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1.
Environ Int ; 158: 107012, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34991268

RESUMEN

OBJECTIVE: The aim of this study was to explore the association between exposure to particulate matter with an aerodynamic diameter of 2.5 mm or less (PM2.5) and blood pressure (BP) levels in children and adolescents and to illustrate the impact of PM2.5 levels on BP growth curves in a cohort study. METHODS: A longitudinal study was designed and included 4303 children (7617 BP measurements) living in the selected areas, and evaluations were conducted in 2014-2015 (visit 1) and followed up in 2019 (visit 2). Two-stage stratified cluster sampling was used to include urban-rural areas. A mixed linear regression model and mixed logistic regression model were used to analyze the effect of PM2.5 exposure on BP and the incidence of prehypertension and hypertension in children. RESULTS: After adjusting for covariates, systolic blood pressure (SBP) (2.21 (95% CIs: 0. 81, 3.62), mmHg), diastolic blood pressure (DBP) (1.92 (95% CIs: 0.74, 3.11), mmHg), mean arterial pressure (MAP) (2.03 (95% CIs: 0.89, 3.17), mmHg) and heart rate (HR) (2.24 (95% CIs: 0.11, 4.37), beats/min) increased significantly in the fourth quartile of PM2.5 exposure levels compared with the first quartile (all P < 0.01). In addition, long-term exposure to PM2.5 was significantly positively correlated with SBP, DBP and MAP, and the effect was more notable in urban areas than that in rural areas. Moreover, the risk of prehypertension and hypertension incidence increased by 1.17 (95% CIs: 1.03, 1.33) fold with a one-quartile increase in PM2.5 exposure. The long-term effects of annual mean PM2.5 exposure on SBP, DBP and MAP were significant from pregnancy to 7, 3 and 4 years of age, respectively. CONCLUSION: Long-term exposure to PM2.5 was positively associated with growth curves of hemodynamics indexed from pregnancy to childhood and adolescence, and the effect was more significant in urban areas than in rural areas.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Hipertensión , Adolescente , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/análisis , Contaminación del Aire/estadística & datos numéricos , Presión Sanguínea , Niño , Estudios de Cohortes , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Humanos , Hipertensión/epidemiología , Estudios Longitudinales , Material Particulado/análisis , Embarazo , Estudios Prospectivos
2.
BMC Genomics ; 23(1): 33, 2022 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-34996349

RESUMEN

BACKGROUND: Long non-coding RNAs (lncRNAs) play a critical role in the pathogenesis of hypoxic pulmonary hypertension (HPH). The role of N7-methylguanosine (m7G) modification in lncRNAs has received increased attentions in recent years. However, the m7G-methylation of lncRNA in HPH has yet to be determined. We have therefore performed a transcriptome-wide analysis of m7G lncRNAs in HPH. RESULTS: Differentially-expressed m7Gs were detected in HPH, and m7G lncRNAs were significantly upregulated compared with non-m7G lncRNAs in HPH. Importantly, this was the first time that the upregulated m7G lncXR_591973 and m7G lncXR_592398 were identified in HPH. CONCLUSION: This study provides the first m7G transcriptome-wide analysis of HPH. Importantly, two HPH-associated m7G lncRNAs were identified, although their clinical significance requires further validation.


Asunto(s)
Hipertensión Pulmonar , ARN Largo no Codificante , Animales , Guanosina/análogos & derivados , Hipertensión Pulmonar/genética , Hipoxia/genética , ARN Largo no Codificante/genética , Ratas
3.
Chin J Dent Res ; 24(4): 267-274, 2022 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-35029098

