Prevalence Of Cardiovascular Disease Research Articles

Plasma Concentrations of Trimethylamine-N-Oxide, Choline, and Betaine in Patients With Moderate to Advanced Chronic Kidney Disease and Their Relation to Cardiovascular and Renal Outcomes

Trimethylamine N-oxide (TMAO) is a gut bacteria mediated liver metabolite of dietary betaine, choline, and carnitine which is excreted by glomerular filtration. We studied whether TMAO is associated with cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). Among 478 patients with CKD stage G2 (n = 104), G3a (n = 163), G3b (n = 123), and G4 (n = 88), we studied the association between fasting plasma concentrations of TMAO, choline or betaine at baseline and kidney function, prevalent CVD and future renal outcomes during a mean follow-up of 5.1 years. Decreased glomerular filtration rate was associated with higher plasma concentrations of TMAO, choline and betaine. Baseline concentrations of TMAO were higher in participants with preexisting CVD compared to those without CVD (8.4 [10.1] vs. 7.8 [8.0] μmol/L; p = 0.047), but the difference was not significant after adjusting for confounders. During the follow up, 147 participants experienced CVD or died and 144 reached the predefined renal endpoint. In the adjusted regression analyses, TMAO or choline concentrations in the upper three quartiles (versus the lowest quartile) were not associated with any of the study clinical endpoints. In contrast, the adjusted hazard ratio of plasma betaine in the highest quartile versus the lowest quartile was 2.14 (1.32, 3.47) for the CVD endpoint and 1.64 (1.00, 2.67) for the renal endpoint. Elevated plasma TMAO concentrations were explained by impaired kidney function. Elevated plasma concentrations of betaine, but not that of TMAO or choline predicted adverse outcomes. TMAO might not be an appropriate target to reduce CVD or renal outcomes in patients with preexisting CKD.

Role of Triglyceride to High Density Lipoprotein (TG/HDL) Ratio as A Marker of Insulin Resistance in Adults of Central India: A Narrative Review

One of the main risk factors for the onset of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) is insulin resistance (IR). But because there aren't many easy-to-use and trustworthy biomarkers or tests, the entity is frequently under diagnosed. The present review was performed with an aim to provide the available data regarding the role or efficacy of TG/HDL ratio as an indicator of IR in adults of central India, a region popular for high prevalence of T2DM and CVD. An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on use of TG/HDL as a marker of insulin resistance published in the period 2002 to 2023 were included in the review. A total of 33 articles were selected based upon their suitability with the current review objectives and analyzed. The review concludes that TG/HDL ratio is a simple, affordable, and feasible marker of IR that can be used in economically poor regions of the India or world for screening IR and risk stratification of T2DM and CVD in adults. However, more studies are needed in India and all over the world to validate this marker and its cut-off values.

The improvement of mental and physical health of people with severe mental disorder: one-year efficacy of a lifestyle experimental intervention

