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Soroosh GP, Tasdighi E, Adhikari R, Blaha MJ. Coronary artery calcium in 2023: Guidelines for LDL-C goals, non-statin therapies, and aspirin use. Prog Cardiovasc Dis 2024:S0033-0620(24)00072-0. [PMID: 38754533 DOI: 10.1016/j.pcad.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Personalizing risk assessment and treatment decisions for the primary prevention of atherosclerotic cardiovascular disease (ASCVD) rely on pooled cohort equations and increasingly coronary artery calcium (CAC) score. A growing body of evidence supports that elevated CAC scores correspond to progressively elevated ASCVD risk, and that scores of ≥100, ≥300, and ≥ 1000 denote risk that is equivalent to certain secondary prevention populations. This has led consensus guidelines to incorporate CAC score thresholds for guiding escalation of preventive therapy for lowering low-density lipoprotein cholesterol goals, initiation of non-statin lipid lowering medications, and use of low-dose daily aspirin. As data on CAC continues to grow, more decision pathways will incorporate CAC score cutoffs to guide management of blood pressure and cardiometabolic medications. CAC score is also being used to enrich clinical trial study populations for elevated ASCVD risk, and to screen for subclinical coronary atherosclerosis in patients who received chest imaging for other diagnostic purposes.
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Affiliation(s)
- Garshasb P Soroosh
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Erfan Tasdighi
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rishav Adhikari
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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2
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Zhang L, Bonomi PD. Immune System Disorder and Cancer-Associated Cachexia. Cancers (Basel) 2024; 16:1709. [PMID: 38730660 PMCID: PMC11083538 DOI: 10.3390/cancers16091709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Cancer-associated cachexia (CAC) is a debilitating condition marked by muscle and fat loss, that is unresponsive to nutritional support and contributes significantly to morbidity and mortality in patients with cancer. Immune dysfunction, driven by cytokine imbalance, contributes to CAC progression. This review explores the potential relationship between CAC and anti-cancer immune response in pre-clinical and clinical studies. Pre-clinical studies showcase the involvement of cytokines like IL-1β, IL-6, IL-8, IFN-γ, TNF-α, and TGF-β, in CAC. IL-6 and TNF-α, interacting with muscle and adipose tissues, induce wasting through JAK/STAT and NF-κB pathways. Myeloid-derived suppressor cells (MDSCs) exacerbate CAC by promoting inflammation. Clinical studies confirm elevated pro-inflammatory cytokines (IL-6, IL-8, TNFα) and immune markers like the neutrophil-to-lymphocyte ratio (NLR) in patients with CAC. Thus, immunomodulatory mechanisms involved in CAC may impact the anti-neoplastic immune response. Inhibiting CAC mechanisms could enhance anti-cancer therapies, notably immunotherapy. R-ketorolac, a new immunomodulator, reversed the weight loss and increased survival in mice. Combining these agents with immunotherapy may benefit patients with cancer experiencing CAC. Further research is vital to understand the complex interplay between tumor-induced immune dysregulation and CAC during immunotherapy.
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Affiliation(s)
| | - Philip D. Bonomi
- Division of Hematology/Oncology, Rush University Medical Center, Chicago, IL 60612, USA;
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Martignoni FV, Rl Júnior JE, Marques IR, Gomes C, Moreira VCS, de Souza IAF, Miyawaki IA, Silva CH, do Amaral Neto AB, Padrão EMH, Cardoso R, de Vasconcellos HD, Miedema M. The association of lipoprotein(a) and coronary artery calcium in asymptomatic patients: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:732-741. [PMID: 38300625 DOI: 10.1093/eurjpc/zwae043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/17/2024] [Accepted: 01/28/2024] [Indexed: 02/02/2024]
Abstract
AIMS Lipoprotein(a) [Lp(a)] is an atherogenic lipid particle associated with increased risk for coronary heart disease (CHD) events. Coronary artery calcium (CAC) score is a tool to diagnose subclinical atherosclerosis and guide clinical decision-making for primary prevention of CHD. Studies show conflicting results concerning the relationship between Lp(a) and CAC in asymptomatic populations. We conducted a meta-analysis to evaluate the association of Lp(a) and CAC in asymptomatic patients. METHODS AND RESULTS We systematically searched PubMed, Embase, and Cochrane until April 2023 for studies evaluating the association between Lp(a) and CAC in asymptomatic patients. We evaluated CAC > 0 Agatston units, and CAC ≥ 100. Lp(a) was analysed as a continuous or dichotomous variable. We assessed the association between Lp(a) and CAC with pooled odds ratios (OR) adopting a random-effects model. A total of 23 105 patients from 18 studies were included in the meta-analysis with a mean age of 55.9 years, 46.4% female. Elevated Lp(a) increased the odds of CAC > 0 [OR 1.31; 95% confidence intervals (CI) 1.05-1.64; P = 0.02], CAC ≥100 (OR 1.29; 95% CI 1.01-1.65; P = 0.04; ), and CAC progression (OR 1.43; 95% CI 1.20-1.70; P < 0.01; ). For each increment of 1 mg/dL in Lp(a) there was a 1% in the odds of CAC > 0 (OR 1.01; 95% CI 1.01-1.01; P < 0.01). CONCLUSION Our findings of this meta-analysis suggest that Lp(a) is positively associated with a higher likelihood of CAC. Higher Lp(a) levels increased the odds of CAC >0. These data support the concept that Lp(a) is atherogenic, although with high heterogeneity and a low level of certainty. PROTOCOL REGISTRATION CRD42023422034. KEY FINDINGS Asymptomatic patients with elevated Lp(a) had 31% higher chances of having any coronary calcification (CAC > 0) and 29% higher chances of having more advanced calcification (CAC > 100). It increased the chances of having progression of coronary calcification over time by 43%. For each 1 mg/dL of Lp(a) there was an increment of 1% chance of having coronary calcification.
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Affiliation(s)
- Felipe Villa Martignoni
- Nolan Family Center for Cardiovascular Health, Minneapolis Heart Institute, 920 East 28th Street, Minneapolis, MN 55407, USA
| | | | - Isabela R Marques
- Department of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Cintia Gomes
- Department of Medicine, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | | | - Caroliny H Silva
- Department of Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Eduardo M H Padrão
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, USA
| | - Rhanderson Cardoso
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | | | - Michael Miedema
- Nolan Family Center for Cardiovascular Health, Minneapolis Heart Institute, 920 East 28th Street, Minneapolis, MN 55407, USA
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Tajani A, Sadeghi M, Omidkhoda N, Mohammadpour AH, Samadi S, Jomehzadeh V. The association between C-reactive protein and coronary artery calcification: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:204. [PMID: 38600488 PMCID: PMC11007925 DOI: 10.1186/s12872-024-03856-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND While coronary artery calcification (CAC) is recognized as a reliable marker for coronary atherosclerosis, the relationship between the concentration of C-reactive protein (CRP) and the incidence and progression of CAC remains controversial. METHOD PubMed, Embase, Web of Science, and Scopus were systematically searched to identify relevant observational studies until October 2023. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was employed to calculate pooled odd ratios (OR) and corresponding 95% confidence intervals, considering heterogeneity among the studies. RESULTS Out of the 2545 records, 42 cross-sectional and 9 cohort studies were included in the systematic review. The meta-analysis on 12 eligible cross-sectional studies revealed no significant association between CAC and CRP [pooled OR: 1.03 (1.00, 1.06)]. Additionally, an insignificant association was found between CAC and CRP through meta-analysis on three eligible cohort studies [pooled OR: 1.05 (0.95, 1.15)] with no considerable heterogeneity across studies. Sensitivity analyses indicated that the meta-analysis models were robust. There was no evidence of publication bias. CONCLUSION Based on the meta-analysis findings, elevated levels of CRP did not emerge as a valuable prognostic maker for CAC incidence and progression prediction.
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Affiliation(s)
- Amirhossein Tajani
- Department of Clinical Pharmacy, School of Pharmacy, Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Sadeghi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Navid Omidkhoda
- Department of Clinical Pharmacy, School of Pharmacy, Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Samadi
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Vahid Jomehzadeh
- Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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5
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Maas AHEM. Female-specific risk variables: From innocent bystanders to key players in cardiovascular risk prediction. Maturitas 2024:107970. [PMID: 38580554 DOI: 10.1016/j.maturitas.2024.107970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/07/2024]
Abstract
There is an increasing interest among professionals in cardiovascular medicine in women-specific risk variables related to gynecologic conditions over the life span. Although adverse lifestyle factors, hypertension, dyslipidemia and insulin resistance are recognized as the most important risk factors in older women, there is still uncertainty over how to account for other risk variables. For instance, migraine from puberty onwards, chronic inflammatory conditions and mental stress affect cardiovascular risk in women. As prevention should start as early in life as possible, appropriate risk estimation in women at middle age is crucial. In case of doubt, a coronary artery calcium score with a computed tomography scan at a radiology department can be helpful to discriminate between low and high risk for an individual. This may also pave the way for safe menopausal hormone therapy if needed. In this paper we summarize the current status of women-specific and other relevant risk variables from the perspective of the cardiologist.
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Affiliation(s)
- Angela H E M Maas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Shahraki N, Samadi S, Arasteh O, Dashtbayaz RJ, Zarei B, Mohammadpour AH, Jomehzadeh V. Cardiac troponins and coronary artery calcium score: a systematic review. BMC Cardiovasc Disord 2024; 24:96. [PMID: 38336618 PMCID: PMC10854184 DOI: 10.1186/s12872-024-03761-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
An early diagnosis of atherosclerosis, particularly in subclinical status, can play a remarkable role in reducing mortality and morbidity. Because of coronary artery calcification (CAC) nature in radiation exposure, finding biomarkers associated with CAC could be useful in identifying individuals at high risk of CAC score. In this review, we focused on the association of cardiac troponins (hs-cTns) and CAC to achieve insight into the pathophysiology of CAC. In October 2022, we systematically searched Web of Science, Scopus, PubMed, and Embase databases to find human observational studies which have investigated the association of CAC with cardiac troponins. To appraise the included articles, we used the Newcastle Ottawa scale (NOS). Out of 520 records, 10 eligible studies were included. Based on findings from longitudinal studies and cross-sectional analyses, troponin T and I were correlated with occurrence of CAC and its severity. Two of the most important risk factors that affect the correlation between hs-cTns serum levels and CAC were age and gender. The elevation of cardiac troponins may affect the progression of CAC and future cardiovascular diseases. Verifying the association between cardiac troponins and CAC may lead to identify individuals exposed to enhanced risk of cardiovascular disease (CVD) complications and could establish innovative targets for pharmacological therapy.
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Affiliation(s)
- Naghmeh Shahraki
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Samadi
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Arasteh
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Javidi Dashtbayaz
- Department of cardiovascular diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Batool Zarei
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Vahid Jomehzadeh
- Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Piña P, Lorenzatti D, Castagna F, Miles J, Kuno T, Scotti A, Arce J, Feinberg A, Huang D, Gilman J, Leiderman E, Daich J, Ippolito P, Gongora CA, Schenone AL, Zhang L, Rodriguez CJ, Blaha MJ, Dey D, Berman DS, Virani SS, Levsky JM, Garcia MJ, Slipczuk L. Association of cardiometabolic and vascular atherosclerosis phenotypes on non-contrast chest CT with incident heart failure in patients with severe hypercholesterolemia. J Clin Lipidol 2024:S1933-2874(24)00020-5. [PMID: 38368138 DOI: 10.1016/j.jacl.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/16/2023] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Coronary artery calcium (CAC), thoracic aorta calcification (TAC), non-alcoholic fatty liver disease (NAFLD), and epicardial adipose tissue (EAT) are associated with atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF). OBJECTIVES We aimed to determine whether these cardiometabolic and atherosclerotic risk factors identified by non-contrast chest computed tomography (CT) are associated with HF hospitalizations in patients with LDL-C≥ 190 mg/dL. METHODS We conducted a retrospective cohort analysis of patients with LDL-C ≥190 mg/dL, aged ≥40 years without established ASCVD or HF, who had a non-contrast chest CT within 3 years of LDL-C measurement. Ordinal CAC, ordinal TAC, EAT, and NAFLD were measured. Kaplan-Meier curves and multivariable Cox regression models were built to ascertain the association with HF hospitalization. RESULTS We included 762 patients with median age 60 (53-68) years, 68% (n=520) female, and median LDL-C level of 203 (194-216) mg/dL. Patients were followed for 4.7 (IQR 2.75-6.16) years, and 107 (14%) had a HF hospitalization. Overall, 355 (47%) patients had CAC=0, 210 (28%) had TAC=0, 116 (15%) had NAFLD, and median EAT was 79 mL (49-114). Moderate-Severe CAC (log-rank p<0.001) and TAC (log-rank p=0.006) groups were associated with increased HF hospitalizations. This association persisted when considering myocardial infarction (MI) as a competing risk. NAFLD and EAT volume were not associated with HF. CONCLUSIONS In patients without established ASCVD and LDL-C≥190 mg/dL, CAC was independently associated with increased HF hospitalizations while TAC, NAFLD and EAT were not.
