1
|
Practice of Comparative Effectiveness Research to Identify Treatment Characteristics of Similar Chinese Patent Medicine for Angina Pectoris. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:7062714. [PMID: 28894471 PMCID: PMC5574271 DOI: 10.1155/2017/7062714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/30/2017] [Indexed: 11/17/2022]
Abstract
Objective Individualized application of TCM is not easy and may lead to undesirable results, such as poor effect or even adverse reactions. This trial aims to compare two common Chinese patent medicines with similar effects. Background of the Research Four hospitals carried out the test at the same time in Tianjin city of China. Participants 144 patients were involved in this study; all patients must meet the diagnostic criteria. Interventions Qishen Yiqi pills, compound danshen pills, and their placebos; an efficacy analysis was conducted after the first medication and after crossover medication. Primary Outcome Measures The primary index of end point includes Seattle Angina Questionnaire score-7 and score of 7-point Likert Scale; the curative effect was compared with minimal clinically important differences value. Result Two drugs have their respective advantages in treating SAP. In practical application, the two drugs shall be discriminated in use based on patients' specific symptoms. Trial Registration Chinese clinical trials register is ChiCTR-TTRCC-14004406 (registered 23 March 2014).
Collapse
|
2
|
Pearce DC, McCaw JM, McVernon J, Mathews JD. Influenza as a trigger for cardiovascular disease: An investigation of serotype, subtype and geographic location. ENVIRONMENTAL RESEARCH 2017; 156:688-696. [PMID: 28477579 DOI: 10.1016/j.envres.2017.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/20/2017] [Accepted: 04/20/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Seasonal peaks of influenza and cardiovascular disease tend to coincide. Many excess deaths may be triggered by influenza, and the severity of this effect may vary with the virulence of the circulating influenza strain and host susceptibility. We aimed to explore the association between hospital admissions for influenza and/or pneumonia (IP) and acute myocardial infarction (AMI) or ischaemic heart disease (IHD) in Queensland, Australia, taking into account temporal and spatial variation of influenza virus type and subtype in 2007, 2008 and 2009. METHODS This ecological study at Statistical Subdivision level (SSD, n=38) used linked patient-level data. For each study year, Standardized Morbidity Ratios (SMRs) were calculated for hospital admissions with diagnoses of IP, AMI and IHD. We investigated the associations between IP and AMI or IHD using spatial autoregressive modelling, adjusting for socio-demographic factors. RESULTS Spatial autocorrelation was detected in SMRs, possibly reflecting underlying social and behavioural risk factors, but consistent with infectious disease spread. SMRs for IP were consistently predictive of SMRs for AMI and IHD when adjusted for socioeconomic status, population density and per cent Indigenous population (coefficient: 0.707, 95% confidence interval (CI): 0.318 - 1.096; 0.553, 0.222 - 0.884; 0.598, 0.307 - 0.888 and 1.017, 0.711 - 1.323; 0.650, 0.342 - 0.958; 1.031, 0.827 - 1.236) in 2007, 2008 and 2009, respectively. CONCLUSIONS This ecological study provides further evidence that severe respiratory infections may trigger the onset of cardiovascular events, implicating the influenza virus as a contributing factor.
Collapse
Affiliation(s)
- D C Pearce
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Faculty of Science & Technology, Federation University Australia, University Drive, Mt Helen, Victoria 3350, Australia.
| | - J M McCaw
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Modelling and Simulation, Infection and Immunity Theme, Murdoch Childrens Research Institute, 9th floor, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; School of Mathematics and Statistics, Level 3, Old Geology South, The University of Melbourne, Victoria 3010, Australia.
| | - J McVernon
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia; Modelling and Simulation, Infection and Immunity Theme, Murdoch Childrens Research Institute, 9th floor, The Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia.
| | - J D Mathews
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Level 3, 207 Bouverie Street, The University of Melbourne, Victoria 3010, Australia.
| |
Collapse
|
3
|
Tate S, Namkung JJ, Noymer A. Did the 1918 influenza cause the twentieth century cardiovascular mortality epidemic in the United States? PeerJ 2016; 4:e2531. [PMID: 27761328 PMCID: PMC5068420 DOI: 10.7717/peerj.2531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/06/2016] [Indexed: 11/20/2022] Open
Abstract
During most of the twentieth century, cardiovascular mortality increased in the United States while other causes of death declined. By 1958, the age-standardized death rate (ASDR) for cardiovascular causes for females was 1.84 times that for all other causes, combined (and, for males, 1.79×). Although contemporary observers believed that cardiovascular mortality would remain high, the late 1950s and early 1960s turned out to be the peak of a roughly 70-year epidemic. By 1988 for females (1986 for males), a spectacular decline had occurred, wherein the ASDR for cardiovascular causes was less than that for other causes combined. We discuss this phenomenon from a demographic point of view. We also test a hypothesis from the literature, that the 1918 influenza pandemic caused the cardiovascular mortality epidemic; we fail to find support.
