Cardiovascular risk factors, geriatrics, nutrition and chronic obstructive pulmonary disease Research Papers (original) (raw)

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder "Betrayer of femininity "affecting about 15 percent women Globally. A polycystic ovary syndrome, a multifactorial reproductive age, metabolic and hormonal affecting condition, increasing number of Adolescent girls and women In Reproductive-Age. it refers to multiple symptoms experienced simultaneously first observed by 'stein-Leventhal' in 1935, so known as 'stein-Leventhal syndrome'.It impact the quality of life and cognitive Wellbeing, which may increase the risk of psychological, neurological issues like anxiety and depression with low self esteem and socially awkward. This study examines the impact of negative peer pressure on adolescents diagnosed with Polycystic Ovary Syndrome (PCOS) characterised by increased susceptibility to peer dynamics, poses unique challenges for individuals navigating the complexities of PCOS management. Negative peer interactions may heightened the psychological agony and health-related struggles experienced by adolescents with PCOS, affecting their self-esteem, adherence to medical treatments, and wellness behaviours. This research investigates the correlation between negative peer pressure and adolescents diagnosed with Polycystic Ovary Syndrome (PCOS),as well as its implications for their health-related

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- Psychology, Infertility, Type 2 Diabetes, Endocrinology & Metabolism

Nonlinear H-infinity control is proposed for the regulation of the levels of oxygen and carbon dioxide in the blood of patients undergoing heart surgery and extracorporeal blood circulation. The levels of blood gases are administered through a membrane oxygenator and the control inputs are the externally supplied oxygen and the aggregate gas supply (oxygen plus nitrogen). The proposed control method is based on linearization of the oxygenator's dynamical model through Taylor series expansion and the computation of Jacobian matrices. The local linearization points are defined by the present value of the oxygenator's state vector and the last value of the control input that was exerted on this system. The modelling errors due to linearization are considered as disturbances which are compensated by the robustness of the control loop. Next, for the linearized model of the oxygenator an H-infinity control input is computed at each iteration of the control algorithm through the solution of an algebraic Riccati equation. With B G. Rigatos

- by Radu-Emil Precup
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- Mathematics, Carbon Dioxide, Oxygen

English) Vitamin D deficiency is newly recognized as a common condition of increasing prevalence worldwide. Clinically, vitamin D has an established role in calcium and bone metabolism, but lower vitamin levels are associated with obesity and an increased risk to develop type 2 diabetes, cardiovascular diseases and cancer. The molecular mechanisms of these associations are partially understood, but it is known that vitamin D stiumlates lypolysis and inhibits adipogenesis in human adipocytes, and lower vitamin D may induce body fat accumulation. Vitamin D receptors are expressed in both pancreatic β-cells and skeletal muscle cells, and their activation results in increased insulin release and responsiveness to insulin for glucose transport. Vitamin D is also newly recognized for potent antiproliferative, prodifferentiative, and immunomodulatory effects in many tissues. Vitamin D deficiency is frequently unrecognized clinically and, although laboratory measurement is easy to perform a...

- by Domenico Caccavo
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- Endocrinology, Obesity, Vitamin D, Type 2 Diabetes

BACKGROUND Currently, chronic obstructive pulmonary disease is the fourth leading cause of death in the world. Nutritional depletion is a common finding in patients with COPD (Chronic Obstructive Pulmonary Disease). Even stable COPD patients have high proportion of under nutrition. Malnutrition is an important factor that leads to low quality of life in COPD patients and could cause exacerbation of the disease. Hence malnutrition needs to be assessed and considered in management of COPD. METHODS A cross sectional study was conducted over a period of 2 years to determine the association of COPD with malnutrition. 50 male COPD patients between 40 to 60 years of age fulfilling the inclusion criteria were selected, and the analysis was restricted to this age group, so as to ensure the uniformity of analysis. They were staged based on PFT and evaluated by anthropometric measures and biochemical parameters. Statistical analysis was done and p < 0.05 was considered statistically significant. RESULTS In this study the average age of the population was 52.52 + 5.64 years. 50 male COPD patients were categorized into mild (n = 10), moderate (n = 27), severe (n = 10) and very severe (n = 3) groups with spirometry based on GOLD criteria. Anthropometric measures (BMI, TSF, MAMA, MAFA) and biochemical parameters (serum albumin and pre-albumin) were evaluated. The difference in severity of airway obstruction, body weight, BMI, pre-albumin and serum albumin among the various age groups was not significant statistically. There was a significant difference (p < 0.05) in BMI, MAMA, MAFA, pre-albumin and serum albumin values in severe and very severe airway obstruction patients when compared to those with mild and moderate airway obstruction. The present study showed a statistically significant and strong correlation of BMI (i.e. r = 0.75 and p < 0.05), MAMA (r = 0.81 and p < 0.05), MAFA (r = 0.72 and p < 0.05), serum pre-albumin (r =-0.315 and p = 0.006), and albumin (r = 0.74) when compared with severity of airway obstruction. CONCLUSION A significant number of patients with Chronic Obstructive Pulmonary Disease was malnourished. Measures of protein stores (serum albumin and pre-albumin) and the anthropometric measures of nutrition [BMI, body muscle mass and fat stores] were inversely related with severity of airway obstruction.