RESUMEN

OBJECTIVE: To investigate the effects of dental anxiety on fluctuations in blood pressure (BP) and heart rate (HR) during tooth extraction in hypertensive patients under local anaesthesia, and how they are influenced by various confounding variables. METHODS: This is a prospective repeated-measures cohort study involving 600 patients successively recruited from Peking University School and Hospital of Stomatology, Beijing, China. BP and HR were repeatedly measured at rest (T0), before anaesthesia (T1), during tooth extraction (T2) and after tooth extraction (T3). Anxiety status was measured prior to local anaesthesia using a modified dental anxiety scale (MDAS). Three groups were assigned: mild anxiety (Corah DAS score of 4 to 8), moderate anxiety (score of 9 to 12) and severe anxiety (score of 13 to 20). We used a generalised linear mixed model (GLMM) to analyse the effects of dental anxiety on fluctuations in BP and HR. Interaction analysis was used to further explore the correlationship between these interactive factors. RESULTS: The mean anxiety scale score was 9.63 ± 2.88. Severe preoperative anxiety (score of 14 to 20) was associated with significantly increased HR during administration of anaesthesia. Patients with severe anxiety also displayed a significantly greater increase in HR during anaesthetic administration (P < 0.001). When analysing the joint effects of different anxiety statuses over time, blood pressure was significantly elevated in all patients with moderate and severe anxiety during tooth extraction at T2 (ß = 1.25, 95% CI 0.24 to 2.27). We also observed a significant decrease in HR in the moderate anxiety group at T3 (ß = -1.51, 95% CI -2.38 to -0.63) and a significant increase in HR in the severe anxiety group at T1, T2 and T3 (ß = 2.52, 95% CI 1.12 to 3.93; ß = 3.84, 95% CI 2.30 to 5.38; ß = 4.57, 95% CI 3.03 to 6.11, respectively). CONCLUSION: This study indicates that the effects of dental anxiety on BP and HR in middle-aged and elderly patients with hypertension during local anaesthesia and tooth extraction were influenced by various confounding variables.


Asunto(s)
Ansiedad al Tratamiento Odontológico , Hipertensión , Anciano , Estudios de Cohortes , Hemodinámica , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Extracción Dental
4.
Zhonghua Nei Ke Za Zhi ; 61(1): 60-65, 2022 Jan 01.
Artículo en Chino | MEDLINE | ID: mdl-34979771

RESUMEN

Objective: The aim of the present study was to re-evaluate the diagnostic value and optimal cutoff point of captopril challenge test (CCT) in diagnosis of primary aldosteronism (PA). Methods: This is a retrospective study. All patients with a high risk for PA underwent screening test, and then proceeded to CCT and fludrocortisone suppression test (FST) on different days. The FST was used as a reference standard for PA. The plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) were measured with an automated chemiluminescence immunoassay. Random number method was performed in the patients with unilateral primary aldosteronism (UPA), in order to make the proportion of the analyzed UPA in PA was 35%. Receiver operating characteristic (ROC) analyses were performed to compare diagnostic accuracy. Results: A total of 543 patients with 400 PA patients and 143 essential hypertension (EH) patients were enrolled. The diagnostic value of post-CCT PAC was significantly higher than that of the post-CCT plasma aldosterone-renin ratio (ARR), and that of the PAC suppression percentage, respectively. The area under the ROC curve (AUCROC) was 0.86 (0.83, 0.89) for PAC, 0.78 (0.74, 0.82) for ARR, and 0.62 (0.56, 0.67) for the PAC suppression percentage (all P<0.01), respectively. The optimal cutoff point of post-CCT PAC for PA was 110 ng/L, in which the sensitivity and specificity were 73.25% and 79.02%, respectively. The diagnostic efficiency of post-CCT PAC was not improved either in combination with PAC suppression percentage or in combination with post-CCT ARR. Conclusions: CCT is a useful test for the confirmation of PA. PAC level of 110 ng/L at 2 h after 50 mg of captopril is recommended as an optimal cutoff point for the diagnosis of PA.


