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Tyagi S, Friedland DR, Rein L, Tarima SS, Mueller C, Benjamin EJ, Vasan RS, Hamburg NM, Widlansky ME. Abnormal hearing patterns are not associated with endothelium-dependent vasodilation and carotid intima-media thickness: The Framingham Heart Study. Vasc Med 2021; 26:595-601. [PMID: 34286655 DOI: 10.1177/1358863x211025087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Prior data suggest associations between hearing loss, cardiovascular (CV) risk factors, and CV disease. Whether specific hearing loss patterns, including a strial pattern associated with inner ear vascular disease, are associated with systemic endothelial dysfunction and carotid intima-media thickness (IMT) remains unclear. METHODS We evaluated participants without prevalent CVD in the Framingham Offspring Study who underwent formal audiogram testing and brachial and carotid artery ultrasounds. Audiograms were categorized as normal or as belonging to one of four abnormal patterns: cochlear-conductive, low-sloping, sensorineural, or strial. Endothelial function as measured by brachial artery flow-mediated dilation (FMDmm and FMD%). Internal and common intima-media thicknesses (icIMT and ccIMT, respectively) were compared between audiogram patterns. RESULTS We studied 1672 participants (mean age 59 years, 57.6% women). The prevalence of each hearing pattern was as follows: 43.7% normal; 20.3% cochlear-conductive; 20.3% sensorineural; 7.7% low-sloping; and 8.0% strial. Strial pattern hearing loss was nearly twice as prevalent (p = 0.001) in those in the highest quartile of ccIMT and nearly 50% higher in those in the highest icIMT quartile (p = 0.04). There were no statistically significant differences between the prevalence of the strial pattern comparing the lowest quartiles of FMDmm and FMD% with the upper three quartiles. Age- and sex-adjusted linear regression models did not show significant associations between the vascular measures and hearing patterns. CONCLUSION Abnormal hearing patterns were not significantly associated with impaired brachial FMD and increased carotid IMT after adjusting for age and sex effects, which may reflect age and sex-related distributional differences based on hearing loss pattern.
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Affiliation(s)
- Sudhi Tyagi
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David R Friedland
- Department of Otolaryngology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lisa Rein
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sergey S Tarima
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christopher Mueller
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Emelia J Benjamin
- Boston University and NHLBI's Framingham Heart Study, Framingham, MA, USA.,Evans Department of Medicine, Boston University, School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University, School of Medicine, Boston, MA, USA
| | - Ramachandran S Vasan
- Boston University and NHLBI's Framingham Heart Study, Framingham, MA, USA.,Evans Department of Medicine, Boston University, School of Medicine, Boston, MA, USA.,Boston University School of Public Health, Boston, MA, USA.,Center for Computing and Data Sciences, Boston University School of Medicine, Boston, MA, USA
| | - Naomi M Hamburg
- Evans Department of Medicine, Boston University, School of Medicine, Boston, MA, USA.,Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA
| | - Michael E Widlansky
- Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Pharmacology, Medical College of Wisconsin, Milwaukee, WI, USA
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Kitzman DW, Whellan DJ, Duncan P, Pastva AM, Mentz RJ, Reeves GR, Nelson MB, Chen H, Upadhya B, Reed SD, Espeland MA, Hewston L, O’Connor CM. Physical Rehabilitation for Older Patients Hospitalized for Heart Failure. N Engl J Med 2021; 385:203-216. [PMID: 33999544 PMCID: PMC8353658 DOI: 10.1056/nejmoa2026141] [Citation(s) in RCA: 259] [Impact Index Per Article: 86.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Older patients who are hospitalized for acute decompensated heart failure have high rates of physical frailty, poor quality of life, delayed recovery, and frequent rehospitalizations. Interventions to address physical frailty in this population are not well established. METHODS We conducted a multicenter, randomized, controlled trial to evaluate a transitional, tailored, progressive rehabilitation intervention that included four physical-function domains (strength, balance, mobility, and endurance). The intervention was initiated during, or early after, hospitalization for heart failure and was continued after discharge for 36 outpatient sessions. The primary outcome was the score on the Short Physical Performance Battery (total scores range from 0 to 12, with lower scores indicating more severe physical dysfunction) at 3 months. The secondary outcome was the 6-month rate of rehospitalization for any cause. RESULTS A total of 349 patients underwent randomization; 175 were assigned to the rehabilitation intervention and 174 to usual care (control). At baseline, patients in each group had markedly impaired physical function, and 97% were frail or prefrail; the mean number of coexisting conditions was five in each group. Patient retention in the intervention group was 82%, and adherence to the intervention sessions was 67%. After adjustment for baseline Short Physical Performance Battery score and other baseline characteristics, the least-squares mean (±SE) score on the Short Physical Performance Battery at 3 months was 8.3±0.2 in the intervention group and 6.9±0.2 in the control group (mean between-group difference, 1.5; 95% confidence interval [CI], 0.9 to 2.0; P<0.001). At 6 months, the rates of rehospitalization for any cause were 1.18 in the intervention group and 1.28 in the control group (rate ratio, 0.93; 95% CI, 0.66 to 1.19). There were 21 deaths (15 from cardiovascular causes) in the intervention group and 16 deaths (8 from cardiovascular causes) in the control group. The rates of death from any cause were 0.13 and 0.10, respectively (rate ratio, 1.17; 95% CI, 0.61 to 2.27). CONCLUSIONS In a diverse population of older patients who were hospitalized for acute decompensated heart failure, an early, transitional, tailored, progressive rehabilitation intervention that included multiple physical-function domains resulted in greater improvement in physical function than usual care. (Funded by the National Institutes of Health and others; REHAB-HF ClinicalTrials.gov number, NCT02196038.).
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Affiliation(s)
- Dalane W. Kitzman
- Department of Internal Medicine, Sections on Cardiovascular Medicine and Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC
| | - David J. Whellan
- Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Pamela Duncan
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Amy M. Pastva
- Department of Orthopaedic Surgery, Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, NC
| | - Robert J. Mentz
- Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC
| | | | - M. Benjamin Nelson
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Haiying Chen
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - Bharathi Upadhya
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Shelby D. Reed
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Mark A. Espeland
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
- Department of Internal Medicine, Section on Geriatrics, Wake Forest School of Medicine, Winston-Salem, NC
| | - LeighAnn Hewston
- Department of Physical Therapy, Jefferson College of Rehabilitation Sciences, Philadelphia, PA
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103
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Seman S, Dražilov SS, Ilić V, Tešić M, Stojiljković S, Arena R, Popović D. Physical activity and exercise as an essential medical strategy for the COVID-19 pandemic and beyond. Exp Biol Med (Maywood) 2021; 246:2324-2331. [PMID: 34233523 DOI: 10.1177/15353702211028543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
COVID-19 disease has been a problem in today's society, which has worldwide effects on different areas, especially on the economy; also, from a health perspective, the disease affects the daily life quality. Physical activity is one major positive factor with regard to enhancing life quality, as it can improve the whole psychological, social, and physical health conditions. Current measures such as social distancing are focused on preventing the viral spread. However, the consequences on other areas are yet to be investigated. Elderly, people with chronic diseases, obese, and others benefit largely from exercise from the perspective of improved health, and preventive measures can drastically improve daily living. In this article, we elaborate the effects of exercise on the immune system and the possible strategies that can be implemented toward greater preventive potential.
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Affiliation(s)
- Stefan Seman
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade 11000, Serbia.,Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL 60612, USA
| | | | - Vladimir Ilić
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade 11000, Serbia
| | - Milorad Tešić
- Division of Cardiology, Clinical Center of Serbia, University of Belgrade, Belgrade 11000, Serbia
| | - Stanimir Stojiljković
- Faculty of Sport and Physical Education, University of Belgrade, Belgrade 11000, Serbia
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL 60612, USA.,Department of Physical Therapy, College of Applied Science, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Dejana Popović
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL 60612, USA.,Division of Cardiology, Clinical Center of Serbia, University of Belgrade, Belgrade 11000, Serbia.,Faculty of Pharmacy, University of Belgrade, Belgrade 11000, Serbia
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104
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The effect of pulmonary rehabilitation on physical performance and health related quality of life in patients with chronic lung disease. Respir Med 2021; 186:106533. [PMID: 34246874 DOI: 10.1016/j.rmed.2021.106533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/30/2022]
Abstract
Pulmonary rehabilitation (PR) is a multidisciplinary approach that improves exercise capacity and health-related quality of life in patients with chronic lung disease. We retrospectively reviewed the medical records of the patients with chronic lung disease who participated in the PR program at University Medical Center in Lubbock, Texas, between 2014 and 2019. Clinical information, 6-min walk test (6 MW T) results, the number of emergency department (ED) visits and hospitalizations, and psychosocial questionnaires (CAT score, PHQ9 and mMRC dyspnea score) were recorded before and after the completion of the program. Multiple variable linear regression and logistic regression were used to analyze the relationships between patient characteristics and changes in the 6-min walk distance and the achievement of a minimal clinically important differences (MCID) in the 6-min walk distance, the CAT score, the PHQ-9, and the mMRC. 279 patients enrolled in pulmonary rehabilitation; 144 patients (52%) completed the program. After completion of the program, 84 patients increased their 6 MW T distance to exceed the MCID with a mean increase of 178 feet, and the number of ED visits and hospitalizations decreased from 0.80 ± 1.11 to 0.55 ± 0.87 (p < 0.05) in the six months before and after rehabilitation. There were statistically significant improvements in all three psychosocial scores. Factors associated with non-completion included younger age, female gender, and shorter baseline 6 MW T distances. The MCID helps evaluate patient outcomes following pulmonary rehabilitation and provide more definite assessment of benefits. The high dropout rate indicates that programs must continuously monitor patient participation and interest.
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105
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Baldassarre ME, Antonucci LA, Castoro G, Di Mauro A, Fanelli M, Grosso FM, Cassibba R, Laforgia N. Maternal Psychological Factors and Onset of Functional Gastrointestinal Disorders in Offspring: A Prospective Study. J Pediatr Gastroenterol Nutr 2021; 73:30-36. [PMID: 33633078 DOI: 10.1097/mpg.0000000000003107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVES Functional gastrointestinal disorders (FGIDs) are a heterogeneous group of conditions of unclear etiology. The biopsychosocial model approach to FGIDs posits that early-life stressors may trigger a cascade of complex interactions between genetic predisposition and risk factors eventually leading to the occurrence of FGIDs. The relationship between the psychological disposition of the mother and FGIDs occurrence is poorly understood. We conducted a study to investigate if parental psychological factors may contribute to the onset of FGIDs in offspring. METHODS We performed a prospective cohort study of parent-infant pairs who completed a battery of self-reported psychological questionnaires and a validated Rome III questionnaire for the diagnosis of infant and toddler FGIDs. The Edinburgh Postpartum Depression Scale (EPDS) was used to examine postpartum depression (PPD) symptoms; the Maternity Blues Questionnaire (MBQ) was applied to measure maternity blues severity; the Symptoms Checklist-Revised (SCL90-R) was used to assess the presence of relevant psychiatric symptoms; adult attachment style in mothers was assessed in a continuous way through the five dimensions of the Attachment Style Questionnaire (ASQ). RESULTS Out of the 360 eligible mothers, 200 were enrolled, 113 completed the 3-month follow-up and were included in the final analysis. PPD symptoms prevalence was 20.4%, 20%, 13.2%, and 13.1% respectively at 3 days, 1 week, 1 month, and 3 months after delivery. 40.4% of mothers suffered from severe blues according to the MBQ. Relevant psychiatric symptoms (SCL90-R) were present in 7.8% and 10.9% of mothers, respectively at 1 week and 3 months after delivery. 48.7% of mothers showed a secure attachment pattern measured through the RQ. At 1-month follow-up, infant regurgitation was diagnosed in 26 (23%) of infants, infantile colic in 31 (27.4%), dyschezia in 17 (15%), and functional constipation in 9 (8%). At 3-month follow-up, FGIDs prevalence was respectively 16 (19.3%), 11 (13.3%), 4 (4.8%), and 11 (13.3%). A significant positive association between PPD symptoms starting 3 days after delivery and the presence of infantile colic on setting 1 month after birth was found (P = 0.028), as well as between PPD symptoms occurrence 7 days after delivery and infantile regurgitation beginning 1 month after birth (P = 0.042). A higher prevalence of infantile colic was found in the offspring of mothers suffering from PPD symptoms from 3 days after delivery (54.5 vs 19.8; P = 0.001). No significant association was found between FGIDs and psychiatric symptoms and maternity blues at any timepoint. On the other hand, mothers of infants with regurgitation with an onset 1 month after birth have higher insecurity score in avoidant and fearful ASQ-related attachment dimensions (respectively, P = 0.03, P = 0.042, P = 0.03). CONCLUSIONS Maternal psychological factors might contribute to the onset of infant FGIDs in offspring. Early screening of postpartum depression symptoms and early implementation of psychological interventions within the postpartum period might promote the health of the mother-infant dyad.
