Cognitive decline after carotid endarterectomy: Systematic review and meta-analysis

The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN We performed a systematic review and meta-analysis of both randomised and nonrandomised trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES We searched Cochrane, PubMed/Medline and Embase databases from the date of database inception to 1 December 2018. ELIGIBILITY CRITERIA We selected longitudinal studies including CEA patients with both pre-operative and postoperative cognitive assessments. Primary outcome was pCD incidence, differentiating delayed neurocognitive recovery (dNCR) and postoperative neurocognitive disorder (pNCD). dNCR and pNCD incidences were expressed as proportions of cases on total CEA sample and pooled as weighted estimates from proportions. Postoperative delirium was excluded from the study design. Secondary outcomes were patient-related (i.e. age, sex, diabetes, hypertension, contralateral stenosis, pre-operative symptoms, dyslipidaemia and statin use) and procedure-related (i.e. hyperperfusion, cross-clamping duration and shunting placement) risk factors for pCD. We estimated odds ratios (ORs) and mean differences through a random effects model by using STATA 13.1 and RevMan 5.3. RESULTS Our search identified 5311 publications and 60 studies met inclusion criteria reporting a total of 4823 CEA patients. dNCR and pNCD incidence were 20.5% [95% confidence interval (CI), 17.1 to 24.0] and ...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Perioperative medicine Source Type: research

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Chronic kidney disease (CKD) is a public health threat with impact in cardiovascular risk. All forms of cardiovascular disease and mortality are more common in CKD. Treatment of cardiovascular risk factors, hypertension, dyslipidemia and diabetes is essential for cardiovascular and kidney protection. CKD is a marker of high or very high cardiovascular risk and its presence require early treatment and specific goals. Lifestyle is a pivotal factor, stopping smoking, reducing weight in the overweight or obese, starting regular physical exercise and healthy dietary pattern are recommended. Office BP should be lowered towards 1...
Source: Journal of Hypertension - Category: Cardiology Tags: REVIEWS AND META-ANALYSES Source Type: research
Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role. The current treatment for dyslipidemia consists of lifestyle modification or drug...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Review Source Type: research
Conclusions: The costs of specialised care decreased with the length of hospital stay reduction. Cardiovascular risk factors were crucial in in-hospital mortality. This study provides population-based data to assist decision-makers at the national level and to contribute to worldwide evaluations and disease surveillance. PMID: 33000981 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
ConclusionPrevalence of dyslipidemia seems to be very high in Pakistan, necessitating an urgent call for early screening and effective management through lifestyle intervention and appropriate lipid lowering drugs to prevent this important cardiovascular risk factor.
Source: Journal of Diabetes and Metabolic Disorders - Category: Endocrinology Source Type: research
Resumo Fundamento Os enxertos de veias safenas (EVS) s ão frequentemente usados em pacientes submetidos a cirurgia de revascularização do miocárdio (CRM). Objetivos Avaliar as relações entre índices aterogênicos e estenose de EVS. Métodos: No total, 534 pacientes (27,7% mulheres, com idade média de 65±8,4 anos) submetidos a CRM e angiografi a coronariana eletiva foram incluídos no estudo. Pacientes com pelo menos uma estenose EVS ≥ 50% foram alocados ao grupo estenose EVS (+) (n=259) e pacientes sem estenose foram classificados como EVS (...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Resumo Fundamento Os enxertos de veias safenas (EVS) s ão frequentemente usados em pacientes submetidos a cirurgia de revascularização do miocárdio (CRM). Objetivos Avaliar as relações entre índices aterogênicos e estenose de EVS. Métodos: No total, 534 pacientes (27,7% mulheres, com idade média de 65±8,4 anos) submetidos a CRM e angiografi a coronariana eletiva foram incluídos no estudo. Pacientes com pelo menos uma estenose EVS ≥ 50% foram alocados ao grupo estenose EVS (+) (n=259) e pacientes sem estenose foram classificados como EVS (...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
Authors: Turkson-Ocran RN, Szanton SL, Cooper LA, Golden SH, Ahima RS, Perrin N, Commodore-Mensah Y Abstract Background: African Americans and other persons of African descent in the United States are disproportionately affected by cardiovascular diseases (CVD). Discrimination is associated with higher CVD risk among US adults; however, this relationship is unknown among African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of African immigrants in Baltimore-Washington, DC, with recruitment and data collection taking place between June 2017 and April 2019. The main outcome ...
Source: Ethnicity and Disease - Category: International Medicine & Public Health Tags: Ethn Dis Source Type: research
In conclusion, it remains unclear if brain-specific regional and temporal changes occur in the expression of the different APP variants during AD progression. Since APP is also found in blood cells, assessing the changes in APP mRNA expression in peripheral blood cells from AD patients has been considering an alternative. However, again the quantification of APP mRNA in peripheral blood cells has generated controversial results. Brain APP protein has been analyzed in only a few studies, probably as it is difficult to interpret the complex pattern of APP variants and fragments. We previously characterized the soluabl...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Özkan S Abstract OBJECTIVES: Unexplained left ventricular hypertrophy (ULVH) is defined as increased wall thickness in the absence of conditions that predispose to hypertrophy. The aim of this study was to evaluate the rate of masked hypertension in patient with unexplained left ventricle hypertrophy. METHOD: A total of 120 consecutive unexplained left ventricle hypertrophy patients without overt hypertension and diabetes and 121 healthy control subjects were included in the study. After a complete medical history and laboratory examination, patients' height, weight, waist circumference heart rate, and ...
Source: Clinical and Experimental Hypertension - Category: Cardiology Authors: Tags: Clin Exp Hypertens Source Type: research
After significant APA advocacy, the House Veterans ’ Affairs Committee removed a proposal to implement a pilot program allowing clinical psychologists to prescribe and manage medications for veterans who seek care in the Veterans Health Administration.After learning about the proposal, APA issued an advocacy alert that resulted in over 1,000 members sending more than 3,000 letters to their elected officials on Capitol Hill, opposing the proposal and urging lawmakers to ensure veterans receive the highest quality mental health care possible. Similarly, APA leadership, as well as government relations and policy staff m...
Source: Psychiatr News - Category: Psychiatry Tags: advocacy APA lobbying psychologists prescribing Saul Levin VA veterans Source Type: research
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