Asunto(s)
Hiperaldosteronismo , Hipertensión , Aldosterona , Captopril , Humanos , Hiperaldosteronismo/diagnóstico , Renina , Estudios Retrospectivos
6.
Trials ; 23(1): 37, 2022 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-35033168

RESUMEN

INTRODUCTION: Hypertension is one of the most important risk factors for cardiovascular disease, and its control rates remain low worldwide. The most effective strategy is that patients with hypertension should be diagnosed and treated early. Preliminary studies showed that the Bushen Jiangya granule (BSJY) could suppress ventricular hypertrophy and inflammatory responses, lower blood pressure, and protect the target organs of hypertension. We designed a randomized, double-blind, placebo-controlled trial to evaluate the efficacy of BSJY in patients with low-to-medium risk hypertension. METHODS AND ANALYSIS: This trial is a one-center, randomized, double-blind, placebo-controlled study. A total of 260 participants will be randomized in a 1:1 ratio to an experimental group (BSJY plus amlodipine) and a control group (placebo plus amlodipine). The trial cycle will last 8 weeks. The primary outcome is the change in 24-h average systolic and diastolic blood pressure. The secondary outcomes include heart rate variability, pharmacogenomic evaluation, improvement in TCM syndrome, and serum pro-inflammatory/anti-inflammatory cytokines between the two groups. The safety of medication will also be evaluated. All the data will be recorded in electronic case report forms and analyzed by SPSS V.22.0. ETHICS AND DISSEMINATION: This study has been approved by the Research Ethics Committee of Guang'anmen Hospital, China Academy of Chinese Medical Sciences in Beijing, China (No. 2019-186-KY-01). The participants are volunteers, understand the process of this trial, and sign an informed consent. The results of this study will be disseminated to the public through peer-reviewed journals and academic conferences. DISCUSSION: We hypothesize that patients with low-to-medium-risk hypertension will benefit from BSJY. If successful, this study will provide evidence-based recommendations for clinicians. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiMCTR1900002876. Registered in November 2019.


Asunto(s)
Hipertensión , Farmacogenética , Presión Sanguínea , China , Método Doble Ciego , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
8.
A A Pract ; 16(1): e01556, 2022 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-35020604

RESUMEN

Autonomic dysreflexia occurs after a spinal cord injury usually at the level of T6 or above, and its hallmark feature is exaggerated autonomic response to noxious stimuli resulting in uncontrolled hypertensive episodes with reflexive bradycardia that can be fatal if not controlled. We present a case highlighting regional anesthetic techniques, including peripheral nerve blocks, to ameliorate the symptoms of autonomic dysreflexia triggered by hip fractures in a 57-year-old woman with an old C5-C6 spinal cord injury before definitive hip surgery. The regional techniques described provide anesthesiologists with a simple strategy to potentially mitigate a life-threatening situation.


Asunto(s)
Anestesia de Conducción , Disreflexia Autónoma , Fracturas de Cadera , Hipertensión , Traumatismos de la Médula Espinal , Disreflexia Autónoma/etiología , Femenino , Fracturas de Cadera/cirugía , Humanos , Persona de Mediana Edad
9.
BMJ Case Rep ; 15(1)2022 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-34980640

RESUMEN

Pseudohypoaldosteronism type 1B is a rare autosomal recessive disorder caused by dysfunction of amiloride-sensitive epithelial sodium channels (ENaCs). We present the case of a neonate with cardiogenic shock after cardiac arrest due to profound hyperkalaemia. Genetic testing revealed a novel homozygous variant in SCNNIA We review diagnostic considerations including the molecular mechanisms of disease, discuss treatment approaches and highlight the possible significance of the diversity of pulmonary ENaCs.


