Background
Although frequently considered a benign condition, new evidence has shown that mitral valve prolapse (MVP) is associated with complex ventricular arrhythmias (VAs) and sudden cardiac death ...(SCD). Therefore, we conducted a systematic review and meta‐analysis of the relevant studies to investigate the parameters that could identify MVP patients at higher risk of experiencing complex VAs.
Method
We performed a systematic literature search of PubMed for potential studies between January 2010 and January 2021. Our meta‐analysis included studies comparing MVP patients with complex VAs (A‐MVP) and those without (NA‐MVP). We used the fixed‐effects model to obtain the odds ratio (OR), risk ratio (RR), or mean difference (MD) and 95% confidence interval (CI) for each analyzed parameter.
Results
Six studies with 848 individuals were included in the meta‐analysis. As compared to the NA‐MVP patients, A‐MVP patients had a higher prevalence of inverted T‐wave (OR: 2.73; 95% CI: 1.85‐4.02; p < .00001) and longer QTc interval on the resting ECG (MD: 14.73; 95% CI: 9.39‐20.08; p < .00001), longer anterior mitral leaflet length (MD: 2.67; 95% CI: 2.02‐3.31; p < .00001), bi‐leaflet prolapse (OR: 1.65; 95% CI: 1.22‐2.24; p = .001), and mitral annulus disjunction (MAD) on echocardiogram (RR: 1.90; 95% CI: 1.50‐2.40; p < .00001), and late gadolinium enhancement (LGE) on cardiac magnetic resonance (RR: 4.38; 95% CI: 1.77‐10.86; p = .001).
Conclusion
Our comprehensive meta‐analysis suggests that risk factors related to A‐MVP are T‐wave inversion, longer QTc interval, bi‐leaflet prolapse, longer anterior mitral valve leaflet, MAD, and LGE.
The focus of dark matter searches to date has been on Weakly Interacting Massive Particles (WIMPs) in the GeV/
c
2
-TeV/
c
2
mass range. The direct, indirect and collider searches in this mass range ...have been extensive but ultimately unsuccessful, providing a strong motivation for widening the search outside this range. Here we describe a new concept for a dark matter experiment, employing superfluid
3
He as a detector for dark matter that is close to the mass of the proton, of order 1 GeV/
c
2
. The QUEST-DMC detector concept is based on quasiparticle detection in a bolometer cell by a nanomechanical resonator. In this paper we develop the energy measurement methodology and detector response model, simulate candidate dark matter signals and expected background interactions, and calculate the sensitivity of such a detector. We project that such a detector can reach sub-eV nuclear recoil energy threshold, opening up new windows on the parameter space of both spin-dependent and spin-independent interactions of light dark matter candidates.
is a gram-negative aerobic pathogen that primarily colonizes the gastric mucosa. Peptic ulcer disease, atrophic gastritis, gastric cancer, and mucosal-associated lymphoid tissue lymphoma have all ...been linked to chronic
infection. Hence, it is critical to diagnose and treat it as early as possible. There are both invasive and noninvasive tests available to detect it. In this review, the diagnostic abilities of two invasive tests - histology and the rapid urease test (RUT) - are compared in a variety of clinical situations. This systematic review was carried out using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 checklist. We performed a literature search using the PubMed and Google Scholar databases in accordance with the eligibility criteria and ultimately selected eight articles for final analysis. The Newcastle-Ottawa scale adapted for cross-sectional studies, the Scale for the Assessment of Narrative Review Articles (SANRA), and the PRISMA 2020 checklist were used to assess the quality of selected articles for cross-sectional studies, traditional literature reviews, and systematic reviews, respectively. According to the findings of the review, both histology and the RUT have high sensitivity and specificity in diagnosing
though this varies depending on the clinical situation, making one test superior to the other. Neither of these tests can be considered the gold standard method on its own. Hence, using at least two diagnostic tests at the same time is critical for ensuring high sensitivity and specificity while accurately diagnosing the pathogen.
The Italian Peninsula was one of the main refugia in southern Europe during the climatic oscillations of the Pleistocene, and was considered a ‘hotspot’ of biodiversity. A number of phylogeographic ...analyses identified highly divergent lineages in Italy that apparently did not contribute to the post‐glacial re‐colonization of Europe, supporting the existence of refugia within refugia in the southern‐most part of Italy. For the bank vole Myodes glareolus, genetic analyses highlighted a low variability for this species on the Italian peninsula, suggesting that cryptic refugia of central Europe were the main source of postglacial re‐colonization in Europe.