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Affiliation(s)
- Pamela Piña
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk); Division of Cardiology, CEDIMAT, Santo Domingo, Dominican Republic (Dr Piña)
| | - Daniel Lorenzatti
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Francesco Castagna
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Jeremy Miles
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Toshiki Kuno
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Andrea Scotti
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Javier Arce
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Ari Feinberg
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Dou Huang
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Jake Gilman
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Ephraim Leiderman
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Jonathan Daich
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Paul Ippolito
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Carlos A Gongora
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Aldo L Schenone
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Lili Zhang
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Carlos J Rodriguez
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Michael J Blaha
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA (Dr Blaha)
| | - Damini Dey
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA (Drs Dey and Berman)
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA (Drs Dey and Berman)
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, The Aga Khan University, Karachi, Pakistan. Section of Cardiology, Texas Heart Institute & Baylor College of Medicine, Houston, TX, USA (Dr Virani)
| | - Jeffrey M Levsky
- Division of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA (Dr Levsky)
| | - Mario J Garcia
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk)
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA (Drs Piña, Lorenzatti, Castagna, Miles, Kuno, Scotti, Arce, Feinberg, Huang, Gilman, Leiderman, Daich, Ippolito, Gongora, Schenone, Zhang, Rodriguez, Garcia, and Slipczuk).
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McGuier EA, Rothenberger SD, Campbell KA, Keeshin B, Weingart LR, Kolko DJ. Team Functioning and Performance in Child Advo cacy Center Multidisciplinary Teams. Child Maltreat 2024; 29:106-116. [PMID: 35943489 PMCID: PMC9908768 DOI: 10.1177/10775595221118933] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The quality of teamwork in Child Advocacy Center (CAC) multidisciplinary teams is likely to affect the extent to which the CAC model improves outcomes for children and families. This study examines associations between team functioning and performance in a statewide sample of CAC teams. Multidisciplinary team members (N = 433) from 21 CACs completed measures of affective, behavioral, and cognitive team functioning. Team performance was assessed with three measures: team member ratings of overall performance, ratings of mental health screening/referral frequency, and caregiver satisfaction surveys. Linear mixed models and regression analyses tested associations between team functioning and performance. Affective team functioning (i.e., liking, trust, and respect; psychological safety) and cognitive team functioning (i.e., clear direction) were significantly associated with team members' ratings of overall performance. Behavioral team functioning (i.e., coordination) and cognitive team functioning were significantly associated with mental health screening/referral frequency. Team functioning was not associated with caregiver satisfaction with CAC services. Aspects of team functioning were associated with team members' perceptions of overall performance and mental health screening/referral frequency, but not caregiver satisfaction. Understanding associations between team functioning and performance in multidisciplinary teams can inform efforts to improve service quality in CACs and other team-based service settings.
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Affiliation(s)
- Elizabeth A. McGuier
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Kristine A. Campbell
- Center for Safe and Healthy Families, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Brooks Keeshin
- Center for Safe and Healthy Families, Department of Pediatrics, University of Utah, Salt Lake City, UT
| | | | - David J. Kolko
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
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Abosheaishaa H, Hussein M, Ghallab M, Abdelhamid M, Balassiano N, Ahammed MR, Baig MA, Khan J, Elshair M, Soliman MY, Abdelwahed M, Ali A, Alzamzamy A, Nassar M. Association between non-alcoholic fatty liver disease and coronary artery disease outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:102938. [PMID: 38194827 DOI: 10.1016/j.dsx.2023.102938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/07/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES To evaluate the association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular outcomes, including angina, coronary artery disease (CAD), coronary artery calcification (CAC), myocardial infarction (MI), and calcified coronary plaques. METHODS A comprehensive search of databases, including PubMed, EMBASE, and Cochrane Library, was conducted up to January 2023. Studies were included investigating the relationship between NAFLD and cardiovascular outcomes in adult populations. Exclusion criteria were studies on animals, pediatric populations, and those not published in English. Two reviewers assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS The meta-analysis included 32 studies with a total of 5,610,990 participants. NAFLD demonstrated significant associations with increased risks of angina (Relative Risk (RR): 1.45, 95% CI: 1.17, 1.79), CAD (RR: 1.21, 95% CI: 1.07, 1.38), CAC >0 (RR: 1.39, 95% CI: 1.15, 1.69), and calcified coronary plaques (RR: 1.55, 95% CI: 1.05, 2.27). However, no significant association was found between NAFLD and CAC >100 (RR: 1.16, 95% CI: 0.97, 1.38) or MI (RR: 1.70, 95% CI: 0.16, 18.32). CONCLUSION The meta-analysis demonstrated a significant association between NAFLD and cardiovascular outcomes independent of conventional cardiovascular disease (CVD) risk factors. These findings emphasize the importance of prevention, early detection, and proper management of NAFLD.
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Affiliation(s)
- Hazem Abosheaishaa
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Mai Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria, Egypt
| | - Muhammad Ghallab
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Magdy Abdelhamid
- Department of Cardiology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Natalie Balassiano
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Md Ripon Ahammed
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Muhammad Almas Baig
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Jawad Khan
- Department of Internal Medicine, Icahn School of Medicine at Mount Sinai / NYC Health + Hospitals Queens, New York, USA
| | - Moaz Elshair
- Hepatology, Gastroenterology, and Infectious Disease Department, Al-Azhar University, Cairo, Egypt
| | - Moataz Yousry Soliman
- Hepatology, Gastroenterology, and Infectious Disease Department, Al-Azhar University, Cairo, Egypt
| | - Mohammed Abdelwahed
- Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA
| | - Amr Ali
- Department of Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Egypt
| | - Mahmoud Nassar
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, New York, USA.
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10
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Grant JK, Orringer CE. Coronary and Extra-coronary Subclinical Atherosclerosis to Guide Lipid-Lowering Therapy. Curr Atheroscler Rep 2023; 25:911-920. [PMID: 37971683 DOI: 10.1007/s11883-023-01161-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW To discuss and review the technical considerations, fundamentals, and guideline-based indications for coronary artery calcium scoring, and the use of other non-invasive imaging modalities, such as extra-coronary calcification in cardiovascular risk prediction. RECENT FINDINGS The most robust evidence for the use of CAC scoring is in select individuals, 40-75 years of age, at borderline to intermediate 10-year ASCVD risk. Recent US recommendations support the use of CAC scoring in varying clinical scenarios. First, in adults with very high CAC scores (CAC ≥ 1000), the use of high-intensity statin therapy and, if necessary, guideline-based add-on LDL-C lowering therapies (ezetimibe, PCSK9-inhibitors) to achieve a ≥ 50% reduction in LDL-C and optimally an LDL-C < 70 mg/dL is recommended. In patients with a CAC score ≥ 100 at low risk of bleeding, the benefits of aspirin use may outweigh the risk of bleeding. Other applications of CAC scoring include risk estimation on non-contrast CT scans of the chest, risk prediction in younger patients (< 40 years of age), its value as a gatekeeper for the decision to perform nuclear stress testing, and to aid in risk stratification in patients presenting with low-risk chest pain. There is a correlation between extra-coronary calcification (e.g., breast arterial calcification, aortic calcification, and aortic valve calcification) and incident ASCVD events. However, its role in informing lipid management remains unclear. Identification of coronary calcium in selected patients is the single best non-invasive imaging modality to identify future ASCVD risk and inform lipid-lowering therapy decision-making.
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Affiliation(s)
- Jelani K Grant
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Carl E Orringer
- NCH Rooney Heart Institute, 399 9th Street North, Suite 300, Naples, FL, 34102, USA.
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11
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Liang J, Yang C, Li P, Zhang M, Xie X, Xie X, Chen Y, Wang Q, Zhou L, Luo X. Astragaloside IV inhibits AOM/DSS-induced colitis-associated tumorigenesis via activation of PPARγ signaling in mice. Phytomedicine 2023; 121:155116. [PMID: 37776619 DOI: 10.1016/j.phymed.2023.155116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/15/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Colitis-associated colorectal cancer (CAC) is a severe complication of inflammatory bowel disease (IBD), resulting from long-term inflammation in the intestines. The primary cause of CAC is the imbalance of oxidative metabolism in intestinal cells, triggered by excessive reactive oxygen (ROS) and nitrogen (NO) species production due to prolonged intestinal inflammation. This imbalance leads to genomic instability caused by DNA damage, eventually resulting in the development of intestinal cancer. Previous studies have demonstrated that astragaloside IV is effective in treating dextran sulfate sodium salt (DSS)-induced colitis, but there is currently no relevant research on its efficacy in treating CAC. METHODS To investigate the effect of astragaloside IV against CAC and the underlying mechanism, C57 mice were treated with (20, 40, 80 mg/kg) astragaloside IV while CAC was induced by intraperitoneal injection of 10 mg/kg azoxymethane (AOM) and ad libitum consumption of 2% dextran sulfate sodium salt (DSS). We re-verified the activating effects of astragaloside IV on PPARγ signaling in IEC-6 cells, which were reversed by GW9662 (the PPARγ inhibitor). RESULTS Our results showed that astragaloside IV significantly improved AOM/DSS-induced CAC mice by inhibiting colonic shortening, preventing intestinal mucosal damage, reducing the number of tumors and, the expression of Ki67 protein. In addition, astragaloside IV could activate PPARγ signaling, which not only promoted the expression of Nrf2 and HO-1, restored the level of SOD, CAT and GSH, but also inhibited the expression of iNOS and reduced the production of NO in the intestine and IEC-6 cells. And this effect could be reversed by GW9662 in vitro. Astragaloside IV thus decreased the level of ROS and NO in the intestinal tract of mice, as well as reduced the damage of DNA, and therefore inhibited the occurrence of CAC. CONCLUSION Astragaloside IV can activate PPARγ signaling in intestinal epithelial cells and reduces DNA damage caused by intestinal inflammation, thereby inhibiting colon tumourigenesis. The novelty of this study is to use PPARγ as the target to inhibit DNA damage to prevent the occurrence of CAC.
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Affiliation(s)
- Junjie Liang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China; Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital)
| | - Caiyi Yang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Pengcheng Li
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Meiling Zhang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Xueqian Xie
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Xuting Xie
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Yunliang Chen
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Qing Wang
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China
| | - Lian Zhou
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China.
| | - Xia Luo
- School of Pharmaceutical Sciences, Guangzhou University of Chinese Medicine, No. 232 Outer Ring Road, Panyu District, Guangzhou, Guang Dong 510006, China.
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12
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Li L, Zhong H, Shao Y, Hua Y, Zhou X, Luo D. Association between the homeostasis model assessment of insulin resistance and coronary artery calcification: a meta-analysis of observational studies. Front Endocrinol (Lausanne) 2023; 14:1271857. [PMID: 38089605 PMCID: PMC10711676 DOI: 10.3389/fendo.2023.1271857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/06/2023] [Indexed: 12/18/2023] Open
Abstract
Background Insulin resistance (IR), a risk factor for cardiovascular diseases, has garnered significant attention in scientific research. Several studies have investigated the correlation between IR and coronary artery calcification (CAC), yielding varying results. In light of this, we conducted a systematic review to investigate the association between IR as evaluated by the homeostasis model assessment (HOMA-IR) and CAC. Methods A comprehensive search was conducted to identify relevant studies in PubMed, Embase, Scopus, and Web of Science databases. In addition, preprint servers such as Research Square, BioRxiv, and MedRxiv were manually searched. The collected data were analyzed using either fixed or random effects models, depending on the heterogeneity observed among the studies. The assessment of the body of evidence was performed using the GRADE approach to determine its quality. Results The current research incorporated 15 studies with 60,649 subjects. The analysis revealed that a higher category of HOMA-IR was associated with a greater prevalence of CAC in comparison to the lowest HOMA-IR category, with an OR of 1.13 (95% CI: 1.06-1.20, I2 = 29%, P < 0.001). A similar result was reached when HOMA-IR was analyzed as a continuous variable (OR: 1.27, 95% CI: 1.14-1.41, I2 = 54%, P < 0.001). In terms of CAC progression, a pooled analysis of two cohort studies disclosed a significant association between increased HOMA-IR levels and CAC progression, with an OR of 1.44 (95% CI: 1.04-2.01, I2 = 21%, P < 0.05). It is important to note that the strength of the evidence was rated as low for the prevalence of CAC and very low for the progression of CAC. Conclusion There is evidence to suggest that a relatively high HOMA-IR may be linked with an increased prevalence and progression of CAC.