IntroductionPatients with severe mental disorders have a significantly reduced life expectancy than the general population, often resulting from the increased prevalence of cardiovascular and metabolic diseases. Reasons include unhealthy lifestyle behaviours, reduced access to screening programs and adverse effects of many psychotropic drugs.ObjectivesOur goal is to assess the efficacy of a psychosocial group intervention promoting healthy lifestyle behaviors compared to a brief psychoeducational group intervention in terms of improvement of severity of psychiatric symptoms and perceived quality of life, and a series of anthropometric and hematological parameters.MethodsThis is a multicenter randomized controlled trial. Patients between 18 and 35 years of age with a diagnosis of schizophrenia and other primary psychotic disorders, unipolar depression and bipolar disorder were recruited. Exclusion criteria were inability to perform moderate physical activity, pregnancy and breastfeeding and impaired cognitive functions.Results401 patients were recruited and randomly assigned to receive the experimental intervention (LIFESTYLE) or a behavioural control intervention. About 57% of the sample were female, with a mean age of 45.8±11.8, and BMI of 32.5±5.5. All of them were receiving almost one psychotropic drug. At one year, we observed a reduction in HOMA-IR index (from 4.3 ± 5.5 to 3.1 ± 2.9, p<0.01) and triglycerides (from 162.5 ± 78.1 mg/dL to 131.4 ± 76.0 mg/dL, p<0.001), as well as an increase in HDL (from 46.2± 14.6 mg/dL to 50.9±26.7 mg/dL, p<0.05). Moreover, a reduction in the values of BPRS “Affectivity” (from 8.7±3.0 to 7.2±2.5, p<0.001), “Activity” (from 4.7±1.9 to 4.2±1.3, p<0.01) and “Negative Symptoms” subscale (from 7.7±3.1 to 7.0±2.7, p<0.001) was also observed, along with an improvement in perceived quality of life (MANSA total score from 4.0 ± 1.0 to 5.3 ± 0.8, p<0.01).ConclusionsThe results support the evidence that the LIFESTYLE intervention has long-lasting positive effects on physical and mental health of people with mental disorders. More efforts need to be done in order to increase the availability of these treatments in routine clinical settings.Disclosure of InterestNone Declared

Retrospective Assessment of Metabolic Syndrome and Cardiovascular Disease Risk Following Monthly and Three-Month Long-Acting Paliperidone Palmitate Treatment in Schizophrenia

IntroductionPatients with schizophrenia exhibit a higher prevalence of metabolic syndrome and cardiovascular diseases compared to the general population, resulting in increased mortality rates. The extent of this risk may vary based on the specific treatment employed.ObjectivesThis study aims to compare the risk assessments of metabolic syndrome and cardiovascular diseases in schizophrenia patients who transitioned from monthly long-acting paliperidone palmitate (PP1M) treatment to three-month long-acting paliperidone palmitate (PP3M) treatment during both treatment periods.MethodsThe research was conducted at the Psychiatry Clinic and Psychotic Disorders Outpatient Clinic of Selcuk University Faculty of Medicine. Eligible participants included patients under PP3M treatment for a minimum of 6 months and undergoing continuous monitoring in the psychotic disorders outpatient clinic. Sociodemographic and clinical data, scales, laboratory values, and measurements taken both before and during the use of PP3M and PP1M were retrieved from file records, encompassing assessments, analyses, and examinations conducted in accordance with the “Psychotic Disorders - Treatment Monitoring Protocol.” Ethical approval was obtained from the Selcuk University Ethics Committee.Results Among the 31 patients transitioning from PP1M to PP3M treatment, 15 (48.4%) were female. The mean age of the patients was 44.4±14.4 years. No statistically significant differences were observed in the mean values of clinical evaluation and side effect assessment scales, body mass index (BMI), waist-to-hip ratio, systolic blood pressure, glucose levels, cholesterol levels, prolactin levels, and thyroid-stimulating hormone (TSH) measurements between the pre- and post-treatment phases (p>0.05). However, a significant difference was identified in the mean Qrisk3 values, a cardiovascular risk index, in two distinct measurements (10-year risk score: PP1M 3.7±4.2 and PP3M 4.6±4.8, p=0.003).Conclusions Our study, designed to investigate the impact of the monthly and three-month long-acting formulations of the same antipsychotic drug on patients’ clinical status, side effects, and general health parameters, found that PP3M treatment did not significantly differ from PP1M treatment in terms of Qrisk3 values. Despite the lack of statistical significance between the parameters used in Qrisk3 calculation, the observed significant difference in Qrisk3 values is attributed to variations in age. In order to promote the widespread adoption of long-acting treatments in schizophrenia management, clinicians should engage in comprehensive comparative studies assessing both efficacy and side effects.Disclosure of InterestNone Declared

Scaling hypertension treatment in 24 low-income and middle-income countries: economic evaluation of treatment decisions at three blood pressure cut-points

ObjectiveEstimate the incremental costs and benefits of scaling up hypertension care in adults in 24 select countries, using three different systolic blood pressure (SBP) treatment cut-off points—≥140, ≥150 and ≥160...