- by Sahithi Challa
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- Medicine, Disease, Intensive Care Medicine, Pulmonary disease

High blood pressurewas the leading cause of death and disability-adjusted life years worldwide. Despite progress in treatment of hypertension, a number of people with uncontrolled or resistant hypertension increases. Hypertensive disorders are strongly linked with an overactive renin-angiotensin aldosterone system. The renin-angiotensin-aldosterone system has been a highly successful pharmacologic target, as the system is strongly implicated in the development of hypertension-related target organ damage.Inhibition of renin-angiotensin aldosterone system, using inhibitors of the angiotensin-converting enzyme or angiotensin II receptor blockers, is an effective way to intervene with the pathogenesis of arterial hypertension.Renin inhibitors block the renin-angiotensin aldosterone systemat the highest level, at its origin, and might thus offer a new exciting approach for pharmacotherapy of hypertension. Aliskiren, an octanamide, is the firstof a new class of completely non-peptide, low...

- by Georges Kamtoh
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- Medicine, Aldosterone, Renin Angiotensin Aldosterone System

Background: Cardiovascular disease (CVD) is the leading cause of death throughout the world. Despite its high prevalence, the atherosclerotic process can be slowed and its consequences markedly reduced by preventive measures. The lack of risk factor awareness is a major barrier. Objectives: We aimed to assess total CV risk, determine the knowledge and awareness regarding CVD, and evaluate the effectiveness of education program in urban population of Turkey. Methods: A 24-item questionnaire was used to detect CV risk factors and the awareness of participants about CVD. The feedback data for the education program were collected by either questionnaires or individual interviews with participants. For comparison of total CVD risk in men and women in different age groups, a sample t test was used. The level of statistical significance was set at p < 0.05. Results: The prevalence of hyperlipidemia was established to be 41.3%. Nearly one-quarter of the women and one-third of the men were smokers (p < 0.001). One-quarter of the responders had a history of hypertension (men: 21.5%, women: 18.6%), and one-tenth were diabetic. The high CV risk rate was more pronounced among men (p < 0.01) and those with low socioeconomic level (p < 0.01). Awareness regarding CV risk factors following the educational program increased from 6.6% to 12.7% for high blood pressure, from 3.9% to 9.2% for diabetes mellitus, and from 10.2% to 15.1% for elevated cholesterol levels. All the increases were statistically significant. The educational program significantly increased the awareness of CVD and risk factors. Conclusions: The prevalence of CV risk factors was higher in low socioeconomic level groups. The knowledge and awareness of the risk factors for CVD before the education program was very low in our study group. The awareness of CVD and risk factors significantly increased following our education programs.

- by Ömer Kozan
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- Medicine, Population, Diabetes mellitus, Hyperlipidemia

Beetroots and tomatoes are rich In vitamins, iron, folic acid, and other nutrients that can be used as an alternative in treating anemia. High protein and calorie intake dietary is necessary to improve patients' nutritional status in pulmonary tuberculosis. The purpose was to examine the effect of beetroot juice consumption, tomato juice combined with a high protein and calorie diet on hemoglobin pulmonary tuberculosis. This research was an analytical comparative with quasi-experimental design by pre-test and post group design. This study was conducted to 45 patients of Pulmonary tuberculosis who having anti-TB treatment at Pulmonary Policlinic Sari Mutiara Medan General Hospital, using purposive sampling technique, divided into three treatment groups. All of the treatments were administered for 30 days, pre and post-treatment were given the hemoglobin test. Data were analyzed by using paired t-test and One Way Anova, followed by Linear Regression. A group treatments are having an increasing level of hemoglobin level in Group I: 2.5 gr/dl, p-value = 0.000., Group II: 1.8 gr/dl. p value = 0.002. , Control group It: 1.1 gr/dl, p-value = 0.004.Beetroot juice with a diet high in proteins and calories most effective to increase levels of hemoglobin and nutritional status in pulmonary tuberculosis, this intervention can be recommended as a management modeling of anemia in pulmonary TB patients who received anti-TB treatment. This open access article is under the CC-BY-SA license.

