The prevention and treatment of skin diseases remains a major challenge in medicine. The search for natural active ingredients that can be used to prevent the development of the disease and ...complement treatment is on the rise. Natural extracts of ginger and hemp offer a wide range of bioactive compounds with potential health benefits. This study evaluates the effectiveness of hemp and ginger extract as a supportive treatment for skin diseases. It reports a synergistic effect of hemp and ginger extract. The contents of cannabinoids and components of ginger are determined, with the highest being CBD (587.17 ± 8.32 µg/g) and 6-gingerol (60.07 ± 0.40 µg/g). The minimum inhibitory concentration for
(156.5 µg/mL),
(625.2 µg/mL) and
(78.3 µg/mL) was also analyzed. Analysis of WM-266-4 cells revealed the greatest decrease in metabolic activity in cells exposed to the extract at a concentration of 1.00 µg/mL. Regarding the expression of genes associated with cellular processes, melanoma aggressiveness, resistance and cell survival, a significant difference was found in the expression of
,
and
compared with the control (cells not exposed to the extract).
In patients with type 1 diabetes mellitus (T1DM) imaging studies have demonstrated an increased prevalence of left ventricular diastolic dysfunction and increased left ventricular mass (LVM) ...unrelated to arterial hypertension and ischemic heart disease. The aim of our study was to identify potential predictors of early subclinical changes in cardiac chamber size and function in such patients. Sixty-one middle-aged asymptomatic normotensive patients with T1DM were included in the study. Conventional and tissue Doppler echocardiography was performed and fasting serum levels of glucose, glycated hemoglobin (HbA1c), lipids, and creatinine were measured. We found moderate bivariate correlations of body mass index (BMI) with left atrial volume (r = 0.47, p < 0.01), LVM (r = 0.42, p < 0.01), left ventricular relative wall thickness (r = 0.32, p = 0.01), and all observed parameters of diastolic function of both ventricles. The five-year average value of HbA1c weakly correlated with the Doppler index of left ventricular filling pressure E/e´sept (r = 0.27, p = 0.04). We found no significant association of diabetes duration, five-year trend of HbA1c, serum lipids, and glomerular filtration rate with cardiac structure and function. After adjusting for other parameters, BMI remained significantly associated with left atrial volume, LVM as well as with the transmitral Doppler ratio E/A. In our study, BMI was the only observed parameter significantly associated with subclinical structural and functional cardiac changes in the asymptomatic middle-aged patients with T1DM.
Background
Data on the relationship between radial access (RA) and outcome in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) are inconclusive. The aim of ...our study was to assess whether RA is associated with 30-day mortality in patients with MI undergoing percutaneous coronary intervention in our center or whether the possible benefit of RA is the result of less bleeding and other confounding factors.
Methods
We retrospectively studied 3501 consecutive patients with MI who underwent PCI between January 2012 and December 2016. The 30-day mortality in the RA and femoral access (FA) groups was observed. Data were analyzed using descriptive statistics.
Results
RA patients had a significantly lower 30-day unadjusted mortality 53(3.8%) patients died in the RA group compared to 207(9.8%) patients in the FA group; p<0.0001. After adjustments for confounders, the difference was no longer significant (adjusted OR: 0.84; 95% CI: 0.58 to 1.22). Cardiogenic shock, age over 70 years, hypertension, hyperlipidemia, anemia on admission, renal dysfunction on admission, ST-elevation MI, bleeding, the contrast volume/GFR ratio, but not RA, predicted 30-day mortality.
Conclusion
RA was not associated with 30-day mortality in patients with MI undergoing PCI. Our study result suggests that the better outcome in the RA group was influenced by confounding factors, especially bleeding and hemodynamic impairment.
Mortality after myocardial infarction is higher in women than in men. Data on the association between sex and mortality are conflicting and inconclusive. We evaluated whether there is a sex ...difference in survival and if sex is associated with the outcome in patients with ST-elevation myocardial infarction (STEMI).
We analyzed 3671 STEMI patients. Long-term and 30-day mortality in men and women were compared.
