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INTRODUCTION: Non-high-density lipoprotein cholesterol (non-HDL-C) levels can increase the cardiometabolic risk factors in patients with hypothyroidism, but the findings across studies have not been consistently conclusive. The aim of this study was to find the association between non-HDL-C and cardiometabolic risk factors in patients with hypothyroidism. MATERIAL AND METHODS: In this case-control study, a total of 120 subjects among which 60 diagnosed hypothyroidism patients and 60 age-matched healthy controls were enrolled, aged 30-65 years. Body mass index (BMI), waist circumference (WC), and systolic and diastolic blood pressures (SBP and DBP) were measured. Thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), fasting blood sugar (FBS), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) were estimated. Low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), and non-HDL-C were calculated. A p-value of <0.05 was considered statistically significant. RESULTS: Mean of BMI, WC, FBS, TSH, TC, TG, non-HDL-C, LDL-C, VLDL-C, SBP, and DBP were significantly elevated in cases compared to controls (p<0.001). However, the mean of T3, T4, and HDL-C were significantly reduced in cases compared to controls (p<0.001). Non-HDL-C has shown a significant positive correlation with age (r=0.345, p<0.01), TC (r=0.451, p<0.01), TG (r=0.269, p<0.05), LDL-C (r=0.402, p<0.01), and VLDL-C (r=0.269, p<0.05) among cases. However, non-HDL-C has shown a significant negative correlation with HDL-C (r=-0.330, p<0.05) among cases. Non-HDL-C significantly predicted cardiometabolic risk in patients with hypothyroidism (F(13,46)=3.500, p<0.001). CONCLUSION: Non-HDL-C has shown a significant association with age and lipid abnormalities in patients with hypothyroidism. Non-HDL-C significantly predicts cardiometabolic risk factors in patients with hypothyroidism.
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Cardio-ankle vascular index (CAVI) is an innovative indicator of large-artery stiffness, which is evaluated by the pulse wave velocity (PWV) measurement. Mortality and morbidity due to cardiovascular diseases among the general public with high-risk conditions such as hypertension are usually associated with arterial stiffness. CAVI modelizes the hazard of future cardiovascular events with standard risk factors. Additionally, the "European Society of Hypertension and Cardiology" included the aortic PWV assessment in managing hypertension in their updated guidelines in 2007. We conducted this systematic review to collect, summarize, and evaluate the evidence from relevant reported studies. A literature search of four databases was conducted comprehensively until February 2024. Cardiovascular events are the primary outcome of interest in this study, cardiovascular events that have been defined as major adverse cardiac events include "heart failure", "stroke", "myocardial infarction", "cardiovascular deaths", "stable angina pectoris", "coronary revascularization", and "unstable angina pectoris". We included five studies with a 11 698 sample size in this systematic review. All five prospective studies investigated composite cardiovascular events as an outcome. Three of them revealed a statistically significant prediction ability of CAVI to assess Cardiovascular disease (CVD) risk. Further analysis is required. Current evidence is insufficient to confirm the predictive power of CAVI in the assessment of cardiovascular risk in hypertensive patients. CAVI is modestly associated with incidents of CVD risk. It is necessary to conduct further studies to assess CAVI concerning CVD predictor measures in the masses and nations other than Asia.
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Pulmonary embolism (PE) is the third most common type of cardiovascular disease and carries a high mortality rate of 30% if left untreated. Although it is commonly known that individuals who suffer heart failure (HF) are more likely to experience a pulmonary embolism, little is known concerning the prognostic relationship between acute PE and HF. This study aims to evaluate the prognostic usefulness of heart failure and pro-BNP in pulmonary embolism cases. A scientific literature search, including PubMed, Medline, and Cochrane reviews, was used to assess and evaluate the most pertinent research that has been published. The findings showed that increased N-terminal brain natriuretic peptide (NT-proBNP) levels could potentially identify pulmonary embolism patients with worse immediate prognoses and were highly predictive of all-cause death. Important prognostic information can be obtained from NT-proBNP and Heart-type Fatty Acid Binding Proteins (H-FABP) when examining individuals with PE. The heart, distal tubular cells of the renal system, and skeletal muscle are where H-FABP is primarily found, with myocardial cells having the highest concentration. Recent studies have indicated that these biomarkers may also help assess the severity of PE and its long-term risk.