Asunto(s)
Hiperpotasemia , Seudohipoaldosteronismo , Amilorida , Canales Epiteliales de Sodio/genética , Homocigoto , Humanos , Hiperpotasemia/diagnóstico , Hiperpotasemia/etiología , Recién Nacido , Seudohipoaldosteronismo/complicaciones , Seudohipoaldosteronismo/diagnóstico , Seudohipoaldosteronismo/genética
10.
Bull World Health Organ ; 100(1): 30-39B, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35017755

RESUMEN

Objective: To assess missed opportunities for hypertension screening at health facilities in India and describe systematic differences in these missed opportunities across states and sociodemographic groups. Methods: We used nationally representative survey data from the 2017-2018 Longitudinal Ageing Study in India to estimate the proportion of adults aged 45 years or older identified with hypertension and who had not been diagnosed with hypertension despite having visited a health facility during the previous 12 months. We estimated age-sex adjusted proportions of missed opportunities to diagnose hypertension, as well as actual and potential proportions of diagnosis, by sociodemographic characteristics and for each state. Findings: Among those identified as having hypertension, 22.6% (95% confidence interval, CI: 21.3 to 23.8) had not been diagnosed despite having recently visited a health facility. If these opportunities had been realized, the prevalence of diagnosed hypertension would have increased from 54.8% (95% CI: 53.5 to 56.1) to 77.3% (95% CI: 76.2 to 78.5). Missed opportunities for diagnosis were more common among individuals who were poorer (P = 0.001), less educated (P < 0.001), male (P < 0.001), rural (P < 0.001), Hindu (P = 0.001), living alone (P = 0.028) and working (P < 0.001). Missed opportunities for diagnosis were more common at private than at public health facilities (P < 0.001) and varied widely across states (P < 0.001). Conclusion: Opportunistic screening for hypertension has the potential to significantly increase detection of the condition and reduce sociodemographic and geographic inequalities in its diagnosis. Such screening could be a first step towards more effective and equitable hypertension treatment and control.


Asunto(s)
Hipertensión , Adulto , Estudios Transversales , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , India/epidemiología , Masculino , Población Rural
11.
Blood Press Monit ; 27(1): 1-8, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34992202

RESUMEN

OBJECTIVE: The present study aimed to analyze the association of 2-year changes in BMI and waist circumference with changes in blood pressure (BP) in a randomized sample of community-dwelling adults. METHODS: A sample of 331 middle-aged and older adults (mean age of 59.6 ± 17.3 years) was randomly selected. Measurements of SBP and DBP, BMI, and waist circumference were collected at baseline and after 2-year follow-up. Chronological age, sex, socioeconomic status, ethnicity, and self-reported medical diagnosis and use of medication for hypertension, diabetes, and high low-density lipoprotein-cholesterol were covariates. Multiple linear regression models were adopted for statistical analysis. RESULTS: SBP was positively associated with BMI (ß = 0.48, P = 0.013) and waist circumference (ß = 0.21, P = 0.005) at baseline and only with waist circumference at follow-up (ß = 0.20, P = 0.007). DBP was positively associated with BMI (ß = 0.31, P = 0.009) and waist circumference (ß = 0.12, P = 0.006) values at baseline and at follow-up (BMI ß = 0.42, P = 0.001; waist circumference ß = 0.18, P = 0.001). Only the 2-year changes in waist circumference were associated to changes in SBP (ß = 0.33, P = 0.013), regardless of confounding factors and BMI. CONCLUSION: It is suggested that waist circumference is the main factor for control over the time in strategies focused on BP management in adult population.


Asunto(s)
Hipertensión , Vida Independiente , Adulto , Anciano , Presión Sanguínea , Índice de Masa Corporal , Humanos , Persona de Mediana Edad , Factores de Riesgo , Circunferencia de la Cintura
12.
Blood Press Monit ; 27(1): 9-13, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34992203

