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Islam MN, Raiyan KR, Mitra S, Mannan M, Tasnim T, Putul AO, Mandol AB. Predictis: an IoT and machine learning-based system to predict risk level of cardio-vascular diseases. BMC Health Serv Res 2023; 23:171. [PMID: 36803252 PMCID: PMC9940443 DOI: 10.1186/s12913-023-09104-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/25/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Despite technological advancement in the field of healthcare, the worldwide burden of illness caused by cardio-vascular diseases (CVDs) is rising, owing mostly to a sharp increase in developing nations that are undergoing fast health transitions. People have been experimenting with techniques to extend their lives since ancient times. Despite this, technology is still a long way from attaining the aim of lowering mortality rates. METHODS From methodological perspective, a design Science Research (DSR) approach is adopted in this research. As such, to investigate the current healthcare and interaction systems created for predicting cardiac disease for patients, we first analyzed the body of existing literature. After that, a conceptual framework of the system was designed using the gathered requirements. Based on the conceptual framework, the development of different components of the system was completed. Finally, the evaluation study procedure was developed taking into account the effectiveness, usability and efficiency of the developed system. RESULTS To attain the objectives, we proposed a system consisting of a wearable device and mobile application, which allows the users to know their risk levels of having CVDs in the future. The Internet of Things (IoT) and Machine Learning (ML) techniques were adopted to develop the system that can classify its users into three risk levels (high, moderate and low risk of having CVD) with an F1 score of 80.4% and two risk levels (high and low risk of having CVD) with an F1 score of 91%. The stacking classifier incorporating best-performing ML algorithms was used for predicting the risk levels of the end-users utilizing the UCI Repository dataset. CONCLUSION The resultant system allows the users to check and monitor their possibility of having CVD in near future using real-time data. Also, the system was evaluated from the Human-Computer Interaction (HCI) point of view. Thus, the created system offers a promising resolution to the current biomedical sector. TRIAL REGISTRATION Not Applicable.
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Affiliation(s)
- Muhammad Nazrul Islam
- Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh.
| | - Kazi Rafid Raiyan
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
| | - Shutonu Mitra
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
| | - M. M. Rushadul Mannan
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
| | - Tasfia Tasnim
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
| | - Asima Oshin Putul
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
| | - Angshu Bikash Mandol
- grid.442983.00000 0004 0456 6642Department of Computer Science and Engineering, Military Institute of Science and Technology, Dhaka-1216, Bangladesh
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Ghosh S, Keretsu S, Cho SJ. Designing of the N-ethyl-4-(pyridin-4-yl)benzamide based potent ROCK1 inhibitors using docking, molecular dynamics, and 3D-QSAR. PeerJ 2021; 9:e11951. [PMID: 34434664 PMCID: PMC8359802 DOI: 10.7717/peerj.11951] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/20/2021] [Indexed: 01/20/2023] Open
Abstract
Rho-associated kinase-1 (ROCK1) has been recognized for its pivotal role in heart diseases, different types of malignancy, and many neurological disorders. Hyperactivity of ROCK phosphorylates the protein kinase-C (PKC), which ultimately induces smooth muscle cell contraction in the vascular system. Inhibition of ROCK1 has been shown to be a promising therapy for patients with cardiovascular disease. In this study, we have conducted molecular modeling techniques such as docking, molecular dynamics (MD), and 3-Dimensional structure-activity relationship (3D-QSAR) on a series of N-ethyl-4-(pyridin-4-yl)benzamide-based compounds. Docking and MD showed critical interactions and binding affinities between ROCK1 and its inhibitors. To establish the structure-activity relationship (SAR) of the compounds, 3D-QSAR techniques such as Comparative Molecular Field Analysis (CoMFA) and Comparative Molecular Similarity Indices Analysis (CoMSIA) were used. The CoMFA (q 2 = 0.774, r 2 = 0.965, ONC = 6, and r p r e d 2 = 0.703) and CoMSIA (q 2 = 0.676, r 2 = 0.949, ONC = 6, and r p r e d 2 = 0.548) both models have shown reasonable external predictive activity, and contour maps revealed favorable and unfavorable substitutions for chemical group modifications. Based on the contour maps, we have designed forty new compounds, among which, seven compounds exhibited higher predictive activity (pIC50). Further, we conducted the MD study, ADME/Tox, and SA score prediction using the seven newly designed compounds. The combination of docking, MD, and 3D-QSAR studies helps to understand the coherence modification of existing molecules. Our study may provide valuable insight into the development of more potent ROCK1 inhibitors.
