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Annals of Medicine

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https://www.readbyqxmd.com/read/29172794/mortality-in-patients-with-atrial-fibrillation-and-common-co-morbidities-a-cohort-study-in-primary-care
#1
Per Wändell, Axel C Carlsson, Martin J Holzmann, Johan Ärnlöv, Jan Sundquist, Kristina Sundquist
OBJECTIVE: To study the association between cardiovascular co-morbidities and mortality risk in primary care patients with atrial fibrillation. METHODS: The study population included all adults (n = 12,283) ≥ 45 years diagnosed with AF at 75 primary care centres in Sweden between 2001 and 2007. The outcome was mortality (until 2010) and data were explored for co-morbidities using Cox regression with hazard ratios (HRs). Analyses were performed stratified by sex and by age-group (45-64, 65-74 and ≥75 years of age) with adjustment for age, socio-economic factors and relevant co-morbidities...
November 27, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29172780/understanding-modern-day-vaccines-what-you-need-to-know
#2
Volker Vetter, Gülhan Denizer, Leonard R Friedland, Jyothsna Krishnan, Marla Shapiro
Vaccines are considered to be one of the greatest public health achievements of the last century. Depending on the biology of the infection, the disease to be prevented, and the targeted population, a vaccine may require the induction of different adaptive immune mechanisms to be effective. Understanding the basic concepts of different vaccines is therefore crucial to understand their mode of action, benefits, risks, and their potential real-life impact on protection. This review aims to provide healthcare professionals with background information about the main vaccine designs and concepts of protection in a simplified way to improve their knowledge and understanding, and increase their confidence in the science of vaccination ( Supplementary Material )...
November 27, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29166795/pharmacological-interventions-for-preventing-acute-mountain-sickness-a-network-meta-analysis-and-trial-sequential-analysis-of-randomized-clinical-trials
#3
Kannan Sridharan, Gowri Sivaramakrishnan
BACKGROUND: Individuals ascending to high altitude are at a risk of getting acute mountain sickness (AMS). The present study is a network meta-analysis comparing all the interventions available to prevent AMS. METHODS: Electronic databases were searched for randomized clinical trials evaluating the use of drugs to prevent AMS. Incidence of AMS was the primary outcome and incidence of severe AMS, paraesthesia (as side effect of acetazolamide use), headache and severe headache, and oxygen saturation were the secondary outcomes...
November 23, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29156997/clinical-manifestations-and-outcomes-of-severe-warfarin-overanticoagulation-from-the-ewa-study
#4
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Aku Virta, K E Juhani Airaksinen
INTRODUCTION: Severe warfarin overanticoagulation is a risk factor for bleeding, but there is little information on its manifestations, prognosis and factors affecting the outcome. We describe the manifestations and clinical outcomes of severe warfarin overanticoagulation in a large group of patients with atrial fibrillation (AF). MATERIALS AND METHODS: All international normalized ratio (INR) samples (n = 961 431) in the Turku University Hospital region between 2003-2015 were screened...
November 20, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29113496/both-youth-and-long-term-vitamin-d-status-is-associated-with-risk-of-type-2-diabetes-mellitus-in-adulthood-a-cohort-study
#5
Feitong Wu, Markus Juonala, Niina Pitkänen, Antti Jula, Terho Lehtimäki, Matthew A Sabin, Katja Pahkala, Nina Hutri-Kähönen, Mika Kähönen, Tomi Laitinen, Jorma S A Viikari, Costan G Magnussen, Olli T Raitakari
OBJECTIVES: To determine whether vitamin D status in childhood and adolescence (herein collectively referred to as youth) and the long-term status from youth to adulthood is associated with risk of developing type 2 diabetes mellitus (T2DM) and impaired fasting glucose (IFG) in adulthood. MATERIALS AND METHODS: This was a 31-year follow-up study of 2300 participants aged 3-18 years. Multinomial logistic regression was used to assess the association of both (a) baseline 25-hydroxyvitamin D (25OHD) levels and (b) the mean of baseline and the latest follow-up 25OHD levels (continuous variable and quartiles) with incident T2DM and IFG (cut-off = 5...
