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Cardiometabolic Factors and Breast Cancer: A Case-Control Study in Women 心脏代谢因子与乳腺癌:一项妇女病例对照研究
Q4 Medicine Pub Date : 2013-11-15 DOI: 10.2174/1876526201305010049
Niki Mourouti, C. Papavagelis, M. Kontogianni, Petrini Plytzanopoulou, T. Vassilakou, N. Malamos, A. Linos, D. Panagiotakos
Background: Previous studies have suggested that individual cardiometabolic factors may be associated with an increased risk of breast cancer. Objective: To evaluate the association between individual cardiometabolic factors with breast cancer development. Design: A case - control study. Two-hundred-and-fifty consecutive, newly diagnosed breast cancer female patients (56±12 years) and 250, one-to-one age-matched with the patients, healthy volunteers (controls), were studied. A standardized, validated questionnaire assessing various socio-demographic, clinical, lifestyle and dietary characteristics, was applied through face-to-face interviews. Adherence to the Mediterranean diet was evaluated using the 11-components MedDietScore (theoretical range 0-55). A detailed medical history regarding the common co-morbidities (i.e., diabetes, hypertension, hypercholesterolemia) and their treatment was also recorded, while women were also catego- rized using the Body Mass Index (BMI) as an indicator of obesity. Results: Obesity (i.e., BMI>30 kg/m 2 ) was positively associated with the likelihood of having breast cancer. Conclusions: With the exception of obesity, none of the other tested cardiometabolic risk factors seemed to be a predisposing factor for breast cancer development.
背景:先前的研究表明,个体心脏代谢因素可能与乳腺癌风险增加有关。目的:探讨个体心脏代谢因子与乳腺癌发展的关系。设计:个案对照研究。研究对象为250例连续的新诊断乳腺癌女性患者(56±12岁)和250例与患者年龄一对一匹配的健康志愿者(对照组)。通过面对面访谈,采用标准化、有效的问卷评估各种社会人口、临床、生活方式和饮食特征。采用11组分MedDietScore(理论范围0-55)对地中海饮食的依从性进行评估。还记录了有关常见合并症(即糖尿病、高血压、高胆固醇血症)及其治疗的详细病史,同时还使用体重指数(BMI)作为肥胖指标对妇女进行了分类。结果:肥胖(即体重指数bbb30 kg/ m2)与患乳腺癌的可能性呈正相关。结论:除了肥胖,其他测试的心脏代谢风险因素似乎都不是乳腺癌发展的易感因素。
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引用次数: 3
Management of Pheochromocytoma in Pregnancy: Case Report andReview of the Literature 妊娠期嗜铬细胞瘤的处理:病例报告及文献回顾
Q4 Medicine Pub Date : 2013-11-15 DOI: 10.2174/1876526201305010045
Andromachi Reklou, A. Kamparoudis, A. Mamopoulos, A. Lazaridis, P. Rakitzi, M. Grammatiki, M. Doumas, E. Gkaliagkousi, C. Spiridis, A. Karagiannis
Pheochromocytoma during pregnancy is rare and lethal to the mother and fetus. Its diagnosis is often missed during pregnancy and is usually made during labour or immediately postpartum with increased mortality rates for both the mother and fetus. Early diagnosis and timely, appropriate management reduce possible maternal and fetal complications. A case of pheochromocytoma recognized at early pregnancy is described.