RESUMEN

BACKGROUND: Innocent heart murmur is common in healthy infants, children and adolescents. Although most cases are not pathologic, a murmur may be the manifestation of cardiovascular disease. It may also cause or be an indicator of blood pressure (BP) and heart rate (HR) changes. OBJECTIVE: This study aimed to document changes in BP and HR in children with Still's vibratory murmur (SVM). METHODS: This study included 226 children with SVM, and the control group included 138 healthy children that were age-, height- and weight-balanced. Patient files and our hospital registry system were retrospectively investigated for laboratory findings and electrocardiography and echocardiography results. In addition, we prospectively performed 24-h ambulatory BP monitoring in both groups. RESULTS: There were no statistically significant differences in 24-h, daytime and nighttime systolic BP, 24-h and nighttime diastolic BP and nighttime HR between the patient and control groups (P = ns). However, daytime diastolic BP, mean HR and daytime HR were significantly higher in patient group (P = 0.009, 0.039 and 0007, respectively). CONCLUSIONS: We believe that in the presence of a higher HR and a higher aortic diastolic BP, which may induce hemodynamic changes in the left ventricle, flow turbulence through the aortic valve may increase, increasing the probability of hearing a murmur. ambulatory BP monitoring could be useful to obtain a better picture of these parameters during the 24-h period.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Adolescente , Presión Sanguínea , Niño , Ritmo Circadiano , Soplos Cardíacos , Frecuencia Cardíaca , Humanos , Estudios Retrospectivos
13.
Blood Press Monit ; 27(1): 27-32, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34992204

RESUMEN

OBJECTIVE: Assessing the state of hypertension care remains the first step towards planning a robust health system needed to tackle the rising burden of hypertension. Prior to the commencement of the Community Action Against Non-Communicable Disease project, we assessed hypertension care using the hypertension care cascade (HCC). This will serve as a baseline to evaluate project performance upon completion. METHODS: Hypertensive subjects were grouped into a mutually exclusive care cascade of 5 categories including unscreened and undiagnosed; screened but undiagnosed; diagnosed but untreated; treated but uncontrolled and treated with controlled hypertension. RESULTS: Of the 372 participants, mean age 48.9 years, 161 (43.3%) were hypertensive, of whom only 12.0% had controlled blood pressure (BP). Among the 88.0% with uncontrolled BP,19.0% were unscreened and undiagnosed, 48.5% were screened but undiagnosed, 13.0% were diagnosed but untreated and 7.5% were treated but BP uncontrolled. The HCC demonstrates that 19% of the hypertensive patients were lost at the screening stage, 60% of those who were screened never diagnosed, 40% of those who were diagnosed did not receive treatment and 60% of those who were on treatment did not reach target BP. CONCLUSION: Unmet need of hypertension care is substantially high, thus underpinning the need for intervention with a multifaceted approach.


Asunto(s)
Hipertensión , Enfermedades no Transmisibles , Presión Sanguínea , Participación de la Comunidad , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/terapia , Persona de Mediana Edad , Nigeria , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/terapia
14.
Blood Press Monit ; 27(1): 33-38, 2022 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-34992205

RESUMEN

BACKGROUND AND OBJECTIVES: Hypertension is one of the most important risk factors for cardiovascular and cerebrovascular events. Inflammatory processes occupy an important place in the pathogenesis of hypertension. Many studies have studied inflammatory markers responsible for the onset of hypertension and organ damage. In this study, we investigated whether the systemic immune-inflammation index (SII) (platelet × neutrophil/lymphocyte), - one of the new inflammatory markers - can be used to predict cerebrovascular events in hypertensive patients. METHODS: Ambulatory blood pressure monitoring results between January 2019 and June 2020 of approximately 379 patients followed up with hypertension were retrospectively analyzed. These patients were divided into two groups as with or without a previous cerebrovascular event in the analyzed database. In all patients, complete blood count and biochemistry test results just before the cerebrovascular event were found from the database. SII, atherogenic index, neutrophil-lymphocyte ratio were calculated from the complete blood count. Forty-nine patients with stroke (group 1: 12.9%; mean age: 64.3 ± 14.6) and 330 patients without stroke (group 2: 87.1%; mean age: 50.8 ± 14.4). RESULTS: Ambulatory blood pressure measurements were lower in group 1. Lipid parameters were also lower in this group. Receiver operating characteristic curve analysis showed that SII had a sensitivity of 85.7% and specificity of 84.8 % for stroke in individuals who participated in the study when the cutoff value of SII was 633.26 × 103 (P = 0.0001) area under curve (95%); 0.898 (0.856-0.941). In multivariate logistic regression analysis, age and SII were significantly associated with a higher risk of stroke. Age, (hazard ratio:1.067; 95% CI, 1.021-1.115), SII (hazard ratio:1.009; 95% CI, 1.000-1.009), respectively. CONCLUSIONS: In conclusion, SII is a simple, useful new inflammatory parameter for predicting stroke from hypertension. We found that the high SII levels increase the risk of stroke in hypertensive patients.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial , Hipertensión , Adulto , Anciano , Presión Sanguínea , Humanos , Hipertensión/complicaciones , Inflamación , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos
15.
G Ital Cardiol (Rome) ; 23(1): 10-14, 2022 Jan.
Artículo en Italiano | MEDLINE | ID: mdl-34985455

