Relationship between Dietary Patterns and Cardiovascular Disease Risk in Korean Older Adults

Objectives: The purpose of this study was to assess the relationship between dietary patterns and the 10-year risk of cardiovascular disease (CVD) in the elderly population in Korea. Methods: Cluster analysis was conducted on the data of 1687 elderly participants (797 men and 890 women) aged ≥65 years from the 2014–2016 Korea National Health and Nutrition Examination Survey (KNHANES), using a 24-h dietary recall survey to assess dietary patterns. Dietary patterns were classified into clusters 1 (typical Korean diet), 2 (high carbohydrate diet), and 3 (healthy diet). The 10-year risk of CVD was calculated based on age, total and HDL-cholesterol levels, systolic blood pressure level, antihypertensive medication use, smoking status, and presence of diabetes. A complex sample general linear model was applied to determine the association between dietary patterns and the 10-year risk of CVD. Results: In total, 275 (33.7%), 141 (17.9%), and 381 (48.3%) men, and 207 (22.6%), 276 (30.9%), and 407(46.6%) women were included in clusters 1, 2, and 3, respectively. The 10-year risk of CVD was lower in men in cluster 3 (healthy diet) than in those in cluster 1 (typical Korean diet) (t = 2.092, p = 0.037). Additionally, the 10-year risk of CVD was lower in men who performed strength training than in those who did not (t = 3.575, p < 0.001). There were no significant differences in women. Conclusions: After adjusting for sociodemographic variables, men who consumed a healthy diet had a lower 10-year risk of CVD than those who consumed a typical Korean diet. When organizing nutrition education programs to improve dietary habits in the elderly, content on diets that consist of various food groups to prevent CVD is required. In particular, it is necessary to develop content that emphasizes the importance of healthy eating habits in men.

Clinical Symptoms and Haematological Characteristics among Male and Female COVID-19 Patients in Rivers State: A Single-center Case Reviews

Objectives: The study seeks to assess the sex differences in reported clinical symptoms and haematological parameters of hospitalized COVID-19 cases. Study Design: A retrospective descriptive cross-sectional study. Place and Duration of Study: Covid-19 Treatment Centre, Rivers State, between May 2020 and July 2020. Methodology: Descriptive data collection for patients diagnosed of COVID-19 was employed within the months of May to July 2020. A comparison of demographic profile, presenting symptoms, comorbidities and laboratory findings between males and females was analyzed using SPSS version 25. Ethical approval was obtained prior to commencing data collection. Results: In this study, data of 56 patients were analyzed of which 31 (55.4%) were males and 25 (44.6%) were females. The mean age for all patients was 36 years and males had a higher mean age (40 ± 12.6) compared to females (31 ± 8.8). Twelve patients (21.4%) reported pre-existing co-morbidities and Hypertension 11 (19.6%) was the prevalent co-morbidity followed by peptic ulcer 2 (3.6%) and Diabetes 2 (3.6%) and these were more common among males. Triglyceride level was significantly higher among females (p= 0.028) and low-density lipoprotein (LDL) level was significantly lower among females (p= 0.044) while systolic blood pressure level was significantly higher among males (p= 0.011). Conclusion: Though similar symptoms and haematological findings occur in males and females, specific disparities in some parameters were observed. We recommend healthcare personnel to consider these differences when caring for patients hospitalized for COVID-19.

Probability assessment of intracerebral hemorrhage in prehospital emergency patients

Background Routing of patients with intracerebral hemorrhage (ICH) and acute ischemic stroke (AIS) to the most appropriate hospital is challenging for emergency medical services particularly when specific treatment options are only provided by specialized hospitals and determination of the exact diagnosis is difficult. We aimed to develop a prehospital score – called prehospital-intracerebral hemorrhage score (ph-ICH score) – to assist in discriminating between both conditions. Methods The ph-ICH score was developed with data from patients treated aboard a mobile stroke unit in Berlin, Germany, between 2011 and 2013 (derivation cohort) and in 2018 (validation cohort). Diagnosis of ICH or AIS was established using clinical data and neuroradiological cerebral imaging. Diagnostic accuracy was measured with significance testing, Cohen’s d and receiver-operating-characteristics. Results We analyzed 416 patients (32 ICH, 224 AIS, 41 transient ischemic attack, 119 stroke mimic) in the derivation cohort and 285 patients (33 ICH and 252 AIS) in the validation cohort. Systolic blood pressure, level of consciousness and severity of neurological deficits (i. e. certain items of the National Institutes of Health Stroke Scale) were used to calculate the ph-ICH score that showed higher values in the ICH compared to the AIS group (derivation cohort: 1.8 ± 1.2 vs. 1.0 ± 0.9 points; validation cohort: 1.8 ± 0.9 vs. 0.8 ± 0.7 points; d = 0.9 and 1.4, both p < 0.01). Receiver-operating-characteristics showed fair and good accuracy with an area under the curve of 0.71 for the derivation and 0.81 for the validation cohort. Conclusions The ph-ICH score can assist medical personnel in the field to assess the likelihood of ICH and AIS in emergency patients.

Comparison of blood pressure levels across the spectrum of hypertension related signs and symptoms in out patients.

