Sex differences in conventional and some behavioral cardiovascular risk factors, Analysis of the prevention clinic database

Background: An increase in Cardiovascular Disease (CVD) frequency was observed over the past three decades in low- and middle income countries, especially in Iran. The purpose of the present study was to review and compare the frequencies of conventional and some non-conventional CVD risk factors between men and women in a tertiary level referral cardiovascular teaching hospital in a six month period in the North of Iran.  Methods: A descriptive cross-sectional study was conducted using medical databases including conventional risk factors: opium consumption, physical inactivity, high salt diet, and serum vitamin D level. The chi-square and independent t tests were used to assess the differences between groups.  Results: A total of 740 (55% women) who had available full medical history data were recruited in the study. Approximately 62% of the participants were older than 45 years with the mean age of 54 (14.2) years old. Percentages of hypertension, diabetes, dyslipidemia, and obesity in women were significantly higher than those of men (P<0.05). A total of 50% of all the participants were physically inactive. Men had higher frequency of opium and saltshaker use than women (P<0.05).  Conclusion: The current study indicated that despite the importance of conventional CVD risk factors like diabetes, hypertension, dyslipidemia, and obesity, educational programs should be considered to improve physical activity and reducing salt consumption and awareness about opium use complications

Relay Selection and Power Allocation for Energy Efficiency Maximization in Hybrid Satellite-UAV Networks With CoMP-NOMA Transmission

AbstractNon-orthogonal multiple access (NOMA) and coordinated multi-point (CoMP) are two fundamental techniques considered for the fifth generation (5 G) of wireless communications. In this paper, a hybrid satellite-unmanned aerial vehicle (UAV) relay network (HSURN) is proposed where the UAV relays (URs) employ CoMP transmission to serve the terrestrial users (UEs). Furthermore, all UEs associated with the CoMP-URs form a single NOMA cluster. For this model, an optimization problem is formulated subject to the minimum quality of services (QoSs) requirements of the UEs, transmission power budgets and, successive interference cancellation (SIC), to select URs and allocate their transmission powers for the energy efficiency (EE) maximization. With this insight, first, a computationally efficient sub-optimal UR selection scheme is proposed. Then, the powers are allocated to the selected URs via the Lagrange multipliers optimization (LMO) method. Due to the non-convex nature of the considered problem, it is relatively difficult to be solved. Hence, a metaheuristic teaching-learning-based optimization (TLBO) algorithm is employed to achieve an efficient solution. Simulation results are provided to verify the effectiveness of the proposed sub-optimal relay selection scheme and the TLBO-based power allocation method compared to the LMO conventional method. Besides, the obtained results also reveal that the CoMP-NOMA transmission in the proposed scenario significantly improves the spectral efficiency (SE) and outage probability (OP) of the system compared to non-comp NOMA transmission case.Abstract Non-orthogonal multiple access (NOMA) and coordinated multi-point (CoMP) are two fundamental techniques considered for the fifth generation (5 G) of wireless communications. In this paper, a hybrid satellite-unmanned aerial vehicle (UAV) relay network (HSURN) is proposed where the UAV relays (URs) employ CoMP transmission to serve the terrestrial users (UEs). Furthermore, all UEs associated with the CoMP-URs form a single NOMA cluster. For this model, an optimization problem is formulated subject to the minimum quality of services (QoSs) requirements of the UEs, transmission power budgets and, successive interference cancellation (SIC), to select URs and allocate their transmission powers for the energy efficiency (EE) maximization. With this insight, first, a computationally efficient sub-optimal UR selection scheme is proposed. Then, the powers are allocated to the selected URs via the Lagrange multipliers optimization (LMO) method. Due to the non-convex nature of the considered problem, it is relatively difficult to be solved. Hence, a metaheuristic teaching-learning-based optimization (TLBO) algorithm is employed to achieve an efficient solution. Simulation results are provided to verify the effectiveness of the proposed sub-optimal relay selection scheme and the TLBO-based power allocation method compared to the LMO conventional method. Besides, the obtained results also reveal that the CoMP-NOMA transmission in the proposed scenario significantly improves the spectral efficiency (SE) and outage probability (OP) of the system compared to non-comp NOMA transmission case

Cardiovascular Effects of Switching from Tobacco Cigarettes to Electronic Cigarettes

The VESUVIUS (Vascular Effects of Regular Cigarettes Versus Electronic Cigarette Use) trial was funded by the British Heart Foundation (grant PG/15/64/31681); and supported by Immunoassay Biomarker Core Laboratory, University of Dundee, the Tayside Medical Sciences Centre, and the NHS Tayside Smoking Cessation Service. The funder had no role in the study design, data collection, data analysis, data interpretation, writing of the report, or in the decision to submit for publication. Dr. Donnan has received research grants from AbbVie, Shire, and Gilead Sciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.Peer reviewedPublisher PD

E-cigarette Use and Risk Behaviors among Lesbian, Gay, Bisexual, and Transgender Adults: The Behavioral Risk Factor Surveillance System (BRFSS) Survey

Introduction: We studied prevalence of e-cigarette use among lesbian, gay, bisexual, and transgender (LGBT) individuals and its association with risk behaviors. Methods: Using data from the Behavioral Risk Factor Surveillance System (BRFSS) survey, we assessed self-reported sexual orientation, e-cigarette use, cigarettes, marijuana, smokeless tobacco, and high-risk behavior (using non-prescribed drugs, treatment for sexually transmitted disease, or receiving monetary or drug compensation in exchange for sex in the previous year). We used multivariable-adjusted logistic regression models to study the association between LGBT and risk behaviors. Results: Prevalence of e-cigarette use among LGBT adults was 13%, nearly twice that of heterosexual adults. LGBT were more likely [Odds Ratio (95% Confidence Interval)] to report current use of e-cigarettes 1.84 (1.64,2.06), cigarettes 1.61 (1.49,1.73), marijuana 2.37 (1.99,2.82), and high-risk behavior 3.69 (3.40,4.01) compared to heterosexual adults. Results for smokeless tobacco were not significant. Conclusion: There are disparities in e-cigarette and other risk behaviors among LGBT adults, which may increase risk of adverse health effects in this vulnerable population

Is there any association between contrast-induced nephropathy and serum uric acid levels?

