Abstract: Ischemic events can culminate in acute myocardial infarction with irreversible cardiac lesions that cannot be restored due to the limited regenerative capacity of the heart. Tissue engineering proposes therapeutic alternatives by using biomaterials to resemble the native extracellular medium combined with healthy and functional cells. This research focused on developing a natural thermosensitive hydrogel, its physical-chemical characterization and in vitro biocompatibility determination. Hydrogels’ morphological characterization was carried out through scanning electron microscopy and its chemical characterization by employing Infrared Spectroscopy technic. In addition, the biocompatibility was determined using fetal human ventricular cardiomyocytes cell line RL-14 and the MTT cytotoxicity test according to the ISO 10993-5 standard. Four biocompatible and thermosensitive hydrogels were obtained with a three-dimensional internal structure and two gelation times. The results show the potential of the hydrogel to increase the cell survival rate to the cardiac cell therapies under investigation and lay the foundations to continue with its characterization and biological evaluation both in vitro and in vivo models.
Abstract: Childhood obesity, which may lead to increased risk for heart diseases in children as well as adults, is one of the most important health problems throughout the world. Prevalences of morbid obesity and metabolic syndrome (MetS) are being increased during childhood age group. MetS is a cluster of metabolic and vascular abnormalities including hypercoagulability and an increased risk of cardiovascular diseases (CVDs). There are also some relations between some components of MetS and leukocytes. The aim of this study is to investigate complete blood cell count parameters that differ between morbidly obese boys and girls with MetS diagnosis. A total of 117 morbid obese children with MetS consulted to Department of Pediatrics in Faculty of Medicine Hospital at Namik Kemal University were included into the scope of the study. The study population was classified based upon their genders (60 girls and 57 boys). Their heights and weights were measured and body mass index (BMI) values were calculated. WHO BMI-for age and sex percentiles were used. The values above 99 percentile were defined as morbid obesity. Anthropometric measurements were performed. Waist-to-hip and head-to-neck ratios as well as homeostatic model assessment of insulin resistance (HOMA-IR) were calculated. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Hematological variables were measured. Statistical analyses were performed using SPSS. The degree for statistical significance was p ≤ 0.05. There was no statistically significant difference between the ages (11.2±2.6 years vs 11.2±3.0 years) and BMIs (28.6±5.2 kg/m2 vs 29.3±5.2 kg/m2) of boys and girls (p ≥ 0.05), respectively. Significantly increased waist-to-hip ratios were obtained for boys (0.94±0.08 vs 0.91±0.06; p=0.023). Significantly elevated values of hemoglobin (13.55±0.98 vs 13.06±0.82; p=0.004), mean corpuscular hemoglobin concentration (33.79±0.91 vs 33.21±1.14; p=0.003), eosinophils (0.300±0.253 vs 0.196±0.197; p=0.014), and platelet (347.1±81.7 vs 319.0±65.9; p=0.042) were detected for boys. There was no statistically significant difference between the groups in terms of neutrophil/lymphocyte ratios as well as HOMA-IR values (p ≥ 0.05). Statistically significant gender-based differences were found for hemoglobin as well as mean corpuscular hemoglobin concentration and hence, separate reference intervals for two genders should be considered for these parameters. Eosinophils may contribute to the development of thrombus in acute coronary syndrome. Eosinophils are also known to make an important contribution to mechanisms related to thrombosis pathogenesis in acute myocardial infarction. Increased platelet activity is observed in patients with MetS and these individuals are more susceptible to CVDs. In our study, elevated platelets described as dominant contributors to hypercoagulability and elevated eosinophil counts suggested to be related to the development of CVDs observed in boys may be the early indicators of the future cardiometabolic complications in this gender.
Abstract: We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.
Abstract: Hypertension is a common condition causing cardio
and cerebrovascular complications. Portugal has one of the highest
mortality rates from stroke and a high prevalence of hypertension.
Systolic Blood Pressure (SBP) is an important risk factor for
cardiovascular events (myocardial infarction and stroke) and
premature mortality, particularly in the elderly population. The
present study aims to estimate the prevalence of hypertension in a
Portuguese population living in a coastal city and to identify some of
its determinants (namely gender, age, the body mass index and
physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal
city in the center of Portugal, between May and August of 2013 were
evaluated. Attendants who reported to have diabetes or taking
antihypertensive drugs in the 2 previous weeks were excluded from
the study. Sociodemographic factors, BMI, habits of exercise and BP
were assessed. Hypertension was defined as blood pressure ≥140/90
mmHg. The majority of the studied population was constituted by women
(75.8%), with a mean age of 54.2±1.6 years old, married or living in
civil union and that had completed secondary school or had higher
education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2.,
and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ±
9.53. In this population we found 4.3% of people with hypertension
and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure
values than women. Of all the factors considered, SBP values also
tended to be higher with age and higher BMI values.
Despite the fact that the mean values of SBP did not present values
higher than 140 mmHg we must be concerned because the studied
population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the
upcoming research about the underlying factors responsible for the
occurrence of SBP.
Abstract: Myocardial infarction is one of the leading causes of
death in the world. Some of these deaths occur even before the
patient reaches the hospital. Myocardial infarction occurs as a result
of impaired blood supply. Because the most of these deaths are due to
coronary artery disease, hence the awareness of the warning signs of
a heart attack is essential. Some heart attacks are sudden and intense,
but most of them start slowly, with mild pain or discomfort, then
early detection and successful treatment of these symptoms is vital to
save them. Therefore, importance and usefulness of a system
designing to assist physicians in early diagnosis of the acute heart
attacks is obvious. The main purpose of this study would be to enable patients to
become better informed about their condition and to encourage them
to seek professional care at an earlier stage in the appropriate
situations. For this purpose, the data were collected on 711 heart
patients in Iran hospitals. 28 attributes of clinical factors can be
reported by patients; were studied. Three logistic regression models
were made on the basis of the 28 features to predict the risk of heart
attacks. The best logistic regression model in terms of performance
had a C-index of 0.955 and with an accuracy of 94.9%. The variables,
severe chest pain, back pain, cold sweats, shortness of breath, nausea
and vomiting, were selected as the main features.
