Diseases Of Circulatory System Research Articles

The Pomological Characteristics and Public Health Significance of Crataegus tanacetifolia

This study aimed to determine the pomological characteristics and allometric relationships of Crataegus tanacetifolia, an endemic plant species in Turkey, as well as to assess its significance for public health. Fruit samples collected from its natural habitat were subjected (Mihalıççık district of Eskişehir province, 1330-1350m) to pomological measurements. Subsequently, pomological characteristics were correlated with allometric relationships. The following pomological parameters were observed for Crataegus tanacetifolia: fruit length was 15.30±1.70mm, width was 19.51±2.30mm, thickness was 18.85±2.30mm, weight was 3.34±0.99g, flesh weight was 2.73±0.901g, arithmetic mean diameter was 17.89±2.04mm, geometric mean diameter was 17.78±2.02mm, sphericity index was 116.26±4.79%, surface area was 1005.55±223.28mm2, appearance ratio was 0.79±0.05, seed ratio was 0.19±0.04, peduncle length was 3.26±0.24mm, flesh hardness was 14.02±1.61kg/cm2, and fruit color (L*a*b) was 71.54±0.92*9.34±1.82*60.62±3.11. The fruit color ranged from light yellow to light pink, with green being the dominant color in unripe fruits. The seed length was 7.20±0.51 mm, width was 4.14±0.37mm, thickness was 5.42±0.43mm, weight was 0.12±0.02g, volume was 53.73±8.48mm3, and surface area was 80.09±9.29. There was a high relationship between fruit surface area and allometric relationships, with R²=0.9603 and R²=0.8729 confidence interval. The allometric relationships between seed ratio and fruit sizes were in the range of R²=0.3984 and R²=0.5045. In this study, it was determined that Crataegus tanacetifolia is important for public health, its fruits are used as food, and its flowers are used against cardiovascular and nervous system diseases within the scope of complementary medicine.

Morphological Analysis of Nanocapsules Processed based on Deer Antler Extract

The research work is devoted to the acquisition of nanocapsules, which are one of the drug delivery systems, and their morphological analysis. In modern times, the development of new drug delivery systems from natural raw materials in the treatment and prevention of diseases of various origins is considered a priority issue of pharmacy. From this point of view, the preparation and analysis of nanocapsules based on the extract from the studied deer antlers is of great importance. As a result of the morphological analysis of nanocapsules prepared from deer antlers grown in the climatic conditions of Azerbaijan, carrageenan-coated nanocapsules have sizes 118.3-243.6 nm in SEM, 10-248 nm in TEM, and tragacanth-coated nanocapsules have sizes 33.15-224.1 nm in SEM, TEM was determined to be 15-254 nm. During numerous studies, it was determined that nanocapsules prepared with tracagant proved to be more intense and more stable. Researches were carried out in the pharmaceutical technology laboratory of Azerbaijan Medical University and AHTARC (DAYTAM) of Atatürk University of the Republic of Turkey. As a result of the conducted research, it was clear that the use of nanocapsules developed by an effective technological method from deer antlers, which has sufficient raw material reserves in Azerbaijan, is considered appropriate for future treatment of diseases in oncology, infertility, osteoarthritis, cardiovascular, and nervous system.

Hospitalizations and hospital expenses during the COVID-19 pandemic

The study aimed to analyze the epidemiological profile of hospital admissions and hospital expenditures during the COVID-19 pandemic. This is an epidemiological, quantitative and retrospective study, with data collection from DATASUS, by consulting the SIH/SUS of Brazil. In 2020 a total of 10,531,196 and in 2021 a total of 11,479,416 hospitalizations were recorded in Brazil, 13.6% and 9% lower than in 2019. There was a reduction in hospitalizations for pregnancy, childbirth, and puerperium (15.9%), digestive system diseases (25.2%), neoplasms (14.2%), external causes (19.1%), circulatory system diseases (20.9%), and for respiratory system diseases (36.1%). However, they increased for infectious and parasitic diseases, about 79.2%. Although hospitalizations reduced in 2020 (13.6%) and 2021 (5.8%), the average value increased by 19.8% and 50.1% and total costs by 19.8% and 50.1%, respectively. We emphasize the importance of subsidizing policies that strengthen primary care in Brazil and that also encompass programs aimed at improving the social determinants of health, thus reducing the number of hospitalizations and expenditures in Brazil.