Comprehensive Cardiovascular Assessment in Critical Patients: The Predictive Role of a Smartphone-based 12-Lead ECG Device

Background: With the increasing prevalence of cardiovascular diseases, there is a growing need for innovative and easily accessible cardiac monitoring tools. This study evaluates the predictive capability of Spandan, a smartphone-based 12-lead electrocardiogram (ECG) device, for assessing cardiovascular abnormalities in critically ill ICU patients at a tertiary care hospital in Uttarakhand. Methods: A cohort of 203 critically ill patients was actively enrolled in the study. Utilizing the Spandan smartphone-based ECG device, comprehensive 12-lead ECG recordings were obtained from each participant. These recordings underwent comparative analysis against the Gold Standard ECG, with diagnoses provided by cardiologists. The study aimed to assess the operational feasibility and accuracy of Spandan in identifying cardiovascular abnormalities within this high-risk population. Result: Initial findings reveal a significant alignment between the ECG recordings obtained via Spandan and the gold standard ECG, corroborating the diagnoses provided by cardiologists. The smartphone-based ECG device demonstrates promising outcomes in detecting various cardiovascular abnormalities in critical patients, including arrhythmias, ischemic changes, and conduction abnormalities. Notably, Spandan exhibits a specificity of 70%, surpassing the Gold Standard's 42%. This suggests Spandan's advantageous capability in accurately identifying true negative cases, thereby offering a higher specificity. Conclusion: The Spandan 12-lead ECG device shows promise as a valuable tool for comprehensive cardiovascular assessment in critically ill patients. Its operational feasibility and precision in identifying cardiovascular abnormalities highlight its potential to facilitate prompt diagnosis and management in this vulnerable demographic. Further extensive research and larger-scale trials are warranted to validate these initial findings and confirm the broad applicability of smartphone-based ECG devices in critical care settings.

Assessment of Cardiovascular Diseases Knowledge among Adults Population in Sulaimani City: A Descriptive Study

Background: The increasing prevalence of cardiovascular disease has emerged as a significant global and public health issue within the category of non-communicable diseases. In this study, we have to assess cardiovascular diseases knowledge and risk factors among adult population in Sulaimani City. Materials and Methods: A descriptive study was done with 131 people in Sulaimani city was collected the data includes socio demographic, clinical characteristics, and information about some risk factors of cardiovascular disease through direct interview. Results: The results of the present study revealed that 60.3%, 39.7% of the participants were males and female respectively. Most of them married and from urban area, 35.9% was graduated from primary school. 51.9% of them were unemployed. 76.3% of them had insufficient economic state. 81% of them were current and second-hand smoke. More than half of them had no information about heart disease, it is risk factors. Most 80.2% of them did not do regular exercise. Conclusion: From this present study, we have concluded that insufficient knowledge of the participants regarding risk factors of heart disease, especially food drug interaction and drug- drug interaction. More than half and nearly a quarter of them did not sure about existing dyslipidemia and hypertension respectively. The majority of them did not perform regular daily exercise. Keywords: cardiovascular diseases, knowledge, adults, population, Sulaimani city, descriptive study

Leveraging Clinical Pharmacy Expertise for Pediatric Cardiology in Low and Middle-Income Country

Pharmacists are universally regarded as an integral component in the therapeutic prescription, particularly within the realm in pediatric population. As the drastic increase in prevalence of cardiovascular diseases in pediatrics in Pakistan harness numerous opportunities for pharmacists to involve in clinical activities such as, to evaluate treatment regimens, therapeutic monitoring, adverse event monitoring, counseling and intervene as needed appropriately in collaboration with physician to facilitate high care to pediatric patients. However, a comprehensive literature review underscores the dearth of such patient-centered practice in Pakistan in public-health sector specially. In this commentary, we accentuate the indispensable involvement of pharmacist in pediatric cardiac unit of public-sector in low and middle income country to optimized pediatric patients care

