Disorders Of Cardiovascular System Research Articles

Geniposide alleviates heart failure with preserved ejection fraction in mice by regulating cardiac oxidative stress via MMP2/SIRT1/GSK3β pathway.

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with cardiac dysfunction, fluid retention and reduced exercise tolerance as the main manifestations. Current treatment of HFpEF is using combined medications of related comorbidities, there is an urgent need for a modest drug to treat HFpEF. Geniposide (GE), an iridoid glycoside extracted from Gardenia Jasminoides, has shown significant efficacy in the treatment of cardiovascular, digestive and central nervous system disorders. In this study we investigated the therapeutic effects of GE on HFpEF experimental models in vivo and in vitro. HFpEF was induced in mice by feeding with HFD and L-NAME (0.5 g/L) in drinking water for 8 weeks, meanwhile the mice were treated with GE (25, 50 mg/kg) every other day. Cardiac echocardiography and exhaustive exercise were performed, blood pressure was measured at the end of treatment, and heart tissue specimens were collected after the mice were euthanized. We showed that GE administration significantly ameliorated cardiac oxidative stress, inflammation, apoptosis, fibrosis and metabolic disturbances in the hearts of HFpEF mice. We demonstrated that GE promoted the transcriptional activation of Nrf2 by targeting MMP2 to affect upstream SIRT1 and downstream GSK3β, which in turn alleviated the oxidative stress in the hearts of HFpEF mice. In H9c2 cells and HL-1 cells, we showed that treatment with GE (1 μM) significantly alleviated H2O2-induced oxidative stress through the MMP2/SIRT1/GSK3β pathway. In summary, GE regulates cardiac oxidative stress via MMP2/SIRT1/GSK3β pathway and reduces cardiac inflammation, apoptosis, fibrosis and metabolic disorders as well as cardiac dysfunction in HFpEF. GE exerts anti-oxidative stress properties by binding to MMP2, inhibiting ROS generation in HFpEF through the SIRT1/Nrf2 signaling pathway. In addition, GE can also affect the inhibition of the downstream MMP2 target GSK3β, thereby suppressing the inflammatory and apoptotic responses in HFpEF. Taken together, GE alleviates oxidative stress/apoptosis/fibrosis and metabolic disorders as well as HFpEF through the MMP2/SIRT1/GSK3β signaling pathway.

Demonstrating the use of population level data to investigate trends in the rate, radiation dose and cost of Computed Tomography across clinical groups: Are there any areas of concern?

Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis of new conditions. Retrospective repeated cross-sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015. For 90 days pre/post diagnosis, CT use (any and 2+ scans), effective dose (mSv), lifetime attributable risk (LAR) of cancer incidence and mortality from CT, and costs were assessed. CT use increased from 209.4 per 1000 new diagnoses in 2006 to 258.0 in 2015; increases were observed for all conditions except neoplasms. Healthcare system costs increased for all conditions but neoplasms and mental disorders. Effective dose increased substantially for respiratory (+2.5 mSv, +23.1%, P < 0.001) and circulatory conditions (+2.1 mSv, +15.4%, P < 0.001). The LAR of cancer incidence and mortality from CT increased for endocrine (incidence +23.4%, mortality +18.0%) and respiratory disorders (+21.7%, +23.3%). Mortality LAR increased for circulatory (+12.1%) and nervous system (+11.0%) disorders. The LAR of cancer incidence and mortality reduced for musculoskeletal system disorders, despite an increase in repeated CT in this group. Use and costs increased for most conditions except neoplasms and mental and behavioural disorders. More strategic CT use may have occurred in musculoskeletal conditions, while use and radiation burden increased for respiratory, circulatory and nervous system conditions. Using this high-level approach we flag areas requiring deeper investigation into appropriateness and value of care.

Demonstrating the use of population level data to investigate trends in the rate, radiation dose and cost of Computed Tomography across clinical groups: Are there any areas of concern?

Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis of new conditions. Retrospective repeated cross-sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015. For 90 days pre/post diagnosis, CT use (any and 2+ scans), effective dose (mSv), lifetime attributable risk (LAR) of cancer incidence and mortality from CT, and costs were assessed. CT use increased from 209.4 per 1000 new diagnoses in 2006 to 258.0 in 2015; increases were observed for all conditions except neoplasms. Healthcare system costs increased for all conditions but neoplasms and mental disorders. Effective dose increased substantially for respiratory (+2.5 mSv, +23.1%, P < 0.001) and circulatory conditions (+2.1 mSv, +15.4%, P < 0.001). The LAR of cancer incidence and mortality from CT increased for endocrine (incidence +23.4%, mortality +18.0%) and respiratory disorders (+21.7%, +23.3%). Mortality LAR increased for circulatory (+12.1%) and nervous system (+11.0%) disorders. The LAR of cancer incidence and mortality reduced for musculoskeletal system disorders, despite an increase in repeated CT in this group. Use and costs increased for most conditions except neoplasms and mental and behavioural disorders. More strategic CT use may have occurred in musculoskeletal conditions, while use and radiation burden increased for respiratory, circulatory and nervous system conditions. Using this high-level approach we flag areas requiring deeper investigation into appropriateness and value of care.

Establishment and evaluation of a premenstrual syndrome rat model induced by progesterone-withdrawal and emotional-stimulation

Premenstrual syndrome(PMS) lacks a highly consistent and feasible animal model that aligns with diagnostic and therapeutic standards in both traditional Chinese medicine(TCM) and western medicine, resulting in a lack of reliable experimental carriers for studying its pathogenesis and pharmacological effects. This study aims to systematically analyze the biological implications of PMS from the perspective of the &quot;disease-syndrome-symptom&quot; correlation and establish preparation and evaluation methods for an improved animal model of this disease. Firstly, clinical symptom gene sets related to the Qi stagnation syndromes due to liver depression and blood stasis in PMS in both modern medicine and TCM diagnostic standards were collected through GeneCards, DisGeNET, Mala-Cards, and the System of Foundational Diagnostic Association(SoFDA) database, as well as published literature. Based on the interaction information between genes, a &quot;disease-syndrome-symptom&quot; correlation network of PMS was established. Based on data mining results, an improved rat model of PMS was prepared by combining chronic restraint stress with the classical progesterone-withdrawal mo-del to simulate emotional depression caused by external environmental stimuli during the clinical onset process, inducing pathological damage from both physiological and emotional dimensions. The evaluation of the improved model before and after modification included open field experiment scores, organ indices, ovarian pathological changes, serum levels of estradiol(E_2), follicle-stimulating hormone/luteinizing hormone(FSH/LH), 5-hydroxytryptamine(5-HT), dopamine(DA), norepinephrine(NE), as well as coagulation parameters and hemorheology indexes. By calculating the degree, betweenness, and closeness centrality of nodes in the &quot;disease-syndrome-symptom&quot; correlation network, 163 core genes with topological importance were identified. Further biological function mining results indicated that core genes in PMS mainly participated in the regulation of the &quot;nervous-endocrine-immune&quot; system and pathways related to circulatory disorders. Mapping analysis of clinical phenotype symptom gene sets suggested significant correlations between core genes in PMS and depressive symptoms and pain symptoms caused by blood stasis. Compared with the simple progesterone withdrawal model, rats subjected to combined injections and restraint stress showed more significant abnormalities in open field experiment scores, ovarian tissue pathology, serum neurotransmitter levels of 5-HT and DA, as well as serum hormone levels of E_2 and FSH/LH. The modified modeling conditions exacerbated the pathological changes in blood rheology, coagulation function, and red blood cell morphology in model rats, confirming that the improved rat model could characterize the &quot;nervous-endocrine-immune&quot; system disorder and circulatory system disorders in the occurrence and progression of PMS, consistent with the clinical diagnostic and therapeutic standards of both TCM and western medicine. The establishment of the improved rat model of PMS can provide a reliable experimental carrier for elucidating the pathogenesis of PMS and discovering and evaluating therapeutic drugs. It also provides references for objectively reflecting the clinical characteristics of PMS in TCM and western medicine and precision treatment.