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly spread across the world, killing more than 4 million individuals globally, with 240 million individuals being confirmed by laboratory tests. Among different therapeutic strategies to prevent SARS-CoV-2 infection, vaccines are the most promising approach for curbing the pandemic. They elicit an immune neutralizing response and thus offer protection against coronavirus disease 2019 (COVID-19). However, some questions regarding the safety of COVID-19 vaccines have been raised and based on sparse reports of severe systemic reactions after vaccination. Among these, evidences on the potential effect of vaccination on the acute rise in blood pressure have been recently accrued. Approved vaccines in Europe increase the endogenous synthesis of SARS-CoV-2 Spike proteins from a variety of cells. Once synthetized in the cells reached by the vaccine, the Spike proteins first assemble in the cytoplasm and then migrate to the cell surface to protrude with a native-like conformation. Spike proteins are recognized by the immune system which rapidly develops an immune response. Furthermore, the Spike proteins assembled in the cells which are eventually destroyed by the immune response circulate in the blood as free-floating forms. Free-floating Spike proteins may interact with angiotensin-converting enzyme 2 (ACE2) receptors leading to internalization, degradation, and dysregulation of the catalytic activities of these receptors. The consequent loss of ACE2 receptor activity leads to a rapid drop in the generation of angiotensin1,7 resulting from inactivation of angiotensin II. The imbalance between angiotensin II (overactivity) and of angiotensin1,7 (deficiency) might play a role in the genesis of acute elevation in blood pressure.


Asunto(s)
COVID-19 , Hipertensión , Vacunas contra la COVID-19 , Humanos , SARS-CoV-2 , Vacunación
16.
Invest Ophthalmol Vis Sci ; 63(1): 1, 2022 01 03.
Artículo en Inglés | MEDLINE | ID: mdl-34978560

RESUMEN

Purpose: The purpose of this study was to investigate trabecular meshwork (TM) and Schlemm's canal (SC) morphology in Posner-Schlossman syndrome (PSS). Methods: Forty-five patients with PSS were recruited. TM thickness and length as well as SC area and diameter of both affected and fellow eyes were assessed using swept-source optical coherence tomography. Results: TM thickness (108.24 ± 28.29 µm vs. 89.36 ± 25.82 µm, P = 0.014), SC area (6010.90 ± 1287.54 µm2 vs. 5445.69 ± 1368.89 µm2, P = 0.003), and SC diameter (239.38 ± 60.17 µm vs. 217.76 ± 60.79 µm, P = 0.010) were significantly greater in the affected eyes. Furthermore, TM thickness (113.32 ± 30.03 µm vs. 89.00 ± 26.99 µm, P = 0.046), SC area (6216.32 ± 1267.87 µm2 vs. 5476.40 ± 1390.15 µm2, P = 0.001), and SC diameter (246.82 ± 64.12 vs. 212.53 ± 64.29 µm, P = 0.001) were significantly greater in the affected eyes than in the fellow eyes in the ocular hypertension (OHT) subgroup (affected eye with intraocular pressure [IOP] > 21 mm Hg). However, those differences were not noted in the ocular normal tension (ONT) subgroup (affected eye with IOP ≤ 21 mm Hg, all P > 0.05). Conclusions: TM edema might play a role in the IOP elevation in PSS. The edematous TM could make controlling IOP of the affected eyes difficult. When TM edema is relieved, IOP of the affected eyes can reduce to normal spontaneously or with IOP-lowing medications.