November 7, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28985689/effect-of-age-period-and-birth-cohort-on-the-frequency-of-glucose-6-phosphate-dehydrogenase-deficiency-in-sardinian-adults
#6
Giovanni Mario Pes, Alessandra Errigo, Angela Bitti, Maria Pina Dore
BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder common in Sardinia. In this study, the frequency variation of G6PD-deficiency across age groups and birth cohorts was investigated using Age-Period-Cohort analysis. METHODS: Data were collected from the clinical records of 11,252 patients (6975 women, age range 17-94 years) who underwent endoscopy between 2000 and 2016 at a teaching hospital (University of Sassari), Italy. G6PD status was assessed by enzymatic assay based on G6PD/6GPD ratio...
October 16, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28972808/joint-associations-of-sauna-bathing-and-cardiorespiratory-fitness-on-cardiovascular-and-all-cause-mortality-risk-a-long-term-prospective-cohort-study
#7
Setor K Kunutsor, Hassan Khan, Tanjaniina Laukkanen, Jari A Laukkanen
PURPOSE: We aimed to evaluate the joint impact of cardiorespiratory fitness (CRF) and frequency of sauna bathing (FSB) on the risk of cardiovascular and all-cause mortality. DESIGN: CRF measured by respiratory gas analyses and sauna exposure were assessed at baseline in a prospective study of 2277 men. CRF was categorized as low and high (median cut-offs) and FSB as low and high (≤2 and 3-7 sessions/week, respectively). RESULTS: During a median follow-up of 26...
October 16, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/29027470/next-generation-sequencing-applications-for-cardiovascular-disease
#8
Samira Kalayinia, Hamidreza Goodarzynejad, Majid Maleki, Nejat Mahdieh
The Human Genome Project (HGP), as the primary sequencing of the human genome, lasted more than one decade to be completed using the traditional Sanger's method. At present, next-generation sequencing (NGS) technology could provide the genome sequence data in hours. NGS has also decreased the expense of sequencing; therefore, nowadays it is possible to carry out both whole-genome (WGS) and whole-exome sequencing (WES) for the variations detection in patients with rare genetic diseases as well as complex disorders such as common cardiovascular diseases (CVDs)...
October 13, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28972811/mechanical-dispersion-is-associated-with-poor-outcome-in-heart-failure-with-a-severely-depressed-left-ventricular-function-and-bundle-branch-blocks
#9
Ivan Stankovic, Aleksandra Janicijevic, Aleksandra Dimic, Milica Stefanovic, Radosav Vidakovic, Biljana Putnikovic, Aleksandar N Neskovic
OBJECTIVES: Bundle branch blocks (BBB)-related mechanical dyssynchrony and dispersion may improve patient selection for device therapy, but their effect on the natural history of this patient population is unknown. METHODS: A total of 155 patients with LVEF ≤ 35% and BBB, not treated with device therapy, were included. Mechanical dyssynchrony was defined as the presence of either septal flash or apical rocking. Contraction duration was assessed as time interval from the electrocardiographic R-(Q-)wave to peak longitudinal strain in each of 17 left ventricular segments...
October 13, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28972798/the-role-of-levothyroxine-in-obstetric-practice
#10
Inés Velasco, Peter Taylor
Thyroid hormones play a pivotal role in somatic growth, metabolic regulation and neurodevelopment. There is growing evidence regarding adverse obstetric and perinatal consequences of maternal thyroid hypofunction during early stages of pregnancy. These include: early pregnancy loss, preterm delivery and lower intelligence quotient (IQ) in children. Different clinical guidelines have been published by scientific societies for the management of thyroid diseases during pregnancy and levothyroxine (LT4) has become a therapeutic agent increasingly prescribed by obstetricians...