Modern ideas about the development of atherosclerosis

Currently, in the leading countries of the world there is a question of a significant increase in diseases associated with circulatory system disorders, but this issue should be considered together with another pathology – atherosclerosis. Analysis of modern scientific literature has shown that at the moment there is no single theory of the origin of atherosclerosis, because this disease can be caused by various factors, both endo- and exogenous. Currently, most scientists and doctors agree that atherosclerosis is a multifactorial disease, in the development of which there are complex, often long-term violations of immunologic, molecular-genetic, biochemical reactions. Many significant structural units are involved in the process of atherogenesis: the vascular wall, local disturbance of blood flow, and blood forming elements. Opinions on the etiology of atherosclerosis vary. However, most authors tend to consider dyslipidemia as the leading mechanism of atherosclerosis development; at the same time, we should not forget other possible causes of its formation.

Effect of heatwaves on daily hospital admissions in Portugal, 2000–18: an observational study

Climate change has increased the frequency, intensity, and duration of heatwaves, posing a serious threat to public health. Although the link between high temperatures and premature mortality has been extensively studied, the comprehensive quantification of heatwave effects on morbidity remains underexplored. In this observational study, we assessed the relationship between heatwaves and daily hospital admissions at a county level in Portugal. We considered all major diagnostic categories and age groups (<18 years, 18-64 years, and ≥65 years), over a 19-year period from 2000 to 2018, during the extended summer season, defined as May 1, to Sept 30. We did a comprehensive geospatial analysis, integrating over 12 million hospital admission records with heatwave events indexed by the Excess Heat Factor (EHF), covering all 278 mainland counties. We obtained data from the Hospital Morbidity Database and E-OBS daily gridded meteorological data for Europe from 1950 to present derived from in-situ observations. To estimate the effect of heatwaves on hospital admissions, we applied negative binomial regression models at both national and county levels. We found a statistically significant overall increase in daily hospital admissions during heatwave days (incidence rate ratio 1·189 [95% CI 1·179-1·198]; p<0·0001). All age groups were affected, with children younger than 18 years being the most affected (21·7% [20·6-22·7] increase in admissions; p<0·0001), followed by the working-age (19·7% [18·7-20·7]; p<0·0001) and elderly individuals (17·2% [16·2-18·2]; p<0·0001). All 25 major disease diagnostic categories showed significant increases in hospital admissions, particularly burns (34·3% [28·7-40·1]; p<0·0001), multiple significant trauma (26·8% [22·2-31·6]; p<0·0001), and infectious and parasitic diseases (25·4% [23·5-27·3]; p<0·0001). We also found notable increases in endocrine, nutritional, and metabolic diseases (25·1% [23·4-26·8]; p<0·0001), mental diseases and disorders (23·0% [21·1-24·8]; p<0·0001), respiratory diseases (22·4% [21·2-23·6]; p<0·0001), and circulatory system disorders (15·8% [14·7-16·9]; p<0·0001). Our results provide statistically significant evidence of the association between heatwaves and increased hospitalisations across all age groups and for all major causes of disease. To our knowledge, this is the first study to estimate the full extent of heatwaves' impact on hospitalisations using the EHF index over a 19-year period, encompassing an entire country, and spanning 25 disease categories during multiple heatwave events. Our data offer crucial information to guide policy makers in effectively and efficiently allocating resources to address the profound health-care consequences resulting from climate change. None.

The epidemiology of dying within 48hours of presentation to emergency departments: a retrospective cohort study of older people across Australia and New Zealand.

Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people. To estimate the need for ED end-of-life care for people aged ≥65years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere. We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression. From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31-6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65-74years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation. Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens.

Application of early warning system (EWS) in patients with cardiovascular disorders : a descriptive study

Incidents of clients experiencing sudden cardiac arrest in the inpatient setting or unexpected and unavoidable deaths in the inpatient setting are common. One of the efforts to improve quality related to patient safety in hospitals is the application of the Early Warning System (EWS) to clinical changes in patients in hospital inpatient installations. The purpose of this study was to describe the application of EWS in clients with cardiovascular system disorders, including the risk of seriousness, respiratory rate, oxygen saturation, use of oxygen supplements, systolic blood pressure, pulse frequency, level of consciousness, and body temperature. This study is an observational descriptive study with a cross-sectional approach. The number of respondents was 48 people, namely clients who were treated with diseases of the cardiovascular system. Data analysis using descriptive analysis. The characteristics of respondents obtained in this study showed that the majority of respondents were female (54.2%), the majority of medical diagnoses were congestive heart failure, which was 43.75%, and the average length of stay was 4.63 days. Most of the patient's risk of seriousness was in the moderate category, namely 22 respondents (45.8%). Assessment of clients with cardiovascular system disorders with EWS in this study can predict the level of patient care so that preventive measures can be taken. Recommendations for future research are research on predicting patient mortality using EWS.

Aortic Dissection: Classification, Etiology, Pathogenesis and Clinical Picture

Aortic dissection is a pathological process in which the aortic wall is divided into inner and outer layers under the action of hemodynamic forces. The process can be localized in various parts of the aorta, and also can be cause of blood supply disorders not only of organs which are located along the vessel (orthograde), but also organs which are located retrogradely. Risk factors for aortic dissection may include age, gender, atherosclerosis, inflammatory diseases, chest injuries, heart surgery, hereditary predisposition, congenital defects of the cardiovascular system and hereditary connective tissue disorders. The most often complication of aortic dissection is malperfusion syndrome, which can manifest itself as symptoms of upper and lower limb ischemia, syncope, ischemic stroke, prerenal azotemia (with decreased renal perfusion), abdominal ischemia syndrome (with occlusion of mesenteric arteries), spinal ischemic stroke. Knowledge of the totality of etiological factors, risk factors, pathogenesis, various manifestations and complications of aortic dissection allows you not to miss the beginning of the pathological process and provide timely assistance.

The Impact of Multimorbidity on the Functional Skills in Elderly People

Introduction. Multimorbidity is defined as the occurrence of two or more chronic diseases and is the most noticeable feature of an elderly person. With age, an increase in the incidence of chronic diseases is observed. Somatic diseases frequently co-occur with mental illnesses. In most cases, chronic diseases result in seniors’ disability. The most common ones include cardiovascular system, locomotor system, sight and hearing disorders; neurological and mental diseases; and mental impairments. Aim. The aim of the paper was to assess the prevalence of multimorbidity in elderly people in their home environment and to determine the relationship between multimorbidity and seniors’ functional skills. Material and Methods. The method of a diagnostic survey was applied, with the direct questionnaire technique. A questionnaire of the authors’ own construction was used, as well as standardized tools, i.e. the Barthel and the Lawton scales. The study involved 504 people aged 66–94 years staying in their home environment. Results. Only 0.05% of the subjects did not report any disease. The average number of diseases was 2.98 (3.03 in women, 2.90 in men). A statistically significant correlation was found between the number of the declared diseases and the patients’ age (p&lt;0.001). In addition, together with an increase in the number of diseases, a deterioration was observed in the results on the Barthel and Lawton scales (p&lt;0.001), as well as in cognitive and emotional skills (p&lt;0.001). Conclusions. The vast majority of people aged over 65 years living in rural areas experienced multimorbidity; the following predominated among the diseases: hypertension, osteoarthritis, circulatory insufficiency, atherosclerosis, and diabetes mellitus. Together with an increase in the number of diseases, a deterioration was observed in the patients’ functional, cognitive, and emotional skills. (JNNN 2024;13(1):17–22)

