جستجوی مقالات مرتبط با کلیدواژه "cardiovascular" در نشریات گروه "پزشکی"

Patients with respiratory viral infections have altered immune responses, which may predispose them to cardiovascular complications. In the face of the pandemic of a new kind of severe acute respiratory syndrome (SARS), coronavirus disease 2019 (COVID-19), there is a resurgence of interest in the early diagnosis, prevention, and treatment of patients who are at risk. COVID-19 often manifests as viral pneumonia, although extrapulmonary manifestations are also common. Acute cardiac damage associated with elevated high-sensitivity troponin levels crucially contributes to mortality in severe COVID-19. The present review clinically compares cardiovascular complications between COVID-19 and other respiratory infections caused by single-stranded RNA viruses, namely influenza, SARS, and Middle East respiratory syndrome (MERS). Estimating the death rate from RVIs has been a subject of intense research, but the mortality from cardiovascular complications in these infections is less understood and calls for further research.

The rational use of drugs is a priority in health policy. Limited studies have been conducted about drug consumption in hospitals. Therefore, we evaluated the pattern of prescription and drug-drug interactions in cardiovascular and gastrointestinal wards. This retrospective study was conducted in a tertiary teaching hospital in Kerman. Data included demographic information and indicators such as type, category, and drug administration route. Diagnosis, outcome, and hospitalization days were other data extracted from the registered patients' information. An online interaction checker of Drug.com (IBM Micromedex) was used to detect drug interactions. Analysis was computed using SPSS V22. Our findings showed that 50.7% of the patients were male in the gastroenterology ward, and 49.3% were female. Patients aged 59±0.7 years and days of hospitalization ranged between 2 to 18 days. Proton pump inhibitors (PPIs) as pantoprazole (28.4%), antibiotics (23.3%) as ceftriaxone, metronidazole and anticoagulant (21.7%) as heparin were the most prescribed drug categories in gastroenterology ward. In the cardiovascular ward, 41.6% of the patients were male and 58.4% female, aged 57±1 years, and days of hospitalization ranged between 3 to 12 days. Anticoagulants/antiplatelets (29.1%), PPIs (13.8%), statins (11.9%), and beta blockers (10.7%) were the most prescribed drug categories in cardiovascular wards. No major drug interaction was seen in gastroenterology inpatients, but major interactions, mainly due to clopidogrel administration, were observed in 11% of cardiovascular ward inpatients. The pattern of drug prescription was based on diagnosis. No correlation was found between drug interaction with diagnosis, outcome, and sex in any of the departments, but a significant correlation was found between drug interaction with patients’ age. In conclusion, appropriate prescribing of drugs based on diagnosis was seen in both wards. The pattern of drug use was rational and comparable to similar documents. Also, lower potential drug interactions could be considered as a notable result.

The main aim of the study was to evaluate and compare the variability of the hepatic, renal and cardiovascular biomarkers in type 2 diabetes mellitus patients with poor glycemic control.

An analytical cross-sectional study utilizing random sampling technique was used to recruit 103 consenting participants at the Kakamega county general hospital. Approximately 6mls of blood sample was collected and processed for biomarkers of hepatic, renal and cardiovascular function using spectrophotometry and florescence-immuno detection. Data was analyzed using the IBM SPSS ver. 22 software. Chi-square and Fisher’s exact test were done on categorical variables and Kruskal-Wallis test on the continuous variables. A Bonferroni Post-hoc test was done to determine the differences between the groups.

The study revealed a significant hepatic biomarker variability in gamma glutamyl transferase (GGT) (P= 0.031), Total bilirubin (P< 0.0001), Direct bilirubin (P< 0.0001), albumin (P= 0.001) and Aspartate transaminase/alanine transaminase (AST/ALT) ratio (P< 0.0001). Renal biomarkers including Urea (P= 0.002), potassium (P= 0.0012), sodium (P< 0.0001) and chloride (0.007) showed a significant variability in poor glycemic control. Additionally, Triglycerides (P< 0.0001) and total cholesterol (P= 0.046) levels were significantly elevated in poor glycemic control.