Polypharmacy and high-alert medications in patients with nasally placed feeding tube on admission and at hospital discharge: Multicenter cross-sectional study

BackgroundPolypharmacy and the use of high-alert medications in patients with nasally placed feeding tube (NPFT) increase the risks of drug related problems. ObjectiveCharacterize drugs prescribed to patients with NPFT and compare the rates of polypharmacy and high-alert medication use at admission and hospital discharge. Design and settingMulticenter cross-sectional study with 327 participants. MethodsData of patients with NPFT were obtained from the medical records and recorded in an electronic data collection tool. Mean number of drugs, polypharmacy and number of high-alert medications prescribed on admission and at discharge were compared using Wilcoxon or McNemar's tests. Generalized Estimating Equations analyzed the relationship between polypharmacy and high-alert medications according to age and time point. Primary reason for hospital admission, level of consciousness, severity of comorbid diseases and patient care complexity were also assessed. ResultsMost patients were male, older people, hospitalized for circulatory system diseases and had at least one comorbidity. On admission, a significant number of patients were alert (59.9%), at high risk for death (43.1%) and high dependent on nursing care (35.4%). Additionally, 92% patients were on polypharmacy on admission, versus 84.7% at hospital discharge (p = 0,0011). The occurrence of polypharmacy was independent of age (p = 0.2377). >17% of all drugs prescribed were high-alert medications, with no statistically significant difference between admission and discharge (p = 0,3957). There was no statistical evidence that the use of high-alert medications increases with age (n = 0,5426). ConclusionsThese results support the planning of multidisciplinary qualified actions for patients using NPFT.

Outcomes Addressed by Longitudinal Whole-Body Electromyostimulation and Belt Electrode-Skeletal Muscle Electrical Stimulation Trials in Middle Aged-Older Adults - an Evidence Map

Introduction: Due to its time-effective, joint friendly and highly customizable character whole-body-electromyostimulation (WB-EMS) is regarded as a feasible solution for a large variety of training issues. Not least for this reason WB-EMS research has increased considerably during the last few years. To identify gaps in research and summarize prevalent evidence we conducted an evidence map on outcomes addressed by WB-EMS trials in middle-aged to older, non-athletic adults so as to align future research more efficiently. Methods: Based on a comprehensive systematic search in five databases and two study registers according to PRISMA, 54 projects published in 80 articles were ultimately identified as meeting our eligibility criteria. Results: More than 90% of the studies reported outcomes related to the physical fitness or function domain. Body composition parameters were addressed by two thirds of the projects, however only 14 studies considered body composition as the primary outcome. Health-related outcomes addressed by WB-EMS trials as primary (or secondary/subordinate) outcomes included cancer/neoplasm (n=3, (n=4)), endocrine regulation (n=2, (n=6)), glucose metabolism (n=6, (n=9)), nervous system diseases (n=2), cardiovascular system diseases (n=6, (16)), non-specific chronic low back pain (n=4), osteopenia (n=2, (n=3)) and diseases of the renal system (n=1, (n=11)). Outcomes related to inflammation were addressed three times as a primary and 15 times as a secondary/subordinate outcome. Of importance, no studies reported clinically relevant adverse effects related to the WB-EMS intervention. Conclusion: In summary, while considerable evidence on outcomes related to fitness/function and body composition is prevalent, evidence gaps of WB-EMS research were particular evident for diseases of the nervous and cerebrovascular system.

Based on the Advantages of Acupuncture and Moxibustion Therapy, the Multiple Exploration of the Correlation between the Meridians and the Circulatory System of the Nervous System

The meridians, nervous system, and circulatory system are important components of traditional Chinese medicine and modern medicine. The meridians have a high degree of consistency with the distribution of the nervous and circulatory systems in modern medicine, and are closely related in the process of disease treatment. Therefore, people often confuse the three. Based on the great advantages of acupuncture and moxibustion in the treatment of nervous system and circulatory system diseases, the author has made diversified exploration on its rele⁃ vance in terms of origin, physiological anatomy, physiological function and clinical application. It is believed that meridians have their relative independence, and the nervous and circulatory systems cannot completely replace meridians. However, meridians are closely related to the nervous and circulatory systems, and in clinical practice, meridians can be combined with the nervous and circulatory systems to guide the treatment of diseases.

