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COVID-19, Long COVID, and Psychosomatic Manifestations: A Possible Burden on Existing Rheumatology Facilities 新冠肺炎、长期COVID和精神症状:对现有风湿病设施的可能负担
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_63_21
Md Bakar Siddiq, J. Rasker
COVID-19 mainly affects the respiratory system; however, other body parts can also be involved. After resolving the acute stage, long-standing COVID effects can continue to trouble COVID survivors; a term used to describe them is “long COVID” or post-COVID syndrome. Long COVID phenotypes are physical and functional: physical symptoms include persistent dyspnea, chest pain, myalgia, impaired mobility, and arthralgia, whereas fatigue, depression, cognitive impairment, anxiety, posttraumatic stress disorder, insomnia, and somatization are considered the functional aspects. Growing evidence suggests inflammatory rheumatic conditions may develop in COVID-19. COVID-19 further impact patients significantly with inflammatory arthritis (IA), their physical, psychological and social relationships, and their quality of life. Psychiatric COVID long-haulers could overload the existing rheumatology facilities globally, especially in the simultaneous presence of IA and COVID-19. This perspective addresses how psychosomatic manifestations of COVID-19 and “long COVID” burden the present rheumatology facility. We further address treatment options of “long COVID” and future research direction regarding its pathophysiology and “long COVID” psychosomatic illness, especially in the setting of chronic rheumatic diseases.
COVID-19主要影响呼吸系统;然而,身体的其他部位也可能受到影响。急性期结束后,COVID的长期影响可能会继续困扰COVID幸存者;一个用来描述它们的术语是“长COVID”或后COVID综合征。长冠状病毒表型是生理和功能性的:生理症状包括持续性呼吸困难、胸痛、肌痛、活动能力受损和关节痛,而疲劳、抑郁、认知障碍、焦虑、创伤后应激障碍、失眠和躯体化被认为是功能方面的症状。越来越多的证据表明,COVID-19可能会出现炎症性风湿病。COVID-19进一步显著影响炎症性关节炎(IA)患者、他们的身体、心理和社会关系以及他们的生活质量。精神科COVID-19长途飞机可能会使全球现有的风湿病设施超负荷,特别是在IA和COVID-19同时存在的情况下。这一观点阐述了COVID-19和“长COVID”的心身表现如何给目前的风湿病设施带来负担。我们进一步探讨“长冠”的治疗选择,以及其病理生理和“长冠”心身疾病的未来研究方向,特别是在慢性风湿病的背景下。
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引用次数: 1
Book review of heart disease: It is all in your head, and what to do about it 心脏病书评:这一切都在你的脑海里,你该怎么做
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_39_22
P. Palade, M. Mahadevan
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引用次数: 0
Sleep, exercise, stress, COVID-19, and human health 睡眠、运动、压力、COVID-19和人类健康
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_40_22
Lin Lu
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引用次数: 2
Efficacy and safety of traditional chinese medicine combined with western medicine for the treatment of COVID-19: A systematic review and meta-analysis 中西医结合治疗新冠肺炎的疗效和安全性:系统评价和荟萃分析
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_10_22
Shanshan Tian, K. Yuan, Yong-Bo Zheng, Xuejiao Gao, Xuan Chen, Ying-bo Yang, Shi-qiu Meng, Lu Cao, Le Shi, Wei Yan, Xiaoxing Liu, Jie Shi, Lin Lu, J. Deng, Y. Bao
Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Traditional Chinese Medicine (TCM) was considered important by Chinese health authorities in the fight against COVID-19. This review systematically analyzed and evaluated the safety and efficacy of TCM combined with Western Medicine (WM) for the treatment of COVID-19. We sought to provide summary evidence for clinicians when using TCM. We searched for studies in PubMed, Web of Science, Embase, Medline, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data from database inception to June 1, 2021. Overall, 31 studies (14,579 participants) were involved in the final systematic review, including 15 randomized controlled trials and 16 observational studies. TCM combined with WM showed main outcomes of a higher clinical efficacy rate (odds ratio [OR] =2.48, 95% confidence interval [CI] =1.90–3.24, I2 = 4%) and lower case fatality rate (OR = 0.31, 95% CI = 0.19–0.49, I2 = 80%) compared with WM treatment alone. No significant overall adverse events were found between TCM plus WM group and WM group (OR = 1.43, 95% CI = 0.63–2.23, I2 = 75%). Some larger randomized control trials would assist in defining the effect of TCM combined with WM on the treatment of COVID-19 complications such as cardiac injury. TCM combined with WM may be safe and effective for the treatment of COVID-19.
