Peripheral and Cerebral Vasodilation in Black and White Women: Examining the Impact of Psychosocial Stress Exposure Versus Internalization and Coping.

BACKGROUND: Black women have among the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that stress internalization and coping strategies are more important than stress exposures alone. We hypothesized that Black women would have blunted peripheral and cerebral vasodilation and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. METHODS: Healthy Black (n=21; 20±2 years) and White (n=16; 25±7 years) women underwent testing for forearm reactive hyperemia, brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity. Psychosocial stress exposures (adverse childhood experiences; past week discrimination) and internalization/coping techniques (John Henryism Active Coping Scale; Giscombe Superwoman Schema Questionnaire) were assessed. RESULTS: Reactive hyperemia and cerebrovascular reactivity were not different between groups (P>0.05), whereas FMD was lower in Black women (P=0.007). Neither adverse childhood experiences nor past week discrimination were associated with FMD in either group (P>0.05 for all). John Henryism Active Coping Scale scores were negatively associated with FMD in Black women (P=0.014) but positively associated with FMD in White women (P=0.042). Superwoman Schema-Succeed was negatively associated (P=0.044) and Superwoman Schema-Vulnerable tended to be negatively associated (P=0.057) with FMD in Black women. CONCLUSIONS: These findings indicate that blunted FMD in Black women may be due more to stress internalization and maladaptive coping than stress exposures alone.

The acute effect of whole-body heat therapy on peripheral and cerebral vascular reactivity in Black and White females.

Among females in the U.S., Black females suffer the most from cardiovascular disease and stroke. While the reasons for this disparity are multifactorial, vascular dysfunction likely contributes. Chronic whole-body heat therapy (WBHT) improves vascular function, but few studies have examined its acute effect on peripheral or cerebral vascular function, which may help elucidate chronic adaptative mechanisms. Furthermore, no studies have investigated this effect in Black females. We hypothesized that Black females would have lower peripheral and cerebral vascular function relative to White females and that one session of WBHT would mitigate these differences. Eighteen young, healthy Black (n = 9; 21 ± 3 yr; BMI: 24.7 ± 4.5 kg/m2) and White (n = 9; 27 ± 3 yr; BMI: 24.8 ± 4.1 kg/m2) females underwent one 60 min session of WBHT (49 °C water via a tube-lined suit). Pre- and 45 min post-testing measures included post-occlusive forearm reactive hyperemia (peripheral microvascular function, RH), brachial artery flow-mediated dilation (peripheral macrovascular function, FMD), and cerebrovascular reactivity (CVR) to hypercapnia. Prior to WBHT, there were no differences in RH, FMD, or CVR (p > 0.05 for all). WBHT improved peak RH in both groups (main effect of WBHT: 79.6 ± 20.1 cm/s to 95.9 ± 30.0 cm/s; p = 0.004, g = 0.787) but not Δ blood velocity (p > 0.05 for both groups). WBHT improved FMD in both groups (6.2 ± 3.4 % to 8.8 ± 3.7 %; p = 0.016, g = 0.618) but had no effect on CVR in either group (p = 0.077). These data indicate that one session of WBHT acutely improves peripheral micro- and macrovascular but not cerebral vascular function in Black and White females.

Peripheral and Cerebral Vascular Reactivity in Black and White Women: Examining the Impact of Psychosocial Stress Exposure Versus Internalization and Coping.

Black women have the highest rates of cardiovascular and cerebrovascular disease prevalence and mortality in part due to blunted vascular function. Psychosocial stress likely also contributes but its relationship to vascular function remains incompletely understood. Recent studies suggest that internalization and coping strategies are more important than stress exposure alone. We hypothesized that Black women have blunted peripheral and cerebral vascular function and that, among Black women, this would be inversely related with psychosocial stress internalization/coping but not stress exposures. Healthy Black ( n = 21; 20 ± 2 yr) and White ( n = 16; 25 ± 7 yr) women underwent testing for forearm reactive hyperemia (RH), brachial artery flow-mediated dilation (FMD), and cerebrovascular reactivity (CVR). Psychosocial stress exposure (adverse childhood experiences, ACEs; past week discrimination, PWD) and internalization/coping techniques (John Henryism Active Coping Scale, JHAC12; Giscombe Superwoman Schema Questionnaire, G-SWS-Q) were assessed. RH and CVR ( p > 0.05) were not different between groups whereas FMD was lower in Black women ( p = 0.007). Neither ACEs nor PWD were associated with FMD in either group ( p > 0.05 for all). JHAC12 scores were negatively associated with FMD in Black women ( p = 0.014) but positively associated with FMD in White women ( p = 0.042). SWS-Succeed was negatively associated ( p = 0.044) and SWS-Vulnerable tended to be negatively associated ( p = 0.057) with FMD in Black women. These findings indicate that blunted FMD in Black women may be due more to internalization and maladaptive coping than stress exposure alone.

Meta-analysis of incidence and outcomes of life-threatening arrhythmias in takotsubo cardiomyopathy.

