Algal docosahexaenoic acid affects plasma lipoprotein particle size distribution in overweight and obese adults.

Fish oils containing both EPA and DHA have been shown to have beneficial cardiovascular effects, but less is known about the independent effects of DHA. This study was designed to examine the effects of DHA on plasma lipid and lipoprotein concentrations and other biomarkers of cardiovascular risk in the absence of weight loss. In this randomized, controlled, double-blind trial, 36 overweight or obese adults were treated with 2 g/d of algal DHA or placebo for 4.5 mo. Markers of cardiovascular risk were assessed before and after treatment. In the DHA-supplemented group, the decrease in mean VLDL particle size (P ≤ 0.001) and increases in mean LDL (P ≤ 0.001) and HDL (P ≤ 0.001) particle sizes were significantly greater than changes in the placebo group. DHA supplementation also increased the concentrations of large LDL (P ≤ 0.001) and large HDL particles (P = 0.001) and decreased the concentrations of small LDL (P = 0.009) and medium HDL particles (P = 0.001). As calculated using NMR-derived data, DHA supplementation reduced VLDL TG (P = 0.009) and total TG concentrations (P = 0.006). Plasma IL-10 increased with DHA supplementation to a greater extent than placebo (P = 0.021), but no other significant changes were observed in glucose metabolism, insulin sensitivity, blood pressure, or markers of inflammation with DHA. In summary, DHA supplementation resulted in potentially beneficial changes in some markers of cardiometabolic risk, whereas other markers were unchanged.

Surge-in-Place: Conversion of a Cardiac Catheterization Laboratory Into a COVID-19 Intensive Care Unit and Back Again.

In Spring 2020, the United States epicenter of COVID-19 was New York City, in which the borough of the Bronx was particularly affected. This Fall, there has been a resurgence of COVID-19 in Europe and the Midwestern United States. We describe our experience transforming our cardiac catheterization laboratories to accommodate an influx of COVID-19 patients so as to provide other hospitals with a potential blueprint. We transformed our pre/postprocedural patient care areas into COVID-19 intensive care and step-down units and maintained emergent invasive care for ST-segment elevation myocardial infarction using existing space and personnel.

Enzyme replacement as an effective treatment for the common symptoms of complex carbohydrate intolerance.

Complex carbohydrates are an essential part of a healthy diet. However, many people suffer from varying degrees of carbohydrate intolerance, resulting in embarrassing gastrointestinal symptoms and avoidance of these components of a healthy diet. To facilitate awareness and discussion, we propose the phrase "complex carbohydrate intolerance" (CCI) as a broad term to encompass the range of symptoms associated with carbohydrate intolerance. While various treatments offer symptomatic relief, enzyme replacement therapy targets the cause of the problem: an enzyme deficiency. The enzyme, alpha-galactosidase, currently only found in the over-the-counter product, Beano, may be an effective preventative treatment for CCI.

Coronary heart disease risk in people 65 years of age and older.

Evidence from epidemiologic studies indicates that the same factors that are associated with increased risk of coronary heart disease (CHD) in middle-aged people are relevant in older adults (i.e., those aged >or=65). The relative risk associated with some risk factors decreases with advancing age but this is offset by greater incidence of CHD among older adults. A growing body of evidence from clinical trials indicates that risk factor modification in older adults reduces CHD risk as effectively as it does in middle-aged adults. Multivariable risk assessment can be used to effectively target intervention to those at significant risk for an initial CHD event and to avoid over-treatment. It is important to appreciate that the average remaining life expectancy after achieving 80 years is about 8 years.