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National Heart, Lung, and Blood Institute

Brian Custer, Shimian Zou, Simone A Glynn, Julie Makani, Claude Tayou Tagny, Magdy El Ekiaby, Ester C Sabino, Nabajyoti Choudhury, Diana Teo, Kenrad Nelson, Emmanuel Peprah, LeShawndra Price, Michael M Engelgau
In April 2017, a workshop sponsored by the National Heart, Lung, and Blood Institute, Division of Blood Diseases and Resources, and the Center for Translation Research and Implementation Science was held to discuss blood availability and transfusion safety in low- and middle-income countries (LMICs). The purpose of the workshop was to identify research opportunities for implementation science (IS) to improve the availability of safe blood and blood components and transfusion practices in LMICs. IS describes the late stages of the translational research spectrum and studies optimal and sustainable strategies to deliver proven-effective interventions...
March 14, 2018: Transfusion
Samantha Sabo, Catalina Denman Champion, Melanie L Bell, Elsa Cornejo Vucovich, Maia Ingram, Celina Valenica, Maria Del Carmen Castro Vasquez, Eduardo Gonzalez-Fagoaga, Jill Geurnsey de Zapien, Cecilia B Rosales
INTRODUCTION: Northern Mexico has among the highest rates of cardiovascular disease (CVD) and diabetes in the world. This research addresses core gaps in implementation science to develop, test and scale-up CVD risk-reduction interventions in diabetics through a national primary care health system. METHODS AND ANALYSIS: The Meta Salud Diabetes (MSD) research project is a parallel two-arm cluster-randomised clinical behavioural trial based in 22 (n=22) health centres in Sonora, Mexico...
March 12, 2018: BMJ Open
Ronald G Victor, Kathleen Lynch, Ning Li, Ciantel Blyler, Eric Muhammad, Joel Handler, Jeffrey Brettler, Mohamad Rashid, Brent Hsu, Davontae Foxx-Drew, Norma Moy, Anthony E Reid, Robert M Elashoff
Background Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. Methods We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants' doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments)...
March 12, 2018: New England Journal of Medicine
Michael C Peters, Sheena Kerr, Eleanor M Dunican, Prescott G Woodruff, Merritt L Fajt, Bruce D Levy, Elliot Israel, Brenda R Phillips, David T Mauger, Suzy A Comhair, Serpil C Erzurum, Mats W Johansson, Nizar N Jarjour, Andrea M Coverstone, Mario Castro, Annette T Hastie, Eugene R Bleecker, Sally E Wenzel, John V Fahy
BACKGROUND: Airway type 2 inflammation is usually corticosteroid sensitive, but the role of type 2 inflammation as a mechanism of asthma in patients on high dose inhaled corticosteroids (ICS) is uncertain. OBJECTIVE: To determine if airway type 2 inflammation persists in patients treated with ICS and to evaluate the clinical features of patients with steroid resistant airway type-2 inflammation. METHODS: We used qPCR to generate a composite metric of type-2 cytokine gene expression (type 2 Gene Mean, "T2GM") in induced sputum cells from healthy controls, severe asthma patients on ICS (n=174), and non-severe asthma patients on ICS (n=85)...
March 7, 2018: Journal of Allergy and Clinical Immunology
Leslee J Shaw, Abhinav Goyal, Christina Mehta, Joe Xie, Lawrence Phillips, Anita Kelkar, Joseph Knapper, Daniel S Berman, Khurram Nasir, Emir Veledar, Michael J Blaha, Roger Blumenthal, James K Min, Reza Fazel, Peter W F Wilson, Matthew J Budoff
BACKGROUND: Cardiovascular disease (CVD) imparts a heavy economic burden on the U.S. health care system. Evidence regarding the long-term costs after comprehensive CVD screening is limited. OBJECTIVES: This study calculated 10-year health care costs for 6,814 asymptomatic participants enrolled in MESA (Multi-Ethnic Study of Atherosclerosis), a registry sponsored by the National Heart, Lung, and Blood Institute, National Institutes of Health. METHODS: Cumulative 10-year costs for CVD medications, office visits, diagnostic procedures, coronary revascularization, and hospitalizations were calculated from detailed follow-up data...