妊娠期嗜铬细胞瘤对母亲和胎儿是罕见且致命的。它的诊断往往在怀孕期间被遗漏,通常是在分娩期间或产后立即做出的,这增加了母亲和胎儿的死亡率。早期诊断和及时、适当的管理可减少可能的母婴并发症。报告一例在妊娠早期发现嗜铬细胞瘤。
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引用次数: 0
LETTER TO THE EDITOR: Dietary Assessment and Cardiovascular Disease Risk Scores 致编辑:饮食评估和心血管疾病风险评分
Q4 Medicine Pub Date : 2013-11-15 DOI: 10.2174/1876526201305010048
E. Georgousopoulou, G. Georgiopoulos, D. Panagiotakos
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引用次数: 0
EDITORIAL: No-Pharmacological Intervention: Pomegranate Juice for the Managementof Hypertension and the Improvement of Cardiovascular Health 社论:无药物干预:石榴汁对高血压的管理和心血管健康的改善
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010023
K. Tziomalos, M. Doumas, V. Athyros
The concept of ideal cardiovascular (CV) health, with emphasis on the prevention of CV disease (CVD), was included by the American Heart Association (AHA) among its strategic goals for 2020 [1]. This concept was intended to focus mainly on the promotion of a healthy lifestyle and the adoption of a multifactorial intervention with nonpharmacological or pharmacological means, aiming at the prevention or the effective control of CVD risk factors [1]. Ideal CV health is defined as optimal levels of 3 CVD risk factors [blood pressure (BP), fasting plasma glucose and total cholesterol) and 4 behaviours [body mass index (BMI), smoking, physical activity and healthy diet] [1]. These 7 ideal CV metrics, called life's simple 7, are probably the best available markers of life-time CVD risk [2]. Recent studies have shown that the levels of ideal CV health in the United States to be very low at a community level [3-5] and to be associated with cardiac events [3], stroke [2] and total mortality [6]. A large study was conducted in 5,785 young adults (20-39 years old) from 5 international populations: the Minneapolis Childhood Cohort Study, the Princeton Follow-up Study, the Bogalusa Heart Study, the Cardiovascular Risk in Young Finns Study, and the Childhood Determinants of Adult Health (CDAH) Study; all members of the International Childhood Cardiovascular Cohort (i3C) Consortium [7]. Results of the study showed that ideal CV health, as defined by the AHA, was rare among young participants of the study. An amazingly low (only 1%) percentage of the participants had all 7 health metrics in the 5,785 young adults participating from all international cohorts [7]. Many of the participants had ideal glucose (73%), cholesterol (64%), and were non-smokers (64%); diet (7%) was the least common metric for participants from any of the cohorts [7]. The lowest prevalence of a clinical CVD risk factor from the life's 7 simple was BP; this was normal in only 52% of the
以预防心血管疾病(CVD)为重点的理想心血管(CV)健康概念已被美国心脏协会(AHA)纳入其2020年战略目标。这一概念旨在主要侧重于促进健康的生活方式和采用非药物或药物手段的多因素干预,旨在预防或有效控制心血管疾病危险因素bb0。理想的心血管健康被定义为3个心血管疾病危险因素(血压、空腹血糖和总胆固醇)和4种行为(体重指数、吸烟、体育活动和健康饮食)的最佳水平。这7个理想的心血管指标,被称为生命简单7,可能是一生心血管疾病风险bb0的最佳标志。最近的研究表明,在美国,理想的心血管健康水平在社区水平上非常低[3-5],并与心脏事件[3]、卒中[2]和总死亡率[6]相关。来自5个国际人群的5,785名年轻人(20-39岁)进行了一项大型研究:明尼阿波利斯儿童队列研究、普林斯顿随访研究、Bogalusa心脏研究、年轻芬兰人心血管风险研究和成人健康的儿童决定因素(CDAH)研究;国际儿童心血管队列(i3C)联盟[7]的所有成员。研究结果表明,按照美国心脏协会的定义,理想的心血管健康在研究的年轻参与者中很少见。在所有国际队列的5,785名年轻人中,具有所有7项健康指标的参与者比例低得惊人(只有1%)。许多参与者有理想的血糖(73%),胆固醇(64%),并且不吸烟(64%);饮食(7%)是所有队列参与者中最不常见的指标。从生活的7个简单的临床心血管疾病危险因素患病率最低的是BP;只有52%的人是正常的
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引用次数: 5
LETTER TO THE EDITORPay-for-performance Versus a Budget-Restrictive System for the Managementof Dyslipidemia. Should this Approach also be Applied in Hypertension? 给编辑的信:按绩效付费与限制预算的血脂异常管理系统。这种方法是否也适用于高血压?