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Affiliation(s)
| | | | | | | | - Margherita Fanelli
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Aldo Moro University of Bari, Bari
| | - Francesca Maria Grosso
- Postgraduate School in Public Health, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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106
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Khosravipour M, Rajati F. Sensorineural hearing loss and risk of stroke: a systematic review and meta-analysis. Sci Rep 2021; 11:11021. [PMID: 34040004 PMCID: PMC8155183 DOI: 10.1038/s41598-021-89695-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 04/29/2021] [Indexed: 02/04/2023] Open
Abstract
The aim of this systematic review and meta-analysis study was to clarify the effects of sensorineural hearing loss (SNHL) on the incidence of stroke. In line with this, PubMed, Scopus, Web of Science, and ScienceDirect databases were searched using related keywords and MeSH terms from inception to March 1, 2020. Out of the 1961 initial records, eight cohort studies comprising 4,564,202 participants were included, and their qualities were assessed using the Newcastle-Ottawa Scale (NOS). Then, the random-effects model was used to pool HR (95% CI) for risk of stroke; and heterogeneity was presented with I2 index. Subgroup analysis and publication bias tests were performed, and the pooled HR (95% CI) of stroke in SNHL was estimated as 1.31 (1.08, 1.53) for the unadjusted model and 1.33 (1.18, 1.49) for the adjusted model. Subgroup analysis indicates a significantly higher risk of stroke in patients with sudden SNHL (SSNHL) in comparison to age-related HL (ARHL) both in the unadjusted model, [HR = 1.46; 95% CI (1.08, 1.63)] versus [HR = 1.14; 95% CI (0.64, 1.65)], and in the adjusted model, [HR = 1.44; 95% CI (1.15, 1.74)] versus [HR = 1.29; 95% CI (1.24, 1.34)]. Our study showed that patients with SNHL face a higher risk of stroke than those without SNHL. It is necessary to perform hematologic and neurological examinations to help clinicians detect patients who are potentially at risk for stroke.
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Affiliation(s)
- Masoud Khosravipour
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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107
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Bahadoran S, Hassanpour H, Arab S, Abbasnia S, Kiani A. Changes in the expression of cardiac genes responsive to thyroid hormones in the chickens with cold-induced pulmonary hypertension. Poult Sci 2021; 100:101263. [PMID: 34225204 PMCID: PMC8260859 DOI: 10.1016/j.psj.2021.101263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Cold stress is an environmental cause of pulmonary hypertension syndrome (PHS) in broiler chickens. This factor could increase the rate of metabolic activity via thyroid hormones (T3 and T4). To evaluate the effect of these hormones on the heart, the plasma concentration of T3, T4, and the gene expression of their receptors (THRα and THRβ) and many contractile proteins (ACTC1, MHCα, MHCβ, RYR2, SERCA2, THRα, THRβ, and troponin I) were measured in the right ventricle in 2 periods of age (21 and 35 d). Plasma T3 concentration was significantly higher in the PHS group of chickens than in the control one at 21 and 35 d while plasma T4 did not change. The relative expression of MHCα, RYR2, SERCA2, and THRα genes in the right ventricle tissues was only higher in PHS group of broilers than control group at 21 d (P < 0.05) whereas the expression of ACTC1, MHCβ, and troponin I did not differ at 2 periods of age. The positive correlations between MHCα, RYR2, SERCA2, and T3, THRα were confirmed. The expression of THRβ gene was only higher in PHS group of broilers than control at 35 d (P < 0.05). The data determined that cold stress could increase thyroid hormones and the gene expression of their receptor (THRα) in the pick of chicken growth (21 d) that they themselves elevates the expression of many genes related to contractile elements (MHCα, RYR2, and SERCA2), leading to adaptive right ventricle hypertrophy.
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Affiliation(s)
- S Bahadoran
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 34141-88186 Iran
| | - H Hassanpour
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 34141-88186 Iran.
| | - S Arab
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 34141-88186 Iran
| | - S Abbasnia
- Department of Basic Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 34141-88186 Iran
| | - A Kiani
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, 34141-88186 Iran
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108
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Fonseca AC, Coelho P. Update on Biomarkers Associated to Cardioembolic Stroke: A Narrative Review. Life (Basel) 2021; 11:life11050448. [PMID: 34067554 PMCID: PMC8156147 DOI: 10.3390/life11050448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/13/2021] [Accepted: 05/15/2021] [Indexed: 12/15/2022] Open
Abstract
Background: In the last years, several studies were conducted that evaluated biomarkers that could be helpful for cardioembolic stroke diagnosis, prognosis, and the determination of risk of stroke recurrence. Methods: We performed a narrative review of the main studies that evaluated biomarkers related to specific cardioembolic causes: atrial fibrillation, patent foramen ovale, atrial cardiomyopathy, and left ventricular wall motion abnormalities. Results: BNP and NT-proBNP are, among all biomarkers of cardioembolic stroke, the ones that have the highest amount of evidence for their use. NT-proBNP is currently used for the selection of patients that will be included in clinical trials that aim to evaluate the use of anticoagulation in patients suspected of having a cardioembolic stroke and for the selection of patients to undergo cardiac monitoring. NT-proBNP has also been incorporated in tools used to predict the risk of stroke recurrence (ABC-stroke score). Conclusions: NT-proBNP and BNP continue to be the biomarkers most widely studied in the context of cardioembolic stroke. The possibility of using other biomarkers in clinical practice is still distant, mainly because of the low methodological quality of the studies in which they were evaluated. Both internal and external validation studies are rarely performed for most biomarkers.
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Affiliation(s)
- Ana Catarina Fonseca
- Department of Neurology, Hospital de Santa Maria, 1640-035 Lisboa, Portugal;
- Institute of Molecular Medicine, 1649-028 Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Correspondence:
| | - Pedro Coelho
- Department of Neurology, Hospital de Santa Maria, 1640-035 Lisboa, Portugal;
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109
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Martins P, Pires A, Santos JL, Sena C, Seiça R. Atherosclerotic Process in Seroreverter Children and Adolescents Exposed to Fetal Antiretroviral Therapy. Curr HIV Res 2021; 19:216-224. [PMID: 33213356 DOI: 10.2174/1570162x18999201118155026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/07/2020] [Accepted: 10/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Human immunodeficiency virus infection is a recognized risk factor for premature atherosclerosis in children and adolescents. However, the atherosclerotic process in uninfected children exposed in utero to the virus and antiretroviral therapy is less clear. OBJECTIVE To determine the potential cardiovascular risk associated to this in utero milieu exposition. MATERIAL AND METHODS A total of 115 individuals were studied (77 in the sample group and 38 in the controls). Eighteen analytical mediators involved in the atherogenic pathways (metabolic dysregulation, inflammation, and prothrombotic state) were analyzed. The carotid intima-media thickness, which is a subclinical marker of atherosclerosis, was also measured. RESULTS No significant statistical differences were identified between the sample and control groups, either in the biochemical or the echographic markers. CONCLUSION In utero exposure to the HIV virus and antiretroviral therapy in uninfected children and adolescents is not correlated to accelerated atherosclerosis.
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Affiliation(s)
- Paula Martins
- Paediatric Cardiology Service, Paediatric Hospital, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - António Pires
- Paediatric Cardiology Service, Paediatric Hospital, Coimbra Hospital and Universitary Centre, Coimbra, Portugal
| | - José Luis Santos
- CMUC, Department of Mathematics, Faculty of Sciences and Technology, University of Coimbra, Coimbra, Portugal
| | - Cristina Sena
- Coimbra Institute for Clinical and Biomedical Researh (iCBR) - Faculty of Medicine - University of Coimbra, Coimbra, Portugal
| | - Raquel Seiça
- Coimbra Institute for Clinical and Biomedical Researh (iCBR) - Faculty of Medicine - University of Coimbra, Coimbra, Portugal
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110
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Park S, Kim MH, Choi I. Autonomic Nervous Function in Patients with Sudden Sensorineural Hearing Loss and Its Association with Prognosis and Disease Severity. Audiol Neurootol 2021; 26:303-309. [PMID: 33951629 DOI: 10.1159/000512462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/21/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Vascular disorder is considered one of the main mechanisms of sudden sensorineural hearing loss (SSNHL) due to the anatomy of the inner ear. One factor that can contribute to vascular disorder is impairment in the autonomic nervous system. This study aims to investigate autonomic function in patients with SSNHL and its association with prognosis and disease severity from January 2018 to October 2019. METHODS We conducted a cross-sectional study involving 40 healthy controls and 55 subjects with SSNHL. We compared the autonomic function of controls and patients using heart rate variability (HRV). SSNHL patients were divided into improvement and no-improvement groups and into mild and severe groups according to pure-tone audiometry results. RESULTS The SSNHL group had significantly decreased total power (TP), low frequency (LF), and high frequency (HF) compared to the control group. However, there were no significant differences between the mild and severe groups. In the no-improvement group, LF was significantly higher and normalized HF was significantly lower than in the improvement group. According to a multiple logistic regression analysis, age and LF were significantly correlated with improvement. CONCLUSION This is the first study to evaluate the significance of HRV in patients with SSNHL, according to prognosis and disease severity. Further studies about the relationship between autonomic nervous system and SSNHL with larger sample size and prospective design are needed.
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Affiliation(s)
- Soyoung Park
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Min Hee Kim
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Inhwa Choi
- Department of Ophthalmology, Otorhinolaryngology, and Dermatology of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
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111
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Wu S, Zhu C, Wang Z, Wang S, Yuan P, Song T, Hou X, Lei Z. Effects of Fish Oil Supplementation on Cardiometabolic Risk Factors in Overweight or Obese Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials. Front Pediatr 2021; 9:604469. [PMID: 33987149 PMCID: PMC8110710 DOI: 10.3389/fped.2021.604469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Influences of fish oil supplementation on body weight and other cardiometabolic factors in overweight or obese children and adolescents remain not fully understood. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of fish oil for these children. Methods: Relevant studies were obtained by search of PubMed, Embase, and Cochrane's Library databases. A random-effect model, which incorporates the potential heterogeneity of the included studies, was used to pool the results. Results: Twelve RCTs including 1,028 overweight or obese children and adolescents were included. Compared to control, fish oil supplementation significantly reduced body mass index [BMI, mean difference (MD): -0.96 kg/m2, 95% confidence interval (CI): -1.69 to -0.23, P = 0.01] but did not significantly reduce body weight or waist circumference (P = 0.68 and 0.76). Moreover, fish oil supplementation significantly reduced serum triglyceride (MD: -0.24 mmol/L, 95% CI: -0.40 to -0.08, P = 0.004) but did not significantly affect serum total cholesterol and high-density or low-density lipoprotein cholesterol (P = 0.83, 0.42, and 0.31, respectively). Additionally, fish oil supplementation significantly lowered systolic blood pressure (SBP, MD: -2.46 mmHg, 95% CI: -4.93 to -0.01, P = 0.04) but did not significantly change diastolic blood pressure (P = 0.22). Supplementation with fish oil did not significantly affect fasting plasma glucose (P = 0.33). Conclusions: In overweight or obese children and adolescents, supplementation with fish oil could reduce BMI, decrease serum triglyceride, and lower SBP, while serum cholesterol and fasting glucose may not be significantly affected.
