Science.gov

Sample records for american heart association

  1. Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association.

    PubMed

    Braun, Lynne T; Grady, Kathleen L; Kutner, Jean S; Adler, Eric; Berlinger, Nancy; Boss, Renee; Butler, Javed; Enguidanos, Susan; Friebert, Sarah; Gardner, Timothy J; Higgins, Phil; Holloway, Robert; Konig, Madeleine; Meier, Diane; Morrissey, Mary Beth; Quest, Tammie E; Wiegand, Debra L; Coombs-Lee, Barbara; Fitchett, George; Gupta, Charu; Roach, William H

    2016-09-13

    The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions. Palliative care, defined as patient- and family-centered care that optimizes health-related quality of life by anticipating, preventing, and treating suffering, should be integrated into the care of all patients with advanced cardiovascular disease and stroke early in the disease trajectory. Palliative care focuses on communication, shared decision making about treatment options, advance care planning, and attention to physical, emotional, spiritual, and psychological distress with inclusion of the patient's family and care system. Our policy recommendations address the following: reimbursement for comprehensive delivery of palliative care services for patients with advanced cardiovascular disease and stroke; strong payer-provider relationships that involve data sharing to identify patients in need of palliative care, identification of better care and payment models, and establishment of quality standards and outcome measurements; healthcare system policies for the provision of comprehensive palliative care services during hospitalization, including goals of care, treatment decisions, needs of family caregivers, and transition to other care settings; and health professional education in palliative care as part of licensure requirements.

  2. Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association.

    PubMed

    Braun, Lynne T; Grady, Kathleen L; Kutner, Jean S; Adler, Eric; Berlinger, Nancy; Boss, Renee; Butler, Javed; Enguidanos, Susan; Friebert, Sarah; Gardner, Timothy J; Higgins, Phil; Holloway, Robert; Konig, Madeleine; Meier, Diane; Morrissey, Mary Beth; Quest, Tammie E; Wiegand, Debra L; Coombs-Lee, Barbara; Fitchett, George; Gupta, Charu; Roach, William H

    2016-09-13

    The mission of the American Heart Association/American Stroke Association includes increasing access to high-quality, evidence-based care that improves patient outcomes such as health-related quality of life and is consistent with the patients' values, preferences, and goals. Awareness of and access to palliative care interventions align with the American Heart Association/American Stroke Association mission. The purposes of this policy statement are to provide background on the importance of palliative care as it pertains to patients with advanced cardiovascular disease and stroke and their families and to make recommendations for policy decisions. Palliative care, defined as patient- and family-centered care that optimizes health-related quality of life by anticipating, preventing, and treating suffering, should be integrated into the care of all patients with advanced cardiovascular disease and stroke early in the disease trajectory. Palliative care focuses on communication, shared decision making about treatment options, advance care planning, and attention to physical, emotional, spiritual, and psychological distress with inclusion of the patient's family and care system. Our policy recommendations address the following: reimbursement for comprehensive delivery of palliative care services for patients with advanced cardiovascular disease and stroke; strong payer-provider relationships that involve data sharing to identify patients in need of palliative care, identification of better care and payment models, and establishment of quality standards and outcome measurements; healthcare system policies for the provision of comprehensive palliative care services during hospitalization, including goals of care, treatment decisions, needs of family caregivers, and transition to other care settings; and health professional education in palliative care as part of licensure requirements. PMID:27503067

  3. Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association.

    PubMed

    Page, Robert L; O'Bryant, Cindy L; Cheng, Davy; Dow, Tristan J; Ky, Bonnie; Stein, C Michael; Spencer, Anne P; Trupp, Robin J; Lindenfeld, JoAnn

    2016-08-01

    Heart failure is a common, costly, and debilitating syndrome that is associated with a highly complex drug regimen, a large number of comorbidities, and a large and often disparate number of healthcare providers. All of these factors conspire to increase the risk of heart failure exacerbation by direct myocardial toxicity, drug-drug interactions, or both. This scientific statement is designed to serve as a comprehensive and accessible source of drugs that may cause or exacerbate heart failure to assist healthcare providers in improving the quality of care for these patients.

  4. Multi-modality imaging: Bird's-eye view from the 2014 American Heart Association Scientific Sessions.

    PubMed

    AlJaroudi, Wael A; Einstein, Andrew J; Chaudhry, Farooq A; Lloyd, Steven G; Hage, Fadi G

    2015-04-01

    A large number of studies were presented at the 2014 American Heart Association Scientific Sessions. In this review, we will summarize key studies in nuclear cardiology, computed tomography, echocardiography, and cardiac magnetic resonance imaging. This brief review will be helpful for readers of the Journal who are interested in being updated on the latest research covering these imaging modalities.

  5. Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association.

    PubMed

    Fonarow, Gregg C; Calitz, Chris; Arena, Ross; Baase, Catherine; Isaac, Fikry W; Lloyd-Jones, Donald; Peterson, Eric D; Pronk, Nico; Sanchez, Eduardo; Terry, Paul E; Volpp, Kevin G; Antman, Elliott M

    2015-05-19

    The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life's Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous

  6. Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association.

    PubMed

    Fonarow, Gregg C; Calitz, Chris; Arena, Ross; Baase, Catherine; Isaac, Fikry W; Lloyd-Jones, Donald; Peterson, Eric D; Pronk, Nico; Sanchez, Eduardo; Terry, Paul E; Volpp, Kevin G; Antman, Elliott M

    2015-05-19

    The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life's Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous

  7. Durability of Class I American College of Cardiology/American Heart Association Clinical Practice Guideline Recommendations

    PubMed Central

    Neuman, Mark D.; Goldstein, Jennifer N.; Cirullo, Michael A.; Schwartz, J. Sanford

    2015-01-01

    IMPORTANCE Little is known regarding the durability of clinical practice guideline recommendations over time. OBJECTIVE To characterize variations in the durability of class I (“procedure/treatment should be performed/administered”) American College of Cardiology/American Heart Association (ACC/AHA) guideline recommendations. DESIGN, SETTING, AND PARTICIPANTS Textual analysis by 4 independent reviewers of 11 guidelines published between 1998 and 2007 and revised between 2006 and 2013. MAIN OUTCOMES AND MEASURES We abstracted all class I recommendations from the first of the 2 most recent versions of each guideline and identified corresponding recommendations in the subsequent version. We classified recommendations replaced by less determinate or contrary recommendations as having been downgraded or reversed; we classified recommendations for which no corresponding item could be identified as having been omitted. We tested for differences in the durability of recommendations according to guideline topic and underlying level of evidence using bivariable hypothesis tests and conditional logistic regression. RESULTS Of 619 index recommendations, 495 (80.0%; 95%CI, 76.6%–83.1%) were retained in the subsequent guideline version, 57 (9.2%; 95%CI, 7.0%–11.8%) were downgraded or reversed, and 67 (10.8%; 95%CI, 8.4%–13.3%) were omitted. The percentage of recommendations retained varied across guidelines from 15.4%(95%CI, 1.9%–45.4%) to 94.1%(95%CI, 80.3%–99.3%; P < .001). Among recommendations with available information on level of evidence, 90.5%(95%CI, 83.2%–95.3%) of recommendations supported by multiple randomized studies were retained, vs 81.0% (95%CI, 74.8%–86.3%) of recommendations supported by 1 randomized trial or observational data and 73.7%(95% CI, 65.8%–80.5%) of recommendations supported by opinion (P = .001). After accounting for guideline-level factors, the probability of being downgraded, reversed, or omitted was greater for

  8. Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association.

    PubMed

    Jeejeebhoy, Farida M; Zelop, Carolyn M; Lipman, Steve; Carvalho, Brendan; Joglar, Jose; Mhyre, Jill M; Katz, Vern L; Lapinsky, Stephen E; Einav, Sharon; Warnes, Carole A; Page, Richard L; Griffin, Russell E; Jain, Amish; Dainty, Katie N; Arafeh, Julie; Windrim, Rory; Koren, Gideon; Callaway, Clifton W

    2015-11-01

    This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation.

  9. Multi-modality Imaging: Bird's eye view from the 2015 American Heart Association Scientific Sessions.

    PubMed

    Einstein, Andrew J; Lloyd, Steven G; Chaudhry, Farooq A; AlJaroudi, Wael A; Hage, Fadi G

    2016-04-01

    Multiple novel studies were presented at the 2015 American Heart Association Scientific Sessions which was considered a successful conference at many levels. In this review, we will summarize key studies in nuclear cardiology, cardiac magnetic resonance, echocardiography, and cardiac computed tomography that were presented at the Sessions. We hope that this bird's eye view will keep readers updated on the newest imaging studies presented at the meeting whether or not they were able to attend the meeting.

  10. Acute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association.

    PubMed

    Mehta, Laxmi S; Beckie, Theresa M; DeVon, Holli A; Grines, Cindy L; Krumholz, Harlan M; Johnson, Michelle N; Lindley, Kathryn J; Vaccarino, Viola; Wang, Tracy Y; Watson, Karol E; Wenger, Nanette K

    2016-03-01

    Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.

  11. Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association.

    PubMed

    Eyre, Harmon; Kahn, Richard; Robertson, Rose Marie

    2004-07-01

    Collectively, cardiovascular disease (including stroke), cancer, and diabetes account for approximately two-thirds of all deaths in the U.S. and about US dollars 700 billion in direct and indirect economic costs each year. Current approaches to health promotion and prevention of cardiovascular disease, cancer, and diabetes do not approach the potential of the existing state of knowledge. A concerted effort to increase application of public health and clinical interventions of known efficacy to reduce prevalence of tobacco use, poor diet, and insufficient physical activity-the major risk factors for these diseases-and to increase utilization of screening tests for their early detection could substantially reduce the human and economic cost of these diseases. In this article, the American Cancer Society, American Diabetes Association, and American Heart Association review strategies for the prevention and early detection of cancer, cardiovascular disease, and diabetes, as the beginning of a new collaboration among the three organizations. The goal of this joint venture is to stimulate substantial improvements in primary prevention and early detection through collaboration between key organizations, greater public awareness about healthy lifestyles, legislative action that results in more funding for and access to primary prevention programs and research, and reconsideration of the concept of the periodic medical checkup as an effective platform for prevention, early detection, and treatment.

  12. Familial Hypercholesterolemia and the 2013 American College of Cardiology/American Heart Association Guidelines: Myths, Oversimplification, and Misinterpretation Versus Facts.

    PubMed

    Knowles, Joshua W; Stone, Neil J; Ballantyne, Christie M

    2015-08-01

    Familial hypercholesterolemia (FH) is a genetic condition resulting in severe, lifelong elevations in low-density lipoprotein cholesterol and a marked increased risk of early-onset coronary disease. FH is treatable when identified, yet is vastly under-recognized and undertreated. Although the 2013 American College of Cardiology/American Heart Association guidelines on the treatment of cholesterol presented a paradigm shift, we believe that there have been serious oversimplifications, misinterpretations, and erroneous reporting about the current ACC/AHA cholesterol guidelines that have contributed to suboptimal care for these subjects. In summary, the ACC/AHA guidelines place tremendous emphasis on the identification of patients with FH, the initiation of high-intensity statin therapy, the need to obtain follow-up lipid values to assess the efficacy and compliance to lifestyle and medical therapy, and the role of nonstatin drugs when needed for optimal care of the individual patient. PMID:26043952

  13. [Cardiovascular disease prevention in adults with type 2 diabetes mellitus according to the recent statement from the American Heart Association/American Diabetes Association].

    PubMed

    Avogaro, Angelo

    2016-03-01

    There is a clear epidemiologic association between glycemic control and cardiovascular disease. There is strong evidence of a microvascular benefit by lowering glycated hemoglobin <7% while acknowledging lack of proven macrovascular benefits. It is therefore relevant, in all diabetic patients, to control all major cardiovascular risk factors such as obesity, hypertension, and dyslipidemia. These risk factors, easily measurable, account for 90% of acute myocardial infarction. In this review, the update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus from the American Heart Association and the American Diabetes Association is discussed and commented.

  14. Understanding and Improving Cardiovascular Health: An Update on the American Heart Association's Concept of Cardiovascular Health.

    PubMed

    Shay, Christina M; Gooding, Holly S; Murillo, Rosenda; Foraker, Randi

    2015-01-01

    The American Heart Association's 2020 Strategic Impact Goal is "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." To monitor progress towards this goal, a new construct "ideal cardiovascular health" (iCVH) was defined that includes the simultaneous presence of optimal levels of seven health behaviors (physical activity, smoking, dietary intake, and body mass index) and factors (total cholesterol, blood pressure and fasting blood glucose). In this review, we present a summary of major concepts related to the concept of iCVH and an update of the literature in this area since publication of the 2020 Strategic Impact Goal, including trends in iCVH prevalence, new determinants and outcomes related to iCVH, strategies for maintaining or improving iCVH, policy implications of the iCVH model, and the remaining challenges to reaching the 2020 Strategic Impact Goal. PMID:25958016

  15. Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association.

    PubMed

    Young, Deborah Rohm; Hivert, Marie-France; Alhassan, Sofiya; Camhi, Sarah M; Ferguson, Jane F; Katzmarzyk, Peter T; Lewis, Cora E; Owen, Neville; Perry, Cynthia K; Siddique, Juned; Yong, Celina M

    2016-09-27

    Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes. PMID:27528691

  16. Sedentary Behavior and Cardiovascular Morbidity and Mortality: A Science Advisory From the American Heart Association.

