Hospital Chronicles (E-Journal)
Not a member yet
657 research outputs found
Sort by
Air Pollution in the Metropolis: A Lurking Health Trap
Get PDFStrong evidence has accumulated from epidemiological and observational studies for a close association between several different air pollutants and adverse health effects, particularly for the residents of metropolitan areas. Although our understanding of the pathophysiological mechanisms involved remains incomplete, there are abundant data which link short-term exposure to air pollution, due to high concentrations of particulate and gaseous matter, toxic metals and aldehydes, with a significant increase in acute cardiopulmonary mortality, particularly in certain high-risk subsets of the population and with an acute increase in hospital admissions for cardiovascular and pulmonary diseases. Furthermore, there is also convincing evidence that prolonged exposure to elevated levels of air pollutants is responsible for chronic ill effects that significantly reduce overall life expectancy. Thus, it is of paramount importance for regulatory agencies to force the implementation of relevant regulations and quality standards in order to protect the health of the population at large. Specific guidelines should also apply for activity restriction for vulnerable and high-risk persons, such as the very young and the elderly, and those with known cardiopulmonary disease or diabetes mellitus
Prevalence of Overweight and Obesity Among Greek Army Recruits
Get PDFOBJECTIVE Obesity poses a major public health issue whose prevalence is reaching epidemic proportions, especially among younger ages. Our aim was to determine the prevalence of overweight and obesity among Greek men recruited in the army, and to evaluate potential associations with place of residence and educational level. SUBJECTS & METHODS Height and weight were measured in 3,684 men, aged 23.2±2.8 (mean ± standard deviation) years. Body mass index (BMI, kg/m2) was used as measure of adiposity. Associations between BMI categories and level of education (≤9 school years, >9 years) and between BMI categories and place of residence (urban, rural) were evaluated using chi-square test. RESULTS Average BMI was 25.2±4 kg/m2. The prevalence of overweight (25<BMI<30) was 33.7% and associated positively with a higher educational level (p<0.001), whereas the prevalence of obesity (BMI>30) was 10.0% and was not associated with educational level. Obesity was associated with place of residence; individuals from rural areas were more obese than those from urban areas (p=0.04). Our results, when compared to those of similar studies conducted in 1969, 1990, and 2006 showed a significant increase in mean BMI. CONCLUSION Overall, we documented a high and increasing prevalence of overweight and obesity (43.7%) among younger Greek men
Novel Oral Anticoagulants: Agent Selection and Patient Monitoring
No full textEnsuing the recent approval of novel oral anticoagulant agents (NOACs) in Greece and many other countries for stoke prevention in patients with non-valvular atrial fibrillation (AF), an overview is herein attempted of some practical points concerning their use with regards to agent selection and patient monitoring. There are currently 3 NOACs, dabigatran (a direct thrombin inhibitor), rivaroxaban and apixaban (direct factor Xa inhibitors), among which physicians are called upon to choose if they decide to use these more expensive agents in lieu of the much cheaper classic vitamin K antagonists (VKA), either to initiate or switch anticoagulant therapy in patients with AF. All three NOACs were evaluated in large randomized trials and found to be effective anticoagulants in patients with non-valvular AF, with comparable to or improved efficacy over warfarin, and a significant reduction in intracranial hemorrhage compared to warfarin. There was even a significant (apixaban) or strong trend toward reduction (dabigatran and rivaroxaban) in all-cause mortality. These agents are easier to administer in fixed once or twice daily doses without the need for routine coagulation monitoring. However, in addition to their much higher pricing, it is important to appreciate the potential challenges and limitations posed by their use and to follow recommendations and guidelines, in order to achieve optimal patient outcomes
Novel Hypolipidemic Agents: Focus on PCSK9 Inhibitors
Get PDFProprotein convertase subtilisin/kexin type 9 (PCSK9) was recently discovered as the third gene involved in autosomal dominant familial hypercholesterolemia. The encoded PCSK9 protein binds and induces degradation of the low-density lipoprotein (LDL) receptor and thereby modulates the plasma levels of LDL-cholesterol. Some of the naturally occurring PCSK9 mutations increase the function of this protein (gain of function) and cause hypercholesterolemia, whereas loss of function mutations produce hypocholesterolemia. Since the loss of a functional PCSK9 in humans is not associated with apparent deleterious effects, this protease is an attractive target for the development of hypocholesterolemic agents, either alone or in combination with statins. Thus, inhibition of PCSK9 with monoclonal antibodies is emerging as a novel strategy for the treatment of hypercholesterolemia. Other novel hypolipidemic agents include mipomersen, an antisense oligonucleotide inhibitor targeted to human apolipoprotein B-100, and lomitapide, an oral microsomal triglyceride transfer protein inhibitor. Data obtained from preliminary studies show that use of these new therapeutic approaches are effective in reducing LDL-cholesterol. An overview of these novel hypolipidemic agents is herein attempted with a focus on PCSK9 inhibition
ICD Device Assistance in Diagnosis and Management of Atrial Tachyarrhythmia
Get PDFAn implanted cardiac resynchronization and defibrillator device was helpful in clarifying the diagnosis of atrial tachyarrhythmia and cardioverting the arrhythmia, and thus restoring atrio-biventricular synchrony, followed by quick response to pharmacotherapy and stabilization of a patient with acute exacerbation of heart failure
Music Interventions as a Complementary Form of Treatment in ICU Patients