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Affiliation(s)
- Longti Li
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Huiqin Zhong
- Innovation Centre of Nursing Research, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Ya Shao
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yu Hua
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Xu Zhou
- Health Management Center, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
| | - Desheng Luo
- Department of Nursing, TaiHe Hospital, Hubei University of Medicine, Shiyan, China
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13
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Ahmed AU, Almasabi S, Firestein R, Williams BRG. Integrin-linked kinase expression in myeloid cells promotes colon tumorigenesis. Front Immunol 2023; 14:1270194. [PMID: 38077324 PMCID: PMC10710162 DOI: 10.3389/fimmu.2023.1270194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most common forms of cancer worldwide and treatment options for advanced CRC, which has a low 5-year survival rate, remain limited. Integrin-linked kinase (ILK), a multifunctional, scaffolding, pseudo-kinase regulating many integrin-mediated cellular processes, is highly expressed in many cancers. However, the role of ILK in cancer progression is yet to be fully understood. We have previously uncovered a pro-inflammatory role for myeloid-specific ILK in dextran sodium sulfate (DSS)-induced colitis. To establish a correlation between chronic intestinal inflammation and colorectal cancer (CRC), we investigated the role of myeloid-ILK in mouse models of CRC. When myeloid-ILK deficient mice along with the WT control mice were subjected to colitis-associated and APCmin/+-driven CRC, tumour burden was reduced by myeloid-ILK deficiency in both models. The tumour-promoting phenotype of macrophages, M2 polarization, in vitro was impaired by the ILK deficiency and the number of M2-specific marker CD206-expressing tumour-associated macrophages (TAMs) in vivo were significantly diminished in myeloid-ILK deficient mice. Myeloid-ILK deficient mice showed enhanced tumour infiltration of CD8+ T cells and reduced tumour infiltration of FOXP3+ T cells in colitis-associated and APCmin/+-driven CRC, respectively, with an overall elevated CD8+/FOXP3+ ratio suggesting an anti-tumour immune phenotypes. In patient CRC tissue microarrays we observed elevated ILK+ myeloid (ILK+ CD11b+) cells in tumour sections compared to adjacent normal tissues, suggesting a conserved role for myeloid-ILK in CRC development in both human and animal models. This study identifies myeloid-specific ILK expression as novel driver of CRC, which could be targeted as a potential therapeutic option for advanced disease.
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Affiliation(s)
- Afsar U Ahmed
- Centre for Cancer Research, Hudson Institute of Medical Research, Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
| | - Saleh Almasabi
- Centre for Cancer Research, Hudson Institute of Medical Research, Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
| | - Ron Firestein
- Centre for Cancer Research, Hudson Institute of Medical Research, Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
| | - Bryan R G Williams
- Centre for Cancer Research, Hudson Institute of Medical Research, Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
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Piña P, Fernandez C, Lorenzatti D, Castagna F, Miles J, Kuno T, Scotti A, Arce J, Gongora CA, Schenone AL, Budoff MJ, Nasir K, Blankstein R, Blaha MJ, Dey D, Berman DS, Levsky JM, Virani SS, Garcia MJ, Slipczuk L. Subclinical atherosclerosis on chest computed tomography and mortality in young patients with severe hypercholesterolemia. Prog Cardiovasc Dis 2023; 81:105-108. [PMID: 37926153 DOI: 10.1016/j.pcad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Pamela Piña
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA; Division of Cardiology, CEDIMAT, Santo Domingo, Dominican Republic
| | - Carol Fernandez
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniel Lorenzatti
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Francesco Castagna
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeremy Miles
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Toshiki Kuno
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrea Scotti
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Javier Arce
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carlos A Gongora
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Aldo L Schenone
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Matthew J Budoff
- Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, TX, USA
| | - Ron Blankstein
- Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael J Blaha
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Damini Dey
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jeffrey M Levsky
- Division of Radiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, The Aga Khan University, Karachi, Pakistan. Section of Cardiology, Texas Heart Institute & Baylor College of Medicine, Houston, TX, USA
| | - Mario J Garcia
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA.
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15
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Vazirian F, Sadeghi M, Kelesidis T, Budoff MJ, Zandi Z, Samadi S, Mohammadpour AH. Predictive value of lipoprotein(a) in coronary artery calcification among asymptomatic cardiovascular disease subjects: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2023; 33:2055-2066. [PMID: 37567791 PMCID: PMC11073574 DOI: 10.1016/j.numecd.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 05/20/2023] [Accepted: 07/11/2023] [Indexed: 08/13/2023]
Abstract
AIMS Studies have indicated inconsistent results regarding the association between plasma levels of Lipoprotein(a) [Lp(a)] and coronary artery calcification (CAC). We performed a systematic review and meta-analysis to investigate the association between elevated levels of Lp(a) and risk of CAC in populations free of cardiovascular disease (CVD) symptoms. DATA SYNTHESIS PubMed, Web of Science, Embase, and Scopus were searched up to July 2022 and the methodological quality was assessed using Newcastle-Ottawa Scale (NOS) scale. Random-effects meta-analysis was used to estimate pooled odds ratio (OR) and 95% confidence interval. Out of 298 studies, data from 8 cross-sectional (n = 18,668) and 4 cohort (n = 15,355) studies were used in meta-analysis. Cohort studies demonstrated a positive significant association between Lp(a) and CAC, so that individuals with Lp(a)≥30-50 exposed to about 60% risk of CAC incidence compared to those with lower Lp(a) concentrations in asymptomatic CVD subjects (OR, 1.58; 95% CI, 1.38-1.80; l2, 0.0%; P, 0.483); Subgroup analysis showed that a cut-off level for Lp(a) measurement could not statistically affect the association, but race significantly affected the relationship between Lp(a) and CAC (OR,1.60; 95% CI, 1.41-1.81). Analyses also revealed that both men and women with higher Lp(a) concentrations are at the same risk for increased CAC. CONCLUSIONS Blood Lp(a) level was significantly associated with CAC incidence in asymptomatic populations with CVD, indicating that measuring Lp(a) may be a useful biomarker for diagnosing subclinical atherosclerosis in individuals at higher risk of CAC score. PROSPERO REGISTRATION NUMBER CRD42022350297.
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Affiliation(s)
- Fatemeh Vazirian
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Theodoros Kelesidis
- Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Matthew J Budoff
- Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Zahra Zandi
- Department of Cardiovascular Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Samadi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Amir Hooshang Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran; Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
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Niarchos G, Georgii L, Ahrens L, Kleja DB, Fagerlund F. A systematic study of the competitive sorption of per- and polyfluoroalkyl substances (PFAS) on colloidal activated carbon. Ecotoxicol Environ Saf 2023; 264:115408. [PMID: 37666203 DOI: 10.1016/j.ecoenv.2023.115408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/30/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023]
Abstract
Treatment of environmental media contaminated with per- and polyfluoroalkyl substances (PFAS) is crucial to mitigate mounting health risks associated with exposure. Colloidal activated carbon (CAC) has shown promise in treating contaminated soils, but understanding the interaction among PFAS during sorption is necessary for optimal remediation. This study investigated the extent to which PFAS of varying chain lengths and functional groups compete for sorption to CAC. Batch tests were conducted with natural soil and spiked water, using CAC at 0.2% w/w to remove seven PFAS with individual starting concentrations up to 0.05 mmol L-1. PFAS sorption to CAC was evaluated in three systems: a composite mixture of all studied compounds, a binary-solute system, and a single-solute system. The sorption experiments exhibited strong PFAS affinity to CAC, with removal rates between 41% and 100%, and solid/liquid partition coefficients (Kd) between 10 and 104 L kg-1. Differences were noticed among the various spiking mixtures, based on perfluorocarbon chain length, functional group, and the starting PFAS concentrations. Competition effects were detected when PFAS were in a multi-solute system, with an average 10% drop in removal, which can evidently become more relevant at higher concentrations, due to the observed non-linearity of the sorption process. The PFAS most vulnerable to competition effects in multi-solute systems were the short-chain perfluoropentanoic acid (PFPeA) and perfluorobutane sulfonic acid (PFBS), with an up to 25% reduction in removal. In bi-solute systems, perfluorooctane sulfonamide (FOSA) dominated over its ionisable counterparts, i.e. perfluorooctane sulfonic acid (PFOS) and perfluorononanoic acid (PFNA), indicating the importance of hydrophobic effects or layer formation in the sorption process. These results underscore the importance of considering competition in PFAS sorption processes when designing and implementing remediation techniques for PFAS-contaminated media.
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Affiliation(s)
- Georgios Niarchos
- Department of Earth Sciences, Uppsala University, P.O. Box 256, SE-751 05 Uppsala, Sweden.
| | - Linnea Georgii
- Department of Earth Sciences, Uppsala University, P.O. Box 256, SE-751 05 Uppsala, Sweden
| | - Lutz Ahrens
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), P.O. Box 7050, SE-750 07 Uppsala, Sweden
| | - Dan Berggren Kleja
- Department of Soil and Environment, Swedish University of Agricultural Sciences (SLU), P. O. Box 7090, SE-750 07 Uppsala, Sweden
| | - Fritjof Fagerlund
- Department of Earth Sciences, Uppsala University, P.O. Box 256, SE-751 05 Uppsala, Sweden
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Bontinis V, Bontinis A, Koutsoumpelis A, Chorti A, Rafailidis V, Giannopoulos A, Ktenidis K. A network meta-analysis on the effi cacy and safety of thermal and nonthermal endovenous ablation treatments. J Vasc Surg Venous Lymphat Disord 2023; 11:854-865.e5. [PMID: 37030442 DOI: 10.1016/j.jvsv.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVE We assessed the mid-term efficacy and safety of thermal and nonthermal endovenous ablation for the treatment of lower limb superficial venous insufficiency. METHODS We performed a systematic review in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement and a Bayesian network meta-analysis. The primary end points were great saphenous vein (GSV) closure and venous clinical severity score (VCSS) improvement. A meta-regression using GSV diameter as a covariate was undertaken for the two primary end points. RESULTS We included 14 studies and 4177 patients, with a mean follow-up of 25.7 months. Radiofrequency ablation (RFA; odds ratio [OR], 3.99; 95% confidence interval [CI], 1.82-10.53), cyanoacrylate ablation (CAC; OR, 3.09; 95% CI, 1.35-8.37), and endovenous laser ablation (EVLA; OR, 2.72; 95% CI, 1.23-7.38) displayed increased odds for GSV closure compared with mechanochemical ablation (MOCA). MOCA inferiority compared with RFA (mean difference [MD], 0.96; 95% CI, 0.71-1.20), EVLA (MD, 0.94; 95% CI, 0.61-1.24), and CAC (MD, 0.89; 95% CI, 0.65-1.15) was also depicted regarding VCSS improvement. EVLA resulted in an increased risk of postoperative paresthesia compared with MOCA (risk ratio [RR], 9.61; 95% CI, 2.32-62.29), CAC (RR, 7.90; 95% CI, 2.44-38.16), and RFA (RR, 6.96; 95% CI, 2.31-28.04). Although the overall analysis identified nonstatistically significant differences for Aberdeen varicose vein questionnaire score improvement, thrombophlebitis, ecchymosis, and pain, further investigation revealed an increase pain profile for EVLA at 1470 nm compared with RFA (MD, 3.22; 95% CI, 0.93-5.47) and CAC (MD, 3.04; 95% CI, 1.05-4.97). A sensitivity analysis displayed a persistent underperformance of MOCA compared with RFA (OR, 4.33; 95% CI, 1.15-55.54) for GSV closure and both RFA (MD, 0.99; 95% CI, 0.22-1.77) and CAC (MD, 0.84; 95% CI, 0.08-1.65) regarding VCCS improvement. Although no regression model reached statistical significance, the GSV closure regression model revealed a trend for considerably decreased efficacy for both CAC and MOCA with larger GSV diameters compared with RFA and EVLA. CONCLUSIONS Although our analysis has produced skepticism regarding the efficacy of MOCA in the mid-term period for VCSS improvement and GSV closure rates, CAC showed equivalent results compared with both RFA and EVLA. Additionally, CAC displayed a decreased risk of postprocedural paresthesia and pigmentation and induration compared with EVLA. Also, both RFA and CAC had an improved pain profile compared with EVLA 1470 nm. The potential underperformance of nonthermal, nontumescent ablation modalities in ablating large GSVs necessitates further research.
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Affiliation(s)
- Vangelis Bontinis
- Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Alkis Bontinis
- Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Koutsoumpelis
- Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Angeliki Chorti
- Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Rafailidis
- Department of Radiology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Argirios Giannopoulos
- Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kiriakos Ktenidis
- Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Samadi S, Sadeghi M, Dashtbayaz RJ, Nezamdoost S, Mohammadpour AH, Jomehzadeh V. Prognostic role of osteoprotegerin and risk of coronary artery calcification: a systematic review and meta-analysis. Biomark Med 2023; 17:171-180. [PMID: 37097006 DOI: 10.2217/bmm-2022-0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Aim: Coronary artery calcification (CAC) is a predictor of atherosclerosis. However, the association of osteoprotegerin (OPG) with CAC is still controversial. Methods: Prospective cohort studies that provided odds ratios with 95% CIs were included from PubMed, Embase, Web of Science and Scopus through July 2022. Results: Out of 14 studies included in the systematic review, three studies with 7642 participants were included in the meta-analysis. The pooled odds ratio indicated a significant association between higher OPG levels and accelerated risk of CAC (1.15; 95% CI: 1.03-1.30; p < 0.001) with relatively no heterogeneity between studies (I2 = 0%; p = 0.43). Conclusion: The results indicated that increased concentrations of OPG are positively associated with a 15% elevated odds of CAC after adjustment of major covariates.