Influence of socio-demographic factors on medicinal plant knowledge among three selected ethnic groups in south-central Ethiopia

BackgroundThe influence of socio-demographic variables was widely explored to evaluate their impact on indigenous and local ethnobotanical knowledge. However, the studies conducted in Ethiopia mainly focused on rural areas. They were limited to exploring and documenting ethnobotanical knowledge and the associated impacts of socio-demographic variables in rural–urban interface areas among ethnic groups. Hence, this study aimed to document plant-based indigenous and local ethnomedicinal knowledge and the associated impacts of socio-demographic variables among selected three ethnic groups in south-central Ethiopia.MethodsEthnobotanical data were collected using semi-structured interviews with 189 key informants, floristic species inventories, and field observations. Quantitative approaches were used to evaluate the use values (UV) of the most important medicinal plants, the informant consensus factor (ICF), fidelity level (FL), relative popularity level (RPL), and rank-order priority (ROP). Statistical tests were applied to evaluate the influences of socio-demographic factors and associations between variables on local ethnobotanical knowledge across ethnic groups in different informant categories.ResultsStatistical analysis revealed significant differences (p < 0.05) in the mean number of medicinal plants reported among age categories. There was also a positive association between the respondent's age and plant knowledge acquisition. Croton macrostachyus Hochst. ex Delile, Albizia gummifera C.A.Sm., Zingiber officinale Roscoe, Aloe macrocarpa Tod., Gymnanthemum amygdalinum (Delile) Sch.Bip., Calpurnia aurea (Aiton) Benth, and Allium sativum L. had the highest use values among ethnic groups. The highest informant consensus factor values were recorded for circulatory system disorders (0.68) followed by febrile illness and reproductive organ complications (0.66 each) across the three studied ethnic groups. The highest FL, RPL, and ROP values were noted for Lactuca inermis Forssk., Moringa stenopetala (Baker f.) Cufod., Withania somnifera (L.) Dunal, Allium sativum L., Citrus limon (L.) Osbeck, Ricinus communis L., Schinus molle L., Antiaris toxicaria (J.F.Gmel.) Lesch., Brucea antidysenterica J.F.Mill., Echinops kebericho Mesfin, Ocimum jamesii Sebald, Afrocarpus falcatus (Thunb.) C.N.Page, Searsia natalensis (Bernh. ex Krauss) F.A.Barkley, and Ricinus communis L. across ethnic groups in the study areas, which showed the conformity of knowledge on species curing potential and their prevalent uses.ConclusionThe study revealed that the ethnic groups of Gedeo, Oromo, and Sidama have considerable indigenous and local ethnobotanical knowledge practices. Statistical analysis shown high variation in the acquisition of local ethnobotanical knowledge among age groups, which boosted our understanding of the effects of socio-demographic factors on the local ethnobotanical knowledge dynamics. Thus, this finding advocates for efforts to repair the observed generation gap via continued professional support and educating local communities to preserve traditional knowledge and practices through systematic documentation.

Characterization of harmful gases and bioaerosols of pig farms: a review of the existing literature

