Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 156.673
Filtrar
1.
Int J Mol Sci ; 22(10)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064609

RESUMO

Monogenic hypertension is rare and caused by genetic mutations, but whether factors associated with mutations are disease-specific remains uncertain. Given two factors associated with high mutation rates, we tested how many previously known genes match with (i) proximity to telomeres or (ii) high adenine and thymine content in cardiovascular diseases (CVDs) related to vascular stiffening. We extracted genomic information using a genome data viewer. In human chromosomes, 64 of 79 genetic loci involving >25 rare mutations and single nucleotide polymorphisms satisfied (i) or (ii), resulting in an 81% matching rate. However, this high matching rate was no longer observed as we checked the two factors in genes associated with essential hypertension (EH), thoracic aortic aneurysm (TAA), and congenital heart disease (CHD), resulting in matching rates of 53%, 70%, and 75%, respectively. A matching of telomere proximity or high adenine and thymine content projects the list of loci involving rare mutations of monogenic hypertension better than those of other CVDs, likely due to adoption of rigorous criteria for true-positive signals. Our data suggest that the factor-disease matching rate is an accurate tool that can explain deleterious mutations of monogenic hypertension at a >80% match-unlike the relatively lower matching rates found in human genes of EH, TAA, CHD, and familial Parkinson's disease.


Assuntos
Doenças Cardiovasculares/genética , Predisposição Genética para Doença , Mutação , Doenças do Sistema Nervoso/genética , Polimorfismo de Nucleotídeo Único , Telômero/genética , Adenina/metabolismo , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Humanos , Doenças do Sistema Nervoso/metabolismo , Doenças do Sistema Nervoso/patologia , Timina/metabolismo
2.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 507-509, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098664

RESUMO

The common chronic disorders in the world, such as cardiovascular diseases, diabetes mellitus, cancers, etc., are all the multi-factorial diseases. They are caused by the interactions of various risk factors among which inflammation plays an important role in the pathogenesis of all these chronic disorders. Any factor which contributes or enhances systemic inflammatory burdens may serve as the risk factors of these diseases. During periodontitis, the bacteremia and subsequent systemic dispersal of periodontal pathogens and bacterial components may elicit production of pro-inflammatory immune mediators, and the pro-inflammatory immune mediators produced locally at the periodontal lesion may also enter the systemic circulation. Behaving as a potential source for increased chronic systemic inflammatory challenge, periodontitis contributes as the risk factor of these systemic inflammation associated chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Periodontite , Humanos , Inflamação , Fatores de Risco
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(6): 584-590, 2021 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-34098676

RESUMO

Periodontitis is closely related to systemic health, especially cardiovascular disease. Periodontal pathogens from periodontal infection actively participate in the formation and development of coronary atherosclerosis. At present, accumulcted evidences show that periodontal pathogen infection is an independent risk factor for cardiovascular events, which promotes the deepening of atherosclerosis through a variety of immune inflammation and metabolism-related molecular mechanisms. The present article reviews multipal aspects of the correlation between periodontitis and periodontal pathogens and cardiovascular disease, and the mechanism of periodontal pathogens affecting the occurrence and development of atherosclerosis.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Periodontite , Humanos , Inflamação , Fatores de Risco
4.
Mar Drugs ; 19(6)2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34073964

RESUMO

Stonefish are regarded as one of the most venomous fish in the world. Research on stonefish venom has chiefly focused on the in vitro and in vivo neurological, cardiovascular, cytotoxic and nociceptive effects of the venom. The last literature review on stonefish venom was published over a decade ago, and much has changed in the field since. In this review, we have generated a global map of the current distribution of all stonefish (Synanceia) species, presented a table of clinical case reports and provided up-to-date information about the development of polyspecific stonefish antivenom. We have also presented an overview of recent advancements in the biomolecular composition of stonefish venom, including the analysis of transcriptomic and proteomic data from Synanceia horrida venom gland. Moreover, this review highlights the need for further research on the composition and properties of stonefish venom, which may reveal novel molecules for drug discovery, development or other novel physiological uses.


