Prevalence of the metabolic syndrome and its association with cardiovascular diseases in Korea

This study aimed to estimate nationwide prevalence of the metabolic syndrome and to identify its association with cardiovascular diseases. The data on a national representative sample of 6,147 adults from 1998 Korea National Health and Nutrition Survey were analyzed. The syndrome was determined according to two kinds of modified definition from ATP III, in which abdominal obesity was determined by waist circumference (WC) standard for Asians and waist-to-hip ratio (WHR). Based on the former, prevalence was 22.1% in men and 27.8% in women. However, based on the latter, prevalence was 28.6% and 27.8%, respectively. Although age-specific prevalence was higher in men than in women among the younger group, it became higher in women among the older group because of its steeper rise with age. In multiple logistic regression, the syndrome was found to be positively associated with cardiovascular diseases (adjusted odds ratios (ORs)1.97 by WC and 1.48 by WHR in men, and 1.54 and 1.31 in women). Moreover, its effect size exceeded that of total cholesterol (adjusted ORs 1.21 in men, and 1.08 in women) or LDL cholesterol (1.58 in men and 1.22 in women). It is obvious that the metabolic syndrome prevails in Korea, and its importance regarding cardiovascular diseases is considerable. Prevention strategies should be implemented immediately to avoid cardiovascular epidemic in the near future.     

Impact of health literacy in patients with cardiovascular diseases: A systematic review and meta-analysis

ObjectiveTo clarify the impacts of health literacy on mortality, readmission, and quality of life (QOL) in the secondary or tertiary prevention of cardiovascular diseases (CVD) through a meta-analysis.MethodsSix electronic databases were searched on June 11, 2020. Observational studies involving patients with CVD, health literacy as an exposure factor and mortality, readmission, or QOL as outcomes were included in this study. Two researchers screened the retrieved articles and extracted data independently. The meta-analysis calculated the pooled relative risk of mortality and readmission. We also assessed the body of evidence based on Grading of Recommendations Assessment, Development and Evaluation (GRADE).ResultsFollowing screening of 1616 studies, 16 observational studies were included. The mean rate of low health literacy was 32.8%. All studies focusing on QOL showed significant impacts of health literacy. Pooled relative risk was 1.621 (95% confidence interval: 1.089–2.412) for mortality and 1.184 (95% confidence interval: 1.035–1.355) for readmission, indicating significant effects of health literacy. GRADE assessment showed “LOW” certainty for each outcome.ConclusionLow health literacy was significantly associated with increased mortality and hospital readmission and decreased QOL in patients with CVD.Practice implicationsConsidering low health literacy in clinical practice is very important to improve prognosis of CVD patients.     

线粒体功能障碍与心血管疾病

 线粒体是真核细胞能量产生的重要细胞器,并在细胞钙稳态、信号传导和细胞凋亡调节中也发挥着举足轻重的作用。导致线粒体功能障碍的可能原因有氧化应激、Ca2+紊乱、线粒体生物合成减少以及线粒体DNA突变等,这些因素也与心血管疾病的发生发展密切相关。认识和研究线粒体功能障碍及其在心血管疾病中的重要作用,对阐明心血管疾病的发病机制、开拓其临床防治和药物研发新思路都具有重要意义。     

Sexting prevalence and correlates: A systematic literature review

Despite considerable controversy and speculation regarding sexting behaviour and its associated risks, to date there has been no integration and analysis of empirical literature on this topic. To collect and synthesise findings of the prevalence of sexting, its correlates, and the context in which it occurs, a systematic search of databases was conducted. Thirty-one studies, reporting on sexting prevalence and a diverse range of related variables, met inclusion criteria. The estimated mean prevalence weighted by sample size was calculated, with trends indicating sexting is more prevalent amongst adults than adolescents, older age is predictive of sexting for adolescents but not adults, and more individuals report receiving sexts than sending them. The correlates of sexting behaviour were grouped in terms of demographic variables, sexual and sexual risk behaviours, attitudes towards sexting, perceived outcomes of sexting, motivations for sexting, mental health and well-being variables, and attachment dimensions. Findings are discussed in terms of the trends indicated by the data, which provided substantiation that sexting behaviour is associated with numerous behavioural, psychological, and social factors. Limitations of the current research literature and future directions are also presented.     

