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Lu J, Gong S, Zhu J, Fang Q. Relationships between obesity and functional outcome after ischemic stroke: a Mendelian randomization study. Neurol Sci 2024; 45:3869-3877. [PMID: 38466476 DOI: 10.1007/s10072-024-07415-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND AND OBJECTIVES Most previous studies suggested obesity deteriorates the functional outcome after ischemic stroke. But there are researches claiming that obesity is associated with lower mortality, recurrence, and readmission rates, which is known as the obesity paradox. Our current research aimed to investigate the correlation between genetically obesity and the post-stroke outcome with the Mendelian randomization (MR) method. METHODS The UK Biobank and the GIANT consortium provided instrumental variables for body mass index (BMI, 806,834 individuals) and waist-to-hip ratio (WHR, 697,734 individuals). Data of functional outcome after ischemic stroke were obtained from the Genetics of Ischemic Stroke Functional Outcome network (6012 individuals). Inverse-variance weighted approach was utilized as the primary analyses. Sensitivity analyses involved the utilization of different MR methods. The heterogeneity among genetic variants was assessed by I2 and Q value statistics. RESULTS In univariable analysis, there was a significant connection between genetic susceptibility to WHR and worse functional outcome (modified Rankin Scale 3) after ischemic stroke (OR [95%CI] = 1.47 [1.07, 2.02], P = 0.016). Genetic liability to BMI and was not associated with post-stroke functional outcome (all P > 0.05). The overall patterns between genetic liability to WHR and functional outcome post-ischemic outcome no longer existed in the multivariable MR analysis after adjusting for BMI (OR [95%CI] = 1.26[0.76,1.67], P = 0.56). CONCLUSION The current MR study provided evidence that WHR was correlated to unfavorable outcome post-ischemic stroke. Exploring interventions against obesity may potentially improve recovery after ischemic stroke.
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Affiliation(s)
- Jieyi Lu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Siqi Gong
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China
| | - Juehua Zhu
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
| | - Qi Fang
- Department of Neurology, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou, 215006, China.
- Department of Neurology, Dushu Lake Hospital Affiliated to Soochow University, 9 Chongwen Road, Suzhou, 215125, China.
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Wakisaka K, Matsuo R, Irie F, Wakisaka Y, Ago T, Kamouchi M, Kitazono T. Association between abdominal adiposity and clinical outcomes in patients with acute ischemic stroke. PLoS One 2024; 19:e0296833. [PMID: 38206990 PMCID: PMC10783725 DOI: 10.1371/journal.pone.0296833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND It is unclear whether abdominal adiposity has an additional effect on post-stroke outcomes. This study aimed to determine whether waist circumference (WC) is independently associated with clinical outcomes after acute ischemic stroke. METHODS We enrolled patients with acute ischemic stroke from a multicenter hospital-based stroke registry in Fukuoka, Japan. We measured WC on admission and categorized patients into four groups (Q1-Q4) according to the quartiles in females and males. The clinical outcomes were poor functional outcome (modified Rankin scale score 2-6) and death from any cause. Logistic regression analysis was performed to estimate the odds ratio and 95% confidence interval of the outcomes of interest after adjusting for potential confounding factors, including body mass index (BMI). RESULTS A total of 11,989 patients (70.3±12.2 years, females: 36.1%) were included in the analysis. The risk of poor functional outcome significantly decreased for Q2-Q4 (vs. Q1) at discharge and Q2-Q3 (vs. Q1) at 3 months, even after adjusting for potential confounders, including BMI. In contrast, adjustment of BMI eliminated the significant association between WC and all-cause death at discharge and 3 months. The association between high WC and favorable functional outcome was not affected by fasting insulin levels or homeostatic model assessment for insulin resistance and was only found in patients without diabetes (P = 0.02 for heterogeneity). CONCLUSIONS These findings suggest that abdominal adiposity has an additional impact on post-stroke functional outcome, independent of body weight and insulin action.