- by Henny Syapitri
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- Medicine, Anemia, Hemoglobin, Pulmonary Tuberculosis
- by Dragana Mladenovska
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Objectives We aimed to evaluate the changes over time in the prevalence, awareness, treatment, and control rate of hypertension in intervention and reference areas of a comprehensive community trial with reference area. Methods Data from independent sample surveys before and after implementation of the program (2001 vs.2007) were used to compare differences in the intervention and references areas over time. Hypertension was defined as blood pressure ≥140/90 mmHg in non-diabetic patients and ≥130/80 mmHg in diabetic individuals and or taking antihypertensive medications. Interventional activities included educational strategies at population level as well as for hypertensive patients, their families and health professionals. Results The study population of the baseline survey included 6175 (48.7% males) in the interventional area and 6339 (51.3% male) in the reference area. The corresponding figures in the post-intervention phase was 4717 (49.3% male) in the interventional area and ...

- by Nizal Sarrafzadegan
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- Iran, Developing Country, Hypertension, Blood Pressure

The renin-angiotensin (Ang)-aldosterone system (RAAS) consists of a group of enzymes and peptides whose main function is to control blood pressure (BP) by regulating vasoconstriction, sodium reabsorption and body fluid homeostasis. Historical Perspective Our knowledge of the RAAS started in 1898 when Tigerstedt and Bergman showed that renal extract from rabbits increased BP when infused and named it as renin. [1] In 1934, Goldblatt demonstrated that renal artery constriction caused renal ischemia and induced hypertension (HTN) in dogs. Later, in 1939-1940, Braun-Menende in Argentina and Page and Helmer in the USA simultaneously discovered a pressor substance capable of causing renal HTN. This was originally named hypertensin in Argentina and angiotonin in the USA and later renamed as angiotensin to give credit to both groups. [1] The discovery of captopril, an orally active Ang-converting enzyme inhibitor (ACE-I) in 1980 and Ang receptor blockers (ARBs) in 1998, went on to revolutionize medical care. [3] Current Understanding of the RAAS Pathway The modern view of the RAAS began with the concept that this was a lifesaving system, which raised BP in case of an acute hemorrhage. RAAS raises BP beginning with the release of renin into the bloodstream. [4] This circulating renin cleaves hepatic angiotensinogen and generates Ang I, which is converted to Ang II by pulmonary ACE. Ang II causes smooth muscle cell vasoconstriction, stimulates the sympathetic nervous system, and promotes renal retention of salt and water. Moreover, in the adrenal glands, Ang II stimulates the release of aldosterone, which enhances tubular sodium reabsorption in the kidney and increases the effective circulating plasma volume [Figure 1]. [4] In the heart, kidney, and brain, AII is also produced by non-ACE pathways namely chymases, cathepsin G, kallikreinlike enzymes and endopeptidases. [2] AII acts by binding to the G protein-coupled receptors type 1 (ATR1) and type 2 (ATR2). The ATR1 receptor mediates the more deleterious effects of AII-that is, vasoconstriction and cardiac and vascular hypertrophy. The ATR2 receptor regulates opposing effects. In addition to the conversion of AI to AII, ACE inactivates two vasodilator peptides, bradykinin and kallidin. [4]

- by Rohan Augustine
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- Hypertension
- by Mariam Haidar
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Essential hypertensionis a typical example of complex, multifactorial trait and a well studied risk factor for cardiovascular disease. hs-CRP is well known marker of inflammation resulting in atherosclerosis and cardiovascular disease. Recent studies showed that 25-OH-vitamin-D has ananti-inflammatory role and decreased levels may increase the cardiovascular risk in subjects with essential hypertension. The study included 30 adults both male and female with essential hypertension (Systolic Blood Pressure ≥ 140 mm Hg and Diastolic Blood Pressure ≥ 90 mm Hg) as cases. 30 age and sex matched healthy individuals both male & female between the age group of 24-60 years attending General OPD, General Medicine Department, NMCH, were taken as controls. The inverse relationship of Vitamin D with hs-CRP levels leads to cardiovascular risk in subjects with essential hypertension.