Low cholesterol is associated with mortality from cardiovascular diseases: a dynamic cohort study in Korean adults

This study was conducted to evaluate the association of single serum total cholesterol (TC) measurement with cardiovascular diseases (CVD) deaths in Korean adults. The study subjects were taken from the multi-site collaborative dynamic prospective cohort for epidemiologic investigation on cancer risk in residents nearby nuclear power plants in Korea. A total of 12,740 adults aged 40 to 69 yr who underwent a mass screening examination were followed up from 1993 to 2008. Occurring CVD deaths were confirmed by the death certificates in the National Statistical Office, Korea. Groups with the lowest group having TC < 160 mg/dL as well as the highest group having >= 240 mg/dL were associated with higher CVD mortality in Cox proportional hazards analysis adjusting for age, sex, smoking and drinking status, body mass index, level of blood pressure, triglyceride and high density lipoprotein cholesterol. The distribution of adjusted hazard ratios showed the U-shaped curve. Based on the results of this study, caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk in Korean adults.     

Sexual dysfunction and the ageing male

Male sexuality in older age is an important issue but is not fully understood. This review aims to clarify the normal ageing process, the sexual behaviour of ageing men and the prevalence of sexual dysfunction. It identifies conditions affecting male sexuality in older age and highlights areas where more extensive research is required.     

Aging with a disability: a systematic review of cardiovascular disease and osteoporosis among women aging with a physical disability

Compared to men, women live longer but experience greater morbidity as they age. However, little is known about the rapidly growing population of women aging with disability. Women aging with disabilities may encounter barriers that increase risk of morbidity, including lack of access to medical care or inadequate assistance, equipment, or services. To evaluate risks of morbidity in this group, we conducted a systematic review focused on two important and prevalent conditions: cardiovascular disease (CVD) and osteoporosis. MEDLINE was searched for reports published between January 1, 1990 and August 6, 2010 and additional studies were identified through searches of bibliographies. 9156 abstracts and 93 articles were reviewed to identify empirical studies of women with physical disability who were 45 years or older and that reported CVD or osteoporosis as an outcome and not a cause of the disability. Articles meeting inclusion criteria were then critically appraised to exclude poor quality studies. In seven articles that evaluated CVD outcomes, we found limited evidence to support an increased risk of prevalence of CVD or risk factors for CVD in women aging with physical disabilities compared to non-disabled control populations. The literature is limited by small sample sizes that reduced statistical power to detect true differences. No articles meeting inclusion criteria were identified to evaluate osteoporosis risk in this group. This review is limited by the narrow focus on physical disabilities and two health outcomes. Additional high quality empirical research is necessary to understand the risks to health of women aging with disabilities.     

Frailty is highly prevalent in specific cardiovascular diseases and females,but significantly worsens prognosis in all affected patients: A systematic review

Cardiologists are more often confronted with older (>60 years) cardiovascular disease (CVD) patients. These patients have particular needs in clinical care because, for example, of frailty. However, it remains to be established what is the prevalence of frailty in different CVD’s and how it relates to mortality. In this systematic review studies were included if they: (i) examined subjects (men and women) aged ≥60 years who suffered from any CVD with or without cardiac surgery, (ii.) examined the presence of frailty with a well-defined frailty tool and (iii.) reported prevalence rates of frailty. From thirty studies comprising 96.841 participants, it is found that 1. Frailty is highly common in older patients with CVD (in particular in females (approximately 1.6 times more than in males), in heart failure (up to 80 % of patients) and aortic valve disease (up to 74 % of patients)), and 2. Frailty is related to a 2.5–3.5-fold elevated mortality risk, even in patients with less severe CVD (e.g. percutaneous coronary intervention). Moreover, there is a lack of consistency on how to assess frailty as up to 20 different tools/assessment batteries are currently used. It is concluded that frailty should be assessed in all older CVD patients in a uniform manner to enhance clinical care and outcomes.     