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Affiliation(s)
- Shaojing Wu
- Department of Clinical Nutrition, Hainan Maternal and Children's Medical Center, Haikou, China
| | - Chunhong Zhu
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Zhen Wang
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Shumei Wang
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Pengfei Yuan
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Tao Song
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Xiaoli Hou
- Department of Pediatrics, Zhongshan Hospital Affiliated to Dalian University, Dalian, China
| | - Zhixian Lei
- Department of Critical Medicine, Hainan Maternal and Children's Medical Center, Haikou, China
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Dong G, Chen H, Zhang H, Gu Y. Long-Term and Short-Term Prognostic Value of Circulating Soluble Suppression of Tumorigenicity-2 Concentration in Chronic Heart Failure: A Systematic Review and Meta-Analysis. Cardiology 2021; 146:433-440. [PMID: 33902050 DOI: 10.1159/000509660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Soluble suppression of tumorigenicity-2 (sST2) has been considered as a prognostic factor of cardiovascular disease. However, the prognostic value of sST2 concentration in chronic heart failure remains to be summarized. METHODS We searched PubMed, Embase, and Web of Science for eligible studies up to January 1, 2020. Data extracted from articles and provided by authors were used in agreement with the PRISMA statement. The endpoints were all-cause mortality (ACM), cardiovascular mortality (CVM)/heart failure-related hospitalization (HFH), and all-cause mortality (ACM)/heart failure-related readmission (HFR). RESULTS A total of 11 studies with 5,121 participants were included in this analysis. Higher concentration of sST2 predicted the incidence of long-term ACM (hazard ratio [HR]: 1.03, 95% confidence interval [CI]: 1.02-1.04), long-term ACM/HFR (HR: 1.42, CI: 1.27-1.59), and long-term CVM/HFH (HR: 2.25, CI: 1.82-2.79), regardless of short-term ACM/HFR (HR: 2.31, CI: 0.71-7.49). CONCLUSION Higher sST2 concentration at baseline is associated with increasing risk of long-term ACM, ACM/HFR, and CVM/HFH and can be a tool for the prognosis of chronic heart failure.
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Affiliation(s)
- Guoqi Dong
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Hao Chen
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Hongru Zhang
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
| | - Yihuang Gu
- School of Acupuncture and Tuina, Nanjing University of CM, Nanjing, China
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113
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Nakata T, Okada M, Hanari T, Takagi T, Fujiwara T, Hato N. Association of the prognosis and severity of idiopathic sudden sensorineural hearing loss with cervical ultrasonographic findings. Auris Nasus Larynx 2021; 48:1074-1080. [PMID: 33745790 DOI: 10.1016/j.anl.2021.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association of the prognosis and severity of idiopathic sudden sensorineural hearing loss (ISSNHL) with cervical ultrasonographic findings suggestive of cardiovascular risk. METHODS Seventy-four inpatients with ISSNHL were included in our study. Cervical ultrasonography was performed to evaluate the common carotid artery (CCA), internal carotid artery (ICA), and vertebral artery (VA). The peak systolic velocity, end diastolic velocity, intima-media thickness, pulsatility index (PI), and resistance index (RI) were evaluated. We investigated the relationship of these variables with the severity and prognosis of ISSNHL. RESULTS ICA-PI, ICA-RI, and CCA-RI were significantly higher in patients with poor hearing prognosis than in those with good prognosis. The variables of VA were not related to the prognosis of ISSNHL. There were no statistically significant differences between ISSNHL severity and cervical ultrasonographic findings. CONCLUSIONS We found that PI and RI might be prognostic factors for ISSNHL.
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Affiliation(s)
- Takahiro Nakata
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Masahiro Okada
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan.
| | - Takahiro Hanari
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Taro Takagi
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
| | - Takashi Fujiwara
- Department of Public Health Research, Kurashiki Clinical Research Institute, Kurashiki, Japan
| | - Naohito Hato
- Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon Ehime 791-0295, Japan
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114
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Magnesium intake, insulin resistance and markers of endothelial function among women. Public Health Nutr 2021; 24:5777-5785. [PMID: 33719988 DOI: 10.1017/s1368980021001063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. DESIGN A cross-sectional study. SETTING Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). PARTICIPANTS Iranian female nurses (n 345) selected by a multistage cluster random sampling method. RESULTS The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. CONCLUSIONS Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.
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Song X, Yang K, Chen G, Duan W, Yao D, Li S, Yuan G, Liu L. Characteristics and Risk Factors of Pulmonary Hypertension in Patients With Hyperthyroidism. Endocr Pract 2021; 27:918-924. [PMID: 33636393 DOI: 10.1016/j.eprac.2021.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/09/2021] [Accepted: 02/14/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to comprehensively assess the characteristics and risk factors of hyperthyroidism with pulmonary hypertension (PH). METHODS This was a retrospective cross-sectional analysis of 315 consecutive patients with hyperthyroidism admitted to the endocrinology department of Tongji Hospital from February 2016 to December 2017. PH was defined as a pulmonary arterial systolic pressure above 35 mm Hg measured by echocardiography. RESULTS Among the 315 patients, 208 were females, the median age was 42 (30-51) years, and the median disease duration was 12 (3-48) months. Thirty-five percent (111/315) of patients were identified with PH. Patients with hyperthyroidism and PH showed significantly higher serum concentrations of free thyroxine (FT4), free triiodothyronine, thyroid receptor antibodies, total bilirubin (TB), direct and indirect bilirubin, lower serum levels of hemoglobin and creatinine, and more severe cardiac load (P < .05 for each) compared with patients without PH. Levels of serum FT4, free triiodothyronine, thyroid receptor antibodies, and thyroid peroxidase antibody were different among groups of patients with different levels of pulmonary arterial systolic pressure (P < .05 for each). Multivariate logistic regression analysis indicated that serum FT4 (odds ratio, 1.02; 95% CI, 1.01-1.04; P = .004) and TB (OR, 1.03; 95% CI, 1.00-1.06; P = .030) were independent risk factors for PH in patients with hyperthyroidism. CONCLUSION Elevated serum FT4 and TB levels may be independent risk factors for PH in patients with hyperthyroidism and valuable indicators for the identification and treatment of patients with PH and hyperthyroidism.
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Affiliation(s)
- Xiaoqing Song
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Kun Yang
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangzhi Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wu Duan
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Di Yao
- Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengzhong Li
- Department of Surgery, Wuhan Jinyintan Hospital, Wuhan, China
| | - Gang Yuan
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China
| | - Li Liu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Branch of National Clinical Research Center for Metabolic Diseases, Hubei, China.
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Review of Trials on Exercise-Based Rehabilitation Interventions Following Acute Decompensated Heart Failure: OBSERVATIONS FROM THE WHO INTERNATIONAL CLINICAL TRIALS REGISTRY PLATFORM. J Cardiopulm Rehabil Prev 2021; 41:214-223. [PMID: 34158455 DOI: 10.1097/hcr.0000000000000583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Cardiac rehabilitation is an important intervention for patients with heart failure. However, its clinical application in acute decompensated heart failure (ADHF) remains underutilized with limited research available. An assessment of current research in this area will help guide future investigations. The aim of this review is to summarize the current research focusing on rehabilitation interventions following recovery from ADHF. REVIEW METHODS A systematic search was carried out on all trials registered in the clinical trial registry database of the World Health Organization-International Clinical Trial Registry Platform (WHO-ICTRP). Studies focusing on ADHF and utilizing any exercise and rehabilitation-based intervention were included. RESULTS A majority of 11 trial protocols, including 3827 participants with low ejection fraction (<40%), were identified from the WHO-ICTRP database. Majority of the protocols (64%) focused on exercise-based interventions with approximately one-quarter (29%) focusing on neuromuscular electrical stimulation and one on noninvasive ventilation during exercise. Irrespective of the mode of exercise, all protocols employed low-moderate intensity training with outcomes focusing on physical function and quality of life. CONCLUSION Studies on rehabilitative interventions for ADHF are still in their early stages. More research is needed using innovative methodologies and testing for feasibility and fidelity.
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Mechanisms of Bone Impairment in Sickle Bone Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041832. [PMID: 33668588 PMCID: PMC7918363 DOI: 10.3390/ijerph18041832] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
Sickle bone disease (SBD) is a chronic and invalidating complication of Sickle cell disease (SCD), a multisystem autosomal recessive genetic disorder affecting millions of people worldwide. Mechanisms involved in SBD are not completely known, especially in pediatric age. Among the hypothesized pathogenetic mechanisms underlying SBD are bone marrow compensatory hyperplasia and bone ischemic damage, both secondary to vaso-occlusive crisis (VOC), which leads to cell sickling, thus worsening local hypoxia with a negative impact on osteoblast recruitment. Furthermore, the hypoxia is a strong activator of erythropoietin, which in turn stimulates osteoclast precursors and induces bone loss. Hemolysis and iron overload due to a chronic transfusion regimen could also contribute to the onset of bone complications. Vitamin D deficiency, which is frequently seen in SCD subjects, may worsen SBD by increasing the resorptive state that is responsible for low bone mineral density, acute/chronic bone pain, and high fracture risk. An imbalance between osteoblasts and osteoclasts, with a relative decrease of osteoblast recruitment and activity, is a further possible mechanism responsible for the impairment of bone health in SCD. Moreover, delayed pubertal growth spurt and low peak bone mass may explain the high incidence of fracture in SCD adolescents. The aim of this review was to focus on the pathogenesis of SBD, updating the studies on biochemical, instrumental, and biological markers of bone metabolism. We also evaluated the growth development and endocrine complications in subjects affected with SCD.
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Hajiabolhassan F, Tavanai E. Diabetes-induced auditory complications: are they preventable? a comprehensive review of interventions. Eur Arch Otorhinolaryngol 2021; 278:3653-3665. [PMID: 33555440 DOI: 10.1007/s00405-021-06630-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels, which, over time, lead to major chronic complications in various organs of the body. A growing body of research suggests that diabetes could also result in degenerative changes in the auditory system. To date, several attempts have been made to prevent and reduce diabetes-induced auditory complications. Such attempts have generally focused on disease modifying as well as other pharmacological treatments involving several herbal and non-herbal agents such as vitamins C and E, rutin, resveratrol, coffee, trigonelline, Dioscorea nipponica, red ginseng, Pterostilbene Bofutsushosan, Daisaikoto, tolrestat, ACE inhibitors (enalapril), Ca antagonists (nimodipine), Lipo-prostaglandin E1, methylprednisolone, dexamethasone, and chlorogenic acid and also other strategies like acupuncture. However, there is no consensus about which are the most effective strategies for preventing and reducing auditory complications in diabetic patients with few side effects and maximum efficacy. This paper provides a comprehensive review of interventions for preventing and treating diabetes-induced auditory complications to help therapists.
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Affiliation(s)
- Fahimeh Hajiabolhassan
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Avenue, 0098, Tehran, Iran.,Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Elham Tavanai
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Avenue, 0098, Tehran, Iran.
