Purpose: Cardiovascular disease (CVD) is more prevalent in men than women, but the mechanisms responsible for this are not fully understood. We aimed to evaluate differences in trimethylamine (TMA), a microbial metabolite and its oxidized form, trimethylamine N-oxide (TMAO), which is thought to promote atherosclerosis, between men and women with coronary heart disease (CHD), using as a reference a non-CVD population. Materials and Methods: This study was carried out within the framework of the CORDIOPREV study (NCT00924937; June 19, 2009), a clinical trial which included 827 men and 175 women with CHD, with a non-CVD population of 375 individuals (270 men and 105 women) as a reference group. Plasma TMA and TMAO were measured by HPLC-MS/MS. The carotid study was ultrasonically assessed bilaterally by the quantification of intima-media thickness of both common carotid arteries (IMT-CC). Results: We found higher TMAO levels and TMAO/TMA ratio in CHD men than CHD women (p=0.034 and p=0.026, respectively). No TMA sex differences were found in CHD patients. The TMA and TMAO levels and TMAO/TMA ratio were lower, and no differences between sexes were found in the non-CVD population. TMAO levels in CHD patients were consistent with higher IMT-CC and more carotid plaques (p=0.032 and p=0.037, respectively) and lower cholesterol efflux in CHD men than CHD women (p<0.001). Conclusions Our results suggest that CHD men have augmented TMAO levels compared with CHD women, presumably as a consequence of higher rate of TMA to TMAO oxidation, which could be associated with CVD, as these sex differences are not observed in a non-CVD population.

An infected aortic aneurysm (IAA) is a rare but potentially life-threatening pathology characterized by rapid growth and a substantial risk of rupture compared to non-infected aneurysms. Reports on the endovscular treatment of infected paravisceral aneurysms are limited in the literature. This article describes our experience with endovascular repair of IAAs involving the visceral arteries and includes a literature review. We present two cases of symptomatic IAAs located at the celiac trunk ostium in high-risk surgical patients. Both cases were successfully treated with the parallel stent grafting (PG) technique in combination with prolonged antibiotic therapy. A bibliographic review of the endovascular treatment of IAAs was also conducted. Complex endovascular repair of paravisceral IAAs using a combination of a thoracic aortic stent graft and PG, together with prolonged antibiotic therapy, appears to be a reasonable treatment option with promising short- and medium-term results.

Background and Objectives: The risk profiles, procedural characteristics, and clinical outcomes for women undergoing bifurcation percutaneous coronary intervention (PCI) are not well defined compared to those in men. Methods: COronary BIfurcation Stenting III (COBIS III) is a multicenter, real-world registry of 2,648 patients with bifurcation lesions treated with second-generation drug-eluting stents.We compared the angiographic and procedural characteristics and clinical outcomes based on sex. The primary outcome was 5-year target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: Women (n=635, 24%) were older, had hypertension and diabetes more often, and had smaller main vessel and side branch reference diameters than men. The pre- and post-PCI angiographic percentage diameter stenoses of the main vessel and side branch were comparable between women and men. There were no differences in procedural characteristics between the sexes. Women and men had a similar risk of TLF (6.3% vs. 7.1%, p=0.63) as well as its individual components and sex was not an independent predictor of TLF. This finding was consistent in the left main and 2 stenting subgroups. Conclusions In patients undergoing bifurcation PCI, sex was not an independent predictor of adverse outcome.

Objective: The scientific literature indicates that there is a correlation between spiritual well-being and stress. However, there is a paucity of knowledge about the interrelationships between these two factors within the context of a Christian community. The objective of this study was to determine the relationship between spiritual well-being and stress in a sample of Peruvian Christians. Methods: This was a cross-sectional and correlational study. The sample consisted of 250 members of a Christian community in southern Peru. The sample was selected by nonprobabilistic purposive sampling. The Spiritual Well-Being Scale (SWBS) and the Stress Scale (SS-7) were used. Results: Negative and statistically significant correlation were found between spiritual well-being religious well-being and existential well-being with stress (p<0.001). The multiple regression analysis showed that spiritual well-being and sex accounted for 27.8% of the variance in stress levels (adjusted R2=0.278). Spiritual well-being (β=-0.512, p<0.001) has a significant negative effect on stress, while being female (β=0.114, p=0.035) is associated with higher stress levels compared to being male. The moderation effect was not significant, indicating that spiritual well-being influences stress similarly across both sexes (b=-0.0303, standard error=0.0405, t=-0.7469, p=0.456). Conclusion These findings support the integration of spiritual well-being into interventions for mental health promotion and prevention with an emphasis on stress; and confirm that the spirituality component of Christians can play an important role in lowering stress levels.