    PubMed

    Young, Deborah Rohm; Hivert, Marie-France; Alhassan, Sofiya; Camhi, Sarah M; Ferguson, Jane F; Katzmarzyk, Peter T; Lewis, Cora E; Owen, Neville; Perry, Cynthia K; Siddique, Juned; Yong, Celina M

    2016-09-27

    Epidemiological evidence is accumulating that indicates greater time spent in sedentary behavior is associated with all-cause and cardiovascular morbidity and mortality in adults such that some countries have disseminated broad guidelines that recommend minimizing sedentary behaviors. Research examining the possible deleterious consequences of excess sedentary behavior is rapidly evolving, with the epidemiology-based literature ahead of potential biological mechanisms that might explain the observed associations. This American Heart Association science advisory reviews the current evidence on sedentary behavior in terms of assessment methods, population prevalence, determinants, associations with cardiovascular disease incidence and mortality, potential underlying mechanisms, and interventions. Recommendations for future research on this emerging cardiovascular health topic are included. Further evidence is required to better inform public health interventions and future quantitative guidelines on sedentary behavior and cardiovascular health outcomes.

  17. Report of the American Heart Association (AHA) Scientific Sessions 2012, Los Angeles.

    PubMed

    Fujita, Jun

    2013-01-01

    The American Heart Association (AHA) Scientific Sessions were held for the first time in Los Angeles in 2012, with the most up-to-date basic and clinical science in the field presented and heard by physicians, research scientists, students, and paramedical personnel from 100 countries. Japan accounted for the second highest number of submitted abstracts and the Japanese Circulation Society actively contributed to the success of the AHA Scientific Sessions this year. The Late-Breaking Clinical Trial sessions comprised 27 clinical studies presented in the main hall. The FREEDOM study revealed the superiority of using a coronary artery bypass graft for diabetic multivessel coronary artery diseases over percutaneous coronary intervention using a drug-eluting stent. A new peptide hormone, serelaxin, improved dyspnea in heart failure patients and significantly reduced mortality rates according to the RELAX-AHF study. In the basic sciences, primary necrosis in mitochondria was the hot topic, while genetics, including genome-wide association studies, and epigenetics were strong features of the basic and clinical cardiovascular (CV) science. It was also clear that regenerative medicine is now part of mainstream CV research, with several clinical trials underway and many basic research projects ongoing around the world. Induced pluripotent stem cells in particular have the potential to change CV medicine, and will underpin the next era of regenerative medicine and personal therapies for heart diseases.

  18. February Is American Heart Month | Poster

    Cancer.gov

    By Camille Rees, Guest Writer February is American Heart Month, and Feb. 7 was designated “National Wear Red Day” by the American Heart Association. The American Heart Association has sponsored the “Go Red for Women” campaign for 10 years. The message: heart disease is the number one killer of women. Did you know that more women die of heart disease than men?  In fact, it is more deadly than all forms of cancer combined. Over the years, the red dress has become the symbol of the fight against heart disease in women.

  19. Transitions of care in heart failure: a scientific statement from the American Heart Association.

    PubMed

    Albert, Nancy M; Barnason, Susan; Deswal, Anita; Hernandez, Adrian; Kociol, Robb; Lee, Eunyoung; Paul, Sara; Ryan, Catherine J; White-Williams, Connie

    2015-03-01

    In patients with heart failure (HF), use of 30-day rehospitalization as a healthcare metric and increased pressure to provide value-based care compel healthcare providers to improve efficiency and to use an integrated care approach. Transition programs are being used to achieve goals. Transition of care in the context of HF management refers to individual interventions and programs with multiple activities that are designed to improve shifts or transitions from one setting to the next, most often from hospital to home. As transitional care programs become the new normal for patients with chronic HF, it is important to understand the current state of the science of transitional care, as discussed in the available research literature. Of transitional care reports, there was much heterogeneity in research designs, methods, study aims, and program targets, or they were not well described. Often, programs used bundled interventions, making it difficult to discuss the efficiency and effectiveness of specific interventions. Thus, further HF transition care research is needed to ensure best practices related to economically and clinically effective and feasible transition interventions that can be broadly applicable. This statement provides an overview of the complexity of HF management and includes patient, hospital, and healthcare provider barriers to understanding end points that best reflect clinical benefits and to achieving optimal clinical outcomes. The statement describes transitional care interventions and outcomes and discusses implications and recommendations for research and clinical practice to enhance patient-centered outcomes.

  20. Report of the American Heart Association (AHA) Scientific Sessions 2013, Dallas.

    PubMed

    Ishimori, Naoki; Kinugawa, Shintaro; Yamada, Satoshi; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Tsutsui, Hiroyuki

    2014-01-01

    The American Heart Association (AHA) Scientific Sessions were held in Dallas on November 16-20, 2013. The meeting is one of the most leading conferences of cardiology in the world, with over 18,000 professional attendees from more than 105 countries. There were 315 invited sessions and 443 abstract sessions, comprising more than 5,000 presentations. The sessions were expanded to 26 program tracks, which included and integrated basic, translational, clinical, and population science. In the series of late-breaking sessions, updates of results from 20 clinical trials were disclosed. Japanese scientists submitted the second most abstracts to the Scientific Sessions in 2013. We appreciate the significant contribution to the sessions by Japanese cardiologists as well as the Japanese Circulation Society.

  1. Associations of adiponectin with individual European ancestry in African Americans: the Jackson Heart Study

    PubMed Central

    Bidulescu, Aurelian; Choudhry, Shweta; Musani, Solomon K.; Buxbaum, Sarah G.; Liu, Jiankang; Rotimi, Charles N.; Wilson, James G.; Taylor, Herman A.; Gibbons, Gary H.

    2014-01-01

    Background: Compared with European Americans, African Americans (AAs) exhibit lower levels of the cardio-metabolically protective adiponectin even after accounting for adiposity measures. Because few studies have examined in AA the association between adiponectin and genetic admixture, a dense panel of ancestry informative markers (AIMs) was used to estimate the individual proportions of European ancestry (PEA) for the AAs enrolled in a large community-based cohort, the Jackson Heart Study (JHS). We tested the hypothesis that plasma adiponectin and PEA are directly associated and assessed the interaction with a series of cardio-metabolic risk factors. Methods: Plasma specimens from 1439 JHS participants were analyzed by ELISA for adiponectin levels. Using pseudo-ancestral population genotype data from the HapMap Consortium, PEA was estimated with a panel of up to 1447 genome-wide preselected AIMs by a maximum likelihood approach. Interaction assessment, stepwise linear and cubic multivariable-adjusted regression models were used to analyze the cross-sectional association between adiponectin and PEA. Results: Among the study participants (62% women; mean age 48 ± 12 years), the median (interquartile range) of PEA was 15.8 (9.3)%. Body mass index (BMI) (p = 0.04) and insulin resistance (p = 0.0001) modified the association between adiponectin and PEA. Adiponectin was directly and linearly associated with PEA (β = 0.62 ± 0.28, p = 0.03) among non-obese (n = 673) and insulin sensitive participants (n = 1141; β = 0.74 ± 0.23, p = 0.001), but not among those obese or with insulin resistance. No threshold point effect was detected for non-obese participants. Conclusions: In a large AA population, the individual proportion of European ancestry was linearly and directly associated with plasma adiponectin among non-obese and non insulin-resistant participants, pointing to the interaction of genetic and metabolic factors influencing adiponectin levels. PMID:24575123

  2. Implementation of the American College of Cardiology/American Heart Association 2008 Guidelines for the Management of Adults With Congenital Heart Disease.

    PubMed

    Goossens, Eva; Fernandes, Susan M; Landzberg, Michael J; Moons, Philip

    2015-08-01

    Although different guidelines on adult congenital heart disease (ACHD) care advocate for lifetime cardiac follow-up, a critical appraisal of the guideline implementation is lacking. We investigated the implementation of the American College of Cardiology/American Heart Association 2008 guidelines for ACHD follow-up by investigating the type of health care professional, care setting, and frequency of outpatient visits in young adults with CHD. Furthermore, correlates for care in line with the recommendations or untraceability were investigated. A cross-sectional observational study was conducted, including 306 patients with CHD who had a documented outpatient visit at pediatric cardiology before age 18 years. In all, 210 patients (68.6%) were in cardiac follow-up; 20 (6.5%) withdrew from follow-up and 76 (24.9%) were untraceable. Overall, 198 patients were followed up in tertiary care, 1/4 (n = 52) of which were seen at a formalized ACHD care program and 3/4 (n = 146) remained at pediatric cardiology. Of those followed in formalized ACHD and pediatric cardiology care, the recommended frequency was implemented in 94.2% and 89%, respectively (p = 0.412). No predictors for the implementation of the guidelines were identified. Risk factors for becoming untraceable were none or lower number of heart surgeries, health insurance issues, and nonwhite ethnicity. In conclusion, a significant number of adults continue to be cared for by pediatric cardiologists, indicating that transfer to adult-oriented care was not standard practice. Frequency of follow-up for most patients was in line with the ACC/AHA 2008 guidelines. A considerable proportion of young adults were untraceable in the system, which makes them vulnerable for discontinuation of care.

  3. Hypertension and coronary artery disease: a summary of the American Heart Association scientific statement.

    PubMed

    Rosendorff, Clive

    2007-10-01

    The American Heart Association scientific statement on the treatment of hypertension in the prevention and management of ischemic heart disease was published recently. The main recommendations were as follows: (1) For most adults with hypertension, the blood pressure (BP) goal is <140/90 mm Hg but should be <130/80 [corrected] mm Hg in patients with diabetes mellitus, chronic kidney disease, known coronary artery disease (CAD), CAD equivalents (carotid artery disease, abdominal aortic aneurism, and peripheral vascular disease), or 10-year Framingham risk score of >/=10%. For those with left ventricular dysfunction, the recommended BP target is <120/80 mm Hg. (2) For primary CAD prevention, any effective antihypertensive drug or combination is indicated, but preference is given to angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), and thiazide diuretics. (3) For the management of hypertension in patients with established CAD (stable or unstable angina, non-ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction), beta-blockers and ACE inhibitors (or ARBs) are the basis of treatment. If further BP lowering is needed, a thiazide diuretic and/or a dihydropyridine CCB (not verapamil or diltiazem) can be added. If a beta-blocker is contraindicated or not tolerated, diltiazem or verapamil can be substituted. (4) If there is left ventricular dysfunction, recommended therapy consists of an ACE inhibitor or ARB, a beta-blocker, and either a thiazide or loop diuretic. In patients with more severe heart failure, an aldosterone antagonist and hydralazine/isosorbide dinitrate (in black patients) should be considered. PMID:17917507

  4. Adoption of American Heart Association 2020 ideal healthy diet recommendations prevents weight gain in young adults.

    PubMed

    Forget, Geneviève; Doyon, Myriam; Lacerte, Guillaume; Labonté, Mélissa; Brown, Christine; Carpentier, André C; Langlois, Marie-France; Hivert, Marie-France

    2013-11-01

    In 2010, the American Heart Association established the concept of ideal cardiovascular health. Nationally representative data estimated that <1% of Americans meet the seven health metrics required for achieving ideal cardiovascular health, with the main challenge residing in meeting the criteria for an ideal Healthy Diet Score. In a cohort of young adults (N=196), we aimed to investigate the prevalence of ideal cardiovascular health and ideal Healthy Diet Score and its association to weight gain over a 4-year follow-up period. Anthropometric measures, blood pressure, and blood samples were taken according to standardized procedures. Dietary intake was measured by a 3-day food diary and verified by a registered dietitian. We observed that only 0.5% of our sample met the criteria for ideal cardiovascular health and only 4.1% met the criteria for an ideal Healthy Diet Score. The components of the Healthy Diet Score with the lowest observance were consumption of fruits and vegetables (9.7%) and whole grains (14.8%). Meeting zero or one out of five of the Healthy Diet Score components was associated with increased risk of weight gain over 4 years compared with meeting at least two components (P=0.03). With the exception of dietary criteria, prevalence was high for achieving ideal levels of the remaining six cardiovascular health metrics. In conclusion, in this sample of young adults, a very low prevalence of ideal overall cardiovascular health was observed, mainly driven by poor dietary habits, and a poor Healthy Diet Score was associated with increased weight gain.