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Affiliation(s)
- Kayo Wakisaka
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Neurology, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | - Ryu Matsuo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Fumi Irie
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshinobu Wakisaka
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tetsuro Ago
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiro Kamouchi
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Fecker AL, Shahin MN, Sheffels S, Nugent JG, Munger D, Miller P, Priest R, Dogan A, Clark W, Wright J, Liu JL. Low body mass index patients have worse outcomes after mechanical thrombectomy. J Neurointerv Surg 2023:jnis-2023-020628. [PMID: 37798104 DOI: 10.1136/jnis-2023-020628] [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: 05/25/2023] [Accepted: 09/10/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND There is evidence that frailty is an independent predictor of worse outcomes after stroke. Similarly, although obesity is associated with a higher risk for stroke, there are multiple reports describing improved mortality and functional outcomes in higher body mass index (BMI) patients in a phenomenon known as the obesity paradox. We investigated the effect of low BMI on outcomes after mechanical thrombectomy (MT). METHODS We conducted a retrospective analysis of 231 stroke patients who underwent MT at an academic medical center between 2020-2022. The patients' BMI data were collected from admission records and coded based on the Centers for Disease Control and Prevention (CDC) obesity guidelines. Recursive partitioning analysis (RPA) in R software was employed to automatically detect a BMI threshold associated with a significant survival benefit. Frailty was quantified using the Modified Frailty Index 5 and 11. RESULTS In our dataset, by CDC classification, 2.6% of patients were underweight, 27.3% were normal BMI, 30.7% were overweight, 19.9% were class I obese, 9.5% were class II obese, and 10% were class III obese. There were no significant differences between these groups. RPA identified a clinically significant BMI threshold of 23.62 kg/m2. Independent of frailty, patients with a BMI ≤23.62 kg/m2 had significantly worse overall survival (P<0.001) and 90-day modified Rankin Scale (P=0.027) than patients above the threshold. CONCLUSIONS Underweight patients had worse survival and functional outcomes after MT. Further research should focus on the pathophysiology underlying poor prognosis in underweight MT patients, and whether optimizing nutritional status confers any neuroprotective benefit.
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Affiliation(s)
- Adeline L Fecker
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Maryam N Shahin
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Samantha Sheffels
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Joseph Girard Nugent
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Daniel Munger
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Parker Miller
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Ryan Priest
- Department of Interventional Radiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Aclan Dogan
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Wayne Clark
- Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - James Wright
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Jesse L Liu
- Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
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Kim JY, Cho SM, Yoo Y, Lee T, Kim JK. Association between Stroke and Abdominal Obesity in the Middle-Aged and Elderly Korean Population: KNHANES Data from 2011-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106140. [PMID: 35627679 PMCID: PMC9141436 DOI: 10.3390/ijerph19106140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 01/27/2023]
Abstract
Obesity and overweight status are primary risk factors for stroke. A relative small number of studies has analyzed the association of abdominal obesity, a crucial indicator for insulin resistance with stroke, compared to general obesity. We aimed to reveal 31,490 records from the Korea National Health and Nutrition Examination Survey (KNHANES). Logistic regression was used to identify the association of abdominal obesity with the risk of stroke. For the multivariate model, covariates were determined based on the cardio-cerebro vascular prediction models. In the sex-specific multivariate logistic regression analysis (including age, antihypertensive drug, diabetes, current smoking, and systolic blood pressure as confounders), the elevated waist circumference (WC) in women was significantly associated with the increased risk for stroke. In case of the categorized form of WC, we discerned the non-linear relationships between WC and the stroke status. The sex-specific associations between the abdominal obesity and stroke status were shown and their relationship pattern exhibited non-linear relationships.