Objective: The scientific literature indicates that there is a correlation between spiritual well-being and stress. However, there is a paucity of knowledge about the interrelationships between these two factors within the context of a Christian community. The objective of this study was to determine the relationship between spiritual well-being and stress in a sample of Peruvian Christians. Methods: This was a cross-sectional and correlational study. The sample consisted of 250 members of a Christian community in southern Peru. The sample was selected by nonprobabilistic purposive sampling. The Spiritual Well-Being Scale (SWBS) and the Stress Scale (SS-7) were used. Results: Negative and statistically significant correlation were found between spiritual well-being religious well-being and existential well-being with stress (p<0.001). The multiple regression analysis showed that spiritual well-being and sex accounted for 27.8% of the variance in stress levels (adjusted R2=0.278). Spiritual well-being (β=-0.512, p<0.001) has a significant negative effect on stress, while being female (β=0.114, p=0.035) is associated with higher stress levels compared to being male. The moderation effect was not significant, indicating that spiritual well-being influences stress similarly across both sexes (b=-0.0303, standard error=0.0405, t=-0.7469, p=0.456). Conclusion These findings support the integration of spiritual well-being into interventions for mental health promotion and prevention with an emphasis on stress; and confirm that the spirituality component of Christians can play an important role in lowering stress levels.

BACKGROUND

Bronchial asthma is one of the most common chronic childhood diseases encountered in the primary care setting. Adherence to recommendations from clinical practice guidelines on asthma can be utilized as an indicator of quality of care when evaluating the implementation of the universal health care in the Philippines.

To determine the clinical profile of pediatric patients with bronchial asthma; and to evaluate the prescription patterns for asthma treatment in a primary care setting.

This was a retrospective cohort study that involved review of the electronic medical records in a rural site of the Philippine Primary Care Studies (PPCS). All patients less than 19 years old who were diagnosed with asthma from April 2019 to March 2021 were included. Quality indicators for asthma care were based on adherence to recommendations from the 2019 Global Initiative for Asthma (GINA) Guidelines.

This study included 240 asthmatic children with mean age of 6 years (SD ± 4.9) and a slight male preponderance (55.4%). Majority (138 children or 57.5%) were less than 6 years old. Out of the 240 children, 224 (93.3%) were prescribed inhaled short-acting beta-agonists (SABA) and 66 (27.5%) were prescribed oral SABA. Only 14 children (5.8%) were prescribed inhaled corticosteroids (ICS), with 13 children (5.4%) given ICS with longacting beta-agonists (LABA) preparations, and one child (0.4%) given ICS alone. Quality indicators used in this study revealed underutilization of ICS treatment across all age groups, and an overuse of SABA-only treatment in children 6 years old and above. Moreover, 71.3% of the total patients were prescribed antibiotics despite the current GINA recommendation of prescribing antibiotics only for patients with strong evidence of lung infection, such as fever or radiographic evidence of pneumonia.

There were 240 children diagnosed with asthma over a 2-year period in a rural community, with a mean age of 6 years old and a slight male predominance. This quality-of-care study noted suboptimal adherence of rural health physicians to the treatment recommendations of the GINA guidelines, with overuse of SABA and underuse of ICS for asthma control.