Assuntos
Mordeduras e Picadas/epidemiologia , Mordeduras e Picadas/terapia , Venenos de Peixe/envenenamento , Peixes Venenosos , Animais , Mordeduras e Picadas/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Venenos de Peixe/análise , Venenos de Peixe/química , Peixes Venenosos/fisiologia , Geografia , Humanos , Oceano Índico/epidemiologia , Doenças Neuromusculares/epidemiologia , Doenças Neuromusculares/etiologia , Doenças Neuromusculares/terapia , Oceano Pacífico/epidemiologia
5.
Int J Mol Sci ; 22(10)2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-34066288

RESUMO

Obstructive sleep apnea (OSA) is known to be an independent cardiovascular risk factor. Among arousal from sleep, increased thoracic pressure and enhanced sympathetic activation, intermittent hypoxia is now considered as one of the most important pathophysiological mechanisms contributing to the development of endothelial dysfunction. Nevertheless, not much is known about blood components, which justifies the current review. This review focuses on molecular mechanisms triggered by sleep apnea. The recurrent periods of hypoxemia followed by reoxygenation promote reactive oxygen species (ROS) overproduction and increase inflammatory response. In this review paper we also intend to summarize the effect of treatment with continuous positive airway pressure (CPAP) on changes in the profile of the endothelial function and its subsequent potential clinical advantage in lowering cardiovascular risk in other comorbidities such as diabetes, atherosclerosis, hypertension, atrial fibrillation. Moreover, this paper is aimed at explaining how the presence of OSA may affect platelet function and exert effects on rheological activity of erythrocytes, which could also be the key to explaining an increased risk of stroke.


Assuntos
Doenças Cardiovasculares/etiologia , Endotélio Vascular/patologia , Eritrócitos/patologia , Hipóxia/fisiopatologia , Estresse Oxidativo , Apneia Obstrutiva do Sono/complicações , Animais , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Pressão Positiva Contínua nas Vias Aéreas , Endotélio Vascular/metabolismo , Eritrócitos/metabolismo , Humanos , Espécies Reativas de Oxigênio/metabolismo , Apneia Obstrutiva do Sono/metabolismo , Apneia Obstrutiva do Sono/patologia
6.
Soins ; 66(855): 14-18, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34103126

RESUMO

The condition of women has vastly improved over recent decades: respect of equality, better salary conditions and health status. Although women, like men, are living longer, certain differences in care are emerging. This survey studies the characteristics of women's cardiovascular health, especially in terms of treatment and follow-up.


Assuntos
Doenças Cardiovasculares , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Feminino , Seguimentos , Nível de Saúde , Humanos , Masculino , Saúde da Mulher
7.
Molecules ; 26(10)2021 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-34064568

RESUMO

Resveratrol is a phytoalexin produced by many plants as a defense mechanism against stress-inducing conditions. The richest dietary sources of resveratrol are berries and grapes, their juices and wines. Good bioavailability of resveratrol is not reflected in its high biological activity in vivo because of resveratrol isomerization and its poor solubility in aqueous solutions. Proteins, cyclodextrins and nanomaterials have been explored as innovative delivery vehicles for resveratrol to overcome this limitation. Numerous in vitro and in vivo studies demonstrated beneficial effects of resveratrol in cardiovascular diseases (CVD). Main beneficial effects of resveratrol intake are cardioprotective, anti-hypertensive, vasodilatory, anti-diabetic, and improvement of lipid status. As resveratrol can alleviate the numerous factors associated with CVD, it has potential as a functional supplement to reduce COVID-19 illness severity in patients displaying poor prognosis due to cardio-vascular complications. Resveratrol was shown to mitigate the major pathways involved in the pathogenesis of SARS-CoV-2 including regulation of the renin-angiotensin system and expression of angiotensin-converting enzyme 2, stimulation of immune system and downregulation of pro-inflammatory cytokine release. Therefore, several studies already have anticipated potential implementation of resveratrol in COVID-19 treatment. Regular intake of a resveratrol rich diet, or resveratrol-based complementary medicaments, may contribute to a healthier cardio-vascular system, prevention and control of CVD, including COVID-19 disease related complications of CVD.