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Affiliation(s)
- Sara Samadi
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
| | - Masoumeh Sadeghi
- Department of Epidemiology, Faculty of Health, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
| | - Reza Javidi Dashtbayaz
- Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
| | - Shirin Nezamdoost
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
| | - Amir H Mohammadpour
- Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
| | - Vahid Jomehzadeh
- Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 91775-1365, Iran
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Farooqui AA, Farooqui T, Sun GY, Lin TN, Teh DBL, Ong WY. COVID-19, Blood Lipid Changes, and Thrombosis. Biomedicines 2023; 11:biomedicines11041181. [PMID: 37189799 DOI: 10.3390/biomedicines11041181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
Although there is increasing evidence that oxidative stress and inflammation induced by COVID-19 may contribute to increased risk and severity of thromboses, the underlying mechanism(s) remain to be understood. The purpose of this review is to highlight the role of blood lipids in association with thrombosis events observed in COVID-19 patients. Among different types of phospholipases A2 that target cell membrane phospholipids, there is increasing focus on the inflammatory secretory phospholipase A2 IIA (sPLA2-IIA), which is associated with the severity of COVID-19. Analysis indicates increased sPLA2-IIA levels together with eicosanoids in the sera of COVID patients. sPLA2 could metabolise phospholipids in platelets, erythrocytes, and endothelial cells to produce arachidonic acid (ARA) and lysophospholipids. Arachidonic acid in platelets is metabolised to prostaglandin H2 and thromboxane A2, known for their pro-coagulation and vasoconstrictive properties. Lysophospholipids, such as lysophosphatidylcholine, could be metabolised by autotaxin (ATX) and further converted to lysophosphatidic acid (LPA). Increased ATX has been found in the serum of patients with COVID-19, and LPA has recently been found to induce NETosis, a clotting mechanism triggered by the release of extracellular fibres from neutrophils and a key feature of the COVID-19 hypercoagulable state. PLA2 could also catalyse the formation of platelet activating factor (PAF) from membrane ether phospholipids. Many of the above lipid mediators are increased in the blood of patients with COVID-19. Together, findings from analyses of blood lipids in COVID-19 patients suggest an important role for metabolites of sPLA2-IIA in COVID-19-associated coagulopathy (CAC).
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Affiliation(s)
- Akhlaq A Farooqui
- Department of Molecular and Cellular Biochemistry, Ohio State University, Columbus, OH 43210, USA
| | - Tahira Farooqui
- Department of Molecular and Cellular Biochemistry, Ohio State University, Columbus, OH 43210, USA
| | - Grace Y Sun
- Department of Biochemistry, University of Missouri, Columbia, MO 65211, USA
| | - Teng-Nan Lin
- Institute of Biomedical Sciences, Academia Sinica, Taipei 11929, Taiwan
| | - Daniel B L Teh
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119260, Singapore
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119260, Singapore
- Neurobiology Research Programme, Life Sciences Institute, National University of Singapore, Singapore 119260, Singapore
| | - Wei-Yi Ong
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119260, Singapore
- Neurobiology Research Programme, Life Sciences Institute, National University of Singapore, Singapore 119260, Singapore
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20
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Lorenzatti D, Piña P, Csecs I, Schenone AL, Gongora CA, Garcia MJ, Blaha MJ, Budoff MJ, Williams MC, Dey D, Berman DS, Virani SS, Slipczuk L. Does Coronary Plaque Morphology Matter Beyond Plaque Burden? Curr Atheroscler Rep 2023; 25:167-180. [PMID: 36808390 DOI: 10.1007/s11883-023-01088-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE OF REVIEW Imaging of adverse coronary plaque features by coronary computed tomography angiography (CCTA) has advanced greatly and at a fast pace. We aim to describe the evolution, present and future in plaque analysis, and its value in comparison to plaque burden. RECENT FINDINGS Recently, it has been demonstrated that in addition to plaque burden, quantitative and qualitative assessment of coronary plaque by CCTA can improve the prediction of future major adverse cardiovascular events in diverse coronary artery disease scenarios. The detection of high-risk non-obstructive coronary plaque can lead to higher use of preventive medical therapies such as statins and aspirin, help identify culprit plaque, and differentiate between myocardial infarction types. Even more, over traditional plaque burden, plaque analysis including pericoronary inflammation can potentially be useful tools for tracking disease progression and response to medical therapy. The identification of the higher risk phenotypes with plaque burden, plaque characteristics, or ideally both can allow the allocation of targeted therapies and potentially monitor response. Further observational data are now required to investigate these key issues in diverse populations, followed by rigorous randomized controlled trials.
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Affiliation(s)
- Daniel Lorenzatti
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Pamela Piña
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
- Cardiology Division, CEDIMAT Cardiovascular Center, Santo Domingo, Dominican Republic
| | - Ibolya Csecs
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Aldo L Schenone
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carlos A Gongora
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mario J Garcia
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Michelle C Williams
- BHF Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging, Queen's Medical Research Institute University of Edinburgh, Edinburgh, UK
| | - Damini Dey
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Salim S Virani
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Section of Cardiology, Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Leandro Slipczuk
- Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY, USA.
- Clinical Cardiology, Advanced Cardiac Imaging, CV Atherosclerosis and Lipid Disorder Center, Montefiore Health System, NewYork, USA.
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21
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Wu HY, Chang PH, Huang YS, Tsai CS, Chen KY, Lin IF, Hsih WH, Tsai WL, Chen JA, Yang TL, Lee CY, Ho TS, Wang HW, Huang SF, Wu AY, Chen HJ, Chen YC, Chen WC, Tseng CH, Lin PC, Yang CH, Hong PL, Lee SS, Chen YS, Liu YC, Wang FD; Infectious Disease Society of Taiwan,, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education,, CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines,, 7th Guidelines Recommendations for Evidence-based Antimicrobial agents use in Taiwan (GREAT) working group. Recommendations and guidelines for the diagnosis and management of Coronavirus Disease-19 (COVID-19) associated bacterial and fungal infections in Taiwan. J Microbiol Immunol Infect 2023; 56:207-35. [PMID: 36586743 DOI: 10.1016/j.jmii.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
Coronavirus disease-19 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2 that has rapidly evolved into a pandemic to cause over 600 million infections and more than 6.6 million deaths up to Nov 25, 2022. COVID-19 carries a high mortality rate in severe cases. Co-infections and secondary infections with other micro-organisms, such as bacterial and fungus, further increases the mortality and complicates the diagnosis and management of COVID-19. The current guideline provides guidance to physicians for the management and treatment of patients with COVID-19 associated bacterial and fungal infections, including COVID-19 associated bacterial infections (CABI), pulmonary aspergillosis (CAPA), candidiasis (CAC) and mucormycosis (CAM). Recommendations were drafted by the 7th Guidelines Recommendations for Evidence-based Antimicrobial agents use Taiwan (GREAT) working group after review of the current evidence, using the grading of recommendations assessment, development, and evaluation (GRADE) methodology. A nationwide expert panel reviewed the recommendations in March 2022, and the guideline was endorsed by the Infectious Diseases Society of Taiwan (IDST). This guideline includes the epidemiology, diagnostic methods and treatment recommendations for COVID-19 associated infections. The aim of this guideline is to provide guidance to physicians who are involved in the medical care for patients with COVID-19 during the ongoing COVID-19 pandemic.
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22
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Kotlo S, Thorgerson A, Kulinski J. Coronary artery calcification as a predictor of adverse outcomes in patients hospitalized with COVID-19. Am Heart J Plus 2023; 28:100288. [PMID: 36925617 PMCID: PMC9993728 DOI: 10.1016/j.ahjo.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/10/2023]
Abstract
Background Subclinical coronary artery calcification (CAC) is a risk factor for adverse cardiovascular events, but studies investigating its association with outcomes in hospitalized patients with COVID-19 are limited. Methods This was a retrospective study of 457 patients without history of clinical coronary artery disease (CAD) who underwent chest CT imaging during COVID-19 hospitalization at MCW/Froedtert-affiliated hospitals from July 1, 2020 to July 1, 2021. Visually estimated CAC (yes/no) and CAC burden (none/mild/moderate/severe) were recorded from radiology reports. Unadjusted and adjusted regression models were used to assess associations between CAC and hospital length of stay (LOS), ICU admission, mechanical ventilation, and mortality. Results The mean age was 63.1 ± 15.3 years. Presence of CAC was associated with mechanical ventilation (p = 0.01), ICU admission (p = 0.02), in-hospital or 30-day mortality (p < 0.01), and hospital LOS (p < 0.001). Compared to no CAC, hospital LOS was increased for mild (p = 0.01) and severe CAC (p = 0.02) after adjustment for covariates. Severe CAC was also associated with increased ICU admission (OR 3.97; p = 0.002) and mechanical ventilation (OR 3.08; p = 0.03) after adjustment. In unadjusted analysis, in-hospital or 30-day mortality increased with magnitude of CAC severity, with HR 2.43 (p = 0.003) for mild and HR 3.70 (p = 0.002) for severe CAC. However, associations with mortality were not significant after adjustment. Conclusions CAC is associated with increased ICU admission, mechanical ventilation, hospital LOS, and in-hospital or 30-day mortality for patients hospitalized with COVID-19. Patients with severe CAC, and without clinical history of CAD, represent a high-risk population for morbidity and mortality.
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Affiliation(s)
- Srisha Kotlo
- Department of Medicine, University of Chicago Medicine, Chicago, IL, United States of America
| | | | - Jacquelyn Kulinski
- Department of Medicine, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, United States of America
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23
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Lin FY, Goebel BP, Lee BC, Lu Y, Baskaran L, Yoon YE, Maliakal GT, Gianni U, Bax AM, Sengupta PP, Slomka PJ, Dey DS, Rozanski A, Han D, Berman DS, Budoff MJ, Miedema MD, Nasir K, Rumberger J, Whelton SP, Blaha MJ, Shaw LJ. Mortality impact of low CAC density predominantly occurs in early atherosclerosis: explainable ML in the CAC consortium. J Cardiovasc Comput Tomogr 2023; 17:28-33. [PMID: 36376147 DOI: 10.1016/j.jcct.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/15/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Machine learning (ML) models of risk prediction with coronary artery calcium (CAC) and CAC characteristics exhibit high performance, but are not inherently interpretable. OBJECTIVES To determine the direction and magnitude of impact of CAC characteristics on 10-year all-cause mortality (ACM) with explainable ML. METHODS We analyzed asymptomatic subjects in the CAC consortium. We trained ML models on 80% and tested on 20% of the data with XGBoost, using clinical characteristics + CAC (ML 1) and additional CAC characteristics of CAC density and number of calcified vessels (ML 2). We applied SHAP, an explainable ML tool, to explore the relationship of CAC and CAC characteristics with 10-year all-cause and CV mortality. RESULTS 2376 deaths occurred among 63,215 patients [68% male, median age 54 (IQR 47-61), CAC 3 (IQR 0-94.3)]. ML2 was similar to ML1 to predict all-cause mortality (Area Under the Curve (AUC) 0.819 vs 0.821, p = 0.23), but superior for CV mortality (0.847 vs 0.845, p = 0.03). Low CAC density increased mortality impact, particularly ≤0.75. Very low CAC density ≤0.75 was present in only 4.3% of the patients with measurable density, and 75% occurred in CAC1-100. The number of diseased vessels did not increase mortality overall when simultaneously accounting for CAC and CAC density. CONCLUSION CAC density contributes to mortality risk primarily when it is very low ≤0.75, which is primarily observed in CAC 1-100. CAC and CAC density are more important for mortality prediction than the number of diseased vessels, and improve prediction of CV but not all-cause mortality. Explainable ML techniques are useful to describe granular relationships in otherwise opaque prediction models.
