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The role of exercise training and dietary sodium restriction in heart failure rehabilitation: A systematic review 运动训练和饮食限钠在心力衰竭康复中的作用:系统综述。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-02 DOI: 10.1016/j.disamonth.2024.101781

Heart failure (HF) rehabilitation seeks to enhance the entire well-being and quality of life of those with HF by focusing on both physical and mental health. Non-pharmacological measures, particularly exercise training, and dietary salt reduction, are essential components of heart failure rehabilitation. This study examines the impact of these components on the recovery of patients with heart failure. By conducting a comprehensive analysis of research articles published from 2010 to 2024, we examined seven relevant studies collected from sources that include PubMed and Cochrane reviews. Our findings indicate that engaging in physical activity leads to favorable modifications in the heart, including improved heart contractility, vasodilation, and cardiac output. These alterations enhance the delivery of oxygen to the peripheral tissues and reduce symptoms of heart failure, such as fatigue and difficulty breathing. Nevertheless, decreasing the consumption of salt in one's diet to less than 1500 mg per day did not have a substantial impact on the frequency of hospitalizations, visits to the emergency room, or overall mortality when compared to conventional treatment. The combination of sodium restriction and exercise training can have synergistic effects due to their complementary modes of action. Exercise improves cardiovascular health and skeletal muscle metabolism, while sodium restriction increases fluid balance and activates neurohormonal pathways. Therefore, the simultaneous usage of both applications may result in more significant enhancements in HF symptoms and clinical outcomes compared to using each program alone.

心力衰竭(HF)康复旨在通过关注身心健康,提高心力衰竭患者的整体健康水平和生活质量。非药物措施,尤其是运动训练和饮食减盐,是心力衰竭康复的重要组成部分。本研究探讨了这些措施对心衰患者康复的影响。通过对 2010 年至 2024 年发表的研究文章进行全面分析,我们研究了从 PubMed 和 Cochrane 综述等来源收集的七项相关研究。我们的研究结果表明,参加体育锻炼会使心脏发生有利的变化,包括改善心脏收缩力、血管扩张和心输出量。这些改变可增强向外周组织输送氧气的能力,减轻心力衰竭的症状,如疲劳和呼吸困难。尽管如此,与传统治疗方法相比,将饮食中的食盐摄入量降至每天 1500 毫克以下对住院频率、急诊就诊率或总体死亡率并无实质性影响。由于钠限制和运动训练的作用模式互补,两者结合可产生协同效应。运动可改善心血管健康和骨骼肌新陈代谢,而限钠则可增加体液平衡并激活神经荷尔蒙通路。因此,与单独使用每种方案相比,同时使用这两种应用可能会更显著地改善高血压症状和临床疗效。
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引用次数: 0
Forword: Heart failure and other selected issues in cardiac pathology 前言:心力衰竭及其他心脏病理学选题。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-29 DOI: 10.1016/j.disamonth.2024.101779
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引用次数: 0
Cardiovascular complications during pregnancy: Advancing cardio-obstetrics 孕期心血管并发症:推进心血管产科的发展。
IF 3.8 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-22 DOI: 10.1016/j.disamonth.2024.101780

As the incidence of cardiovascular diseases (CVDs) continues to rise among women of childbearing age, the pregnant population with pre-existing heart conditions presents a complex and heterogeneous profile. These women face varying degrees of risk concerning maternal cardiovascular, obstetric, and fetal complications. Effectively managing adverse cardiovascular events during pregnancy presents substantial clinical challenges. The uncertainties surrounding diagnostic and therapeutic approaches create a dynamic landscape with potential implications for maternal and fetal health. Cardio-obstetrics has become increasingly recognized as a vital multidisciplinary field necessitating a collaborative approach to managing cardiovascular conditions during pregnancy. In this review, we aim to provide a thorough and up-to-date examination of the existing evidence, offering a comprehensive overview of strategies and considerations in the management of cardiovascular complications during pregnancy. Special emphasis is placed on the safety assessment of diagnostic procedures and the exploration of treatment options designed to prioritize the well-being of the mother and fetus. We also explore the significance of a multidisciplinary cardio-obstetrics team in providing comprehensive care for women of childbearing age with or at risk for CVD.

随着育龄妇女心血管疾病(CVDs)发病率的持续上升,患有先心病的孕妇群体呈现出复杂的异质性特征。这些妇女在孕产妇心血管、产科和胎儿并发症方面面临着不同程度的风险。有效控制孕期心血管不良事件给临床带来了巨大挑战。诊断和治疗方法的不确定性给孕产妇和胎儿的健康带来了潜在的影响。越来越多的人认识到,心血管产科是一个重要的多学科领域,需要采取合作的方式来管理孕期心血管疾病。在这篇综述中,我们旨在对现有证据进行全面和最新的研究,对孕期心血管并发症的管理策略和注意事项进行全面概述。我们特别强调了诊断程序的安全性评估,以及旨在优先考虑母亲和胎儿健康的治疗方案的探索。我们还探讨了多学科心血管产科团队在为患有心血管疾病或有此风险的育龄妇女提供全面护理方面的重要意义。
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引用次数: 0
Title Page 标题页
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-20 DOI: 10.1016/S0011-5029(24)00095-6
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引用次数: 0
Information for Readers 读者信息
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-20 DOI: 10.1016/S0011-5029(24)00096-8
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引用次数: 0
C2: Editorial Board C2:编辑委员会
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-20 DOI: 10.1016/S0011-5029(24)00094-4
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引用次数: 0
The efficacy and safety of gene therapy approaches in Parkinson's disease: A systematic review 帕金森病基因治疗方法的有效性和安全性:系统综述。
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-06 DOI: 10.1016/j.disamonth.2024.101754
Chiranjeevee R. Saravanan MBBS , Reem Faiz Hussein Eisa MBBS , Elizabeth Gaviria MD , Amani Algubari MD , Kiran Kishor Chandrasekar MBBS , Pugazhendi Inban MD , Priyadarshi Prajjwal MBBS , Hyma Bamba MBBS , Gurmehar Singh MBBS , Mohammed Dheyaa Marsool Marsool MBChB , Srikanth Gadam MD