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Affiliation(s)
- Jong Yeon Kim
- Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.K.); (S.M.C.)
| | - Sung Min Cho
- Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.K.); (S.M.C.)
| | - Youngmin Yoo
- Department of Medicine, Graduate School, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Taesic Lee
- Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- The Study of Obesity and Metabolic Syndrome, Korean Academy of Family Medicine, Daejeon 35365, Korea
| | - Jong Koo Kim
- Department of Family Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Institute of Global Health Care and Development, Wonju 26426, Korea
- Correspondence:
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Cong X, Liu S, Wang W, Ma J, Li J. Combined consideration of body mass index and waist circumference identifies obesity patterns associated with risk of stroke in a Chinese prospective cohort study. BMC Public Health 2022; 22:347. [PMID: 35180873 PMCID: PMC8855545 DOI: 10.1186/s12889-022-12756-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 02/08/2022] [Indexed: 12/24/2022] Open
Abstract
Background In China, few studies have examined the relationship between the combination of body mass index and waist circumference and the risk of stroke. Moreover, the relationship may also be different in different genders. Thus, we investigated the association between the combination of body mass index and waist circumference and the risk of stroke in Chinese. Methods This prospective cohort study included 36 632 participants aged 18 to 90 years. Participants were recruited from 60 surveillance sites (25 urban sites and 35 rural sites) across China in 2010 China Chronic Disease Risk Factor Surveillance, and followed up in 2016-2017. Incident cases of stroke were identified through questionnaires (including the basis of clinical diagnosis, imaging tests, time of diagnosis, diagnosis unit) and Cardiovascular Event Report System. Risk factors for stroke were collected at baseline using questionnaire, physical measurements and laboratory tests. Cox proportional hazards regression models were used to generate adjusted hazard ratios and 95%CI. All analyses were duplicated by gender stratification. Results During 6.42 ± 0.50 years of follow-up, 1 333 (597 males, 736 females) stroke events were observed among the 27 112 participants who did not have cardiovascular diseases at baseline. Compared with the general population who have normal weight or underweight with normal WC, those who have normal weight or underweight with abdominal obesity (adjusted hazard ratios 1.45, 95%CI 1.07-1.97 in males; 0.98, 95%CI 0.78-1.24 in females), overweight with abdominal obesity (1.41, 95%CI 1.14-1.75 in males; 1.33, 95%CI 1.10-1.61 in females), obesity with abdominal obesity (1.46, 95%CI 1.11-1.91 in males; 1.46, 95%CI 1.17-1.81 in females). Overweight with normal WC was found to be not statistically significant for both males and females (all P>0.05). Subgroup analysis found a multiplicative interaction between age and anthropometric group in females (P for interaction <0.05). Sensitivity analysis results did not change. In the subjects with CVD risk factors, we found a similar relationship as in the general population . Conclusions Combined assessment of body mass index and waist circumference identifies obesity patterns associated with stroke risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12756-2.
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Affiliation(s)
- Xiangfeng Cong
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 100050, Beijing, China
| | - Shaobo Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 100050, Beijing, China
| | - Wenjuan Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 100050, Beijing, China
| | - Jixiang Ma
- Office of Non-Communicable Diseases and Ageing Health Management, Chinese Center for Disease Control and Prevention, 102206, Beijing, China
| | - Jianhong Li
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 100050, Beijing, China.