Asunto(s)
Limbo de la Córnea/patología , Malla Trabecular/patología , Uveítis Anterior/patología , Adulto , Estudios Transversales , Femenino , Glaucoma de Ángulo Abierto/patología , Gonioscopía , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Hipertensión Ocular/patología , Tamaño de los Órganos , Microscopía con Lámpara de Hendidura , Síndrome , Tomografía de Coherencia Óptica , Adulto Joven
17.
Br J Radiol ; 95(1129): 20210699, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34538091

RESUMEN

Dual-energy CT (DECT) imaging is a technique that extends the capabilities of CT beyond that of established densitometric evaluations. CT pulmonary angiography (CTPA) performed with dual-energy technique benefits from both the availability of low kVp CT data and also the concurrent ability to quantify iodine enhancement in the lung parenchyma. Parenchymal enhancement, presented as pulmonary perfused blood volume maps, may be considered as a surrogate of pulmonary perfusion. These distinct capabilities have led to new opportunities in the evaluation of pulmonary vascular diseases. Dual-energy CTPA offers the potential for improvements in pulmonary emboli detection, diagnostic confidence, and most notably severity stratification. Furthermore, the appreciated insights of pulmonary vascular physiology conferred by DECT have resulted in increased use for the assessment of pulmonary hypertension, with particular utility in the subset of patients with chronic thromboembolic pulmonary hypertension. With the increasing availability of dual energy-capable CT systems, dual energy CTPA is becoming a standard-of-care protocol for CTPA acquisition in acute PE. Furthermore, qualitative and quantitative pulmonary vascular DECT data heralds promise for the technique as a "one-stop shop" for diagnosis and surveillance assessment in patients with pulmonary hypertension. This review explores the current application, clinical value, and limitations of DECT imaging in acute and chronic pulmonary vascular conditions. It should be noted that certain manufacturers and investigators prefer alternative terms, such as spectral or multi-energy CT imaging. In this review, the term dual energy is utilised, although readers can consider these terms synonymous for purposes of the principles explained.


Asunto(s)
Angiografía por Tomografía Computarizada/métodos , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Vasculares/diagnóstico por imagen , Angiografía por Tomografía Computarizada/instrumentación , Humanos , Hipertensión Pulmonar/diagnóstico por imagen , Circulación Pulmonar , Embolia Pulmonar/diagnóstico por imagen
18.
Yonsei Med J ; 63(1): 26-33, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34913281

RESUMEN

PURPOSE: Oxidative stress plays an important role in the pathogenesis of chronic metabolic diseases. This study investigated the effect of the antioxidant-rich dietary intervention on oxidative stress, metabolic parameters, and arterial stiffness in elderly Koreans with metabolic syndrome (MetS). MATERIALS AND METHODS: Thirty-one subjects with MetS were enrolled and randomly divided into dietary intervention group and control group. Subjects in the intervention group received three meal boxes prepared with antioxidant-rich ingredients every day for 4 weeks, and subjects in the control group maintained their usual diets. Anthropometric and various biochemical parameters related to oxidative stress, inflammation, and MetS were assessed. Brachial-ankle pulse wave velocity (baPWV) and fat measurement using computed tomography were also conducted before and after 4 weeks. RESULTS: There were significant differences in waist circumference, visceral to subcutaneous fat ratio, lipid peroxidation, oxidized low density lipoprotein (oxLDL), systolic and diastolic blood pressure, lipid parameters, advanced glycation end products, and baPWV between before and after the study in the experimental group (all p<0.05). Significant inter-group differences were observed between the experimental and control group in terms of the differences in body mass index, waist circumference, oxygen radical absorbance capacity, protein carboxylation, lipid peroxidation, oxLDL, blood pressure, lipid parameters, and baPWV between before and after the study (all p<0.05). CONCLUSION: Antioxidant-rich dietary intervention for a 4-week period ameliorated the state of oxidative stress and improved the components of MetS including central obesity, dyslipidemia, hypertension, and arterial stiffness in elderly Koreans with MetS.