  5. The Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study

    PubMed Central

    Grubbs, Vanessa; Vittinghoff, Eric; Beck, James D.; Kshirsagar, Abhijit V.; Wang, Wei; Griswold, Michael E.; Powe, Neil R.; Correa, Adolfo; Young, Bessie

    2015-01-01

    Background Chronic kidney disease (CKD) remains a prevalent public health problem that disproportionately affects African Americans, despite intense efforts targeting traditional risk factors. Periodontal disease, a chronic bacterial infection of the oral cavity, is both common and modifiable and has been implicated as a novel potential CKD risk factor. We sought to examine to what extent periodontal disease is associated with kidney function decline. Methods Retrospective cohort study of 699 African American participants with preserved kidney function defined by an estimated glomerular filtration rate (eGFR) >60ml/min/1.73m2 at baseline who underwent complete dental examinations as part of the Dental-Atherosclerosis Risk in Communities study (1996–1998) and subsequently enrolled in the Jackson Heart Study (2000–2004). Using multivariable Poisson regression we examined the association of periodontal disease (severe vs. non-severe) with incident CKD defined as incident eGFR<60ml/min/1.73m2 and rapid (5% annualized) eGFR decline at follow-up among those with preserved eGFR at baseline. Results Mean age at baseline was 65.4 years (SD 5.2) and 16.3% (n=114) had severe periodontal disease. There were 21 cases (3.0%) of incident CKD after a mean follow-up of 4.8 (SD 0.6) years. Compared to participants with non-severe periodontal disease, those with severe periodontal disease had a 4-fold greater rate of incident CKD [adjusted incidence rate ratio 4.18, 95% CI (1.68 – 10.39), p=0.002]. Conclusion Severe periodontal disease is prevalent among a population at high-risk for CKD and is associated with clinically significant kidney function decline. Further research is needed to determine if periodontal disease treatment alters the trajectory of renal deterioration. PMID:26110451

  6. Perceived Discrimination is Associated with Health Behaviors among African Americans in the Jackson Heart Study*

    PubMed Central

    Sims, Mario; Diez-Roux, Ana V.; Gebreab, Samson Y.; Brenner, Allison; Dubbert, Patricia; Wyatt, Sharon; Bruce, Marino; Hickson, DeMarc; Payne, Tom; Taylor, Herman

    2016-01-01

    Background Using Jackson Heart Study data, we examined associations of multiple measures of perceived discrimination with health behaviors among African Americans (AA). Methods The cross-sectional associations of everyday, lifetime, and burden of discrimination with odds of smoking and mean differences in physical activity, dietary fat, and sleep were examined among 4,939 35–84 year old participants after adjustment for age and socioeconomic status (SES). Results Men reported slightly higher levels of everyday and lifetime discrimination than women and similar levels of burden of discrimination as women. After adjustment for age and SES, everyday discrimination was associated with more smoking and a greater percentage of dietary fat in men and women (OR for smoking: 1.13, 95%CI 1.00,1.28 and 1.19, 95%CI 1.05,1.34; mean difference in dietary fat: 0.37, p<.05 and 0.43, p<.01, in men and women, respectively). Everyday and lifetime discrimination were associated with fewer hours of sleep in men and women (mean difference for everyday discrimination: −0.08, p<.05 and −0.18, p<.001, respectively; and mean difference for lifetime discrimination: −0.08, p<.05, and −0.24, p<.001, respectively). Burden of discrimination was associated with more smoking and fewer hours of sleep in women only. Conclusions Higher levels of perceived discrimination were associated with select health behaviors among men and women. Health behaviors offer a potential mechanism through which perceived discrimination affects health in AA. PMID:26417003

  7. Common genetic variation near the connexin-43 gene is associated with resting heart rate in African Americans: A genome-wide association study of 13,372 participants

    PubMed Central

    Deo, R.; Nalls, M.A.; Avery, C.L.; Smith, J.G.; Evans, D.S.; Keller, M.F.; Butler, A.M.; Buxbaum, S.G.; Li, G.; Quibrera, P. Miguel; Smith, E.N.; Tanaka, T.; Akylbekova, E.L.; Alonso, A.; Arking, D.E.; Benjamin, E.J.; Berenson, G.S.; Bis, J.C.; Chen, L.Y.; Chen, W.; Cummings, S.R.; Ellinor, P.T.; Evans, M.K.; Ferrucci, L.; Fox, E.R.; Heckbert, S.R.; Heiss, G.; Hsueh, W.C.; Kerr, K.F.; Limacher, M.C.; Liu, Y.; Lubitz, S.A.; Magnani, J.W.; Mehra, R.; Marcus, G.M.; Murray, S.S.; Newman, A.B.; Njajou, O.; North, K.E.; Paltoo, D.N.; Psaty, B.M.; Redline, S.S.; Reiner, A.P.; Robinson, J.G.; Rotter, J.I.; Samdarshi, T.E.; Schnabel, R.B.; Schork, N.J.; Singleton, A.B.; Siscovick, D.; Soliman, E.Z.; Sotoodehnia, N.; Srinivasan, S.R.; Taylor, H.A.; Trevisan, M.; Zhang, Z.; Zonderman, A.B.; Newton-Cheh, C.; Whitsel, E.A.

    2013-01-01

    BACKGROUND Genome-wide association studies have identified several genetic loci associated with variation in resting heart rate in European and Asian populations. No study has evaluated genetic variants associated with heart rate in African Americans. OBJECTIVE To identify novel genetic variants associated with resting heart rate in African Americans. METHODS Ten cohort studies participating in the Candidate-gene Association Resource and Continental Origins and Genetic Epidemiology Network consortia performed genome-wide genotyping of single nucleotide polymorphisms (SNPs) and imputed 2,954,965 SNPs using HapMap YRI and CEU panels in 13,372 participants of African ancestry. Each study measured the RR interval (ms) from 10-second resting 12-lead electrocardiograms and estimated RR-SNP associations using covariate-adjusted linear regression. Random-effects meta-analysis was used to combine cohort-specific measures of association and identify genome-wide significant loci (P ≤ 2.5 × 10−8). RESULTS Fourteen SNPs on chromosome 6q22 exceeded the genome-wide significance threshold. The most significant association was for rs9320841 (+13 ms per minor allele; P = 4.98 × 10−15). This SNP was approximately 350 kb downstream of GJA1, a locus previously identified as harboring SNPs associated with heart rate in Europeans. Adjustment for rs9320841 also attenuated the association between the remaining 13 SNPs in this region and heart rate. In addition, SNPs in MYH6, which have been identified in European genome-wide association study, were associated with similar changes in the resting heart rate as this population of African Americans. CONCLUSIONS An intergenic region downstream of GJA1 (the gene encoding connexin 43, the major protein of the human myocardial gap junction) and an intragenic region within MYH6 are associated with variation in resting heart rate in African Americans as well as in populations of European and Asian origin. PMID:23183192

  8. Report of the American Heart Association (AHA) Scientific Sessions 2015, Orlando.

    PubMed

    Aizawa, Yoshiyasu; Kimura, Mai; Kohno, Takashi; Fujita, Jun; Fukuda, Keiichi

    2016-01-01

    The American Heart Association Scientific Sessions were held in Orlando on November 7-15, 2015. The meeting attracted more than 18,000 participants, including physicians, research scientists, students, and paramedical personnel, from more than 100 countries. Sessions over the 5 days included a comprehensive and unparalleled education delivered via more than 5,000 presentations, with 1,000 invited faculty members and 4,000 abstract presentations from the world leaders in cardiovascular disease. It also displayed the newest cardiovascular technology and resources by more than 200 exhibitors. There were 19 trials scheduled in 6 late-breaking clinical trial sessions. The Systolic Blood Pressure Intervention Trial (SPRINT) aimed to determine the most appropriate targets for the systolic blood pressure among persons without diabetes. A total of 9,361 persons with systolic blood pressure of ≥130 mmHg and an increased cardiovascular risk, but without diabetes, were randomly assigned to a target systolic blood pressure of <120 mmHg (intensive treatment) or a target of <140 mmHg (standard treatment). A significantly lower rate of the primary composite outcome and all-cause mortality in the intensive-treatment group than in the standard-treatment group was observed. Summaries and overviews of the late-breaking trials, clinical science special report sessions, and sessions to which members of the Japanese Circulation Society contributed are presented.

  9. Residential Proximity to Major Roadways Is Not Associated with Cardiac Function in African Americans: Results from the Jackson Heart Study

    PubMed Central

    Weaver, Anne M.; Wellenius, Gregory A.; Wu, Wen-Chih; Hickson, DeMarc A.; Kamalesh, Masoor; Wang, Yi

    2016-01-01

    Cardiovascular disease (CVD), including heart failure, is a major cause of morbidity and mortality, particularly among African Americans. Exposure to ambient air pollution, such as that produced by vehicular traffic, is believed to be associated with heart failure, possibly by impairing cardiac function. We evaluated the cross-sectional association between residential proximity to major roads, a marker of long-term exposure to traffic-related pollution, and echocardiographic indicators of left and pulmonary vascular function in African Americans enrolled in the Jackson Heart Study (JHS): left ventricular ejection fraction, E-wave velocity, isovolumic relaxation time, left atrial diameter index, and pulmonary artery systolic pressure. We examined these associations using multivariable linear or logistic regression, adjusting for potential confounders. Of 4866 participants at study enrollment, 106 lived <150 m, 159 lived 150–299 m, 1161 lived 300–999 m, and 3440 lived ≥1000 m from a major roadway. We did not observe any associations between residential distance to major roads and these markers of cardiac function. Results were similar with additional adjustment for diabetes and hypertension, when considering varying definitions of major roadways, or when limiting analyses to those free from cardiovascular disease at baseline. Overall, we observed little evidence that residential proximity to major roads was associated with cardiac function among African Americans. PMID:27304962

  10. Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share common pathophysiological mechanisms. It is possible that strategies to reduce CVD risk may also benefit bone health. We tested the hypothesis that adherence to the 2006 American Heart Association Diet and Li...

  11. A dataset to assess providers׳ knowledge and attitudes towards the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline.

    PubMed

    Pokharel, Yashashwi; Steinberg, Lynne; Chan, Winston; Akeroyd, Julia M; Jones, Peter H; Nambi, Vijay; Nasir, Khurram; Petersen, Laura; Ballantyne, Christie M; Virani, Salim S

    2016-06-01

    We previously examined provider׳s understanding of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol management guideline (DOI: http://dx.doi.org/10.1016/j.jacl.2015.11.002)(Virani et al., 2013) [1], and also assessed whether a case-based educational intervention could improve providers׳ knowledge gaps and attitudes towards the guideline (DOI: 10.1016/j.atherosclerosis.2015.12.044) (Pokharel, et al., 2016) [2]. Here we describe the dataset that we used to examine our objectives. PMID:27054163

  12. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association.

    PubMed

    Brook, Robert D; Rajagopalan, Sanjay; Pope, C Arden; Brook, Jeffrey R; Bhatnagar, Aruni; Diez-Roux, Ana V; Holguin, Fernando; Hong, Yuling; Luepker, Russell V; Mittleman, Murray A; Peters, Annette; Siscovick, David; Smith, Sidney C; Whitsel, Laurie; Kaufman, Joel D

    2010-06-01

    In 2004, the first American Heart Association scientific statement on "Air Pollution and Cardiovascular Disease" concluded that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. In the interim, numerous studies have expanded our understanding of this association and further elucidated the physiological and molecular mechanisms involved. The main objective of this updated American Heart Association scientific statement is to provide a comprehensive review of the new evidence linking PM exposure with cardiovascular disease, with a specific focus on highlighting the clinical implications for researchers and healthcare providers. The writing group also sought to provide expert consensus opinions on many aspects of the current state of science and updated suggestions for areas of future research. On the basis of the findings of this review, several new conclusions were reached, including the following: Exposure to PM <2.5 microm in diameter (PM(2.5)) over a few hours to weeks can trigger cardiovascular disease-related mortality and nonfatal events; longer-term exposure (eg, a few years) increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years; reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM(2.5) exposure and cardiovascular morbidity and mortality. This body of evidence has grown and been strengthened substantially since the first American Heart Association scientific statement was published. Finally, PM(2.5) exposure is deemed a modifiable factor

  13. Joint association of nicotinic acetylcholine receptor variants with abdominal obesity in American Indians: the Strong Heart Family Study.

    PubMed

    Zhu, Yun; Yang, Jingyun; Yeh, Fawn; Cole, Shelley A; Haack, Karin; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2014-01-01

    Cigarette smoke is a strong risk factor for obesity and cardiovascular disease. The effect of genetic variants involved in nicotine metabolism on obesity or body composition has not been well studied. Though many genetic variants have previously been associated with adiposity or body fat distribution, a single variant usually confers a minimal individual risk. The goal of this study is to evaluate the joint association of multiple variants involved in cigarette smoke or nicotine dependence with obesity-related phenotypes in American Indians. To achieve this goal, we genotyped 61 tagSNPs in seven genes encoding nicotine acetylcholine receptors (nAChRs) in 3,665 American Indians participating in the Strong Heart Family Study. Single SNP association with obesity-related traits was tested using family-based association, adjusting for traditional risk factors including smoking. Joint association of all SNPs in the seven nAChRs genes were examined by gene-family analysis based on weighted truncated product method (TPM). Multiple testing was controlled by false discovery rate (FDR). Results demonstrate that multiple SNPs showed weak individual association with one or more measures of obesity, but none survived correction for multiple testing. However, gene-family analysis revealed significant associations with waist circumference (p = 0.0001) and waist-to-hip ratio (p = 0.0001), but not body mass index (p = 0.20) and percent body fat (p = 0.29), indicating that genetic variants are jointly associated with abdominal, but not general, obesity among American Indians. The observed combined genetic effect is independent of cigarette smoking per se. In conclusion, multiple variants in the nAChR gene family are jointly associated with abdominal obesity in American Indians, independent of general obesity and cigarette smoking per se.