BACKGROUND: Takotsubo cardiomyopathy (TC) or stress-induced cardiomyopathy is a transient heart condition that clinically resembles an acute coronary syndrome. This study aims to assess the incidence of life-threatening arrhythmias in patients with Takotsubo cardiomyopathy and evaluate the outcomes of patients with life-threatening arrhythmias (LTAs) in Takotsubo cardiomyopathy compared with those without LTA. METHODS: We comprehensively searched the PubMed, Google Scholar, and Embase databases from inception to February 2021. The primary aim of the study was to determine the incidence of LTAs in TC patients. Other outcomes of interest were the odds of in-hospital, long-term mortality, and cardiogenic shock (CS) in TC patients with LTAs versus those without LTAs. For all statistical analyses, ReviewManager and MedCalc were used. RESULTS: Eighteen studies were included in this study involving 55,557 participants (2,185 with LTAs and 53,372 without LTAs). The pooled incidence of LTAs in the patients of TC was found to be 6.29% (CI: 4.70-8.08%; I2 = 94.67%). There was a statistically significant increased risk of in-hospital mortality (OR = 4.74; CI: 2.24-10.04; I2 = 77%, p < 0.0001) and cardiogenic shock (OR = 5.60; CI: 3.51-8.95; I2 = 0%, p < 0.00001) in the LTA group versus the non-LTA group. LTA was not associated with long-term mortality (OR = 2.23; CI: 0.94-5.28; I2 = 53%, p = 0.07). CONCLUSION: The pooled incidence of life-threatening arrhythmias in the patients of TC was found to be 6.29%. In the group of TC patients with LTAs, the odds of in-hospital mortality and CS, was higher than in the TC patients without LTAs.

Socioeconomic Status in Pregnant Women and Sleep Quality During Pregnancy.

This review focuses on factors contributing to sleep quality among pregnant women with low socioeconomic statuses during the third trimester of their pregnancy. Electronic searches were conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched for published, peer reviewed, English language primary research articles using electronic databases including PubMed, EMBASE, Ovid, MEDLINE and Google Scholar ending June 2019. All references were reviewed manually and independently by authors. After applying the inclusion criteria, 56 articles were selected; 38 of which are full-text and included in this review. All articles related to the analysis of poor sleep quality among uncomplicated pregnant women were included. Pregnant women with a specific pathology were excluded. We found poor sleep quality among pregnant women is correlated with low socioeconomic levels. Pregnant women with lower incomes tend to have inadequate diets, which further complicates the health of the mother and the baby. External factors including low income, poor quality of life and poor diet tend to increase the possibility of future health complications in both mother and child, and can result in complications such as preterm labor, low birth weight, preeclampsia, perinatal death, and spontaneous abortion.

Herramientas Cartográficas digitales en vigilancia de enfermedades transmitidas por Aedes spp; caso en Costa Rica / Digital cartographic tools in surveillance of diseases transmitted by Aedes spp; Case in Costa Rica

Resumen Los mosquitos del genero Aedes, han provocado importantes epidemias de enfermedades como dengue, chikungunya, fiebre amarilla y zika en las Américas. La vigilancia epidemiológica de tales enfermedades, a través de los sistemas de información geográfica y la cartografía digital se han convertido en aliados para la Salud Pública. El objetivo de este estudio es describir el uso práctico de una herramienta geoespacial de acceso gratuito, en la vigilancia de enfermedades transmitidas por Aedes spp., en un sector endémico de Costa Rica para la presencia de este vector. Metodología: Se trata de un estudio de caso sobre la implementación de Herramientas Cartográficas digitales en un Área Rectora de Salud local del Ministerio de Salud, y su uso exitoso para la geo-localización de los casos sospechosos de dengue, zika y chikungunya notificados en esa área entre 2013 y 2016. Resultados: Se logró implementar el mapeo digital de los casos a través de marcas de posición. Con ventajas en la vigilancia epidemiológica, gracias al programa que permitió la identificación rápida de las viviendas, identificación de conglomerados, y selección de zonas prioritarias para intervenir. Además, fue un apoyo en la ejecución de los planes operativos, y en la conducción de actividades de movilización social. Discusión: Por su calidad de visualización topográfica y la interfaz intuitiva, las Herramientas Cartográficas digitales fueron útiles útil para la vigilancia epidemiológica de la transmisión de virus por el vector Aedes spp en Nandayure de Guanacaste, Costa Rica.

Abstract Aedes mosquito, because of it´s capability for spreading several virus, and it´s wide distribution at the American Continent, has generated epidemics of dengue, chikungunya, yellow fever and zika. Epidemic surveillance of these vector transmitted diseases, using free Geographic Information Systems and digital programs, has become into a great partner of Public Health departments. Objective: This study describes the practical use of free software of satellite image and free Geographic Information Systems, for the surveillance of Aedes spp transmitted diseases, in a Costa Rican Aedes endemic location. Methods: It is a case study developed at one local office, of Ministry of health in Costa Rica, geo locating the reported cases of dengue, zika, chikungunya from 2013 to 2016. Results: the achievement of position marks representing the house of all the cases reported, in a digital database of points and layers. Improvement in epidemic surveillance, thanks to the use of the selected programs that permitted to identify the conglomerates of cases at the neighborhoods, and the higher priority intervention zones. Discussion: the programs used, helped to visualize planned routes for the execution of social movement actions, and operational plans. Thanks to the image quality and the easy interactive interface, free Software selected, resulted into a useful tool for the surveillance of Aedes spp. transmitted diseases in the case of the public health department of Nandayure, from Guanacaste province of Costa Rica.