In this work, we analysed the mtDNA phylogeography of M. glareolus with a special emphasis on the Italian refugium. We extended previous analyses by including new sequences from a wider range of samples across the Italian peninsula. Our results suggest a high mitochondrial diversity of the bank vole in Italy and support the existence of an ancient and deeply divergent population in the Calabria region. This population did not participate to the recent re‐colonization of Italy while we highlight the possible occurrence of multiple and more recent colonization events between Europe and Italy. The phylogeographic pattern observed in Italy appears compatible with refugia‐within‐refugia scenario.
In recent years, there has been an increasing trend in the development of non-alcoholic fatty liver disease (NAFLD) due to lifestyle changes. The limited treatment option for the disease makes it ...challenging to manage. This study aims to summarize the relationship between NAFLD and metabolic syndrome (MetS) and to give a clear idea of the risk factors in this systematic research. The five databases screened were PubMed, Google Scholar, Science Direct, and BMC using keywords and Medical Subject Heading (Mesh) combinations. The keywords used are “Metabolic Syndrome,” “Syndrome X,” “Insulin Resistance,” “Obesity,” “Type 2 Diabetes,” and “Dyslipidemia.” Articles underwent a detailed process of screening and quality appraisal. Using the English language as a primary filtering parameter, papers over the last 13 years, dating from 2010 to 2023, are the basis of this review. We reviewed all possible human studies documenting NAFLD with a component of MetS. A total of 1106 papers were identified. After duplicate removal, 995 articles underwent a rigorous review, and 35 articles were chosen for quality appraisal. A total of 15 articles are part of this systematic review. This systematic review strongly concludes that NAFLD predominates in MetS patients. The pathophysiology and insulin resistance that is shared by the two conditions as well as the fact that obesity is at the center of both is the connecting factor in this. Besides various demographic and risk factors, physical activity and diet also play a role in the development of NAFLD. Consequently, more studies on this relevant topic are needed.
Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease and is a prevalent cause of sudden cardiac death (SCD). This study aims to establish the benefits and therapeutic value ...metoprolol or verapamil offer to patients who suffer from symptoms caused by HCM, with regard to resolving left ventricular outflow tract obstruction (LVOTO), as well as improving a patient's quality of life and reducing symptoms. We conducted a systematic review to find clinical studies that described the use of metoprolol or verapamil in the management of HCM. Three databases were analyzed for studies, PubMed, Google Scholar, and ScienceDirect. We discovered 6,260 potentially eligible records across all the databases. According to our eligibility criteria, we included four studies in this review. Metoprolol showed median left ventricular outflow tract (LVOT) gradients of 25 mm Hg versus 72 mm Hg (P = 0.007) at rest, 28 mm Hg versus 62 mm Hg (P < 0.001) at peak exercise, and 45 mm Hg versus 115 mm Hg (P < 0.001) post-exercise. Verapamil also showed a statistically significant increase in exercise capacity. Both drugs have been shown to be safe to use with a good side effect profile; however, metoprolol was better tolerated in the patient population that was tested in the studies collected. In this study, metoprolol was effective in reducing LVOT and improving the quality of life in patients, while verapamil showed variable effects on both exercise capacity and baseline hemodynamics.
Brunham LR, Tietjen I, Bochem AE, Singaraja RR, Franchini PL, Radomski C, Mattice M, Legendre A, Hovingh GK, Kastelein JJP, Hayden MR. Novel mutations in scavenger receptor BI associated with high ...HDL cholesterol in humans.
The scavenger receptor class B, member 1 (SR‐BI), is a key cellular receptor for high‐density lipoprotein (HDL) in mice, but its relevance to human physiology has not been well established. Recently a family was reported with a mutation in the gene encoding SR‐BI and high HDL cholesterol (HDL‐C). Here we report two additional individuals with extremely high HDL‐C (greater than the 90th percentile for age and gender) with rare mutations in the gene encoding SR‐BI. These mutations segregate with high HDL‐C in family members of each proband and are associated with a 37% increase in plasma HDL‐C in heterozygous individuals carrying them. Both mutations occur at highly conserved positions in the large extracellular loop region of SR‐BI and are predicted to impair the function of the SR‐BI protein. Our findings, combined with the prior report of a single mutation in the gene encoding SR‐BI, further validate that mutations in SR‐BI are a rare but recurring cause of elevated HDL‐C in humans.