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Affiliation(s)
- Fay Y Lin
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Benjamin P Goebel
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Benjamin C Lee
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Yao Lu
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Lohendran Baskaran
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Yeonyee E Yoon
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Sungnam, South Korea
| | - Gabriel Thomas Maliakal
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA; Department of Computer Science, Michigan State University, East Lansing, MI, USA
| | - Umberto Gianni
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - A Maxim Bax
- Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA
| | - Partho P Sengupta
- Division of Cardiology, Rutgers Robert Wood Medical School and University Hospital, New Brunswick, NJ, USA
| | - Piotr J Slomka
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Damini S Dey
- Departments of Imaging and Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alan Rozanski
- Department of Cardiology, Mount Sinai St. Luke's Hospital, New York, NY, USA
| | - Donghee Han
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Daniel S Berman
- Biomedical Imaging Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Michael D Miedema
- Cardiovascular Prevention, Minneapolis Heart Institute Foundation, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA
| | - John Rumberger
- Princeton Longevity Center, Princeton Forrestal Village, Princeton, NJ, USA
| | - Seamus P Whelton
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Leslee J Shaw
- Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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24
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Perez-Cervera J, Arce J, Fattouh M, Kuno T, Schenone AL, Brahmanandam V, Lee UJ, Haramati LB, Levsky JM, Villines TC, Garcia MJ, Slipczuk L. Influence of BMI on virtual coronary artery calcium scoring. Int J Cardiovasc Imaging 2022. [PMID: 36583813 DOI: 10.1007/s10554-022-02785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE Virtual non-contrast (VNC) coronary artery calcium scoring (CAC) may obviate the need for traditional non-contrast (TNC) CAC. There is no data on the influence of body mass index (BMI) on VNC reliability. We aimed to evaluate the influence of BMI on VNC CAC agreement with TNC. MATERIALS AND METHODS All patients who underwent sequential CAC and coronary CT angiography (CCTA) using spectral CT with TNC CAC > 0 between August 2020 and December 2021 were included. Agatston CAC scores were calculated manually by 2 blinded readers from VNC scans. A correction factor was calculated from the slope of the linear regression using the method of least squares and applied to the VNC scores. Bland-Altman plots and Cohen's weighted Kappa were utilized. RESULTS We included 174 patients (57.5% female). Mean BMI was 32.6 ± 7.02 kg/m2 [BMI < 30 (39.7%); BMI 30-40 (45.4%); and BMI > 40 kg/m2 (14.9%)]. Mean TNC CAC was 177.8 ± 316.86 and mean VNC CAC after applying the correction factor 149.34 ± 296.73. The TNC value strongly correlated with VNC (r = 0.94; p < 0.0001). As BMI increased there was a progressive reduction in signal-to-noise ratio, contrast-to-noise ratio and coronary enhancement (p < 0.05). The degree of agreement between VNC and TNC CAC decreased as BMI increased (agreement = 91.79 (weighted Kappa = 0.72), 91.14 (weighted Kappa = 0.58) and 88.46% (weighted Kappa = 0.48) (all P values < 0.001) for BMI < 30; 30-40 and > 40 kg/m2, respectively). CONCLUSION BMI has a significant influence on the accuracy of VNC CAC. VNC CAC shows substantial agreement in non-obese patients but performs poorly in BMI > 40 kg/m2. This is the first study to evaluate the influence of body mass index (BMI) on virtual non-contrast (VNC) coronary artery calcium scoring (CAC) as compared to traditional non-contrast (TNC). We retrospectively evaluated 174 patients with TNC CAC and two blinded reviewers manually calculated the VNC CAC. All cases were included without specific selection for quality. The ratio between the two directly proportional values was determined using the slope from the linear regression through the method of least squares. This correction factor of 2.65 was applied to the calcium scores obtained from VNC images. We found that VNC CAC shows substantial risk-class agreement with TNC in non-obese patients (agreement = 91.79 and weighted Kappa = 0.72) but performs poorly in BMI > 40 kg/m2 (agreement: 88.46% and weighted Kappa = 0.48). These findings show the potential use of VNC CAC to avoid additional radiation in non-obese patients. However, further research on potential improvement strategies for VNC CAC in obese patients is needed.
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25
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Piña P, Lorenzatti D, Paula R, Daich J, Schenone AL, Gongora C, Garcia MJ, Blaha MJ, Budoff MJ, Berman DS, Virani SS, Slipczuk L. Imaging subclinical coronary atherosclerosis to guide lipid management, are we there yet? Am J Prev Cardiol 2022; 13:100451. [PMID: 36619296 PMCID: PMC9813535 DOI: 10.1016/j.ajpc.2022.100451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/07/2022] [Accepted: 12/17/2022] [Indexed: 12/23/2022] Open
Abstract
Atherosclerotic cardiovascular disease risk (ASCVD) is an ongoing epidemic, and lipid abnormalities are its primordial cause. Most individuals suffering a first ASCVD event are previously asymptomatic and often do not receive preventative therapies. The cornerstone of primary prevention has been the identification of individuals at risk through risk calculators based on clinical and laboratory traditional risk factors plus risk enhancers. However, it is well accepted that a clinical risk calculator misclassifies a significant proportion of individuals leading to the prescription of a lipid-lowering medication with very little yield or a missed opportunity for lipid-lowering agents with a potentially preventable event. The development of coronary artery calcium scoring (CAC) and CT coronary angiography (CCTA) provide complementary tools to directly visualize coronary plaque and other risk-modifying imaging components that can potentially provide individualized lipid management. Understanding patient selection for CAC or potentially CCTA and the risk implications of the different parameters provided, such as CAC score, coronary stenosis, plaque characteristics and burden, epicardial adipose tissue, and pericoronary adipose tissue, have grown more complex as technologies evolve. These parameters directly affect the shared decision with patients to start or withhold lipid-lowering therapies, to adjust statin intensity or LDL cholesterol goals. Emerging lipid lowering studies with non-invasive imaging as a guide to patient selection and treatment efficacy, plus the evolution of lipid lowering therapies from statins to a diverse armament of newer high-cost agents have pushed these two fields forward with a complex interaction. This review will discuss existing risk estimators, and non-invasive imaging techniques for subclinical coronary atherosclerosis, traditionally studied using CAC and more recently CCTA with qualitative and quantitative measurements. We will also explore the current data, gaps of knowledge and future directions on the use of these techniques in the risk-stratification and guidance of lipid management.
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Affiliation(s)
- Pamela Piña
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Daniel Lorenzatti
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Rita Paula
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Jonathan Daich
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Aldo L Schenone
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Carlos Gongora
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Mario J Garcia
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease. Baltimore, MD, USA
| | - Matthew J Budoff
- Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Daniel S Berman
- Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Salim S Virani
- Section of Cardiology, Department of Medicine. Baylor College of Medicine, and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- The Aga Khan University, Karachi, Pakistan
| | - Leandro Slipczuk
- Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine. Bronx, NY, USA
- Corresponding author.
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Zhang H, Lao Q, Zhang J, Zhu J. Coagulopathy in COVID-19 and anticoagulation clinical trials. Best Pract Res Clin Haematol 2022; 35:101377. [PMID: 36494146 PMCID: PMC9395291 DOI: 10.1016/j.beha.2022.101377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory disease coronavirus 2 (SARS-COV-2) first emerged in Wuhan, China, in December 2019 and has caused a global pandemic of a scale unprecedented in the modern era. People infected with SARS-CoV-2 can be asymptomatic, moderate symptomatic or develop severe COVID-19. Other than the typical acute respiratory distress syndrome (ARDS), patients with moderate or severe COVID-19 also develop a distinctive systemic coagulopathy, known as COVID-19-associated coagulopathy (CAC), which is different from sepsis-related forms of disseminated intravascular coagulation (DIC). Endotheliopathy or endotheliitis are other unique features of CAC. The endothelial cell perturbation can further increase the risk of thrombotic events in COVID-19 patients. In this review, we will summarize the current knowledge on COVID-19 coagulopathy and the possible mechanisms for the condition. We also discuss the results of clinical trials testing methods for mitigating thrombosis events in COVID-19 patients.
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Affiliation(s)
- Heng Zhang
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA
| | - Qifang Lao
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA; Department of Critical Care Medicine, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, China
| | - Jue Zhang
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA
| | - Jieqing Zhu
- Blood Research Institute, Versiti Blood Center of Wisconsin, Milwaukee, WI, USA; Department of Biochemistry, Medical College of Wisconsin, Milwaukee, WI, USA.
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27
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Westphaln KK, Manges KA, Regoeczi WC, Johnson J, Ronis SD, Spilsbury JC. Facilitators and barriers to Children's Advo cacy Center-based multidisciplinary teamwork. Child Abuse Negl 2022; 131:105710. [PMID: 35728288 DOI: 10.1016/j.chiabu.2022.105710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/09/2022] [Accepted: 06/08/2022] [Indexed: 05/22/2023]
Abstract
BACKGROUND Children's Advocacy Centers (CACs) use a multidisciplinary team (MDT) approach to initiate, coordinate, and provide essential multisector services for children and families who experience child abuse. Despite rapid dissemination of the CAC model across the world, little is known about characteristics associated with CAC-based teamwork. OBJECTIVE Given that teamwork characteristics may impact the outcomes of child and families who interact with CACs, the purpose of this qualitative study was to explore experiences, facilitators, and barriers to CAC-based multidisciplinary teamwork. PARTICIPANTS, SETTING, & METHODS We conducted semi-structured interviews with members of a MDT at a Midwestern CAC. RESULTS Findings suggest that MDT teamwork was fostered by clear communication, responsiveness, commitment, openness, and appropriate resources whereas MDT teamwork was hindered by role confusion, conflicting perspectives, poor communication, low staffing, complex politics, and structural barriers. CONCLUSIONS Characteristics of CAC-based teamwork may vary from the teamwork of other types of child protection teams. Interventions that enhance CAC-based teamwork may optimize the function of CAC MDTs and improve outcomes for children and families who engage with CACs.
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Affiliation(s)
- Kristi K Westphaln
- University of California Los Angeles, School of Nursing, Los Angeles, CA 90095, USA; University Hospitals Center for Child Health and Policy, Cleveland, OH, USA.
| | - Kirstin A Manges
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, USA; Center for Health Equity Promotion and Research, Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA.
| | - Wendy C Regoeczi
- Cleveland State University, Department of Criminology, Anthropology, and Sociology, Cleveland, OH, USA.
| | | | - Sarah D Ronis
- University Hospitals Center for Child Health and Policy, Cleveland, OH, USA; Case Western Reserve University, School of Medicine, Department of Pediatrics, Cleveland, OH, USA.
| | - James C Spilsbury
- Case Western Reserve University, School of Medicine, Department of Population and Quantitative Health Sciences, Cleveland, OH, USA.
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28
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Koukaki E, Rovina N, Tzannis K, Sotiropoulou Z, Loverdos K, Koutsoukou A, Dimopoulos G. Fungal Infections in the ICU during the COVID-19 Era: Descriptive and Comparative Analysis of 178 Patients. J Fungi (Basel) 2022; 8:jof8080881. [PMID: 36012869 PMCID: PMC9410292 DOI: 10.3390/jof8080881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: COVID-19-associated fungal infections seem to be a concerning issue. The aim of this study was to assess the incidence of fungal infections, the possible risk factors, and their effect on outcomes of critically ill patients with COVID-19. Methods: A retrospective observational study was conducted in the COVID-19 ICU of the First Respiratory Department of National and Kapodistrian University of Athens in Sotiria Chest Diseases Hospital between 27 August 2020 and 10 November 2021. Results: Here, 178 patients were included in the study. Nineteen patients (10.7%) developed fungal infection, of which five had COVID-19 associated candidemia, thirteen had COVID-19 associated pulmonary aspergillosis, and one had both. Patients with fungal infection were younger, had a lower Charlson Comorbidity Index, and had a lower PaO2/FiO2 ratio upon admission. Regarding health-care factors, patients with fungal infections were treated more frequently with Tocilizumab, a high regimen of dexamethasone, continuous renal replacement treatment, and were supported more with ECMO. They also had more complications, especially infections, and subsequently developed septic shock more frequently. Finally, patients with fungal infections had a longer length of ICU stay, as well as length of mechanical ventilation, although no statistically significant difference was reported on 28-day and 90-day mortality. Conclusions: Fungal infections seem to have a high incidence in COVID-19 critically ill patients and specific risk factors are identified. However, fungal infections do not seem to burden on mortality.
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Affiliation(s)
- Evangelia Koukaki
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Nikoletta Rovina
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Kimon Tzannis
- 2nd Propaedeutic Department of Internal Medicine, ATTIKON University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Zoi Sotiropoulou
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Konstantinos Loverdos
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonia Koutsoukou
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - George Dimopoulos
- ICU, 1st Department of Pulmonary Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
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Yu W, Zhang F, Liu B, Wang J, Shao X, Yang MF, Yang X, Wu Z, Li S, Shi Y, Wang B, Xu Y, Wang Y. Incremental value of epicardial fat volume to coronary artery calcium score and traditional risk factors for predicting myocardial ischemia in patients with suspected coronary artery disease. J Nucl Cardiol 2022; 29:1583-1592. [PMID: 33608856 DOI: 10.1007/s12350-021-02538-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Epicardial fat volume (EFV) has been reported to be associated with coronary artery disease (CAD). CAD is the leading cause of myocardial ischemia and myocardial ischemia is closely related to major adverse cardiovascular events. We hypothesized that EFV could provide incremental value to traditional risk factors and coronary artery calcium score (CACS) in predicting myocardial ischemia in Chinese patients with suspected CAD. METHODS We retrospectively studied 204 Chinese patients with suspected CAD who underwent single-photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) combined with computed tomography (CT). Pericardial contours were manually defined, and EFV was automatically calculated. A reversible perfusion defect with summed difference score (SDS) ≥ 2 was defined as myocardial ischemia. RESULTS The myocardial ischemia group had higher EFV than normal MPI group (137.80 ± 34.95cm3 vs. 106.63 ± 29.10 cm3, P < .001). In multivariable logistic regression analysis, high EFV was significantly associated with myocardial ischemia [odds ratio (OR): 8.30, 95% CI: 3.72-18.49, P < .001]. Addition of EFV to CACS and traditional risk factors could predict myocardial ischemia more effectively, with larger AUC .82 (P < .001), positive net reclassification index .14 (P = .04) and integrated discrimination improvement .14 (P < .001). The bootstrap resampling method (times = 500) was used to internally validation and calculate the 95% confidence interval (CI) of the AUC (95% CI .75-.87). The calibration curve for the probability of myocardial ischemia demonstrated good agreement between prediction and observation. CONCLUSIONS In Chinese patients with suspected CAD, EFV was significantly associated with myocardial ischemia, and improved prediction of myocardial ischemia above traditional risk factors and CACS.