March 13, 2018: Journal of the American College of Cardiology
Daniel J Jackson, Leonard B Bacharier, David T Mauger, Susan Boehmer, Avraham Beigelman, James F Chmiel, Anne M Fitzpatrick, Jonathan M Gaffin, Wayne J Morgan, Stephen P Peters, Wanda Phipatanakul, William J Sheehan, Michael D Cabana, Fernando Holguin, Fernando D Martinez, Jacqueline A Pongracic, Sachin N Baxi, Mindy Benson, Kathryn Blake, Ronina Covar, Deborah A Gentile, Elliot Israel, Jerry A Krishnan, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Dayna Long, Ngoc Ly, Jyothi Marbin, James N Moy, Ross E Myers, J Tod Olin, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Robert F Lemanske
Background Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. Methods We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year...
March 3, 2018: New England Journal of Medicine
Lovic, Dragan B Djordjevic, Ivan S Tasic, Ivana P Nedeljkovic
AIMS: The aim of this study is to evaluate the impact of metabolic syndrome (MetS) on clinical severity and long term prognosis in patients with myocardial infarction with ST segment elevation (STEMI). METHODS: We examined 507 patients with STEMI who were admitted for primary percutaneous coronary intervention classified according to the presence of MetS using American Heart Association and the National Heart, Lung and Blood Institute definition. After applying these criteria, the patients were categorized in patients with MetS and without MetS...
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Meghan K Edwards, Paul D Loprinzi
PURPOSE: Limited research has evaluated the independent and additive associations of moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and cardiorespiratory fitness (CRF) with metabolic syndrome, which was the purpose of this study. DESIGN: Cross-sectional. SETTING: National Health and Nutrition Examination Survey 2003 to 2004. SAMPLE: Three hundred seven adults aged 20 to 49 years. MEASURES: Moderate-to-vigorous physical activity and SB were assessed via accelerometer, whereas CRF was assessed via submaximal treadmill testing...
March 2018: American Journal of Health Promotion: AJHP
Chesney D Castleberry, John L Jefferies, Ling Shi, James D Wilkinson, Jeffrey A Towbin, Ryan W Harrison, Joseph W Rossano, Elfriede Pahl, Teresa M Lee, Linda J Addonizio, Melanie D Everitt, Justin Godown, Joseph Mahgerefteh, Paolo Rusconi, Charles E Canter, Steven D Colan, Paul F Kantor, Hiedy Razoky, Steven E Lipshultz, Tracie L Miller
OBJECTIVES: This study aimed to examine the role of nutrition in pediatric dilated cardiomyopathy (DCM). BACKGROUND: In adults with DCM, malnutrition is associated with mortality, whereas obesity is associated with survival. METHODS: The National Heart, Lung, and Blood Institute-funded Pediatric Cardiomyopathy Registry was used to identify patients with DCM and categorized by anthropometric measurements: malnourished (MN) (body mass index [BMI] <5% for ≥2 years or weight-for-length <5% for <2 years), obesity (BMI >95% for age ≥2 years or weight-for-length >95% for <2 years), or normal bodyweight (NB)...
February 1, 2018: JACC. Heart Failure
William C Anderson, Stanley J Szefler
Strategies to control the risk domain of NHLBI EPR-3 (National Heart, Lung, and Blood Institute Expert Panel Report-3) asthma guidelines, which includes exacerbations requiring systemic corticosteroids, reduction in lung growth, and progressive loss of lung function, and treatment-related adverse effects, are evolving in children and adolescents. Increasing evidence demonstrates that children and adolescents with asthma are at risk of a reduction in lung growth, leading to lower lung function and potentially chronic obstructive pulmonary disease as adults...
February 2018: Seminars in Respiratory and Critical Care Medicine
Lauren G Johnson, Allison Armstrong, Caroline M Joyce, Anne M Teitelman, Alison M Buttenheim
BACKGROUND: Developed countries, such as the USA, have achieved significant decreases in cervical cancer burden since the introduction of Pap smear-based programs in the 1960s. Due to implementation barriers and limited resources, many countries in sub-Saharan Africa (SSA) have been unable to attain such reductions. The purpose of this review is to evaluate implementation strategies used to improve the uptake and sustainability of cervical cancer prevention programs in SSA. METHODS: A reviewer (LJ) independently searched PubMed, Ovid/MEDLINE, Scopus, and Web of Science databases for relevant articles with the following search limits: English language, peer reviewed, and published between 1996 and 2017...