整合素与心血管疾病

细胞 -细胞之间以及细胞 -细胞外基质蛋白之间的正常粘附是细胞生长 ,分化以及迁移的基础 ,负责细胞内、外信号的传递 ,也是心血管系统所有组成成分维持功能正常的前提条件。因此 ,粘附功能异常在心血管疾病发病机制中也起着关键作用。目前为止 ,总共有 6个粘附分子家族 ,整合素 (ｉｎｔｅｇｒｉｎ)是细胞表面介导细胞 -细胞间以及细胞与细胞外基质粘附作用的粘附分子之一 ,与细胞的迁移、增殖和分化密切相关 ,是细胞信息传递的一个重要组成部分。整合素在维持血管正常结构和血管壁的通透性 ,防止血小板沉积和血栓形成 ,促进创伤愈合 ,以及…     

Sexual dysfunction in depression and anxiety: Conceptualizing sexual dysfunction as part of an internalizing dimension

Sexual dysfunction is often implicated in depression and anxiety disorders, but the current nosology of sexual dysfunction, depression, and anxiety (i.e., DSM-IV) does not adequately address these relationships. Because recent papers (Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111–133) have suggested and provided evidence for latent internalizing and externalizing dimensions that help explain high comorbidity between mental disorders, the current paper suggests that sexual dysfunction might conceptually belong to a latent internalizing factor. To address this, evidence is presented for the relationship among disorders of sexual desire, arousal, and orgasm comorbid with depression and anxiety. A review of sexual disorders is also presented along with a critical examination of the way the current DSM is organized with respect to sexual dysfunction, depression, and anxiety.     

Abdominal Aortic Calcification is Associated with Diastolic Dysfunction, Mortality, and Nonfatal Cardiovascular Events in Maintenance Hemodialysis Patients

This study evaluated the significance of aortic calcification index (ACI), an estimate of abdominal aortic calcification by plain abdominal computed tomography (CT), in terms of left ventricular (LV) diastolic dysfunction, mortality, and nonfatal cardiovascular (CV) events in chronic hemodialysis patients. Hemodialysis patients who took both an abdominal CT and echocardiography were divided into a low-ACI group (n = 64) and a high-ACI group (n = 64). The high-ACI group was significantly older, had a longer dialysis vintage and higher comorbidity indices, and more patients had a previous history of CV disease than the low-ACI group. The ACI was negatively correlated with LV end-diastolic volume or LV stroke volume, and was positively correlated with the ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/E' ratio), a marker of LV diastolic function. The E/E' ratio was independently associated with the ACI. The event-free survival rates for mortality and nonfatal CV events were significantly lower in the high-ACI group compared with those in the low-ACI group, and the ACI was an independent predictor for all-cause deaths and nonfatal CV events. In conclusion, ACI is significantly associated with diastolic dysfunction and predicts all-cause mortality and nonfatal CV events in hemodialysis patients.     