Collapse
Affiliation(s)
- Steven Tate
- Pritzker School of Medicine, University of Chicago, Chicago, IL, United States
| | - Jamie J. Namkung
- Program in Public Health, University of California, Irvine, CA, United States
| | - Andrew Noymer
- Department of Population Health and Disease Prevention, University of California, Irvine, CA, United States
| |
Collapse
|
4
|
Phrommintikul A, Wongcharoen W, Kuanprasert S, Prasertwitayakij N, Kanjanavanit R, Gunaparn S, Sukonthasarn A. Safety and tolerability of intradermal influenza vaccination in patients with cardiovascular disease. JOURNAL OF GERIATRIC CARDIOLOGY : JGC 2014; 11:131-5. [PMID: 25009563 PMCID: PMC4076453 DOI: 10.3969/j.issn.1671-5411.2014.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 04/23/2014] [Accepted: 05/10/2014] [Indexed: 11/18/2022]
Abstract
Background It is well-established that influenza vaccination reduces adverse cardiovascular outcomes in patients with cardiovascular diseases (CVD), however, the vaccine coverage rate in most countries remains low. The concern about the local adverse effects of intramuscular injection, particularly in CVD patients receiving antithrombotic therapy, is one of the important impediments. This study was conducted to assess the safety, side effects and tolerability of intradermal influenza vaccine in CVD patients. Methods This was an observational study in adult CVD patients who had undergone vaccination against seasonal influenza by intradermal vaccination between May 16th and May 30th, 2012 at Maharaj Nakorn Chiang Mai Hospital. The medical history, patients' acceptability and adverse effects were collected using a written questionnaire completed by the patient immediately following vaccination and by a telephone survey eight days later. Results Among 169 patients, 52.1% were women and the mean age was 63 ± 12 years. Coronary artery disease, valvular heart disease and dilated cardiomyopathy were present in 121 (71.6%), 40 (23.7%) and 8 (4.7%), respectively. Antithrombotics were used in 89.3%. After vaccination, the pain score was 0, 1 or 2 (out of 10) in 44.4%, 15.1%, and 27.6% of the patients, respectively. Eight days after vaccination, the common adverse reactions were itching 19 (11.9%), swelling 9 (5.7%) and fatigue (4.7%). No hematoma or bruising was reported. Conclusions The intradermal influenza vaccination is safe and well tolerates with high rates of satisfaction in CVD patients. This technique should be useful in expanding influenza vaccine coverage.
Collapse
Affiliation(s)
- Arintaya Phrommintikul
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Wanwarang Wongcharoen
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Srun Kuanprasert
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Narawudt Prasertwitayakij
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Rungsrit Kanjanavanit
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Siriluck Gunaparn
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| | - Apichard Sukonthasarn
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50210, Thailand
| |
Collapse
|
5
|
Comas-García A, García-Sepúlveda CA, Méndez-de Lira JJ, Aranda-Romo S, Hernández-Salinas AE, Noyola DE. Mortality attributable to pandemic influenza A (H1N1) 2009 in San Luis Potosí, Mexico. Influenza Other Respir Viruses 2010; 5:76-82. [PMID: 21306570 PMCID: PMC4942002 DOI: 10.1111/j.1750-2659.2010.00187.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Acute respiratory infections are a leading cause of morbidity and mortality worldwide. Starting in 2009, pandemic influenza A(H1N1) 2009 virus has become one of the leading respiratory pathogens worldwide. However, the overall impact of this virus as a cause of mortality has not been clearly defined. OBJECTIVES To determine the impact of pandemic influenza A(H1N1) 2009 on mortality in a Mexican population. METHODS We assessed the impact of pandemic influenza virus on mortality during the first and second outbreaks in San Luis Potosí, Mexico, and compared it to mortality associated with seasonal influenza and respiratory syncytial virus (RSV) during the previous winter seasons. RESULTS We estimated that, on average, 8·1% of all deaths that occurred during the 2003-2009 seasons were attributable to influenza and RSV. During the first pandemic influenza A(H1N1) 2009 outbreak, there was an increase in mortality in persons 5-59 years of age, but not during the second outbreak (Fall of 2009). Overall, pandemic influenza A (H1N1) 2009 outbreaks had similar effects on mortality to those associated with seasonal influenza virus epidemics. CONCLUSIONS The impact of influenza A(H1N1) 2009 virus on mortality during the first year of the pandemic was similar to that observed for seasonal influenza. The establishment of real-time surveillance systems capable of integrating virological, morbidity, and mortality data may result in the timely identification of outbreaks so as to allow for the institution of appropriate control measures to reduce the impact of emerging pathogens on the population.