Get PDFMusic can influence a wide range of physiological and psychological effects and is effective in decreasing stress and facilitating relaxation responses. Music therapy has been widely used in a variety of cultures for centuries to decrease patients’ perception of pain, anxiety and depression, and boost their feelings of relaxation. Music can be used as a safe and inexpensive non-pharmacologic antianxiety intervention to enhance relaxation and decrease stress in ICU patients
Cardiology News / Recent Literature Review / First Three Quarters 2013
No full textCardiology News /Recent Literature Review / First Quarter 2013 HRS Meeting will take place in Denver, 8-11/5/13 EuroPCR to be held in Paris, 21-24/5/13 EuroPace will be held in Athens, 23-26/6/13 ESC Congress will be held in Amsterdam, 31/8-4/9/13 TCT Meeting: San Francisco, 28/10-1/11/13 AHA 2013: Dallas, 16-20/11/13 Pre-RELAX-AHF and RELAX-AHF Trials: Relaxin Reduces 6-month Mortality in Acute Heart Failure Patients In the Pre-RELAX-AHF (Relaxin in Acute Heart Failure) phase II study and RELAX-AHF phase III study patients hospitalized for acute heart failure were randomized within 16 h to IV placebo or serelaxin. Serelaxin reduced 6-month mortality in both studies (combined studies: N = 1,395; hazard ratio: 0.62; p = 0.0076). In RELAX-AHF, serelaxin improved the markers of cardiac (high-sensitivity cardiac troponin T), renal (creatinine/cystatin-C), and hepatic (AST/ALT) damage and of decongestion (N-T pro–BNP), while changes in these markers at day 2 and worsening heart failure during admission were associated with 6-month mortality. The authors concluded that early administration of serelaxin was associated with a reduction of 6-month mortality, while fewer signs of organ damage and more rapid relief of congestion were noted during the first days after admission (Metra et al, J Am Coll Cardiol 2013;61:196–206) Favorable 5-Year Outcome after TAVI The 5-year outcome was evaluated in 88 patients undergoing successful TAVI with a balloon-expandable valve. Mean aortic valve gradient decreased from 46 + 18 mm Hg to 10 + 4.5 mm Hg after TAVI and maintained at 11.8 + 5.7 mm Hg at 5 years (p for post-TAVI trend = 0.06). Mean aortic valve area increased from 0.62 + 0.17 cm2 to 1.67 + 0.41 cm2 after TAVI and 1.40 + 0.25 cm2 at 5 years (p for post-TAVI trend <0.01). At 5 years, 3 patients (3.4%) had moderate prosthetic valve dysfunction. Survival rates at 1 to 5 years were 83%, 74%, 53%, 42%, and 35%, respectively. Median survival time after TAVI was 3.4 years, and the risk of death was significantly increased in patients with chronic obstructive pulmonary disease (hazard ratio [HR]: 2.17) and at least moderate paravalvular regurgitation (adjusted HR: 2.98). Thus, a favorable long-term outcome after TAVI was demonstrated. Signs of moderate prosthetic valve failure were observed in 3.4% of patients. No patients developed severe prosthetic regurgitation or stenosis. Comorbidities, mainly chronic lung disease and at least moderate paravalvular regurgitation, were associated with reduced long-term survival (Toggweiler et al, J Am Coll Cardiol 2013;61:413–419)... (excerpt
Nurse's Role in the Modern Resuscitation Era
Get PDFAim: The aim of the present study was to explore the current literature referring to the new roles of nurses in the modern resuscitation era.Methods and Material: For the present study, a systematic search of international bibliography from both the review and the research literature was performed to sort out articles mainly over the last several years from the Medline, Medscape and Science Direct databases. Used keywords included cardiac arrest, resuscitation, cardio-pulmonary resuscitation (CPR), nursing role, and rapid response nurse.Results: The review of the literature indicated that improvement in nursing education, increased needs for expert nurses due to the requirements of specialized fields of medicine, and an increase in the autonomy of the nursing role have led to a change in nurses' responsibilities during CPR. Furthermore, the review showed that roles and duties of nurses during CPR are limited mainly in preparing the drugs administered and monitoring the patients' vital signs. Regarding nurses’ perspectives, a commonly held view is that their role during CPR is slowly but steadily improving. Finally, nurses are perceived by the community as the most capable individuals to perform effective CPR. Conclusion: Nurses should become more active members of the multidisciplinary team during CPR by increasing their knowledge and improving their skills. Nurses working in departments such as Cardiology, Cardiac and Intensive Care Units and Accident and Emergency Departments should be more willing to attend CPR seminars
Micro RNAs: a Revolutionary Discovery in Biology
Get PDFMicroRNAs (miRNAs) are endogenous, single-stranded, short, noncoding ribonucleic acids (RNAs), which can bind to their target messenger RNAs (mRNAs), leading to the inhibition of translation or degradation of the mRNA. Only recently have scientists discovered the important role that miRNAs play in gene regulation. To date, more than 700 miRNAs have been identified from the human genome. Malfunctioning miRNAs have been implicated in a number of diseases, due to their regulatory functions in transcription, signal transduction, cell cycle regulation, proliferation, cell growth and metabolism, cell apoptosis, and neurogenesis. Absence of miRNAs or their mutations, detected by genetic analysis, has been associated with a broad spectrum of disease processes, such as various cancers and autoimmune, cardiovascular, infectious, metabolic, neurodegenerative, skin, and psychiatric diseases. The large progress made in understanding miRNAs also points to their great potential as new biomarkers in the diagnosis and early detection of various diseases, as well as their promising role in future therapeutics
Mediterranean Diet and Coronary Heart Disease
Get PDFThe traditional Mediterranean diet is the diet that prevailed in the olive tree-growing areas of the Mediterranean basin up to the early 1960s, before globalization invaded the local food culture. The seminal studies by Keys and his colleagues brought the concept of the Mediterranean diet into the mainstream of the science focusing on the relation between nutrition and health. The interest in the diet has resurged in recent years with further studies indicating lower incidence of coronary heart disease and reduced mortality in those adhering to this traditional dietary pattern