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010032
M. Doumas, K. Tziomalos, V. Athyros
The results of the Dyslipidemia International Study (DYSIS) were reported yesterday in the European Society of Cardiology (ESC) congress held at Amsterdam, Netherlands [1]. DYSIS compared low density lipoprotein cholesterol (LDL-C) target achievement in two West European Countries, UK, with an incentive-driven reimbursement system and Germany, with a budget-restrictive healthcare system. Overall, 80% of UK patients achieved the LDL-C target of <100 mg/dL (mean levels 82 mg/dL), compared with just 42% of patients in Germany (mean levels 111 mg/dL), despite the higher use of ezetimibe in the German population than in the UK population (11 vs. 3%). Dyslipidemic patients in the UK were more likely to be treated with potent statins whereas German doctors were more concerned with insurance restrictions than UK physicians [1]. Thus, it seems that lipid targets are more likely to be achieved in clinical practice in pay-for-performance than in budget-restrictive systems, like in Germany [1]. The UK healthcare system makes physicians participate in a clinical audit, and these results are used to assess the quality of care provided. There are no specific quality-improvement strategies in Germany. Interestingly, the German reimbursement for atorvastatin changed in recent years, and many patients were subsequently switched to the less potent simvastatin [1]. A total of 85% of German patients were treated with simvastatin (average dose 27 mg/d) compared with just 66% of UK patients (average simvastatin dose 37 mg/d), while nearly 25% of UK patients were treated with atorvastatin (average dose 34 mg/d) vs. just
昨天在荷兰阿姆斯特丹举行的欧洲心脏病学会(ESC)大会上报告了血脂异常国际研究(DYSIS)的结果。DYSIS比较了两个西欧国家的低密度脂蛋白胆固醇(LDL-C)目标实现情况,英国采用激励驱动的报销制度,德国采用预算限制的医疗保健制度。总体而言,80%的英国患者达到了LDL-C <100 mg/dL的目标(平均水平为82 mg/dL),而德国患者只有42%(平均水平为111 mg/dL),尽管依折替米比在德国人群中的使用率高于英国人群(11%比3%)。英国的血脂异常患者更有可能接受有效的他汀类药物治疗,而德国医生比英国医生更关心保险限制。因此,在临床实践中,脂质目标似乎更有可能在按绩效付费的系统中实现,而不是在预算限制的系统中,如德国bbb。英国医疗保健系统使医生参与临床审计,这些结果用于评估所提供的护理质量。德国没有具体的质量改进策略。有趣的是,近年来,德国对阿托伐他汀的报销发生了变化,许多患者随后转而使用效力较低的辛伐他汀bbb。共有85%的德国患者接受了辛伐他汀治疗(平均剂量为27mg /d),而英国患者的这一比例仅为66%(平均辛伐他汀剂量为37mg /d),而近25%的英国患者接受了阿托伐他汀治疗(平均剂量为34mg /d)
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引用次数: 2
LETTER TO THE EDITOR: The Effects of Nutraceuticals in Patients with or without Chronic Kidney Disease: Classification Matters 致编辑:营养药品对有或无慢性肾病患者的影响:分类问题
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010035
B. Nikolaidou, N. Katsiki, A. Lazaridis, Andromachi Reklou, M. Grammatiki, M. Doumas
We have read with great interest the study by Cicero and colleagues [1], reporting the long-term effects of lipidlowering nutraceuticals on Low Density Lipoprotein Cholesterol (LDL-C) levels and arterial stiffness. The impressive reduction of LDL-C combined with the excellent safety profile points towards further research in this field and calls for a wider use of nutraceuticals in everyday clinical practice. Furthermore, the beneficial effects of nutraceuticals in patients with chronic kidney disease (CKD) are of clinical importance, since this group of patients is highly susceptible to atherosclerosis and cardiovascular disease is their primary cause of death [2-4].
我们饶有兴趣地阅读了Cicero及其同事b[1]的研究,报告了降脂营养保健品对低密度脂蛋白胆固醇(LDL-C)水平和动脉硬度的长期影响。令人印象深刻的LDL-C的降低以及良好的安全性预示着该领域的进一步研究,并呼吁在日常临床实践中更广泛地使用营养保健品。此外,营养保健品对慢性肾脏疾病(CKD)患者的有益作用具有重要的临床意义,因为这类患者极易发生动脉粥样硬化,心血管疾病是其主要死亡原因[2-4]。
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引用次数: 0
LETTER TO THE EDITOR: Pomegranate Juice is Useful for the Management of Hypertension and the Improvement of Cardiovascular Health 致编辑:石榴汁对高血压的管理和心血管健康的改善是有用的
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010041
K. Tziomalos, M. Doumas, V. Athyros
Price and availability of pomegranate juice (PJ) are indeed two major issues. The daily cost of PJ consumption is ranging from 0.5 to 1 $ per day, according to the dose used. PJ is available in almost all Western and several Asian countries. PJ is preserved in deep refrigeration and is readily available during the entire year. PJ circulates mainly in two forms: pure juice in 200 to 500 mL bottles (adulteration is practically impossible, because the color and the taste are unique) and in 1 L bottles, blended with purple grape juice without added sugar. The later contains resveratrol, a type of natural phenol and a phytoalexin, found in the skin of red grapes with definite antidiabetic effects and proposed but not proved yet anti-aging and anticancer effects. Resveratrol treatment has shown beneficial effects on glucose and lipid metabolism in some, but not all studies [2,3]. Study population, resveratrol source, and dose vary widely, potentially explaining inconsistency of findings among studies. Enhancement in endothelial function, systolic blood pressure, and markers of oxidative stress and inflammation in several studies have been reported [2,3].