Unadjusted mortality at day 30 was higher in women 221 (8.7%) men died compared to 147 (13.1%) women; p < 0.0001. After multivariate adjustments, this became insignificant (OR 1.65; 95% CI; 0.81 to 1.40). The long-term, unadjusted mortality was also higher in women 674 (26.3%) men died compared to 382 (34%) women; p < 0.0001. After multivariable adjustments, female sex (adjusted HR 0.81; 95% CI 0.71 to 0.93; p = 0.002), bleeding (adjusted HR 1.79; 95% CI 1.52 to 2.10; p < 0.0001), renal dysfunction adjusted HR (1.60; 95% CI 1.40 to 1.84; p < 0.0001), hyperlipidemia (adjusted HR 1.61; 95% CI 1.40 to 1.85; p < 0.0001), arterial hypertension (adjusted HR 1.17; 95% CI 1.03 to 1.33; p = 0.015), diabetes (adjusted HR 1.55; 95% CI 1.35 to 1.78; p < 0.0001), age (adjusted HR 1.05; 95% CI 1.04 to 1.06; p < 0.0001), anemia on admission (adjusted HR 1.38; 95% CI 1.23 to 1.58; p < 0.0001), and heart failure (adjusted HR 2.40; 95% CI 2.09 to 2.75; p < 0.0001) predicted long-term mortality.
Female sex was associated with a lower risk of dying in the long term. However, risk factors, age, and comorbidities associated with female patients affected the worse outcome.
•The long-term, all-cause unadjusted mortality in STEMI patients was higher in women.•After adjustment for confounders, women had a better long-term prognosis.•Female sex predicted lower long-term mortality.•Risk factors, heart failure, age, and comorbidities rather than sex affect the worse outcome.
Uvod Ehokardiografska meritev iztisnega deleža (EF) levega prekata predstavlja večinoma dober in uporaben označevalec sistolične funkcije levega prekata (LP). Omejitve so slab prikaz endokarda LP, ...obsežne regionalne motnje krčljivosti s diskinetičnimi področji, disinhrono gibanje sten LP in pomembna mitralna regurgitacija (MR) ter znano dejstvo, da EF slabše korelira s funkcionalnim razredom posameznih bolnikov s kroničnim srčnim popuščanjem (SP). Uporaba doplerskih tehnik nam omogoča natančno merjenje hitrosti krvi v srčnih votlinah in hitrosti miokarda, vključno z meritvami trajanja posameznih časovnih intervalov v toku srčnega ciklusa, neinvazivno oceno utripnega volumna LP in tlakov v srčnih votlinah. Cilji Cilj naše raziskave je bil, da s pomočjo doplerske ehokardiografije, natančneje s sintezo pulznega in tkivnega doplerja, izmerimo pospešek krčenja LP pri zdravih preiskovancih in pri simptomatičnih bolnikih s kroničnim SP. Upoštevaje pospešek krčenja LP in dimenzije LP smo izračunali indeks akceleracije levega prekata 1 (AccLV1) in indeks akceleracije levega prekata 2 (AccLV2). Indeks AccLV1 je premosorazmeren z doseženo maksimalno hitrostjo v času iztisa v iztočnem delu LP (Vmax LVOT) v cm/s in obratno sorazmeren s časovnim intervalom (dt) od začetka izovolumetrične kontrakcije LP do dosežene maksimalne hitrosti v LVOT, merjenim v sekundah in s končnim diastoličnim volumnom LP (EDV) v mililitrih. Indeks AccLV2 pa je premosorazmeren z V max LVOT in obratno sorazmeren s dt in s končnim diastoličnim premerom LP (LVEDD), merjenim v cm. Oba indeksa imata potencial doplerskih pokazateljev globalne sistolične disfunkcije, oziroma okvare LP. V nadaljevanju raziskave smo oba indeksa primerjali s standardno oceno sistolične funkcije LP z merjenjem EF. Bolniki in metode V prospektivno, opazovalno raziskavo smo vključili 121 preiskovancev, 76 (62,8 %) zdravih preiskovancev in 45 (37,2 %) bolnikov z znanim kroničnim SP. Pri vseh smo opravili standardne ehokardiografske meritve in izračunali AccLV1 po formuli: AccLV1=Vmax LVOT / dt x EDV cm/s2 ml in AccLV2 po formuli: AccLV2=Vmax LVOT / dt x LVEDD 1/s2. Preiskovance smo nato opazovali dve leti in spremljali pojav končnih opazovanih dogodkov, ki kažejo na poslabšanje SP (ambulantna obravnava in hospitalizacija zaradi poslabšanja kroničnega SP, potreba po biventrikularni elektrostimulaciji, operativna korekcija mitralne zaklopke zaradi pomembne regurgitacije in smrtni izhod zaradi odpovedi LP). Zaključek Z izračunom indeksov AccLV1 in AccLV2 lahko v primerjavi z meritvami EF z večjo natančnostjo razlikujemo med zdravimi in bolniki s simptomatičnim SP, prav tako vrednosti AccLV1 in AccLV2 dobro, oziroma bolje kot EF, korelirajo s funkcijskim razredom NYHA v skupini bolnikov. Oba indeksa nakazujeta prav tako boljšo napovedno vrednost za klinično poslabšanje SP v primerjavi z EF. (Abstract shortened by ProQuest.)