From the ecological and economic point of view, intensive pig farming is drawing more and more attention due to the appearance of harmful substances, which significantly increases the risks of air, water and soil pollution. In addition, the optimal criteria for the content of harmful gases, dust and microorganisms in the environment of pig farms are currently not clearly defined. In order to better understand the interaction of harmful emissions and aerosols, the article reviews data from the literature on their main components, concentrations, and interactions. The results showed that the main pollutants in pig farming are harmful gases (ammonia (NH3), carbon dioxide (CO2), methane (CH4), nitrogen oxide (N2O), hydrogen sulfide (H2S), which are released from manure. The presence of even small concentrations of harmful gases in farm air can cause respiratory and cardiovascular system disorders not only in animals, but also in humans. Along with harmful gases, it is important to control the emission of solid particles and dust from livestock premises, which can form aerosols. Microbial aerosols in pig houses contain bacteria, fungi, viruses, which mainly come from the animals themselves, manure or service personnel. The bioaerosol includes the Firmicutes and Bacteroidetes bacterial divisions and their derivatives. In addition, the content of potentially dangerous bacteria in the bioaerosol can reach up to 40 %. A major concern causes the presence of a large number of antibiotic-resistant microorganisms in the air of these farms (including MRSA). The existing strategies and methods to combat these problems are still imperfect and need to be refined. Currently, the interaction of harmful gases, dust, solid particles and microorganisms is not taken into account, which can increase the toxic effect of each other on the animal's body. Therefore, there is a need for a better understanding of these interactions in order to improve the strategy for improving the microclimate conditions by correcting the microbiota, finding and developing biological preparations that contain natural bacteria capable of neutralizing odors and disinfecting livestock premises.

Rates, Outcomes, and Resource Burden of Extracorporeal Membrane Oxygenation Use in Hospitalizations in the United States During the Pandemic.

Extracorporeal membrane oxygenation (ECMO) is a lifesaving medical intervention for patients with severe refractory cardiopulmonary dysfunction. This study aims to characterize hospitalizations and resource use burdens associated with ECMO use during the onset of the pandemic. We performed a retrospective analysis of ECMO use in United States (US) hospitals between 2019 and 2020, utilizing data from the National Inpatient Sample database. Patient demographics, comorbidities, admission characteristics, inpatient mortality, length of hospital stay (LOS), healthcare costs, and ECMO utilization trends were assessed. Of the 17,520 hospitalizations analyzed, the most common reasons for admission were diseases and disorders of the circulatory system (40.5%) and diseases and disorders of the respiratory system (31.2%). The average patient age was 52.5 years, with a male predominance (64.2%). Hospitalizations were predominantly for White Americans (59.5%), followed by Blacks (16.3%) and Hispanics (14.8%). Nearly 88.2% of cases were at an extremely high risk of mortality without intervention. Inpatient mortality was significantly associated with Hispanic descent, a higher Charlson Comorbidity Index (CCI) score, age >60 years, and a higher All Patients Refined Diagnosis Related Groups (APRDRG) risk of mortality. Hospitalizations involving ECMO had a significantly higher inpatient mortality rate compared to non-ECMO hospitalizations (43.1% vs. 2.1%, p<0.0001). The mean LOS was 26 days for ECMO hospitalizations, with ECMO initiation occurring approximately five days from admission. ECMO-related hospitalizations often involve over 10 unique procedures, resulting in an average healthcare cost of US$967,647 per hospitalization, totaling US$16.7 billion. Comparatively, non-ECMO hospitalizations had shorter LOS and lower mean costs (mean LOS, 4.7 days, and US$52,659, respectively). ECMO utilization increased significantly from 2019 to 2020, reflecting rising demand for this life-saving therapy. Compared to non-ECMO hospitalizations, ECMO patients had higher inpatient mortality, associated with Hispanic descent, higher CCI scores, an age >60 years, and a higher APRDRG risk. ECMO hospitalizations had longer stays (26 days) and higher costs (US$967,647 per case, US$16.7 billion total) compared to pre-pandemic levels. ECMO use increased significantly from 2019 to 2020, reflecting rising demand.

Vitamin D Levels Assessment among the Neonates with and without Seizures: A Single Center Cross-Sectional Study.

