Biomechanical factors in atherosclerosis: mechanisms and clinical implications†
Eur Heart J. 2014 Sep 17;
Authors: Kwak BR, Bäck M, Bochaton-Piallat ML, Caligiuri G, Daemen MJ, Davies PF, Hoefer IE, Holvoet P, Jo H, Krams R, Lehoux S, Monaco C, Steffens S, Virmani R, Weber C, Wentzel JJ, Evans PC
Blood vessels are exposed to multiple mechanical forces that are exerted on the vessel wall (radial, circumferential and longitudinal forces) or on the endothelial surface (shear stress). The stresses and strains experienced by arteries influence the initiation of atherosclerotic lesions, which develop at regions of arteries that are exposed to complex blood flow. In addition, plaque progression and eventually plaque rupture is influenced by a complex interaction between biological and mechanical factors-mechanical forces regulate the cellular and molecular composition of plaques and, conversely, the composition of plaques determines their ability to withstand mechanical load. A deeper understanding of these interactions is essential for designing new therapeutic strategies to prevent lesion development and promote plaque stabilization. Moreover, integrating clinical imaging techniques with finite element modelling techniques allows for detailed examination of local morphological and biomechanical characteristics of atherosclerotic lesions that may be of help in prediction of future events. In this ESC Position Paper on biomechanical factors in atherosclerosis, we summarize the current ‘state of the art’ on the interface between mechanical forces and atherosclerotic plaque biology and identify potential clinical applications and key questions for future research.
PMID: 25230814 [PubMed - as supplied by publisher]
The Uninvestigated Factor Behind the Negative Attitudes Toward Cadaveric Organ Donation in China.
Transplantation. 2014 Sep 17;
Authors: Lavee J, Singh MF, Trey T, Sharif A
PMID: 25232866 [PubMed - as supplied by publisher]
Dexmedetomidine Attenuates Hypoxemia During Palliative Reconstruction of the Right Ventricular Outflow Tract in Pediatric Patients.
Medicine (Baltimore). 2014 Sep;93(13):e69
Authors: Chen Q, Wu W, Zhang GC, Cao H, Chen LW, Hu YN, Chen YD
The objective of this study was to investigate whether the α agonist dexmedetomidine has the ability to attenuate hypoxemia in pediatric patients undergoing palliative pulmonary artery reconstruction.From January 2009 to January 2013, a total of 25 pediatric patients with Tetralogy of Fallot, pulmonary atresia (ventricular septal defect), or persistent truncus arteriosus (I) were enrolled in our study. Due to hypoplastic pulmonary arteries, all patients received palliative pulmonary artery reconstruction. During the perioperative period, they were allocated to receive either dexmedetomidine (bolus dose of 0.3 μg/kg followed by an infusion of 0.2-0.3 μg/kg/h, n = 15) or control drug (n = 10) intravenously. Any desaturation was recorded. Heart rate, mean arterial pressure, pulse oximetry, and arterial blood gas parameters were measured during the perioperative period.There were no significant differences between the groups in hemodynamic variables. The arterial oxygen saturation and arterial blood gas parameters increased in the dexmedetomidine groups (P < 0.05).These findings suggest that the injection of dexmedetomidine can attenuate hypoxemia during palliative pulmonary artery reconstruction in pediatric patients.
PMID: 25233325 [PubMed - as supplied by publisher]
Prevalence of Hypertension in Member Countries of South Asian Association for Regional Cooperation (SAARC): Systematic Review and Meta-Analysis.
Medicine (Baltimore). 2014 Sep;93(13):e74
Authors: Neupane D, McLachlan CS, Sharma R, Gyawali B, Khanal V, Mishra SR, Christensen B, Kallestrup P
Hypertension is a leading attributable risk factor for mortality in South Asia. However, a systematic review on prevalence and risk factors for hypertension in the region of the South Asian Association for Regional Cooperation (SAARC) has not carried out before.The study was conducted according to the Meta-Analysis of Observational Studies in Epidemiology Guideline. A literature search was performed with a combination of medical subject headings terms, “hypertension” and “Epidemiology/EP”. The search was supplemented by cross-references. Thirty-three publications that met the inclusion criteria were included in the synthesis and meta-analyses. Hypertension is defined when an individual had a systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, was taking antihypertensive drugs, or had previously been diagnosed as hypertensive by health care professionals. Prehypertension is defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg.The overall prevalence of hypertension and prehypertension from the studies was found to be 27% and 29.6%, respectively. Hypertension varied between the studies, which ranged from 13.6% to 47.9% and was found to be higher in the studies conducted in urban areas than in rural areas. The prevalence of hypertension from the latest studies was: Bangladesh: 17.9%; Bhutan: 23.9%; India: 31.4%; Maldives: 31.5%; Nepal: 33.8%; Pakistan: 25%; and Sri Lanka: 20.9%. Eight out of 19 studies with information about prevalence of hypertension in both sexes showed that the prevalence was higher among women than men. Meta-analyses showed that sex (men: odds ratio [OR] 1.19; 95% confidence interval [CI]: 1.02, 1.37), obesity (OR 2.33; 95% CI: 1.87, 2.78), and central obesity (OR 2.16; 95% CI: 1.37, 2.95) were associated with hypertension.Our study found a variable prevalence of hypertension across SAARC countries, with a number of countries with blood pressure above the global average. We also noted that studies are not consistent in their data collection about hypertension and related modifiable risk factors.
PMID: 25233326 [PubMed - as supplied by publisher]
Orthopaedic surgery can transform the lives of adults with spasticity.
Authors: Freeman RT, Pickard S, Jarvis S
PMID: 25230582 [PubMed - in process]
Urine testing for HPV.
Authors: Kitchener HC, Owens GL
PMID: 25230583 [PubMed - in process]
NHS plans new workforce for long term conditions.
Authors: O’Dowd A
PMID: 25230761 [PubMed - in process]
The need for preclinical studies of combined modality systemic therapy plus radiotherapy.
Authors: Kunkler IH
PMID: 25230764 [PubMed - in process]
Case finding in dementia is truly a fudge.
Authors: Iliffe S
PMID: 25230831 [PubMed - in process]
Public health leader apologises for language in Twitter row.
Authors: Iacobucci G
PMID: 25230832 [PubMed - in process]