  14. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    PubMed

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  15. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    PubMed

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  16. Prevalence of the American Heart Association's “Ideal Cardiovascular Health” Metrics in a Rural, Cross‐sectional, Community‐Based Study: The Heart of New Ulm Project

    PubMed Central

    Kim, Jacqueline I.; Sillah, Arthur; Boucher, Jackie L.; Sidebottom, Abbey C.; Knickelbine, Thomas

    2013-01-01

    Background The American Heart Association (AHA) recently created the construct of “ideal cardiovascular health” based on 7 cardiovascular health metrics to measure progress toward their 2020 Impact Goal. The present study applied this construct to assess the baseline cardiovascular health of a rural population targeted with a community‐based cardiovascular disease prevention program. Methods and Results The sample consists of 4754 New Ulm, Minn, adult residents who participated in either the 2009 or 2011 community heart health screenings offered by the Hearts Beat Back: The Heart of New Ulm (HONU) Project (mean age 52.1 years, 58.3% women). Data collected at the screenings were analyzed to replicate the AHA's ideal cardiovascular health measure and the 7 metrics that comprise the construct. Screening participants met, on average (±SD), 3.4 (±1.4) ideal cardiovascular health metrics. Only 1.0% of participants met the AHA's definition of ideal health in all metrics and 7.1% met ≤1 ideal health metric. Higher proportions of women met the ideal category in all metrics except physical activity. Women over the age of 60 were less likely to meet the ideal category for cholesterol and hypertension than were men in the same age range. Conclusion Prevalence of ideal cardiovascular health is extremely low in this rural population. To make progress toward the 2020 Impact Goal, targeted community‐based interventions must be implemented based on the most prevalent cardiovascular risk factors. PMID:23619743

  17. Promoting Physical Activity Through the Shared Use of School Recreational Spaces: A Policy Statement From the American Heart Association

    PubMed Central

    Young, Deborah R.; Spengler, John O.; Frost, Natasha; Evenson, Kelly R.; Vincent, Jeffrey M.; Whitsel, Laurie

    2014-01-01

    Most Americans are not sufficiently physically active, even though regular physical activity improves health and reduces the risk of many chronic diseases. Those living in rural, non-White, and lower-income communities often have insufficient access to places to be active, which can contribute to their lower level of physical activity. The shared use of school recreational facilities can provide safe and affordable places for communities. Studies suggest that challenges to shared use include additional cost, liability protection, communication among constituencies interested in sharing space, and decision-making about scheduling and space allocation. This American Heart Association policy statement has provided recommendations for federal, state, and local decision-makers to support and expand opportunities for physical activity in communities through the shared use of school spaces. PMID:24134355

  18. Heart failure in African Americans.

    PubMed

    Yancy, Clyde W

    2005-10-10

    The demographics of the United States are changing, and in the next few decades there will no longer be a racial/ethnic majority population. Increased awareness of cardiovascular disease (CVD) in special populations is warranted as these populations increase. Heart failure carries a substantial burden on those affected, particularly African Americans, who have a disproportionate burden of heart disease. Current treatments for heart failure include angiotensin-converting enzyme inhibitors, beta-blockers, angiotensin II-receptor antagonists, and vasodilating agents. This review discusses the unique characteristics of CVD in African Americans and addresses the need for targeted treatments to reduce the excess burden found in this population.

  19. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association.

    PubMed

    Steinberger, Julia; Daniels, Stephen R; Hagberg, Nancy; Isasi, Carmen R; Kelly, Aaron S; Lloyd-Jones, Donald; Pate, Russell R; Pratt, Charlotte; Shay, Christina M; Towbin, Jeffrey A; Urbina, Elaine; Van Horn, Linda V; Zachariah, Justin P

    2016-09-20

    This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided.

  20. Cardiovascular Health Promotion in Children: Challenges and Opportunities for 2020 and Beyond: A Scientific Statement From the American Heart Association.

    PubMed

    Steinberger, Julia; Daniels, Stephen R; Hagberg, Nancy; Isasi, Carmen R; Kelly, Aaron S; Lloyd-Jones, Donald; Pate, Russell R; Pratt, Charlotte; Shay, Christina M; Towbin, Jeffrey A; Urbina, Elaine; Van Horn, Linda V; Zachariah, Justin P

    2016-09-20

    This document provides a pediatric-focused companion to "Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association's Strategic Impact Goal Through 2020 and Beyond," focused on cardiovascular health promotion and disease reduction in adults and children. The principles detailed in the document reflect the American Heart Association's new dynamic and proactive goal to promote cardiovascular health throughout the life course. The primary focus is on adult cardiovascular health and disease prevention, but critical to achievement of this goal is maintenance of ideal cardiovascular health from birth through childhood to young adulthood and beyond. Emphasis is placed on the fundamental principles and metrics that define cardiovascular health in children for the clinical or research setting, and a balanced and critical appraisal of the strengths and weaknesses of the cardiovascular health construct in children and adolescents is provided. Specifically, this document discusses 2 important factors: the promotion of ideal cardiovascular health in all children and the improvement of cardiovascular health metric scores in children currently classified as having poor or intermediate cardiovascular health. Other topics include the current status of cardiovascular health in US children, opportunities for the refinement of health metrics, improvement of health metric scores, and possibilities for promoting ideal cardiovascular health. Importantly, concerns about the suitability of using single thresholds to identify elevated cardiovascular risk throughout the childhood years and the limits of our current knowledge are noted, and suggestions for future directions and research are provided. PMID:27515136

  1. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association

    PubMed Central

    Morgenstern, Lewis B.; Hemphill, J. Claude; Anderson, Craig; Becker, Kyra; Broderick, Joseph P.; Connolly, E. Sander; Greenberg, Steven M.; Huang, James N.; Macdonald, R. Loch; Messe, Steven R.; Mitchell, Pamela H.; Selim, Magdy; Tamargo, Rafael J.

    2015-01-01

    Purpose The aim of this statement is to present current and comprehensive recommendations for the diagnosis and treatment of acute spontaneous intracerebral hemorrhage (ICH). Methods A formal literature search of Medline was performed. Data were synthesized with the use of evidence tables. Writing committee members met by teleconference to discuss data derived recommendations. The American Heart Association Stroke Council’s Levels of Evidence grading algorithm was used to grade each recommendation. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Leadership Committee. It is intended that this guideline be fully updated in 3 years’ time. Results Evidence-based guidelines are presented for the care of patients presenting with ICH. The focus was sub-divided into diagnosis, hemostasis, blood pressure management, inpatient and nursing management, preventing medical comorbidities, surgical treatment, outcome prediction, rehabilitation, prevention of recurrence, and future considerations. Conclusions ICH is a serious medical condition where outcome can be impacted by early, aggressive care. The guidelines offer a framework for goal directed treatment of the ICH patient. PMID:20651276

  2. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial.

    PubMed

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients.

  3. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial.

    PubMed

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients. PMID:26198559

  4. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association task force on practice guidelines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The goals of the American College of Cardiology (ACC) and the American Heart Association (AHA) are to prevent cardiovascular (CV) diseases, improve the management of people who have these diseases through professional education and research, and develop guidelines, standards and policies that promot...

  5. Adult Congenital Heart Association

    MedlinePlus

    ... survivable, manageable, yet in the routine years between infancy and adulthood, sometimes forgettable. The Adult Congenital Heart ... understand the continuum of the disease from its infancy. The Adult Congential Heart Association brings together valuable ...

  6. New cholesterol guidelines for the management of atherosclerotic cardiovascular disease risk: a comparison of the 2013 American College of Cardiology/American Heart Association cholesterol guidelines with the 2014 National Lipid Association recommendations for patient-centered management of dyslipidemia.

    PubMed

    Adhyaru, Bhavin B; Jacobson, Terry A

    2015-05-01

    This review discusses the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults and compares it with the 2014 National Lipid Association (NLA) Recommendations for Patient-Centered Management of Dyslipidemia. The review discusses some of the distinctions between the guidelines, including how to determine a patient's atherosclerotic cardiovascular disease risk, the role of lipoprotein treatment targets, the importance of moderate- and high-intensity statin therapy, and the use of nonstatin therapy in light of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial.

  7. New Cholesterol Guidelines for the Management of Atherosclerotic Cardiovascular Disease Risk: A Comparison of the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines with the 2014 National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia.

    PubMed

    Adhyaru, Bhavin B; Jacobson, Terry A

    2016-03-01

    This review discusses the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults and compares it with the 2014 National Lipid Association (NLA) Recommendations for Patient-Centered Management of Dyslipidemia. The review discusses some of the distinctions between the guidelines, including how to determine a patient's atherosclerotic cardiovascular disease risk, the role of lipoprotein treatment targets, the importance of moderate- and high-intensity statin therapy, and the use of nonstatin therapy in light of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial. PMID:26892995

  8. Heart Truth for African American Women

    MedlinePlus

    THE HEART TRUTH ® FOR AFRICAN AMERICAN WOMEN: AN ACTION PLAN When you hear the term “heart disease,” what’s your first reaction? Like many women, you may ... in four women dies of heart disease. For African American women, the risk of heart disease is especially ...

  9. More than 10 million steps in the right direction: results from the first American Heart Association scientific sessions walking challenge.

    PubMed

    Harrington, Robert A; Arena, Ross; Després, Jean-Pierre; Ciarochi, Amy; Croll, Elizabeth; Bloch, Kenneth D

    2015-01-01

    In 2013, the Global Congress theme at the American Heart Association (AHA) Annual Scientific Sessions was Physical Activity (PA). As a key component of the Congress, iHealth working in collaboration with AHA provided a Bluetooth-enabled wireless PA and sleep tracker to up to 2,000 Scientific Sessions attendees. Approximately 1850 Scientific Sessions attendees registered for, received a PA tracker and participated in the Walking Challenge. More than 10 million steps were walked by participants (10,703,504) during the 2.5 days of the Walking Challenge. This translates into almost 6000 miles walked (5976.3 miles) and 656,716 calories burned by participants during the Challenge. The Global Congress of PA held at Scientific Sessions 2013 not only extensively reviewed the science of PA as a powerful/independent and, most importantly, modifiable cardiovascular risk factor, but it also provided evidence from a fun and entertaining challenge that PA as a risk behavior can be assessed and targeted. We just took 10 million steps in the right direction. Join us and make your steps count!

  10. More than 10 million steps in the right direction: results from the first American Heart Association scientific sessions walking challenge.

    PubMed

    Harrington, Robert A; Arena, Ross; Després, Jean-Pierre; Ciarochi, Amy; Croll, Elizabeth; Bloch, Kenneth D

    2015-01-01

    In 2013, the Global Congress theme at the American Heart Association (AHA) Annual Scientific Sessions was Physical Activity (PA). As a key component of the Congress, iHealth working in collaboration with AHA provided a Bluetooth-enabled wireless PA and sleep tracker to up to 2,000 Scientific Sessions attendees. Approximately 1850 Scientific Sessions attendees registered for, received a PA tracker and participated in the Walking Challenge. More than 10 million steps were walked by participants (10,703,504) during the 2.5 days of the Walking Challenge. This translates into almost 6000 miles walked (5976.3 miles) and 656,716 calories burned by participants during the Challenge. The Global Congress of PA held at Scientific Sessions 2013 not only extensively reviewed the science of PA as a powerful/independent and, most importantly, modifiable cardiovascular risk factor, but it also provided evidence from a fun and entertaining challenge that PA as a risk behavior can be assessed and targeted. We just took 10 million steps in the right direction. Join us and make your steps count! PMID:25269063

  11. African-Americans and Heart Disease, Stroke

    MedlinePlus

    ... more about African-Americans and stroke at our Power To End Stroke website This content was last reviewed July 2015. ... Attack • Heart Failure (HF) • Heart Valve Problems and Disease • High Blood ...

  12. Perceived stress following race-based discrimination at work is associated with hypertension in African-Americans. The metro Atlanta heart disease study, 1999-2001.

    PubMed

    Din-Dzietham, Rebecca; Nembhard, Wendy N; Collins, Rakale; Davis, Sharon K

    2004-02-01

    There is increasing evidence of an association between stress related to job strain and hypertension. However little data exist on stress from racism and race-based discrimination at work (RBDW). The objective of this study was to investigate whether blood pressure (BP) outcomes are positively associated with stressful racism towards African-Americans from non-African-Americans as well as RBDW from other African-Americans. The metro Atlanta heart disease study was a population-based study which included 356 African-American men and women, aged >/=21 years, residing in metropolitan Atlanta, Georgia during 1999-2001. Perceived stress was self-reported by 197 participants for racism from non-African-Americans and 95 for RBDW from other African-Americans. Sitting systolic (SBP) and diastolic (DBP) BP were taken at a clinic visit and was the average of the last two of three BP measures. Hypertension was self-reported as physician-diagnosed high BP on 2 or more visits. Logistic and least-squares linear regression models were fit accordingly and separately for each type of stress, adjusting for age, gender, body mass index, and coping abilities. The likelihood of hypertension significantly increased with higher levels of perceived stress following racism from non-African-Americans, but not from RBDW from other African-Americans; adjusted odd ratios (95% CI) were 1.4 (1.0, 1.9) and 1.2 (0.8, 1.5) per unit increment of stress. The adjusted magnitude of SBP and DBP increase between low and very high level of stress, conversely, was greater when RBDW originated from African-Americans than racism from non-African-Americans. Stressful racism and RBDW encounters are associated with increased SBP and DBP and increased likelihood of hypertension in African-Americans. Future studies with a larger sample size are warranted to further explore these findings for mechanistic understanding and occupational policy consideration regarding stress risk reduction.