Метод автоматического детектирования характерных точек пульсовой волны

The high prevalence of cardiovascular diseases (CVD) requires the development of new methods for their timely preliminary diagnosis. One of the promising approaches in this direction is the analysis of photoplethysmogram (PPG). The article presents an algorithmic method of digital processing of the PPG signal for automatic determination of the position of characteristic points on the pulse wave. This task is relevant, as amplitude and time characteristics of the location of characteristic points allow obtaining information about the state of the cardiovascular system (CVS). The developed method is characterised by low sensitivity to the variability of the signal shape due to the application of differentiation and interpolation procedures. The proposed solution can be used for creation of modern technical means of preliminary diagnostics of CVS.

Clinicopathological Features of Smoking Patients with Multivessel Coronary Artery Disease According to the Frailty Registry

Aim. To analyse clinicopathological features of smoking patients with multivessel coronary artery disease.Material and Methods. We analysed the data from the FRAILTY registry which includes patients with coronary artery disease. In addition to clinical features, we assessed echocardiography data and lipid metabolism levels (total cholesterol, triglycerides, low- and high-density lipoproteins, and high-sensitive C-reactive protein).Results. Of the 381 CAD patients, 178 (46.7%) have smoked at some point (107 (60.1%) current smokers and 71 (39.1%) smoking quitters), whereas 203 (53.3%) patients have never smoked. These groups were comparable in age and cardiovascular disease prevalence. Smokers or smoking quitters’ group had higher proportion of males (78.1 vs. 69%; p = 0.045), higher prevalence of myocardial infarction (61.8 vs. 55.2%; p = 0.047), chronic obstructive pulmonary disease (6.4 vs. 2.3%; p = 0.045), and lower extremity peripheral artery disease (47.8 vs. 31.5%; p = 0.041). There were no differences between the groups regarding the risk of death after cardiac surgery. The level of total cholesterol was 1.8-fold higher in smokers and smoking quitters as compared with patients who never smoked (5.5 (3.7; 6.7) vs. 3.0 (2.2; 4.0) mmol/L; p = 0.01). Similar pattern was discovered regarding to the level of C-reactive protein (5.1 (2.4; 5.3) vs. 3.9 (2.2; 4.2) mg/L in smokers/smoking quitters and never smokers, respectively; p = 0.041). The analysis of echocardiography parameters did not reveal statistically significant differences.Conclusion. Smoking frequently accompanies coronary artery disease. Current smokers and smoking quitters were characterized by higher frequency of myocardial infarction, chronic obstructive pulmonary disease, and lower extremity peripheral artery disease Further, current smokers and smoking quitters had higher serum total cholesterol and C-reactive protein.

The prevalence of cardiovascular diseases, chronic kidney disease, and obesity in patients with type 2 diabetes mellitus and the description of concurrent treatments: A two-center retrospective cross-sectional study in Saudi Arabia