The impact that vitamin D (vit D) has on a variety of medical conditions like diabetes, cardiovascular, oncological, and central nervous system disorders has been a topic of interest for many years now. It is well-known that vit D deficiency is substantially more common in epileptics than in healthy subjects. The current research was piloted to analyse the vit D levels of the blood in newborns with seizures, as well as mothers' vit D status included subjects. A cross-sectional examination was piloted at a tertiary care center, which had a neonatal intensive care unit (NICU). The subjects were neonates and their mothers. The levels of vit D were measured in term and late preterm newborns who had been brought to the NICU with convulsions. Term or late preterm infants who were healthy and hospitalized in the same hospital's postnatal unit as their mothers served as the controls for the study. Demographics, as well as the vit D levels of both the neonate and the mother, were estimated and compared and evaluated for any significance, keeping significance at less than 0.05. Of the 72 neonates included, they were similarly distributed between the epileptic (37) and healthy subjects. (40) The mothersy subjects.cluded, they were sim D levels averaged 15.11 ded, they were similarly distributed b D levels of their newborns were 13.26 ± 5.12 ng/mL (P = 0.77). There was no significant variance between the healthy and epileptic neonates (P = 0.212). The current studyficant variance between the healthy and epileptic neonates (eptic with convulsions. Termserum vit D levels and epileptic activity in neonates. Nevertheless, the levels of the vitamin were < 20 ng/mL among all the neonates. Interventions to improve the vit D levels have to be implemented.

Japanese Internists' Most Memorable Diagnostic Error Cases: A Self-reflection Survey.

Objective The etiologies of diagnostic errors among internal medicine physicians are unclear. To understand the causes and characteristics of diagnostic errors through reflection by those involved in them. Methods We conducted a cross-sectional study using a web-based questionnaire in Japan in January 2019. Over a 10-day period, a total of 2,220 participants agreed to participate in the study, of whom 687 internists were included in the final analysis. Participants were asked about their most memorable diagnostic error cases, in which the time course, situational factors, and psychosocial context could be most vividly recalled and where the participant provided care. We categorized diagnostic errors and identified contributing factors (i.e., situational factors, data collection/interpretation factors, and cognitive biases). Results Two-thirds of the identified diagnostic errors occurred in the clinic or emergency department. Errors were most frequently categorized as wrong diagnoses, followed by delayed and missed diagnoses. Errors most often involved diagnoses related to malignancy, circulatory system disorders, or infectious diseases. Situational factors were the most cited error cause, followed by data collection factors and cognitive bias. Common situational factors included limited consultation during office hours and weekends and barriers that prevented consultation with a supervisor or another department. Conclusion Internists reported situational factors as a significant cause of diagnostic errors. Other factors, such as cognitive biases, were also evident, although the difference in clinical settings may have influenced the proportions of the etiologies of the errors that were observed. Furthermore, wrong, delayed, and missed diagnoses may have distinctive associated cognitive biases.

Pathophysiological aspects of microgravity and gravity therapy in cardiovascular diseases

Deconditioning in space from gravity deprivation, the problems of the consequences of modern sedentary lifestyle, bed rest and changes observed in sedentary aging demonstrate similar mechanisms of development, which are interpreted as disorders of mechanotransduction. Tensegrity theory provides the framework for understanding how external and internal mechanical forces influence biological control at the molecular and cellular levels in conditions associated with a sharp and steady disappearance of the gravitational vector signal. Microgravity causes pathologies such as severe loss of bone density and skeletal muscle strength, loss of functional capacity of the cardiovascular system, immune system and other disorders. The effect on the human body for therapeutic and preventive purposes with various parameters of artificial gravity is a modern and highly effective technology of restorative medicine. The aim of this lecture is to summarize the most important findings about the effects of gravitational therapy in different, mainly vascular based pathologies according to literary sources.