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Affiliation(s)
- Wenji Yu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Feifei Zhang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Bao Liu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Jianfeng Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Xiaoliang Shao
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Min-Fu Yang
- Department of Nuclear Medicine, Affiliated Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Xiaoyu Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
| | - Zhifang Wu
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Sijin Li
- Department of Nuclear Medicine, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yunmei Shi
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Bing Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Yiduo Xu
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China
| | - Yuetao Wang
- Department of Nuclear Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu Province, China.
- Changzhou Key Laboratory of Molecular Image, Changzhou, Jiangsu Province, China.
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30
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Al Rifai M, Ahmed AI, Al-Mallah MH. Evaluating coronary atherosclerosis progression among South Asians. Atherosclerosis 2022; 353:30-32. [PMID: 35753821 DOI: 10.1016/j.atherosclerosis.2022.06.1016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Mahmoud Al Rifai
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
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31
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Leite-Gomes E, Dias AM, Azevedo CM, Santos-Pereira B, Magalhães M, Garrido M, Amorim R, Lago P, Marcos-Pinto R, Pinho SS. Bringing to Light the Risk of Colorectal Cancer in Inflammatory Bowel Disease: Mucosal Glycosylation as a Key Player. Inflamm Bowel Dis 2022; 28:947-962. [PMID: 34849933 DOI: 10.1093/ibd/izab291] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 02/06/2023]
Abstract
Colitis-associated cancer is a major complication of inflammatory bowel disease remaining an important clinical challenge in terms of diagnosis, screening, and prognosis. Inflammation is a driving factor both in inflammatory bowel disease and cancer, but the mechanism underlying the transition from colon inflammation to cancer remains to be defined. Dysregulation of mucosal glycosylation has been described as a key regulatory mechanism associated both with colon inflammation and colorectal cancer development. In this review, we discuss the major molecular mechanisms of colitis-associated cancer pathogenesis, highlighting the role of glycans expressed at gut epithelial cells, at lamina propria T cells, and in serum proteins in the regulation of intestinal inflammation and its progression to colon cancer, further discussing its potential clinical and therapeutic applications.
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Affiliation(s)
- Eduarda Leite-Gomes
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Ana M Dias
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Catarina M Azevedo
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Beatriz Santos-Pereira
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Mariana Magalhães
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.,Department of Gastroenterology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Mónica Garrido
- Department of Gastroenterology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Rita Amorim
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.,Pediatrics Department, Centro Hospitalar e Universitário São João, Porto, Portugal.,Medical Faculty, University of Porto, Porto, Portugal
| | - Paula Lago
- Department of Gastroenterology, Centro Hospitalar e Universitário do Porto, Porto, Portugal
| | - Ricardo Marcos-Pinto
- Department of Gastroenterology, Centro Hospitalar e Universitário do Porto, Porto, Portugal.,School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.,Centre for Research in Health Technologies and Information Systems, University of Porto, Portugal
| | - Salomé S Pinho
- i3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.,School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal.,Medical Faculty, University of Porto, Porto, Portugal
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32
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Titcombe P, Murray R, Hewitt M, Antoun E, Cooper C, Inskip HM, Holbrook JD, Godfrey KM, Lillycrop K, Hanson M, Barton SJ. Human non-CpG methylation patterns display both tissue-specific and inter-individual differences suggestive of underlying function. Epigenetics 2022; 17:653-664. [PMID: 34461806 PMCID: PMC9235887 DOI: 10.1080/15592294.2021.1950990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/25/2021] [Accepted: 06/29/2021] [Indexed: 12/29/2022] Open
Abstract
DNA methylation (DNAm) in mammals is mostly examined within the context of CpG dinucleotides. Non-CpG DNAm is also widespread across the human genome, but the functional relevance, tissue-specific disposition, and inter-individual variability has not been widely studied. Our aim was to examine non-CpG DNAm in the wider methylome across multiple tissues from the same individuals to better understand non-CpG DNAm distribution within different tissues and individuals and in relation to known genomic regulatory features.DNA methylation in umbilical cord and cord blood at birth, and peripheral venous blood at age 12-13 y from 20 individuals from the Southampton Women's Survey cohort was assessed by Agilent SureSelect methyl-seq. Hierarchical cluster analysis (HCA) was performed on CpG and non-CpG sites and stratified by specific cytosine environment. Analysis of tissue and inter-individual variation was then conducted in a second dataset of 12 samples: eight muscle tissues, and four aliquots of cord blood pooled from two individuals.HCA using methylated non-CpG sites showed different clustering patterns specific to the three base-pair triplicate (CNN) sequence. Analysis of CAC sites with non-zero methylation showed that samples clustered first by tissue type, then by individual (as observed for CpG methylation), while analysis using non-zero methylation at CAT sites showed samples grouped predominantly by individual. These clustering patterns were validated in an independent dataset using cord blood and muscle tissue.This research suggests that CAC methylation can have tissue-specific patterns, and that individual effects, either genetic or unmeasured environmental factors, can influence CAT methylation.
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Affiliation(s)
- Philip Titcombe
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Robert Murray
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Matthew Hewitt
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Elie Antoun
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
- Centre for Biological Sciences, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Joanna D Holbrook
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Karen Lillycrop
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
- Centre for Biological Sciences, University of Southampton, Southampton, UK
| | - Mark Hanson
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sheila J Barton
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
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Zhang N, Jia X, Fan S, Wu B, Wang S, OuYang B. NMR Characterization of Long-Chain Fatty Acylcarnitine Binding to the Mitochondrial Carnitine/Acylcarnitine Carrier. Int J Mol Sci 2022; 23:ijms23094608. [PMID: 35563000 PMCID: PMC9103206 DOI: 10.3390/ijms23094608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023] Open
Abstract
The mitochondrial carnitine/acylcarnitine carrier (CAC) transports short-, medium- and long-carbon chain acylcarnitines across the mitochondrial inner membrane in exchange for carnitine. How CAC recognizes the substrates with various fatty acyl groups, especially long-chain fatty acyl groups, remains unclear. Here, using nuclear magnetic resonance (NMR) technology, we have shown that the CAC protein reconstituted into a micelle system exhibits a typical six transmembrane structure of the mitochondrial carrier family. The chemical shift perturbation patterns of different fatty acylcarnitines suggested that the segment A76–G81 in CAC specifically responds to the long-chain fatty acylcarnitine. Molecular dynamics (MD) simulations of palmitoyl-L-carnitine inside the CAC channel showed the respective interaction and motion of the long-chain acylcarnitine in CAC at the cytosol-open state and matrix-open state. Our data provided a molecular-based understanding of CAC structure and transport mechanism.
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Affiliation(s)
- Ningning Zhang
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China;
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaopu Jia
- School of Pharmacy, Tianjin Medical University, Tianjin 300070, China; (X.J.); (S.F.)
| | - Shuai Fan
- School of Pharmacy, Tianjin Medical University, Tianjin 300070, China; (X.J.); (S.F.)
| | - Bin Wu
- National Facility for Protein Science in Shanghai, ZhangJiang Laboratory, Shanghai Advanced Research Institute, Chinese Academy of Sciences, Shanghai 201203, China;
| | - Shuqing Wang
- School of Pharmacy, Tianjin Medical University, Tianjin 300070, China; (X.J.); (S.F.)
- Correspondence: (S.W.); (B.O.); Tel.: +86-021-54920143 (B.O.)
| | - Bo OuYang
- State Key Laboratory of Molecular Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai 200031, China;
- University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: (S.W.); (B.O.); Tel.: +86-021-54920143 (B.O.)
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34
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Nagao-Kitamoto H, Kitamoto S, Kamada N. Inflammatory bowel disease and carcinogenesis. Cancer Metastasis Rev 2022; 41:301-316. [PMID: 35416564 DOI: 10.1007/s10555-022-10028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/27/2022] [Indexed: 11/24/2022]
Abstract
Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer mortality worldwide. Colitis-associated colorectal cancer (CAC) is a subtype of CRC associated with inflammatory bowel disease (IBD). It is well known that individuals with IBD have a 2-3 times higher risk of developing CRC than those who do not, rendering CAC a major cause of death in this group. Although the etiology and pathogenesis of CAC are incompletely understood, animal models of chronic inflammation and human cohort data indicate that changes in the intestinal environment, including host response dysregulation and gut microbiota perturbations, may contribute to the development of CAC. Genomic alterations are a hallmark of CAC, with patterns that are distinct from those in sporadic CRC. The discovery of the biological changes that underlie the development of CAC is ongoing; however, current data suggest that chronic inflammation in IBD increases the risk of developing CAC. Therefore, a deeper understanding of the precise mechanisms by which inflammation triggers genetic alterations and disrupts intestinal homeostasis may provide insight into novel therapeutic strategies for the prevention of CAC.
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Affiliation(s)
- Hiroko Nagao-Kitamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA. .,WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan.
| | - Sho Kitamoto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA.,WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan
| | - Nobuhiko Kamada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA. .,WPI Immunology Frontier Research Center, Osaka University, Suita, Osaka, Japan.
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Rovina N, Koukaki E, Romanou V, Ampelioti S, Loverdos K, Chantziara V, Koutsoukou A, Dimopoulos G. Fungal Infections in Critically Ill COVID-19 Patients: Inevitabile Malum. J Clin Med 2022; 11:jcm11072017. [PMID: 35407625 PMCID: PMC8999371 DOI: 10.3390/jcm11072017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with severe COVID-19 belong to a population at high risk of invasive fungal infections (IFIs), with a reported incidence of IFIs in critically ill COVID-19 patients ranging between 5% and 26.7%. Common factors in these patients, such as multiple organ failure, immunomodulating/immunocompromising treatments, the longer time on mechanical ventilation, renal replacement therapy or extracorporeal membrane oxygenation, make them vulnerable candidates for fungal infections. In addition to that, SARS-CoV2 itself is associated with significant dysfunction in the patient’s immune system involving both innate and acquired immunity, with reduction in both CD4+ T and CD8+ T lymphocyte counts and cytokine storm. The emerging question is whether SARS-CoV-2 inherently predisposes critically ill patients to fungal infections or the immunosuppressive therapy constitutes the igniting factor for invasive mycoses. To approach the dilemma, one must consider the unique pathogenicity of SARS-CoV-2 with the deranged immune response it provokes, review the well-known effects of immunosuppressants and finally refer to current literature to probe possible causal relationships, synergistic effects or independent risk factors. In this review, we aimed to identify the prevalence, risk factors and mortality associated with IFIs in mechanically ventilated patients with COVID-19.
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Virani SS, Al Rifai M. The Utility of Coronary Artery Calcium for Guiding Treatment With Preventive Pharmacotherapy: Opportunities and Nuances. JACC Cardiovasc Imaging 2022; 15:652-4. [PMID: 35393067 DOI: 10.1016/j.jcmg.2021.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022]
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Mortensen MB. Coronary Artery Calcium in Acute Chest Pain Patients: Valuable in the High-Sensitivity Troponin Era. JACC Cardiovasc Imaging 2022; 15:281-283. [PMID: 35144765 DOI: 10.1016/j.jcmg.2021.11.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022]
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Lantz R, Young S, Lubov J, Ahmed A, Markert R, Sadhu S. Self- vs provider-referral differences for coronary artery calcium testing. Am Heart J Plus 2022; 13:100088. [PMID: 38560077 PMCID: PMC10978187 DOI: 10.1016/j.ahjo.2022.100088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/21/2021] [Accepted: 01/07/2022] [Indexed: 04/04/2024]
Abstract
Study objectives The objectives of this study were to identify independent predictors for moderate/accentuated coronary artery calcium (CAC) score and compare patients who self-referred for CAC Computed Tomography (CT) testing to those who were provider-referred. Design Patients underwent CAC between January to July 2019. The analysis was divided into self-referred patients influenced by a CAC community campaign who identified themselves as having cardiovascular risk factors compared to provider-referred intermediate-risk patients who were asymptomatic. SAS version 9.4 (SAS Institute, Inc., Cary, NC) was used for all analyses. Setting Seven southwest Ohio hospitals from a single network. Participants 2124 adult patients who received CAC CT (163 self and 1961 provider-referred). Interventions CAC CT. Main outcome measures Demographics, risk factors, lab values, prescriptions, and referral status were used to compare CAC score differences between self- and provider-referred patients. Results For 2124 patients, three predictors for moderate/accentuated CAC score remained significant after multiple logistic regression: CKD (OR 0.24, CI 0.008-0.68, p < 0.05), COPD (OR 0.39, CI 0.19-0.80, p < 0.05), and CAD (OR 0.46, CI 0.22-0.98, p < 0.05). There were four differences between referred groups: history of PVD (OR 0.21, CI 0.05-0.86, p < 0.05), higher triglyceride (OR 1.004, CI 1.00-1.01, p < 0.05), higher LDL levels (OR 0.991, CI 0.98-1.00, p < 0.05), and beta blocker prescription (OR 4.38, CI 1.49-12.85, p < 0.05) in self-referred patients. Conclusions CAC CT testing is associated with independent risk predictors and can be used to clarify cardiovascular risk in self- and provider-referred patients with statistical similarity. Patients reliably self-refer for CAC CT when risk is present during a community initiative. Such initiatives may have a preventive benefit and lead to earlier pursuit and optimization of anti-lipid therapies.