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Yıldırım B, Karakaya Z, Acar E, Demir A, Gökçek K, Gökçek A, Doğan V, Biteker M. Controlling Nutritional Status Score Predicts In-Hospital Mortality in Acute Pulmonary Embolism. Med Princ Pract 2022; 31:439-444. [PMID: 35613540 PMCID: PMC9801349 DOI: 10.1159/000525240] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/09/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The association between the nutritional status and outcomes in pulmonary embolism is unclear. This study was aimed at examining the value of the Controlling Nutritional Status (CONUT) score in assessing malnutrition among acute pulmonary embolism patients. SUBJECT AND METHODS We retrospectively reviewed the records of adult patients with acute pulmonary embolism hospitalized through our ED. Demographic, clinical, and laboratory data on admission were recorded. Nutritional status was assessed with the CONUT score, which is calculated by the albumin, total cholesterol, and lymphocyte counts. The primary endpoint of the study was in-hospital mortality. RESULTS A total of 308 consecutive patients (mean age 68.2 ± 12.9 years, 53.9% female) were included, and 35 of the patients (11.4%) died during their in-hospital course. Multivariate analysis showed that a pulmonary embolism severity index >148 (OR 3.12, 95% CI: 1.65-8.81, p < 0.001), the presence of heart failure (1.25, 95% CI: 1.08-1.78, p = 0.03), and a CONUT score >4 (OR 1.39, 95% CI: 1.146-3.424, p = 0.015) were independent predictors of in-hospital mortality. CONCLUSION The present study indicates that the presence of malnutrition defined by the CONUT score predicts in-hospital mortality following acute pulmonary embolism.
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Affiliation(s)
- Birdal Yıldırım
- Department of Emergency Medicine, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Zeynep Karakaya
- Department of Emergency Medicine, İzmir Katip Celebi University, İzmir, Turkey
- *Zeynep Karakaya,
| | - Ethem Acar
- Department of Emergency Medicine, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Ahmet Demir
- Department of Emergency Medicine, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Kemal Gökçek
- Department of Emergency Medicine, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Aysel Gökçek
- Department of Cardiology, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Volkan Doğan
- Department of Cardiology, Muğla Sıtkı Koçman University, Kötekli, Turkey
| | - Murat Biteker
- Department of Cardiology, Muğla Sıtkı Koçman University, Kötekli, Turkey
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Celik AI, Bezgin T, Biteker M. Predictive role of the modified Glasgow prognostic score for in-hospital mortality in stable acute pulmonary embolism. Med Clin (Barc) 2021; 158:99-104. [PMID: 33781570 DOI: 10.1016/j.medcli.2020.11.041] [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: 10/17/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND IMPORTANCE The modified Glasgow prognostic score (mGPS) has been reported to have a prognostic value in various patient populations. However, the prognostic significance of mGPS has not been studied inacute pulmonary embolism (APE). OBJECTIVE This study aimed to investigate the predictive value of mGPS on in-hospital mortality in patients with hemodynamically stableAPE. METHODS We retrospectively included 258 hemodynamically stableAPE patients. Clinical, echocardiographic, and laboratory data recorded on admission. The mGPS scored as 0, 1, or 2 based on the C-reactive protein (CRP) and albumin levels. RESULTS A total of 258hemodynamically stableAPE patients were included, and 28 (10.9%) died during the hospital stay. Compared with survivors, non-survivors were older, had higher N-terminal pro-B-type natriuretic peptide, CRP, creatinine, high-sensitive cardiac troponin T (hs-cTnT), and mGPS levels, and had higher pulmonary embolism severity index (PESI) at study entry. In the multivariate logistic regression analysis, NT-proBNP>2350pg/mL (OR: 2.180, 95% CI 1.102-5.213, p<0.001), hs-cTnT>21pg/mL (OR: 1.426, 95% CI 0.951-3.751, p=0.001), CRP>3.1mg/dL (OR: 1.567, 95% CI 1.072-4.429, p=0.001), PESI>139 (OR: 2.745, 95% CI 0.869-6.369, p=0.001), systolic blood pressure<100mmHg (OR: 3.465, 95% CI 0.867-8.934, p<0.001), mGPS=1 (OR: 2.120, 95% CI 1.089-3.754, p=0.011), and mGPS=2 (OR: 3.350, 95% CI 1.457-5.367, p<0.001) were independently associated with in-hospital mortality. CONCLUSION This study demonstrates the mGPS, which is a new and easily measurable marker, is a useful predictor in-hospital mortality in hemodynamically stableAPE.