BackgroundAtherosclerotic cardiovascular disease (ASCVD), heart failure (HF), chronic kidney disease (CKD), and obesity are associated with increased morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Nonetheless, their prevalence among patients with T2DM in Saudi Arabia (SA) remains unknown. As current guidelines recommend, these comorbidities require adding certain antidiabetic agents with cardiorenal benefits. However, the prescribers' adherence to these recommendations remains unclear. MethodsA two-center retrospective cross-sectional study was conducted including adult patients (≥18 years) with T2DM admitted to hospital or seen at outpatient clinics between January and December 2020. Patients were classified into two groups based on the presence or absence of ASCVD. Patients with no prior ASCVD history were further classified based on the 10-year ASCVD risk estimation. Endpoints of interest included the prevalence of ASCVD, HF, CKD, and obesity in patients with T2DM. We also evaluated the characteristics of the utilized antidiabetic agents, statin, and aspirin therapies.. ResultsOf the 1,218 included patients with T2DM, the majority were female (57.0 %), and aged 45–64 years (53.0 %) with a mean age of 59.3 ± 13.1 years. Hypertension and dyslipidemia were the most prevalent comorbidities (67.7 % and 69.0 %, respectively). Among all patients, 18.6 % had an established ASCVD and the prevalence of HF, CKD, and obesity were 5.1 %, 8.7 %, and 58.3 %, respectively. The most common types of ASCVD witnessed were revascularization (42.3 %), myocardial infarction (36.6 %), and stroke (33.9 %); with an increased prevalence of ASCVD as the age increases (52.8 % at age ≥ 65 years). In the non‐ASCVD group, the 10-year ASCVD risk was intermediate or high in 62.7 % of these patients. The rates of utilization of guidelines-recommended therapies were 83.6 % for metformin, 9.4 % for GLP-1 RA, 10.8 % for SGLT2i, 35.2 % for aspirin alone or in combination with clopidogrel, and 79.7 % for statin therapy. ConclusionsASCVD, HF, CKD, and obesity are common complications in patients with T2DM in SA, with low overall utilization of the recommended guidelines-recommended medical therapies. Multimodal strategies should be utilized to assess T2DM and its complications, and to improve prescribers' adherence to guidelines-recommended therapies.

Multiple cardiovascular risk factor care in 55 low- and middle-income countries: A cross-sectional analysis of nationally-representative, individual-level data from 280,783 adults.

The prevalence of multiple age-related cardiovascular disease (CVD) risk factors is high among individuals living in low- and middle-income countries. We described receipt of healthcare services for and management of hypertension and diabetes among individuals living with these conditions using individual-level data from 55 nationally representative population-based surveys (2009-2019) with measured blood pressure (BP) and diabetes biomarker. We restricted our analysis to non-pregnant individuals aged 40-69 years and defined three mutually exclusive groups (i.e., hypertension only, diabetes only, and both hypertension-diabetes) to compare individuals living with concurrent hypertension and diabetes to individuals with each condition separately. We included 90,086 individuals who lived with hypertension only, 11,975 with diabetes only, and 16,228 with hypertension-diabetes. We estimated the percentage of individuals who were aware of their diagnosis, used pharmacological therapy, or achieved appropriate hypertension and diabetes management. A greater percentage of individuals with hypertension-diabetes were fully diagnosed (64.1% [95% CI: 61.8-66.4]) than those with hypertension only (47.4% [45.3-49.6]) or diabetes only (46.7% [44.1-49.2]). Among the hypertension-diabetes group, pharmacological treatment was higher for individual conditions (38.3% [95% CI: 34.8-41.8] using antihypertensive and 42.3% [95% CI: 39.4-45.2] using glucose-lowering medications) than for both conditions jointly (24.6% [95% CI: 22.1-27.2]).The percentage of individuals achieving appropriate management was highest in the hypertension group (17.6% [16.4-18.8]), followed by diabetes (13.3% [10.7-15.8]) and hypertension-diabetes (6.6% [5.4-7.8]) groups. Although health systems in LMICs are reaching a larger share of individuals living with both hypertension and diabetes than those living with just one of these conditions, only seven percent achieved both BP and blood glucose treatment targets. Implementation of cost-effective population-level interventions that shift clinical care paradigm from disease-specific to comprehensive CVD care are urgently needed for all three groups, especially for those with multiple CVD risk factors.