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Chen HH, Lin CH, Hsieh TY, Chen DY, Ying JC, Chao WC. Factors Associated with Incident Severe Pulmonary Arterial Hypertension in Systemic Autoimmune Rheumatic Diseases: a Nationwide Study. Rheumatology (Oxford) 2021; 60:5351-5361. [PMID: 33547781 DOI: 10.1093/rheumatology/keab118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/22/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To assess the association of severe pulmonary arterial hypertension (PAH) with particulate matter <2.5 μm (PM2.5) and clinical data in patients with systemic autoimmune rheumatic diseases (SARDs). METHODS We used the 2003-2017 nationwide data in Taiwan to identify patients with SARDs, including systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, dermatomyositis/polymyositis and primary Sjögren's syndrome. We identified 479 cases with severe PAH and selected controls matched (1:4) for age, sex, and index-year. We used conditional logistic regression analysis to determine factors associated with risks for severe PAH shown as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS We found that severe PAH was highly associated with interstitial lung disease (OR, 8.57; 95% CI, 5.52-13.32), congestive heart failure (OR, 7.62; 95% CI, 5.02-11.55), valvular heart disease (OR, 3.34; 95% CI, 2.03-5.50) and slightly associated with thyroid diseases (OR, 1.88; 95% CI, 1.18-3.00), but not the level of exposure to PM2.5. Increased risk for PAH was found in patients receiving corticosteroid (prednisolone equivalent dosage, mg/day, OR, 1.03; 95% CI, 1.01-1.05), biologics (OR, 2.18; 95% CI, 1.15-4.12) as well as immunosuppressants, including cyclosporin (OR, 2.17; 95% CI, 1.31-3.59), azathioprine (OR, 1.96; 95% CI, 1.48-2.61), cyclophosphamide (OR, 2.01; 95% CI, 1.30-3.11) and mycophenolate mofetil/mycophenolic acid (OR, 2.42; 95% CI, 1.37-4.27), and those with the highest level of insured amount (reference, lowest level; OR, 0.53; 95% CI, 0.34-0.83). CONCLUSION The population-based study identified risks for severe PAH in patients with SARDs, and these findings provide evidence for PAH risk stratification in patients with SARDs.
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Affiliation(s)
- Hsin-Hua Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Biomedical Science and Rong Hsing Research Centre for Translational Medicine, Chung Hsing University, Taichung, Taiwan.,Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung, Taiwan.,Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.,Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tsu-Yi Hsieh
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.,Ph.D. Programme of Business, Feng Chia University, Taichung, Taiwan
| | - Der-Yuan Chen
- School of Medicine, China Medical University, Taichung, Taiwan.,Rheumatology and Immunology Centre, China Medical University Hospital, Taichung, Taiwan.,Translational Medicine Laboratory, Rheumatic Diseases Research Centre, China Medical University Hospital, Taichung, Taiwan
| | - Jia-Ching Ying
- Department of Management Information Systems, National Chung Hsing University, Taichung, Taiwan
| | - Wen-Cheng Chao
- Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Computer Science, Tunghai University, Taichung, Taiwan
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Cardiac Rehabilitation in Heart Failure. ACTA ACUST UNITED AC 2021; 3:1-14. [PMID: 36263110 PMCID: PMC9536716 DOI: 10.36628/ijhf.2020.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/06/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022]
Abstract
Heart failure (HF) is a complex clinical syndrome caused by a structural and/or functional cardiac abnormality, resulting in reduced organ perfusion. The goals of treatment in patients with HF are to improve functional capacity and quality of life, and to reduce mortality. Cardiac rehabilitation (CR) including exercise training is one of the treatment options, and current guidelines recommend CR as safe and effective for patients with HF. CR has been known to improve exercise capacity and quality of life, minimize HF progression, and lower mortality in patients with HF. Improvement of vascular endothelial function, activation of the neurohormonal system, increase of mitochondrial oxygen utilization in peripheral muscles, and increase of chronotropic responses are possible mechanisms of the beneficial effects of exercise-based CR in HF. Although CR has been shown to decrease morbidity and mortality, it is underutilized in clinical practice. Despite the existence of concrete evidence of clinical benefits, the CR participation rates of patients with HF range from only 14% to 43% worldwide, with high dropout rates after enrollment. These low participation rates have been attributed to several barriers, including patient factors, professional factors, and service factors. The motivation for participating in CR and for overcoming the patients' barriers for CR before discharge should be provided to each patient. Current guidelines strongly recommend applying a CR program to all eligible patients with HF.
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Araruna LVM, de Oliveira DC, Pereira MC, Moura Neto A, Tambascia MA, Zantut-Wittmann DE. Interplay Between Thyroid Hormone Status and Pulmonary Hypertension in Graves' Disease: Relevance of the Assessment in Thyrotoxic and Euthyroid Patients. Front Endocrinol (Lausanne) 2021; 12:780397. [PMID: 35069439 PMCID: PMC8772033 DOI: 10.3389/fendo.2021.780397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/26/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Graves' disease (GD) is the most common cause of hyperthyroidism and can cause cardiac changes, such as pulmonary hypertension. METHODS This is a prospective study in which we obtained demographic, clinical, laboratory data and characteristics of the GD, in addition to investigating cardiorespiratory function, focusing on the detection of pulmonary hypertension. Patients were separated into two groups: thyrotoxicosis and euthyroidism. Ninety patients with GD of both sexes, over 18 years of age, were included. The cardiorespiratory assessment included an echocardiographic evaluation, a questionnaire of specific symptoms, spirometry and a six-minute walk test. RESULTS The hyperthyroid group included 42 patients (47.73%) and the euthyroid group 46 patients (52.27%); 78 were women (86.67%). The prevalence of pulmonary hypertension between the hyperthyroidism (48.57%) and the euthyroidism (29.41%) groups was not different. Free thyroxine levels (FT4) (OR 1.266), higher left atrium volume (OR 1.113) and right ventricle diameter were associated with pulmonary hypertension. A direct correlation between FT4 with forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), as also an inverse correlation between initial oxygen saturation (SpO2) with diagnostic time and drop SpO2 with the ratio between the diastolic velocity E of the mitral flow and the diastolic velocity of the mitral ring (E/e') were observed in the euthyroid group. An inverse correlation between FT4 levels with walked distance as % of predicted value, and a direct correlation between E/e' ratio and walked distance as % of predicted value were observed in the hyperthyroid group. CONCLUSION We emphasize the importance of a cardiorespiratory reassessment in GD, even after a long-term control of the thyrotoxic state, as we demonstrate that about 30% of these patients remain with PH and are subject to specific treatment.
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Affiliation(s)
- Larisse Vieira Mendes Araruna
- Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Daniela Camargo de Oliveira
- Cardiology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Mônica Corso Pereira
- Pneumology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Arnaldo Moura Neto
- Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Marcos Antonio Tambascia
- Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Denise Engelbrecht Zantut-Wittmann
- Endocrinology Division, Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, Brazil
- *Correspondence: Denise Engelbrecht Zantut-Wittmann, ; orcid.org/0000-0002-7434-5701
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Di Mauro A, Baldassarre ME, Laforgia N. Eat Healthy to Live Healthy: Habits and Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249422. [PMID: 33339128 PMCID: PMC7765576 DOI: 10.3390/ijerph17249422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
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Baldassarre ME, Di Mauro A, Caroli M, Schettini F, Rizzo V, Panza R, De Giorgi A, Capozza M, Fanelli M, Laforgia N. Premature Birth is an Independent Risk Factor for Early Adiposity Rebound: Longitudinal Analysis of BMI Data from Birth to 7 Years. Nutrients 2020; 12:nu12123654. [PMID: 33261215 PMCID: PMC7760942 DOI: 10.3390/nu12123654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/17/2020] [Accepted: 11/24/2020] [Indexed: 12/13/2022] Open
Abstract
Adiposity rebound (AR) refers to the second rise of the body mass index (BMI) curve that usually occurs physiologically between five and seven years of age. AR timing has a great impact on patients’ health, since early adiposity rebound (EAR) is associated with the development of metabolic syndrome later in life. We aimed to investigate the prevalence of EAR in a cohort of inborn preterm infants admitted to the Neonatal Intensive Care Section of the Policlinico University Hospital of Bari, Italy. Secondarily, we assessed whether some determinants such as (1) gender; (2) delivery mode; (3) birth weight and classification into small, normal, or large for gestational age; (4) type of feeding; (5) breastfeeding duration; (6) timing of introduction of solid food; (7) parental education; and (8) parental pre-pregnancy body mass index (BMI) influenced EAR in this cohort. The tertiary aim was to evaluate the prevalence of obesity or being overweight at seven years of age in children according to early versus timely AR. This is a prospective, population-based longitudinal study conducted at the Neonatal Intensive Care Section of the Policlinico University Hospital of Bari, Italy. Inborn preterm infants admitted to the neonatal ward between 2009 and 2011 were eligible. Enrolled preterm infants were evaluated at birth and at 1, 3, 6, 9, 12, 15, 18, and 24 months and 3, 4, 5, 6, and 7 years of age. Weight and height data were analyzed, and BMI was calculated. AR was assessed in the growth trajectory in a body mass index (BMI) plot. Of the 250 preterm newborns included, 100 completed the seven-year follow-up and entered the final analysis, 138 were lost during the seven-year follow-up, and in 12 cases parents withdrew over the course of the study. The prevalence of EAR in our cohort of preterm newborns was 54% at seven years of age. Early adiposity rebound was associated with being large for gestational age (LGA) at birth. No other factors were associated with EAR. Early adiposity rebounders had a significantly higher BMI at seven years compared to children with timely AR (17.2 ± 2.7 vs. 15.6 ± 2.05, p = 0.021). No significant differences were found in the prevalence of obesity or being overweight at seven years of age in children with early or timely AR (29% vs. 14%, p = 0.202). Ex-preterm infants have an increased risk of EAR. Since EAR may lead to long-term detrimental health effects with the onset of various chronic diseases (e.g., obesity, metabolic syndrome, etc.), healthcare providers should be prepared to counteract its occurrence, especially in delicate sub-populations of infants.
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Affiliation(s)
- Maria Elisabetta Baldassarre
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
- Correspondence:
| | - Antonio Di Mauro
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | | | - Federico Schettini
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | - Valentina Rizzo
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | - Raffaella Panza
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | - Alessia De Giorgi
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | - Manuela Capozza
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
| | - Margherita Fanelli
- Department of Interdisciplinary Medicine, “Aldo Moro” University of Bari, 70100 Bari, Italy;
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Neonatology and Neonatal Intensive Care Unit, “Aldo Moro” University of Bari, 70100 Bari, Italy; (A.D.M.); (F.S.); (V.R.); (R.P.); (A.D.G.); (M.C.); (N.L.)
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Lammers MJW, Young E, Westerberg BD, Lea J. Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta-Analysis. Laryngoscope 2020; 131:1369-1377. [PMID: 33156954 DOI: 10.1002/lary.29237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/17/2020] [Accepted: 10/21/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown, but labyrinthine artery infarction has been proposed. The objective of this study was to perform a systematic review and conduct a meta-analysis assessing the risk of developing stroke and myocardial infarction after presentation with ISSNHL. METHODS A systematic literature review was conducted using Pubmed, Embase, Web of Science, and Cochrane Libraries. All studies investigating an association between ISSNHL and stroke and/or myocardial infarction (MI) were included. Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias, and evaluated the relevance and quality of evidence. RESULTS Three observational studies evaluating the risk of stroke in ISSNHL were included (n = 6,521 patients). All individual study results indicated an increased relative risk of stroke after ISSNHL (unadjusted relative risk range 1.21-1.63). Pooled adjusted hazard ratios revealed a 1.42-fold increased risk of stroke after ISSNHL (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.15-1.75, I2 = 55%). Subgroup analysis of one study demonstrated that the increased risk is only present in adults aged above 50 years (HR 1.23; 95% CI 1.07-1.42). Five observational studies evaluating the risk of MI in patients with ISSNHL were included (n = 61,499 patients). Pooled analyses demonstrated that ISSNHL was not associated with MI (HR 1.08, 95% CI 0.87-1.34). CONCLUSION ISSNHL may be an independent risk factor for the subsequent development of stroke especially in a subgroup of elderly patients. More studies are needed to confirm this association and to assess whether such patients would benefit from cardiovascular risk assessment and management to prevent future strokes. Laryngoscope, 131:1369-1377, 2021.