Assuntos
COVID-19/tratamento farmacológico , Doenças Cardiovasculares , Resveratrol , SARS-CoV-2/metabolismo , Disponibilidade Biológica , COVID-19/complicações , COVID-19/metabolismo , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Humanos , Resveratrol/farmacocinética , Resveratrol/uso terapêutico
8.
BMJ Open ; 11(6): e045537, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135038

RESUMO

INTRODUCTION: Career firefighters experience chronic circadian rhythm disruption, increasing their risk of cardiometabolic disease. The recent discovery that eating patterns regulate circadian rhythmicity in metabolic organs has raised the hypothesis that maintaining a consistent daily cycle of eating and fasting can support circadian rhythms and reduce disease risks. Preclinical animal studies and preliminary clinical trials have shown promising effects of time-restricted eating (TRE) to reduce disease risk without compromising physical performance. However, there is a lack of research on TRE in shift workers including firefighters. This study aims to investigate the feasibility and efficacy of 10-hour TRE on health parameters that contribute to cardiometabolic disease risks among career firefighters who work on a 24-hour shift schedule. METHODS AND ANALYSES: The Healthy Heroes Study is a randomised controlled parallel open-label clinical trial with 150 firefighters over 1 year. Firefighters are randomised with a 1:1 ratio to either the control or intervention group. The control group receives Mediterranean diet nutritional counselling (standard of care, 'SOC'). The intervention group receives the same SOC and a self-selected 10-hour TRE window. After the 2-week baseline, participants enter a 3-month monitored intervention, followed by a 9-month self-guided period with follow-up assessments. The impact of TRE on blood glucose, body weight, body composition, biomarkers (neuroendocrine, inflammatory and metabolic), sleep and mood is evaluated. These assessments occur at baseline, at the end of intervention and at 6, 9 and 12-month follow-ups. Temporal calorie intake is monitored with the smartphone application myCircadianClock throughout the study. Continuous glucose monitors, wrist-worn actigraphy device and questionnaires are used to monitor glucose levels, activity, sleep and light exposure. ETHICS AND DISSEMINATION: The study was approved by the Institutional Review Boards of the University of California San Diego and the Salk Institute for Biological Studies. Results will be disseminated through peer-reviewed manuscripts, reports and presentations. TRIAL REGISTRATION NUMBER: NCT03533023; Pre result.


Assuntos
Doenças Cardiovasculares , Bombeiros , Jornada de Trabalho em Turnos , Doenças Cardiovasculares/prevenção & controle , Ritmo Circadiano , Estudos de Viabilidade , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Pharmacol Rev ; 73(3): 924-967, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34088867