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Affiliation(s)
- Suparna Ghosh
- Department of Biomedical Sciences, College of Medicine, Chosun University, Gwangju, South Korea
| | - Seketoulie Keretsu
- Department of Biomedical Sciences, College of Medicine, Chosun University, Gwangju, South Korea
| | - Seung Joo Cho
- Department of Biomedical Sciences, College of Medicine, Chosun University, Gwangju, South Korea.,Department of Cellular and Molecular Medicine, College of Medicine, Chosun University, Gwangju, South Korea
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Endukuru CK, Gaur GS, Yerrabelli D, Sahoo J, Vairappan B. Impaired baroreflex sensitivity and cardiac autonomic functions are associated with cardiovascular disease risk factors among patients with metabolic syndrome in a tertiary care teaching hospital of South-India. Diabetes Metab Syndr 2020; 14:2043-2051. [PMID: 33113471 DOI: 10.1016/j.dsx.2020.10.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND & AIM Baroreflex sensitivity (BRS) and heart rate variability (HRV) have been proposed to assess early autonomic dysfunction in metabolic syndrome (MetS) patients. Autonomic dysfunction in MetS patients may increase the risk of developing cardiovascular disease (CVD). However, the association of BRS and HRV with CVD risk factors remains elusive in MetS. The primary aim of this study was to assess the BRS and HRV in MetS patients among South-Indian adults and check whether BRS and HRV are associated with CVD risk factors. METHODS We performed anthropometric indices, body composition, physiological parameters such as BRS, HRV, and other autonomic function tests in 176 subjects divided into MetS patients (n = 88) and healthy controls (n = 88). Fasting blood samples were collected for biochemical profiles and calculated insulin resistance indices, atherogenic index (AI), and rate pressure product (RPP). RESULTS When compared to controls, we found significantly reduced BRS and an increased ratio of low-frequency (LF) to high-frequency (HF) power of HRV (LF/HF) in the MetS group. We observed significant differences in body composition and biochemical profiles among the MetS group. BRS and LF/HF ratio of HRV have shown a significant association with CVD risk factors in the MetS group. CONCLUSIONS We observed autonomic dysfunction as low BRS and high LF/HF ratio of HRV in MetS patients. Additionally, the present results emphasize that the association of BRS and LF/HF ratio with anthropometric, glucose, lipid parameters, and other CVD risk factors may increase the susceptibility of MetS patients to higher CVD risk.
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Affiliation(s)
- Chiranjeevi Kumar Endukuru
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Girwar Singh Gaur
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Dhanalakshmi Yerrabelli
- Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Balasubramaniyan Vairappan
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
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Peradze N, Farr OM, Perakakis N, Lázaro I, Sala-Vila A, Mantzoros CS. Short-term treatment with high dose liraglutide improves lipid and lipoprotein profile and changes hormonal mediators of lipid metabolism in obese patients with no overt type 2 diabetes mellitus: a randomized, placebo-controlled, cross-over, double-blind clinical trial. Cardiovasc Diabetol 2019; 18:141. [PMID: 31672146 DOI: 10.1186/s12933-019-0945-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Long-term treatment with up to 1.8 mg liraglutide improves cardiovascular and all-cause mortality in patients with type 2 diabetes at high risk for cardiovascular disease (CVD) and is currently under investigation in subjects without diabetes. Aim of our study was to investigate whether high dose (3 mg) short-term (5 weeks) treatment with liraglutide in obese patients with no overt type 2 diabetes affects metabolites, lipid and lipoprotein profile and components of activin-follistatin axis in cardiovascular beneficial or detrimental way. RESEARCH DESIGN AND METHODS Twenty obese patients participated in a randomized, placebo-controlled, cross-over, double-blind study and were administrated liraglutide 3 mg or placebo for 5 weeks. Metabolites, fatty acids, lipid-lipoprotein profile and concentrations of activins and follistatins (250 parameters) were assessed in serum at start and completion of each treatment. RESULTS Concentrations of important cardiovascular markers such as total, free and remnant cholesterol were reduced with liraglutide before and after adjusting for weight loss. Similarly, reductions in number of small and medium size LDL particles and in their total lipid concentration were observed with liraglutide and partially weight-loss related. Tyrosine levels were reduced and behenic acid levels were increased whereas only minor changes were observed in HDL, VLDL and IDL. Concentrations of activin AB and follistatin were significantly reduced in liraglutide-treated group. CONCLUSIONS Treatment of obese patients without overt type 2 diabetes with high dose of liraglutide for a short period of time induces changes in lipid-lipoprotein and hormonal profile that are suggestive of lower risk of atherosclerosis and CVD. Trial registration ClinicalTrials.gov Identifier: NCT02944500. Study ID Number 2015P000327. Registered November 2016.