Влияние угольной отрасли на экономику регионов России

The article is a study dedicated to assessment of the economy of Russian regions, taking into account operation of the coal industry. Based on the hierarchical cluster analysis, 80 constituent entities of the Russian Federation were divided into groups according to the aggregated energy, environmental, social and economic indicators. The existence of a relationship between the level of the disease (according to the class of diseases – respiratory diseases, neoplasms, circulatory system disorders, congenital anomalies and malformations) and the volume of pollutant emissions into the atmosphere emitted by the coal industry companies operating in the regions was confirmed. The relationship between the social and environmental, energy and economic indicators has been determined. It is shown that the more developed is the coal industry in the regions, the higher the GRP and per capita incomes are; the higher the emissions are, the higher the incidence or burden on healthcare professionals is. At the same time, the presence of the lowest mortality rate in the leading regions of the coal industry can be associated with a high level of income of the population.

Comorbid Conditions in Persons Exposed to Ionizing Radiation and Veterans of the Soviet-Afghan War: A Cohort Study in Kazakhstan.

This study investigated the prevalence and characteristics of comorbid conditions in patients exposed to ionizing radiation and those who were involved in the Soviet-Afghan war. This study analyzed the frequency and spectrum of morbidity and comorbidity in patients over a long-term period (30-35 years) following exposure to ionizing radiation at the Semipalatinsk nuclear test site or the Chornobyl nuclear power plant, and among participants of the Soviet-Afghan war. A cohort study, both prospective and retrospective, was conducted on 675 patients who underwent comprehensive examinations. Numerical data were analyzed using the Statistica 6 program. The results are presented as the mean±standard deviation, median, and interquartile range (25-75th percentiles). The statistical significance of between-group differences was assessed using the Student t-test and Pearson chi-square test. A p-value of less than 0.05 was considered statistically significant. We found a high prevalence of cardiovascular diseases, including hypertension (55.0%) and cardiac ischemia (32.9%); these rates exceeded the average for this age group in the general population. The cumulative impact of causal occupational, environmental, and ultra-high stress factors in the combat zone in participants of the Soviet-Afghan war, along with common conventional factors, contributed to the formation of a specific comorbidity structure. This necessitates a rational approach to identifying early predictors of cardiovascular events and central nervous system disorders, as well as pathognomonic clinical symptoms in this patient cohort. It also underscores the importance of selecting suitable methods and strategies for implementing treatment and prevention measures.

Impact of infrasound and low frequency noise on human health and well-being. Part II: Review of epidemiological studies

This paper summarizes the currently available knowledge on the impact of infrasound (IS) and low frequency noise (LFN) on human health and well-being. This narrative review of the literature data was based on the selected, mostly, peer-reviewed research papers, review articles, and meta-analyses that were published in 1971-2022. It has been focused on the results of epidemiological studies concerning the annoyance related to infrasound and low frequency noise, as well as their impact on the cardiovascular system and sleep disorders. Particular attention was also paid to the latest research results and specific sources of IS and LFN, i.e., wind turbines. Med Pr Work Health Saf. 2023;74(5):409-23.

Predicting mortality in paraquat poisoning through clinical findings, with a focus on pulmonary and cardiovascular system disorders

BackgroundParaquat, one of the most widely used herbicides, poses a significant risk of mortality through self-poisoning and subsequent multiple organ failure. The primary objective aimed to identify the factors associated with death in patients poisoned by paraquat.MethodsA cross-sectional retrospective review was conducted at a tertiary referral hospital over five years. Eligible patients presented with acute paraquat toxicity between 1 January 2016 and 31 December 2020. Medical records of 148 patients were reviewed.ResultsThe in-hospital fatality rate was found to be 21.8%. Multivariate analysis revealed that the amount of paraquat ingested and clinical presentations, particularly pulmonary and cardiovascular system disorders, were significantly associated with mortality.ConclusionOur study highlights that the amount of paraquat ingested, along with the presence of pulmonary and cardiovascular system disorders, can serve as prognostic indicators for mortality rates in cases of paraquat poisoning. These findings have important implications for physicians in predicting the prognosis and mortality of paraquat poisoning patients.Graphical