 6,711,952; mean age at baseline 31 years, 53% women). We retrieved information on exposure, outcomes, and covariates by linking individual-level information from several nationwide registers. We analyzed the abovementioned associations using Poisson regression. A total of 126,522 (1.9%) parents lost at least 1 child during the study period. Bereaved parents had a higher risk of IHD and AMI than the nonbereaved [incidence rate ratios (IRRs) (95% confidence intervals (CIs)): 1.20 (1.18 to 1.23), P < 0.001 and 1.21 (1.17 to 1.25), P < 0.001, respectively]. The association was present not only in case of losses due to CVD or other natural causes, but also in case of unnatural deaths. The AMI risk was highest in the first week after the loss [IRR (95% CI): 3.67 (2.08 to 6.46), P < 0.001], but a 20% to 40% increased risk was observed throughout the whole follow-up period. Study limitations include the possibility of residual confounding by socioeconomic, lifestyle, or health-related factors and the potentially limited generalizability of our findings outside Scandinavia. Conclusions The death of an offspring was associated with an increased risk of IHD and AMI. The finding that the association was present also in case of losses due to unnatural causes, which are less likely to be confounded by cardiovascular risk factors clustering in families, suggests that stress-related mechanisms may also contribute to the observed associations.

Predicting the Risk of Ischemic Stroke in Patients Treated with Novel Oral Anticoagulants: A Machine Learning Approach

<b><i>Introduction:</i></b> The aim of this cohort study was to estimate the predictors of ischemic stroke in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) in a large database containing data from general practitioners in Germany using machine learning methods. <b><i>Methods:</i></b> This retrospective cohort study included 39,652 patients with a diagnosis of atrial fibrillation (AF) and an initial prescription of NOAC in 1,278 general practices in Germany between January 2011 and December 2018. Of 39,652 patients, 2,310 (5.8%) receive the first stroke or TIA diagnosis during the follow-up time (average follow-up time 2.5 [SD: 1.8] years). Sub-Population Optimization and Modeling Solutions (SOMS) tool was used to identify subgroups at a higher risk of stroke compared to the overall population receiving NOAC based on 37 different variables. <b><i>Results:</i></b> Using SOMS, a total of 9 variables were considered important for the stroke prediction. Age had 59.1% of prediction importance, following by ischemic heart diseases (10.6%), urinary tract infections (4.6%), dementia (3.5%), and male sex (3.5%). Further variables with less importance were dizziness (2.2%), dorsalgia (1.5%), shoulder lesions (1.1%), and diabetes mellitus (1.1%). <b><i>Discussion/Conclusions:</i></b> The stroke risk in AF patients treated with NOAC could be predicted based on comorbidities like ischemic heart diseases, urinary tract infections, and dementia additionally to age and male sex. Knowing and addressing these factors may help reduce the risk of stroke in this patient population.