Background and Objectives: The risk profiles, procedural characteristics, and clinical outcomes for women undergoing bifurcation percutaneous coronary intervention (PCI) are not well defined compared to those in men. Methods: COronary BIfurcation Stenting III (COBIS III) is a multicenter, real-world registry of 2,648 patients with bifurcation lesions treated with second-generation drug-eluting stents.We compared the angiographic and procedural characteristics and clinical outcomes based on sex. The primary outcome was 5-year target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization. Results: Women (n=635, 24%) were older, had hypertension and diabetes more often, and had smaller main vessel and side branch reference diameters than men. The pre- and post-PCI angiographic percentage diameter stenoses of the main vessel and side branch were comparable between women and men. There were no differences in procedural characteristics between the sexes. Women and men had a similar risk of TLF (6.3% vs. 7.1%, p=0.63) as well as its individual components and sex was not an independent predictor of TLF. This finding was consistent in the left main and 2 stenting subgroups. Conclusions In patients undergoing bifurcation PCI, sex was not an independent predictor of adverse outcome.

Objective: The scientific literature indicates that there is a correlation between spiritual well-being and stress. However, there is a paucity of knowledge about the interrelationships between these two factors within the context of a Christian community. The objective of this study was to determine the relationship between spiritual well-being and stress in a sample of Peruvian Christians. Methods: This was a cross-sectional and correlational study. The sample consisted of 250 members of a Christian community in southern Peru. The sample was selected by nonprobabilistic purposive sampling. The Spiritual Well-Being Scale (SWBS) and the Stress Scale (SS-7) were used. Results: Negative and statistically significant correlation were found between spiritual well-being religious well-being and existential well-being with stress (p<0.001). The multiple regression analysis showed that spiritual well-being and sex accounted for 27.8% of the variance in stress levels (adjusted R2=0.278). Spiritual well-being (β=-0.512, p<0.001) has a significant negative effect on stress, while being female (β=0.114, p=0.035) is associated with higher stress levels compared to being male. The moderation effect was not significant, indicating that spiritual well-being influences stress similarly across both sexes (b=-0.0303, standard error=0.0405, t=-0.7469, p=0.456). Conclusion These findings support the integration of spiritual well-being into interventions for mental health promotion and prevention with an emphasis on stress; and confirm that the spirituality component of Christians can play an important role in lowering stress levels.

Purpose: Cardiovascular disease (CVD) is more prevalent in men than women, but the mechanisms responsible for this are not fully understood. We aimed to evaluate differences in trimethylamine (TMA), a microbial metabolite and its oxidized form, trimethylamine N-oxide (TMAO), which is thought to promote atherosclerosis, between men and women with coronary heart disease (CHD), using as a reference a non-CVD population. Materials and Methods: This study was carried out within the framework of the CORDIOPREV study (NCT00924937; June 19, 2009), a clinical trial which included 827 men and 175 women with CHD, with a non-CVD population of 375 individuals (270 men and 105 women) as a reference group. Plasma TMA and TMAO were measured by HPLC-MS/MS. The carotid study was ultrasonically assessed bilaterally by the quantification of intima-media thickness of both common carotid arteries (IMT-CC). Results: We found higher TMAO levels and TMAO/TMA ratio in CHD men than CHD women (p=0.034 and p=0.026, respectively). No TMA sex differences were found in CHD patients. The TMA and TMAO levels and TMAO/TMA ratio were lower, and no differences between sexes were found in the non-CVD population. TMAO levels in CHD patients were consistent with higher IMT-CC and more carotid plaques (p=0.032 and p=0.037, respectively) and lower cholesterol efflux in CHD men than CHD women (p<0.001). Conclusions Our results suggest that CHD men have augmented TMAO levels compared with CHD women, presumably as a consequence of higher rate of TMA to TMAO oxidation, which could be associated with CVD, as these sex differences are not observed in a non-CVD population.

An infected aortic aneurysm (IAA) is a rare but potentially life-threatening pathology characterized by rapid growth and a substantial risk of rupture compared to non-infected aneurysms. Reports on the endovscular treatment of infected paravisceral aneurysms are limited in the literature. This article describes our experience with endovascular repair of IAAs involving the visceral arteries and includes a literature review. We present two cases of symptomatic IAAs located at the celiac trunk ostium in high-risk surgical patients. Both cases were successfully treated with the parallel stent grafting (PG) technique in combination with prolonged antibiotic therapy. A bibliographic review of the endovascular treatment of IAAs was also conducted. Complex endovascular repair of paravisceral IAAs using a combination of a thoracic aortic stent graft and PG, together with prolonged antibiotic therapy, appears to be a reasonable treatment option with promising short- and medium-term results.