  13. Prevalence, associated factors and heritabilities of metabolic syndrome and its individual components in African Americans: the Jackson Heart Study

    PubMed Central

    Khan, Rumana J; Gebreab, Samson Y; Sims, Mario; Riestra, Pia; Xu, Ruihua; Davis, Sharon K

    2015-01-01

    Objective Both environmental and genetic factors play important roles in the development of metabolic syndrome (MetS). Studies about its associated factors and genetic contribution in African Americans (AA) are sparse. Our aim was to report the prevalence, associated factors and heritability estimates of MetS and its components in AA men and women. Participants and setting Data of this cross-sectional study come from a large community-based Jackson Heart Study (JHS). We analysed a total of 5227 participants, of whom 1636 from 281 families were part of a family study subset of JHS. Methods Participants were classified as having MetS according to the Adult Treatment Panel III criteria. Multiple logistic regression analysis was performed to isolate independently associated factors of MetS (n=5227). Heritability was estimated from the family study subset using variance component methods (n=1636). Results About 27% of men and 40% of women had MetS. For men, associated factors with having MetS were older age, lower physical activity, higher body mass index, and higher homocysteine and adiponectin levels (p<0.05 for all). For women, in addition to all these, lower education, current smoking and higher stress were also significant (p<0.05 for all). After adjusting for covariates, the heritability of MetS was 32% (p<0.001). Heritability ranged from 14 to 45% among its individual components. Relatively higher heritability was estimated for waist circumference (45%), high density lipoprotein-cholesterol (43%) and triglycerides (42%). Heritability of systolic blood pressure (BP), diastolic BP and fasting blood glucose was 16%, 15% and 14%, respectively. Conclusions Stress and low education were associated with having MetS in AA women, but not in men. Higher heritability estimates for lipids and waist circumference support the hypothesis of lipid metabolism playing a central role in the development of MetS and encourage additional efforts to identify the underlying

  14. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association.

    PubMed

    Brook, Robert D; Appel, Lawrence J; Rubenfire, Melvyn; Ogedegbe, Gbenga; Bisognano, John D; Elliott, William J; Fuchs, Flavio D; Hughes, Joel W; Lackland, Daniel T; Staffileno, Beth A; Townsend, Raymond R; Rajagopalan, Sanjay

    2013-06-01

    Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential

  15. The Heart of 25 by 25: Achieving the Goal of Reducing Global and Regional Premature Deaths From Cardiovascular Diseases and Stroke: A Modeling Study From the American Heart Association and World Heart Federation.

    PubMed

    Sacco, Ralph L; Roth, Gregory A; Reddy, K Srinath; Arnett, Donna K; Bonita, Ruth; Gaziano, Thomas A; Heidenreich, Paul A; Huffman, Mark D; Mayosi, Bongani M; Mendis, Shanthi; Murray, Christopher J L; Perel, Pablo; Piñeiro, Daniel J; Smith, Sidney C; Taubert, Kathryn A; Wood, David A; Zhao, Dong; Zoghbi, William A

    2016-06-01

    In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovascular disease and its risk factors be aggressively addressed. The Global Cardiovascular Disease Taskforce, comprising the World Heart Federation, American Heart Association, American College of Cardiology Foundation, European Heart Network, and European Society of Cardiology, with expanded representation from Asia, Africa, and Latin America, along with global cardiovascular disease experts, disseminates information and approaches to reach the United Nations 2025 targets. The writing committee, which reflects Global Cardiovascular Disease Taskforce membership, engaged the Institute for Health Metrics and Evaluation, University of Washington, to develop region-specific estimates of premature cardiovascular mortality in 2025 based on various scenarios. Results show that >5 million premature CVD deaths among men and 2.8 million among women are projected worldwide by 2025, which can be reduced to 3.5 million and 2.2 million, respectively, if risk factor targets for blood pressure, tobacco use, diabetes mellitus, and obesity are achieved. However, global risk factor targets have various effects, depending on region. For most regions, United Nations targets for reducing systolic blood pressure and tobacco use have more substantial effects on future scenarios compared with maintaining current levels of body mass index and fasting plasma glucose. However, preventing increases in body mass index has the largest effect in some high-income countries. An approach achieving reductions in multiple risk factors has the largest impact for almost all regions. Achieving these goals can be accomplished only if countries set priorities

  16. The Heart of 25 by 25: Achieving the Goal of Reducing Global and Regional Premature Deaths From Cardiovascular Diseases and Stroke: A Modeling Study From the American Heart Association and World Heart Federation.

    PubMed

    Sacco, Ralph L; Roth, Gregory A; Reddy, K Srinath; Arnett, Donna K; Bonita, Ruth; Gaziano, Thomas A; Heidenreich, Paul A; Huffman, Mark D; Mayosi, Bongani M; Mendis, Shanthi; Murray, Christopher J L; Perel, Pablo; Piñeiro, Daniel J; Smith, Sidney C; Taubert, Kathryn A; Wood, David A; Zhao, Dong; Zoghbi, William A

    2016-06-01

    In 2011, the United Nations set key targets to reach by 2025 to reduce the risk of premature noncommunicable disease death by 25% by 2025. With cardiovascular disease being the largest contributor to global mortality, accounting for nearly half of the 36 million annual noncommunicable disease deaths, achieving the 2025 goal requires that cardiovascular disease and its risk factors be aggressively addressed. The Global Cardiovascular Disease Taskforce, comprising the World Heart Federation, American Heart Association, American College of Cardiology Foundation, European Heart Network, and European Society of Cardiology, with expanded representation from Asia, Africa, and Latin America, along with global cardiovascular disease experts, disseminates information and approaches to reach the United Nations 2025 targets. The writing committee, which reflects Global Cardiovascular Disease Taskforce membership, engaged the Institute for Health Metrics and Evaluation, University of Washington, to develop region-specific estimates of premature cardiovascular mortality in 2025 based on various scenarios. Results show that >5 million premature CVD deaths among men and 2.8 million among women are projected worldwide by 2025, which can be reduced to 3.5 million and 2.2 million, respectively, if risk factor targets for blood pressure, tobacco use, diabetes mellitus, and obesity are achieved. However, global risk factor targets have various effects, depending on region. For most regions, United Nations targets for reducing systolic blood pressure and tobacco use have more substantial effects on future scenarios compared with maintaining current levels of body mass index and fasting plasma glucose. However, preventing increases in body mass index has the largest effect in some high-income countries. An approach achieving reductions in multiple risk factors has the largest impact for almost all regions. Achieving these goals can be accomplished only if countries set priorities

  17. American Heart Association

    MedlinePlus

    ... teach others that healthy foods can be tasty. Voters can send Big Soda a powerful message. Sugary ... Healthy diet, exercise may help brain Test may ID clot risk in chemo patients Stressed-out mate ...

  18. Clinical trials update from the Heart Failure Society of America and the American Heart Association meetings in 2008: SADHART-CHF, COMPARE, MOMENTUM, thyroid hormone analogue study, HF-ACTION, I-PRESERVE, β-interferon study, BACH, and ATHENA

    PubMed Central

    Coletta, Alison P.; Clark, Andrew L.; Cleland, John G.F.

    2009-01-01

    This article provides information and a commentary on trials relevant to the pathophysiology, prevention, and treatment of heart failure presented at the Heart Failure Society of America and the American Heart Association meetings in 2008. Unpublished reports should be considered as preliminary, as analyses may change in the final publication. (i) SADHART-CHF showed no difference in outcome for heart failure patients with depression treated with sertraline compared with placebo. (ii) A controlled release carvedilol formulation showed similar LV haemodynamic effects to the standard carvedilol formulation in the COMPARE study. (iii) A post hoc analysis of the MOMENTUM study suggested that patients with less severe heart failure may be more likely to benefit from a continuous aortic flow augmentation device. (iv) A thyroid hormone analogue was poorly tolerated in patients with heart failure. (v) HF-ACTION showed that exercise training is safe and offers modest clinical benefits in patients with heart failure. (vi) Irbesartan failed to improve outcomes in patients with preserved ejection fraction in the I-PRESERVE study. (vii) A phase II study of beta-interferon administration in patients with dilated cardiomyopathy showed encouraging results. (viii) The BACH study showed that mid-regional pro-adrenomedullin was more accurate than BNP or NT-proBNP at predicting outcome at 90 days in patients with acute heart failure. (ix) A secondary analysis from ATHENA showed a reduction in cardiovascular hospitalizations and strokes for patients with atrial fibrillation receiving dronedarone compared with placebo. PMID:19168521

  19. American Health Care Association

    MedlinePlus

    ... Governors, Directors at Annual Convention in Nashville American Health Care Association Files Court Challenge to Arbitration Rule AHCA ... this Page | Privacy Policy | Terms and Conditions © American Health Care Association Google Plus .

  20. American Brain Tumor Association

    MedlinePlus

    ... in the Ear Canals Read More ABTA News October 5, 2016 Largest American Brain Tumor Association Team Running in Bank of America Chicago Marathon Sunday, October 9 September 21, 2016 American Brain Tumor Association Awards 16 Grants to Support ...

  1. Association of aldosterone synthase polymorphism (CYP11B2 -344T>C) and genetic ancestry with atrial fibrillation and serum aldosterone in African Americans with heart failure.

    PubMed

    Bress, Adam; Han, Jin; Patel, Shitalben R; Desai, Ankit A; Mansour, Ibrahim; Groo, Vicki; Progar, Kristin; Shah, Ebony; Stamos, Thomas D; Wing, Coady; Garcia, Joe G N; Kittles, Rick; Cavallari, Larisa H

    2013-01-01

    The objective of this study was to examine the extent to which aldosterone synthase genotype (CYP11B2) and genetic ancestry correlate with atrial fibrillation (AF) and serum aldosterone in African Americans with heart failure. Clinical data, echocardiographic measurements, and a genetic sample for determination of CYP11B2 -344T>C (rs1799998) genotype and genetic ancestry were collected from 194 self-reported African Americans with chronic, ambulatory heart failure. Genetic ancestry was determined using 105 autosomal ancestry informative markers. In a sub-set of patients (n = 126), serum was also collected for determination of circulating aldosterone. The CYP11B2 -344C allele frequency was 18% among the study population, and 19% of patients had AF. Multiple logistic regression revealed that the CYP11B2 -344CC genotype was a significant independent predictor of AF (OR 12.7, 95% CI 1.60-98.4, p = 0.0150, empirical p = 0.011) while holding multiple clinical factors, left atrial size, and percent European ancestry constant. Serum aldosterone was significantly higher among patients with AF (p = 0.036), whereas increased West African ancestry was inversely correlated with serum aldosterone (r = -0.19, p = 0.037). The CYP11B2 -344CC genotype was also overrepresented among patients with extreme aldosterone elevation (≥90th percentile, p = 0.0145). In this cohort of African Americans with chronic ambulatory heart failure, the CYP11B2 -344T>C genotype was a significant independent predictor of AF while holding clinical, echocardiographic predictors, and genetic ancestry constant. In addition, increased West African ancestry was associated with decreased serum aldosterone levels, potentially providing an explanation for the lower risk for AF observed among African Americans.

  2. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity.

    PubMed

    Alberti, K G M M; Eckel, Robert H; Grundy, Scott M; Zimmet, Paul Z; Cleeman, James I; Donato, Karen A; Fruchart, Jean-Charles; James, W Philip T; Loria, Catherine M; Smith, Sidney C

    2009-10-20

    A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and central obesity. Various diagnostic criteria have been proposed by different organizations over the past decade. Most recently, these have come from the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. The main difference concerns the measure for central obesity, with this being an obligatory component in the International Diabetes Federation definition, lower than in the American Heart Association/National Heart, Lung, and Blood Institute criteria, and ethnic specific. The present article represents the outcome of a meeting between several major organizations in an attempt to unify criteria. It was agreed that there should not be an obligatory component, but that waist measurement would continue to be a useful preliminary screening tool. Three abnormal findings out of 5 would qualify a person for the metabolic syndrome. A single set of cut points would be used for all components except waist circumference, for which further work is required. In the interim, national or regional cut points for waist circumference can be used. PMID:19805654

  3. Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves: A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

    PubMed

    Hiratzka, Loren F; Creager, Mark A; Isselbacher, Eric M; Svensson, Lars G; Nishimura, Rick A; Bonow, Robert O; Guyton, Robert A; Sundt, Thoralf M

    2016-02-16

    Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (J Am Coll Cardiol 2010;55:e27-130) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (J Am Coll Cardiol 2014;63:e57-185). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.

  4. Genome-wide association study of a heart failure related metabolomic profile among African Americans in the Atherosclerosis Risk in Communities (ARIC) study.

    PubMed

    Yu, Bing; Zheng, Yan; Alexander, Danny; Manolio, Teri A; Alonso, Alvaro; Nettleton, Jennifer A; Boerwinkle, Eric

    2013-12-01

    Both the prevalence and incidence of heart failure (HF) are increasing, especially among African Americans, but no large-scale, genome-wide association study (GWAS) of HF-related metabolites has been reported. We sought to identify novel genetic variants that are associated with metabolites previously reported to relate to HF incidence. GWASs of three metabolites identified previously as risk factors for incident HF (pyroglutamine, dihydroxy docosatrienoic acid, and X-11787, being either hydroxy-leucine or hydroxy-isoleucine) were performed in 1,260 African Americans free of HF at the baseline examination of the Atherosclerosis Risk in Communities (ARIC) study. A significant association on chromosome 5q33 (rs10463316, MAF = 0.358, P-value = 1.92 × 10(-10) ) was identified for pyroglutamine. One region on chromosome 2p13 contained a nonsynonymous substitution in N-acetyltransferase 8 (NAT8) was associated with X-11787 (rs13538, MAF = 0.481, P-value = 1.71 × 10(-23) ). The smallest P-value for dihydroxy docosatrienoic acid was rs4006531 on chromosome 8q24 (MAF = 0.400, P-value = 6.98 × 10(-7) ). None of the above SNPs were individually associated with incident HF, but a genetic risk score (GRS) created by summing the most significant risk alleles from each metabolite detected 11% greater risk of HF per allele. In summary, we identified three loci associated with previously reported HF-related metabolites. Further use of metabolomics technology will facilitate replication of these findings in independent samples.

