Work-related well-being of non-public attention attendants used in the aged attention field: Inciden
Author : Reilly Daly | Published On : 14 Nov 2024
The current treatment of radiation-induced coronary artery disease (RCAD) is comparable to that of generic coronary artery disease (CAD); however, the outcomes of these treatment measures have not been fully examined in RCAD. learn more A 33-year-old woman, without conventional cardiovascular risk factors, presented with left main coronary artery (LMCA) lesions. At the age of 26, she received mediastinal radiation therapy (RT) to treat mixed cellularity Hodgkin lymphoma. One BiodivYsio 3.5 × 18 mm stent was implanted at the LMCA site. At the age of 38, the patient was treated by balloon dilatation because of approximately 50% in-stent stenosis. At the last follow-up in February 2018, when the patient was 51 years old, she no longer complained of chest pain. Coronary angiography showed no de novo or in-stenosis lesions, although optical coherence tomography showed mild neointimal proliferation, calcific plaque, small ruptured intima, and several uncovered struts. The experience of treating this case may shed some light on coronary stenting in coronary lesions caused by RCAD.Impaired fatty acid metabolism is associated with heart failure (HF) prognosis. However, specific changes in acylcarnitine profiles and their potential clinical value have not been well explored in patients recovering from acute decompensation.This study recruited 79 HF patients hospitalized because of acute decompensation with a left ventricular ejection fraction (LVEF) of less then 40% and 51 normal controls. Patients were dichotomized into two groups, namely, the "improved (IMP) " and the "non-improved (NIMP) " groups, as defined by the changes in LVEF from baseline to 12 months after discharge. Mass spectrometry was used to quantify the acylcarnitine concentrations at baseline and 6 and 12 months after discharge. The IMP and NIMP groups contained 42 and 37 patients, respectively. At baseline, HF patients had higher plasma concentrations of specific long-, medium-, and short-chain acylcarnitines compared to normal controls. From baseline to 12 months post-discharge, the IMP group showed significant decreases in long- and short-chain acylcarnitine concentrations, but significant increases in medium-chain acylcarnitines. In the NIMP group, none of the acylcarnitines significantly decreased, and significant increases were noted in long-, medium-, and short-chain acylcarnitines. Generalized estimating equations demonstrated that nine acylcarnitines could discriminate the IMP group from the NIMP group, including three long-chain (C181, C16, and C161) and six short-chain acylcarnitines (C5, C5-OH, C4, C41-DC, C3, and C2). After adjusting for age, the six short-chain acylcarnitines remained significant. Changes in short-chain acylcarnitine profiles are independently associated with the improvement in cardiac systolic function after acute decompensation.The aim of this meta-analysis was to compare the clinical outcomes in patients who underwent rapid deployment aortic valve replacement (RDAVR) and conventional bio prosthetic aortic valve replacement (CAVR).We performed a literature search by August 2018. The primary outcomes were hospital and 1-year mortality, and the secondary endpoints included the aortic cross-clamp (ACC), cardiopulmonary bypass (CPB) time, and postoperative and valve-related complications.Two randomized controlled trials and 13 propensity score-matched studies were included. There was no difference between RDAVR and CAVR in hospital mortality (2.5% versus 2.1%; risk ratio (RR) 1.16 [95% confidence interval (CI) 0.80-1.68]) or 1-year mortality (2.9% versus 4.1%; RR 0.69 [95% CI 0.34-1.34]). RDAVR significantly reduced the ACC time ( (mean difference (MD) -24.33 [95% CI -28.35 to -20.32]) and CPB time (MD -21.51 [95% CI -22.83 to -20.20]). The pooled analysis showed that RDAVR doubled the occurrence of permanent pacemaker implantation (8.6% versus 4.3%; RR 2.05 [95% CI 1.62-2.60]). Meanwhile, the blood transfusion amount (MD -1.54 [95% CI -2.22 to -0.86]) and postoperative atrial fibrillation (POAF) occurrence (RR 0.83 [95% CI 0.69-0.99]) was reduced. The difference of paravalvular leakage frequency between RDAVR and CAVR was marginal (RR 1.77 [95% CI 1.00-3.17]; P = 0.05). Furthermore, RDAVR was related to larger valves (MD 0.70 cm [95% CI 0.33-1.07]) and lower mean pressure gradients (MD -1.93 mmHg [95% CI -3.58 to -0.28]).The hospital and 1-year survival rates between RDAVR and CAVR are comparable. RDAVR reduces POAF occurrence and blood transfusion but is associated with a higher occurrence of pacemaker implantation.We aimed to evaluate the acute physiological effects of high-load deadlift exercise on the lumbar intervertebral discs using MR diffusion-weighted imaging (DWI).
Fifteen volunteers (11 men and 4 women; 23.2 ± 3.3 years) without lumbar intervertebral disc degeneration performed deadlift exercise (70% of 1 repetition maximum, 6 repetitions, 5 sets, 90 s rest between sets) using a Smith machine. Sagittal MR diffusion-weighted images of the lumbar intervertebral discs were obtained using a 1.5-Tesla MR system with a spine coil before and immediately after the exercise. We calculated apparent diffusion coefficient (ADC; an index of water movement) of the nucleus pulposus from diffusion weighted images at all lumbar intervertebral discs (L1/2 through L5/S1).
All lumbar intervertebral discs showed significantly decreased ADC values immediately after deadlift exercise (L1/2, -2.8%; L2/3, -2.1%; L3/4, -2.8%; L4/5, -4.9%; L5/S1, -6.2%; P < 0.01). In addition, the rate of ADC decrease of the L5/S1 disc was significantly greater than those of the L1/2 (P = 0.017), L2/3 (P < 0.01), and L3/4 (P = 0.02) discs.
The movement of water molecules within the lumbar intervertebral discs is suppressed by high-load deadlift exercise, which would be attributed to mechanical stress on the lumbar intervertebral discs during deadlift exercise. In particular, the L5/S1 disc is subjected to greater mechanical stress than the other lumbar intervertebral discs.
The movement of water molecules within the lumbar intervertebral discs is suppressed by high-load deadlift exercise, which would be attributed to mechanical stress on the lumbar intervertebral discs during deadlift exercise. In particular, the L5/S1 disc is subjected to greater mechanical stress than the other lumbar intervertebral discs.