石榴汁(PJ)的价格和可得性确实是两个主要问题。根据所使用的剂量,每天服用PJ的费用从0.5美元到1美元不等。PJ几乎在所有西方国家和一些亚洲国家都有。PJ在深度冷藏中保存,全年都可以随时获得。PJ主要以两种形式流通:200至500毫升的纯果汁(实际上不可能掺假,因为颜色和味道都是独特的)和1升的瓶装,与不添加糖的紫葡萄汁混合。后者含有白藜芦醇,这是一种天然苯酚和一种植物抗菌素,在红葡萄皮中发现,具有明确的抗糖尿病作用,并有抗衰老和抗癌作用,但尚未得到证实。在一些研究中,白藜芦醇治疗显示出对糖和脂质代谢的有益作用,但不是所有的研究[2,3]。研究人群、白藜芦醇来源和剂量差异很大,这可能解释了研究结果的不一致。几项研究报道了内皮功能、收缩压、氧化应激和炎症标志物的增强[2,3]。
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引用次数: 1
LETTER TO THE EDITORIs Pomegranate Juice Readily Available and Useful for the Management ofHypertension and the Improvement of Cardiovascular Health 致编辑的信石榴汁随时可用,对高血压的管理和心血管健康的改善有用
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010040
F. Barkas, E. Liberopoulos
[1] Tziomalos K, Doumas M, Athyros V. No-pharmacological intervention: Pomegranate juice for the management of hypertension and the improvement of cardiovascular health. Open Hypertens J 2013, Current Issue. [2] Asgary S, Sahebkar A, Afshani MR, Keshvari M, Haghjooyjavanmard S, Rafieian-Kopaei M. Clinical Evaluation of Blood Pressure Lowering, Endothelial Function Improving, Hypolipidemic and Anti-Inflammatory Effects of Pomegranate Juice in Hypertensive Subjects. Phytotherapy research : PTR 2013. [3] Davidson MH, Maki KC, Dicklin MR, et al. Effects of consumption of pomegranate juice on carotid intima-media thickness in men and women at moderate risk for coronary heart disease. Am J cardiol 2009; 104(7): 936-42. [4] Muraki I, Imamura F, Manson JE, et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies. BMJ 2013; 347: f5001. [5] The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl J Med 1994; 330(15): 1029-35. [6] Heart Protection Study Collaborative G. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 highrisk individuals: a randomised placebo-controlled trial. Lancet 2002; 360(9326): 23-33. [7] Estruch R, Ros E, Salas-Salvado J, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013; 368(14): 1279-90. [8] Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34(28): 2159-219.
[10]王晓明,王晓明,王晓明,等。石榴汁对高血压的治疗作用及其对心血管健康的影响。Open Hypertens J 2013, Current Issue。[10]王晓明,王晓明,王晓明,等。石榴汁对高血压患者降血压、改善内皮功能、降血脂和抗炎作用的临床评价。植物疗法研究:PTR 2013。[10] david MH, Maki KC, Dicklin MR,等。饮用石榴汁对冠心病中度风险男性和女性颈动脉内膜-中膜厚度的影响Am J cardiol 2009;104(7): 936 - 42。[10]张建军,张建军,张建军,等。水果消费与2型糖尿病风险:来自三个前瞻性纵向队列研究的结果。BMJ 2013;347: f5001。维生素E和胡萝卜素对男性吸烟者肺癌和其他癌症发病率的影响。-生育酚,-胡萝卜素癌症预防研究小组。中华医学杂志1994;330(15): 1029 - 35。20536名高危人群补充抗氧化维生素的心脏保护研究:一项随机安慰剂对照试验。《柳叶刀》2002年;360(9326): 23-33。[10]刘建军,刘建军,刘建军,等。地中海饮食对心血管疾病的初级预防。中华医学杂志。2013;368(14): 1279 - 90。[10] Mancia G, Fagard R, Narkiewicz K,等。2013 ESH/ESC动脉高血压管理指南:欧洲高血压学会(ESH)和欧洲心脏病学会(ESC)动脉高血压管理工作组。欧洲心脏杂志2013;34(28): 2159 - 219。
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引用次数: 1
CONGRESS COVERAGE: Obese Children have a Quadrupled Risk of Becoming Hypertensive Adults in Comparison to Children with Normal Weight 国会报道:肥胖儿童成人患高血压的风险是正常体重儿童的四倍
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010043
E. Ganotakis, A. Papagianni, V. Athyros