  5. Socioeconomic Position Is Positively Associated With Blood Pressure Dipping Among African-American Adults: The Jackson Heart Study

    PubMed Central

    Hickson, DeMarc A; Diez Roux, Ana V; Wyatt, Sharon B; Gebreab, Samson Y; Ogedegbe, Gbenga; Sarpong, Daniel F; Taylor, Herman A; Wofford, Marion R

    2014-01-01

    BACKGROUND Blunted nocturnal blood pressure (NBP) dipping is a significant predictor of cardiovascular events. Lower socioeconomic position (SEP) may be an important predictor of NBP dipping, especially in African Americans (AA). However, the determinants of NBP dipping are not fully understood. METHODS The cross-sectional associations of individual and neighborhood SEP with NBP dipping, assessed by 24-h ambulatory BP monitoring, were examined among 837 AA adults (Mean age: 59.2 ± 10.7 years; 69.2% women), after adjustment for age, sex, hypertension status, body mass index (BMI), health behaviors, office, and 24-h systolic BP (SBP). RESULTS The mean hourly SBP was consistently lower among participants in the highest category of individual income compared to those in the lowest category, and these differences were most pronounced during sleeping hours. The odds of NBP dipping (defined as >10% decline in the mean asleep SBP compared to the mean awake SBP) increased by 31% (95% confidence interval: 13–53%) and 18% (95% confidence interval: 0–39%) for each s.d. increase in income and years of education, respectively, after multivariable adjustment. CONCLUSIONS NBP dipping is patterned by income and education in AA adults even after accounting for known risk factors. These results suggest that low SEP is a risk factor for insufficient NBP dipping in AA. PMID:21654853

  6. 76 FR 6303 - American Heart Month, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-03

    ... continuing to raise awareness of heart disease and its risk factors among Americans of all ages. First Lady... this thirty-first day of January, in the year of our Lord two thousand eleven, and of the Independence of the United States of America the two hundred and thirty- fifth. (Presidential Sig.) [FR Doc....

  7. American Sleep Apnea Association

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    American Sleep Apnea Association Learn About the CPAP Assistance Program About ASAA News about ASAA Who we are Leadership Team Supporting the ASAA Financials Learn Healthy sleep Sleep apnea Other sleep ...

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    ... Codes and Names Join ASA Press Room American Sleep Association Improving public health by increasing awareness about ... Members Username or Email Password Remember Me Register Sleep Blog Signs and Symptoms of Insomnia Anxiety Disorder ...

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  12. Social class and heart disease mortality among African Americans.

    PubMed

    Barnett, Elizabeth; Williams, Carol R; Moore, Latetia; Chen, Fangfei

    2002-01-01

    The purpose of the present study was to examine variation in heart disease death rates by the social class of decedents. The term, "social class" refers to a complex set of phenomena such as control over economic resources, social status, and power relative to others in society. The target population for this study was African-American adults aged 35-74 years old who resided in the United States during the years 1996-1997. As a proxy for social class, we examined 5 levels of educational attainment: 0-8 years of school completed (Social Class I), 9-11 years of school completed (Social Class II), high school graduate/12 years of school completed (Social Class III), some college completed (Social Class IV), and college degree completed (Social Class V). Older age, male gender, and lower social class were all independently associated with higher heart disease death rates. For all ages, more disadvantaged social classes had a higher risk of heart disease mortality. The highest relative risks were found for Social Classes I and II among the younger age groups. Many of the "prerequisites" for the "heart healthy lifestyle" are predicated on the benefits of a privileged social class position. For African Americans, there are the additional stressors of segregation, exclusion, and discrimination to overcome, as well as the cumulative physiological toll of lifetime resistance to various forms of racism. For many African Americans in disadvantaged social class positions, the obstacles to reducing the risk for heart disease are very difficult to overcome.

  13. Heart failure in African Americans: disparities can be overcome.

    PubMed

    Sharma, Alok; Colvin-Adams, Monica; Yancy, Clyde W

    2014-05-01

    African Americans are disproportionately affected by heart failure, with a high prevalence at an early age. Hypertension, diabetes, obesity, and chronic kidney disease are all common in African Americans and all predispose to heart failure. Neurohormonal imbalances, endothelial dysfunction, genetic polymorphisms, and socioeconomic factors also contribute. In general, the same evidence-based treatment guidelines that apply to white patients with heart failure also apply to African Americans. However, the combination of hydralazine and isosorbide dinitrate is advised specifically for African Americans.

  14. 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of pediatric and neonatal patients: pediatric basic life support.

    PubMed

    2006-05-01

    This publication presents the 2005 American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) of the pediatric patient and the 2005 American Academy of Pediatrics/AHA guidelines for CPR and ECC of the neonate. The guidelines are based on the evidence evaluation from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations, hosted by the American Heart Association in Dallas, Texas, January 23-30, 2005. The "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" contain recommendations designed to improve survival from sudden cardiac arrest and acute life-threatening cardiopulmonary problems. The evidence evaluation process that was the basis for these guidelines was accomplished in collaboration with the International Liaison Committee on Resuscitation (ILCOR). The ILCOR process is described in more detail in the "International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations." The recommendations in the "2005 AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" confirm the safety and effectiveness of many approaches, acknowledge that other approaches may not be optimal, and recommend new treatments that have undergone evidence evaluation. These new recommendations do not imply that care involving the use of earlier guidelines is unsafe. In addition, it is important to note that these guidelines will not apply to all rescuers and all victims in all situations. The leader of a resuscitation attempt may need to adapt application of the guidelines to unique circumstances. The following are the major pediatric advanced life support changes in the 2005 guidelines: There is further caution about the use of endotracheal tubes. Laryngeal mask airways are acceptable when used by experienced

  15. AHA Scientific Statement Population Approaches to Improve Diet, Physical Activity, and Smoking Habits A Scientific Statement From the American Heart Association

    PubMed Central

    Mozaffarian, Dariush; Afshin, Ashkan; Benowitz, Neal L.; Bittner, Vera; Daniels, Stephen R.; Franch, Harold A.; Jacobs, David R.; Kraus, William E.; Kris-Etherton, Penny M.; Krummel, Debra A.; Popkin, Barry M.; Whitsel, Laurie P.; Zakai, Neil A.

    2013-01-01

    Background Poor lifestyle, including suboptimal diet, physical inactivity, and tobacco use are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established. Methods and Results For this American Heart Association Scientific Statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) media and education campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies. Conclusions This systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other

  16. Social class and heart disease mortality among African Americans.

    PubMed

    Barnett, Elizabeth; Williams, Carol R; Moore, Latetia; Chen, Fangfei

    2002-01-01

    The purpose of the present study was to examine variation in heart disease death rates by the social class of decedents. The term, "social class" refers to a complex set of phenomena such as control over economic resources, social status, and power relative to others in society. The target population for this study was African-American adults aged 35-74 years old who resided in the United States during the years 1996-1997. As a proxy for social class, we examined 5 levels of educational attainment: 0-8 years of school completed (Social Class I), 9-11 years of school completed (Social Class II), high school graduate/12 years of school completed (Social Class III), some college completed (Social Class IV), and college degree completed (Social Class V). Older age, male gender, and lower social class were all independently associated with higher heart disease death rates. For all ages, more disadvantaged social classes had a higher risk of heart disease mortality. The highest relative risks were found for Social Classes I and II among the younger age groups. Many of the "prerequisites" for the "heart healthy lifestyle" are predicated on the benefits of a privileged social class position. For African Americans, there are the additional stressors of segregation, exclusion, and discrimination to overcome, as well as the cumulative physiological toll of lifetime resistance to various forms of racism. For many African Americans in disadvantaged social class positions, the obstacles to reducing the risk for heart disease are very difficult to overcome. PMID:12477160

  17. Evaluation of the American College of Cardiology/American Heart Association and the Society for Coronary Angiography and Interventions lesion classification system in the current "stent era" of coronary interventions (from the ACC-National Cardiovascular Data Registry).

    PubMed

    Krone, Ronald J; Shaw, Richard E; Klein, Lloyd W; Block, Peter C; Anderson, H Vernon; Weintraub, William S; Brindis, Ralph G; McKay, Charles R

    2003-08-15

    In 1988 American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for Coronary Angioplasty proposed a lesion classification system to stratify lesions by difficulty and risk to better understand the outcomes of coronary interventions. It was a 3-level (A, B, and C) classification based on 11 lesion characteristics. A modification, dividing the intermediate B category into B1 and B2, is also in common use. Recently, a simplification of this classification was evaluated using the large Society for Cardiac Angiography and Interventions (SCAI) Registry (SCAI I = non-C/patent; SCAI II = C/patent; SCAI III = non-C/occluded; SCAI IV = C/occluded). The lesion classification systems were evaluated in 61,926 patients from the ACC National Cardiovascular Data Registry who underwent single-vessel percutaneous coronary intervention between January 1998 and September 2000. Stents were placed in 74.5% of patients. Logistic models for lesion success and complications were constructed and compared. The c statistic for success using the ACC/AHA original classification system was 0.69, 0.71 for the modified ACC/AHA system, and 0.75 for the SCAI classification. The range of complication and success rates was greater using the SCAI models, and the logistic models for success and complication were more robust for the SCAI system. Thus, in the large ACC-National Cardiovascular Data Registry, with a high percentage of stent usage, the simpler SCAI lesion classification provided better discrimination for success and complications than the more complex ACC/AHA lesion classification system-original or modified.

  18. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie D'intervention).

    PubMed

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella®; left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  19. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care (Endorsed by the American Heart Association, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention).

    PubMed

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-06-01

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  20. Plant-Based No Added Fat or American Heart Association Diets, Impact on Cardiovascular Risk in Obese Hypercholesterolemic Children and Their Parents

    PubMed Central

    Macknin, Michael; Kong, Tammie; Weier, Adam; Worley, Sarah; Tang, Anne S.; Alkhouri, Naim; Golubic, Mladen

    2015-01-01

    Objective To perform a randomized trial to determine if there is cardiovascular disease (CVD) risk reduction from a plant-based no added fat diet (PB) and the American Heart Association Diet (AHA) in children. Study design Four-week (4/20/2013-5/18/2013) prospective randomized trial in a large Midwestern hospital system’s predominantly middle class outpatient pediatric practices. Thirty children (9–18 years old) parent pairs with a last recorded child BMI >95th percentile and child cholesterol >169 mg/dL were randomized to PB or AHA with weekly 2-hour classes of nutrition education. Results Children on PB had nine and children on AHA had four statistically significant (P<0.05) beneficial changes from baseline (mean decreases): BMI Z-scorePB (−0.14), systolic blood pressurePB (−6.43 mm Hg), total cholesterolPB (−22.5 mg/dL), low density lipoproteinPB (−13.14 mg/dL), hsCRPPB (−2.09 mg/L), insulinPB (−5.42uU/ml), myeloperoxidasePB/AHA (−75.34/69.23 pmol/L), mid-arm circumferencePB/AHA (−2.02/−1.55 cm), weightPB/AHA (−3.05/ −1.14kg) and waist circumferenceAHA (−2.96 cm). Adults on PB and AHA had seven and two respectively statistically significant (P<0.05) beneficial changes. The significant change favoring AHA was a 1% difference in children’s waist circumference. Difficulty shopping for food for the PB was the only statistically significant acceptability barrier. Conclusions PB and the AHA in both children and adults demonstrated potentially beneficial changes from baseline in risk factors for CVD. Future larger, long-term randomized trials with easily accessible PB foods will further define the role of the PB in preventing CVD. PMID:25684089

  1. 75 FR 73076 - National Gas Supply Association, American Forest and Paper Association, Inc., American Public Gas...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-29

    ... Energy Regulatory Commission National Gas Supply Association, American Forest and Paper Association, Inc., American Public Gas Association, Independent Petroleum Association of America, Process Gas Consumers Group... Association, American Forest and Paper Association, Inc., American Public Gas Association,...

  2. Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults.

    PubMed

    Mattei, Josiemer; Bhupathiraju, Shilpa; Tucker, Katherine L

    2013-11-01

    A score based on diet and lifestyle recommendations from the AHA has been associated with cardiovascular risk factors. We aimed to assess whether the diet components alone were associated with metabolic syndrome (MetS) and allostatic load (AL; a composite measure of 10 physiologically dysregulated variables). The diet score ranged from 0 to 90 and included intake components for dietary fats, fruits and vegetables, whole grains, salt, added sugars, and alcohol and was tested in a cross-sectional analysis of 1318 Puerto Rican adults (aged 45-75 y; 72% women) living in Boston, MA. The mean ± SD diet score was 28.0 ± 9.9 for men and 30.0 ± 10.1 for women. Replicating findings from a previous study in this cohort that used both the diet and lifestyle components, we observed associations between the diet-only score and insulin, waist circumference, and HDL cholesterol. We found novel significant associations between the continuous diet score and AL components, namely an inverse association with urinary cortisol and a positive association with serum dehydroepiandrosterone sulfate in women as well as an inverse association with urinary norepinephrine in men (all P < 0.05). In multinomial logistic regression, every 10 AHA diet score units were associated with 22% (95% CI: 1, 38; P = 0.043) lower odds of having ≥6 (vs. ≤2) dysregulated AL components in women. In men, every 10 diet score units were associated with lower odds of MetS (OR: 0.69; 95% CI: 0.52, 0.93; P = 0.016). Following AHA recommendations for a healthy diet may protect against the development of components of MetS and AL in Puerto Rican adults.

