ABSTRACT
Perioperative stroke is a devastating complication that occurs during surgery or within 30 days following the surgical procedure. Its prevalence ranges from 0.08 to 10% although it is most likely an underestimation, as sedatives and narcotics can substantially mask symptomatology and clinical presentation. Understanding the underlying pathophysiology and identifying potential therapeutic targets are of paramount importance. Protease-activated receptors (PARs), a unique family of G-protein-coupled receptors, are widely expressed throughout the human body and play essential roles in various physiological and pathological processes. This review elucidates the biology and significance of PARs, outlining their diverse functions in health and disease, and their intricate involvement in cerebrovascular (patho)physiology and neuroprotection. PARs exhibit a dual role in cerebral ischemia, which underscores their potential as therapeutic targets to mitigate the devastating effects of stroke in surgical patients.
ABSTRACT
BACKGROUND: The clinical impact of vasopressin in hemorrhagic shock remains largely unknown. OBJECTIVE: This systematic review and meta-analysis was designed to investigate the effects of vasopressin receptor agonists during the resuscitation of hemorrhagic shock. METHODS: A systematic search of PubMed (MEDLINE), Scopus, and PubMed Central was conducted for relevant articles. Experimental (animal) and clinical studies were included. The primary objective was to investigate the correlation of vasopressin receptor agonist use with mortality and various hemodynamic parameters. RESULTS: Data extraction was possible in thirteen animal studies and two clinical studies. Differences in risk of mortality between patients who received a vasopressin receptor agonist were not statistically significant when compared to those who were not treated with such agents [RR (95% CI): 1.17 (0.67, 2.08); p = 0.562; I2 = 50%]. The available data were insufficient to conduct a meta-analysis assessing the effect of vasopressin receptor agonists on hemodynamics. Drawing safe conclusions from animal studies was challenging, due to significant heterogeneity in terms of species and dosage of vasopressin receptor agonists among studies. CONCLUSIONS: Differences in risk of mortality between patients who received a vasopressin receptor agonist were not statistically significant when compared to those who were not treated with such agents after hemorrhagic shock. More data are needed to deduce certain conclusions.
ABSTRACT
Pulmonary embolism (PE) is a rather common cardiovascular disorder constituting one of the major manifestations of venous thromboembolism (VTE). It is associated with high mortality and substantial recurrence rates, and its diagnosis may be challenging, especially in patients with respiratory comorbidities. Therefore, providing a prompt and accurate diagnosis for PE through developing highly sensitive and specific diagnostic algorithms would be of paramount importance. There is sound evidence supporting the use of biomarkers to enhance the diagnosis and predict the recurrence risk in patients with PE. Therefore, several novel biomarkers, such as factor VIII, Ischemia Modified Albumin, and fibrinogen, as well as several MicroRNAs and microparticles, have been investigated for the diagnosis of this clinical entity. The present review targets to comprehensively present the literature regarding the novel diagnostic biomarkers for PE, as well as to discuss the evidence for their use in daily routine.
ABSTRACT
BACKGROUND: Ectopic Health Sciences students often experience higher level of stress due to clinical knowledge, and it has been reported that they frequently develop worries and symptoms of illness. These observations had lead to the hypothesis that studying health sciences may increase the risk for developing health anxiety. OBJECTIVE: To investigate the correlation between studying health sciences and health anxiety risk in students of a Greek university. METHODS: A cross-sectional study was conducted among health science and non-health science students from the University of Thessaly, Greece. The 14 item - Short Health Anxiety Inventory (SHAI) was used to measure students' health anxiety. Univariable and multivariable logistic regression analyses were used to test the hypothesis. RESULTS: The population sample consisted of 562 health science students and 204 agriculture and computer science students. The prevalence of health anxiety (SHAI score >14) was 18.1% (95% CI 15.4%-21.1%) while 8.3% (95% CI 6.4%-10.5%) of the participants suffered from clinical health anxiety (SHAI score >18). Health science students had higher SHAI scores compared to non-health science students. Multivariable analysis revealed an increased risk for health anxiety in health science students (OR: 2.01, 95% CI: 1.02-3.97, p=0.044). Health anxiety was also associated with sex (female) (p<0,008) and the presence of health anxiety in a family member (p<0,001). CONCLUSION: The current study identified studying health sciences as a determinant of health anxiety in students of a Greek university, after considering several confounding factors. This relatively neglected hypothesis should be further examined, preferably in a prospective cohort design.