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Avishai E, Yeghiazaryan K, Golubnitschaja O. Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine. EPMA J 2017; 8:23-33. [PMID: 28620441 PMCID: PMC5471802 DOI: 10.1007/s13167-017-0081-y] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/29/2017] [Indexed: 12/14/2022]
Abstract
Whereas the physiologic wound healing (WH) successfully proceeds through the clearly defined sequence of the individual phases of wound healing, chronic non-healing wounds/ulcers fail to complete the individual stages and the entire healing process. There are many risk factors both modifiable (such as stress, smoking, inappropriate alcohol consumption, malnutrition, obesity, diabetes, cardio-vascular disease, etc.) and non-modifiable (such as genetic diseases and ageing) strongly contributing to the impaired WH. Current statistics demonstrate that both categories are increasingly presented in the populations, which causes dramatic socio-economic burden to the healthcare sector and society at large. Consequently, innovative concepts by predictive, preventive and personalised medicine are crucial to be implemented in the area. Individual risk factors, causality, functional interrelationships, molecular signature, predictive diagnosis, and primary and secondary prevention are thoroughly analysed followed by the expert recommendations in this paper.
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Affiliation(s)
- Eden Avishai
- Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Kristina Yeghiazaryan
- Radiological Clinic, Medical Faculty, Friedrich-Wilhels-University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
| | - Olga Golubnitschaja
- Radiological Clinic, Medical Faculty, Friedrich-Wilhels-University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
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Jeemon P, Narayanan G, Kondal D, Kahol K, Bharadwaj A, Purty A, Negi P, Ladhani S, Sanghvi J, Singh K, Kapoor D, Sobti N, Lall D, Manimunda S, Dwivedi S, Toteja G, Prabhakaran D. Task shifting of frontline community health workers for cardiovascular risk reduction: design and rationale of a cluster randomised controlled trial (DISHA study) in India. BMC Public Health 2016; 16:264. [PMID: 26975187 PMCID: PMC4791774 DOI: 10.1186/s12889-016-2891-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/18/2016] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Effective task-shifting interventions targeted at reducing the global cardiovascular disease (CVD) epidemic in low and middle-income countries (LMICs) are urgently needed. METHODS DISHA is a cluster randomised controlled trial conducted across 10 sites (5 in phase 1 and 5 in phase 2) in India in 120 clusters. At each site, 12 clusters were randomly selected from a district. A cluster is defined as a small village with 250-300 households and well defined geographical boundaries. They were then randomly allocated to intervention and control clusters in a 1:1 allocation sequence. If any of the intervention and control clusters were <10 km apart, one was dropped and replaced with another randomly selected cluster from the same district. The study included a representative baseline cross-sectional survey, development of a structured intervention model, delivery of intervention for a minimum period of 18 months by trained frontline health workers (mainly Anganwadi workers and ASHA workers) and a post intervention survey in a representative sample. The study staff had no information on intervention allocation until the completion of the baseline survey. In order to ensure comparability of data across sites, the DISHA study follows a common protocol and manual of operation with standardized measurement techniques. DISCUSSION Our study is the largest community based cluster randomised trial in low and middle-income country settings designed to test the effectiveness of 'task shifting' interventions involving frontline health workers for cardiovascular risk reduction. TRIAL REGISTRATION CTRI/2013/10/004049 . Registered 7 October 2013.