February 9, 2018: Implementation Science: IS
Matthew J Crowley, Sana M Al-Khatib, Tracy Y Wang, Prateeti Khazanie, Nancy R Kressin, Harlan M Krumholz, Catarina I Kiefe, Barbara L Wells, Sean M O'Brien, Eric D Peterson, Gillian D Sanders
BACKGROUND: Outcomes research training programs should prepare trainees to successfully compete for research funding. We examined how early-career investigators' prior and desired training aligns with recently funded cardiovascular (CV) outcomes research. METHODS: We (1) reviewed literature to identify 13 core competency areas in CV outcomes research; (2) surveyed early-career investigators to understand their prior and desired training in each competency area; (3) examined recently funded grants commonly pursued by early-career outcomes researchers to ascertain available funding in competency areas; and (4) analyzed alignment between investigator training and funded research in each competency area...
February 2018: American Heart Journal
Eleanor M Dunican, Brett M Elicker, David S Gierada, Scott K Nagle, Mark L Schiebler, John D Newell, Wilfred W Raymond, Marrah E Lachowicz-Scroggins, Selena Di Maio, Eric A Hoffman, Mario Castro, Sean B Fain, Nizar N Jarjour, Elliot Israel, Bruce D Levy, Serpil C Erzurum, Sally E Wenzel, Deborah A Meyers, Eugene R Bleecker, Brenda R Phillips, David T Mauger, Erin D Gordon, Prescott G Woodruff, Michael C Peters, John V Fahy
BACKGROUND: The link between mucus plugs and airflow obstruction has not been established in chronic severe asthma, and the role of eosinophils and their products in mucus plug formation is unknown. METHODS: In clinical studies, we developed and applied a bronchopulmonary segment-based scoring system to quantify mucus plugs on multidetector computed tomography (MDCT) lung scans from 146 subjects with asthma and 22 controls, and analyzed relationships among mucus plug scores, forced expiratory volume in 1 second (FEV1), and airway eosinophils...
March 1, 2018: Journal of Clinical Investigation
Shahabeddin Rezaei, Sara Harsini, Mona Kavoosi, Reza Shervin Badv, Maryam Mahmoudi
Low glycemic index treatment (LGIT) is one of the new kinds of ketogenic diet (KD), designed to simplify the implementation of the KD. To date, several studies have attempted to determine the efficacy of LGIT in patients with epilepsy; however, their results are debatable. This study aims to retrieve all the LGIT studies to shed light on LGIT efficacy in epileptic patients. Electronic literature databases including MEDLINE/PubMed, Web of Science, Scopus, EMBASE were searched in July 2017. Interventional or observational studies exploring the efficacy of LGIT were included in the study...
January 24, 2018: Acta Neurologica Belgica
Adishesh K Narahari, Eric J Charles, J Hunter Mehaffey, Robert B Hawkins, Sarah A Schubert, Curtis G Tribble, Richard B Schuessler, Ralph J Damiano, Irving L Kron
BACKGROUND: The Ruth L. Kirschstein Institutional National Research Service Award (T32) provides institutions with financial support to prepare trainees for careers in academic medicine. In 1990, the Cardiac Surgery Branch of the National Heart, Lung and Blood Institute (NHLBI) was replaced by T32 training grants, which became crucial sources of funding for cardiothoracic (CT) surgical research. We hypothesized that T32 grants would be valuable for CT surgery training and yield significant publications and subsequent funding...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
Divya Ravi, Mehrnaz Ghasemiesfe, Deborah Korenstein, Thomas Cascino, Salomeh Keyhani
Background: Marijuana use is increasing in the United States, and its effect on cardiovascular health is unknown. Purpose: To review harms and benefits of marijuana use in relation to cardiovascular risk factors and clinical outcomes. Data Sources: PubMed, MEDLINE, EMBASE, PsycINFO, and the Cochrane Library between 1 January 1975 and 30 September 2017. Study Selection: Observational studies that were published in English, enrolled adults using any form of marijuana, and reported on vascular risk factors (hyperglycemia, diabetes, dyslipidemia, and obesity) or on outcomes (stroke, myocardial infarction, cardiovascular mortality, and all-cause mortality in cardiovascular cohorts)...