Sexual dysfunction in women: population based epidemiological study

Summary Sexual dysfunction is defined as a disturbance of the processes that characterise the sexual response cycle or as pain associated with sexual intercourse. The objective of this epidemiological study, conducted in a representative sample of the population of women aged 20 and older in Casablanca, Morocco, is to determine the prevalence of sexual dysfunction in women. Criteria of sexual dysfunction followed classification by DSM-IV. The mean age of the sample (n = 728) was 36.76 ± 12.67 years; 29% had no education, 78% pursued no professional activity; and 58% were married. The main results were that 26.6% had sexual dysfunction always or often during the 6 months before the study. The most common finding was hypoactive sexual desire disorder, and age, financial dependency, number of children, and sexual harassment were positively associated. The prevalence of remaining disorders resembled that found in the literature. Even though these women were aware about their disorder and its negative impact on their lives, only 17% of them asked for help. Accepted July 28, 2002; Published online October 1, 2002 Correspondence: Prof. Nadia Kadri M.D., University Psychiatric Center Ibn Rushd, Rue Tarik Ibn Ziad, Casablanca, Morocco. E-mail: n.kadri@casanet.net.ma     

Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors

With advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men. The efficacy of phosphodiesterase type 5 inhibitors, together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction. For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder. We sought to evaluate the use of androgens in the treatment of a lack of libido in women, comparing two periods, i.e., before and after the advent of the phosphodiesterase type 5 inhibitors. We also analyzed the risks and benefits of androgen administration. We searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof. We selected articles written in English, Portuguese, or Spanish.After the advent of phosphodiesterase type 5 inhibitors, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder. However, the risks and benefits of testosterone administration have yet to be clarified.     

Distribution of the ankle-brachial index and associated cardiovascular risk factors in a population of middle-aged and elderly koreans

The Doppler ankle-brachial pressure index (ABI) is an objective and efficient tool that can be used to determine the presence and severity of peripheral arterial disease in the lower extremities. The ABI value is inversely associated with other cardiovascular risk factors. To date, there have been no studies of the distribution of ABI in Korea. We performed a cross-sectional study of 1,943 subjects (681 men and 1,262 women; 45-74 yr old) in Namwon, Korea. The prevalence of a low ABI (<0.90) was 2.2% in men and 1.8% in women, and a high ABI (>or=1.30) was prevalent in 3.1% of men and 0.8% of women. Age, smoking habits, waist circumference, hypertension, and blood pressure were associated with ABI values in both sexes. The presence of carotid plaques was associated with ABI values only in men, whereas pulse pressure was associated with ABI values only in women (p<0.05). Although the prevalence of a low ABI in the present study was lower than those reported previously for Western populations and Japanese men, our results suggest that the ABI might be used as an indicator of cardiovascular risk factors in adult Koreans.     

The prevalence and mortality of cryptococcal meningitis in patients with autoimmune diseases: a systematic review and meta-analysis

Growing evidence suggests that autoimmune diseases (AIDs) are risk factors for cryptococcal meningitis (CM). Therefore, understanding the epidemiological and clinical profile of CM in patients with AIDs is important. This meta-analysis assessed the prevalence, clinical profiles, and clinical outcomes of CM in AIDs. Studies on CM in patients with AIDs were searched for in PubMed, EMBASE, Web of Science, and China National Knowledge Infrastructure, and meta-analyses were performed using the statistical program of R. Nineteen studies with 36,631 patients with AIDs were analyzed. The overall pooled CM prevalence was 0.4% (95% confidence interval [CI], 0.3–0.6%), 90.7% of which occurred in female patients. Thirteen studies with 77 patients with AIDs diagnosed with CM were analyzed, and the mortality rate was 26.7% (95% CI, 9.5–47.2%). Of patients with systemic lupus erythematosus, 30.1% of CM cases were initially misdiagnosed (95% CI, 0–65.6%). The primary symptom of CM with AIDs was headache (99.4%; 95% CI, 92.1–100%), followed by fever (93.7%; 95% CI, 82.8–100%) and vomiting (37.2%; 95% CI, 13.2–61.2%). The prevalence of CM infections among patients with AIDs should not be underestimated despite non-specific clinical presentations as there were fatal outcomes. Our results suggest that more research is needed to understand the relationship between AIDs and CM, and clinical trials are necessary to improve treatment strategies.