Gas6-Axl signal promotes indoor VOCs exposure-induced pulmonary fibrosis via pulmonary microvascular endothelial cells–fibroblasts cross-talk

Volatile organic compounds (VOCs) as environmental pollutants were associated with respiratory diseases. Pulmonary fibrosis (PF) was characterized by an increase of extracellular matrix, leading to deterioration of lung function. The adverse effects on lung and the potential mechanism underlying VOCs induced PF had not been elucidated clearly. In this study, the indoor VOCs exposure mouse model along with an ex vivo biosensor assay was established. Based on scRNA-seq analysis, the adverse effects on lung and potential molecular mechanism were studied. Herein, the results showed that VOCs exposure from indoor decoration contributed to decreased lung function and facilitated pulmonary fibrosis in mice. Then, the whole lung cell atlas after VOCs exposure and the heterogeneity of fibroblasts were revealed. We explored the molecular interactions among various pulmonary cells, suggesting that endothelial cells contributed to fibroblasts activation in response to VOCs exposure. Mechanistically, pulmonary microvascular endothelial cells (MPVECs) secreted Gas6 after VOCs-induced PANoptosis phenotype, bound to the Axl in fibroblasts, and then activated fibroblasts. Moreover, Atf3 as the key gene negatively regulated PANoptosis phenotype to ameliorate fibrosis induced by VOCs exposure. These novel findings provided a new perspective about MPVECs could serve as the initiating factor of PF induced by VOCs exposure.

Knowledge-guided generative artificial intelligence for automated taxonomy learning from drug labels.

To automatically construct a drug indication taxonomy from drug labels using generative Artificial Intelligence (AI) represented by the Large Language Model (LLM) GPT-4 and real-world evidence (RWE). We extracted indication terms from 46421 free-text drug labels using GPT-4, iteratively and recursively generated indication concepts and inferred indication concept-to-concept and concept-to-term subsumption relations by integrating GPT-4 with RWE, and created a drug indication taxonomy. Quantitative and qualitative evaluations involving domain experts were performed for cardiovascular (CVD), Endocrine, and Genitourinary system diseases. 2909 drug indication terms were extracted and assigned into 24 high-level indication categories (ie, initially generated concepts), each of which was expanded into a sub-taxonomy. For example, the CVD sub-taxonomy contains 242 concepts, spanning a depth of 11, with 170 being leaf nodes. It collectively covers a total of 234 indication terms associated with 189 distinct drugs. The accuracies of GPT-4 on determining the drug indication hierarchy exceeded 0.7 with "good to very good" inter-rater reliability. However, the accuracies of the concept-to-term subsumption relation checking varied greatly, with "fair to moderate" reliability. We successfully used generative AI and RWE to create a taxonomy, with drug indications adequately consistent with domain expert expectations. We show that LLMs are good at deriving their own concept hierarchies but still fall short in determining the subsumption relations between concepts and terms in unregulated language from free-text drug labels, which is the same hard task for human experts.

Medical reasons for permanent and temporary disqualification of Turkish civil aviation pilots

The aim of this study was to identify diseases that result in permanent and temporary medical disqualification for civil aviation pilots and their changes over the years. A retrospective analysis was conducted on the medical examination records performed in Turkey from 2018 to 2022, in accordance with ICAO and EASA standards. The permanent disqualification rate was 1.3%, and the temporary disqualification rate was 6.6%. The most common reasons for permanent disqualification among pilots were circulatory system diseases (24%), mental and behavioral disorders (22.9%), and nervous system diseases (11.5%). The most common reasons for temporary disqualification among pilots were circulatory system diseases (17.9%), digestive system diseases (11.8%), and health problems related to COVID-19 infection (9.5%). The data obtained from this study may be useful in developing preventive medicine approaches to prevent medical disqualifications and in-flight medical incapacitation.

Prevalence of signs of professional burnout among medical workers involved in providing medical care for circulatory system diseases