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Affiliation(s)
- Marc J W Lammers
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Emily Young
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian D Westerberg
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jane Lea
- BC Rotary Hearing and Balance Centre at St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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125
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Li C, Zhou H, Feng Y, Zhao Y, Wang J, Chen Z, Yin S. Coagulation States in Patients With Sudden Sensorineural Hearing Loss Evaluated by Thromboelastography. Otolaryngol Head Neck Surg 2020; 164:1280-1286. [PMID: 33138704 DOI: 10.1177/0194599820965240] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The state of coagulation is controversial in patients with sudden sensorineural hearing loss (SSNHL). We used thromboelastography (TEG) to explore the relationships between blood coagulation parameters and SSNHL pathogenesis and recovery. STUDY DESIGN Prospective study. SETTING Affiliated Sixth People's Hospital, Shanghai Jiao Tong University. METHODS A total of 104 newly diagnosed patients with SSNHL and 29 matched healthy controls were recruited. Hearing assessments, TEG, and conventional coagulation tests (CCTs) were performed, followed by standard treatments and follow-up. RESULTS The TEG parameters of patients with SSNHL were in the normal range, but the group exhibited a significantly prolonged kinetic time (K; P = .004) and a smaller angle (P = .003) as compared with the controls. After grouping the patients with SSNHL according to audiograms and comparing them in pairs, we found that the differences were significant only when controls were compared with patients with low-frequency SSNHL (K, P = .023; angle, P = .04) and flat-type SSNHL (K, P = .017; angle, P = .014). Logistic regression analysis showed that neither TEG nor CCT parameters significantly affected hearing improvement after SSNHL treatment. CONCLUSIONS Although the K value and angle were significantly increased and significantly reduced, respectively, in the test group as compared with the control group, the state of coagulation in patients with SSNHL was still within the normal range. No CCT or TEG coagulation parameters (except the angle) differed significantly among patients in each group according to hearing recovery status, which suggested that the coagulation status does not determine the prognosis of patients with SSNHL.
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Affiliation(s)
- Chunyan Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Huiqun Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yanmei Feng
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Yan Zhao
- Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China.,Shanghai Jinshan District Central Hospital, Shanghai, China.,Shanghai Jinshan Hospital of Traditional Chinese Medicine, Shanghai, China
| | - Jingjing Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Zhengnong Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Xuhui District, Shanghai, China.,Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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126
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Acanfora D, Casucci G, Ciccone MM, Scicchitano P, Lonobile T, Chiariello L, Maestri R, Pedone C, Provitera V, Nolano M, Incalzi RA. Biomechanical and neuroautonomic adaptation to acute blood volume displacement in ischemic dilated cardiomyopathy: the predictive value of the CD25 test. J Appl Physiol (1985) 2020; 129:1173-1182. [PMID: 32940562 DOI: 10.1152/japplphysiol.00514.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The adaptation to volume displacement induced by tilt test was assessed in patients with heart failure and previous inferoapical/inferolateral or basal/apical septal myocardial infarction. The responsiveness of cardiac muscle to sympathetic nervous system stimulation predicts the mortality in patients with ischemic heart failure and may represent a useful tool for clinicians in the general assessment of this kind of patients.
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Affiliation(s)
- Domenico Acanfora
- San Francesco Hospital, Telese Terme, Benevento, Italy
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
| | | | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy
| | - Pietro Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy
| | | | | | - Roberto Maestri
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Montescano, Pavia, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Policlinico Universitario, Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Provitera
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
| | - Maria Nolano
- Maugeri Scientific Clinical Institutes, SpA SB, Institute of Care and Scientific Research, Rehabilitation Institute of Telese Terme, Telese Terme, , Italy
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127
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Effect of omega-3 fatty acids supplementation on anthropometric indices in children and adolescents: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020; 53:102487. [PMID: 33066870 DOI: 10.1016/j.ctim.2020.102487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/02/2020] [Accepted: 06/15/2020] [Indexed: 12/17/2022] Open
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128
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Rinaldi M, Cavallaro G, Cariello M, Scialpi N, Quaranta N. Metabolic syndrome and idiopathic sudden sensori-neural hearing loss. PLoS One 2020; 15:e0238351. [PMID: 32857825 PMCID: PMC7454951 DOI: 10.1371/journal.pone.0238351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/14/2020] [Indexed: 01/27/2023] Open
Abstract
The purpose of this study was to evaluate the association between the presence of Metabolic Syndrome (MetS) and idiopathic sudden sensorineural hearing loss (ISSHL) and the impact of MetS on recovery of patients with ISSHL. 39 Patients with ISSHL and 44 controls were enrolled in this study. Demographic, clinical characteristics and hearing recovery were evaluated. MetS was defined according to the diagnostic criteria of International Diabetes Federation (IDF) consensus definition. Patients affected by ISSHL presented a body mass index (BMI), waist circumference, waist hip ratio (WHR), fasting glucose and blood pressure significantly higher compared to controls. Considering patients with central obesity, 5 controls and 15 ISSHL patients met the criteria of MetS. According to Siegel criteria, a complete or partial recovery was observed in 60% of patients with MetS and in 91,66% of patients without MetS. MetS was associated with ISSHL and this association negatively influenced the hearing recovery of these patients.
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Affiliation(s)
- Massimo Rinaldi
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Giada Cavallaro
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Bari, Italy
| | - Marica Cariello
- Clinica Medica Cesare Frugoni, Department of Interdisciplinary Medicine, University of Bari Aldo Moro “Aldo Moro”, Bari, Italy
| | - Natasha Scialpi
- Clinica Medica Cesare Frugoni, Department of Interdisciplinary Medicine, University of Bari Aldo Moro “Aldo Moro”, Bari, Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Bari, Italy
- * E-mail:
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129
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Disoteo OE, Zampetti B, Garascia A, Attanasio R, Cozzi R. Autoimmune Polyendocrine Syndrome Complicated by Pulmonary Hypertension. Endocr Metab Immune Disord Drug Targets 2020; 21:561-565. [PMID: 32744953 DOI: 10.2174/1871530320666200801033106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/10/2020] [Accepted: 03/17/2020] [Indexed: 11/22/2022]
Abstract
A 24-years old female was admitted for acute renal failure, melanoderma, hyponatremia, and hyperkalemia. The clinical suspicion of Addison's disease was confirmed by laboratory test and the appropriate replacement therapy with corticosteroids and fludrocortisone was started. In the meantime primary hypothyroidism and diabetes mellitus type 1 were disclosed and treated, thus fulfilling a diagnosis of autoimmune polyendocrine syndrome type 2. Eighteen months later she was admitted for right-sided heart failure. The work-up allowed to diagnose pulmonary arterial hypertension. Here, we report the clinical course and discuss the putative link between these two rare diseases.
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Affiliation(s)
- Olga E Disoteo
- ASST Grande Ospedale Metropolitano Niguarda, Diabetology Unit, Milan, Italy
| | - Benedetta Zampetti
- ASST Grande Ospedale Metropolitano Niguarda, Endocrinology Department, Milan, Italy
| | - Andrea Garascia
- ASST Grande Ospedale Metropolitano Niguarda, Cardiology Unit, Milan, Italy
| | - Roberto Attanasio
- IRCCS Orthopedic Institute Galeazzi, Endocrinology Service, Milan, Italy
| | - Renato Cozzi
- ASST Grande Ospedale Metropolitano Niguarda, Endocrinology Department, Milan, Italy
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130
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Cortese F, Quaranta N, Scicchitano P, Faienza MF, Pontillo V, Ciccone MM. The role of N-terminal pro-B type natriuretic peptide in subjects with idiopathic sudden sensorineural hearing loss: a paradigm of its vascular function. J Cardiovasc Med (Hagerstown) 2020; 21:620-621. [PMID: 32073431 DOI: 10.2459/jcm.0000000000000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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131
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Ambari AM, Setianto B, Santoso A, Radi B, Dwiputra B, Susilowati E, Tulrahmi F, Doevendans PA, Cramer MJ. Angiotensin Converting Enzyme Inhibitors (ACEIs) Decrease the Progression of Cardiac Fibrosis in Rheumatic Heart Disease Through the Inhibition of IL-33/sST2. Front Cardiovasc Med 2020; 7:115. [PMID: 32850979 PMCID: PMC7399157 DOI: 10.3389/fcvm.2020.00115] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022] Open
Abstract
Rheumatic heart disease (RHD) is common in developing countries and poses a big medical challenge and burden. The pathogenesis of RHD is influenced by the triad of host, agent, and environment. Autoantigens generated from Group A Streptococcus (GAS) infection are captured by the resident dendritic cells (DCs) in the heart's valvular endothelium. DCs differentiate into antigen presenting cells (APC) in the valve interstices. APC induces activation of autoreactive T cells, which triggers inflammation and tissue fibrosis. Cardiac fibrosis is promoted through the activation of Mitogen activated protein kinases (MAPKs) and its downstream signaling, including its interaction with transforming growth factor-β (TGF-β) and Smad proteins. TGF-β-induced phosphorylation of Smad2 complexes with Smad3 and Smad4, and translocates into the nucleus. Angiotensin II enhances the migration, maturation, and presentation of DC. In RHD, Angiotensin II induces fibrosis via the stimulation of TGF-β, which further increases the binding of IL-33 to sST2 but not ST2L, resulting in the upregulation of Angiotensin II and progression of cardiac fibrosis. This cascade of inflammation and valvular fibrosis causes calcification and stiffening of the heart valves in RHD. Angiotensin converting enzyme inhibitors (ACEIs) inhibit Angiotensin II production, which in turn decreases TGF-β expression and the onset of overt inflammatory response. This condition leads to a reduction in the sST2 as the decoy receptor to "steal" IL-33, and IL-33 binds to ST2L and results in cardioprotection against cardiac fibrosis in the pathogenesis of RHD.
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Affiliation(s)
- Ade M. Ambari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, National Cardiovascular Center Harapan Kita, University of Indonesia, Jakarta, Indonesia
| | - Budhi Setianto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, National Cardiovascular Center Harapan Kita, University of Indonesia, Jakarta, Indonesia
| | - Anwar Santoso
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, National Cardiovascular Center Harapan Kita, University of Indonesia, Jakarta, Indonesia
| | - Basuni Radi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, National Cardiovascular Center Harapan Kita, University of Indonesia, Jakarta, Indonesia
| | - Bambang Dwiputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, National Cardiovascular Center Harapan Kita, University of Indonesia, Jakarta, Indonesia
| | - Eliana Susilowati
- Research Assistants of Preventive Cardiology, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Fadilla Tulrahmi
- Research Assistants of Preventive Cardiology, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Pieter A. Doevendans
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
- Cardiovascular Departement, The Netherlands Heart Institute Utrecht, Utrecht, Netherlands
| | - Maarten J. Cramer
- Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
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132
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Lassandro G, Palmieri VV, Palladino V, Amoruso A, Faienza MF, Giordano P. Venous Thromboembolism in Children: From Diagnosis to Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144993. [PMID: 32664502 PMCID: PMC7400059 DOI: 10.3390/ijerph17144993] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 02/07/2023]
Abstract
Venous thromboembolism (VTE) in children is a rare occurrence, although in recent decades we have seen an increase due to several factors, such as the rise in survival of subjects with chronic conditions, the use of catheters, and the increased sensitivity of diagnostic tools. Besides inherited thrombophilia, acquired conditions such as cardiovascular diseases, infections, chronic disorders, obesity and malignancy are also common risk factors for paediatric VTE. The treatment of paediatric VTE consists of the use of heparins and/or vitamin K antagonists to prevent dissemination, embolization, and secondary VTE. Randomized clinical trials of direct oral anticoagulants in paediatric VTE are ongoing, with the aim to improve the compliance and the care of patients. We reviewed the physiological and pathological mechanisms underlying paediatric thrombosis and updated the current diagnosis and treatment options.