Collapse
Affiliation(s)
- Andreu Comas-García
- Microbiology Department, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México
| | | | | | | | | | | |
Collapse
|
6
|
Azambuja MI. A parsimonious hypothesis to the cause of influenza lethality and its variations in 1918-1919 and 2009. Med Hypotheses 2010; 74:681-4. [PMID: 19962834 PMCID: PMC7130991 DOI: 10.1016/j.mehy.2009.10.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 10/27/2009] [Accepted: 10/31/2009] [Indexed: 11/24/2022]
Abstract
Current explanations to the high 1918-1919 mortality involve either a higher pathogenicity of the virus or bacterial super-infection in the absence of adequate therapeutic resources. However, neither of these hypotheses accounts for the age-distribution of severe cases and deaths, or for the geographic and other variations in rates and explosiveness of mortality during the Pandemic. It will be shown here that, alternatively, the epidemiology of the influenza lethality could be completely explained by a combination of two determinants: (1) acquired immune-differentiation of birth-cohorts, within populations, through developmental epigenetic adaptation (and selection) secondary to maternal or early-life episodes of influenza infection and (2) a triggering context - emergence of a new sub-type/strain, and its co-circulation (competition?) with seasonal viruses immunologically related to ones that had circulated in the past and primed particular population birth-cohorts. This article (1) presents age, geographic, and temporal variations in 1918-1919 and 2009 influenza severity, (2) presents and discusses ecologic evidence in favor of the hypothesis to influenza lethality advanced here, (3) suggests biologic mechanisms capable of explaining it, (4) retrospectively, proposes co-circulation between the Pandemic and a 1918 seasonal (H3?) influenza virus as the context for the increased lethality during the second wave of the 1918 Pandemic, and (5) predicts an increase in influenza severity in the northern hemisphere as the 2009-2010 season advances and H3 circulation increases.
Collapse
Affiliation(s)
- M I Azambuja
- Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos 2600, 4/420 Porto Alegre, 90035-003 Rio Grande do Sul, Brazil.
| |
Collapse
|
7
|
Inflammation as the cause of coronary heart disease. THE LANCET. INFECTIOUS DISEASES 2010; 10:142-3. [DOI: 10.1016/s1473-3099(10)70029-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
8
|
|
9
|
Mamas MA, Fraser D, Neyses L. Cardiovascular manifestations associated with influenza virus infection. Int J Cardiol 2008; 130:304-9. [PMID: 18625525 DOI: 10.1016/j.ijcard.2008.04.044] [Citation(s) in RCA: 160] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2007] [Revised: 02/08/2008] [Accepted: 04/25/2008] [Indexed: 10/21/2022]
Abstract
Influenza accounts for 3 to 5 million cases of severe illness and up to 300,000 deaths annually. Cardiovascular involvement in acute influenza infection can occur through direct effects of the virus on the myocardium or through exacerbation of existing cardiovascular disease. Epidemiological studies have demonstrated an association between influenza epidemics and cardiovascular mortality and a decrease in cardiovascular mortality in high risk patients has been demonstrated following vaccination with influenza vaccine. Influenza is a recognised cause of myocarditis which can lead to significant impairment of cardiac function and mortality. With recent concerns regarding another potential global pandemic of influenza the huge potential for cardiovascular morbidity and mortality is discussed.
Collapse
Affiliation(s)
- Mamas Andreas Mamas
- Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK
| | | | | |
Collapse
|
10
|
The inflammation paradigm: Towards a consensus to explain coronary heart
disease mortality in the 20th century. Glob Heart 2008. [DOI: 10.1016/j.cvdpc.2008.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|