Objectives: To compare the blood pressure levels across the categories of hypertension related signs and symptoms among outpatients aged up to 45 years. Study Design: Cross Sectional study. Setting: Sindh Government Urban Health Centre Karachi. Period: July 2017 to February 2018. Material & Methods: A cross-sectional survey was organized in the outpatient department of a secondary care hospital of Karachi. Patients aged up to 45 years with self-reported history of hypertension and taking anti-hypertensive medication were included in the study. All patient related data was recorded by interviewing using the study questionnaire whereas the blood pressure levels were measured through a sphygmomanometer with stethoscope. Data were analyzed on SPSS version 20. Results: The study results showed that systolic blood pressure level was significantly different across categories of headache history (p=0.045), sleep apnea (p=0.043) and palpitation (p=0.03) where for headache history patients without whereas for sleep apnea and palpitation patients with these signs and symptoms had higher mean rank of systolic blood pressure levels. Moreover, the diastolic blood pressure level was not significantly different across categories of any of the sign and symptom of hypertension. Conclusion: Blood pressure levels were found to be significantly different across categories of a number of clinical manifestations of hypertension. Moreover, the observed differences differed among patients with different durations of hypertension.

Perinatal Survival and Predictors of Mortality among Mothers with Hypertensive Disorders of Pregnancy at Antenatal care Clinics in Gamo Zone Public Hospitals

BACKGROUND፡ Pregnancy induced hypertension represents a significant public health problem throughout the world, which may complicate 0.5%–10% of all pregnancies. It is the leading cause of maternal as well perinatal mortality and morbidity worldwide. Pregnancy induced hypertension is a multisystem disorder unique to pregnancy and results in high perinatal mortality. The objective of this study was to determine the survival status, incidence and predictors of perinatal mortality among mothers with pregnancy induced hypertension at antenatal clinics of Gamo Zone public hospitals.METHODS: Facility-based retrospective cohort study was conducted among selected 576(192 exposed and 384 unexposed) antenatal care attendants' record at Gamo Zone public hospitals from 1st January 2018 to 31st December 2018. Data were entered into Epi data version 3.02 and exported to SPSS V 25 for analysis. Kaplan Meier survival curve together with log rank test was fitted to test the survival time. Statistical significance was declared at Pvalue <0.05 using cox proportional hazard model.RESULT: The incidence of perinatal mortality was 124/1000 births. The cumulative proportion of surviving at the end of 4th , 8th, 12th and 16th weeks of follow-up among the exposed groups was 96.9%, 93.5%, 82.1% and 61.6% respectively whereas it was 99.5%, 98.9% and 98.5% at the end of 4th, 8th and 12th weeks of follow-up for the non-exposed groups respectively. Parity of >5(AHR: 6.3; 95%CI: 1.36,10.55), mothers who delivered at<34 weeks of gestation(AHR:7.8; 95%CI: 2.6,23.1), being preterm(AHR:6; 95%CI: 5.3,19.2), perinatal birth weight<2500gm(AHR:6.1; 95&CI: 1.01,37.9), vaginal deliveryn(AHR:2.7; 95%CI:1.13,6.84), maternal highest systolic blood pressure level >160mmHg (AHR: 2.3; 95%CI: 1.02,5.55) and prepartum onset of pregnancy induced hypertension (AHR:6; 95%CI: 5.3,19.2) were statistically significant in multivariable analysis.CONCLUSION: The risk of perinatal mortality was high among the mothers with pregnancy induced hypertension compared to those of pregnancy induced hypertension free mother,s and the perinatal mortality rate was high. High parity, low gestational age, low number of antenatal care visits, low birth weight, vaginal delivery, antepartum onset of pregnancy induced hypertension and highest maternal systolic blood pressure level were the independent predictors of perinatal mortality.

Indicators of oxidative stress, inflammation, and endothelial dysfunction in patients with coronary atherosclerosis while taking statins

The aim of the study was to study the changes in clinical and biochemical parameters in patients with different severity of coronary atherosclerosis, depending on the administration of lipid‑lowering therapy. The study included 354 patients with coronary heart disease. All patients underwent coronary angiography with the calculation of the Gensini index. Patients were determined the level of oxidative modification of proteins, RF‑reactive protein, homocysteine and superoxide dismutase activity depending on the administration of lipid‑lowering therapy (statins). A statistical relationship between the group of patients divided by the Gensini index and statin intake was revealed. In the assessment of clinical and anthropometric indicators, significant differences in BMI, waist circumference, systolic blood pressure level were established. In assessing the lipid profile revealed significant differences between the study groups in the level of total cholesterol and the level of HDL‑cholesterol. Low adherence to lipid‑lowering therapy was noted in patients with hemodynamically significant coronary atherosclerosis. In this regard, it remains necessary to search for residual risk markers, taking into account the importance of non‑lipid risk factors.

HEMODYNAMIC RESPONSE AFTER CONCURRENT CROSS EXERCISE IN HYPERTENSIVE WOMEN

ABSTRACT Introduction: Systemic arterial hypertension is a disease that mainly affects women. Objective: This study aimed to verify the hypotensive effect and blood pressure reactivity in women submitted to a concurrent cross exercise (CC) session. Methods: Fifteen volunteers (54±3) performed aerobic exercise alternated with a series of weights exercises, for the analysis of blood pressure variation (by the oscillometric method) and pressure reactivity (by the Cold pressure test) before and after exercise. Results: The results demonstrated the occurrence of post-exercise hypotension in the systolic phase in the comparison between CC and C post-exercise (−11.65 mmHg). CC led to attenuation of 7mmHg and 4mmHg for SBP and DBP, respectively, in the blood pressure reactivity after one session. Conclusion: It is concluded that concurrent cross exercise ensures hypotension and positive reactivity of systolic blood pressure. Level of evidence II; Therapeutic studies-Investigating the results of treatment.