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Meta-Analysis Addressing the Effect of Mineralcorticoid Receptor Antagonists on the Risk for New-Onset Atrial Fibrillation
Atrial fibrillation (AF) constitutes the most common, major cardiac arrhythmia worldwide, with an estimated prevalence in the United States equal to 2.3 million affected subjects, projected to increase to 5.6 million by 2050.1 Hypertension and background heart disease (mainly, congestive heart failure) or valve disease represent main risk factors for AF development.1 Other modifiable risk factors are sedentary lifestyle, smoking, obesity, diabetes mellitus, and obstructive sleep apnea.2 AF is associated with a significant increase in the risk for all-cause and cardiovascular death, ischemic stroke, heart failure (HF), isch...
Source: The American Journal of Cardiology - August 13, 2021 Category: Cardiology Authors: Dimitrios Patoulias, Christodoulos Papadopoulos, Maria Toumpourleka, Michael Doumas Source Type: research

Anesthetic management for robotic hysterectomy in obese women
Purpose of review Obesity is a major health epidemic, with the prevalence reaching ∼40% in the United States in recent years. It is associated with increased risk of hypertension, diabetes, heart disease, stroke, obstructive sleep apnea (OSA), and gynecologic conditions requiring surgery. Those comorbidities, in addition to the physiologic changes associated with obesity, lead to increased risk of perioperative complications. The purpose of this review is to highlight the anesthetic considerations for robotic assisted hysterectomy in obese patients. Recent findings In the general gynecologic population, minima...
Source: Current Opinion in Anaesthesiology - May 12, 2021 Category: Anesthesiology Tags: OBSTETRIC AND GYNECOLOGICAL ANESTHESIA: Edited by Jill Mhyre Source Type: research

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1 β Deficient Murine Hearts
Conclusion: These findings limit the possible roles of gene transcriptional changes in previously reported age-dependent pro-arrhythmic electrophysiologial changes observed in Pgc-1β-/- atria to an altered Ca2+-ATPase (Atp2a2) expression. This directly parallels previously reported arrhythmic mechanism associated with p21-activated kinase type 1 deficiency. This could add to contributions from the direct physiological outcomes of mitochondrial dysfunction, whether through reactive oxygen species (ROS) production or altered Ca2+ homeostasis. Introduction Atrial arrhythmias constitute a major public health pro...
Source: Frontiers in Physiology - April 23, 2019 Category: Physiology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Sickle Cell Disease Subjects Have a Distinct Abnormal Autonomic Phenotype Characterized by Peripheral Vasoconstriction With Blunted Cardiac Response to Head-Up Tilt
Conclusion We have shown that SCD subjects are much more likely than non-SCD subjects to have impaired cardiac, but intact peripheral responses to orthostatic stress induced by HUT. These abnormal responses are associated with low baseline cardiac parasympathetic activity, independent of hemoglobin level. The classification of autonomic phenotypes based on HUT response may have potential use for predicting disease severity, guiding and targeting treatments/interventions to alleviate the risk of adverse outcomes in SCD. Ethics Statement All experiments were conducted at Children’s Hospital Los Angeles (CHLA). The ...
Source: Frontiers in Physiology - April 10, 2019 Category: Physiology Source Type: research

Sleep disorders and the risk of stroke.
Authors: McDermott M, Brown DL, Chervin RD Abstract INTRODUCTION: Stroke is a major cause of disability and death in the United States and across the world, and the incidence and prevalence of stroke are expected to rise significantly due to an aging population. Obstructive sleep apnea, an established independent risk factor for stroke, is a highly prevalent disease that is estimated to double the risk of stroke. It remains uncertain whether non-apnea sleep disorders increase the risk of stroke. Areas covered: This paper reviews the literature describing the association between incident stroke and sleep apnea, REM sle...
Source: Expert Review of Neurotherapeutics - June 15, 2018 Category: Neurology Tags: Expert Rev Neurother Source Type: research

Modafinil for the Improvement of Patient Outcomes Following Traumatic Brain Injury
Conclusion. Modafinil is a central nervous system stimulant with well-established effectiveness in the treatment of narcolepsy and shift-work sleep disorder. There is conflicting evidence about the benefits of modafinil in the treatment of fatigue and EDS secondary to TBI. One randomized, controlled study states that modafinil does not significantly improve patient wakefulness, while another concludes that modafinil corrects EDS but not fatigue. An observational study provides evidence that modafinil increases alertness in fatigued patients with past medical history of brainstem diencephalic stroke or multiple sclerosis. ...
Source: Innovations in Clinical Neuroscience - April 1, 2018 Category: Neuroscience Authors: ICNS Online Editor Tags: Current Issue Review excessive daytime sleep fatigue head injury modafinil stroke TBI traumatic brain injury Source Type: research

Impact of testosterone replacement therapy on thromboembolism, heart disease, and obstructive sleep apnea in men
ConclusionsThis study adds to growing evidence that cardiovascular risk from TRT may be less than once feared. The increased risk of sleep apnea in men using TRT is noteworthy. The study strengths include the large number of healthy and young men exposed to TRT. Limitations include the retrospective study design inability to account for granular details of TRT use such as dosage, specific forms of TRT and serum testosterone levels pre‐ and post‐TRT.This article is protected by copyright. All rights reserved.
Source: BJU International - January 31, 2018 Category: Urology & Nephrology Authors: Alexander P Cole, Julian Hanske, Wei Jiang, Nicollette K. Kwon, Stuart R Lipsitz, Martin N Kathrins, Peter A Learn, Maxine Sun, Adil H Haider, Shehzad S Basaria, Quoc ‐Dien Trinh Tags: Original Article Source Type: research

Association between Exposure to p,p ′-DDT and Its Metabolite p,p′-DDE with Obesity: Integrated Systematic Review and Meta-Analysis
Conclusions: We classified p,p′-DDT and p,p′-DDE as “presumed” to be obesogenic for humans, based on a moderate level of primary human evidence, a moderate level of primary in vivo evidence, and a moderate level of supporting evidence from in vivo and in vitro studies. https://doi.org/10.1289/EHP527 Received: 17 May 2016 Revised: 04 May 2017 Accepted: 09 May 2017 Published: 18 September 2017 Please address correspondence to M.A. La Merrill, Dept. of Environmental Toxicology, University of California, Davis, 1 Shields Ave., 4245 Meyer Hall, Davis, CA 95616-5270 USA. Telephone: (530) 754-7254. Email: mlamerrill...
Source: EHP Research - September 18, 2017 Category: Environmental Health Authors: Daniil Lyalko Tags: Review Source Type: research