     

Sexual functioning of cervical cancer survivors: a review with a female perspective

Objective

Sex is an important, often deteriorated, dimension of quality of life after cancer treatment. We conducted a systematic review on sexual functioning of cervical cancer survivors.

Methods

Studies between January 1988 and April 2010 were rated on their internal validity. Results were analyzed focusing on four major categories of sexual functioning: desire, arousal, orgasm, pain. Comparisons were made between healthy controls versus cervical cancer survivors, survivors before versus after treatment and between different treatment modalities.

Results

Twenty studies were included. Most studies showed no differences in the ability to achieve an orgasm. Cervical cancer survivors reported more dyspareunia than healthy controls and dyspareunia was more frequent and lasted longer after radiotherapy. Lack of lubrication was more frequent in cervical cancer survivors and a significant decrease in sexual interest and activity after treatment was found.

Conclusion

Cervical cancer survivors are at risk for sexual pain disorders, while sexual satisfaction (orgasm) is not impaired and radiotherapy negatively influenced sexual pain disorders. Health care providers should inform cervical cancer survivors about the possible risk of developing sexual pain disorders after cervical cancer treatment, especially after radiotherapy. As sexual satisfaction per se is not impaired, we suggest that prevention and treatment of sexual dysfunction should focus on painless and satisfactory sex instead of on resuming intercourse.     

Stem cells for treatment of cardiovascular diseases: An umbrella review of randomized controlled trials

AimsStem cells are a promising therapy for various medical conditions. The literature regarding their adoption for the clinical care of cardiovascular diseases (CVD) is still conflicting. Therefore, our aim is to assess the strength and credibility of the evidence on clinical outcomes and application of stem cells derived from systematic reviews and meta-analyses of intervention studies in CVD.Methods and resultsUmbrella review of systematic reviews with meta-analyses of randomized controlled trials (RCTs) using placebo/no intervention as control group. For meta-analyses of RCTs, outcomes with a random-effect p-value <0.05, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessment was used, classifying the evidence from very low to high. From 184 abstracts initially identified, 11 meta-analyses (for a total of 34 outcomes) were included. Half of the outcomes were statistically significant (p < 0.05), indicating that stem cells are more useful than placebo. High certainty of evidence supports the associations of the use of stem cells with a better left ventricular end systolic volume and left ventricular ejection fraction (LVEF) in acute myocardial infarction; improved exercise time in refractory angina; a significant lower risk of amputation rate in critical limb ischemia; a higher successful rate in complete healing in case of lower extremities ulcer; and better values of LVEF in systolic heart failure, as compared to placebo.Conclusion and relevanceThe adoption of stem cells in clinical practice is supported by a high certainty of strength in different CVD, with the highest strength in acute myocardial infarction and refractory angina.     

Health-related information needs and preferences for information of individuals with cardiovascular disease from underserved populations: A systematic review

ObjectiveThis systematic review aimed to identify the information needs and preferences of individuals with CVD from underserved populations.MethodsFive databases were searched from data inception to February 2022. Pilot and case report studies, non-peer-reviewed literature, and studies published in a language other than English, Portuguese, or Spanish were excluded. Structured and thematic analysis of all included studies were performed. The Critical Appraisal Skills Program and the Downs and Black Checklist were used to assess the quality of the qualitative and quantitative studies, respectively.ResultsOf 35,698 initial records, 19 studies were included, most in observational design and classified as “fair” quality. Underserved populations – women, people living in rural areas, ethnic minority groups, older people, and those with low socioeconomic status – presented unique needs in four main groups, with some similarities across them: information about CVD, primary and secondary prevention of CVD, CVD management, and health care, policies and practices. Across the studies there was a lack of standardization on how individuals’ needs were assessed and reported.ConclusionUnderserved populations with CVD have unique information needs and preferences that should be address during their care.Practical implicationInformation from this study may assist health care professionals with the development of comprehensive strategies to improve their provision of care for specific CVD patient groups.