Poor glycemic control causes elevation in GGT, AST/ALT ratio, potassium, triglycerides and total cholesterol while bilirubin, albumin, sodium and chloride are reduced.

The purpose of this study was to assess the risk factors and clinical characteristics of cardiovascular and cerebrovascular events in elderly hemodialysis patients.

Elderly patients undergoing hemodialysis (HD) at Deqing County People’s Hospital in Zhejiang, China, from May 2020 to May 2023 were enrolled in this study. They were divided into two groups depending on the occurrence of cardiovascular or cerebrovascular events: the case group and the control group.

A total of 106 patients were enrolled in this study. Among them, 49 patients experienced cardiovascular or cerebrovascular events, resulting in an incidence rate of 46.23%. According to whether cardiovascular or cerebrovascular events occurred, 57 patients were assigned to the control group, and 49 patients were assigned to the case group. Comparing the basic information and clinical indicators of the two groups, significant differences were observed in patients with hypertensive nephropathy and diabetic nephropathy (P < .05). There were also significant differences in dialysis duration, smoking history, systolic and diastolic blood pressures, uric acid, blood glucose, total cholesterol (TC), low-density lipoprotein cholesterol (TG), C-reactive protein (CRP), and PTH (parathyroid hormone) levels and platelet-to-lymphocyte ratio (PLR), between the two groups (P < .05). Multivariate logistic regression analysis revealed that longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH, and blood glucose levels, smoking history, elevated PLR, and CRP were independent risk factors for cardiovascular and cerebrovascular events. The ROC curve showed that these risk factors predicted cardiovascular and cerebrovascular events in patients.

Patients with underlying diseases such as hypertensive or diabetic nephropathy are more likely to experience cardiovascular and cerebrovascular events. Longer dialysis duration, higher systolic and diastolic blood pressures, elevated uric acid, TC, TG, LDL-C, PTH and blood glucose levels, and boosted inflammatory reaction are risk factors for these events among elderly HD patients. The purpose of this study is to provide practical guidelines for clinical treatment. Comprehensive measures such as active intervention of risk factors, rational drug use and regular examination should be taken to improve the overall health level to the greatest extent for elderly patients with high-risk HD.

The performance of hospitals has been affected by the COVID-19 pandemic. This study investigated the performance of a cardiovascular hospital using indicators such as admissions and revenue.

The medical records of patients with selected cardiovascular diseases were studied in a teaching cardiovascular hospital in the capital city of West Azerbaijan in the second quarter of 2019 and 2020. Data were collected from the medical records, including length of stay, hospitalization type, sex, age, insurance, deaths, and readmissions. Bills were collected from the revenue department and the hospital information system. Two performances, two results, and two control indicators were used. Revenue, length of stay, and bed occupancy rate were calculated for both periods. Data were analyzed using SPSS (version 16) and the Mann-Whitney statistical test.

One thousand three hundred and forty-one cases were studied in two study periods, with 57% being hospitalized in 2019, showing a decline of 14% in 2020. A decrease was observed in the average length of stay and total revenue during the pandemic. The difference in the mean total revenue was significant for 2 years (P = 0.00). The percentage of readmissions decreased slightly, and deaths increased in 2020.

The COVID-19 pandemic undermined hospital performance. The analysis of the studied indicators showed that hospitalizations, bed occupancy rates, and total revenue followed a similar decreasing pattern in the selected hospital during the COVID-19 pandemic. The hospital should adopt appropriate strategies so that, in conditions identical to the COVID-19 pandemic, its performance is accompanied by the proper management of resources, efficiency, and minimal reduction in revenue.

Cardiovascular diseases are among the most important causes of death worldwide. The present study aimed to evaluate the trend of changes in the death rate due to cardiovascular diseases, with an emphasis on short- and long-term effective variables.