RESUMO

The endothelium, a cellular monolayer lining the blood vessel wall, plays a critical role in maintaining multiorgan health and homeostasis. Endothelial functions in health include dynamic maintenance of vascular tone, angiogenesis, hemostasis, and the provision of an antioxidant, anti-inflammatory, and antithrombotic interface. Dysfunction of the vascular endothelium presents with impaired endothelium-dependent vasodilation, heightened oxidative stress, chronic inflammation, leukocyte adhesion and hyperpermeability, and endothelial cell senescence. Recent studies have implicated altered endothelial cell metabolism and endothelial-to-mesenchymal transition as new features of endothelial dysfunction. Endothelial dysfunction is regarded as a hallmark of many diverse human panvascular diseases, including atherosclerosis, hypertension, and diabetes. Endothelial dysfunction has also been implicated in severe coronavirus disease 2019. Many clinically used pharmacotherapies, ranging from traditional lipid-lowering drugs, antihypertensive drugs, and antidiabetic drugs to proprotein convertase subtilisin/kexin type 9 inhibitors and interleukin 1ß monoclonal antibodies, counter endothelial dysfunction as part of their clinical benefits. The regulation of endothelial dysfunction by noncoding RNAs has provided novel insights into these newly described regulators of endothelial dysfunction, thus yielding potential new therapeutic approaches. Altogether, a better understanding of the versatile (dys)functions of endothelial cells will not only deepen our comprehension of human diseases but also accelerate effective therapeutic drug discovery. In this review, we provide a timely overview of the multiple layers of endothelial function, describe the consequences and mechanisms of endothelial dysfunction, and identify pathways to effective targeted therapies. SIGNIFICANCE STATEMENT: The endothelium was initially considered to be a semipermeable biomechanical barrier and gatekeeper of vascular health. In recent decades, a deepened understanding of the biological functions of the endothelium has led to its recognition as a ubiquitous tissue regulating vascular tone, cell behavior, innate immunity, cell-cell interactions, and cell metabolism in the vessel wall. Endothelial dysfunction is the hallmark of cardiovascular, metabolic, and emerging infectious diseases. Pharmacotherapies targeting endothelial dysfunction have potential for treatment of cardiovascular and many other diseases.


Assuntos
Aterosclerose , COVID-19 , Fármacos Cardiovasculares , Doenças Cardiovasculares , Endotélio Vascular , Aterosclerose/tratamento farmacológico , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , COVID-19/tratamento farmacológico , COVID-19/metabolismo , COVID-19/fisiopatologia , Fármacos Cardiovasculares/classificação , Fármacos Cardiovasculares/farmacologia , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Descoberta de Drogas , Endotélio Vascular/efeitos dos fármacos , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiopatologia , Humanos , Terapia de Alvo Molecular/métodos , Terapia de Alvo Molecular/tendências , SARS-CoV-2
10.
JAMA ; 325(22): 2294-2306, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34100866

RESUMO

Importance: General health checks, also known as general medical examinations, periodic health evaluations, checkups, routine visits, or wellness visits, are commonly performed in adult primary care to identify and prevent disease. Although general health checks are often expected and advocated by patients, clinicians, insurers, and health systems, others question their value. Observations: Randomized trials and observational studies with control groups reported in prior systematic reviews and an updated literature review through March 2021 were included. Among 19 randomized trials (906 to 59 616 participants; follow-up, 1 to 30 years), 5 evaluated a single general health check, 7 evaluated annual health checks, 1 evaluated biannual checks, and 6 evaluated health checks delivered at other frequencies. Twelve of 13 observational studies (240 to 471 415 participants; follow-up, cross-sectional to 5 years) evaluated a single general health check. General health checks were generally not associated with decreased mortality, cardiovascular events, or cardiovascular disease incidence. For example, in the South-East London Screening Study (n = 7229), adults aged 40 to 64 years who were invited to 2 health checks over 2 years, compared with adults not invited to screening, experienced no 8-year mortality benefit (6% vs 5%). General health checks were associated with increased detection of chronic diseases, such as depression and hypertension; moderate improvements in controlling risk factors, such as blood pressure and cholesterol; increased clinical preventive service uptake, such as colorectal and cervical cancer screening; and improvements in patient-reported outcomes, such as quality of life and self-rated health. In the Danish Check-In Study (n = 1104), more patients randomized to receive to a single health check, compared with those randomized to receive usual care, received a new antidepressant prescription over 1 year (5% vs 2%; P = .007). In a propensity score-matched analysis (n = 8917), a higher percentage of patients who attended a Medicare Annual Wellness Visit, compared with those who did not, underwent colorectal cancer screening (69% vs 60%; P < .01). General health checks were sometimes associated with modest improvements in health behaviors such as physical activity and diet. In the OXCHECK trial (n = 4121), fewer patients randomized to receive annual health checks, compared with those not randomized to receive health checks, exercised less than once per month (68% vs 71%; difference, 3.3% [95% CI, 0.5%-6.1%]). Potential adverse effects in individual studies included an increased risk of stroke and increased mortality attributed to increased completion of advance directives. Conclusions and Relevance: General health checks were not associated with reduced mortality or cardiovascular events, but were associated with increased chronic disease recognition and treatment, risk factor control, preventive service uptake, and improved patient-reported outcomes. Primary care teams may reasonably offer general health checks, especially for groups at high risk of overdue preventive services, uncontrolled risk factors, low self-rated health, or poor connection or inadequate access to primary care.