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Affiliation(s)
- Rebekah Lantz
- Wright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of America
| | - Steve Young
- Wright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of America
| | - Janet Lubov
- Wright State University Boonshoft School of Medicine, Fairborn, OH 45324, United States of America
| | - Anas Ahmed
- Wright State University Boonshoft School of Medicine, Internal Medicine Residency, Dayton, OH 45409, United States of America
| | - Ronald Markert
- Wright State University Boonshoft School of Medicine, Department of Internal Medicine and Neurology, Fairborn, OH 45324, United States of America
| | - Srikanth Sadhu
- Premier Cardiovascular Institute, Interventional Cardiology, Premier Health, Dayton, OH 45409, United States of America
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Zhang MM, Yin DK, Rui XL, Shao FP, Li JC, Xu L, Yang Y. Protective effect of Pai-Nong-San against AOM/DSS-induced CAC in mice through inhibiting the Wnt signaling pathway. Chin J Nat Med 2021; 19:912-920. [PMID: 34961589 DOI: 10.1016/s1875-5364(22)60143-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Indexed: 02/06/2023]
Abstract
Pai-Nong-San (PNS), a prescription of traditional Chinese medicine, has been used for years to treat abscessation-induced diseases including colitis and colorectal cancer. This study was aimed to investigate the preventive effects and possible protective mechanism of PNS on a colitis-associated colorectal cancer (CAC) mouse model induced by azoxymethane (AOM)/dextran sodium sulfate (DSS). The macroscopic and histopathologic examinations of colon injury and DAI score were observed. The inflammatory indicators of intestinal immunity were determined by immunohistochemistry and immunofluorescence. The high throughput 16S rRNA sequence of gut microbiota in the feces of mice was performed. Western blot was used to investigate the protein expression of the Wnt signaling pathway in colon tissues. PNS improved colon injury, as manifested by the alleviation of hematochezia, decreased DAI score, increased colon length, and reversal of pathological changes. PNS treatment protected against AOM/DSS-induced colon inflammation by regulating the expression of CD4+ and CD8+ T cells, inhibiting the production of HIF-α, IL-6, and TNF-α, and promoting the expression of IL-4 and IFN-γ in colon tissues. Meanwhile, PNS improved the components of gut microbiota, as measured by the adjusted levels of Firmicutes, Bacteroidetes, Proteobacteria, and Lactobacillus. PNS down-regulated the protein expression of p-GSK-3β, β-catenin, and c-Myc, while up-regulating the GSK-3β and p-β-catenin in colon tissues of CAC mice. In conclusion, our results suggested that PNS exhibits protective effect on AOM/DSS-induced colon injury and alleviates the development of CAC through suppressing inflammation, improving gut microbiota, and inhibiting the Wnt signaling pathway.
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Affiliation(s)
- Meng-Meng Zhang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Deng-Ke Yin
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China; Anhui Provincial Key Laboratory for Chinese Medicinal Formula, Hefei 230031, China; Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei 230021, China; Anhui Provincial Key Laboratory of Research & Development of Chinese Medicine, Hefei 230021, China.
| | - Xue-Lin Rui
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Fu-Ping Shao
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Jia-Cheng Li
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Li Xu
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China
| | - Ye Yang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei 230031, China; Institute of Pharmaceutics, Anhui Academy of Chinese Medicine, Hefei 230021, China; Anhui Provincial Key Laboratory of Research & Development of Chinese Medicine, Hefei 230021, China.
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Popov J, Caputi V, Nandeesha N, Rodriguez DA, Pai N. Microbiota-Immune Interactions in Ulcerative Colitis and Colitis Associated Cancer and Emerging Microbiota-Based Therapies. Int J Mol Sci 2021; 22:11365. [PMID: 34768795 PMCID: PMC8584103 DOI: 10.3390/ijms222111365] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 02/07/2023] Open
Abstract
Ulcerative colitis (UC) is a chronic autoimmune disorder affecting the colonic mucosa. UC is a subtype of inflammatory bowel disease along with Crohn's disease and presents with varying extraintestinal manifestations. No single etiology for UC has been found, but a combination of genetic and environmental factors is suspected. Research has focused on the role of intestinal dysbiosis in the pathogenesis of UC, including the effects of dysbiosis on the integrity of the colonic mucosal barrier, priming and regulation of the host immune system, chronic inflammation, and progression to tumorigenesis. Characterization of key microbial taxa and their implications in the pathogenesis of UC and colitis-associated cancer (CAC) may present opportunities for modulating intestinal inflammation through microbial-targeted therapies. In this review, we discuss the microbiota-immune crosstalk in UC and CAC, as well as the evolution of microbiota-based therapies.
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Affiliation(s)
- Jelena Popov
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada;
- College of Medicine and Health, University College Cork, T12 XF62 Cork, Ireland
| | - Valentina Caputi
- Department of Poultry Science, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Nandini Nandeesha
- School of Medicine, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland;
| | | | - Nikhil Pai
- Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada;
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON L8S 4L8, Canada
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Saeseow S, Vantanasiri K, Suvikapakornkul R, Sukarayothin T, Apirakkittikul N, Disthabanchong S. Parathyroidectomy is associated with slow progression of vascular calcification in maintenance haemodialysis patients: A propensity score-matched case-control study. Nephrology (Carlton) 2021; 27:355-362. [PMID: 34651396 DOI: 10.1111/nep.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/18/2021] [Accepted: 10/11/2021] [Indexed: 11/26/2022]
Abstract
Parathyroidectomy has been the mainstay of treatment of severe hyperparathyroidism in patients with kidney failure until the introduction of calcimimetic. Several large observational studies demonstrated the improvement in patient outcomes after parathyroidectomy. The benefit of parathyroidectomy on vascular calcification remains largely unexplored. AIM To examine the association between parathyroidectomy and the progression of vascular calcification as well as overall survival in maintenance haemodialysis patients. METHOD This is a matched case-control study undertaken between 2012 and 2020. Patients who underwent parathyroidectomy were identified and matched 1:1 to non-parathyroidectomized (non-PTX) haemodialysis patients using propensity score matching method resulting in 120 patients in each arm. Aortic arch calcification (AoAC) score was determined annually in the posteroanterior chest x-ray. The average follow-up period was 38 months. RESULTS Baseline demographic, laboratory data and AoAC score were comparable among the two groups of patients. The prevalence of AoAC was 59% in the PTX group and 54% in the non-PTX group (p = .43). Progression of AoAC occurred in 33% in the PTX group and 47% in the non-PTX group (p = .04). Multivariate generalized linear model revealed parathyroidectomy as an independent protective factor [β (95% CI) -1.04 (-1.68, -0.41)] and increased serum calcium as a potentiating factor [β (95% CI) 0.62 (0.25, 0.1)] for progression of AoAC. Linear mixed models revealed an increase in AoAC score in both groups but between group comparisons indicated substantially slower progression in the PTX group. Rapid progression of AoAC was also observed more frequently among non-PTX patients. Death occurred in 7 and 16% in the PTX and non-PTX groups, respectively. Kaplan-Meier survival curve revealed better survival associated with parathyroidectomy (p = .01). More rapid progression of AoAC also correlated with worse survival. CONCLUSION Parathyroidectomy was associated with slow progression of vascular calcification in maintenance haemodialysis patients.
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Affiliation(s)
- Sarunya Saeseow
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | - Ronnarat Suvikapakornkul
- Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thongchai Sukarayothin
- Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Navarat Apirakkittikul
- Department of Otolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sinee Disthabanchong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Cuzzucoli Crucitti V, Contreas L, Taresco V, Howard SC, Dundas AA, Limo MJ, Nisisako T, Williams PM, Williams P, Alexander MR, Wildman RD, Muir BW, Irvine DJ. Generation and Characterization of a Library of Novel Biologically Active Functional Surfactants (Surfmers) Using Combined High-Throughput Methods. ACS Appl Mater Interfaces 2021; 13:43290-43300. [PMID: 34464079 DOI: 10.1021/acsami.1c08662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We report the first successful combination of three distinct high-throughput techniques to deliver the accelerated design, synthesis, and property screening of a library of novel, bio-instructive, polymeric, comb-graft surfactants. These three-dimensional, surface-active materials were successfully used to control the surface properties of particles by forming a unimolecular deep layer on the surface of the particles via microfluidic processing. This strategy deliberately utilizes the surfactant to both create the stable particles and deliver a desired cell-instructive behavior. Therefore, these specifically designed, highly functional surfactants are critical to promoting a desired cell response. This library contained surfactants constructed from 20 molecularly distinct (meth)acrylic monomers, which had been pre-identified by HT screening to exhibit specific, varied, and desirable bacterial biofilm inhibitory responses. The surfactant's self-assembly properties in water were assessed by developing a novel, fully automated, HT method to determine the critical aggregation concentration. These values were used as the input data to a computational-based evaluation of the key molecular descriptors that dictated aggregation behavior. Thus, this combination of HT techniques facilitated the rapid design, generation, and evaluation of further novel, highly functional, cell-instructive surfaces by application of designed surfactants possessing complex molecular architectures.
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Affiliation(s)
- Valentina Cuzzucoli Crucitti
- Centre for Additive Manufacturing and Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD U.K
| | - Leonardo Contreas
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD U.K
| | - Vincenzo Taresco
- School of Chemistry, University of Nottingham, Nottingham, NG7 2RD U.K
| | | | - Adam A Dundas
- Centre for Additive Manufacturing and Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD U.K
| | - Marion J Limo
- Interface and Surface Analysis Centre, University of Nottingham, Nottingham, NG7 2RD U.K
| | - Takasi Nisisako
- Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, Kanagawa 226-8503, Japan
| | - Philip M Williams
- School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD U.K
| | - Paul Williams
- Biodiscovery Institute, National Biofilms Innovation Centre and School of Life Sciences, University of Nottingham, Nottingham, NG7 2RD U.K
| | | | - Ricky D Wildman
- Centre for Additive Manufacturing and Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD U.K
| | | | - Derek J Irvine
- Centre for Additive Manufacturing and Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham, Nottingham, NG7 2RD U.K
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Fonseca MIH, Almeida-Pititto BD, Bittencourt MS, Bensenor IM, Lotufo PA, Ferreira SRG. Menopause Per se Is Associated with Coronary Artery Calcium Score: Results from the ELSA-Brasil. J Womens Health (Larchmt) 2021; 31:23-30. [PMID: 34520264 DOI: 10.1089/jwh.2021.0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background: Menopause and aging deteriorate the metabolic profile, but little is known about how they independently contribute to structural changes in coronary arteries. We compared a broad cardiometabolic risk profile of women according to their menopausal status and investigated if menopause per se is associated with presence of coronary artery calcium (CAC) in the ELSA-Brasil. Materials and Methods: All participants, except perimenopausal women, who had menopause <40 years or from non-natural causes or reported use of hormone therapy were included. Sample was stratified according to menopause and age categories (premenopause ≤45 years, premenopause >45 years, and postmenopause); their clinical profile and computed tomography-determined CAC were compared using Kruskal-Wallis and chi squared test for frequencies. Associations of CAC (binary variable) with menopause categories adjusted for traditional and nontraditional covariables were tested using logistic regression. Results: From 2,047 participants 51 ± 9 years of age, 1,175 were premenopausal (702 ≤ 45 years) and 872 were postmenopausal women. Mean values of anthropometric variables, blood pressure, lipid and glucose parameters, branched-chain amino acids (BCAA), and homeosthasis model assessment (HOMA-IR), as well as frequencies of morbidities, were more favorable in premenopausal, particularly in younger ones. In crude analyses, CAC >0 was associated with triglyceride-rich lipoprotein remnants, dense low-density lipoprotein, BCAA, and other variables, but not with HOMA-IR. Menopause was independently associated with CAC >0 (odds ratios 2.37 [95% confidence interval 1.17-4.81]) when compared to the younger premenopausal group. Conclusion: Associations of menopause with CAC, independent of traditional and nontraditional cardiovascular risk factors, suggest that hormonal decline per se may contribute to calcium deposition in coronary arteries.
