cardiovascular illness
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2022 ◽  
Vol 23 (2) ◽  
pp. 804
Author(s):  
Ting-Wei Kao ◽  
Chin-Chou Huang

Phenotyping cardiovascular illness and recognising heterogeneities within are pivotal in the contemporary era. Besides traditional risk factors, accumulated evidence suggested that a high inflammatory burden has emerged as a key characteristic modulating both the pathogenesis and progression of cardiovascular diseases, inclusive of atherosclerosis and myocardial infarction. To mechanistically elucidate the correlation, signalling pathways downstream to Toll-like receptors, nucleotide oligomerisation domain-like receptors, interleukins, tumour necrosis factor, and corresponding cytokines were raised as central mechanisms exerting the effect of inflammation. Other remarkable adjuvant factors include oxidative stress and secondary ferroptosis. These molecular discoveries have propelled pharmaceutical advancements. Statin was suggested to confer cardiovascular benefits not only by lowering cholesterol levels but also by attenuating inflammation. Colchicine was repurposed as an immunomodulator co-administered with coronary intervention. Novel interleukin-1β and −6 antagonists exhibited promising cardiac benefits in the recent trials as well. Moreover, manipulation of gut microbiota and associated metabolites was addressed to antagonise inflammation-related cardiovascular pathophysiology. The gut-cardio-renal axis was therein established to explain the mutual interrelationship. As for future perspectives, artificial intelligence in conjunction with machine learning could better elucidate the sequencing of the microbiome and data mining. Comprehensively understanding the interplay between the gut microbiome and its cardiovascular impact will help identify future therapeutic targets, affording holistic care for patients with cardiovascular diseases.


2022 ◽  
Vol 23 (2) ◽  
pp. 683
Author(s):  
Katalin Kauser ◽  
Kevin S. Warner ◽  
Blake Anderson ◽  
Edgar Dalles Keyes ◽  
RB Hayes ◽  
...  

The development of bioscaffolds for cardiovascular medical applications, such as peripheral artery disease (PAD), remains to be a challenge for tissue engineering. PAD is an increasingly common and serious cardiovascular illness characterized by progressive atherosclerotic stenosis, resulting in decreased blood perfusion to the lower extremities. Percutaneous transluminal angioplasty and stent placement are routinely performed on these patients with suboptimal outcomes. Natural Vascular Scaffolding (NVS) is a novel treatment in the development for PAD, which offers an alternative to stenting by building on the natural structural constituents in the extracellular matrix (ECM) of the blood vessel wall. During NVS treatment, blood vessels are exposed to a photoactivatable small molecule (10-8-10 Dimer) delivered locally to the vessel wall via an angioplasty balloon. When activated with 450 nm wavelength light, this therapy induces the formation of covalent protein–protein crosslinks of the ECM proteins by a photochemical mechanism, creating a natural scaffold. This therapy has the potential to reduce the need for stent placement by maintaining a larger diameter post-angioplasty and minimizing elastic recoil. Experiments were conducted to elucidate the mechanism of action of NVS, including the molecular mechanism of light activation and the impact of NVS on the ECM.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
M. D. Amzad Hossen ◽  
Tahia Tazin ◽  
Sumiaya Khan ◽  
Evan Alam ◽  
Hossain Ahmed Sojib ◽  
...  

Cardiovascular illness, often commonly known as heart disease, encompasses a variety of diseases that affect the heart and has been the leading cause of mortality globally in recent decades. It is associated with numerous risks for heart disease and a requirement of the moment to get accurate, trustworthy, and reasonable methods to establish an early diagnosis in order to accomplish early disease treatment. In the healthcare sector, data analysis is a widely utilized method for processing massive amounts of data. Researchers use a variety of statistical and machine learning methods to evaluate massive amounts of complicated medical data, assisting healthcare practitioners in predicting cardiac disease. This study covers many aspects of cardiac illness, as well as a model based on supervised learning techniques such as Random Forest (RF), Decision Tree (DT), and Logistic Regression (LR). It makes use of an existing dataset from the UCI Cleveland database of heart disease patients. There are 303 occurrences and 76 characteristics in the collection. Only 14 of these 76 characteristics are evaluated for testing, which is necessary to validate the performance of various methods. The purpose of this study is to forecast the likelihood of individuals getting heart disease. The findings show that logistic regression achieves the best accuracy score (92.10%).


Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4405
Author(s):  
Tzu-Chien Chen ◽  
Yu-Yu Ho ◽  
Rui-Chian Tang ◽  
Yong-Chen Ke ◽  
Jhih-Ni Lin ◽  
...  