Assuntos
Exame Físico , Atenção Primária à Saúde , Prevenção Primária , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/prevenção & controle , Doença Crônica , Neoplasias Colorretais/diagnóstico , Depressão/diagnóstico , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Observacionais como Assunto/estatística & dados numéricos , Exame Físico/efeitos adversos , Serviços Preventivos de Saúde/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia
11.
J Pak Med Assoc ; 71(4): 1128-1132, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125756

RESUMO

OBJECTIVE: To estimate the levels of myeloperoxidase in various stages of chronic kidney disease, and to correlate them with an inflammatory marker and lipid profile. Method: The cross-sectional study was conducted at the Biochemistry Department, Basic Medical Sciences Institute, in collaboration with the Nephrology Department, Jinnah Post Graduate Medical Centre, Karachi, from January 2013 to September 2014, and comprised chronic kidney disease patients and healthy controls. Serum cholesterol, triglycerides, high-density lipoprotein, C-reactive protein and myeloperoxidase levels were noted. Data was subjected to statistical analysis. RESULTS: Of the 150 subjects, 84(56%) were cases and 66(44%) were controls. Weight, body mass index, triglycerides, very low-density lipoprotein, C-reactive protein and myeloperoxidase levels were significantly higher among the cases compared to the controls (p<0.05). Serum myeloperoxidase had a significantly positive association with C-reactive protein (p<0.01), cholesterol (p<0.01), triglycerides (p<0.01), low-density lipoprotein (p<0.01) and very low-density lipoprotein (p<0.01), and had a negative correlation with high-density lipoprotein (p<0.01). CONCLUSIONS: Myeloperoxidase concentration had association with lipid profile and C-reactive protein.


Assuntos
Doenças Cardiovasculares , Insuficiência Renal Crônica , Doenças Cardiovasculares/epidemiologia , HDL-Colesterol , Estudos Transversais , Humanos , Peroxidase , Insuficiência Renal Crônica/epidemiologia , Centros de Atenção Terciária , Triglicerídeos
14.
Biomed Environ Sci ; 34(5): 395-399, 2021 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-34059177

RESUMO

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Doenças Cardiovasculares/etiologia , Temperatura Baixa/efeitos adversos , Doenças do Sistema Digestório/etiologia , Utilização de Instalações e Serviços/estatística & dados numéricos , Temperatura Alta/efeitos adversos , Doenças Respiratórias/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Criança , Pré-Escolar , China/epidemiologia , Efeitos Psicossociais da Doença , Doenças do Sistema Digestório/epidemiologia , Doenças do Sistema Digestório/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/terapia , Fatores de Risco , Adulto Jovem
15.
Int J Mol Sci ; 22(9)2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-34064510

RESUMO

The nuclear factor of activated T cells 5 (NFAT5) is well known for its sensitivity to cellular osmolarity changes, such as in the kidney medulla. Accumulated evidence indicates that NFAT5 is also a sensitive factor to stress signals caused by non-hypertonic stimuli such as heat shock, biomechanical stretch stress, ischaemia, infection, etc. These osmolality-related and -unrelated stimuli can induce NFAT5 upregulation, activation and nuclear accumulation, leading to its protective role against various detrimental effects. However, dysregulation of NFAT5 expression may cause pathological conditions in different tissues, leading to a variety of diseases. These protective or pathogenic effects of NFAT5 are dictated by the regulation of its target gene expression and activation of its signalling pathways. Recent studies have found a number of kinases that participate in the phosphorylation/activation of NFAT5 and related signal proteins. Thus, this review will focus on the NFAT5-mediated signal transduction pathways. As for the stimuli that upregulate NFAT5, in addition to the stresses caused by hyperosmotic and non-hyperosmotic environments, other factors such as miRNA, long non-coding RNA, epigenetic modification and viral infection also play an important role in regulating NFAT5 expression; thus, the discussion in this regard is another focus of this review. As the heart, unlike the kidneys, is not normally exposed to hypertonic environments, studies on NFAT5-mediated cardiovascular diseases are just emerging and rapidly progressing. Therefore, we have also added a review on the progress made in this field of research.