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Affiliation(s)
- Aziz Inan Celik
- Department of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey.
| | - Tahir Bezgin
- Department of Cardiology, Gebze Fatih State Hospital, Kocaeli, Turkey
| | - Murat Biteker
- Department of Cardiology, Mugla Sıtkı Kocman University, Faculty of Medicine, Mugla, Turkey
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Wang B. Diagnosis of Waist Muscle Injury after Exercise Based on High-Frequency Ultrasound Image. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5528309. [PMID: 33833856 PMCID: PMC8018867 DOI: 10.1155/2021/5528309] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 11/25/2022]
Abstract
The low back is the weight-bearing part of the human trunk and has a complex anatomy with a variety of lesions. The traditional diagnostic imaging methods include X-ray, CT, and magnetic resonance imaging (MRI). With the rapid development of ultrasound diagnostic instruments and diagnostic techniques, high-frequency ultrasonography plays a more important role in the diagnosis of musculoskeletal disorders by virtue of its advantages of being safe, noninvasive, inexpensive, repeatable in a short period of time, and real-time imaging, especially for the display of fine structures of soft tissues, which is superior to CT and MRI. In this paper, the puncture needle was punctured near the intervertebral foramen, anti-inflammatory analgesics were injected under ultrasound surveillance. The anti-inflammatory and analgesic drugs mainly consist of local anesthetics and glucocorticoids. Local anesthetics can immediately block the nociceptive transmission of the diseased nerve, improve muscle tension, and eliminate muscle spasm, and glucocorticoids can effectively eliminate edema and inflammation of the lumbar nerve root and its surrounding tissues. The results showed that high-frequency ultrasound, as a noninvasive imaging examination, can clearly display the structure and spatial hierarchy of the skin, superficial fascia, deep fascia, and muscles of the low back, can provide real-time dynamic bilateral contrast observation, which can be the preferred imaging examination method for soft tissue disorders of the low back, and can compensate with general X-ray, CT, and magnetic resonance imaging to provide richer clinical diagnosis and treatment. It can provide richer imaging information for clinical diagnosis and treatment.
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Affiliation(s)
- Bingke Wang
- Sports Institute, Pingdingshan University, Pingdingshan 467000, China
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Yawoot N, Govitrapong P, Tocharus C, Tocharus J. Ischemic stroke, obesity, and the anti-inflammatory role of melatonin. Biofactors 2021; 47:41-58. [PMID: 33135223 DOI: 10.1002/biof.1690] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/14/2020] [Indexed: 02/06/2023]
Abstract
Obesity is a predominant risk factor in ischemic stroke and is commonly comorbid with it. Pathologies following these conditions are associated with systemic and local inflammation. Moreover, there is increasing evidence that the susceptibility for ischemic brain damage increases substantially in experimental models of ischemic stroke with concomitant obesity. Herein, we explore the proinflammatory events that occur during ischemic stroke and obesity, and we discuss the influence of obesity on the inflammatory response and cerebral damage outcomes in experimental models of brain ischemia. In addition, because melatonin is a neurohormone widely reported to exhibit protective effects in various diseases, this study also demonstrates the anti-inflammatory role and possible mechanistic actions of melatonin in both epidemic diseases. A summary of research findings suggests that melatonin administration has great potential to exert an anti-inflammatory role and provide protection against obesity and ischemic stroke conditions. However, the efficacy of this hormonal treatment on ischemic stroke with concomitant obesity, when more serious inflammation is generated, is still lacking.