Global, regional and national temporal trends in prevalence for cardiovascular diseases in women of childbearing age, from 1990 to 2019: An age-period-cohort analysis

BackgroundEpidemiological studies on cardiovascular diseases (CVD) among women of childbearing age (WCBA) remain scarce. Our research aims to delineate the prevalence trends of CVD within this population over the past three decades, considering age, period, and birth cohort dynamics. MethodsEstimates of CVD prevalence for WCBA, along with their 95% uncertainty intervals (UI), were extracted from the Global Burden of Diseases 2019 (GBD2019). An age-period-cohort (APC) model was utilized to assess the annual percentage change (net drifts) in overall prevalence, annual percentage changes in prevalence for individual age groups (local drifts), and fitted longitudinal age-specific rates adjusted for age effects and period/cohort relative risks (period/cohort effect). ResultsIn 2019, the global prevalence of CVD among WCBA was 53.42 million (95% UI: 47.77 to 60.18). Eight countries recorded a prevalence exceeding one million, accounting for 54.17% of the global CVD prevalence in WCBA. Over the past 30 years, the annual net drift in CVD prevalence among the global WCBA was 0.27% (95% CI: 0.25 to 0.29). This value was 0.01% (95% CI: 0.04 to 0.06) in regions with a high sociodemographic index (SDI) and 0.21% (95% CI: 0.19 to 0.22) in those with a low SDI. Seventy-seven countries demonstrated an increasing trend in CVD prevalence, while 53 showed a decrease, and 74 remained relatively stable. Notably, as shown in local drift, there was a rise in CVD prevalence among adolescents aged 15–19 and adults aged 40–49 in regions categorized by five distinct SDI levels. This drift varied by SDI regions. Regions with a high SDI consistently had elevated period risks throughout the study duration, while other regions had lower period risks until 2000–2004 and displayed increased adverse period risks. The prevalence in low-middle and low SDI regions manifested detrimental trends, whereas other regions demonstrated an initial decline followed by a surge in successive birth cohorts. ConclusionsResources dedicated to CVD care for WCBA are largely insufficient, especially in low SDI regions. Thus, there is an urgent need to allocate cardiovascular healthcare resources variably across different SDI regions, aiming to diminish risks among successively younger birth cohorts. Throughout this endeavor, the formulation of targeted policies and the judicious distribution of resources are essential to reduce risks for women across all age groups.

Associations of urinary volatile organic compounds with cardiovascular disease among the general adult population

ABSTRACT This study was to estimate the associations of volatile organic compounds (VOCs) exposure with the prevalence of total and specific cardiovascular disease (CVD) among the general adult population. This cross-sectional study analyzed 15 urinary VOC metabolites in the general population using the 2011–2016 National Health and Nutrition Examination Survey (n = 5,213). The weighted study population with 47.0 years median age, was primarily female (51.2%). The prevalence of total CVD in the overall population was 7.9%. The single-exposure analyzes of AAMA, ATCA, CEMA, CYMA, DHBMA, 3HPMA, and 3MHA +4MHA were significantly associated with increased prevalence of total CVD. Qgcomp regression consistently showed that urinary VOCs-mixed exposure was positively correlated with the prevalence of total and specific CVDs (chronic heart failure, angina, and stroke), and highlighted each VOCs metabolite weights and direction. The similar results were observed for the WQS regression using mixed analysis methods. In conclusion, exposure to VOCs increases CVD prevalence and advances the identification of risk factors for CVD for environmental study.

Трансуретральная резекция предстательной железы по поводу инфравезикальной обструкции у больных с сахарным диабетом 2 типа.

Introduction. Bladder obstruction caused by benign prostatic hyperplasia (BPH) is common disease among males with diabetes mellitus (T2DM). Objective. To evaluate lower urinary tract symptoms (LUTS) and clinical outcomes among patients with/without DM2T after undergoing transurethral resection prostate (TURP). Materials and methods. Retrospective study based on medical data throughout 1,5 years (2021–2022 гг.) and participation of 48 diabetic and non-diabetic patients with persistent LUTS who also have underwent TURP for BPH. Results. Patients with DM2T show higher prevalence of cardiovascular diseases (р=0,01). They also show higher need for alpha-blockers during 1-12 months after TURP for urinary dysorders (OR=5,5, 95% CI: 1,42–21,30, р=0,01). Discussion. Wide-population prospective clinical studies are needed for creating of effective personalized strategies. Conclusion. Patients with T2DM more often need alpha-blockers within 1-12 months after TURP. T2DM leads to higher rate of post-surgery urinary retention and worse results compared with non-diabetic patients.