  3. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram

  4. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

    2014-02-01

    The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG

  5. Give your heart a workout

    MedlinePlus

    ... JM, Ard JD, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ... risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. ...

  6. American Indian and Alaska Native Heart Disease and Stroke

    MedlinePlus

    ... and Stroke Maps Social Determinants of Health Maps Poverty Unemployment High School Education Health Insurance Million Hearts® ... percent have a bachelor's degree or higher. The poverty rate of people who report American Indian and ...

  7. American Diabetes Association

    MedlinePlus

    ... 2383) Give by Mail Close November is American Diabetes Month® Share your personal diabetes story and show ... Next » « Previous Our Mission: To prevent and cure diabetes and to improve the lives of all people ...

  8. Storytelling: The Heart of American Indian Scholarship

    ERIC Educational Resources Information Center

    Washburn, Frances

    2006-01-01

    Recently some writers and scholars have complained that the academy, particularly American Indian Studies (AIS) programs, gives too much attention to American Indian literature while ignoring scholarly works that focus on the pressing needs of American Indian communities in the areas of economic development, social justice, and sovereignty, among…

  9. American Chiropractic Association

    MedlinePlus

    ... Radio Chiropractic Cares Social Media Facebook Twitter YouTube Instagram LinkedIn Advocacy Regulatory Policy Issue Briefs Medicare Veteran's ... for Event Connect with ACA Facebook Twitter YouTube Instagram LinkedIn Featured Executive Sponsors: © 2016 Copyright American Chiropractic ...

  10. American Association for Geriatric Psychiatry

    MedlinePlus

    ... in your area. Read more » AAGP Journal Official Journal of the American Association for Geriatric Psychiatry. Read more ... RESEARCHERS GMHF Scholars Since my program is so small and there is not much interest among my ...

  11. 77 FR 5373 - American Heart Month, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-03

    ... disease, high cholesterol, high blood pressure, physical inactivity, obesity, tobacco use, and alcohol.... Resources on how to join the initiative are available at: MillionHearts.HHS.gov . To secure our children's heart health and end childhood obesity within a generation, First Lady Michelle Obama's Let's...

  12. ACCF/AHA methodology for the development of quality measures for cardiovascular technology: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Performance Measures.

    PubMed

    Bonow, Robert O; Douglas, Pamela S; Buxton, Alfred E; Cohen, David J; Curtis, Jeptha P; Delong, Elizabeth; Drozda, Joseph P; Ferguson, T Bruce; Heidenreich, Paul A; Hendel, Robert C; Masoudi, Frederick A; Peterson, Eric D; Taylor, Allen J

    2011-09-27

    Consistent with the growing national focus on healthcare quality, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have taken a leadership role over the past decade in developing measures of the quality of cardiovascular care by convening a joint ACCF/AHA Task Force on Performance Measures. The Task Force is charged with identifying the clinical topics appropriate for the development of performance measures and with assembling writing committees composed of clinical and methodological experts in collaboration with appropriate subspecialty societies. The Task Force has also created methodology documents that offer guidance in the development of process, outcome, composite, and efficiency measures. Cardiovascular performance measures using existing ACCF/AHA methodology are based on Class I or Class III guidelines recommendations, usually with Level A evidence. These performance measures, based on evidence-based ACCF/AHA guidelines, remain the most rigorous quality measures for both internal quality improvement and public reporting. However, many of the tools for diagnosis and treatment of cardiovascular disease involve advanced technologies, such as cardiac imaging, for which there are often no underlying guideline documents. Because these technologies affect the quality of cardiovascular care and also have the potential to contribute to cardiovascular health expenditures, there is a need for more critical assessment of the use of technology, including the development of quality and performance measures in areas in which guideline recommendations are absent. The evaluation of quality in the use of cardiovascular technologies requires consideration of multiple parameters that differ from other healthcare processes. The present document describes methodology for development of 2 new classes of quality measures in these situations, appropriate use measures and structure/safety measures. Appropriate use measures are based on

  13. 2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

    PubMed

    Rihal, Charanjit S; Naidu, Srihari S; Givertz, Michael M; Szeto, Wilson Y; Burke, James A; Kapur, Navin K; Kern, Morton; Garratt, Kirk N; Goldstein, James A; Dimas, Vivian; Tu, Thomas

    2015-05-19

    Although historically the intra-aortic balloon pump has been the only mechanical circulatory support device available to clinicians, a number of new devices have become commercially available and have entered clinical practice. These include axial flow pumps, such as Impella(®); left atrial to femoral artery bypass pumps, specifically the TandemHeart; and new devices for institution of extracorporeal membrane oxygenation. These devices differ significantly in their hemodynamic effects, insertion, monitoring, and clinical applicability. This document reviews the physiologic impact on the circulation of these devices and their use in specific clinical situations. These situations include patients undergoing high-risk percutaneous coronary intervention, those presenting with cardiogenic shock, and acute decompensated heart failure. Specialized uses for right-sided support and in pediatric populations are discussed and the clinical utility of mechanical circulatory support devices is reviewed, as are the American College of Cardiology/American Heart Association clinical practice guidelines.

  14. Macro- and micronutrients in African-Americans with heart failure.

    PubMed

    Bhattacharya, Syamal K; Ahokas, Robert A; Carbone, Laura D; Newman, Kevin P; Gerling, Ivan C; Sun, Yao; Weber, Karl T

    2006-03-01

    An emerging body of evidence suggests secondary hyperparathyroidism (SHPT) may be an important covariant of congestive heart failure (CHF), especially in African-Americans (AA) where hypovitaminosis D is prevalent given that melanin, a natural sunscreen, mandates prolonged exposure of skin to sunlight and where a housebound lifestyle imposed by symptomatic CHF limits outdoor activities and hence sunlight exposure. In addition to the role of hypovitaminosis D in contributing to SHPT is the increased urinary and fecal losses of macronutrients Ca(2+) and Mg(2+) associated with the aldosteronism of CHF and their heightened urinary losses with furosemide treatment of CHF. Thus, a precarious Ca(2+) balance seen with reduced serum 25(OH)D is further compromised when AA develop CHF with circulating RAAS activation and are then treated with a loop diuretic. SHPT accounts for a paradoxical Ca(2+) overloading of diverse tissues and the induction of oxidative stress at these sites which spills over to the systemic circulation. In addition to SHPT, hypozincemia and hyposelenemia have been found in AA with compensated and decompensated heart failure and where an insufficiency of these micronutrients may have its origins in inadequate dietary intake, altered rates of absorption or excretion and/or tissue redistribution, and treatment with an ACE inhibitor or AT(1) receptor antagonist. Zn and Se deficiencies, which compromise the activity of several endogenous antioxidant defenses, could prove contributory to the severity of heart failure and its progressive nature. These findings call into question the need for nutriceutical treatment of heart failure and which is complementary to today's pharmaceuticals, especially in AA. PMID:16819577

  15. Heart Disease Down Among Over-40 Americans

    MedlinePlus

    ... risk factors is likely why the rates of heart disease are coming down. These factors include high blood pressure, abnormal cholesterol, smoking, diabetes, overweight and obesity. The rates of high blood pressure and abnormal cholesterol haven' ...

  16. Heart failure - fluids and diuretics

    MedlinePlus

    ... Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research. State of the science: promoting self-care in persons with heart failure: ...

  17. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-03-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  18. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization : a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology. Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Brindis, Ralph G; Beckman, Karen J; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Allen, Joseph M; Douglas, Pamela S; Hendel, Robert C; Peterson, Eric D

    2009-02-15

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  19. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization: a report by the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2009-02-10

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an appropriateness review of common clinical scenarios in which coronary revascularization is frequently considered. The clinical scenarios were developed to mimic common situations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. Approximately 180 clinical scenarios were developed by a writing committee and scored by a separate technical panel on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization was considered appropriate and likely to improve health outcomes or survival. Scores of 1 to 3 indicate revascularization was considered inappropriate and unlikely to improve health outcomes or survival. The mid range (4 to 6) indicates a clinical scenario for which the likelihood that coronary revascularization would improve health outcomes or survival was considered uncertain. For the majority of the clinical scenarios, the panel only considered the appropriateness of revascularization irrespective of whether this was accomplished by percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG). In a select subgroup of clinical scenarios in which revascularization is generally considered appropriate, the appropriateness of PCI and CABG individually as the primary mode of revascularization was considered. In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy were viewed less favorably. It is

  20. 78 FR 8345 - American Heart Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ..., obesity, tobacco use, and physical inactivity. Any one of them can lead to heart disease, and additional..., many insurance plans must cover certain preventive services like blood pressure screening and obesity... affordable health insurance available to millions of men, women, and children--including those with...

  1. American Heart Association’s Life’s Simple 7: Avoiding Heart Failure and Preserving Cardiac Structure and Function

    PubMed Central

    Folsom, Aaron R.; Shah, Amil M.; Lutsey, Pamela L.; Roetker, Nicholas S.; Alonso, Alvaro; Avery, Christy L.; Miedema, Michael D.; Konety, Suma; Chang, Patricia P.; Solomon, Scott D.

    2015-01-01

    BACKGROUND Many people may underappreciate the role of lifestyle in avoiding heart failure. We estimated whether greater adherence in middle age to American Heart Association’s Life’s Simple 7 guidelines -- on smoking, body mass, physical activity, diet, cholesterol, blood pressure, and glucose -- is associated with lower lifetime risk of heart failure and greater preservation of cardiac structure and function in old age. METHODS We studied the population-based Atherosclerosis Risk in Communities Study cohort of 13,462 adults aged 45-64 years in 1987-89. From the 1987-89 risk factor measurements, we created a Life’s Simple 7 score (range 0-14, giving 2 points for ideal, 1 point for intermediate, and 0 points for poor components). We identified 2,218 incident heart failure events using surveillance of hospital discharge and death codes through 2011. In addition, in 4,855 participants free of clinical cardiovascular disease in 2011-13, we performed echocardiography from which we quantified left ventricular hypertrophy and diastolic dysfunction. RESULTS One in four participants (25.5%) developed heart failure through age 85. Yet, this lifetime heart failure risk was 14.4% for those with a middle-age Life’s Simple 7 score of 10-14 (optimal), 26.8% for a score of 5-9 (average), and 48.6% for a score of 0-4 (inadequate). Among those with no clinical cardiovascular event, the prevalence of left ventricular hypertrophy in late life was approximately 40% as common, and diastolic dysfunction was approximately 60% as common, among those with an optimal middle-age Life’s Simple 7 score compared with an inadequate score. CONCLUSIONS Greater achievement of American Heart Association’s Life’s Simple 7 in middle-age is associated with a lower lifetime occurrence of heart failure and greater preservation of cardiac structure and function. PMID:25908393

  2. Heart disease - resources

    MedlinePlus

    Resources - heart disease ... The following organizations are good resources for information on heart disease: American Heart Association -- www.heart.org Centers for Disease Control and Prevention -- www.cdc.gov/heartdisease

  3. Use of isosorbide dinitrate and hydralazine in African-Americans with heart failure 9 years after the African-American Heart Failure Trial.

    PubMed

    Ferdinand, Keith Copelin; Elkayam, Uri; Mancini, Donna; Ofili, Elizabeth; Piña, Ileana; Anand, Inder; Feldman, Arthur Michael; McNamara, Dennis; Leggett, Christopher

    2014-07-01

    The 2013 American College of Cardiology Foundation/American Heart Association guidelines recommend combined isosorbide dinitrate (ISDN) and hydralazine to reduce mortality and morbidity for African-Americans with symptomatic heart failure (HF) and reduced ejection fraction, currently receiving optimal medical therapy (class I, level A). Nitrates can alleviate HF symptoms, but continuous use is limited by tolerance. Hydralazine may mitigate nitrate tolerance, and the ISDN-hydralazine combination in the Vasodilators in Heart Failure Trial (V-HeFT) I improved survival and exercise tolerance in men with dilated cardiomyopathy or HF with reduced ejection fraction, most notably in self-identified black participants. In the subsequent V-HeFT II, survival was greater with enalapril than with ISDN-hydralazine in the overall cohort, but mortality rate was similar in the enalapril and ISDN-hydralazine groups in the self-identified black patients. Consequently, in the African-American Heart Failure Trial (A-HeFT) in self-identified black patients with symptomatic HF, adding a fixed-dose combination ISDN-hydralazine to modern guideline-based care improved outcomes versus placebo, including all-cause mortality, and led to early trial termination. Hypertension underlies HF, especially in African-Americans; the A-HeFT and its substudies demonstrated not only improvements in echocardiographic parameters, morbidity, and mortality but also a decrease in hospitalizations, potentially affecting burgeoning HF health-care costs. Genetic characteristics may, therefore, determine response to ISDN-hydralazine, and the Genetic Risk Assessment in Heart Failure substudy demonstrated important hypothesis-generating pharmacogenetic data.

  4. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.