Patients at risk of pulmonary arterial hypertension (PAH) may present with abnormal dynamic pulmonary vascular resistance (PVR) during exercise. However, its clinical significance remains unclear. The present study aimed at analysing the meaning of dynamic PVR in two populations at risk of PAH: secundum atrial septal defect (ASD) and systemic sclerosis (SSc). Adult patients with corrected ASD were consecutively selected from the database of Pediatric and Congenital Heart Disease of the University Hospitals Leuven. Patients with SSc were consecutively selected from the rheumatology database of the University Hospital Liège. At inclusion, all underwent a rest and bicycle stress echocardiography to obtain baseline right heart characteristics and dynamic PVR. Routine follow-up echocardiography was performed. Twenty-eight patients with corrected ASD (mean age 41 ± 17 years, 79% female) were followed for a median time of 3.7 [inter-quartile range (IQR) 2.9-4.1] years. No patient developed...

- by Damien Voilliot
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- Risk, Pulmonary Hypertension, Vascular Resistance

Cardiovascular Disease (CVD) is the leading cause of death in both developed and developing countries. While it is relatively easy to identify those who are obviously at high risk and those at the lowest risk for CVD, it is often the large group of individuals with what appears to be modestly abnormal risk factors who contributes most to the burden of CVD. This is where estimation of CVD risk is necessary. Many tools for risk assessment have been devised. All these risk scores have their own inherent advantages and disadvantages. Furthermore, they may also not be directly applicable to a local population. Ideally, each country should have its own risk score that takes into account other factors as well. In the interim, it is worthwhile to be familiar with one of these scores, select one that is most appropriate for your patient and discuss treatment options based on the estimated risk.

- by Yook C Chia
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- Primary Care, Cardiovascular disease, Pain Management, Hypertension

Hydrocarbon is known to alter blood parameters; some of these blood parameters may affect the
activities of certain systems like cardiovascular system. Hydrocarbon gets into man and animal either
through ingestion of contaminated food and water, bio-concentration through food chain, occupational
exposure or by using hydrocarbon products. Effects of crude oil on plasma electrolytes, packed cell
volume (PCV) and plasma lipid profile were examined in male Rattus norvegicus in this study. Crude oil
was administered orally at dosages of 5 ml/kg (group I), 10 ml/kg (group II) and 20 ml/kg (group III) for
two weeks while the control group received drinking water only. The result shows a reduction in packed
cell volume in all treated groups compared to control (37.14±0.85, P < 0.05) and a significant (P < 0.05)
increase in plasma sodium level in treated groups compared to control (22.486±2.983 mg/L) while there
was no significant alteration in plasma lipids profile of the treated groups relative to the control. Oral
administration of crude oil significantly altered the plasma levels of electrolytes and PCV.
Key words: Electrolytes, crude oil, plasma lipids profile, packed cell volume.

To examine the prognosis of treated, hypertensive individuals in the Reykjavik Study. A population-based longitudinal study of 9328 men and 10 062 women. Subjects were included in the study during the period 1967-1996. Two groups of treated, hypertensive subjects were defined at baseline: with controlled blood pressure and with uncontrolled blood pressure. Main outcome measures were cardiovascular disease (CVD) mortality and all-cause mortality. Of the hypertensive men 24.8% were treated, and of those 38.3% were controlled, and of the hypertensive women 45.3% were treated, and of those 52.7% were controlled. Comparing treated and uncontrolled (systolic blood pressure (SBP) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =160 mmHg and/or diastolic blood pressure (DBP) &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or =95 mmHg) versus treated and controlled hypertensive subjects, followed for up to 30 years, the uncontrolled men and women were at significantly higher risk of CVD mortality, hazard ratio (HR) = 1.47 (95% confidence interval (CI): 1.06-2.02) and HR 1.70 (CI: 1.23-2.36), respectively, showing the benefit of hypertension control. The risk of all-cause mortality was increased for treated, uncontrolled men and women, compared with those who were treated and controlled, but did not reach significance. When analyzing blood pressure as a continuous variable among treated, hypertensive subjects, SBP was a better predictor than DBP of CVD mortality and all-cause mortality in women. This was not the case in men. Control of blood pressure among hypertensive-treated subjects at baseline was associated with a lower risk of CVD mortality during follow-up. SBP was the single best predictor of CVD mortality and all-cause mortality in treated women. The uncontrolled women were at a higher risk than the uncontrolled men.

- by Magnus Johannsson
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- Cardiovascular disease, Prospective studies, Hypertension, Blood Pressure

The renin-angiotensin-aldosterone system (RAAS) blockers have been widely used in chronic kidney disease patients undergoing hemodialysis; however, whether RAAS blockers have beneficial effects for cardiovascular disease in those patients has not been fully defined. This review focuses on the effects of RAAS blockers in chronic kidney disease undergoing hemodialysis for cardiovascular disease.