January 23, 2018: Annals of Internal Medicine
George A Mensah, Richard S Cooper, Anna Maria Siega-Riz, Lisa A Cooper, Justin D Smith, C Hendricks Brown, John M Westfall, Elizabeth O Ofili, LeShawndra N Price, Sonia Arteaga, Melissa C Green Parker, Cheryl R Nelson, Bradley J Newsome, Nicole Redmond, Rebecca A Roper, Bettina M Beech, Jada L Brooks, Debra Furr-Holden, Samson Y Gebreab, Wayne H Giles, Regina Smith James, Tené T Lewis, Ali H Mokdad, Kari D Moore, Joseph E Ravenell, Al Richmond, Nancy E Schoenberg, Mario Sims, Gopal K Singh, Anne E Sumner, Roberto P Treviño, Karriem S Watson, M Larissa Avilés-Santa, Jared P Reis, Charlotte A Pratt, Michael M Engelgau, David C Goff, Eliseo J Pérez-Stable
Cardiovascular disparities remain pervasive in the United States. Unequal disease burden is evident among population groups based on sex, race, ethnicity, socioeconomic status, educational attainment, nativity, or geography. Despite the significant declines in cardiovascular disease mortality rates in all demographic groups during the last 50 years, large disparities remain by sex, race, ethnicity, and geography. Recent data from modeling studies, linked micromap plots, and small-area analyses also demonstrate prominent variation in cardiovascular disease mortality rates across states and counties, with an especially high disease burden in the southeastern United States and Appalachia...
January 19, 2018: Circulation Research
Sotirios Tsimikas, Sergio Fazio, Keith C Ferdinand, Henry N Ginsberg, Marlys L Koschinsky, Santica M Marcovina, Patrick M Moriarty, Daniel J Rader, Alan T Remaley, Gissette Reyes-Soffer, Raul D Santos, George Thanassoulis, Joseph L Witztum, Simhan Danthi, Michelle Olive, Lijuan Liu
Pathophysiological, epidemiological, and genetic studies provide strong evidence that lipoprotein(a) [Lp(a)] is a causal mediator of cardiovascular disease (CVD) and calcific aortic valve disease (CAVD). Specific therapies to address Lp(a)-mediated CVD and CAVD are in clinical development. Due to knowledge gaps, the National Heart, Lung, and Blood Institute organized a working group that identified challenges in fully understanding the role of Lp(a) in CVD/CAVD. These included the lack of research funding, inadequate experimental models, lack of globally standardized Lp(a) assays, and inadequate understanding of the mechanisms underlying current drug therapies on Lp(a) levels...
January 16, 2018: Journal of the American College of Cardiology
Michele Colicchia, Alessandro Morlacco, Laureano J Rangel, Rachel E Carlson, Fabrizio Dal Moro, R Jeffrey Karnes
BACKGROUND: Metabolic syndrome (MetS) is considered a potential risk factor for adverse outcomes after radical prostatectomy (RP). Furthermore, studies about the effect of MetS on low-risk prostate cancer (PCa) and its implications in active surveillance (AS) are limited. OBJECTIVE: To investigate the role of MetS (using International Diabetes Federation-American Heart Association/National Heart, Lung, and Blood Institute criteria) on perioperative and oncological outcomes after RP in low-risk PCa and in a subgroup potentially eligible for AS...
January 3, 2018: European Urology Focus
Alimohammad Fatemi, Azadeh Ghanbarian, Zahra Sayedbonakdar, Mehdi Kazemi, Abbas Smiley
The aim of this study was to determine the prevalence of metabolic syndrome (MetS) in Iranian patients with systemic lupus erythematosus (SLE) and its determinants. In a cross-sectional study, 98 patients with SLE and 95 controls were enrolled. Prevalence of MetS was determined based on American Heart Association and National Heart, Lung, and Blood Institute (AHA/NHLBI) and 2009 harmonizing criteria. In addition, demographic features and lupus characteristics such as disease duration, pharmacological treatment, laboratory data, SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage index (SDI) were recorded...
January 5, 2018: Clinical Rheumatology
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