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Affiliation(s)
- Nuttapong Yawoot
- Department of Physiology, Chiang Mai University, Chiang Mai, Thailand
- Graduate School, Chiang Mai University, Chiang Mai, Thailand
| | | | | | - Jiraporn Tocharus
- Department of Physiology, Chiang Mai University, Chiang Mai, Thailand
- Functional Food Research Center for Well-being, Chiang Mai University, Chiang Mai, Thailand
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Saintrain MVDL, Sandrin RLESP, Bezerra CB, Lima AOP, Nobre MA, Braga DRA. Nutritional assessment of older adults with diabetes mellitus. Diabetes Res Clin Pract 2019; 155:107819. [PMID: 31425770 DOI: 10.1016/j.diabres.2019.107819] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/14/2019] [Indexed: 01/12/2023]
Abstract
AIMS We aimed to screen the nutritional status of older adults with diabetes mellitus, seeking to outline the needs of this population group considering their socioeconomic status. METHODS Cross-sectional study of 246 diabetic people aged 65-94 years in Northeastern Brazil. Semi-structured questionnaires were used to collect sociodemographic, general health and lifestyle data. The Mini Nutritional Assessment was used to screen nutritional status. RESULTS Participants' mean age was 73 ± 6.4 years, and there was a predominance of women (56.5%). The mean duration of diabetes was 14.1 years (±9.6 years). Patients aged 80 years or older presented a 3.7-fold higher risk of malnutrition (p < 0.001), and those who were uneducated exhibited a 5.8-fold higher risk of malnutrition (p = 0.040). Patients with BMI of 18.6-24.9 km/m2 presented a 2.2-fold higher risk of malnutrition than overweight or obese patients (p < 0.001). Nutritional status was significantly associated with coronary artery disease (p = 0.010) and stroke (p < 0.001). Malnourished patients exhibited a 2.2-fold higher occurrence of infection in the past 6 months (p = 0.017) and 2-fold higher occurrence of foot injuries (p = 0.028) than their well-nourished peers. CONCLUSION Malnutrition in older diabetic patients exacerbates underlying diseases and contributes to unfavorable prognosis, particularly in the oldest old and in individuals with low levels of education.
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Affiliation(s)
- Maria Vieira de Lima Saintrain
- Public Health Graduation Program, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil.
| | | | - Carina Bandeira Bezerra
- School of Medicine, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Ana Ofélia Portela Lima
- Public Health Graduation Program, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Marina Arrais Nobre
- School of Medicine, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
| | - Débora Rosana Alves Braga
- School of Dentistry, University of Fortaleza - Unifor, Av. Washington Soares, 1321, Edson Queiroz, CEP 60.811-905, Fortaleza, Ceará, Brazil
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Boban M, Bulj N, Kolačević Zeljković M, Radeljić V, Krcmar T, Trbusic M, Delić-Brkljačić D, Alebic T, Vcev A. Nutritional Considerations of Cardiovascular Diseases and Treatments. Nutr Metab Insights 2019; 12:1178638819833705. [PMID: 30923440 PMCID: PMC6431763 DOI: 10.1177/1178638819833705] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/28/2019] [Indexed: 12/16/2022] Open
Abstract
Nutritional considerations of many chronic diseases are not fully understood or taken into consideration in everyday clinical practice. Therefore, it is not surprising that high proportion of hospitalized patients with cardiovascular diseases remains underdiagnosed with malnutrition. Malnourished patients have increased risk of poor clinical outcomes, complications rate, prolonged hospital stay, more frequent rehospitalizations, and lower quality of life. The purpose of this review is to recapitulate recent data on nutritional considerations in cardiovascular medicine.
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Affiliation(s)
- Marko Boban
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia.,Department of Rehabilitation and Sports Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Internal Medicine, Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Internal Medicine and Physiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Nikola Bulj
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia.,Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Vjekoslav Radeljić
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia
| | - Tomislav Krcmar
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia
| | - Matias Trbusic
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia
| | - Diana Delić-Brkljačić
- Department of Cardiology, University Hospital Centre "Sestre Milosrdnice," Zagreb, Croatia.,Department of Internal Medicine, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tamara Alebic
- Department of Internal Medicine, Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Aleksandar Vcev
- Department of Internal Medicine, Medical Faculty, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.,Department of Internal Medicine and Physiology, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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