2019冠状病毒病(COVID-19)在全球迅速蔓延。中国卫生部门认为中医药在抗击新冠肺炎中非常重要。本综述系统分析和评价中西医结合治疗新冠肺炎的安全性和有效性。我们试图为临床医生在使用中药时提供总结证据。我们检索了PubMed、Web of Science、Embase、Medline、Cochrane图书馆、中国国家知识基础设施和万方数据从数据库建立到2021年6月1日的研究。总体而言,最终的系统评价涉及31项研究(14,579名受试者),其中包括15项随机对照试验和16项观察性研究。中西医结合治疗的主要结局是临床有效率较高(优势比[OR] =2.48, 95%可信区间[CI] =1.90 ~ 3.24, I2 = 4%),病死率较低(OR = 0.31, 95% CI = 0.19 ~ 0.49, I2 = 80%)。中西医结合治疗组与中西医结合治疗组总体不良事件无显著性差异(OR = 1.43, 95% CI = 0.63 ~ 2.23, I2 = 75%)。一些规模更大的随机对照试验将有助于确定中西医结合治疗新冠肺炎并发症(如心脏损伤)的效果。中西医结合治疗新冠肺炎可能是安全有效的。
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引用次数: 1
The Role of Cortisol in the Development of Post-Stroke Dementia: A Narrative Review 皮质醇在脑卒中后痴呆发展中的作用:叙述性综述
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_32_22
Isabella Edwards, I. Singh, R. Rose'meyer
Stroke is defined as a neurological deficit which lasts more than 24 h or leads to death, which is caused by a focal acute injury to the central nervous system with a vascular origin. Strokes are one of the greatest challenges in public health. As an acutely stressful event, strokes have been associated with an increased release in the stress hormone cortisol. Elevated cortisol has been linked to deleterious impacts on the brain, particularly the hippocampus, and has been associated with the development of dementia, though the mechanisms behind this remain unclear. Dementia is also an important stroke outcome, affecting approximately a third of stroke survivors in the long term. This review explores the relationship between strokes and cortisol, to determine the association between cortisol and hippocampal/neuronal damage and poststroke dementia and cortisol.
中风被定义为由血管源性中枢神经系统局灶性急性损伤引起的持续24小时以上或导致死亡的神经功能缺损。中风是公共卫生领域最大的挑战之一。作为一种急性应激事件,中风与应激激素皮质醇的释放增加有关。皮质醇升高与大脑,尤其是海马体的有害影响有关,并与痴呆症的发展有关,尽管其背后的机制尚不清楚。痴呆症也是中风的一个重要后果,长期影响约三分之一的中风幸存者。这篇综述探讨了中风和皮质醇之间的关系,以确定皮质醇与海马/神经元损伤以及中风后痴呆和皮质醇之间的关系。
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引用次数: 3
Facing sleep and mental health problems in the COVID-19 era: What shall we do? 面对新冠肺炎时代的睡眠和心理健康问题,我们该怎么办?
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_38_22
Shi-qiu Meng, Lin Lu, K. Yuan, Doris G. Yang, Icey Zhang
In this interview, Prof. Lin Lu introduced ways to improve sleep and relieve stress, influences of sleep on the heart and mental health, essential qualities of psychiatrists, etc. His major viewpoints are: (a) sleep deprivation disrupts physiological functions, (b) prevalence of mental health problems in the general population, health-care workers, and students showed an increasing trend following COVID-19, and (c) it is a tendency for doctors to develop a comprehensive and integrated treatment plan from the physical and mental perspectives.
在这次采访中,林路教授介绍了改善睡眠和缓解压力的方法、睡眠对心脏和心理健康的影响、精神科医生的基本素质等,新冠肺炎后,学生人数呈增加趋势,(c)医生倾向于从身心角度制定全面综合的治疗计划。
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引用次数: 1
Neutrophil-to-Lymphocyte Ratio and Outpatient Management of Low-Risk Acute Pulmonary Embolism 中性粒细胞与淋巴细胞比值与低危急性肺栓塞的门诊管理
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_20_21
Abdolmohammad Ranhbar, B. Sohrabi, Reza Hajizadeh, M. Shoar, Hadiseh Kavandi, Sahar Ghodratizadeh, Hanieh Sakha, Kamran Mohammadi
Purpose: Low-risk pulmonary thromboembolism (PTE) outpatient management has been described recently. The blood neutrophil/lymphocyte ratio (NLR) has been shown to be a useful marker of cardiovascular disease and an independent predictor of cardiac mortality. The predictive value of NLR in predicting mortality of low-risk PTE was evaluated in this study. Materials and Methods: The total of 168 patients with definite pulmonary embolism diagnosed by computed tomography angiography whose on-admission simplified Pulmonary Embolism Severity Index (PESI) score was zero enrolled in this study. The survival rate of patients according to their NLR was evaluated. Results: During 12 months' follow-up period, eight patients (4.7%) died. None of the patients with an NLR of <3.2 died during the follow-up. The median values of NLR in the nonsurvivor and survivor groups were 9.2 ± 3.03 (2–29.5) and 4.69 ± 0.43 (0.8–24.5), respectively. NLR values were significantly higher in nonsurvivors compared to survivors (P = 0.043). Conclusion: This study suggests that patients with zero PESI score and NLR <3.2 could be managed patiently with good results.