Introduction: During the recent years, several studies have investigated that hyperuricemia is associated with greater incidence of contrast induced nephropathy (CIN). Most of them are in acute conditions like primary percutaneous coronary interventions. This study aimed to assess the relationship between high serum uric acid and incidence of acute kidney injury in patients undergoing elective angiography and angioplasty. Methods: This prospective study was conducted on 211 patients who were admitted to hospital for elective coronary angiography or angioplasty. The researchers measured serum creatinine and uric acid on admission and repeated creatinine measurement in 48 hours and seven days after the procedure. According to serum uric acid, the patients were divided into two groups; group 1 with normal uric acid and group 2 with hyperuricemia which was defined as uric acid more than 6 mg/dL in women and 7 mg/dL in men. CIN is defined as an increased creatinine level of more than 0.5 mg/dL or 25% from the baseline in 48 hours after the intervention. Results: In total, 211 patients with mean age of 60.58 years were enrolled in the study. Of these, 87 (41.2%) patients were in the high uric acid group and 124 (58.8%) were in the normal uric acid group. CIN was occurred in 16 patients (7.5%). Seven out of 16 (8.04%) were in the high uric acid and nine (7.2%) were in the normal uric acid group. There were no significant differences between the two groups (P =0.831). Conclusion: The frequency of CIN development was not different in the patients with hyperuricemia

Erectile Dysfunction as an Independent Predictor of Future Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis

Vascular erectile dysfunction (ED) and cardiovascular disease (CVD) share common risk factors including obesity, hypertension, metabolic syndrome, diabetes mellitus, and smoking. ED and CVD also have common underlying pathological mechanisms, including endothelial dysfunction, inflammation, and atherosclerosis.1 Despite these close relationships, the evidence documenting ED as an independent predictor of future CVD events is limited

Treatment of Traumatic Direct Carotid-Cavernous Fistula with a BeGraft-Covered Stent

The widely accepted option for treating traumatic direct carotid-cavernous fistula (dCCF) has been endovascular treatment using detachable balloons, coils, or embolic agents. Covered stent deployment has been applied by a few operators and has shown promising results. This is a retrospective study on patients with dCCF treated by an endovascular approach using BeGraft, a covered stent. In 4 cases, this device was successfully deployed without any complications. Immediate complete occlusion was achieved in 3 patients (75%) after deployment of the covered stents. One patient required transvenous coiling for occlusion of the remaining endoleak. Follow-up imaging demonstrated 100% fistula occlusion with complete internal carotid artery patency. No early or late complications occurred following treatment. In conclusion, the BeGraft-covered stent could be a promising safe and effective alternative option for the endovascular treatment of dCCF

Development of Risk Prediction Equations for Incident Chronic Kidney Disease

IMPORTANCE ‐ Early identification of individuals at elevated risk of developing chronic kidney disease  could improve clinical care through enhanced surveillance and better management of underlying health  conditions.  OBJECTIVE – To develop assessment tools to identify individuals at increased risk of chronic kidney  disease, defined by reduced estimated glomerular filtration rate (eGFR).  DESIGN, SETTING, AND PARTICIPANTS – Individual level data analysis of 34 multinational cohorts from  the CKD Prognosis Consortium including 5,222,711 individuals from 28 countries. Data were collected  from April, 1970 through January, 2017. A two‐stage analysis was performed, with each study first  analyzed individually and summarized overall using a weighted average. Since clinical variables were  often differentially available by diabetes status, models were developed separately within participants  with diabetes and without diabetes. Discrimination and calibration were also tested in 9 external  cohorts (N=2,253,540). EXPOSURE Demographic and clinical factors.  MAIN OUTCOMES AND MEASURES – Incident eGFR <60 ml/min/1.73 m2.  RESULTS – In 4,441,084 participants without diabetes (mean age, 54 years, 38% female), there were  660,856 incident cases of reduced eGFR during a mean follow‐up of 4.2 years. In 781,627 participants  with diabetes (mean age, 62 years, 13% female), there were 313,646 incident cases during a mean follow‐up of 3.9 years. Equations for the 5‐year risk of reduced eGFR included age, sex, ethnicity, eGFR, history of cardiovascular disease, ever smoker, hypertension, BMI, and albuminuria. For participants  with diabetes, the models also included diabetes medications, hemoglobin A1c, and the interaction  between the two. The risk equations had a median C statistic for the 5‐year predicted probability of  0.845 (25th – 75th percentile, 0.789‐0.890) in the cohorts without diabetes and 0.801 (25th – 75th percentile, 0.750‐0.819) in the cohorts with diabetes. Calibration analysis showed that 9 out of 13 (69%) study populations had a slope of observed to predicted risk between 0.80 and 1.25. Discrimination was  similar in 18 study populations in 9 external validation cohorts; calibration showed that 16 out of 18 (89%) had a slope of observed to predicted risk between 0.80 and 1.25. CONCLUSIONS AND RELEVANCE – Equations for predicting risk of incident chronic kidney disease developed in over 5 million people from 34 multinational cohorts demonstrated high discrimination and  variable calibration in diverse populations