Assuntos
Doenças Cardiovasculares/genética , Epigênese Genética , MicroRNAs/genética , RNA Longo não Codificante/genética , Fatores de Transcrição/genética , Viroses/genética , Proteínas de Ancoragem à Quinase A/genética , Proteínas de Ancoragem à Quinase A/metabolismo , Animais , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/patologia , Metilação de DNA , Proteínas de Choque Térmico HSP70/genética , Proteínas de Choque Térmico HSP70/metabolismo , Resposta ao Choque Térmico/genética , Histonas/genética , Histonas/metabolismo , Humanos , Medula Renal/metabolismo , Medula Renal/patologia , MicroRNAs/metabolismo , Antígenos de Histocompatibilidade Menor/genética , Antígenos de Histocompatibilidade Menor/metabolismo , Concentração Osmolar , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas/metabolismo , RNA Longo não Codificante/metabolismo , Transdução de Sinais , Fatores de Transcrição/metabolismo , Viroses/metabolismo , Viroses/patologia , Viroses/virologia , Proteínas Quinases p38 Ativadas por Mitógeno/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
16.
Curr Treat Options Oncol ; 22(7): 58, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34097148

RESUMO

OPINION STATEMENT: Cardio-oncology is a field dedicated to the prevention, diagnosis, and management of cardiovascular disease in cancer patients before, during, and after cancer therapy. It is an emerging field with limited opportunities for structured education and training. In the year 2021, we cannot define the requirements of cardio-oncology training without acknowledging the impact of the global coronavirus disease 19 (COVID-19) pandemic. While this pandemic poses significant health risks to patients with cancer and cardiovascular disease as well as the providers who care for them, it also allows novel opportunities for the nascent field of cardio-oncology to readily adapt. In this article, we detail how the COVID-19 pandemic has impacted all aspects of cardio-oncology training, how programs and trainees can adapt to these challenges, and how lessons learned from the COVID-19 era can continue to positively impact cardio-oncology training for the foreseeable future.


Assuntos
COVID-19/complicações , Doenças Cardiovasculares/prevenção & controle , Neoplasias/tratamento farmacológico , COVID-19/virologia , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/virologia , Humanos , Oncologia/tendências , Neoplasias/complicações , Neoplasias/patologia , Neoplasias/virologia , SARS-CoV-2/patogenicidade
19.
BMC Public Health ; 21(1): 1031, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074276