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Brunetti G, Faienza MF, Piacente L, Storlino G, Oranger A, D’Amato G, De Filippo G, Colucci S, Grano M. Shedding "LIGHT" on the Link between Bone and Fat in Obese Children and Adolescents. Int J Mol Sci 2020; 21:E4739. [PMID: 32635185 PMCID: PMC7370129 DOI: 10.3390/ijms21134739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/15/2022] Open
Abstract
Obesity may affect bone health, but literature reports are contradictory about the correlation of body mass index (BMI) and bone markers. LIGHT, one of the immunostimulatory cytokines regulating the homeostasis of bone and adipose tissue, could be involved in obesity. The study involved 111 obese subjects (12.21 ± 3.71 years) and 45 controls. Patients underwent the evaluation of bone status by quantitative ultrasonography (QUS). LIGHT amounts were evaluated in sera by ELISA, whereas its expression on peripheral blood cells was evaluated by flow cytometry. Osteoclastogenesis was performed by culturing peripheral blood mononuclear cells (PBMCs) with or without anti-LIGHT antibodies. Obese patients showed significant high BMI-standard deviation score (SDS), weight-SDS, and Homeostatic model assessment for insulin resistance (HOMA-IR) that negatively correlated with the reduced Amplitude Dependent Speed of Sound (AD-SoS)-Z-score and Bone Transmission Time (BTT-Z)-score. They displayed significantly higher serum levels of LIGHT compared with controls (497.30 ± 363.45 pg/mL vs. 186.06 ± 101.41 pg/mL, p < 0.001). LIGHT expression on monocytes, CD3+-T-cells, and neutrophils was also higher in obese patients than in the controls. Finally, in PBMC cultures, the addition of anti-LIGHT antibodies induced a significant osteoclastogenesis inhibition. Our study highlighted the high serum levels of LIGHT in obese children and adolescents, and its relationship with both the grade of obesity and bone impairment.
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Affiliation(s)
- Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Felicia Faienza
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Laura Piacente
- Department of Biomedical Science and Human Oncology, Paediatric Unit, University of Bari, 70100 Bari, Italy; (M.F.F.); (L.P.)
| | - Giuseppina Storlino
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Angela Oranger
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
| | - Gabriele D’Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, 70131 Bari, Italy;
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d’Endocrinologie Diabétologie Pédiatrique, 75019 Paris, France;
| | - Silvia Colucci
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy;
| | - Maria Grano
- Department of Emergency and Organ Transplantation, Section of Human Anatomy and Histology, University of Bari, 70124 Bari, Italy; (G.S.); (A.O.); (M.G.)
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Baldassarre ME, Di Mauro A, Salvatore S, Tafuri S, Bianchi FP, Dattoli E, Morando L, Pensabene L, Meneghin F, Dilillo D, Mancini V, Talarico V, Tandoi F, Zuccotti G, Agosti M, Laforgia N. Birth Weight and the Development of Functional Gastrointestinal Disorders in Infants. Pediatr Gastroenterol Hepatol Nutr 2020; 23:366-376. [PMID: 32704497 PMCID: PMC7354866 DOI: 10.5223/pghn.2020.23.4.366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the association between birth weight and the development of functional gastrointestinal disorders (FGIDs) in the first year of life. METHODS This is a secondary analysis of a prospective cohort multicenter study including neonates, consecutively enrolled at birth, and followed up for one year. At birth all infants were classified by birth weight as extremely low (ELBW), very low, or low when <1,000, <1,500, and <2,500 g, respectively, and by birth weight for gestational age as appropriate (AGA, weight in the 10-90th percentile), small (SGA, weight <10th percentile), and large (LGA, weight >90th percentile) for gestational age. FGIDs were classified according to the Rome III criteria and assessed at 1, 3, 6, and 12 months of life. RESULTS Among 1,152 newborns enrolled, 934 (81.1%) completed the study: 302 (32.3%) were preterm, 35 (3.7%) were ELBW, 104 (11.1%) were SGA, 782 (83.7%) were AGA, and 48 (5.1%) were LGA infants. Overall, throughout the first year of life, 718 (76.9%) reported at least one FGID. The proportion of infants presenting with at least one FGID was significantly higher in ELBW (97%) compared to LBW (74%) (p=0.01) and in LGA (85.4%) and SGA (85.6%) compared to AGA (75.2%) (p=0.0001). On multivariate analysis, SGA was significantly associated with infantile colic. CONCLUSION We observed an increased risk of FGIDs in ELBW, SGA, and LGA neonates. Our results suggest that prenatal factors determining birth weight may influence the development of FGIDs in infants. Understanding the role of all potential risk factors may provide new insights and targeted approaches for FGIDs.
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Affiliation(s)
| | - Antonio Di Mauro
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvia Salvatore
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Enzo Dattoli
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Lucia Morando
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Licia Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Fabio Meneghin
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Dario Dilillo
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | | | - Valentina Talarico
- Department of Medical and Surgical Sciences, Pediatric Unit, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Francesco Tandoi
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Massimo Agosti
- Unit of Pediatrics and Neonatology, "F. Del Ponte" Hospital, Dipartimento di Medicina e Chirurgia University of Insubria, Varese, Italy
| | - Nicola Laforgia
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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135
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Roy C, Lejeune S, Slimani A, de Meester C, Ahn As SA, Rousseau MF, Mihaela A, Ginion A, Ferracin B, Pasquet A, Vancraeynest D, Beauloye C, Vanoverschelde JL, Horman S, Gruson D, Gerber BL, Pouleur AC. Fibroblast growth factor 23: a biomarker of fibrosis and prognosis in heart failure with preserved ejection fraction. ESC Heart Fail 2020; 7:2494-2507. [PMID: 32578967 PMCID: PMC7524237 DOI: 10.1002/ehf2.12816] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/05/2020] [Accepted: 05/20/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS Besides regulating calcium-phosphate metabolism, fibroblast growth factor 23 (FGF-23) has been associated with incident heart failure (HF) and left ventricular hypertrophy. However, data about FGF-23 in HF and preserved ejection fraction (HFpEF) remain limited. The aim of this study was to assess the association between FGF-23 levels, clinical and imaging characteristics, particularly diffuse myocardial fibrosis, and prognosis in HFpEF patients. METHODS AND RESULTS We prospectively included 143 consecutive HFpEF patients (78 ± 8 years, 61% female patients) and 31 controls of similar age and gender (75 ± 6 years, 61% female patients). All subjects underwent a complete two-dimensional echocardiography and cardiac magnetic resonance with extracellular volume (ECV) assessment by T1 mapping. FGF-23 was measured at baseline. Among the patients, differences in clinical and imaging characteristics across tertiles of FGF-23 levels were analysed with a trend test across the ordered groups. Patients were followed over time for a primary endpoint of all-cause mortality and first HF hospitalization and a secondary endpoint of all-cause mortality. Median FGF-23 was significantly higher in HFpEF patients compared with controls of similar age and gender (247 [115; 548] RU/mL vs. 61 [51; 68] RU/mL, P < 0.001). Among HFpEF patients, higher FGF-23 levels were associated with female sex, higher incidence of atrial fibrillation, lower haemoglobin, worse renal function, and higher N terminal pro brain natriuretic peptide levels (P for trend < 0.05 for all). Regarding imaging characteristics, patients with higher FGF-23 levels had greater left atrial volumes, worse right ventricular systolic function, and more fibrosis estimated by ECV (P for trend < 0.05 for all). FGF-23 was moderately correlated with ECV (r = 0.46, P < 0.001). Over a mean follow-up of 30 ± 8 months, 43 patients (31%) died and 69 patients (49%) were hospitalized for HF. A total of 87 patients (62%) reached the primary composite endpoint of all-cause mortality and/or first HF hospitalization. In multivariate Cox regression analysis for the primary endpoint, FGF-23 (HR: 3.44 [2.01; 5.90], P < 0.001) and E wave velocities (HR: 1.01 [1.00; 1.02], P = 0.034) were independent predictors of the primary composite endpoint. In multivariate Cox regression analysis for the secondary endpoint, ferritin (HR: 1.02 [1.01; 1.03], P < 0.001), FGF-23 (HR: 2.85 [1.26; 6.44], P = 0.012), and ECV (HR: 1.26 [1.03; 1.23], P = 0.008) were independent predictors of all-cause mortality. CONCLUSIONS Fibroblast growth factor 23 (FGF-23) levels were significantly higher in HFpEF patients compared with controls of similar age and gender. FGF-23 was correlated with fibrosis evaluated by ECV. High levels of FGF-23 were significantly associated with signs of disease severity such as worse renal function, larger left atrial volumes, and right ventricular dysfunction. Moreover, FGF-23 was a strong predictor of poor outcome (mortality and first HF hospitalization).
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Affiliation(s)
- Clotilde Roy
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Sibille Lejeune
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Alisson Slimani
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe de Meester
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Sylvie A Ahn As
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Michel F Rousseau
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Amzulescu Mihaela
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Audrey Ginion
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Ferracin
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium
| | - Agnès Pasquet
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - David Vancraeynest
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Beauloye
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Louis Vanoverschelde
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Sandrine Horman
- Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Brussels, Belgium
| | - Bernhard L Gerber
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Anne-Catherine Pouleur
- Division of Cardiology, Department of Cardiovascular Diseases, Cliniques Universitaires St. Luc, Avenue Hippocrate, 10, Brussels, 1200, Belgium.,Pôle de Recherche Cardiovasculaire (CARD), Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium
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136
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Ho CH, Tan TY, Hwang CF, Lin WC, Wu CN, Yang CH. Association of carotid intima-media thickness with the risk of sudden sensorineural hearing loss. PeerJ 2020; 8:e9276. [PMID: 32547881 PMCID: PMC7275684 DOI: 10.7717/peerj.9276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 05/11/2020] [Indexed: 12/24/2022] Open
Abstract
Cardiovascular factors are associated with the pathophysiological features and risk of sudden sensorineural hearing loss (SSNHL). However, little is known about the link between carotid intima-media thickness (IMT), SSNHL risk, and their respective treatment outcomes. In this study, we retrospectively reviewed 47 SSNHL cases and 33 control subjects from a single medical center and compared their demographic data and clinical characteristics, including their carotid IMT and audiological data. Of the 80 enrolled subjects, the proportion of those with high carotid IMT was greater in the SSNHL group (53.2%) than in the control group (21.2%), with an odds ratio (OR) of 4.22 (95% confidence interval (CI) [1.53–11.61], P = 0.004). Notably, high carotid IMT was more common in female SSNHL patients than females in the control group (54.2% vs. 12.5%; OR, 8.27 (95% CI [1.53–44.62]), P = 0.008), particularly in female patients ≥50 years of age (75% vs. 25%; OR, 9.0 (95% CI [1.27–63.9]), P = 0.032). The multivariate regression analyses showed the association between high carotid IMT and SSNHL with an adjusted OR of 4.655 (95% CI [1.348–16.076], P = 0.015), particularly in female SSNHL patients (adjusted OR, 9.818 (95% CI [1.064–90.587], P = 0.044). The carotid IMT was not associated with the treatment outcomes of SSNHL. Our results indicate that early-stage atherosclerosis may be associated with SSNHL, particularly in female patients more than 50 years old.
