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Subclinical disease

Olubunmi O Olubamwo, Jyrki K Virtanen, Ari Voutilainen, Jussi Kauhanen, Jussi Pihlajamäki, Tomi-Pekka Tuomainen
BACKGROUND: Fatty liver disease (FLD) has been identified as constituting cardiometabolic risk. However, evidence on the association of fatty liver index (FLI) with cardiovascular disease (CVD) is largely cross-sectional, with limited evidence on the predictability of incident CVD, and specifically, acute myocardial infarction (AMI). Therefore, we aimed to investigate the prospective associations between fatty liver as estimated by FLI and incident CVD, and specifically AMI, in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort...
June 16, 2018: European Journal of Gastroenterology & Hepatology
Sashi Niranjan Nair, Harish Kumar, Manoj Raveendran, V Usha Menon
Introduction: The benefits of treating subclinical hypothyroidism are currently under debate, prevention of adverse cardiac events purporting to be one of the main benefits. The effect of subclinical hypothyroidism on the cardiovascular health of the Indian sub-population is largely unknown. This study was designed to examine these effects and to help guide treatment of this disorder. Methods: A cross-sectional adult population survey was carried out in urban coastal area of central Kerala...
March 2018: Indian Journal of Endocrinology and Metabolism
Rishi Bolia, Anshu Srivastava, Aditya Kapoor, Surender Kumar Yachha, Ujjal Poddar
INTRODUCTION: We assessed cardiac function (CF) in celiac disease (CD) patients and the effect of gluten-free diet (GFD) on CF. METHODS: Prospective evaluation of CF using conventional and tissue doppler echocardiography in 50 CD patients (age 4.2 ± 1.1 years) at diagnosis and after a year of GFD (group 1), 100 CD children (group 2; 47 compliant and 53 non-compliant) in follow-up and 25 healthy controls. RESULTS: Untreated CD (n = 50) children had larger left ventricle end diastolic dimension (35...
June 16, 2018: Scandinavian Journal of Gastroenterology
Rowan S Hardy, Hong Zhou, Markus J Seibel, Mark S Cooper
Osteoporosis associated with long-term glucocorticoid therapy remains a common and serious bone disease. In addition, in recent years it has become clear that more subtle states of endogenous glucocorticoid excess may have a major impact on bone health. Adverse effects can be seen with mild systemic glucocorticoid excess but there is also evidence of tissue-specific regulation of glucocorticoid action within bone as a mechanism of disease. This review article will examine a) the role of endogenous glucocorticoids in normal bone physiology, b) the skeletal effects of endogenous glucocorticoid excess in the context of endocrine conditions such as Cushing's disease/syndrome and autonomous cortisol secretion (subclinical Cushing's syndrome), and c) the actions of therapeutic (exogenous) glucocorticoids on bone...
June 13, 2018: Endocrine Reviews
Gianni Allais, Giulia Chiarle, Silvia Sinigaglia, Gisella Airola, Paola Schiapparelli, Chiara Benedetto
Migraine has a predilection for female sex and the course of symptoms is influenced by life stage (presence of menstrual cycle, pregnancy, puerperium, menopause) and use of hormone therapy, such as hormonal contraception and hormone replacement therapy. Hormonal changes figure among common migraine triggers, especially sudden estrogen drop. Moreover, estrogens can modulate neuronal excitability, through serotonin, norepinephrine, dopamine, and endorphin regulation, and they interact with the vascular endothelium of the brain...
June 2018: Neurological Sciences
Sean R Christensen
Cutaneous squamous cell carcinoma (SCC) is among the most common cancers in humans, and many patients with SCC will develop multiple tumors within their lifetime. The field cancerization concept, originally proposed over 60 years ago, hypothesized that multiple primary cancers may arise simultaneously and coexist with subclinical precursor lesions within a defined field. Genetic sequencing of SCC and precursor lesions has identified what may be the earliest clonal proliferations in SCC development and confirmed that field cancerization in the skin is mediated by ultraviolet radiation...
2018: F1000Research
Paola Conigliaro, Paola Triggianese, Gianluca Draghessi, Claudia Canofari, Gianluca Aloe, Maria Sole Chimenti, Claudia Valeri, Carlo Nucci, Roberto Perricone, Massimo Cesareo
BACKGROUND: Retinal involvement in systemic lupus erythematosus (SLE) and Sjögren syndrome (SS) may be subclinical and thus underdiagnosed. OBJECTIVES: We aimed at evaluating morphological and functional visual abnormalities in a cohort of SLE and SS patients in the absence of an overt clinical visual impairment. We also investigated potential associations between retinal disorders and disease activity, organ involvement, and treatment with steroid and/or hydroxychloroquine...