Region-Disentangled Diffusion Model for High-Fidelity PPG-to-ECG Translation

The high prevalence of cardiovascular diseases (CVDs) calls for accessible and cost-effective continuous cardiac monitoring tools. Despite Electrocardiography (ECG) being the gold standard, continuous monitoring remains a challenge, leading to the exploration of Photoplethysmography (PPG), a promising but more basic alternative available in consumer wearables. This notion has recently spurred interest in translating PPG to ECG signals. In this work, we introduce Region-Disentangled Diffusion Model (RDDM), a novel diffusion model designed to capture the complex temporal dynamics of ECG. Traditional Diffusion models like Denoising Diffusion Probabilistic Models (DDPM) face challenges in capturing such nuances due to the indiscriminate noise addition process across the entire signal. Our proposed RDDM overcomes such limitations by incorporating a novel forward process that selectively adds noise to specific regions of interest (ROI) such as QRS complex in ECG signals, and a reverse process that disentangles the denoising of ROI and non-ROI regions. Quantitative experiments demonstrate that RDDM can generate high-fidelity ECG from PPG in as few as 10 diffusion steps, making it highly effective and computationally efficient. Additionally, to rigorously validate the usefulness of the generated ECG signals, we introduce CardioBench, a comprehensive evaluation benchmark for a variety of cardiac-related tasks including heart rate and blood pressure estimation, stress classification, and the detection of atrial fibrillation and diabetes. Our thorough experiments show that RDDM achieves state-of-the-art performance on CardioBench. To the best of our knowledge, RDDM is the first diffusion model for cross-modal signal-to-signal translation in the bio-signal domain.

The Epidemic of Immobility in Hospitalised Patients: How to Get Your Patient Up and Moving

The global population is ageing and with cardiovascular disease (CVD) prevalence also increasing, the face of the prototypical cardiology inpatient is changing, from a middle-aged man with cardiovascular risk factors, to an older adult with multimorbidity and frailty. Hospital care is inherently harmful, with immobilization and reliance on others causing functional decline to be the leading complication of hospitalization in older adults. It is imperative to reinvent hospital care, employing age-friendly health systems to maintain health and function in older adults, improving not only CVD outcomes, but patient-centered outcomes such as function and independence and preventing avoidable harms.

Sequelae Treatment Needs Following Peripheral Facial Palsy: Retrospective Analysis of 525 Patients.

This study uses retrospective longitudinal data from a large unselected cohort of patients with peripheral facial paralysis to determine the prevalence and patient characteristic predictors of sequelae receiving intervention. Retrospective case review. Karolinska University Hospital in Stockholm Sweden serves as the only tertiary facial palsy center in the region. Here, patients are diagnosed, are followed up, and undergo all major interventions. All adult patients presenting with peripheral facial palsy due to idiopathic, zoster, or Borrelia origin at Karolinska, January 1, 2010 to December 31, 2011 with follow-up until December 2022. Patient charts were studied to identify patient characteristics, etiology, initial treatment, severity of palsy, and treatments targeting sequelae. Types of initial and late treatments were noted. Sunnybrook and/or House-Brackmann scales were used for palsy grading. Five hundred twenty-five patients were included. Thirty-three patients (6.3%) received botulinum toxin injections and/or surgical treatment. In this subgroup, 67% received corticosteroids compared to 85% of all patients ( p = 0.005), cardiovascular disease prevalence was higher (23 and 42%, respectively, p = 0.009). For 81 patients (15%), follow-up was discontinued although the last measurement was Sunnybrook less than 70 or House-Brackmann 3 to 6. Of patients with peripheral facial palsy, 6.3% underwent injections and/or surgical treatment within 12 years. However, due to a rather large proportion not presenting for follow-up, this might be an underestimation. Patients receiving late injections and/or surgical treatment had more comorbidities and received corticosteroid treatment to a significantly lower extent in the acute phase of disease.