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Affiliation(s)
- Panniyammakal Jeemon
- />Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Gitanjali Narayanan
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Dimple Kondal
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Kashvi Kahol
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Ashok Bharadwaj
- />Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh India
| | - Anil Purty
- />Pondicherry Institute of Medical Sciences, Puducherry, India
| | | | | | - Jyoti Sanghvi
- />Sri Aurbindo Institute of Medical Sciences, Indore, India
| | - Kuldeep Singh
- />Sri Aurbindo Institute of Medical Sciences, Indore, India
| | - Deksha Kapoor
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Nidhi Sobti
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Dorothy Lall
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - Sathyaprakash Manimunda
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
- />National Centre for Disease Informatics and Research, ICMR, Bangalore, India
| | | | | | - Dorairaj Prabhakaran
- />Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
| | - On behalf of DISHA study investigators
- />Centre for Control of Chronic Conditions, Public Health Foundation of India, New Delhi, India
- />Centre for Chronic Disease Control, Sector 44, Plot 47, Gurgaon, Haryana India
- />Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh India
- />Pondicherry Institute of Medical Sciences, Puducherry, India
- />Indira Gandhi Medical College, Shimla, India
- />Aga Khan Health Services, Mumbai, India
- />Sri Aurbindo Institute of Medical Sciences, Indore, India
- />National Centre for Disease Informatics and Research, ICMR, Bangalore, India
- />Indian Council of Medical Research, New Delhi, India
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Smith AM, Lingard L, Heslop P, Gray J, Walker DJ. Vascular disease as a cause of death in patients with severe disability due to osteoarthritis and rheumatoid arthritis. Springerplus 2015; 4:328. [PMID: 26180748 PMCID: PMC4495088 DOI: 10.1186/s40064-015-1108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 06/22/2015] [Indexed: 11/11/2022]
Abstract
Objectives The mechanism of the increased risk of cardiovascular disease in rheumatoid arthritis (RA) remains uncertain. We had the opportunity to compare the causes and ages of death in a population of osteoarthritis (OA) and RA patients who had had similar lower limb disability. Methods Death certificates were sought for a population of OA and RA patients who had had knee joint replacements performed by a single orthopaedic surgeon over a 10 year period with a minimum follow up period of 18 years. Primary cause of death was assigned by a blinded clinician and compared between the populations. Competing risk analysis was used to compare RA and OA populations for cardiovascular deaths. Results The total population was 607 (294 OA; 313 RA). 85% (249) of the OA and 79% (246) of the RA patients had deceased at the time of study in 2008. 85% of the death certificates were found. The RA patients were operated an average of 7.5 years younger and also died 7.5 years younger. The causes of death were similar in the two populations. The ages at death were consistently and similarly older for the OA group for all causes of death. There was a 9% increased risk of cardiovascular death in the RA group but this was not statistically different from the OA group. Conclusions OA and RA patients, controlled for lower limb disability, have similar causes of death including cardiovascular disease. However, the RA patients died significantly younger. Cause of death is likely to be related to things that OA and RA share, such as disability and some treatments e.g. NSAIDs, whereas age at death relates to differences, such as age of onset and inflammation.
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Affiliation(s)
- Ann Marie Smith
- Rheumatology Department, Room 22, Musculoskeletal Unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust, The Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
| | - Liz Lingard
- North East Quality Observatory System (NEQOS), 1st Floor, Ridley House, Henry Street, Gosforth, Newcastle upon Tyne, NE3 1DQ UK
| | - Peta Heslop
- Clinical Trials Office, Education Centre, North Tyneside General Hospital, Rake Lane, North Shields, Tyne & Wear, NE29 8NH UK
| | - Janine Gray
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT UK
| | - David J Walker
- Rheumatology Department, Room 22, Musculoskeletal Unit, The Newcastle upon Tyne Hospitals NHS Foundation Trust, The Freeman Hospital, Newcastle upon Tyne, NE7 7DN UK
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Abstract
Background: Settings-based approach for health promotion includes conducting risk factor surveillance as one of its component. It was aimed to estimate the prevalence of CVD risk factors among group C employees of tertiary care hospital in south India. Materials and Methods: A cross-sectional survey was conducted among 400 group C employees aged ≥20 years using the WHO “STEPwise approach to surveillance of non-communicable diseases” (STEPS) methodology. Standardized international protocols were used to measure behavioral risk factors (smoking, alcohol consumption, fruit and vegetable consumption, physical activity) and physical characteristics (weight, waist and hip circumferences, height, and blood pressure). Multivariate analysis was done to predict the factors, which carry independent risk of hypertension. Risk factor profiling of the staff was done using WHO/ISH risk prediction chart to calculate the 10-year risk of a fatal or non-fatal major cardiovascular events (myocardial infarction or stroke), according to age, gender, blood pressure, smoking status, and presence or absence of diabetes mellitus. Results: Mean age in years was 40.9 (±10.4), and men constituted 81.3% of study population. Prevalence of major cardiovascular risk factors was as follows: Current smokers 12.3% men, regular alcohol intake 33.2% among men, overweight (≥23 kg/m2) 74.5%, central obesity 78.7%, hypertension 38.8%, and history of diabetes mellitus 13.2%. Age, gender, physical inactivity, obesity, and family history of hypertension were found to be independently associated with hypertension. Four percent participants had a >10% risk of developing CVD in next 10 years. Conclusion: The prevalence of CVD risk factors is high in the sample population. Employee wellness program should be started in the institute to combat the burden of cardiovascular diseases.