In this descriptive-analytical (time series) study, all deaths due to cardiovascular diseases registered in the health registration system of death cases by the Health Vice-Chancellor of Urmia University of Medical Sciences from 2018 to 2021 were analyzed. A total of 27,146 cases of death due to cardiovascular causes were recorded and included in our study. SPSS, Minitab, and SAS software were utilized for data analysis.

The rate of death due to cardiovascular causes in this study was 30.51% during the investigated period. The univariate time series model (ARMA 1, 2) was deemed the most suitable fit model for cardiovascular death data. Also, age and education were identified as effective factors in the rate of cardiovascular deaths.

The trend of cardiovascular deaths has not been rising. It has increased with age and lower education levels over time. This rate has been further exacerbated during the COVID-19 pandemic.

With the increasing proportion of the elderly population, neurodegenerative diseases such as dementia are becoming more prevalent worldwide. Vascular risk factors are considered significant targets for cognitive decline prevention. We reviewed the effect of cardiovascular risk factors on cognitive decline prevention in the elderly to evaluate the quantity and quality of evidence in managing the elderly population with cognitive decline. Data analysis was available from 25 studies that explored the effects of controlling cardiovascular risk factors on the risk of cognitive impairment. These risk factors include diabetes mellitus, high blood pressure, high cholesterol levels, and exercise and physical activity. The most positive evidence was found for exercise and physical activity. On the other hand, diabetes mellitus and cholesterol modifications showed no positive impact on cognitive function. Studies on hypertension control were incongruous. There is a need for large-sample, robust randomized clinical trials to provide sufficient evidence for the modification of various cardiovascular risk factors in preventing cognitive decline.

Brisk walking exercise is an aerobic exercise with the moderate intensity that can reduce the risk in people with hypertension. This systematic review and meta-analysis aimed to investigate the effects of interventions related to brisk walking and blood pressure reduction in hypertensive patients.

Search strategy through the PubMed, Science Direct, ProQuest, and Google Scholar databases limited from 2018 to 2023. The components measured are systolic blood pressure and diastolic blood pressure. This study uses the Black and Downs checklist to measure the quality of the study, which consists of 3, namely high quality, medium quality, and low quality. Effect size analysis of the study used the standard mean difference between brisk walking exercise and not doing brisk walking exercise.

The results of the identification of the database obtained 1700 articles, then limited by title, year, abstract (n = 381), and full-text article feasibility (n = 76) to obtain nine articles included. Nine articles were included in the systematic review and meta-analysis by study quality: six studies of high quality, 2 of medium quality, and 1 of low quality. Systolic blood pressure had a substantial effect size in all studies (P<0.05; SMD: -0.55) while diastolic blood pressure had an effect medium size (P=0.05; SMD: 0.13).

Brisk walking exercise can significantly reduce blood pressure in people with hypertension—recommendations for the future to carry out community-based physical activity in improving physical health, including heart health.

 Laryngoscopy and tracheal intubation lead to an increased sympathetic reflex response, which is associated with increased heart rate and blood pressure. This response can be detrimental in patients with myocardial ischemia. This study aimed to investigate the effects of etomidate in comparison to a combination of midazolam and sodium thiopental in reducing the sympathetic response to laryngoscopy and tracheal intubation.

 This double-blind, randomized clinical trial study was conducted on two groups of 39 candidates for elective surgery under general anesthesia. Anesthesia was induced by etomidate (E) 0.3 mg/kg in the first group and sodium thiopental 2.5 mg/kg and midazolam 0.075 mg/kg in the second group (TM); then, the patients were intubated. Laryngoscopy findings and cardiovascular response were evaluated during the study. Finally, the data were analyzed using SPSS version 23 (IBM SPSS, Armonk, NY, USA).