Summary
Background
Echocardiographically measured ejection fraction (EF) of the left ventricle (LV) is the most useful standard of the LV systolic function. Its limitations are poor delineation of ...the LV endocardium, pronounced regional disorders of contractility, dyssynchrony of the LV and in particular significant mitral regurgitation. The aim of this research is to evaluate the advantage of Doppler indices of left ventricular function such as index of acceleration of contraction of the LV (AccLV) over EF in patients with heart failure.
Methods
We performed a prospective observational study. We included 45 patients with known chronic heart failure and 76 healthy subjects. We performed standard echocardiographic measurements. AccLV was calculated by the following formula: AccLV = Vmax LVOT/dt × EDV cm/s
2
ml. Vmax LVOT represents the maximum velocity during ejection in the left ventricular outflow tract (LVOT), dt stands for the interval from the beginning of the LV contraction to the achieved Vmax LVOT, EDV represents end-diastolic volume of the LV.
Results
Between patients and healthy subjects we observed statistically significant differences in mean EF values (65.4 ± 6.7 % vs. 38.6 ± 18.0 %;
p
< 0.001) and of AccLV (12.1 ± 2.88 cm/s
2
ml vs. 4.4 ± 2.1 cm/s
2
ml;
p
< 0.001). Receiver operating characteristic (ROC) curve showed higher area under the curve values for AccLV in comparison to EF (0.996 vs. 0.897). In the patient group we observed more important correlation between AccLV index and the New York Heart Association (NYHA) functional classes (
r
= − 0.657;
p
< 0.001), than between EF and the NYHA classes (
r
= − 0.539;
p
< 0.001).
Conclusions
We could distinguish with higher accuracy between healthy subjects and patients with heart failure LV by calculated AccLV in comparison to EF. AccLV values correlated with NYHA functional classes in patients with heart failure better than EF values.
Pulse wave analysis (PWA) uses the technique of applanation tonometry to obtain a peripheral pulse pressure waveform from which central hemodynamic information is derived. Using PWA, subendocardial ...viability ratio (SEVR) can be measured. SEVR represents a noninvasive measure of myocardial perfusion. It is related to the work of the heart, the oxygen consumption, and the energy supply of the heart. Anemia is a common complication of chronic kidney disease (CKD). A complex relationship exists between CKD, cardiovascular disease (CVD), and anemia. The aim of our study was to assess the relationship between SEVR and hemoglobin in non-dialysis CKD patients.
We examined the associations between PWA hemodynamic parameters, 24-hour ambulatory blood pressure (BP) measurements, and laboratory variables including hemoglobin, cardiac biomarkers troponin I, NT-proBNP, and hs-CRP in a cohort of 91 nondialysis CKD patients. PWA was assessed by radial applanation tonometry (SphygmoCor, Atcor, Sydney, Australia). The patients were divided into two groups according to the median value of hemoglobin.
Mean age of included patients was 60.2 years, 67% were men, 44% were smokers, 25.3% had diabetes. A significant correlation between hemoglobin and SEVR was found (r = 0.26; p = 0.012). With multivariate regression analysis, SEVR as dependent variable turned out to be statistically significantly associated with hemoglobin (β = 0.344, p = 0.013) and with troponin I (β = -0.217, p = 0.037). Patients in the group with lower hemoglobin had statistically-significantly higher serum creatinine, cystatin C, NT-proBNP, and 24-hour ambulatory systolic BP and lower e-GFR, SEVR, and office diastolic BP.
Results of our study show that SEVR is independently associated with hemoglobin in nondialysis CKD patients. CKD patients with lower hemoglobin have lower SEVR. .
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