Asunto(s)
Hipertensión , Síndrome Metabólico , Rigidez Vascular , Anciano , Índice Tobillo Braquial , Antioxidantes , Presión Sanguínea , Humanos , Análisis de la Onda del Pulso , República de Corea
19.
J Clin Neurosci ; 95: 172-179, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34929642

RESUMEN

Idiopathic intracranial hypertension (IIH) is characterized by increased intracranial pressure, manifested by papilledema and radiological findings, in the absence of an identifiable casual factor. The primary symptoms include headache, vision loss, and pulsatile tinnitus, and are recognized to have profound impacts on quality of life and visual function. IIH demonstrates a strong predilection towards obese women of reproductive age, and the population incidence is rising with the growing prevalence of obesity worldwide. The pathophysiology involves dysregulation of cerebrospinal fluid (CSF) dynamics and venous sinus pressure, and recent studies highlighting the pathogenic role of metabolic and hormonal factors have led to the identification of several pharmacological targets and development of novel therapeutic agents. The overarching treatment goals include symptomatic alleviation and prevention of permanent vision loss. The Idiopathic Intracranial Hypertension Treatment Trial, the first of its kind randomized controlled trial on IIH, provides class I evidence for treatment with weight loss and acetazolamide. In medically refractive or fulminant cases, optic nerve sheath fenestration, CSF diversion, and venous sinus stenting, have been successfully implemented. However, there are few high-quality prospective studies investigating the treatment and natural history of IIH, highlighting the compelling need for further research to determine the optimal treatment regimen.


Asunto(s)
Hipertensión Intracraneal , Seudotumor Cerebral , Femenino , Humanos , Estudios Prospectivos , Seudotumor Cerebral/diagnóstico , Seudotumor Cerebral/terapia , Calidad de Vida , Stents
20.
Biol Trace Elem Res ; 200(1): 67-75, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33634366

RESUMEN

Hypertension (HT) is an important risk factor for mortality and morbidity. Previous studies showed that cadmium (Cd) was associated with increased blood pressures and the prevalence of HT. This study hypothesized that Cd, regardless of its level, may increase blood pressures/HT. The objective of this study was to examine the associations between a low level of serum Cd concentration and blood pressures/HT among a general population in the Iwaki area, Japan. This was a cross-sectional study, conducted in the Aomori prefecture with 1144 volunteers aged over 19 years old, who were participants of the Iwaki health check-up in 2014. The study assessed questionnaire survey, body composition, and serum Cd concentrations. Median serum Cd concentration was 0.06 ng/mL (interquartile range 0.05-0.08 ng/mL) among our study population. Compared to the lowest quintile of serum Cd concentration group, the highest quintile of serum Cd concentration group had 4.9 mmHg higher systolic blood pressure (SBP) (95% confidence interval [CI] 1.53-8.31, p < 0.01) and 2.4 mmHg higher diastolic blood pressure (DBP) (95% CI 0.36-4.34, p < 0.05), compared to the lowest quintile group. Similarly, the highest quintile of serum Cd concentration group had 1.7 times higher prevalence of HT (95% CI 1.10-2.51, p < 0.05) than the lowest quintile group. This study identified that higher serum Cd concentration was significantly, positively, associated with SBP and DBP and HT prevalence. This study provided evidence for the associations between environmental exposure to Cd and blood pressures/HT which should be considered for future preventive measures.


Asunto(s)
Cadmio , Hipertensión , Adulto , Anciano , Presión Sanguínea , Estudios Transversales , Humanos , Japón/epidemiología , Adulto Joven
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