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Affiliation(s)
- Marília I H Fonseca
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Bianca de Almeida-Pititto
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Department of Preventive Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Márcio S Bittencourt
- Internal Medicine Department, University of Sao Paulo, Sao Paulo, Brazil.,Faculdade Israelita de Ciencias da Saude Albert Einstein, Sao Paulo, Brazil
| | - Isabela M Bensenor
- Internal Medicine Department, University of Sao Paulo, Sao Paulo, Brazil
| | - Paulo A Lotufo
- Internal Medicine Department, University of Sao Paulo, Sao Paulo, Brazil
| | - Sandra R G Ferreira
- Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
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Pluta J, Pihowicz A, Horban A, Trzebicki J. DIC, SIC or CAC - the haemostatic profile in COVID-19 patients hospitalised in the intensive care unit: a single-centre retrospective analysis. Anaesthesiol Intensive Ther 2021; 53:108-14. [PMID: 34284551 DOI: 10.5114/ait.2021.106691] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Infection with SARS-CoV-2 in its most severe form leads to acute respiratory distress syndrome requiring mechanical ventilation under the conditions of the Intensive Care Unit (ICU). The state of hypercoagulation described in COVID-19 may deepen respiratory failure, leading to increased mortality. The aim of the presented study is to characterise the haemostatic profile based on the results of clotting system parameters and risk assessment of thromboembolic complications of patients hospitalised in the ICU. MATERIAL AND METHODS This retrospective study covered the first 10 adult patients hospitalised in the ICU of the Hospital for Infectious Diseases in Warsaw in the second quarter of 2020. Demographic, clinical and laboratory parameters of the coagulation system and the risk of thromboembolic complications were assessed. Well known criteria of haemostatic disorders were used to classify the observed derangements. RESULTS The most frequently observed deviations in the coagulation system were high concentrations of D-dimer and fibrinogen. In select cases the clotting time was prolonged. No severe thrombocytopenia was observed. All patients presented a high risk of thromboembolic complications as assesed by the Padua score. The observed clotting abnormalities did not meet the criteria for DIC (disseminated intravascular coagulation) and SIC (sepsis-induced coagulopathy) diagnosis. CONCLUSIONS The main elements of coagulopathy that were observed in our cases differ from those usually seen in patients with recognised sepsis. The unique haemostatic profile of COVID-19 patients treated in the ICU has been described as CAC (COVID-19-associated coagulopathy).
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Pluta J, Cieniewicz A, Trzebicki J. COVID-19: coagulation disorders and anticoagulant treatment in patients hospitalised in ICU. Anaesthesiol Intensive Ther 2021; 53:153-61. [PMID: 34006056 DOI: 10.5114/ait.2021.105783] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patients hospitalized in the intensive care unit (ICU) due to the COVID-19 experience a high incidence (up to 43%) of venous thromboembolic events. While laboratory findings in COVID-19-associated coagulopathy (CAC) show increased D-dimer and fibrinogen levels, the abnormalities in standard coagulation tests and platelet count are minimal. Recent studies suggest contribution of fibrinolysis shutdown to this phenomenon. Endothelial injury and alteration of its antithrombotic activity can lead to micro- and macrovascular thrombosis in the lungs, occurrence of which is associated with poor clinical outcome in critically ill patients with COVID-19. Additionally, the hypercoagulability induced by activation of coagulation pathways during the immune response to SARS-CoV-2 infection contributes to impaired organ perfusion. This, alongside with hypoxemia, leads to multiorgan failure. Various diagnostic regimens, some of which include global assays of haemostasis, are currently being published and discussed. Numerous guidelines and recommendations of scientific societies and groups of specialists have been published. However, there is no single optimal algorithm for anticoagulation treatment and monitoring specific to the ICU patients with COVID-19. The authors have attempted to summarize the data related to CAC and thrombotic disease and develop an algorithm consistent with the latest clinical practice guideline recommendations.
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Azour L, Steinberger S, Toussie D, Titano R, Kukar N, Babb J, Jacobi A. Influence of coronary dominance on coronary artery calcification burden. Clin Imaging 2021; 77:283-6. [PMID: 34171741 DOI: 10.1016/j.clinimag.2021.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/29/2021] [Accepted: 06/06/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the influence of coronary artery dominance on observed coronary artery calcification burden in outpatients presenting for coronary computed tomography angiography (CCTA). METHODS A 12-month retrospective review was performed of all CCTAs at a single institution. Coronary arterial dominance, Agatston score and presence or absence of cardiovascular risk factors including hypertension (HTN), hyperlipidemia (HLD), diabetes and smoking were recorded. Dominance groups were compared in terms of calcium score adjusted for covariates using analysis of covariance based on ranks. Only covariates observed to be significant independent predictors of the relevant outcome were included in each analysis. All statistical tests were conducted at the two-sided 5% significance level. RESULTS 1223 individuals, 618 women and 605 men were included, mean age 60 years (24-93 years). Right coronary dominance was observed in 91.7% (n = 1109), left dominance in 8% (n = 98), and codominance in 1.3% (n = 16). The distribution of patients among Agatston score severity categories significantly differed between codominant and left (p = 0.008), and codominant and right (p = 0.022) groups, with higher prevalence of either zero or severe CAC in the codominant patients. There was no significant difference in Agatston score between dominance groups. In the subset of individuals with coronary artery calcification, Agatston score was significantly higher in codominant versus left dominant patients (mean Agatston score 595 ± 520 vs. mean 289 ± 607, respectively; p = 0.049), with a trend towards higher scores in comparison to the right-dominant group (p = 0.093). Significance was not maintained upon adjustment for covariates. CONCLUSIONS While the distribution of Agatston score severity categories differed in codominant versus right- or left-dominant patients, there was no significant difference in Agatston score based on coronary dominance pattern in our cohort. Reporting and inclusion of codominant subsets in larger investigations may elucidate whether codominant anatomy is associated with differing risk.
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Qiu X, Zhang H, Zhao Y, Zhao J, Wan Y, Li D, Yao Z, Lin D. Application of circulating genetically abnormal cells in the diagnosis of early-stage lung cancer. J Cancer Res Clin Oncol 2021. [PMID: 33893839 DOI: 10.1007/s00432-021-03648-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/19/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Lung cancer is the leading cause of cancer-related death worldwide. The early detection of lung cancer is crucial for the diagnosis of this disease. Therefore, an effective and noninvasive method for the early diagnosis of lung cancer is urgently needed. METHODS To evaluate the diagnostic performance of circulating genetically abnormal cells (CACs) in early lung cancer, a total of 63 participants who completed CAC detection by Zhuhai SanMed Biotech Inc. and obtained pathological results from January to December 2020 were included in our study; 50 patients had lung cancer and 13 patients had benign lung disease. The levels of lung cancer-related markers in peripheral blood and the chest computed tomography (CT) imaging characteristics of these patients were collected before pathological acquisition. RESULTS The positive rate of CAC was 90.0% in the lung cancer group and 23.1% in the benign lung disease group, and the difference was statistically significant (P < 0.01). The area under the receiver operating characteristic (ROC) curve of CAC was 0.837, the sensitivity was 90%, and the specificity was 76.9%. The area under the ROC curve and sensitivity were both higher than those of the combined or single serum tumor marker test. CONCLUSIONS This study preliminarily concludes that the CAC test, as a noninvasive test, has high sensitivity and specificity for the early diagnosis of lung cancer. This test is expected to help with the early detection of disease in lung cancer patients.
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Li J, Qu C, Li F, Chen Y, Zheng J, Xiao Y, Jin Q, Jin G, Huang X, Jin D. Inonotus obliquus Polysaccharide Ameliorates Azoxymethane/Dextran Sulfate Sodium-Induced Colitis-Associated Cancer in Mice via Activation of the NLRP3 Inflammasome. Front Pharmacol 2021; 11:621835. [PMID: 33603669 PMCID: PMC7884887 DOI: 10.3389/fphar.2020.621835] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/30/2020] [Indexed: 12/19/2022] Open
Abstract
Inonotus obliquus polysaccharide (IOP), the primary constituent of the parasitic fungus Inonotus obliquus, has anti-tumor, anti-inflammatory, anti-oxidation effects. However, the roles of IOP on colitis-associated cancer (CAC) are still unclear. Herein, we tested the efficacy of IOP using a mouse model of CAC induced by azoxymethane and dextran sulfate sodium (AOM/DSS). We confirmed that intragastric administration of IOP decreased CAC-induced body weight loss, colon tissue damage, colon shortening, and expression of proinflammatory mediators. Meanwhile, IOP treatment increased in expression of the NLRP3 inflammasome, IL-1β, and IL-18 in the colon of CAC mice. Moreover, in vitro, IOP inhibited the proliferation of SW620 colorectal cancer cells. Finally, overexpression of NLRP3 with plasmid transfection could further enhance the activation of NLRP3 inflammasome by IOP. Taken together, these results suggest that IOP suppresses the development of CAC, possibly by activation of the NLRP3 inflammasome, and reveal that IOP may be a therapeutic drug candidate for CAC.
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Affiliation(s)
- Jiawei Li
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Chao Qu
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Fangfang Li
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Yifang Chen
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Jinjuan Zheng
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Yao Xiao
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Quanxin Jin
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Guihua Jin
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
| | - Xuezhu Huang
- Department of Anesthesiology, Affiliated Hospital of Yanbian University, Yanji, China
| | - Dan Jin
- Immunology and Pathogenic Biology Key Laboratory of Jilin Province, Yanbian University, Yanji, China
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Shahrokhi-Shahraki R, Benally C, El-Din MG, Park J. High efficiency removal of heavy metals using tire-derived activated carbon vs commercial activated carbon: Insights into the adsorption mechanisms. Chemosphere 2021; 264:128455. [PMID: 33032208 DOI: 10.1016/j.chemosphere.2020.128455] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
In this study, activated carbon was derived from pulverized waste tires using carbonization and chemical activation techniques. Single and competitive batch adsorption experiments for the removal of three synthetic heavy metal ions (Pb2+, Cu2+ and Zn2+) from an aqueous solution were performed to benchmark the efficiency of the Tire-derived Activated Carbon (TAC) in comparison to that of commercial activated carbon (CAC), which was used as the reference material. The sorbents physicochemical properties with corresponding adsorption mechanisms were evaluated by different experimental techniques. TAC exhibited great potential to adsorb heavy metals, with monolayer adsorption capacities as high as 322.5, 185.2, and 71.9 mg g-1 for Pb2+, Cu2+ and Zn2+, respectively, which were significantly higher than the adsorption capacities exhibited by CAC, which were 42.5, 15.0, and 14.0 mg∙g-1 for Pb2+, Cu2+ and Zn2+, respectively. Competitive adsorption results demonstrated the adsorption ability of sorbents is restricted by presence of other ions, and was decreased compared to the single sorption. Sorption kinetics data, with better fit to the pseudo-second order kinetics model, revealed that TAC had faster sorption rate in comparison to CAC. The adsorption capacities of TAC and CAC were reduced to half of their initial capacities after three successive adsorption-desorption cycles. Zeta potential, FT-IR, and XPS analyses revealed that electrostatic attraction and surface complexation mechanisms, as two metal-adsorbing mechanisms, were more influential for TAC. For CAC, a higher cation exchange capacity (CEC) value indicated that the removal of heavy metals by ion exchange was the predominant mechanism.
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Affiliation(s)
- Rahim Shahrokhi-Shahraki
- Department of Civil and Environmental Engineering, Seoul National University, Seoul, South Korea.
| | - Chelsea Benally
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Mohamed Gamal El-Din
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, Alberta, Canada.
| | - Junboum Park
- Department of Civil and Environmental Engineering, Seoul National University, Seoul, South Korea.
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Jin H, Ji JJ, Zhu Y, Wang XD, Li YP, Shi QY, Chen YF. Brain-Derived Neurotrophic Factor, a New Predictor of Coronary Artery Calcification. Clin Appl Thromb Hemost 2021; 27:1076029621989813. [PMID: 33523719 PMCID: PMC7863173 DOI: 10.1177/1076029621989813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 12/26/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022] Open
Abstract
Brain-derived neurotrophic factor (BDNF) plays a functional role in vascular endothelium homeostasis and the alleviation of atherosclerosis. Matrix gla protein (MGP) and Nε-(1-carboxymethyl)-l-lysine (CML) are both confirmed to be VC predictors. This study investigated the association between BDNF, MGP, CML and coronary artery calcification (CAC). Plasma BDNF, MGP, and CML levels were measured in 274 patients who underwent computed tomography to determine the CAC score (Agatston score). It was found that patients with CAC exhibited lower BDNF and MGP and higher CML levels than those without CAC. Plasma BDNF levels in patients with diabetes or hypertension were lower compared with the control groups. In logistic regression analysis, age, hypertension, BDNF, and MGP were independent predictors of CAC. Plasma BDNF and MGP levels were both correlated with the Agatston score even after adjustment for age, total cholesterol level, triglycerides, low-density lipoprotein level, creatinine clearance rate, and the presence of hypertension and diabetes mellitus. In 167 patients with CAC, circulating BDNF level was inversely associated with CML level and positively related to MGP level. In the receiver operating characteristic analysis for CAC, the areas under the curves for BDNF, MGP, and CML were 0.757, 0.777 and 0.653, respectively. In summary, plasma BDNF levels are associated with the Agatston score, and BDNF further predicts the occurrence of CAC.
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Affiliation(s)
- Hong Jin
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Jing-jing Ji
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yi Zhu
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Xiao-dong Wang
- Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, People’s Republic of China
| | - Yi-ping Li
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Qiu-yin Shi
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People’s Republic of China
| | - Yi-fei Chen
- Department of Cardiology, Xishan Hospital, Wuxi, People’s Republic of China
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