June 14, 2018: International Archives of Allergy and Immunology
Alan Rozanski, Daniel S Berman
PURPOSE OF REVIEW: This review aims to assess the synergistic use of coronary artery calcium (CAC) scanning and stress-rest SPECT myocardial perfusion imaging (MPI) for the workup of patients with suspected coronary artery disease (CAD). RECENT FINDINGS: The CAC score bears a proportional relationship to both the frequency of obstructive CAD and inducible ischemia. Consequently, the test can be used to improve the Bayesian assessment of pre-test CAD likelihood and assist in triaging patients for stress testing...
June 13, 2018: Current Cardiology Reports
Ib C Bygbjerg, Lone Simonsen, Karin L Schiøler
The global malaria burden, including falciparum malaria, has been reduced by 50% since 2000, though less so in Sub-Saharan Africa. Regional malaria elimination campaigns beginning in the 1940s, up-scaled in the 1950s, succeeded in the 1970s in eliminating malaria from Europe, North America, the Caribbean (except Haiti), and parts of Asia and South- and Central America. Dengue has grown dramatically throughout the pantropical regions since the 1950s, first in Southeast Asia in the form of large-scale epidemics including severe dengue, though mostly sparing Sub-Saharan Africa...
2018: Frontiers in Microbiology
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
A 77 year old male underwent elective bioprosthetic aortic valve replacement (23mm Carpentier-Edwards Perimount MagnaEase) for severe aortic stenosis. His pre-discharge transthoracic echocardiogram (TTE) was normal. He presented 9 days after surgery with dyspnoea and fever. He was in sinus rhythm. Blood cultures were taken and he was commenced on empirical antibiotics for possible infective endocarditis (subsequently all negative). Repeat TTE showed a well-seated prosthesis without regurgitation but elevated gradients (peak / mean gradients 49 / 22 mmHg respectively)...
June 12, 2018: Echo Research and Practice
Christopher L Schlett, Roberto Lorbeer, Carolyn Arndt, Sigrid Auweter, Jürgen Machann, Holger Hetterich, Birgit Linkohr, Wolfgang Rathmann, Annette Peters, Fabian Bamberg
OBJECTIVES: Local, abdominal fat depots may be related to alterations in cardiac function and morphology due to a metabolic linkage. Thus, we aimed to determine their association with subtle cardiac changes and the potential interaction with hyperglycemic metabolic states. METHODS: Subjects from the general population and without history of cardiovascular disease were drawn from the Cooperative Health Research in the Region of Augsburg FF4 cohort and underwent 3 T cardiac and body MRI...
June 12, 2018: Cardiovascular Diabetology
Mattia Arrigo, Petra Nijst, Alain Rudiger
Acute heart failure (AHF) is a life-threatening condition requiring immediate treatment. The initial therapy should take into account the clinical presentation, pathophysiology at play, precipitating factors and underlying cardiac pathology. Particular attention should be given to polymorbidity and the avoidance of potential iatrogenic harm. Patient preferences and ethical issues should be integrated into the treatment plan at an early stage. The average survival of AHF patients is 2 years and the most vulnerable period is the 3-month time window directly after discharge...
May 2018: Cardiac Failure Review
Kenan Yalta, Mustafa Yilmaztepe, Cafer Zorkun
Takotsubo cardiomyopathy (TTC) is primarily regarded as a form of acute and transient myocardial disease with a variety of characteristic wall-motion abnormalities. Importantly, a significant portion of TTC cases generally present with variable degrees of acute left ventricular (LV) dysfunction with or without clinical HF. On the other hand, LV dysfunction in the setting of TTC has been universally and exclusively considered as a synonym for systolic dysfunction, potentially overlooking other forms of myocardial pathologies, including transient diastolic dysfunction, in this setting...
May 2018: Cardiac Failure Review
Arnold C T Ng, Victoria Delgado, Jeroen J Bax
PURPOSE OF REVIEW: Left ventricular (LV) global longitudinal strain (GLS) is widely recognized as a more sensitive measure of LV systolic function compared with LV ejection fraction (LVEF). In addition, the measurement of LVGLS is more reproducible than two-dimensional LVEF. Current guidelines for diagnosis and treatment of valvular heart disease include LVEF as one of the parameters to take into consideration in the clinical decision-making. However, a large body of evidence is showing that LVGLS may be a better prognosticator than LVEF in various valvular heart diseases...