 There was no significant difference between the two groups in terms of age (P = 0.82), weight (P = 0.42), height (P = 0.201), body mass index (P = 0.78), gender (P = 0.65), American Society of Anesthesiologists (ASA) physical status (P = 0.36), and laryngoscopy view grading (P = 0.83). The average laryngoscopy time in the E group was less than the TM group (P = 0.019). In the TM group, at 10 minutes after intubation, mean diastolic blood pressure (P = 0.029) and mean arterial blood pressure (P = 0.023) were significantly lower; however, at other times, there was no significant difference between the two groups (P > 0.05). There was no significant difference between the two groups in terms of adverse responses to laryngoscopy and intubation (P = 0.19).

 The results of the present study showed that etomidate (E) and a combination of midazolam-sodium thiopental (TM) acted similarly in attenuating the cardiovascular response to laryngoscopy and tracheal intubation, and it seems that TM can be used instead of E if needed.

It is now hypothesized that the Ambulatory Blood Pressure Measurement (ABPM) method in determining and controlling blood pressure and renal disease-related cardiac defects in children with renal impairment can be more applicable. We aimed to compare the mean blood pressure measured by the ABPM method with blood pressure measured by the auscultation method in determining cardiovascular complications by measuring left ventricular mass index (LVMI) in children with chronic kidney disease.
This cross-sectional study was performed on 40 children suffering from chronic kidney disease referred to Mofid Children Hospital in Tehran between 2019 and 2021. Each child was evaluated during the first 24 hours, every 20 minutes during the day, and every 30 minutes during the night, and blood pressure was assessed by the ABPM method and every 3 hours by the auscultation method. Patients also underwent echocardiography to determine LVMI.
Based on the assessment by auscultation method, 47.0% of children suffered from systolic hypertension, and 40.0% had diastolic hypertension. In total, 50% were hypertensive. According to ABPM blood pressure data, 23 patients (57%) had systolic hypertension and 24 patients (60%) had diastolic hypertension. In total, 16 patients (40%) had normal blood pressure and 24 patients (60%) had hypertension by the ABPM method. Also, according to ABPM measurement, 10 patients (25%) suffered from masked hypertension, and 6 patients (15%) from white-coat hypertension. There was a significant association between LVMI and the blood pressures assessed by the ABPM method.
Auscultation blood pressure measurement alone may not be sufficient to diagnose hypertension in patients with chronic kidney disease. It should be used in conjunction with the ABPM method.

Covid-19 can acute cardiovascular syndrome. The aim of this study was to determine the frequency of cardiovascular involvement in patients with Covid-19 disease .All patients who were diagnosed with Covid-19 disease and were hospitalized and monitored due to disease conditions (stages 2 and 3) were eligible to enter the study. At the beginning of the patient's hospitalization, the patients' vital signs were recorded and the first 12-lead ECG was taken. Patients then underwent cardiac monitoring. Patients underwent echocardiography during hospitalization. Preliminary tests including biochemistry, blood cell count, CRP and ESR and troponin were also performed for patients.More than half of these patients are men. There was a significant relationship between Sinus.tach and history of heart disease (p = 0.02). The relationship between atrial fibrillation and history of heart disease was significant (p = 0.02). Nonspecific variable was also significantly associated with a history of heart disease (p = 0.04). Studies showed that ejection fraction was normal in 87.7% of patients and severe in 5.5%. There was a significant relationship between diastolic dysfunction grade and the history of heart disease (p = 0.02).The average age of patients with Covid-9 is 63.55%, 20.2% of people with a history of heart disease,Due to the sensitivity of the subject, the presence of underlying diseases,can increase the risk of Covid-19 disease and also increase the mortality rate of this disease in these. Therefore, it is suggested that more attention, priority in vaccinating against this disease in people with underlying diseases.

Cardiovascular diseases (CVD) represent a leading cause of global mortality, necessitating proactive identification of risk factors for preventive strategies. This study aimed to uncover prognostic factors influencing cardiovascular patient survival.  

