Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: A meta-analysis of cohort studies

This meta-analysis evaluated the potential association of a simultaneously measured inter-arm systolic blood pressure difference (IASBPD) and all-cause mortality and cardiovascular mortality. The Medline, Cochrane Library, Embase, and PubMed databases were searched through to April 14, 2023 for relevant literature. The outcomes were the associations of IASBPD with all-cause and cardiovascular mortality. Finally, 10 cohort studies that included 15 320 individuals were included. An IASBPD of ≥15 mm Hg was associated with increased all-cause mortality (pooled hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.02–1.61) but an IASBPD of ≥10 mm Hg was not (pooled HR 1.28, 95% CI 0.89–1.85). The pooled HR for cardiovascular mortality was 1.88 (95% CI 1.31–2.71) for an IASBPD of ≥10 mm Hg and 1.93 (95% CI 1.24–2.99) for an IASBPD of ≥15 mm Hg. Subgroup analysis showed that younger patients (HR 9.03, 95% CI 2.00–40.82, p = .004) with an IASBPD ≥15 mm Hg were at higher risk of cardiovascular mortality than older patients (HR 1.67, 95% CI 1.06–2.64, p = .03); the difference between groups was statistically significant (p = .04). In conclusions, our findings show that a simultaneously measured IASBPD ≥15 mm Hg predicts increased all-cause mortality and an IASBPD of ≥15 mm Hg or ≥10 mm Hg predicts increased cardiovascular mortality. An IASBPD ≥15 mm Hg appears to be more correlated with cardiovascular mortality in younger patients than in older patients.     

A rare case of cardiogenic shock caused by takotsubo syndrome associated with SARS-CoV-2 infection: The value of echocardiography in the diagnosis and monitoring of the efficacy of extracorporeal membrane oxygenation

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly invades the respiratory system, but may also cause various cardiovascular complications. We report a rare case of myocarditis associated with SARS-CoV-2 infection. A 61-year-old man was admitted to the hospital with a positive nucleic acid test for SARS-CoV-2. A sudden increase in troponin level (up to .144 ng/mL) was observed on the 8th day after admission. He developed symptoms of heart failure and progressed rapidly to cardiogenic shock. Echocardiography on the same day showed reduced left ventricular ejection fraction, reduced cardiac output, and segmental ventricular wall motion abnormalities. Takotsubo cardiomyopathy associated with SARS-CoV-2 infection was considered based on the typical echocardiography findings. We immediately started veno-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment. The patient was successfully withdrawn from VA-ECMO after 8 days following recovery of ejection fraction to 65% and all indicators qualifying the withdrawal criteria. Echocardiography plays an important role in dynamic monitoring of cardiac changes in such cases and can help determine the timing of extracorporeal membrane oxygenation treatment and withdrawal.     

The Acne Disability Index: Usefulness confirmed

One hundred and four patients with acne completed a questionnaire derived from the Cardiff Acne Disability Index Questionnaire. In addition, 59% of patients returned an identical follow-up questionnaire 6 months later. Significant disability from acne was identified in many patients, with the median initial Acne Disability Index (ADI) being 6 (maximum possible 15), improving to 3 after treatment. Scores correlated poorly with the clinical severity of acne. The questionnaire proved useful for identifying patients with poor self-image who might benefit from more potent treatment for their acne, and to evaluate the effect of treatment.     

The characteristics of a 12-lead electrocardiogram measuring premature ventricular contractions originating from the tricuspid annulus using the clock position method

Objective

This study aimed to analyze the conventional surface electrocardiogram (ECG) characteristics of premature ventricular contractions (PVCs) originating from the tricuspid annulus and to investigate the efficacy of locating their origins according to ECG results.

Methods

Eight patients who underwent radiofrequency ablation in the First Hospital of Shanxi Medical University (China) were included in the study. Pace mapping (PM) was used to analyze the characteristics of the PVCs originating from the tricuspid annulus recorded via 12-lead body surface ECGs.

Results

An R-wave was found in leads I, V₅, and V₆. The QRS wave was narrower when the PVCs originated from the septum and shifted in lead V₃ (R-wave amplitude/S-wave amplitude in the precordial lead—1). The QRS wave was broadest when the PVCs originated from the 7 to 9 o'clock position. The augmented vector left lead showed RS, QS, or RSR-type waves with a low amplitude when the PVCs originated from the upper part of the annulus. When the PVCs originated from the lower part of the annulus, the augmented vector right lead reflected multidirectional and QS-type waves.