Patent foramen ovale (PFO) is a standard variant that is present in 25% of the whole adult population. In a certain population, PFO can lead to cerebrovascular accidents. Mechanism of cerebrovascular ...accidents can be by paradoxical embolization from the right circulation or in situ thrombosis. Diagnosis of a PFO-responsible cerebrovascular accident is based on a thorough work-up to exclude other possible etiologies and detect PFO on trans-thoracic or trans-esophageal echocardiography with bubble study and/or Doppler. Over the last few years, multiple studies have supported that percutaneous PFO closure is superior to medical therapy in the secondary prevention of cerebrovascular accidents. However, numerous adverse events have been linked to PFO closure devices in general compared to medical therapy as new-onset atrial fibrillation, residual shunt, device-related thrombus, bleeding, deep vein thrombosis, pulmonary embolism, and inter-atrial septal erosions. Amplatzer device is one of the PFO occluder devices approved by the FDA. Device-related adverse events have been addressed by comparing the Amplatzer device with other PFO occluder devices. Based on the new data, we expect to see more complications related to PFO closure in the coming few years. We reviewed different studies that looked at the PFO closure-related complications and the trials comparing adverse events in the Amplatzer PFO occluder device compared to other devices. Amplatzer PFO occluder device is either superior or non-statistically different from other PFO occluder devices related to new-onset atrial fibrillation and residual shunt. More studies are needed to address the other less common adverse events. Since many of the device-related complications appear many years after device placement, a long-term follow-up is recommended.
Targeted temperature management (TTM) has been the cornerstone of post-cardiac arrest care, but even after therapy, neurological outcomes remain poor. We performed a systematic review to evaluate the ...influence of TTM in post-cardiac arrest treatment, its effect on the neurological outcome, survival, and the adverse events associated with it. We also aimed to examine any difference between the effect of therapy at various intensities and durations on the prognosis of the patient.A search of two databases was done to find relevant studies, followed by a thorough screening in which the inclusion and exclusion criteria were applied, and a quality appraisal of clinical trials was done. In this systematic review, six randomized clinical trials with a total of 3870 participants were examined. Of these, 2,767 participants were treated with targeted hypothermia to varying degrees (between 31 and 36 degrees Celsius), 931 participants were treated with targeted normothermia (36.5 to 37.5 degrees Celsius), and 172 participants were treated with only normothermia (without any active cooling or interventions).It was concluded that TTM at a lower temperature did not have any benefit regarding the neurological outcome and mortality over targeted normothermia but was superior to no temperature management. TTM was also found to have significantly more negative effects when the intensity or duration was increased.
The most common cause of portal hypertension is liver cirrhosis. Portal hypertension causes many complications in cirrhotic patients; a significant complication is the formation of varices and the ...subsequent life-threatening variceal bleeding due to elevated portal venous pressures. Hepatic venous pressure gradient (HVPG) is the gold standard for measuring portal hypertension and guides management. Pharmacological treatments lower the HVPG, preventing the progression of varices and subsequent variceal bleeding. The pharmacological treatments frequently used in primary and secondary prophylaxis of a variceal bleed are nonselective beta (β)-adrenergic blockers. Propranolol was the first nonselective β-adrenergic blocker used for lowering HVPG and has been well studied. However, in the past decade, clinical trials have shown that carvedilol has been more effective. This study aims to establish whether carvedilol is more effective than propranolol in reducing the hepatic venous pressure gradient and decreasing the risk of variceal bleeding in adult cirrhotic patients. A systematic review has been conducted to gather relevant clinical trials comparing drugs and their effects on HVPG. Four databases: PubMed (Medical Literature Analysis and Retrieval System Online (MEDLINE)), Google Scholar, the Cochrane Library, and ScienceDirect, were analyzed, and records from January 1, 1999, to January 1, 2023, were chosen. There were a total of 1,235 potentially eligible records across the four databases. Using the eligibility criteria for this systematic review, seven studies of 533 patients were included. Across all seven clinical trials, it was found that carvedilol reduced HVPG more than propranolol and decreased the risk of variceal bleeding in adult cirrhotic patients.