October 11, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28927303/case-fatality-of-acute-coronary-events-is-improving-even-among-elderly-patients-the-finami-study-1995-2012
#11
Heli Koukkunen, Aki S Havulinna, Seppo Lehto, Matti Ketonen, Juha Mustonen, Juhani K Airaksinen, Olavi Ukkola, Y Antero Kesäniemi, Veikko Salomaa
AIM: To examine trends in incidence and 28-day case fatality of myocardial infarction (MI) in persons aged 75-99 years in four areas of Finland. METHODS AND RESULTS: The Finnish Acute Myocardial Infarction (FINAMI) register is a population-based MI register study, which during 1995-2012 recorded 30561 suspected acute coronary syndromes in persons aged ≥75 years. Of them, 16229 fulfilled the American Heart Association criteria for a definite, probable or possible MI or coronary death...
October 3, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28929822/genetic-and-ethnic-modulation-of-cardiovascular-toxicity-of-vascular-endothelial-growth-factor-inhibitors
#12
Yen-Chou Chen, Cheng-Chih Chung, Yung-Kuo Lin, Yi-Jen Chen
Vascular endothelial growth factor (VEGF) inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors (TKIs), are important as anticancer treatments through curbing tumour angiogenesis and growth. VEGF inhibitors have significant cardiovascular effects. By blocking VEGF receptors, ligands, or signal pathways, VEGF inhibitors disturb the balance between vasodilation and vasoconstriction, undermine endothelial cell integrity, and activate cardiomyocyte apoptosis. VEGF inhibitors increase risks of hypertension, heart failure, thromboembolism and arrhythmia...
September 27, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28892413/enhancing-the-real-world-prediction-of-cardiovascular-events-and-major-bleeding-with-the-cha2ds2-vasc-and-has-bled-scores-using-multiple-biomarkers
#13
Vanessa Roldán, José Miguel Rivera-Caravaca, Alena Shantsila, Amaya García-Fernández, María Asunción Esteve-Pastor, Juan Antonio Vilchez, Marta Romera, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
BACKGROUND: Atrial fibrillation (AF)-European guidelines suggest the use of biomarkers to stratify patients for stroke and bleeding risks. We investigated if a multibiomarker strategy improved the predictive performance of CHA2DS2-VASc and HAS-BLED in anticoagulated AF patients. METHODS: We included consecutive patients stabilized for six months on vitamin K antagonists (INRs 2.0-3.0). High sensitivity troponin T, NT-proBNP, interleukin-6, von Willebrand factor concentrations and glomerular filtration rate (eGFR; using MDRD-4 formula) were quantified at baseline...
September 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28879775/direct-indirect-and-total-bilirubin-and-risk-of-incident-coronary-heart-disease-in-the-dongfeng-tongji-cohort
#14
Xuefeng Lai, Qin Fang, Liangle Yang, Xuguang Chen, Hao Wang, Lin Ma, Wenting Guo, Miao Liu, Handong Yang, Ce Zhang, Xiulou Li, Xinwen Min, Jing Yuan, Mei-An He, Tangchun Wu, Xiaomin Zhang
BACKGROUND: Total bilirubin (TBIL) is known to be inversely associated with coronary heart disease (CHD) risk, however, whether this association is dose-response remains inconsistent and it is unclear which subtype of bilirubin is responsible for the potential protective effect. METHODS: We included 12,097 participants who were free of CHD, stroke, cancer and potential liver, biliary and renal diseases at baseline from September 2008 to June 2010 and were followed-up until October 2013...
