RESUMEN
OBJECTIVE: In our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort. DESIGN: Community prospective cohort study, follow-up of a case-control study in community. SUBJECTS: Patients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension. RESULTS: A total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (ß=4.874, p<0.0001) and the patients with persistent masked hypertension (ß=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (ß=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (ß=1.634, p=0.015). CONCLUSIONS: Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.
Asunto(s)
Hipertrofia Ventricular Izquierda/complicaciones , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Hipertensión Enmascarada/diagnóstico , Hipertensión Enmascarada/epidemiología , Adolescente , Presión Sanguínea , Monitoreo Ambulatorio de la Presión Arterial , Índice de Masa Corporal , Estudios de Casos y Controles , Ecocardiografía , Femenino , Estudios de Seguimiento , Hong Kong/epidemiología , Humanos , Modelos Lineales , Masculino , Análisis Multivariante , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
Traditional Chinese Medicine (TCM) has been used in patients with atopic dermatitis (AD), but its therapeutic effects are debatable. We evaluated the clinical and biochemical effects of a TCM capsule (PentaHerbs capsule) in children with AD. After a run-in period of 4 weeks, children old enough to manage oral medication were admitted and their disease severity was evaluated by the SCORing Atopic Dermatitis (SCORAD) index. Blood was obtained for complete blood count, total and allergen-specific immunoglobulin E (IgE), biochemical studies and inflammatory markers of AD severity [serum cutaneous T cell-attracting chemokine (CTACK), macrophage-derived chemokine (MDC), thymus and activation-regulated chemokine (TARC) and eosinophil cationic protein (ECP)] prior to, and after 3 months of, TCM use. Three PentaHerbs capsules twice a day were prescribed for 4 months. Patients were followed monthly to ensure compliance, and SCORAD scores were obtained at each visit. Five boys and four girls participated in the study. All patients had detectable food or inhalant-specific IgE in serum. There was significant improvement in the overall and component SCORAD scores. There were no significant differences between the pre- and post-treatment values of the serum CTACK, MDC, TARC and ECP levels but CTACK showed a decreasing trend (p = 0.069). No clinical or biochemical evidence of any adverse drug reaction was observed during the study period. The PentaHerbs capsules were well tolerated by the children and apparent beneficial effects were noted clinically. A larger, randomized placebo-controlled study is required to confirm the efficacy of this formulation for AD.
Asunto(s)
Dermatitis Atópica/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Fitoterapia , Cápsulas , Niño , Dermatitis Atópica/sangre , Medicamentos Herbarios Chinos/administración & dosificación , Hipersensibilidad a los Alimentos/inmunología , Humanos , Inmunoglobulina E/sangre , Selección de PacienteRESUMEN
BACKGROUND: It has become apparent recently that cardiac myocytes can divide after myocardial infarction, a circumstance that challenges the orthodox view that myocytes may be terminally differentiated. Replacement of the necrosed heart tissue by newly regenerated functional myocardium is a therapeutic ideal, but attempts to reconstitute functional myocardia and coronary vessels have been less successful. METHODS: We isolated a fraction containing 5 compounds from the Chinese herb Geum japonicum, which stimulates the processes of angiogenesis and cardiomyogenesis. We investigated these dual properties in both ex vivo and in vivo systems. RESULTS: We observed that this bioactive fraction displayed favorable dual actions on early angiogenesis and cardiomyogenesis in acute myocardial infarction in an animal model. Our results demonstrated that application of this bioactive fraction showed pronounced effects on limiting infarct size by 35%-45%, stimulating early development of new blood vessels in 24 h, and regenerating myocardium, replacing approximately 49% of the total infarction volume after 2 weeks. Echocardiographic studies demonstrated marked improvement of left ventricular function within 2 days after infarction, and the improvement was sustained for >1 month. CONCLUSIONS: The properties of this bioactive fraction appear to be entirely novel and represent a new approach for the treatment of ischemic heart disease.