Obesity is characterized as abnormal or excessive fat accumulation harmful to one’s health, linked to hormonal imbalances, cardiovascular illness, and coronary artery disease. Since the disease stems mainly from overconsumption, studies have aimed to control intestinal absorption as a route for treatment. In this study, chitosan-thioglycolic acid (CT) was developed as a physical barrier in the gastrointestinal tracts to inhibit nutrient uptake. CT exhibits a superior mucoadhesive property compared to chitosan both in vitro and in vivo for the ability to form disulfide bonds with the intestinal mucosa. For CT as a potential drug delivery platform, hesperidin, a herb for bodyweight control in traditional Chinese medication, is encapsulated in CT and can be released consistently from this absorption barrier. In animal studies, CT encapsulated with hesperidin (CTH) not only results in a weight-controlling effect but limits adipose accumulation by hindering absorption, suggesting a potential role in obesity treatment. Neither CT nor CTH exhibit cytotoxicity or produce adverse immunological reactions in vivo.


Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1065
Author(s):  
Robertus van Aalst ◽  
Stefan Gravenstein ◽  
Vincent Mor ◽  
Salaheddin M. Mahmud ◽  
Jan Wilschut ◽  
...  

Two influenza vaccines are licensed in the U.S. exclusively for the 65 years and older population: a trivalent inactivated high-dose influenza vaccine (HD-IIV3) and a trivalent inactivated adjuvanted influenza vaccine (aIIV3). In a recent publication, we estimated a relative vaccine effectiveness (rVE) of HD-IIV3 vs. aIIV3 of 12% (95% CI: 3.3–20%) for influenza-related hospitalizations using a retrospective study design, but did not report the number of prevented hospitalizations nor the associated avoided cost. In this paper we report estimations for both. Methods: Leveraging the rVE of a cohort study over two influenza seasons (2016/17 and 2017/18), we collected cost data for healthcare provided to the same study population. Vaccine costs were obtained from the Medicare pricing schedule. Our economic assessment compared cost of vaccination and hospital care for patients experiencing acute respiratory or cardiovascular illness. Results: We analyzed 1.9 million HD-IIV3 and 223,793 aIIV3 recipients. Average vaccine list prices were $46.23 for HD-IIV3 and $48.26 for aIIV3. The hospitalization rates for respiratory disease in HD-IIV3 and aIIV3 recipients were 187 (95% CI: 185–189) and 212 (195–231) per 10,000 persons-years, respectively. Attributing the average cost per hospitalization of $12,652 ($12,214–$13,090) to the difference in hospitalization rates, we estimate net savings of HD-IIV3 to be $34 ($10–$62) per recipient. Conclusion: Pooled over two predominantly A/H3N2 respiratory seasons, vaccination with HD-IIV3 was associated with lower hospitalization rates and associated costs compared to aIIV3 in senior members of a large national managed health care company in the U.S. Reduced hospitalizations affect healthcare utilization overall, and therefore other costly health outcomes.


Antioxidants ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1357
Author(s):  
Hui-Hsuan Lin ◽  
Ming-Chang Hsieh ◽  
Chi-Ping Wang ◽  
Pei-Rong Yu ◽  
Ming-Shih Lee ◽  
...  

Gossypetin (GTIN), known as 3,5,7,8,3′,4′-hexahydroxyflavone, has been demonstrated to exert anti-atherosclerotic potential against apoptotic injury in oxidized low-density lipoprotein-incubated endothelial cells, and atherosclerotic lesions of cholesterol-fed rabbits. However, the effect and underlying mechanism of GTIN on abnormal vascular smooth muscle cells (VSMCs) proliferation and migration, a major event in the pathogenesis of atherosclerosis, is still unknown. In this study, non-cytotoxic doses of GTIN abolished the VSMCs A7r5 proliferation and cell-cycle S phase distribution. The GTIN-arrested G0/G1 phase might be performed by increasing the expressions of phosphorylated p53 and its downstream molecules that inhibit the activation of cyclin E/cyclin-dependent kinase (cdk)-2, blocking retinoblastoma protein (Rb) phosphorylation and the subsequent dissociation of Rb/transcription factor E2F1 complex. In addition, the results indicated that GTIN inhibited VSMCs wound-healing and migratory abilities through reducing matrix metalloproteinase (MMP)-9 activity and expression, as well as down-regulating protein kinase B (PKB)/nuclear factor-kappaB (NF-κB) signaling. GTIN also revealed potential in diminishing reactive oxygen species (ROS) generation. These findings suggested the inhibitory effects of GTIN on VSMCs dysfunction could likely lead to the containment of atherosclerosis and other cardiovascular illness.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S70-S70
Author(s):  
Damodar Chari ◽  
Mohammed Abbas ◽  
Kajal Dhesi