September 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28844171/a-clinical-decision-making-algorithm-for-penicillin-allergy
#15
Angèle Soria, Elodie Autegarden, Emmanuelle Amsler, Hafida Gaouar, Amandine Vial, Camille Francès, Jean-Eric Autegarden
BACKGROUND: About 10% of subjects report suspected penicillin allergy, but 85-90% of these patients are not truly allergic and could safely receive beta-lactam antibiotics Objective: To design and validate a clinical decision-making algorithm, based on anamnesis (chronology, severity, and duration of the suspected allergic reactions) and reaching a 100% sensitivity and negative predictive value, to assess allergy risk related to a penicillin prescription in general practise. STUDY DESIGN AND METHODS: All patients were included prospectively and explorated based on ENDA/EAACI recommendations...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28805463/oxygen-uptake-at-aerobic-threshold-is-inversely-associated-with-fatal-cardiovascular-and-all-cause-mortality-events
#16
Setor K Kunutsor, Sudhir Kurl, Hassan Khan, Francesco Zaccardi, Rainer Rauramaa, Jari A Laukkanen
PURPOSE: We aimed to assess the associations of oxygen uptake at aerobic threshold (VO2 at AT) with cardiovascular and all-cause mortality. DESIGN: VO2 at AT was assessed in 1663 middle-aged men in a cohort study. Hazard ratios (HRs) were calculated for sudden cardiac death (SCD), fatal coronary heart disease (CHD) and cardiovascular disease (CVD) and all-cause mortality. RESULTS: During a median follow-up of 25.6 years, 138 SCDs, 209 fatal CHDs, 333 fatal CVDs and 719 all-cause mortality events occurred...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28797175/role-of-lipids-and-intraplaque-hypoxia-in-the-formation-of-neovascularization-in-atherosclerosis
#17
Dimitry A Chistiakov, Alexandra A Melnichenko, Veronika A Myasoedova, Andrey V Grechko, Alexander N Orekhov
According to the current paradigm, chronic vascular inflammation plays a central role in the pathogenesis of atherosclerosis. The plaque progression is typically completed with rupture and subsequent acute cardiovascular complications. Previously, the role of adventitial vasa vasorum in atherogenesis was underestimated. However, investigators then revealed that vasa vasorum neovascularization can be observed when no clinical manifestation of atherosclerosis is present. Vasa vasorum is involved in various proatherogenic processes such as intimal accumulation of inflammatory leukocytes, intimal thickening, necrotic core formation, intraplaque haemorrhage, lesion rupture and atherothrombosis...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28786719/nutraceutical-approaches-to-metabolic-syndrome
#18
Cesare R Sirtori, Chiara Pavanello, Laura Calabresi, Massimiliano Ruscica
Metabolic Syndrome (MetS), affecting at least 30% of adults in the Western World, is characterized by three out of five variables, from high triglycerides, to elevated waist circumference and blood pressure. MetS is not characterized by elevated cholesterolemia, but is rather the consequence of a complex interaction of factors generally leading to increased insulin resistance. Drug treatments are of difficult handling, whereas well-characterized nutraceuticals may offer an effective alternative. Among these, functional foods, e...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28782992/pdtcm-a-systems-pharmacology-platform-of-traditional-chinese-medicine-for-psoriasis
#19
Dongmei Wang, Jiangyong Gu, Wei Zhu, Fang Luo, Lirong Chen, Xiaojie Xu, Chuanjian Lu
INTRODUCTION: Psoriasis is a refractory skin disorder, and usually requires a lifetime control. Traditional Chinese medicine (TCM) is effective and safe for this disease. However, the cellular and molecular mechanisms of TCM remedies for psoriasis are still not fully understood. TCM contains numerous natural products. Natural products have historically been invaluable as a resource of therapeutic agents. Yet, there is no integrated information about active compounds of TCM for psoriasis...
December 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28540743/a-review-on-cardiovascular-effects-of-newer-hypoglycaemic-medications
#20
B Tate Cutshall, Jennifer D Twilla, Andrew S Olinger, Carrie S Oliphant
Cardiovascular disease (CVD) is the most prevalent cause of morbidity and mortality in diabetic patients. Improvement in cardiovascular complications with glycaemic control and managing cardiovascular risk factors is well established. However, the impact of hypoglycaemic medications on CVD is of increasing importance. In 2008, the U.S. Food and Drug Administration issued study regulations for hypoglycaemic agents after rosiglitazone was shown to increase the incidence of myocardial infarction, and the European Medicines Agency provided their own guidance in 2012...
November 2017: Annals of Medicine
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