A few days ago (Sept 12, 2013) the results of a large prospective study that included 1,117 healthy children who were followed up for 27 years were presented in the American Heart Association (AHA) High Blood Pressure Research Scientific Sessions in New Orleans [1]. The aim was to record the development of obesity in childhood and to investigate the incidence of arterial hypertension (HTN) in adults that were obese or overweight children [1]. The original cohort was established in 1986, and consisted of 1,117 healthy children (47% male), recruited from schools in Indianapolis, Indiana, USA (mean age 12 years). During follow-up, blood pressure (BP), height, and weight were measured twice a year. Body mass index (BMI) was calculated from height and weight; weight status was determined by age and sexadjusted BMI percentile values (BMI %). Subjects were classified as normal weight, overweight (BMI% 85% and < 95%), or obese (BMI% 95%) of BMI distribution of the entire cohort [1]. The above revealed that 765 (68%) had normal weight, 176 (16%) were overweight, and 176 (16%) were obese [1]. The rate of adult HTN was higher for those classified as overweight or obese as children (14% and 26% respectively, p = <0.0001). Children classified as overweight or obese had double and quadruple the risk of having HTN in adulthood, respectively, as compared to normal weight children [odds ratio (OR) = 2.2; 95% confidence interval (CI) = 1.3 to 3.6, OR = 4.4; 95% CI = 2.8 to 6.9, respectively] [1]. It has also been shown that children who had one or more high BP readings are 3 times more likely to develop HTN as adults. Using the same pool of Indianapolis kids, researchers found that the rate of high BP during adulthood was 8.6% for children who didn't have a high BP reading when they were young. That rate jumped to 18% for adults who had at least 1 high reading as a kid, and 35% for adults who had 2 or more high readings as children [1]. This study highlights the need for pediatricians to regularly check BP
几天前(2013年9月12日),在新奥尔良举行的美国心脏协会(AHA)高血压研究科学会议上发表了一项大型前瞻性研究的结果,该研究对1117名健康儿童进行了27年的随访。目的是记录儿童时期肥胖的发展情况,并调查肥胖或超重儿童的成人动脉高血压(HTN)的发病率。最初的队列建立于1986年,包括从美国印第安纳州印第安纳波利斯的学校招募的1,117名健康儿童(47%为男性)(平均年龄12岁)。随访期间,每年测量两次血压、身高和体重。体重指数(BMI)由身高和体重计算;体重状况由年龄和性别调整后的BMI百分位数(BMI %)决定。受试者按整个队列BMI分布[1]分为正常体重、超重(BMI% 85%和< 95%)和肥胖(BMI% 95%)。其中体重正常765人(68%),超重176人(16%),肥胖176人(16%)。成人HTN的发生率在儿童超重或肥胖人群中较高(分别为14%和26%,p = <0.0001)。与体重正常的儿童相比,超重或肥胖儿童成年后患HTN的风险分别为两倍和四倍[优势比(or) = 2.2;95%置信区间(CI) = 1.3 ~ 3.6, OR = 4.4;95% CI = 2.8 ~ 6.9]。研究还表明,有一次或多次高血压读数的儿童成年后患HTN的可能性是常人的3倍。研究人员对印第安纳波利斯的同一群孩子进行了研究,发现那些年轻时血压读数不高的孩子成年后血压升高的比例为8.6%。在儿童时期至少有一次高阅读量的成年人中,这一比例跃升至18%,在儿童时期有两次或两次以上高阅读量的成年人中,这一比例跃升至35%。这项研究强调了儿科医生定期检查血压的必要性
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引用次数: 0
LETTER TO THE EDITOR: Pomegranate Juice Intake and Cardiovascular Health 给编辑的信:石榴汁的摄入和心血管健康
Q4 Medicine Pub Date : 2013-11-14 DOI: 10.2174/1876526201305010027
V. Notara, D. Panagiotakos
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引用次数: 0
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Open Hypertension Journal
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