目的:低风险肺血栓栓塞(PTE)的门诊管理已被描述最近。血液中性粒细胞/淋巴细胞比率(NLR)已被证明是心血管疾病的有用标志和心脏死亡率的独立预测因子。本研究评估NLR对低危PTE死亡率的预测价值。材料与方法:本研究共纳入168例经计算机断层血管造影诊断为明确肺栓塞且入院时简化肺栓塞严重指数(PESI)评分为零的患者。根据NLR评估患者的生存率。结果:随访12个月,死亡8例(4.7%)。NLR <3.2的患者在随访期间均无死亡。非存活组和存活组NLR的中位值分别为9.2±3.03(2-29.5)和4.69±0.43(0.8-24.5)。非幸存者的NLR值明显高于幸存者(P = 0.043)。结论:本研究提示PESI评分为零、NLR <3.2的患者可以耐心治疗,效果良好。
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引用次数: 0
Exercise, Advanced Glycation End Products, and Their Effects on Cardiovascular Disorders: A Narrative Review 运动、晚期糖基化终产物及其对心血管疾病的影响:一项叙述性综述
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_31_22
S. Hooshiar, Helia Esmaili, A. Taherian, S. Jafarnejad
Lifelong accumulation of advanced glycation end products (AGEs) is linked to cardiovascular disease (CVD). As a result of AGEs, cardiovascular dysfunction develops and progresses via two main mechanisms: cross-linking AGEs with tissue proteins and binding of AGEs to their receptor for AGE (RAGE). In addition, the formation of atherosclerotic plaques in these patients may be due to increased oxidative stress, leading to an elevation in blood circulation and tissue AGEs. Increasing physical activity is a critical approach among the different strategies to manage the deleterious effects of these changes caused by disease. Exercise prevents the accumulation of AGEs and slows the progression of chronic disease sequels. Exercise reduces AGE levels through a reduction of insulin sensitivity, fat mass, inflammation, and RAGE expression. An improvement in glucose metabolism and glycemic control are also other possible explanations. Reduced peripheral insulin resistance may attenuate AGE accumulation. Physical exercise causes more antioxidant enzyme secretion and reduces oxidative stress. Antioxidant and anti-inflammatory endothelial function is improved by exercise. After exercise, subendothelial matrix stiffness decreases, and endothelial function is improved. In this current study, the association between AGEs and exercise and their interaction effects on CVD are discussed.
晚期糖基化终产物(AGEs)的终生积累与心血管疾病(CVD)有关。由于AGEs,心血管功能障碍通过两种主要机制发展和发展:AGEs与组织蛋白的交联和AGEs与其AGE受体(RAGE)的结合。此外,这些患者动脉粥样硬化斑块的形成可能是由于氧化应激增加,导致血液循环和组织AGEs升高。在管理疾病引起的这些变化的有害影响的不同策略中,增加体育活动是一种关键方法。运动可以防止AGEs的积累,减缓慢性病后遗症的进展。运动通过降低胰岛素敏感性、脂肪量、炎症和RAGE表达来降低AGE水平。葡萄糖代谢和血糖控制的改善也是其他可能的解释。外周胰岛素抵抗降低可能会减弱AGE的积累。体育锻炼可以分泌更多的抗氧化酶,减少氧化应激。运动可以改善抗氧化和抗炎的内皮功能。运动后,内皮下基质硬度降低,内皮功能改善。在本研究中,讨论了AGEs与运动之间的关系及其对CVD的相互作用。
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引用次数: 5
A Narrative Review on Exercise and Cardiovascular Events: “Primum Non Nocere” 关于运动和心血管事件的叙述性评论:“Primum Non Nocere”
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_25_22
K. Dimitriadis, E. Bletsa, E. Lazarou, I. Leontsinis, P. Stampouloglou, E. Dri, Athanasios Sakalidis, Nikolaos Pyrpyris, P. Tsioufis, G. Siasos, D. Tsiachris, K. Tsioufis
Exercise provides beneficial effects on the primary and secondary prevention of numerous chronic conditions, including cardiovascular disease, diabetes mellitus, and malignancies. Despite its indisputable benefits, exercise can rarely trigger major adverse cardiovascular events such as ventricular arr hythmias, myocardial infarction, or even sudden cardiac arrest in susceptible individuals. Physiological changes that occur during exercise, including increased sympathetic activity and cardiac oxygen requirements, may account for ischemia and trigger ventricular ectopy with eventually adverse outcomes. Tailored preparticipation screening for exercise and sports engagement is fundamental to unveiling underlying pathological conditions. The present review summarizes the overall impact of exercise on cardiovascular health and highlights the recommended prevention strategies.