This study, which used a sample size of 410, showed how to analyze data using simple random sampling. It was conducted at the Tikur Anbessa Specialist Hospital in Addis Ababa, Ethiopia, between September 2012 and April 2016. The Cox PH and stratified Cox regression models were used for the analysis.  

Findings disclosed a patient cohort where 200 patients (48.8%) persisted through subsequent evaluation, while 210 patients (51.2%) succumbed. Blood pressure (BP), specific CVD, and education levels (EL) exhibited nonproportionalities in scaled Schoenfeld residuals (P < 0.001), prompting necessary stratification. Inadequacies in the Cox proportional hazards model led to favoring the stratified Cox model. Notably, EL, BP, cholesterol level (CL), alcohol use (AU), smoking use (SU), and pulse rate (PR) exhibited statistical significance (P < 0.001). Acceptability of the absence of interaction in the model, with disease types as strata, was established. Different cardiovascular conditions served as distinct groups, where EL, AU, BP, PR, CL, and SU emerged as variables with statistically substantiated significance associated with the mortality of patients with CVD.  

Implications stress the imperative of widespread awareness among policymakers and the public concerning cardiovascular disease incidence. Such awareness is pivotal in mitigating identified risk factors, guiding more effective healthcare interventions tailored to the multifaceted challenges posed by cardiovascular health.

Background  The European Union Medical Device Regulation (MDR) requires manufacturers to undertake post-market clinical follow-up (PMCF) to assess the safety and performance of their devices following approval and Conformité Européenne (CE) marking. The quality and reliability of device registries for this Regulation have not been reported. As part of the Coordinating Research and Evidence for Medical Devices (CORE-MD) project, we identified and reviewed European cardiovascular and orthopaedic registries to assess their structures, methods, and suitability as data sources for regulatory purposes.Methods  Regional, national and multi-country European cardiovascular (coronary stents and valve repair/replacement) and orthopaedic (hip/knee prostheses) registries were identified using a systematic literature search. Annual reports, peer-reviewed publications, and websites were reviewed to extract publicly available information for 33 items related to structure and methodology in six domains and also for reported outcomes.Results  Of the 20 cardiovascular and 26 orthopaedic registries fulfilling eligibility criteria, a median of 33% (IQR: 14%-71%) items for cardiovascular and 60% (IQR: 28%-100%) items for orthopaedic registries were reported, with large variation across domains. For instance, no cardiovascular and 16 (62%) orthopaedic registries reported patient/procedure-level completeness. No cardiovascular and 5 (19%) orthopaedic registries reported outlier performances of devices, but each with a different outlier definition. There was large heterogeneity in reporting on items, outcomes, definitions of outcomes, and follow-up durations.Conclusion  European cardiovascular and orthopaedic device registries could improve their potential as data sources for regulatory purposes by reaching consensus on standardised reporting of structural and methodological characteristics to judge the quality of the evidence as well as outcomes.

This article emphasizes the importance of preventing common travel-related issues through common-sense measures, often overlooked by travelers. It provides recommendations backed by scientific evidence for travel health advisors to pass on to travelers. Additionally, it highlights the significance of addressing the health concerns of individuals with compromised immunity, such as those with severe immunosuppression. Furthermore, it underscores the need to consider the unique health challenges faced by elderly travelers when journeying to developing countries. The purpose of this study is to provide guidelines for an evidence-based approach to pre-travel counseling and medical considerations for the elderly in a travel clinic.

During the COVID-19 pandemic, the implementation of social distancing and public fear of the virus postponed follow-up visits to manage patients' underlying medical problems, especially cardiovascular diseases and diabetes. Telehealth provides accessible and cost-effective care for vulnerable patients. The aim of this early study was to review the telehealth interventions for patients with cardiovascular and metabolic disorders during COVI-19 outbreak.