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Affiliation(s)
- Chun-Hsien Ho
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Teng-Yeow Tan
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Nung Wu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chao-Hui Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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137
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Serum Bilirubin Level as a Potential Marker for the Hearing Outcome in Severe-Profound Bilateral Sudden Deafness. Otol Neurotol 2020; 40:728-735. [PMID: 31135669 PMCID: PMC6594721 DOI: 10.1097/mao.0000000000002287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text Objective: To investigate the association of serum bilirubin level with hearing outcomes in bilateral sudden sensorineural hearing loss (BSSHL) patients. Participants: One hundred thirteen in-patient BSSHL patients were consecutively enrolled between July 2008 and December 2015 in a tertiary center. Main Outcome Measures: Multivariable linear regression, generalized estimating equations (GEE), and stratified analyses were applied to examine the association between serum bilirubin level and hearing outcome measures such as final hearing threshold and absolute and relative hearing gains in BSSHL. Results: After full adjustment for potential confounders, total bilirubin levels (TBIL) were observed to be positively and independently associated with hearing outcomes as measured by final hearing (β [95% confidence interval {CI}]: −1.5 [−2.7, −0.2] dB HL per 1 μmol/L increase in TBIL) and absolute and relative hearing gains (β [95% CI]: 1.4 [0.2, 2.7] dB and 1.6 [0.2, 3.1] dB, respectively) in the severe to profound hearing loss subpopulation. Conclusions: Higher TBIL levels, within the normal or mildly elevated ranges, were independently and significantly associated with better hearing outcome in BSSHL patients with severe to profound hearing loss. Given bilirubin elevation treatments exist, our finding suggests a novel pharmacological strategy for this specific subpopulation.
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138
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Stefania DS, Clodoveo ML, Cariello M, D'Amato G, Franchini C, Faienza MF, Corbo F. Polyphenols and obesity prevention: critical insights on molecular regulation, bioavailability and dose in preclinical and clinical settings. Crit Rev Food Sci Nutr 2020; 61:1804-1826. [PMID: 32436425 DOI: 10.1080/10408398.2020.1765736] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Obesity represents one of the most important public health challenges of the 21st century and is characterized by a multifactorial etiology in which environmental, behavioral, metabolic, and genetic factors work together. Despite the rapid increase in prevalence of obesity in the last decades, especially in children, it remains a preventable disease. To battle obesity a multisector approach promoting healthier lifestyle in terms of physical activity and nutrition is needed. Specifically, biologically active dietary compounds, as polyphenols, are able to modulate the expression of genes involved in the development and progression of obesity and its comorbidities as demonstrated by multiple studies using different obesity models. However, human studies focusing on the transcriptomic modulation by polyphenols in obese patients are still limited and do not often recapitulate the results obtained in preclinical setting likely due to the underestimation of some variables such as bioavailability, dose and form (native vs. metabolized) of polyphenols used. The aim of this review is to summarize the state-of-art of nutrigenomic in vitro, in vivo and ex vivo studies as well as clinical trials based on dietary polyphenols to fight obesity. We also critical discuss the variables to be considered to fill the gap between preclinical and clinical settings.
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Affiliation(s)
- De Santis Stefania
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
| | - M L Clodoveo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - M Cariello
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - G D'Amato
- Neonatal Intensive Care Unit, Di Venere Hospital, Bari, Italy
| | - C Franchini
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
| | - M F Faienza
- Pediatric Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - F Corbo
- Department of Pharmacy-Drug Science, University of Bari Aldo Moro, Bari, Italy
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139
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Nickel NP, Yuan K, Dorfmuller P, Provencher S, Lai YC, Bonnet S, Austin ED, Koch CD, Morris A, Perros F, Montani D, Zamanian RT, de Jesus Perez VA. Beyond the Lungs: Systemic Manifestations of Pulmonary Arterial Hypertension. Am J Respir Crit Care Med 2020; 201:148-157. [PMID: 31513751 DOI: 10.1164/rccm.201903-0656ci] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a disease characterized by progressive loss and remodeling of the pulmonary arteries, resulting in right heart failure and death. Until recently, PAH was seen as a disease restricted to the pulmonary circulation. However, there is growing evidence that patients with PAH also exhibit systemic vascular dysfunction, as evidenced by impaired brachial artery flow-mediated dilation, abnormal cerebral blood flow, skeletal myopathy, and intrinsic kidney disease. Although some of these anomalies are partially due to right ventricular insufficiency, recent data support a mechanistic link to the genetic and molecular events behind PAH pathogenesis. This review serves as an introduction to the major systemic findings in PAH and the evidence that supports a common mechanistic link with PAH pathophysiology. In addition, it discusses recent studies describing morphological changes in systemic vessels and the possible role of bronchopulmonary anastomoses in the development of plexogenic arteriopathy. On the basis of available evidence, we propose a paradigm in which metabolic abnormalities, genetic injury, and systemic vascular dysfunction contribute to systemic manifestations in PAH. This concept not only opens exciting research possibilities but also encourages clinicians to consider extrapulmonary manifestations in their management of patients with PAH.
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Affiliation(s)
- Nils P Nickel
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, California
| | - Ke Yuan
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, California
| | - Peter Dorfmuller
- Department of Pathology, University of Giessen, Giessen, Germany
| | - Steeve Provencher
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec, Canada
| | - Yen-Chun Lai
- Division of Pulmonary and Critical Care Medicine, Indiana University, Bloomington, Indiana
| | - Sebastien Bonnet
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec, Canada
| | - Eric D Austin
- Division of Pediatric Pulmonary and Critical Care Medicine, Vanderbilt University, Nashville Tennessee
| | - Carl D Koch
- Division of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison Morris
- Division of Pulmonary and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Frédéric Perros
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Quebec, Canada.,Inserm Université Paris Sud-Centre chirurgical Marie Lannelongue 999, Université Paris Sud-Paris Saclay, Hôpital Marie Lannelongue, Le Plessis Robinson, France; and
| | - David Montani
- Inserm Université Paris Sud-Centre chirurgical Marie Lannelongue 999, Université Paris Sud-Paris Saclay, Hôpital Marie Lannelongue, Le Plessis Robinson, France; and.,Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Le Kremlin-Bicêtre, France
| | - Roham T Zamanian
- Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, California
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140
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Ulu Ş, Kınar A, Bucak A, Özdemir M. Systemic Immune Inflammatory Index of Patients With Idiopathic Sudden Sensorineural Hearing Loss: Comparison of NLR and PRL Values. EAR, NOSE & THROAT JOURNAL 2020; 100:726-730. [PMID: 32396031 DOI: 10.1177/0145561320924312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Şahin Ulu
- Department of Ear Nose and Throat Head and Neck Diseases, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Abdullah Kınar
- Ear Nose and Throat Head and Neck Diseases, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Abdulkadir Bucak
- Department of Ear Nose and Throat Head and Neck Diseases, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Murat Özdemir
- Department of Ear Nose and Throat Head and Neck Diseases, Afyonkarahisar Health Sciences University School of Medicine, Afyonkarahisar, Turkey
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141
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Sancaktar ME, Ağrı İ, Çeçen AB, Akgül G, Çelebi M. The Prognostic Value of Circulating Inflammatory Cell Counts in Sudden Sensorineural Hearing Loss and the Effect of Cardiovascular Risk Factors. EAR, NOSE & THROAT JOURNAL 2020; 99:464-469. [PMID: 32320296 DOI: 10.1177/0145561320920968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Recent studies suggest that elevated neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are poor prognostic factors in sudden sensorineural hearing loss (SSNHL). We aimed to investigate the accuracy of this hypothesis by taking into account the effect of cardiovascular risk (CVR) factors. METHODS Medical records of 122 patients with SSNHL were reviewed retrospectively and grouped into 2 as; patients without CVR (group 1; n = 68) and patients having CVR (group 2; n = 54). Moreover, 60 control cases who did not have SSNHL were also included and grouped into 2 as; group 3 (n = 30) with CVR and group 4 (n = 30) healthy controls without having SSNHL or CVRs. Neutrophil (N), lymphocyte (L), platelet (Plt), NLR, and PLR between the groups and their relationship with the severity of hearing loss, recovery rates, and audiogram configurations were analyzed. RESULTS The highest N and NLR values were in group 1 and were significantly higher than the values of group 4 (P < .05, P < .01). There was no significant relationship between the groups in terms of L, Plt, or PLR values. The highest NLR and PLR values were determined in SSNHL patients with mild hearing loss, complete recovery, and up-sloping audiogram configuration (P > .05). CONCLUSIONS Elevated levels of N and NLR may be considered as strong laboratory findings showing an inflammatory response in the diagnosis of SSNHL, but the presence of CVR factors does not seem to increase the inflammatory response in SSNHL as expected. In patients with SSNHL, NLR and PLR elevation may indicate better prognosis.
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Affiliation(s)
- Mehmet Eser Sancaktar
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - İbrahim Ağrı
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Ayşe Bel Çeçen
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Gökhan Akgül
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
| | - Mehmet Çelebi
- Department of Otorhinolaryngology-Head and Neck Surgery, Ministry of Health, University of Medical Sciences, Samsun Training and Research Hospital, Samsun/Turkey
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142
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Talebi S, Bagherniya M, Atkin SL, Askari G, Orafai HM, Sahebkar A. The beneficial effects of nutraceuticals and natural products on small dense LDL levels, LDL particle number and LDL particle size: a clinical review. Lipids Health Dis 2020; 19:66. [PMID: 32276631 PMCID: PMC7149933 DOI: 10.1186/s12944-020-01250-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases (CVDs) are globally the major causes of morbidity and mortality. Evidence shows that smaller and denser low-dense lipoprotein (sdLDL) particles are independent atherogenic risk factors for CVD due to their greater susceptibility to oxidation, and permeability in the endothelium of arterial walls. sdLDL levels are an independent risk factor and of more predictive value than total LDL-C for the assessment of coronary artery disease and metabolic syndrome. Functional food ingredients have attracted significant attention for the management of dyslipidemia and subsequently increase cardio-metabolic health. However, to date there is no study that has investigated the effect of these bioactive natural compounds on sdLDL levels. Therefore, the aim of the present review is to summarize the evidence accrued on the effect of special dietary ingredients such as omega-3 polyunsaturated fatty acids, nutraceuticals and herbal medicines on the levels of sdLDL, LDL particle number, and LDL particle size. Based on the results of the existing clinical trials this review suggests that natural products such as medicinal plants, nutraceuticals and omega-3 fatty acids can be used as adjunct or complementary therapeutic agents to reduce sdLDL levels, LDL particle numbers or increase LDL particle size and subsequently may prevent and treat CVD, with the advantage that theses natural agents are generally safe, accessible, and inexpensive.
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Affiliation(s)
- Sepide Talebi
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Bagherniya
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Gholamreza Askari
- Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein M Orafai
- Department of Pharmaceutics, Faculty of Pharmacy, Al-Zahraa University, Karbala, Iraq
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran. .,Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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143
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Xi J, Liu H, Wang X. Prostaglandin E1 effects on CD62p and PAC-1 in patients with sudden sensorineural hearing loss. Thromb Res 2020; 188:31-38. [PMID: 32044505 DOI: 10.1016/j.thromres.2020.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 11/16/2022]
Abstract
PERSPECTIVES To evaluate the treatment outcome of vasodilator prostaglandin E1 (PGE1) in treating sudden sensorineural hearing loss (SSNHL) and to determine its effects on platelet activation, as reflected by changes in CD62p and PAC-1. METHODS We prospectively enrolled 60 patients with confirmed SSNHL and randomly divided them into two groups: the SSNHL group received regular therapy, and the SSNHL-PGE1 group received additional intravenous injection of PGE1. After 14 days of treatment, we measured clinical improvement and CD62p-positive and PAC-1-positive platelets. 30 healthy medical staff members were included as a control group. RESULTS The SSNHL patients had significantly higher levels of CD62p-positive or PAC-1 positive platelets than the healthy subjects. The ratios of CD62p positive or PAC-1 positive platelets significantly decreased after the two treatments. The average pure tone (PTA) hearing thresholds decreased to 26.51 ± 12.65 dB in SSNHL-PGE1 group after treatment, which was significantly lower than that of the SSNHL group (34.46 ± 10.35 dB). Patients with initial severe or profound hearing loss (PTA ≥ 71 dB) had better hearing improvement on PGE1 than on the regular treatment. Patients in the SSNHL-PGE1 treatment group had significantly lower CD62p and PAC-1 levels than those in the SSNHL group. Patients with higher initial positive CD62p and PAC-1 ratios tended to have higher potential of clinical improvement and hearing gains after PGE1 treatment. Initial CD62p and PAC-1 levels were significantly correlated with hearing thresholds in patients with SSNHL. CONCLUSION PGE1 application could improve treatment efficacy and suppress excessive platelet activation in patients with SSNHL.