AimsMeasure compliance with standards requiring baseline work up before Lithium therapy is commenced and subsequent Lithium level monitoring during the initiation phaseMethodAll inpatients and outpatients who were started on Lithium between 2018 and 2019 within the Leicestershire Partnership NHS trust. Case notes were of patients 128 were retrieved from the electronic system and an audit proforma was completed to ascertain adherence to auditing standards as per BNF and trust guidelines. Parameters monitored were full blood count (FBC), renal functions test including serum electrolytes, thyroid function test, and BMI before commencing Lithium, and serum Lithium periodically after. ECG was needed for those patients with cardiovascular illness. Data were systematically compiled and analyzed descriptively using Microsoft ExcelResultA total of 128 patients were included in the study. 111 (86.71%) had FBC, 118 (92.19%) had renal function test and electrolytes, 114 (89.06%) had thyroid function test while 99 (77.34%) had their BMI/weight recorded before initiating Lithium. 26 out of 36 patients with cardiovascular disorder had their ECG recorded. After Lithium was commenced, 108 (84.37%) had serum Lithium tested a week later, while only 89 (69.53%) had lithium monitored weekly. Trust guidelines recommend weekly monitoring for up to 4 weeks after a stable dose was reached. This was monitored in only 16 out of 128 patients.ConclusionMost of the patients had blood test done before being commenced on Lithium. However it was observed that serum Lithium was not adequately monitored at regular intervals after dose escalations. These finding indicate that there has to be greater awareness of the trust and BNF guidelines with regards to Lithium monitoring.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rosa María Ruiz Calero Cendrero ◽  
María Victoria Martín Hidalgo Barquero ◽  
Eva Vázquez Leo ◽  
María Antonia Fernández Solís ◽  
María Cruz Cid Parra ◽  
...  

Abstract Background and Aims Hemodialysis patients are high-risk patients for severe forms of SARS-Cov 2. Extremadura has two provinces Badajoz(B) and Caceres(C) with one million of people. The incidence was small in the first part of the pandemic (2,6%) compared with the national incidence, and it was higher in C than in B (5,6% vs 1,1%) The aim of this study was to estimate the incidence of COVID-19 disease in the population of Extremadura's hemodialysis patients and to study the clinical evolution, treatment and mortality in patients with confirmed infection with Polymerase chain reaction(PCR) during the second wave. Method Multicenter, retrospective, observational study of hemodialysis patients with COVID-19 disease between August and December of 2020. There were 683 hemodialysis patients in this period distributed in 5 hospital units and 7 out of hospital Units. Results Incidence: 6,8% (46 infected of SARS-Cov 2), with almost one patient in each center (the highest with 16,1%) and higher incidence in B than in C (8,1% vs 4,1%). Males (58,7%), media age, (69,3±11,9) and median renal replacement therapy time 29 months (RIC 47,4). The most frequent CKD was diabetic nephropathy (16%), but 35% of the patients have diabetes, 86% hypertension and 56% cardiovascular illness. Treatment with angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers 40% and with vitamin D 62,8%. There were 42% patients who had contacted with positive people of hemodialysis unit and 37% with positive people outside. 67% have symptoms: the most frequent cough and fever (46%). Hospitalized patients: 41,6%, all of them with bilateral pneumonia. All had lymphocytopenia and high acute phase reactants: D -dimer 1195 ng/ml (RIC 1545), Ferritin 950,12ng/ml (RIC 533,6) IL-6 30,11pg/ml (RIC 41,13) C-reactive protein 28 mg/l (RIC 62,10) Procalcitonin 0,42 ng/ml (RIC 0,44), all increased in the hospitalized period without significant differences. Median hospitalized time was 10 days (RIC 11). Nine patients died (19,5%), 3 of them in intensive unit care with 15 days median. Most of them needed antibiotic therapy, steroids and anticoagulation, 5 convalescent plasma and 5 tocilizumab. We stopped isolated room dialysis when they had negative PCR (56%) or IgG positive (54%), median insulation 17 days (RIC 7). We haven´t found differences in hospitalized vs no hospitalized patients in age, gender, renal replacement therapy time, etiology, DM, hypertension or cardiovascular illness and treatment, nor in relation with mortality. Conclusion We have observed an increase in the incidence of infection in this period compared with the first period of the pandemic, parallel to the increases in the incidence of the general population in Extremadura (more in B than in C). The mortality is high but similar to other publications. We have to do screening due to the possibility of asymptomatic patients that could have contributed to expand the infection. The high number of hospitalized patients and the need of isolated rooms dialysis for infections patients is a challenge for the organization of hemodialysis units but having positive serologic reduce the isolation time.


2021 ◽  
Author(s):  
Brenna Franco

Environmental greenness is often associated with improved psychological outcomes, but the use of green space as a protective factor for maintaining physiologic health is understudied. However, growing evidence exists on the benefit of greenness on physiologic health. The purpose of this systematic review was to evaluate the effect of green space on the physiologic function of the adult. Cohort studies were searched for that had all elements of inclusion criteria. Six final studies were included in this systematic review utilizing PRISMA guidelines and CASP tool for cohort studies. Data from the studies was collected and a cross study analysis was conducted to compare all studies and assess for themes in study outcomes. Results of this review demonstrate that green space has a protective effect on physiologic health. Areas with higher levels of greenness are associated with lower prevalence of central obesity, diabetes mellitus, and self-reported rates of cardiovascular disease and stroke as well as decreased rates of mortality from cancers, and kidney and respiratory diseases. Implications of this study include the importance in understanding risk factors for development of disease. Awareness of a patient’s environment that includes natural spaces should be identified as a potential risk factor for the development of cardiovascular illness, obesity, and diabetes mellitus.


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