This study used rapid review to provide an accurate review of the articles. Study selection was based on the Preferred Reporting Items for Systematic Reviews (PRISMA) guideline. A systematic review was conducted on studies published from January 2020 to   July 30, 2020, in PubMed, Web of Science, Google Scholar, and Scopus databases, and the update was done on October 31, 2020

Technology-based interventions were performed in various countries: two studies in the USA, three in Europe (Italy, Germany, and London), two in Asia (China and Pakistan), and one in South America. Most Telehealth approaches used in the included articles are video consultations using mobile applications such as Skype, face time, and regular phone calls. 

According to the results, the application of technology in the management of cardiovascular and metabolic disorders can be used to provide healthcare to patients regardless of distance, detection of disease, monitoring disease progression and complications, reducing healthcare costs, saving available resources, preventing readmission of patients, reducing the provider workload, and increasing family participation in disease management, quality of life, and patient satisfaction.

 Inflammation and oxidative stress are contributed to cardiovascular diseases. Vitamin D (Vit D) has antioxidant and anti-inflammatory properties. In the current research, the effect of Vit D on cardiac fibrosis and inflammation, and oxidative stress indicators in cardiovascular tissues was studied in lipopolysaccharides(LPS) injected rats.

 Rats were distributed into 5 groups and were treated for 2 weeks. Control: received vehicle(saline supplemented with tween-80) instead of Vit D and saline instead of LPS, LPS: treated by 1 mg/kg of LPS and was given vehicle instead of Vit D, LPS-Vit D groups: received 3 doses of Vit D (100, 1000, and 10000 IU/kg) of Vit D in addition to LPS. Vit D was dissolved in saline supplemented with tween-80 (final concentration 0.1%) and LPS was dissolved in saline. The white blood cell (WBC) was counted. Oxidative stress markers were determined in serum, aorta, and heart. Cardiac tissue fibrosis was also estimated using Masson’s trichrome staining method.

 WBC and malondialdehyde (MDA) were higher in the LPS group than the control group, whereas the thiol content, superoxide dismutase (SOD), and catalase (CAT) were lower in the LPS group than the control group (P<0.01 and P<0.001). Administration of Vit D decreased WBC (P<0.001) and MDA (P<0.05 and P<0.001) while enhanced thiol (dose 10000 IU/Kg) (P<0.001), SOD (dose 10000 IU/kg) (P<0.001), and CAT (P<0.05 and P<0.001) compared to the LPS group. All doses of Vit D also decreased cardiac fibrosis compared to the LPS group (P<0.001).

 Vit D protected the cardiovascular against the detrimental effect of LPS. This cardiovascular protection can be attributed to the antioxidant and anti-inflammatory properties of Vit D.

Liver function tests such as AST/ALT ratio may play an important role in the progression of nonalcoholic fatty liver disease (NAFLD) and its related cardiovascular dysfunctions. The study aims to assess whether AST/ALT was associated with arterial stiffness in a large population-based cohort of apparently healthy Persian women and men.

 To evaluate arterial stiffness non-invasively, Pulse Wave Velocity (PWV) and Augmentation Index (AI) were measured in 5031 healthy adults. Laboratory parameters, including AST and ALT, were measured after all subject's blood samples were collected. The one-way-ANOVA, the Kruskal-Wallis, and chi-square tests were used to compare the AST/ALT ratio among groups with baseline characteristics of participants following the calculation of AST: ALT through the division of AST levels by ALT levels. The univariate linear regression model was used to assess the association between mean pulse wave velocity (PWV) and AST/ALT ratio quartiles. 

 The results showed no statically significant difference in Age, HR, and MET among the different AST/ALT groups. Univariate analysis displayed that age, SBP, DBP, FBS, TG, MET, Fatty liver status, and hypertension status were positively correlated with Mean PWV. Evaluation of univariate linear regression models presented that AST/ALT has a significant correlation with Mean PWV (β = -0.139, 95% confidence interval (CI): -0.032 to -0.021, P-value < 0.001). We found that there was no linear relationship.

 According to the present study results, there was a significant negative correlation between AST/ALT with PWV. Moreover, a non-linear relationship between AST/ALT and PWV was observed as well.