BACKGROUND: Among 13 thousand doctors interviewed in 2021, 42% displayed signs of professional burnout. This phenomenon negatively affects the frequency of repeated hospitalizations, the number of adverse events, and increased employee turnover. However, studies concerning burnout in doctors are rare and do not focus on specialists who provide medical care for patients with circulatory system diseases (CSD). AIM: was to assess the level of burnout in medical workers involved in the provision of medical care for patients with CSD and to explore staff perceptions of its prevention. MATERIALS AND METHODS: A sociological survey (based on the standardized Maslach Burnout Inventory questionnaire) was conducted among medical personnel (women represented the majority of the sample — 76%, men — 24%). The sample is represented by doctors (n=89), nursing staff and auxillary nurses (NSAN) (n=128). The mean age for the whole group of respondents was 40.7±0.7, professional experience lasted 12.0±0.6 years. Standard methods of descriptive statistics were used for the data analysis. The age characteristics of the group had no significant differences by professional categories. Doctors had 39.0±1.2 years (min — 24, max — 63), NSAN had 41.0±0.6 years (min — 19, max — 67). Professional experience lasted differed doctors 39.0±1.2 years, in NSAN — 12.3±0.8. Men were characterized by a mean age of 36.7±1.6 years and professional experience lasted 10.0±1.2 years and women 42.0±0.7 years and 12.6±0.7 years, respectively. The character of distribution of quantitative data in the presented study was analyzed using the Kolmogorov–Smirnov and Shapiro–Wilk criterion. RESULTS: 80.2% of respondents presented with a high level of reduced professional accomplishments (RPA), 53.4% — a moderate average level of depersonalization. The emotional exhaustion was similar in all respondents, although average level of emotional exhaustion was the most prevalent (39.6%). 43.8% of doctors had an average level of emotional exhaustion, which is higher compared with NSAN — 37.5%. Clinical and paraclinical units are associated with a medium level of emotional exhaustion and a high RPA. At the same time, paraclinical units are characterized by a medium level of depersonalization, in contrast to clinical units, which are found to have a high level of this factor. According to the respondents, possible measures to prevent emotional burnout should include a set of measures including, rational distribution of responsibilities within departments, workload among the staff, as well as the formation of special skills to overcome stressful situations and optimization of activities with the help of digital solutions (support system for medical decisions, etc.). CONCLUSION: Working as medical staff and providing medical care for patients with CSD is strongly associated with a high level of reduced professional accomplishments (80.2% of respondents). Proper measures for the prevention of emotional burnout should primarily include organizational solutions focused on optimizing internal processes in medical staff’ work. According to the respondents, among the measures aimed at the prevention of emotional burnout, the most demanded may be: rational distribution of responsibilities within departments, workload among staff, as well as the formation of special skills to overcome stressful situations and optimization of activities with the help of digital solutions (medical decision support system, etc.).

Influence of medical-social and socio-economic factors on infant mortality rate in the Republic of Ingushetia

BACKGROUND: The infant mortality rate, as one of the indicators of the health and quality of life of the population, is an important factor that determines the country’s healthcare priorities. Despite the steadily decreasing infant mortality rates in the Russian Federation, the value of this indicator varies by region; thus, studying the factors influencing its value is relevant. If the leading medical, social, and socioeconomic factors that influence the level of infant mortality could be determined using data from a representative region (Republic of Ingushetia), the main directions for organizing measures aimed at reducing mortality among children in the first year of life will be identified. AIM: To determine the main medical, social and socio-economic factors that influence the infant mortality rate in the Republic of Ingushetia. MATERIALS AND METHODS: An observational single-center retrospective study was performed to examine the influence of medical, social, and socioeconomic factors on the mortality rate of children aged 1 year in the Republic of Ingushetia. The obtained data were compared with similar indicators for the Russian Federation as a whole and the North Caucasus Federal District. RESULTS: During the study period (2011–2019), significant changes were observed in infant mortality rates in the Republic of Ingushetia: infant mortality has decreased because of the age components, leading to the normal ratio of neonatal and post neonatal mortality. Rates of infant mortality from certain conditions arising in the perinatal period, congenital anomalies, and nervous system and circulatory system diseases have significantly decreased. The proportion of women admitted under the supervision of antenatal clinics in the early pregnancy (up to 12 weeks) has increased, the incidence of morbidity among pregnant women has decreased, and the proportion of normal births has been increasing. Although many medical organizations have employed a sufficient number of medical personnel, the coverage for biochemical screening has decreased, detection of malformations and biochemical abnormalities during prenatal diagnostics was low, medical personnel have low qualifications, and the shortage of obstetric and pediatric beds and pathology beds for newborns and premature infants was significant. A statistically significant dependence of the frequency of deaths of children aged 1 year on socioeconomic indicators−unemployment level, monetary income of the population, and housing conditions−was revealed. CONCLUSION: The main medical, social, and socioeconomic factors that influence infant mortality were analyzed using data from the Republic of Ingushetia. Positive and negative trends in the current state of the healthcare system of this republic have been identified.