Conclusion

The ECG-lead characteristics related to the origin of PVCs in the tricuspid annulus indicate some level of significance and can be used to formulate a specific diagnosis.     

A novel mutation in a CARD14-associated papulosquamous eruption

CARD14-associated papulosquamous eruption (CAPE), a spectrum that includes clinical features of psoriasis and pityriasis rubra pilaris (PRP), is associated with activating mutations in the CARD14 gene. Herein we describe the clinical features of a family with CAPE and a novel mutation of CARD14, and highlight ectropion as part of the phenotypic spectrum of CAPE.     

Adipose-derived mesenchymal stem cells-sourced exosomal microRNA-7846-3p suppresses proliferation and pro-angiogenic role of keloid fibroblasts by suppressing neuropilin 2

Background

Exosomes (Exos) and their contained microRNAs (miRNAs) have been emergingly recognized as key regulators in spanning biological processes, including proliferation and angiogenesis.

Aim of the study

This work investigates the function of Exos derived from adipose-derived mesenchymal stem cells (adMSCs) in viability of keloid fibroblasts (KFs).

Methods

Abnormally expressed miRNAs in keloid tissues were screened using the GEO dataset GSE113620. Meanwhile, miRNAs enriched in adMSC-Exos were predicted by bioinformatics system. Exos were extracted from acquired adMSCs and identified, which were co-incubated with KFs. Uptake of Exos by KFs was examined by fluorescence staining. Viability, proliferation, and apoptosis of KFs were analyzed by CCK-8, EdU labeling, and TUNEL assays. Conditioned medium of KFs was collected to stimulate angiogenesis of human umbilical vein endothelial cells (HUVECs). Binding between miR-7846-3p and neuropilin 2 (NRP2) was validated by luciferase assay. Protein levels of NRP2 and the Hedgehog pathway molecules were analyzed by western blot analysis.

Results

miR-7846-3p was predicted as an exosomal miRNA aberrantly expressed in keloids. AdMSC-Exos reduced viability, proliferation, and apoptosis resistance of KFs, and they blocked the angiogenesis of HUVECs. miR-7846-3p targeted NRP2 mRNA. miR-7846-3p upregulation in KFs suppressed NRP2 expression and reduced the expression of Hedgehog pathway molecules SHH, SMO, and GLI1. Either miR-7846-3p inhibition in Exos or NRP2 overexpression in KFs blocked the effects of Exos and restored the viability, proliferation, and pro-angiogenic role of KFs.

Conclusion

This work unravels that adMSC-Exos-derived miR-7846-3p suppresses NRP2 and inactivates the Hedgehog signaling to reduce proliferation and pro-angiogenic role of KFs.     

Safety and efficacy of CO2 dot matrix laser combined with platelet-rich plasma on depressed scar after acne vulgaris and influencing factors of its repair effect: A retrospective analysis

Background

Acne vulgaris (AV) is the most pervasive inflammatory disease of hair follicle and sebaceous gland in the dermatology department, and depressed scar (DS) is the most common and serious sequela of AV.

Aims

To explore the clinical value of CO₂ dot matrix laser combined with platelet-rich plasma (PRP)-treated AV.

Methods

Total 81 patients with DS at the rear of AV from December 2018 to October 2019 were selected, randomly divided into observation group (OG, n = 39) and control group (CG, n = 42). Patients in the OG group were treated with CO₂ dot matrix laser combined with PRP, and those in the CG group were treated with CO₂ dot matrix laser. To observe clinical outcomes in both groups.

Results

According to experimental analysis, compared with the CG group, CO₂ dot matrix laser combined with PRP can more strongly improve the clinical efficacy on patients, shorten the scar scabbing time and decrustation time, more effectively contributed to their scar repair, comfort, skin condition, psychological state and satisfaction, and reduced their pain. The subsequent follow-up results also showed that patients in the OG group experienced better quality of life. Moreover, according to the logistic regression analysis, the course of disease, scar degree, and staying up late were independent risk factors for the repair effect, and the repair method of CO₂ dot matrix laser combined with PRP was an independent protection factor.

Conclusion

To sum up, CO₂ dot matrix laser combined with PRP can strongly enhance the scar repair effect, psychological state, and life quality of patients with DS after AV, so it is worth popularizing in clinical practice.