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Acute heart failure (AHF) episodes are marked by high rates of morbidity and mortality during the episode and minimal advancements in its care. Multiple biomarker monitoring is now a crucial supplementary technique in the therapy of AHF. A scientific literature search was conducted by assessing and evaluating the most pertinent research that has been published, including original papers and review papers with the use of PubMed, Medline, and Cochrane databases. Established biomarkers like natriuretic peptides (BNP, NT-proBNP) and cardiac troponins play crucial roles in diagnostic and prognostic evaluation. Emerging biomarkers such as microRNAs, osteopontin, galectin-3, ST2, and GDF-15 show promise in enhancing risk stratification and predicting adverse outcomes in HF. However, while these biomarkers offer valuable insights, their clinical utility requires further validation and integration into practice. Continued research into novel biomarkers holds promise for early HF detection and risk assessment, potentially mitigating the global burden of HF. Understanding the nuances of biomarker utilization is crucial for their effective incorporation into clinical practice, ultimately improving HF management and patient care.
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Heart failure (HF) rehabilitation seeks to enhance the entire well-being and quality of life of those with HF by focusing on both physical and mental health. Non-pharmacological measures, particularly exercise training, and dietary salt reduction, are essential components of heart failure rehabilitation. This study examines the impact of these components on the recovery of patients with heart failure. By conducting a comprehensive analysis of research articles published from 2010 to 2024, we examined seven relevant studies collected from sources that include PubMed and Cochrane reviews. Our findings indicate that engaging in physical activity leads to favorable modifications in the heart, including improved heart contractility, vasodilation, and cardiac output. These alterations enhance the delivery of oxygen to the peripheral tissues and reduce symptoms of heart failure, such as fatigue and difficulty breathing. Nevertheless, decreasing the consumption of salt in one's diet to less than 1500 mg per day did not have a substantial impact on the frequency of hospitalizations, visits to the emergency room, or overall mortality when compared to conventional treatment. The combination of sodium restriction and exercise training can have synergistic effects due to their complementary modes of action. Exercise improves cardiovascular health and skeletal muscle metabolism, while sodium restriction increases fluid balance and activates neurohormonal pathways. Therefore, the simultaneous usage of both applications may result in more significant enhancements in HF symptoms and clinical outcomes compared to using each program alone.
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Key Clinical Message: Chikungunya encephalitis, though rare, warrants clinical attention due to its severe complications. Early identification and appropriate management are crucial for improved outcomes in patients with this rare manifestation of chikungunya virus (CHIKV) infection. Abstract: CHIKV infection is commonly associated with fever and joint pains, but neurological complications such as encephalitis are rare. Here, we present a unique case of confirmed chikungunya encephalitis in a 12-year-old male exhibiting atypical neurological symptoms. The diagnostic journey involved comprehensive neuroimaging and serological investigations, revealing intriguing findings on magnetic resonance imaging and positive CHIKV RNA in serum and cerebrospinal fluid. We discuss the clinical presentation, radiological characteristics, and management strategies, emphasizing the importance of recognizing this uncommon neurological manifestation of CHIKV infection.
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The consequences of lung cancer over the past century have been quite deadly and cost millions of lives. Besides the statistics that show its brutal mortality rate, the comorbidities secondary to lung cancer have had their toll and burden on patients too. Lung cancer is broadly and histologically divided into small and non-small cell lung cancers (NSCLC), with the latter associated with a heavy smoking history. Initial presentation of NSCLC varies, and many patients present with an advanced disease that has spread to different parts of the body. Metastasis to the bone can lead to severe pain requiring extreme analgesia regimens. Here, we present a case of a 68-year-old male with advanced NSCLC who initially presented with bony pain due to metastasis.
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A tracheal diverticulum is a rare clinical entity that is mostly diagnosed incidentally in radiographic pictures. It is infrequently mentioned in literature because of its relatively asymptomatic presentation. Its etiology is mostly attributed to tracheal wall weakness, which could either be congenital or acquired. Here we present a case of a 26-year-old man who presented with chronic intermittent cough and was incidentally diagnosed to have a tracheal diverticulum on the radiographic pictures of a high-resolution computed tomography scan of the chest (HRCT chest).