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Affiliation(s)
- Jie Xi
- Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710068, Shaanxi, China
| | - Hui Liu
- Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Medical Research School of Northwestern Polytechnical University, 710068, Shaanxi, China.
| | - Xin Wang
- Otorhinolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China
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144
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Vascular, cardiac and renal target organ damage associated to arterial hypertension: which noninvasive tools for detection? J Hum Hypertens 2020; 34:420-431. [DOI: 10.1038/s41371-020-0307-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/04/2020] [Accepted: 01/27/2020] [Indexed: 01/16/2023]
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145
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Correlation of plasma soluble suppression of tumorigenicity-2 level with the severity and stability of coronary atherosclerosis. Coron Artery Dis 2020; 31:628-635. [PMID: 32040025 DOI: 10.1097/mca.0000000000000851] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Soluble growth stimulation expressed gene 2 (sST2) is the receptor of interleukin (IL)-33. We hypothesized the IL-33/ST2 pathway may be closely related to the progression of coronary atherosclerotic lesions. METHODS We analyzed 262 patients, including 63 with stable angina pectoris (SAP), 97 with acute coronary syndrome (ACS), and 102 control subjects. Plasma sST2 levels were determined using ELISA. Gensini scores were calculated. Patients with ACS and SAP were further divided according to the complexity of atherosclerotic lesions (simple/complex). Statistical analysis was performed on all data. RESULTS The plasma sST2 levels were significantly higher in patients with coronary artery disease (CAD) than in the control group, and were significantly higher in ACS patients with complex lesions than in those with simple lesions. There were no correlations between plasma sST2 level and both the number of culprit vessels and Gensini score. Multivariate stepwise regression analysis revealed that angiographically detected complex lesions were independently correlated with plasma sST2 level. Logistic regression analyses showed that sST2 was an independent factor of both CAD and the lesion type (simple/complex) of ACS. For the diagnosis of ACS and complex lesions, the area under the receiver operating characteristic curve of sST2 was 0.651. CONCLUSIONS The plasma sST2 level was not correlated with the stenosis severity of coronary atherosclerosis. A relationship between the plasma sST2 level and the morphology of complex lesions was found for the first time, especially in ACS patients. It may be a new marker for assessing the stability and complexity of atherosclerotic plaques.
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Santana-Romo F, Lagos CF, Duarte Y, Castillo F, Moglie Y, Maestro MA, Charbe N, Zacconi FC. Innovative Three-Step Microwave-Promoted Synthesis of N-Propargyltetrahydroquinoline and 1,2,3-Triazole Derivatives as a Potential Factor Xa (FXa) Inhibitors: Drug Design, Synthesis, and Biological Evaluation. Molecules 2020; 25:molecules25030491. [PMID: 31979319 PMCID: PMC7037264 DOI: 10.3390/molecules25030491] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 12/22/2022] Open
Abstract
The coagulation cascade is the process of the conversion of soluble fibrinogen to insoluble fibrin that terminates in production of a clot. Factor Xa (FXa) is a serine protease involved in the blood coagulation cascade. Moreover, FXa plays a vital role in the enzymatic sequence which ends with the thrombus production. Thrombosis is a common causal pathology for three widespread cardiovascular syndromes: acute coronary syndrome (ACS), venous thromboembolism (VTE), and strokes. In this research a series of N-propargyltetrahydroquinoline and 1,2,3-triazole derivatives as a potential factor Xa (FXa) inhibitor were designed, synthesized, and evaluated for their FXa inhibitor activity, cytotoxicity activity and coagulation parameters. Rational design for the desired novel molecules was performed through protein-ligand complexes selection and ligand clustering. The microwave-assisted synthetic strategy of selected compounds was carried out by using Ullmann-Goldberg, N-propargylation, Mannich addition, Friedel-Crafts, and 1,3-dipolar cycloaddition type reactions under microwave irradiation. The microwave methodology proved to be an efficient way to obtain all novel compounds in high yields (73–93%). Furthermore, a thermochemical analysis, optimization and reactivity indexes such as electronic chemical potential (µ), chemical hardness (η), and electrophilicity (ω) were performed to understand the relationship between the structure and the energetic behavior of all the series. Then, in vitro analysis showed that compounds 27, 29–31, and 34 exhibited inhibitory activity against FXa and the corresponding half maximal inhibitory concentration (IC50) values were calculated. Next, a cell viability assay in HEK293 and HepG2 cell lines, and coagulation parameters (anti FXa, Prothrombin time (PT), activated Partial Thromboplastin Time (aPTT)) of the most active novel molecules were performed to determine the corresponding cytotoxicity and possible action on clotting pathways. The obtained results suggest that compounds 27 and 29 inhibited FXa targeting through coagulation factors in the intrinsic and extrinsic pathways. However, compound 34 may target coagulation FXa mainly by the extrinsic and common pathway. Interestingly, the most active compounds in relation to the inhibition activity against FXa and coagulation parameters did not show toxicity at the performed coagulation assay concentrations. Finally, docking studies confirmed the preferential binding mode of N-propargyltetrahydroquinoline and 1,2,3-triazole derivatives inside the active site of FXa.
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Affiliation(s)
- Fabián Santana-Romo
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile; (F.S.-R.); (F.C.); (N.C.)
| | - Carlos F. Lagos
- Chemical Biology & Drug Discovery Laboratory, Facultad de Medicina y Ciencia, Universidad San Sebastián, Lota 2465, Providencia 7510157, Santiago de Chile, Chile;
| | - Yorley Duarte
- Center for Bioinformatics and Integrative Biology, Facultad de Ciencias de la Vida, Universidad Andrés Bello, Santiago 8370146, Chile;
| | - Francisco Castillo
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile; (F.S.-R.); (F.C.); (N.C.)
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile
| | - Yanina Moglie
- Departamento de Química, Instituto de Química del Sur (INQUISUR-CONICET), Universidad Nacional del Sur Avenida Alem 1253, Bahía Blanca B8000CPB, Argentina;
| | - Miguel A. Maestro
- Department of Chemistry—CICA, University of A Coruña, Campus da Zapateira, 15008A A Coruña, Spain;
| | - Nitin Charbe
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile; (F.S.-R.); (F.C.); (N.C.)
| | - Flavia C. Zacconi
- Departamento de Química Orgánica, Facultad de Química y de Farmacia, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile; (F.S.-R.); (F.C.); (N.C.)
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological Sciences, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Macul, Santiago 7820436, Chile
- Correspondence: ; Tel.: +56-2354-1150
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Watanabe H, Sano H, Maki A, Ino T, Nakagawa T, Okamoto M, Yamashita T. Investigation of Stress Levels before the Onset of Idiopathic Sudden Sensorineural Hearing Loss. J Int Adv Otol 2020; 15:51-55. [PMID: 31058595 DOI: 10.5152/iao.2019.6197] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We hypothesized that patients with idiopathic sudden sensorineural hearing loss (ISSHL) would have experienced more stress prior to the onset than they typically did. This study investigated stress levels in patients before the onset of ISSHL. MATERIALS AND METHODS Forty-two patients with ISSHL were investigated. We used an original questionnaire to evaluate subjective stress levels in 1 week before onset. Serum hemoglobin A1c (HbA1c) and total cholesterol were examined to evaluate biochemical stress markers reflecting the preceding 1 to 2 months. The results on admission were compared with those at the follow-up visit. RESULTS Significantly more patients reported greater physical exhaustion, greater mental exhaustion, or a worse physical condition on admission than at follow-up (p<0.01, for each variable). On admission, 81% of patients reported greater than normal stress with regard to at least 1 of 3 items. The mean serum HbA1c was slightly but nonsignificantly lower at the follow-up visit (p=0.10), while the mean serum total cholesterol was significantly lower at follow-up than on admission (p<0.01). CONCLUSION The results indicate that patients were under a greater degree of stress before the onset of ISSHL, suggesting that stress plays a role in inducing ISSHL.
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Affiliation(s)
- Hiroyuki Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
| | - Hajime Sano
- Kitasato University, School of Allied Health Sciences, Sagamihara, Japan
| | - Atsuko Maki
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
| | - Takeshi Ino
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
| | - Takahito Nakagawa
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
| | - Makito Okamoto
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
| | - Taku Yamashita
- Department of Otolaryngology, Head and Neck Surgery, Kitasato University, School of Medicine, Sagamihara, Japan
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Consenso de expertos en la asistencia multidisciplinaria y el abordaje integral de la insuficiencia cardiaca. Desde el alta hospitalaria hasta la continuidad asistencial con primaria. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/s1131-3587(20)30018-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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149
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Anderson A, Campo A, Fulton E, Corwin A, Jerome WG, O'Connor MS. 7-Ketocholesterol in disease and aging. Redox Biol 2020; 29:101380. [PMID: 31926618 PMCID: PMC6926354 DOI: 10.1016/j.redox.2019.101380] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/06/2019] [Accepted: 11/10/2019] [Indexed: 02/08/2023] Open
Abstract
7-Ketocholesterol (7KC) is a toxic oxysterol that is associated with many diseases and disabilities of aging, as well as several orphan diseases. 7KC is the most common product of a reaction between cholesterol and oxygen radicals and is the most concentrated oxysterol found in the blood and arterial plaques of coronary artery disease patients as well as various other disease tissues and cell types. Unlike cholesterol, 7KC consistently shows cytotoxicity to cells and its physiological function in humans or other complex organisms is unknown. Oxysterols, particularly 7KC, have also been shown to diffuse through membranes where they affect receptor and enzymatic function. Here, we will explore the known and proposed mechanisms of pathologies that are associated with 7KC, as well speculate about the future of 7KC as a diagnostic and therapeutic target in medicine.
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150
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Chen H, Jiang X, Shi Y, Yuan F, Hu Z. Systemic sclerosis associated with moyamoya syndrome: A case report and literature review. Immunobiology 2019; 225:151882. [PMID: 31812345 DOI: 10.1016/j.imbio.2019.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
Systemic sclerosis (SSc) associated with moyamoya syndrome (MMS) is a clinically rare disease. To further understand the clinical characteristics of SSc associated with MMS, we investigated and analyzed one case of SSc associated with MMS and conducted a literature review about this disease. Publications retrieved from MEDLINE and Wanfang databases were reviewed and discussed, and we found five well-described cases of SSc associated with MMS. The five patients had no family history of moyamoya disease, and the risk factors (cardiovascular disease) `were found in one of the five patients. The patients included in this study were more frequently female, and they often had limited or diffuse SSc. Unilateral involvement was frequently observed with clinical symptoms including hemiplegia, headache, loss of eyesight, and aphasia. The medical treatments included corticosteroids, immunosuppressive agents, antiplatelet agents, and anticoagulant therapy. The treatment with extra-intracranial revascularization was an effective treatment strategy for MMD and MMS. Unilateral MMD was more likely to be associated with SSc. The efficacy of corticosteroids and immunosuppressive agents was uncertain.
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Affiliation(s)
- Haifeng Chen
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Jiangsu, China
| | - Xinyu Jiang
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Jiangsu, China
| | - Yitian Shi
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Jiangsu, China
| | - Fenghong Yuan
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Jiangsu, China.
| | - Zhigang Hu
- The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Children's Hospital, Jiangsu, China.
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