Assessment of polypharmacy, potentially inappropriate medications, and drug-drug interactions in older patients with cancer.

This study aimed to determine polypharmacy, potentially inappropriate medications, and potential drug-drug interactions in elderly patients hospitalized in the oncology services of a university hospital in Turkey. This retrospective cross-sectional study was conducted between September 2021 and September 2022 on cancer patients over 65 years old hospitalized at Suleyman Demirel University Medical Faculty Hospital in Isparta, Turkey. Potentially inappropriate medications were defined according to the 2023 Beers Criteria of the American Geriatrics Society. Potential drug-drug interactions were determined with Medscape® drug interaction checker. The median (min-max) of drugs used by the patients was 6 (2-15). Most of the patients (74.3%) had polypharmacy. Approximately half of the patients (51.4%) had potentially inappropriate medications. The most commonly used potentially inappropriate medications were diuretics (22.1%), metoclopramide (11.4%), antidepressant drugs (7.9%), and opioids (6.4%). The presence of comorbidities, mental, behavioral, and neurodevelopmental disorders, circulatory system diseases, and respiratory system diseases were found to be statistically significantly higher in the group with potentially inappropriate medication than in the group without potentially inappropriate medication (p < 0.05). In total, 98 patients (70%) had at least one potential drug-drug interaction. Potential drug-drug interactions were minor in 33.3%, major in 57.5%, serious in 7.74%, and contraindicated in 0.22. According to our study, polypharmacy, potentially inappropriate medications, and potential drug-drug interactions were high in elderly cancer patients. It is important to determine potential drug-drug interactions and potentially inappropriate medications in cancer patients by a multidisciplinary team, including the clinical pharmacist, to prevent possible negative consequences.

Diosmetin as a promising natural therapeutic agent: In vivo, in vitro mechanisms, and clinical studies.

Diosmetin, a natural occurring flavonoid, is primarily found in citrus fruits, beans, and other plants. Diosmetin demonstrates a variety of pharmacological activities, including anticancer, antioxidant, anti-inflammatory, antibacterial, metabolic regulation, cardiovascular function improvement, estrogenic effects, and others. The process of literature search was done using PubMed, Web of Science and ClinicalTrials databases with search terms containing Diosmetin, content, anticancer, anti-inflammatory, antioxidant, pharmacological activity, pharmacokinetics, in vivo, and in vitro. The aim of this review is to summarize the in vivo, in vitro and clinical studies of Diosmetin over the last decade, focusing on studies related to its anticancer, anti-inflammatory, and antioxidant activities. It is found that DIO has significant therapeutic effects on skin and cardiovascular system diseases, and its research in pharmacokinetics and toxicology is summarized. It provides the latest information for researchers and points out the limitations of current research and areas that should be strengthened in future research, so as to facilitate the relevant scientific research and clinical application of DIO.

Small Intestinal Bacterial Overgrowth (SIBO) and Twelve Groups of Related Diseases-Current State of Knowledge.

The human gut microbiota creates a complex microbial ecosystem, characterized by its high population density, wide diversity, and complex interactions. Any imbalance of the intestinal microbiome, whether qualitative or quantitative, may have serious consequences for human health, including small intestinal bacterial overgrowth (SIBO). SIBO is defined as an increase in the number of bacteria (103-105 CFU/mL), an alteration in the bacterial composition, or both in the small intestine. The PubMed, Science Direct, Web of Science, EMBASE, and Medline databases were searched for studies on SIBO and related diseases. These diseases were divided into 12 groups: (1) gastrointestinal disorders; (2) autoimmune disease; (3) cardiovascular system disease; (4) metabolic disease; (5) endocrine disorders; (6) nephrological disorders; (7) dermatological diseases; (8) neurological diseases (9); developmental disorders; (10) mental disorders; (11) genetic diseases; and (12) gastrointestinal cancer. The purpose of this comprehensive review is to present the current state of knowledge on the relationships between SIBO and these 12 disease groups, taking into account risk factors and the causal context. This review fills the evidence gap on SIBO and presents a biological-medical approach to the problem, clearly showing the groups and diseases having a proven relationship with SIBO, as well as indicating groups within which research should continue to be expanded.