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Affiliation(s)
- K Aswin
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Arun G Ghorpade
- Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Ganesh Kumar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Peigné M, Dewailly D. Long term complications of polycystic ovary syndrome (PCOS). Ann Endocrinol (Paris) 2014; 75:194-9. [PMID: 25156132 DOI: 10.1016/j.ando.2014.07.111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/15/2014] [Accepted: 07/18/2014] [Indexed: 12/18/2022]
Abstract
Polycystic ovary syndrome (PCOS) is a frequent endocrine disease affecting 10 to 15% of women. Menstrual disorders, hyperandrogenism and ultrasonographic aspect of ovaries are typical of the disease and are established diagnostic criteria. But PCOS has also long term complications frequently forgotten and underestimated. During pregnancy, gestational diabetes and gestational hypertensive disorders can occur. At an older age, metabolic disease such as glucose intolerance, type 2 diabetes or dyslipidaemia are frequently described. Women with PCOS have increased classical cardiovascular risks and increased subclinical cardio-vascular disease without proven increase of cardiovascular morbidity and mortality. Finally, endometrial cancer seems to be more frequent in women with PCOS. Therefore, PCOS have numerous long-term health risks and a life-long follow-up is necessary for these women "at-risk" to detect and prevent complications as soon as possible.
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Affiliation(s)
- Maëliss Peigné
- Department of Endocrine Gynaecology and Reproductive Medicine, hôpital Jeanne-de-Flandre, CHRU, avenue Eugène-Avinée, 59037, Lille cedex, France; Université Lille 2, Lille, France.
| | - Didier Dewailly
- Department of Endocrine Gynaecology and Reproductive Medicine, hôpital Jeanne-de-Flandre, CHRU, avenue Eugène-Avinée, 59037, Lille cedex, France; Université Lille 2, Lille, France.
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Herbsleb M, Schulz S, Ostermann S, Donath L, Eisenträger D, Puta C, Voss A, Gabriel HW, Bär KJ. The relation of autonomic function to physical fitness in patients suffering from alcohol dependence. Drug Alcohol Depend 2013; 132:505-12. [PMID: 23664500 DOI: 10.1016/j.drugalcdep.2013.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 03/09/2013] [Accepted: 03/26/2013] [Indexed: 01/14/2023]
Abstract
BACKGROUND Reduced cardio-vascular health has been found in patients suffering from alcohol dependence. Low cardio-respiratory fitness is an independent predictor of cardio-vascular disease. METHODS We investigated physical fitness in 22 alcohol-dependent patients 10 days after acute alcohol withdrawal and compared results with matched controls. The standardized 6-min walk test (6 MWT) was used to analyze the relationship of autonomic dysfunction and physical fitness. Ventilatory indices and gas exchanges were assessed using a portable spiroergometric system while heart rate recordings were obtained separately. We calculated walking distance, indices of heart rate variability and efficiency parameters of heart rate and breathing. In addition, levels of exhaled carbon monoxide were measured in all participants to account for differences in smoking behaviour. Multivariate analyses of variance (MANOVA) were performed to investigate differences between patients and controls with regard to autonomic and efficiency parameters. RESULTS Patients walked a significantly shorter distance in comparison to healthy subjects during the 6 MWT. Significantly decreased heart rate variability was observed before and after the test in patients when compared to controls, while no such difference was observed during exercise. The efficiency parameters indicated significantly reduced efficiency in physiological regulation when the obtained parameters were normalized to the distance. DISCUSSION The 6 MWT is an easily applied instrument to measure physical fitness in alcohol dependent patients. It can also be used during exercise interventions. Reduced physical fitness, as observed in our study, might partly be caused by autonomic dysfunction, leading to less efficient regulation of physiological processes during exercise.
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Affiliation(s)
- Marco Herbsleb
- Pain & Autonomic Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital, Jena, Germany; Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University, Jena, Germany
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Abstract
High sensitive C-reactive protein (hs-CRP), a non-specific marker of inflammatory status has considerable interest focused due to its ability to predict myocardial infarction, stroke, peripheral arterial disease and sudden cardiac death. Alcoholics are known to be associated with inflammation of heart. This study was taken up to look for an association between consumption of alcoholic beverages over 10 years and serum concentration of hs-CRP. 3 groups were studied, 30 age matched control, 30 non-drinkers with cardio vascular complications and 30 alcoholics with history of cardio-vascular disease. Blood was analyzed for hs-CRP. Results indicated that the level of hs-CRP was 0.17 ± 0.16 mg/lit in group 1; 0.79 ± 0.41 mg/lit in group 2 and 1.67 ± 0.16 mg/lit in group 3. A correlation was also obtained between the hs-CRP levels and cardiac efficiency in chronic alcoholics. The elevated hs-CRP levels in chronic alcoholic with heart disease could probably be due to enhanced damaging effect of alcohol on the heart and other organs.
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Affiliation(s)
- R Latha
- Department of Physiology, Father Muller's Medical College, Kanaknady, Mangalore, 575002 India
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