运动对许多慢性疾病的一级和二级预防具有有益效果,包括心血管疾病、糖尿病和恶性肿瘤。尽管运动有着无可争议的好处,但在易感人群中,运动很少会引发重大不良心血管事件,如室性心律失常、心肌梗死,甚至心脏骤停。运动过程中发生的生理变化,包括交感神经活动和心脏氧气需求的增加,可能是缺血的原因,并引发心室异位,最终导致不良后果。针对运动和体育活动进行量身定制的准备性筛查是揭示潜在病理状况的基础。本综述总结了运动对心血管健康的总体影响,并强调了建议的预防策略。
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引用次数: 4
Cardiac Remodeling in Female Athletes with Relation to Sport Discipline and Exercise Dose – A Cardiac Magnetic Resonance Study 女运动员心脏重构与运动规律和运动剂量的关系——一项心脏磁共振研究
Q4 Psychology Pub Date : 2022-07-01 DOI: 10.4103/hm.hm_19_22
L. Malek, B. Miłosz-Wieczorek, M. Marczak
Purpose: To compare chronic cardiac adaptations to exercise at various intensities and in different sports categories of female athletes. Methods: This was a retrospective study including 30 elite female athletes (members of the National Team), 14 amateur female athletes training 3-6 h per week for several years, and 20 inactive female controls who underwent cardiac magnetic resonance. Results: Left and right ventricular end-diastolic volumes (LVEDVI and RVEDVI) differed between all studied groups. They rose from controls to elite athletes, with amateur athletes in-between (for LVEDVI 73 ± 9 vs. 83 ± 6 vs. 95 ± 13 ml/m2, P < 0.001, for RVEDVI 74 ± 7 vs. 84 ± 6 vs. 97 ± 14 ml/m2, P < 0.001, respectively). Left and right atrial areas (LAA and RAA) were larger in amateur and elite athletes than in controls (P < 0.001), but there was no difference between the two athlete groups. The interventricular septal diameter was mildly higher only in elite female athletes (9 ± 1 mm vs. 8 ± 1 mm, P < 0.001). No difference in the above parameters was found between power and endurance athletes. Three athletes presented with benign myocardial fibrosis in the lower left ventricular (LV)-right ventricle junction point. Conclusions: The hearts of female athletes differed from inactive controls. Part of the changes was related to exercise intensity (LVEDVI and RVEDVI, mild LV muscle thickening), but other changes were not (LAA and RAA). There was no difference in the heart chamber size and LV muscle thickness between studied athletes engaging in power and endurance disciplines. There were also no significant myocardial tissue changes observed in both elite and amateur female athletes.
目的:比较女性运动员对不同强度和不同运动类别运动的慢性心脏适应能力。方法:这是一项回顾性研究,包括30名优秀女运动员(国家队成员),14名业余女运动员,连续几年每周训练3-6小时,以及20名接受心脏磁共振检查的非活动女性对照。结果:所有研究组的左心室和右心室舒张末期容积(LVEDVI和RVEDVI)不同。他们从对照组上升到精英运动员,业余运动员介于两者之间(LVEDVI分别为73±9 vs.83±6 vs.95±13 ml/m2,P<0.001,RVEDVI分别是74±7 vs.84±6 vs.97±14 ml/m2,P=0.001)。业余和精英运动员的左心房和右心房面积(LAA和RAA)大于对照组(P<0.001),但两组运动员之间没有差异。室间隔直径仅在优秀女运动员中略高(9±1mm对8±1mm,P<0.001)。力量和耐力运动员在上述参数上没有差异。三名运动员在左下心室-右心室交界处出现良性心肌纤维化。结论:女性运动员的心脏与非活动对照组不同。部分变化与运动强度有关(LVEDVI和RVEDVI,轻度左心室肌肉增厚),但其他变化则与运动强度无关(LAA和RAA)。参加力量和耐力训练的运动员在心室大小和左心室肌肉厚度方面没有差异。在精英和业余女运动员中也没有观察到显著的心肌组织变化。
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引用次数: 1
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Heart and Mind
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