Cardiovascular risk factors among nurses: A global systematic review and meta-analysis.

Nurses as the largest group of health workers have a very stressful job which can cause number of diseases specially increase cardiovascular risk factors. This study aims to investigate the overall epidemiology of cardiovascular disease (CVD) risk factors among nurses. We searched all four main databases such as Scopus, PubMed, Embase and Web of Sciences from the beginning of 2000 to March 2022 with appropriate Mesh Terms. We also searched Google scholar. Then we applied inclusion and exclusion criteria and after selection the studies the Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of included studies. Comprehensive Meta-analysis and R software was used for analysis. Finally, 22 articles with a total number of 117922 nurses were included. Among all risk factors, sedentary lifestyle and lack of regular physical activity with a prevalence of 46.3% (CI 95%, 26.6-67.2) was regarded as the main prevalent risk factor among nurses. The mean systolic blood pressure (SBP) measured in the study population was 121.31 (CI 95%, 114.73-127.90) and the mean diastolic blood pressure (DBP) was 78.08 (CI 95%, 74.90-81.25). Also family history of cardiovascular disease (41.9%; 95% IC: 29.8-55.1%), being overweight (33.3%; 95% IC: 24.7-43.2%), and alcohol consumption (24.6%; 95% IC: 16.4-35.2%) was found among the participants. Study results revealed that sedentary lifestyle was the main prevalent CVD risk factor among nurses followed by family history of cardiovascular disease, being overweight and alcohol consumption. Furthermore, among nurses with shift works almost all risk factors got higher score representing the worse condition in comparison with day workers' nurses. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. In general, many studies have emphasized the impact of the nursing profession on the incidence of some cardiovascular patients. Also, different shifts of nurses can have a double effect. In this study, the mean for sedentary lifestyle was reported to be 46.3% which represented the most prevalent risk factor for cardiovascular risk factors among study population. This study enables learning the associated risk factors of CVD among nurses to facilitate interventional programs with a view to reduce the exposure of nursing staff particularly those who work in shifts to cardiovascular risk factors. This information can comprise essential tools for health human resource management contributing to advance nursing.

Bridging Metabolic-Associated Steatotic Liver Disease and Cardiovascular Risk: A Potential Role for Ketogenesis.

The prevalence of cardiovascular diseases (CVDs) is a growing global health concern. Recent advances have demonstrated significant reductions in acute cardiovascular events through the management of modifiable cardiovascular risk factors. However, these factors are responsible for about 50% of the global cardiovascular disease burden. Considering that CVDs are one of the top mortality causes worldwide, the concept of residual cardiovascular risk is an important emerging area of study. Different factors have been proposed as sources of residual risk markers, including non-HDL particles characterization, as well as inflammation measured by serum and imaging technics. Among these, metabolic-associated steatotic liver disease (MASLD) remains controversial. Two opposing viewpoints contend: one positing that fatty liver disease merely reflects classical risk factors and thus adds no additional risk and another asserting that fatty liver disease independently impacts cardiovascular disease incidence. To address this dilemma, one hypothetical approach is to identify specific hepatic energy-yielding mechanisms and assess their impact on the cardiovascular system. Ketogenesis, a metabolic intermediate process particularly linked to energy homeostasis during fasting, might help to link these concepts. Ketogenic metabolism has been shown to vary through MASLD progression. Additionally, newer evidence supports the significance of circulating ketone bodies in cardiovascular risk prediction. Furthermore, ketogenic metabolism modification seems to have a therapeutic impact on cardiovascular and endothelial damage. Describing the relationship, if any, between steatotic liver disease and cardiovascular disease development through ketogenesis impairment might help to clarify MASLD's role in cardiovascular risk. Furthermore, this evidence might help to solve the controversy surrounding liver steatosis impact in CVD and might lead to a more accurate risk assessment and therapeutic targets in the pursuit of precision medicine.