June 9, 2018: Current Opinion in Cardiology
Marc L Turner
There has been concern for several decades around the possibility that prion diseases may be transmissible by blood components and / or plasma products. Whilst the evidence in respect of transmission of sporadic Creutzfeldt-Jakob disease (CJD) is largely circumstantial, the identification of variant CJD gave rise to increased concern due to the evidence of prion accumulation in peripheral lymphoid tissue at the time of clinical disease. A series of studies of appendix tissues in the United Kingdom revealed prion accumulation in around 1 / 2000 of the individuals tested and raised further concern that there may be a significant proportion of the healthy population with subclinical infection posing an increased risk of transmission by substances of human origin (blood, plasma, tissues, organs) and interventional medical and surgical procedures...
2018: Handbook of Clinical Neurology
K P Dalton, A Balseiro, R A Juste, A Podadera, I Nicieza, D Del Llano, R González, J M Martin Alonso, J M Prieto, F Parra, R Casais
RHDVb has become the dominant RHDV on the Iberian Peninsula. A better understanding of its pathogenicity is required to aid control measures. Thus, the clinical course, humoral immune response, viraemia and kinetics of RHDV-N11 (a Spanish RHDVb isolate) infection in different tissues at both viral RNA and protein levels were studied in experimentally infected young and adult rabbits. The case fatality rate differed between the two age groups, with 21% of kits succumbing while no deaths were observed in adults...
July 2018: Veterinary Microbiology
Jordi Broncano, Daniel Vargas, Sanjeev Bhalla, Kristopher W Cummings, Constantine A Raptis, Antonio Luna
The term vasculitis includes a variable group of entities in which the common characteristic is inflammation of the walls of blood vessels occurring at some time during the course of the disease. The vasculitides can be divided into primary and secondary vasculitides, depending on the etiology and according to the size of the vessel affected. Both primary vasculitis and secondary vasculitis are associated with cardiac morbidity that is often subclinical. Cardiac involvement is associated with prognostic implications and higher rates of related mortality...
June 8, 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Eun Sun Yoon, Kevin S Heffernan, Sae Young Jae, Hyun Jeong Kim, Kanokwan Bunsawat, Bo Fernhall
OBJECTIVE: Despite preserved metabolic function, metabolically healthy obesity may increase the risk of subclinical atherosclerosis. Given the high prevalence of cardiometabolic diseases in individuals with spinal cord injury, the aim of this study was to investigate the association of insulin resistance, systemic low-grade inflammation, and markers of subclinical atherosclerosis with metabolically healthy obesity in individuals with spinal cord injury. METHODS: Insulin resistance index (HOMA-IR), high-sensitivity C-reactive protein, carotid artery intima-media thickness and carotid-femoral pulse wave velocity were measured in individuals with spinal cord injury classified with metabolically healthy obesity (n = 12), metabolically unhealthy obesity (n = 8), or metabolically healthy normal-weight (n = 18)...
June 8, 2018: Journal of Rehabilitation Medicine
Anna Babinska, Mariusz Kaszubowski, Krzysztof Sworczak
Due to the fact that overweight or obesity is accompanied by hormonally active adrenal tumors: Cushing Syndrome-(CS) and Subclinical Cushing Syndrome (SCS), it is of high interest the correlation between different adipokines and cytokines secreted by adipose tissue, with metabolic disorders and hormonal activity in this group. Even in non-functioning adrenal incidentalomas (NFAI) elevated risk for cardiovascular disease and metabolic syndrome was demonstrated. The aim of the study was to investigate plasma adiponectin, leptin, resistin, tumor necrosis factor α (TNFα), interleukin 6 (IL6) and monocyte chemoattractant protein 1 (MCP1) levels in patients with NFAIs and healthy subjects...
June 5, 2018: Endocrine Journal
Sophie Mavrogeni, Lambros Fotis, Loukia Koutsogeorgopoulou, Vasiliki Vartela, Vana Papaevangelou, Genovefa Kolovou
Juvenile idiopathic arthritis (JIA) is the commonest rheumatic disease in childhood and presents several subtypes according to the ILAR classification. JIA, specifically in its systemic form, may seriously damage various structures of the cardiovascular system. Other JIA phenotypes are also of interest, as cardiovascular disease (CVD) is underestimated and understudied, but chronic systemic inflammation and risk factors remained important contributors for CVD development. The currently applied non-invasive modalities, although they are important for the initial evaluation of JIA patients, frequently fail to detect the silent, subclinical forms of CVD...
June 6, 2018: Rheumatology International
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