RESUMO

BACKGROUND: The rate of decline in cardiovascular disease (CVD) mortality has lessened nationally. How these findings apply to specific states or causes of CVD deaths is not known. Examining these trends at the state level is important to plan local interventions. METHODS: We analyzed CVD mortality trends in Minnesota (MN) using the U.S. Centers for Disease Control and Prevention (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER). Trends were analyzed by age, sex, type of CVD and location of death. RESULTS: CVD mortality rates in MN declined in 2000-2009 and then leveled off in 2010-2018, paralleling national rates. Age- and sex-adjusted CVD mortality decreased by 3.7% per year in 2000-2009 (average annual percent changes [AAPC]: -3.7; 95% CI: - 4.8, - 2.6) with no change observed in 2010-2018. Those aged 65-84 years had the most rapid early decline in CVD mortality (AAPC: -5.9, 95% CI: - 6.2, - 5.7) and had less improvement in 2010-2018 (AAPC: -1.8, 95% CI: - 2.2, - 1.5), and the younger age group (25-64 years) now experiences the most adverse trends (AAPC: 1.2, 95% CI: 0.7-1.8). Coronary heart disease (CHD) and cerebrovascular disease had the largest relative decreases in mortality in 2000-2009 (CHD AAPC: -5.2; 95% CI: - 6.5,-3.9; cerebrovascular disease AAPC: -4.4, 95% CI: - 5.2, - 3.6) with no change 2010-2018. Heart failure (HF)/cardiomyopathy followed similar trends with a 2.5% decrease (AAPC 95% CI: - 3.5, - 1.5) per year in 2000-2009 and no change in 2010-2018. Deaths from other CVD also decreased in the early time period (AAPC: -1.6, 95% CI: - 2.7, - 0.5) but increased in 2010-2018 (AAPC: 1.9, 95% CI: 0.5, 3.3). In- and out-of-hospital death rates improved in 2000-2009 with a slowing in improvement for in-hospital death and no further improvement for out-of-hospital death in 2010-2018. CONCLUSION: Concerning CVD mortality trends occurred in MN. In the most recent decade (2010-2018) mortality from all CVD subtypes plateaued or even increased. CVD mortality among the younger age groups increased as well. These data are congruent with adverse national trends supporting their generalizability. These adverse trends underscore the urgent need for CVD prevention and treatment, as well as continued surveillance to assess progress at the state and national level.


Assuntos
Doenças Cardiovasculares , Transtornos Cerebrovasculares , Insuficiência Cardíaca , Adulto , Transtornos Cerebrovasculares/epidemiologia , Mortalidade Hospitalar , Humanos , Pessoa de Meia-Idade , Minnesota/epidemiologia
20.
Ann Med ; 53(1): 874-884, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34096808

RESUMO

BACKGROUND: Statins are widely used to treat people with metabolic and cardiovascular disorders. The effect of statins on coronavirus disease 2019 (COVID-19) is unclear. To investigate the association between statins and COVID-19 outcomes and, if possible, identify the subgroup population that benefits most from statin use. MATERIALS AND METHODS: A systematic review and meta-analysis of published studies that included statin users and described COVID-19 outcomes through 10 November 2020. This study used the generic inverse variance method to perform meta-analyses with random-effects modelling. The main outcomes were evaluation of the need for invasive mechanical ventilator (IMV) support, the need for intensive care unit (ICU) care and death. All outcomes were measured as dichotomous variables. RESULTS: A total of 28 observational studies, covering data from 63,537 individuals with COVID-19, were included. The use of statins was significantly associated with decreased mortality (odds ratio [OR] = 0.71, 95% confidence interval [CI]: 0.55-0.92, I2=72%) and the need for IMV (OR = 0.81, 95% CI: 0.69-0.95, I2=0%) but was not linked to the need for ICU care (OR = 0.91, 95% CI: 0.55-1.51, I2=66%). Subgroup analysis further identified five types of studies in which statin users had even lower odds of death. CONCLUSIONS: The use of statins was significantly associated with a reduced need for IMV and decreased mortality among individuals with COVID-19. Statins may not need to be discontinued because of concern for COVID-19 on admission. Further randomized controlled trial (RCTs) are needed to clarify the causal effect between statin use and severe COVID-19 outcomes.Key messagesParticipants in five types of studies were shown to have even lower odds of death when taking statins.The use of statins was significantly associated with a reduced need for invasive mechanical ventilation and decreased all-cause mortality among individuals with COVID-19. However, statin use did not prevent participants from needing care in the intensive care unit.The results justify performing randomized controlled trials (RCTs) to validate the benefits of statins on COVID-19 outcomes.


Assuntos
COVID-19/mortalidade , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Respiração Artificial/estatística & dados numéricos , COVID-19/terapia , Doenças Cardiovasculares/tratamento farmacológico , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...