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Successful Aging in Research
Published in Thomas S. Inui, Richard M. Frankel, Enhancing the Professional Culture of Academic Health Science Centers, 2022
Bruce M. Psaty, David S. Siscovick
The electronic files at Group Health were well suited to the conduct of population-based case-control studies. In a study of myocardial infarction, for instance, the diagnostic data could serve as pointers to potential events that could be verified by medical-record review. Cases should represent all the events in a defined population, and controls should be sampled from the same population from which the cases arose. The cancer case-control studies typically used the community cancer registry to identify cases in a geographic area; as a result, to obtain a sample of population-based controls, the cancer epidemiologists often used the complex method of random-digit dialing. At Group Health, the health-maintenance-organization’s enrollment files defined the population from which the perfect controls could be sampled easily and inexpensively. The computerized pharmacy database also represented an outstanding source of information about prescription drugs. Patient recall, especially for past use, may not be reliable, and medical records are sometimes incomplete. But patients do not continue to refill prescription medications that are without street value and that they are not using. Our pharmacoepidemiological case-control studies emerged from this confluence of data and mentoring resources.
Coronary Artery Disease
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Acute myocardial infarction is caused by narrowing or blockage of the coronary arteries with atherosclerotic plaque. Factors that lead to this include high LDL, and excessive saturated fat and trans fats in the diet. Modifiable risk factors represent over 90% of the risks for acute MI. Risk factors include diabetes mellitus, obesity, smoking, hypertension, high cholesterol, high triglycerides, increased age, and family history of heart disease. Additional risk factors include high stress levels, lack of physical exercise, use of amphetamines or cocaine, and a history of preeclampsia.
Amniotic Fluid Embolism
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Zaid Diken, Antonio F. Saad, Luis D. Pacheco
Patients with the following risks factors, such as, diabetes, smoking, obesity, advanced maternal age, chronic hypertension, dyslipidemia, and previous history of coronary artery disease should be ruled out for acute myocardial infarction. Workup should include cardiac troponins and a 12-lead electrocardiograph as soon as possible. A bedside echocardiography is a useful tool in assisting in the diagnosis of cardiogenic shock secondary to myocardial ischemia or to rare causes such as a peri-partum dilated cardiomyopathy [27].
Basic demographic characteristics and prevalence of comorbidities in acute mesenteric ischemia: a systematic review and proportional meta-analysis
Published in Scandinavian Journal of Gastroenterology, 2023
Wenhan Wu, Jia He, Shijian Zhang, Changtong Zeng, Qifa Wang
Our research also showed that AMI patients have a high prevalence of multisystem comorbidities, including cardiovascular disease, endocrine and metabolic diseases, kidney diseases, digestive diseases, respiratory diseases, vascular diseases, and cancer. Cardiovascular comorbidities are the major comorbidities in patients with AMI, and their prevalence is much higher than in other abdominal surgery patients [114]. This may be due to the direct relationship between cardiovascular disease and the occurrence of AMI, as well as the concomitant age-related cardiac disease due to the advanced age of AMI patients. Previous studies have shown that heart failure and arrhythmias are closely related to the survival of patients with AMI [5,6]. The results of this study showed that the prevalence of heart failure and arrhythmia in AMI were 23.8% and 38.2%, respectively. Therefore, optimal fluid management and control of arrhythmias and their complications are necessary for this subset of patients. We also found that a considerable proportion (35.1%) of AMI patients have coronary artery disease. Besides, many AMI patients have peripheral vascular disease or atherosclerosis, and such patients often also have coronary artery disease. Perioperative strategies for these AMI patients may also include enhanced drug therapy such as β-adrenergic receptor blockers, antiplatelet drugs, and continuous monitoring of postoperative troponin to achieve early diagnosis of asymptomatic myocardial infarction.
Future prospects in the tissue engineering of heart valves: a focus on the role of stem cells
Published in Expert Opinion on Biological Therapy, 2023
Benjamin J Albert, Jonathan T Butcher
Damage to the heart wall can cause changes in the function of the AV valves because of the location of attachment for the chordae tendineae [51]. Myocardial infarction can prevent complete contraction of the ventricle and can lead to compensatory remodeling. Heart muscle dysfunction can alter tension on the chordae during systole and prolapse and/or regurgitation may result [52]. HVD can lead to further cardiac remodeling in the form of hypertrophy to overcome valve inefficacy [2,48]. Hypertrophy or other cardiac remodeling, such as dilative cardiomyopathy, can alter the size or shape of the valve annulus. Changing the supporting geometry may lead to a loss of coaptation that results in additional regurgitation [53]. In this way, valvular dysfunction can sometimes lead to a feedback loop that results in heart failure.
Cardioprotective doses of thyroid hormones improve NO bioavailability in erythrocytes and increase HIF-1α expression in the heart of infarcted rats
Published in Archives of Physiology and Biochemistry, 2022
Alexandre Luz de Castro, Rafael Oliveira Fernandes, Vanessa D. Ortiz, Cristina Campos, Jéssica H. P. Bonetto, Tânia Regina G. Fernandes, Adriana Conzatti, Rafaela Siqueira, Angela Vicente Tavares, Adriane Belló-Klein, Alex Sander da Rosa Araujo
Acute myocardial infarction is an ischaemic pathology of the heart that involves an irreversible loss of cardiomyocytes, leading to a decrease in cardiac function (Schenkel et al. 2010). This condition is a leading cause of morbidity and mortality (Hong et al. 2019). Besides that, myocardial infarction is also associated with a decrease in nitric oxide (NO) bioavailability in the heart and in the red blood cells (Eligini et al. 2013, De Castro et al. 2015). The maintenance of NO levels in the cardiac tissue is important, mainly after the ischaemic injury, since this molecule can upregulate the expression of the hypoxia inducible factor-1α (HIF-1α) by activating the phosphatidylinositol 3-kinase (PI3K)-Akt pathway (Sandau et al. 2000, Kasuno et al. 2004). Activation and upregulation of HIF-1α has been recently found to be a protective mechanism against ischemia-reperfusion injury in the heart (Alchera et al. 2008, Zhong et al. 2008).