Abstract: Death within 30 days is an important factor to be looked into, as there is a significant risk of deaths immediately following or soon after, myocardial infarction (MI) or stroke. In this paper, we will model the deaths within 30 days following a myocardial infarction (MI) or stroke in the UK. We will see how the probabilities of sudden deaths from MI or stroke have changed over the period 1981-2000. We will model the sudden deaths using a generalized linear model (GLM), fitted using the R statistical package, under a Binomial distribution for the number of sudden deaths. We parameterize our model using the extensive and detailed data from the Framingham Heart Study, adjusted to match UK rates. The results show that there is a reduction for the sudden deaths following a MI over time but no significant improvement for sudden deaths following a stroke.
Abstract: The concept of myocardial injury, although first recognized from animal studies, is now recognized as a clinical phenomenon that may result in microvascular damage, no-reflow phenomenon, myocardial stunning, myocardial hibernation and ischemic preconditioning. The final consequence of this event is left ventricular (LV) systolic dysfunction leading to increased morbidity and mortality. The typical clinical case of reperfusion injury occurs in acute myocardial infarction (MI) with ST segment elevation in which an occlusion of a major epicardial coronary artery is followed by recanalization of the artery. This may occur spontaneously or by means of thrombolysis and/or by primary percutaneous coronary intervention (PCI) with efficient platelet inhibition by aspirin (acetylsalicylic acid), clopidogrel and glycoprotein IIb/IIIa inhibitors. In recent years, percutaneous coronary intervention (PCI) has become a well-established technique for the treatment of coronary artery disease. PCI improves symptoms in patients with coronary artery disease and it has been increasing safety of procedures. However, peri- and post-procedural myocardial injury, including angiographical slow coronary flow, microvascular embolization, and elevated levels of cardiac enzyme, such as creatine kinase and troponin-T and -I, has also been reported even in elective cases. Furthermore, myocardial reperfusion injury at the beginning of myocardial reperfusion, which causes tissue damage and cardiac dysfunction, may occur in cases of acute coronary syndrome. Because patients with myocardial injury is related to larger myocardial infarction and have a worse long-term prognosis than those without myocardial injury, it is important to prevent myocardial injury during and/or after PCI in patients with coronary artery disease. To date, many studies have demonstrated that adjunctive pharmacological treatment suppresses myocardial injury and increases coronary blood flow during PCI procedures. In this review, we highlight the usefulness of pharmacological treatment in combination with PCI in attenuating myocardial injury in patients with coronary artery disease.
Abstract: Synchronization between 0.1 Hz oscillations in heart rate and blood pressure is studied and its change during vertical tilt is evaluated in 37 myocardial infarction patients. Two groups of patients are identified with decreased and increased, respectively, synchronization of the studied oscillations as a response to a tilt test. It is shown that assessment of synchronization of 0.1 Hz oscillations as a response to vertical tilt can be used as a guideline for selecting optimal dose of beta-blocker treatment in post-myocardial infarction patients.
Abstract: Deaths from cardiovascular diseases have decreased substantially over the past two decades, largely as a result of advances in acute care and cardiac surgery. These developments have produced a growing population of patients who have survived a myocardial infarction. These patients need to be continuously monitored so that the initiation of treatment can be given within the crucial golden hour. The available conventional methods of monitoring mostly perform offline analysis and restrict the mobility of these patients within a hospital or room. Hence the aim of this paper is to design a Portable Cardiac Telemedicine System to aid the patients to regain their independence and return to an active work schedule, there by improving the psychological well being. The portable telemedicine system consists of a Wearable ECG Transmitter (WET) and a slightly modified mobile phone, which has an inbuilt ECG analyzer. The WET is placed on the body of the patient that continuously acquires the ECG signals from the high-risk cardiac patients who can move around anywhere. This WET transmits the ECG to the patient-s Bluetooth enabled mobile phone using blue tooth technology. The ECG analyzer inbuilt in the mobile phone continuously analyzes the heartbeats derived from the received ECG signals. In case of any panic condition, the mobile phone alerts the patients care taker by an SMS and initiates the transmission of a sample ECG signal to the doctor, via the mobile network.
Abstract: Chest pain is one of the most prevalent complaints
among adults that cause the people to attend to medical centers. The
aim was to determine the prevalence and risk factors of chest pain
among over 30 years old people in Tehran. In this cross-sectional
study, 787 adults took part from Apr 2005 until Apr 2006. The
sampling method was random cluster sampling and there were 25
clusters. In each cluster, interviews were performed with 32 over 30
years old, people lived in those houses. In cases with chest pain, extra
questions asked. The prevalence of CP was 9% (71 cases). Of them
21 cases (6.5%) were in 41-60 year age ranges and the remainders
were over 61 year old. 19 cases (26.8%) mentioned CP in resting
state and all of the cases had exertion onset CP. The CP duration was
10 minutes or less in all of the cases and in most of them (84.5%), the
location of pain mentioned left anterior part of chest, left anterior part
of sternum and or left arm. There was positive history of myocardial
infarction in 12 cases (17%). There was significant relation between
CP and age, sex and between history of myocardial infarction and
marital state of study people. Our results are similar to other studies-
results in most parts, however it is necessary to perform
supplementary tests and follow up studies to differentiate between
cardiac and non-cardiac CP exactly.