- by Yoshiyuki Morishita and +1
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- Cardiovascular disease, Risk factors for cardiovascular diseases, Aldosterone, Renin Angiotensin Aldosterone System

- by Bentham Open
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- Kidney diseases, Chronic kidney disease, Enzyme Inhibitors, Cardiovascular disease

The role of vitamin D in the regulation of bone metabolism has been well established. However, in recent years, many studies have demonstrated that its role extends far beyond bone health. Growing evidence has shown a strong association between vitamin D deficiency and hypertension, metabolic syndrome, diabetes mellitus and atherosclerosis. The mechanisms by which vitamin D exerts its cardiovascular protective effects are still not completely understood, but there is evidence that it participates in the regulation of renin-angiotensin system and the mechanisms of insulin sensitivity and activity of inflammatory cytokines, besides its direct cardiovascular actions. In this review, several studies linking vitamin D deficiency with cardiometabolic risk as well as small randomized trials that have evaluated the cardiovascular effects of its supplementation are presented. However, large randomized placebo-controlled studies are still needed before we can definitively establish the role of vitamin D supplementation in the prevention and control of cardiovascular disease.

Background: Development of pulmonary vascular disease (PVD)
has been considered a risk factor in the long-term course of ASD
(atrial septal defect). Lung biopsy remains the gold standard to
confirm the degree of severity in pulmonary vascular disease in
patients with isolated ASD.
Objective: To determine the effect on natural course on
pulmonary vascular diseases in isolated ASD patients at high
altitude .To assess the histological degree of pulmonary vascular
diseases in isolated ASD patients.
Material and Methods: This study was carried in the Department
of Cardiovascular and Thoracic Surgery Sher-i-Kashmir Institute
of Medical Sciences between 1st September 2010 to 31st November
2012.Patients with isolated ASD was included in the study.
Isolated ASD Patients. Ostium secundum (OS) type. Patients
residing at more than 3,500ft above sea-level. All patients were
subjected to cardiac cath prior to surgery. Pulmonary vascular
resistance was calculated in all patients. Lung Biopsy (which was
taken during repair of ASD before patient was put on cardio
pulmonary bypass) was sent for histopathological examination.
Histopathological examination of the specimen was done by a
single histopathologist. Severity of the pulmonary vascular disease
was assigned a Score between 1 - 4.
Results: histopathological score of one was seen in none whereas
5.6% of the patients (n=2) had a histopathological score of 2; 44.4
% (n=8) had a histological score of 3 and 50% (n=9) had a
histological score of 4. Most of our patients (94.4%; n=17) had a
higher histopathological score of 3 & 4.
Conclusion: No formal study has been conducted so far to analyze
the effect of high altitude on pulmonary vascular disease in Atrial
Septal defect. All of our patients had established pulmonary
vascular changes at the time of presentation. Severity of the
pulmonary vascular disease as proved by histopathological scoring and Cath data was quite high. This is in contrast with
those residing at low altitude as reported in the literature.
Therefore, it seems that high altitude has a strong bearing on the
natural course of the disease, its complications and outcome after
surgery.

This study was performed to asses and establishes the prevalence of Polypharmacy in geriatric population in the Medicine ward of Rajah Muthaiya Medical College and Hospital, Annamalai University, during one year from January 2013 to January 2014. Demographic analyses of this prospective study revealed that out of 520 patients, 342 (65.76%) were males and 178 (34.23%) were females. All the collected prescriptions were scrutinized for Polypharmacy and were categorized as minor Polypharmacy -concurrent use of ≤ 5 drugs; and major Polypharmacy -concurrent use of > 5 drugs. Out of 502 Prescriptions 61(11.73%) prescriptions were minor Polypharmacy and 457(88.26%) prescriptions were major Polypharmacy. The maximum patients were in the age group of 60-64 (38.84%) range lead to a significant increase in the number of medications. The most common diseases associated systems were Cardiovascular system 147 (28.26 %) patients, and followed by Respiratory system 103(19.80%). Our results show that there is a higher prevalence of Polypharmacy among the males than females. The length of hospital stay of geriatric patients is increase in major Polypharmacy compare with minor Polypharmacy. The prevalence of cardiovascular drugs and respiratory drugs were often involved in Polypharmacy among geriatric patients. Polypharmacy is very common among geriatric patient and health care professional’s interventions to improve the optimal use of medication in geriatric could lead to reduction in the drug related problems associated with Polypharmacy.

- by kevin ng
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