No abstract available.
Interleukin-6* ; Lymphocytes*

Hypertrophic cardiomyopathy (HCM) is a genetic disease associated with a risk of malignant ventricular tachyarrhythmias and sudden cardiac death (SCD). Assessment of the SCD risk is crucial for its clinical management, and there has been considerable interest in developing risk stratification strategies. An implantable cardioverter-defibrillator (ICD) is a life-saving treatment for patients with HCM who are at a high-risk of ventricular tachyarrhythmias and SCD. However, a substantial number of ICD recipients experience adverse effects arising from inappropriate device therapy and implant-related complications. This has led to numerous investigations of the risk of SCD and the indications for ICD implantation. American guidelines were recently updated to include new risk markers, including left ventricular systolic dysfunction, apical aneurysm, and extensive late gadolinium enhancement, while European guidelines recommend individualized estimated 5-year SCD risk assessment models. Studies evaluating other risk factors for SCD in patients with HCM have also been published. Drawing on recent guidelines and publications on clinical risk factors, we focus this review on updated risk assessments for SCD with ICD therapy in patients with HCM.

Lowering low-density lipoprotein-cholesterol (LDL-C) is the primary target to prevent cardiovascular events in patients with dyslipidemia at high risk for cardiovascular disease. Many patients on statin therapy have initial or recurrent coronary heart disease events despite reductions in LDL-C. Indeed, 2/3 of patients on statin therapy suffer from residual risk. Low high-density lipoprotein-cholesterol (HDL-C) and high triglycerides levels are modifiable and important factors to resolve a residual risk. Especially, low serum levels of HDL-C (< 40 mg/dL for men, < 50 mg/dL for women) are highly prevalent and are recognized as an independent risk factor for cardiovascular morbidity (myocardial infarction, stroke, peripheral arterial disease, and restenosis after coronary stenting) and mortality. Thus, therapy focusing on raising HDL-C may be an important paradigm for treating and slowing progression of atherosclerosis, coronary heart disease, and co-morbid metabolic disorders. In this review, we discuss the importance of HDL-C based on experimental and large scaled clinical trials.
Cardiovascular Diseases ; Cholesterol ; Coronary Artery Disease ; Coronary Disease ; Dyslipidemias ; Heart Diseases ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Infarction ; Lipoproteins ; Male ; Peripheral Arterial Disease ; Risk Factors ; Stroke ; Triglycerides

Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.
Adult ; Basal Ganglia ; Brain ; Brain Ischemia ; Brain Stem ; Cerebellum ; Cerebrovascular Circulation ; Follow-Up Studies ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Magnetic Resonance Imaging ; Male ; Perfusion

Intracranial chordoma is a rare tumor, originating from embryonic remnants of the primitive notochord. It typically appears as an enhancing extradural midline tumor with bone involvement. We introduce a rare case of a 27-year-old male who had a nonenhancing intradural chordoma showing paramedian location, involving the left cavernous sinus, Meckel's cave, and prepontine cistern. The pathologic diagnosis was confirmed as an intradural chordoma. The imaging findings of this unusual case of a nonenhancing intradural paramedian chordoma will be presented with the differential diagnosis focused on the epidermoid cyst.

BACKGROUND AND OBJECTIVES: Empirical evidence is lacking on the cumulative disease burden of obesity and hypertension and its impact on cardiac function and exercise capacity. The purpose of this study was to determine whether the presence of obesity and hypertension together was associated with cardiac dysfunction and exercise capacity. SUBJECTS AND METHODS: Using a retrospective study design, medical records were reviewed for echocardiographic and treadmill exercise stress test data. Subjects were grouped according to four categories: normal control, obese, hypertensive, or obese and hypertensive. RESULTS: Obese, hypertensive persons showed significantly lower Ea and E/A ratio and greater E/Ea ratio, deceleration time, left ventricular (LV) mass, and LV mass index compared to their counter parts (normal control, obese and/or hypertensive) (all p<0.05), after controlling for age and sex. After controlling for age and sex, significant differences in exercise capacity indices were found, with the obese group having shorter exercise time, lower metabolic equivalents, and lower maximal oxygen uptake than the normal control, hypertensive, or both groups (all p<0.05). The hypertensive or obese and hypertensive group had greater maximal blood pressure compared with the normal control group (all p<0.001). Obese and hypertensive persons were approximately three times more likely to have diastolic dysfunction (odd ratio=2.96, p=0.001), when compared to the reference group (normotensive, non-obese, or hypertensive only persons). CONCLUSION: Diastolic dysfunction was associated with obesity and/or hypertension. The cumulative risk of obesity and hypertension and their impact on diastolic dysfunction which could be modifiable could reduce exercise capacity.
Blood Pressure ; Deceleration ; Echocardiography ; Exercise Test ; Humans ; Hypertension* ; Medical Records ; Metabolic Equivalent ; Obesity* ; Oxygen ; Retrospective Studies

In the article, the 3rd author's affiliation was misspelled.

PURPOSE: This study was done to understand nursing students' exposure of needlestick and sharp injuries (NSSI), level of anxiety as well as experience of practicing injection with human beings during Fundamentals of Nursing (FN) practice. METHODS: Data consisted of self-report questionnaires completed by 571 nursing students who had completed an injection practice in FN. The questionnaire included questions on general characteristics, exposure to NSSI, experience of practicing injections with human beings, level of anxiety and other experiences. Data were analyzed using descriptive statistics and content analysis. RESULTS: Of the students, 17.5% experienced NSSI and 83.2% performed invasive injection procedures in the FN practice. The level of anxiety was 4.62–6.46/10 points when injecting a classmate and 1.27–1.93/10 points when using manikins. The feeling most often reported was worried about making a mistake that could hurt my classmate (57.2%). CONCLUSION: Nursing students are exposed to NSSI and experience a high degree of anxiety in invasive injection practice. These results indicate that it is necessary to develop and implement standardized NSSI prevention and anxiety reduction programs in FN.
Anxiety* ; Humans* ; Manikins ; Needlestick Injuries* ; Nursing ; Students, Nursing