Palliative care at the present stage in Krasnoyarsk

Palliative medicine, aimed at ensuring the quality of life of patients with severe and incurable diseases, is becoming increasingly important in medical practice. In this article, we consider the current state and prospects for the development of palliative medicine in the city of Krasnoyarsk. The study showed that the number of patients in need of palliative care is increasing, mainly people older than working age with diseases of the cardiovascular system and oncological diseases. Approaches to anesthesia, prevention and treatment of pressure sores in hospice patients are described. The problems include a lack of qualified personnel and violations of the socio-psychological status of medical personnel, limited access to palliative medicine for remote areas of the region.

The implications of APOBEC3-mediated C-to-U RNA editing for human disease

Intra-organism biodiversity is thought to arise from epigenetic modification of constituent genes and post-translational modifications of translated proteins. Here, we show that post-transcriptional modifications, like RNA editing, may also contribute. RNA editing enzymes APOBEC3A and APOBEC3G catalyze the deamination of cytosine to uracil. RNAsee (RNA site editing evaluation) is a computational tool developed to predict the cytosines edited by these enzymes. We find that 4.5% of non-synonymous DNA single nucleotide polymorphisms that result in cytosine to uracil changes in RNA are probable sites for APOBEC3A/G RNA editing; the variant proteins created by such polymorphisms may also result from transient RNA editing. These polymorphisms are associated with over 20% of Medical Subject Headings across ten categories of disease, including nutritional and metabolic, neoplastic, cardiovascular, and nervous system diseases. Because RNA editing is transient and not organism-wide, future work is necessary to confirm the extent and effects of such editing in humans.

The risk factors of development of circulatory system diseases according the results of STEPS-study in Belarus in 2016-2017 and 2019-2020: what was succeeded to change?

The article for the first time analyzes and compares data of STEPS-studies in 2016-2017 and 2019-2020 in Belarus. It demonstrates impact of organizational measures and management decisions at level of the Ministry of Health of the Republic of Belarus on monitoring indicators of main risk factors of development of non-communicable diseases based on results of the study. The prospects of impact of risk factors of development of diseases of circulatory system on levels of population morbidity is demonstrated. The STEPS-studies of 2016-2017 and 2019-2020 were carried out by the authors as coordinators for the Brest region. In Belarus, the study was part of set of the UN measures implemented by the WHO targeted to ensuring increase in standard of living and well-being of population of Belarus. In 2016-2020, Belarus implemented project "Prevention of noncommunicable diseases, promotion of a healthy lifestyle and modernization of the healthcare system in the Republic of Belarus" (BELMED), funded by the EU as international technical assistance project. Within this project with the support of the WHO, national study was organized on prevalence of main risk factors of development of non-communicable diseases (NCDs) in population of the Republic of Belarus aged 18-69 years. The article compares and demonstrates dynamics of indicators of main risk factors of development of diseases of circulatory system (BSC) according STEPS-studies of 2016-2017 and 2019-2020. It is demonstrated that organizational and managerial decisions made on the basis of large-scale studies can affect further prevalence of risk factors of NCDs in population. The problems of prospects for further increasing of incidence of BSC in the Republic of Belarus and their relationship with cardiovascular risks are also highlighted.

Years of Life Lost Due to Premature Mortality in Northern Iran: A Cross-sectional Study

Background: Years of life lost (YLL) is commonly used to determine the social and economic burden of loss due to premature mortality. The present study estimated YLL based on general mortality groups in Golestan Province, Iran, in 2018. Methods: In this cross-sectional study, by referring to the province death registration system information and using standard expected years of life lost (SEYLL) of the World Health Organization (WHO), YLL was calculated due to premature mortality based on general mortality groups in ICD-10 (international classification of diseases 10th revision). Results: The total number of deaths in Golestan Province was 8543 in 2018. The overall YLL due to premature mortality was 129838 years, of which 57.4% occurred among men. The major causes of YLL due to premature mortality (YLL%) were diseases of the circulatory system (I00-I99) (32.3%), external causes (V01-Y89) (17.3%), certain conditions originating in the perinatal period (P00-P96) (14.5%), and cancers (C00-D48) (13.9%). After diseases of the circulatory system, the most common cause of YLL due to premature mortality is external causes (22.9%) among men and cancers (16.2%) among women. In general, the highest YLL rate occurred due to circulatory system diseases (22.5 per 1000 people). Conclusion: According to the results of our study, most years of life lost in both sexes are related to diseases of the circulatory system, followed by external causes of morbidity and mortality. Therefore, it is important to pay attention to the diseases of the circulatory system and its causes, as well as external causes of morbidity and mortality.