Background

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the brain. Despite existing treatments, there remains an unmet need for therapies that can halt or reverse disease progression. Gene therapy has been tried and tested for a variety of illnesses, including PD. The goal of this systematic review is to assess gene therapy techniques' safety and effectiveness in PD clinical trials.

Methods

Online databases PubMed/Medline, and Cochrane were used to screen the studies for this systematic review. The risk of bias of the included studies was assessed using standard tools.

Results

Gene therapy can repair damaged dopaminergic neurons from the illness or deal with circuit anomalies in the basal ganglia connected to Parkinson's disease symptoms. Rather than only treating symptoms, this neuroprotective approach alters the illness itself. Medication for gene therapy is currently administered at the patient's bedside. It can hyperactivate specific brain circuits associated with motor dysfunction. PD therapies are developing quickly, and there aren't enough head-to-head trials evaluating the safety and effectiveness of available treatments. When choosing an advanced therapy, patient-specific factors should be considered in addition to the effectiveness and safety of each treatment option.

Conclusion

In comparison to conventional therapies, gene therapy may be advantageous for PD. It may minimize side effects, relieve symptoms, and offer dependable dopamine replacement.

背景:帕金森病(PD)是一种神经退行性疾病,其特征是大脑中多巴胺能神经元的逐渐丧失。尽管已有一些治疗方法,但对于能阻止或逆转疾病进展的疗法的需求仍未得到满足。基因疗法已在包括帕金森病在内的多种疾病中进行了尝试和测试。本系统综述旨在评估基因治疗技术在帕金森病临床试验中的安全性和有效性:本系统综述使用在线数据库 PubMed/Medline 和 Cochrane 筛选研究。采用标准工具评估了纳入研究的偏倚风险:基因疗法可以修复因疾病而受损的多巴胺能神经元,或治疗与帕金森病症状相关的基底节回路异常。这种神经保护方法不仅能治疗症状,还能改变疾病本身。基因治疗的药物目前是在病人床边使用的。它可以过度激活与运动功能障碍相关的特定脑回路。帕金森病疗法发展迅速,但目前还没有足够的正面试验来评估现有疗法的安全性和有效性。在选择先进疗法时,除了考虑每种治疗方案的有效性和安全性外,还应考虑患者的具体因素:结论:与传统疗法相比,基因疗法可能对帕金森病具有优势。结论:与传统疗法相比,基因疗法可能对帕金森病有优势,它可以最大限度地减少副作用,缓解症状,并提供可靠的多巴胺替代。
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引用次数: 0
Title Page 标题页
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.1016/S0011-5029(24)00083-X
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引用次数: 0
Information for Readers 读者信息
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.1016/S0011-5029(24)00084-1
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引用次数: 0
Ovarian tumors in the pediatric population: An update 儿童卵巢肿瘤:最新进展。
IF 4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-01 DOI: 10.1016/j.disamonth.2024.101691
Berrin Ergun-Longmire MD, Donald E. Greydanus MD, DrHC (Athens)

Research reveals that 1% of neoplasms in females under 17 years of age are ovarian neoplasms and though usually benign, malignant tumors may occur in the pediatric age group. This review considers various current concepts of these tumors including the epidemiology, risk factors, clinical presentations, diagnosis, differential diagnosis, and treatment options including the need to provide fertility-sparing surgery as well as their potential impacts on the psychological well-being of children and adolescents.

We gathered data from the published articles ranging from studies, meta-analyses, retrospective studies, and reviews. We focused on the articles published in English between January 1, 2000, and August 31, 2023. Only a few articles published prior to 2000 were included for historical perspective.

研究显示,17 岁以下女性的肿瘤中有 1%是卵巢肿瘤,虽然通常是良性的,但恶性肿瘤也可能发生在儿童群体中。这篇综述探讨了目前关于这些肿瘤的各种概念,包括流行病学、风险因素、临床表现、诊断、鉴别诊断、治疗方案(包括提供保胎手术的必要性)以及它们对儿童和青少年心理健康的潜在影响。我们从已发表的研究、荟萃分析、回顾性研究和综述等文章中收集数据。我们重点研究了 2000 年 1 月 1 日至 2023 年 8 月 31 日期间发表的英文文章。只有少数 2000 年之前发表的文章被纳入其中,以了解历史。
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引用次数: 0
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