Evaluation of reports received on a digital platform for monitoring and self-care of individuals facing the COVID-19 pandemic in Brazil: Contributions to public health

ObjectivesTo evaluate the contribution of the digital platform “Meu Diário de Quarentena (MDQ)" or My Quarantine Diary concerning the monitoring and self-care of individuals with COVID-19 in Brazil. And to analyze the epidemiological and clinical characteristics related to the disease and the users who adhered to the support provided by MDQ. MethodsMDQ was developed by a multidisciplinary team and offered to the general population to provide self-care and health education during the COVID-19 pandemic, relying on users' self-reporting of information (such as signs and symptoms, pre-existing health conditions, and medications used during quarantine). The outcomes were measured, and the web app's support experience for public health was reported. ResultsMDQ had 2439 active users on the platform, with 485 (19.9 %) self-reporting a COVID-19 diagnosis, mostly from individuals in the southeastern region of Brazil (56.5 %). The most common pre-existing health condition reported was related to circulatory system diseases. The most frequent reported signs and symptoms included headache, cough, myalgia, nasal congestion and muscle weakness. Corticosteroids, multivitamins, and anti-inflammatories were the most used medications during the pandemic period. There were several reports related to how users were feeling during the pandemic, and among these reports, negative feelings toward isolation stood out, such as “feeling lonely”, “anxious”, and “feeling useless”. A significant association was found between sex (p < 0.001) and age (p < 0.001) in relation to self-reported cases of COVID-19. ConclusionsThe use of MDQ during extended quarantine was an easy and interesting way of interaction and support for people during COVID-19 pandemic.

Comparative Efficacy of Monotherapy of Angiotensin-converting Enzyme Inhibitors Versus Angiotensin Receptor Blockers in Treating Essential Hypertension – A Meta-analysis

Background: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely used medications for treating essential hypertension, but there is limited research comparing their effectiveness. To address this gap, a recent meta-analysis was conducted to evaluate and compare the efficacy of these two drug classes in decreasing blood pressure (BP) among patients with essential hypertension. Objective: Evaluating of comparative efficacy of ACEIs versus ARBs in reducing BP in essential hypertension. Methods: An extensive literature search for randomized controlled trials (RCTs) following PRISMA guidelines (2020), with inclusion criteria of age ≥18 years, with either gender and diagnosed of essential hypertension and receiving ACEIs or ARBs for at least 4 weeks. Patients with secondary hypertension, malignancy, symptomatic cardiovascular system (CVS) disease, hepatic involvement, and studies with Fimasartan and Allisartan were excluded. For this study, all RCTs that reported changes in mean systolic BP (SBP) and diastolic BP (DBP) before and after administration of the drugs were gathered. Standardized mean difference (SMD) was calculated using RevMan 5.4.1 software. The significance level was set at a P &lt; 0.05. Results: A total of 28 RCTs ( n = 9778) were included in our study. Both groups reduce SBP and DBP from the baseline values. Pooled analyses of studies showed that ARBs were superior to ACEIs with SMD = 0.179 in the random-effect model, 95% confidence interval (CI) (0.0975–0.260), P &lt; 0.001, and in the fixed-effect model, SMD = 0.207, 95% CI (0.167–0.248), P &lt; 0.001 in the mean reduction of SBP. Furthermore, for a mean reduction in DBP, ARBs were superior to ACEIs with SMD = 0.329 in the random-effect model, 95% CI (0.161–0.496), P &lt; 0.001, and in the fixed-effect model, SMD = 0.317, 95% CI (0.276–0.357), P &lt; 0.001. Our study included 28 RCTs with a combined sample size of 9778 participants. Both ACEIs and ARBs were found to effectively reduce SBP and DBP from their baseline values. However, our pooled analysis of the studies revealed that ARBs were more effective than ACEIs in reducing mean SBP, with an SMD of 0.179 in the random-effect model and 0.207 in the fixed-effect model. The 95% CIs for these estimates were (0.0975–0.260) and (0.167–0.248), respectively, with P &lt; 0.001. Similarly, for a mean reduction in DBP, ARBs were found to be superior to ACEIs with a SMD of 0.329 in the random-effect model and 0.317 in the fixed-effect model, with 95% CIs of (0.161–0.496) and (0.276–0.357), respectively, and a P &lt; 0.001. Conclusion: ARBs are more efficacious as compared to ACEIs in essential hypertension.