    PubMed

    Simpson, John; Lopez, Leo; Acar, Philippe; Friedberg, Mark; Khoo, Nee; Ko, Helen; Marek, Jan; Marx, Gerald; McGhie, Jackie; Meijboom, Folkert; Roberson, David; Van den Bosch, Annemien; Miller, Owen; Shirali, Girish

    2016-10-01

    Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment. PMID:27655864

  5. Review: Heart failure with preserved ejection fraction in African Americans.

    PubMed

    Shah, Sachil

    2012-01-01

    Heart failure (HF) affects 5,700 000 people in the United States, with heart failure with preserved ejection fraction (HFPEF) being responsible for between 30%-50% of acute admissions. Epidemiological studies and HF registries have found HFPEF patients to be older, hypertensive and to have a history of atrial fibrillation. These findings, however, may not be fully applicable to African Americans, as they have been poorly studied making up only a minority of the test subjects. This review article is intended to discuss the pathophysiology and epidemiology of HFPEF within African Americans, highlight the differences compared to Caucasian populations and review current treatment guidelines. Studies looking at African Americans in particular have shown them to be younger, female and have worse diastolic dysfunction compared to Caucasian populations. African Americans also have been shown to have a worse mortality outcome especially in patients without coronary artery disease. The treatment of HFPEF is primarily symptomatic with no survival benefit seen in randomized controlled trials. Mechanisms postulated for the worse prognosis in African Americans with HFPEF include: greater incidence of hypertension and diastolic dysfunction, undefined race-driven genetic predispositions or relative resistance to medications that treat HF in general. The biological predispositions may also be compounded by inequality of healthcare access; something still felt to exist today. Prospective studies and randomized controlled trials need to be conducted with particular emphasis on African American populations to fully elucidate this disease and to formulate race specific treatment outcomes for the future.

  6. Comparison of Health-related Quality of Life between American and Taiwanese Heart Failure Patients

    PubMed Central

    Huang, Tsuey-Yuan; Moser, Debra K.; Hwang, Shiow-Li; Lennie, Terry A.; Chung, Misook L.

    2011-01-01

    Few investigators have compared health-related quality of life (HRQOL) in heart failure (HF) patients from different countries. The purposes of this study were to compare HRQOL between American (n=87) and Taiwanese (n=88) HF patients and to determine factors associated with HRQOL in both groups. In this cross-sectional survey, HRQOL was measured using the Minnesota Living with Heart Failure Questionnaire. American patients rated their HRQOL worse than did Taiwanese patients. Socio-demographics, disease severity, and symptom severity were associated with HRQOL, accounting for 42.4% of the variance in HRQOL in Americans and 57.3% in Taiwanese. Symptom severity was the most important predictor of HRQOL in both groups. Interventions targeting symptom severity could improve HF patients’ HRQOL. PMID:20371738

  7. MedlinePlus: Heart Diseases--Prevention

    MedlinePlus

    ... and Tests Cholesterol Test (American Association for Clinical Chemistry) Heart-Health Screenings (American Heart Association) hs-CRP Test (American Association for Clinical Chemistry) Screening for Peripheral Artery Disease and Cardiovascular Disease ...

  8. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians.

    PubMed

    Douglas, Pamela S; Garcia, Mario J; Haines, David E; Lai, Wyman W; Manning, Warren J; Patel, Ayan R; Picard, Michael H; Polk, Donna M; Ragosta, Michael; Parker Ward, R; Weiner, Rory B

    2011-03-01

    The American College of Cardiology Foundation (ACCF), in partnership with the American Society of Echocardiography (ASE) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 (1) and the original stress echocardiography appropriateness criteria published in 2008 (2). This revision reflects new clinical data, reflects changes in test utilization patterns,and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria.The indications (clinical scenarios)were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of the original appropriate use criteria (AUC).The 202 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9,to designate appropriate use(median 7 to 9), uncertain use(median 4 to 6), and inappropriate use (median 1 to 3). Ninety-seven indications were rated as appropriate, 34 were rated as uncertain, and 71 were rated as inappropriate. In general,the use of echocardiography for initial diagnosis when there is a change in clinical status or when the results of the echocardiogram are anticipated to change patient management were rated appropriate. Routine testing when there was no change in clinical status or when results of testing were unlikely to modify management were more likely to be inappropriate than appropriate/uncertain.The AUC for echocardiography have the potential to impact physician decision making,healthcare delivery, and reimbursement policy. Furthermore,recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research.

  9. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians.

    PubMed

    Douglas, Pamela S; Garcia, Mario J; Haines, David E; Lai, Wyman W; Manning, Warren J; Patel, Ayan R; Picard, Michael H; Polk, Donna M; Ragosta, Michael; Parker Ward, R; Weiner, Rory B

    2011-03-01

    The American College of Cardiology Foundation (ACCF), in partnership with the American Society of Echocardiography (ASE) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 (1) and the original stress echocardiography appropriateness criteria published in 2008 (2). This revision reflects new clinical data, reflects changes in test utilization patterns,and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria.The indications (clinical scenarios)were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of the original appropriate use criteria (AUC).The 202 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9,to designate appropriate use(median 7 to 9), uncertain use(median 4 to 6), and inappropriate use (median 1 to 3). Ninety-seven indications were rated as appropriate, 34 were rated as uncertain, and 71 were rated as inappropriate. In general,the use of echocardiography for initial diagnosis when there is a change in clinical status or when the results of the echocardiogram are anticipated to change patient management were rated appropriate. Routine testing when there was no change in clinical status or when results of testing were unlikely to modify management were more likely to be inappropriate than appropriate/uncertain.The AUC for echocardiography have the potential to impact physician decision making,healthcare delivery, and reimbursement policy. Furthermore,recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID

  10. American Association for Marriage and Family Therapy

    MedlinePlus

    ... My Account Find Members Benefits American Association for Marriage and Family Therapy 112 South Alfred Street Alexandria, ... Fax: (703) 838-9805 © 2002 - American Association for Marriage and Family Therapy Terms of Use | Privacy Policy | ...

  11. Public policy on smoking and health: toward a smoke-free generation by the year 2000. A statement of a working group to the Subcommittee on Smoking of the American Heart Association.

    PubMed

    Warner, K E; Ernster, V L; Holbrook, J H; Lewit, E M; Pertschuk, M; Steinfeld, J L; Whelan, E M

    1986-02-01

    On May 20, 1984, the Surgeon General challenged the health community to work toward attainment of a smoke-free society by the year 2000. The leadership of the nation's three major voluntary organizations joined numerous associations of health professionals in accepting the challenge. The Subcommittee on Smoking of the American Heart Association (AHA) has concluded that attaining this objective requires the development and implementation of public policies designed to facilitate the transition from a smoking to a nonsmoking society. To study the relevant issues and recommend appropriate policies, the subcommittee commissioned a working group of distinguished experts in the field of smoking and health to prepare a policy statement. The statement, published here, has received the enthusiastic endorsement of the Subcommittee on Smoking and the leadership of the AHA. The working group discusses and recommends four policies: Increase the federal cigarette excise tax. Eliminate or restrict tobacco advertising and other forms of promotion. Assure the rights of nonsmokers to clean air through legislative means. Identify mechanisms to ease and assist the transition of tobacco farmers to other crops or careers.

  12. Healthy Lifestyle Interventions to Combat Noncommunicable Disease—A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine.

    PubMed

    Arena, Ross; Guazzi, Marco; Lianov, Liana; Whitsel, Laurie; Berra, Kathy; Lavie, Carl J; Kaminsky, Leonard; Williams, Mark; Hivert, Marie-France; Franklin, Nina Cherie; Myers, Jonathan; Dengel, Donald; Lloyd-Jones, Donald M; Pinto, Fausto J; Cosentino, Francesco; Halle, Martin; Gielen, Stephan; Dendale, Paul; Niebauer, Josef; Pelliccia, Antonio; Giannuzzi, Pantaleo; Corra, Ugo; Piepoli, Massimo F; Guthrie, George; Shurney, Dexter

    2015-08-01

    Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale. PMID:26143646

  13. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A; Masoudi, Frederick A; Dehmer, Gregory J; Patel, Manesh R; Smith, Peter K; Chambers, Charles E; Ferguson, T Bruce; Garcia, Mario J; Grover, Frederick L; Holmes, David R; Klein, Lloyd W; Limacher, Marian C; Mack, Michael J; Malenka, David J; Park, Myung H; Ragosta, Michael; Ritchie, James L; Rose, Geoffrey A; Rosenberg, Alan B; Russo, Andrea M; Shemin, Richard J; Weintraub, William S; Wolk, Michael J; Bailey, Steven R; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Shaw, Leslee; Stainback, Raymond F; Allen, Joseph M

    2012-04-01

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  14. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/SCCT 2012 Appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography.

    PubMed

    Patel, Manesh R; Dehmer, Gregory J; Hirshfeld, John W; Smith, Peter K; Spertus, John A

    2012-02-28

    The American College of Cardiology Foundation (ACCF), Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and the American Association for Thoracic Surgery, along with key specialty and subspecialty societies, conducted an update of the appropriate use criteria (AUC) for coronary revascularization frequently considered. In the initial document, 180 clinical scenarios were developed to mimic patient presentations encountered in everyday practice and included information on symptom status, extent of medical therapy, risk level as assessed by noninvasive testing, and coronary anatomy. This update provides a reassessment of clinical scenarios the writing group felt to be affected by significant changes in the medical literature or gaps from prior criteria. The methodology used in this update is similar to the initial document, and the definition of appropriateness was unchanged. The technical panel scored the clinical scenarios on a scale of 1 to 9. Scores of 7 to 9 indicate that revascularization is considered appropriate and likely to improve patients' health outcomes or survival. Scores of 1 to 3 indicate revascularization is considered inappropriate and unlikely to improve health outcomes or survival. Scores in the mid-range (4 to 6) indicate a clinical scenario for which the likelihood that coronary revascularization will improve health outcomes or survival is uncertain. In general, as seen with the prior AUC, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia is appropriate. In contrast, revascularization of asymptomatic patients or patients with low-risk findings on noninvasive testing and minimal medical therapy are viewed less favorably. The technical panel felt that based on recent studies, coronary artery bypass grafting remains an appropriate method of revascularization for patients with high burden of coronary artery disease (CAD

  15. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP).

    PubMed

    Steinke, Elaine E; Jaarsma, Tiny; Barnason, Susan A; Byrne, Molly; Doherty, Sally; Dougherty, Cynthia M; Fridlund, Bengt; Kautz, Donald D; Mårtensson, Jan; Mosack, Victoria; Moser, Debra K

    2013-11-01

    After a cardiovascular event, patients and their families often cope with numerous changes in their lives, including dealing with consequences of the disease or its treatment on their daily lives and functioning. Coping poorly with both physical and psychological challenges may lead to impaired quality of life. Sexuality is one aspect of quality of life that is important for many patients and partners that may be adversely affected by a cardiac event. The World Health Organization defines sexual health as '… a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences ….'(1(p4)) The safety and timing of return to sexual activity after a cardiac event have been well addressed in an American Heart Association scientific statement, and decreased sexual activity among cardiac patients is frequently reported.(2) Rates of erectile dysfunction (ED) among men with cardiovascular disease (CVD) are twice as high as those in the general population, with similar rates of sexual dysfunction in females with CVD.(3) ED and vaginal dryness may also be presenting signs of heart disease and may appear 1-3 years before the onset of angina pectoris. Estimates reflect that only a small percentage of those with sexual dysfunction seek medical care;(4) therefore, routine assessment of sexual problems and sexual counselling may be of benefit as part of effective management by physicians, nurses, and other healthcare providers. PMID:23900695

  16. Guidelines for clinical use of cardiac radionuclide imaging, December 1986. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Cardiovascular Procedures (Subcommittee on Nuclear Imaging).

    PubMed

    1986-12-01

    This report describes the nuclear cardiology procedures available for use as diagnostic techniques in patients with definite or suspected cardiovascular disease. The usefulness of myocardial imaging, radionuclide angiocardiography, and other radionuclide cardiovascular imaging techniques is classified within specific disease states. The clinical utility of each technique is graded from I to IV, depending on the clinical importance of the technique (I equals most important; IV equals not indicated). A grade of V is given for methods now considered to be in their research phase. The usefulness of these methods is discussed in patients with acute ischemic heart disease, chronic ischemic heart disease, valvular heart disease, pulmonary vascular disease, and hypertensive heart disease. Selected references are provided.

  17. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research.

  18. ACCF/SCAI/AATS/AHA/ASE/ASNC/HFSA/HRS/SCCM/SCCT/SCMR/STS 2012 appropriate use criteria for diagnostic catheterization: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

    PubMed

    Patel, Manesh R; Bailey, Steven R; Bonow, Robert O; Chambers, Charles E; Chan, Paul S; Dehmer, Gregory J; Kirtane, Ajay J; Wann, L Samuel; Ward, R Parker

    2012-05-29

    The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. PMID:22578925

  19. A national interactive web-based physical activity intervention in women, evaluation of the american heart association choose to move program 2006-2007.

    PubMed

    Lieber, Sarah B; Redberg, Rita F; Blumenthal, Roger S; Gandhi, Anu; Robb, Karen J; Mora, Samia

    2012-06-15

    Increased physical activity (PA) is associated with improvement of cardiac risk factors and prevention of cardiovascular disease, yet many women remain sedentary. With rising Internet use, Web-based interventions provide an alternative to improve PA, but their effectiveness for change in PA and quality of life (QOL) in a real-world setting is unknown. Participants were United States women ≥18 years old who received 12 weekly PA modules and completed surveys on PA, QOL, and readiness for PA at registration (registration cohort, n = 3,796) or registration and 12 weeks (evaluation cohort, n = 892). QOL was assessed with a modified Short Form-36 with subscores for energy and well-being. Participants showed significant (p <0.001) favorable changes in PA (baseline, median 240 kcal/week, interquartile range 62 to 667; 12 weeks, 343 kcal/week, 131 to 828), stage of readiness for PA, and body mass index (baseline, 29.3 kg/m(2), 24.9 to 34.7; 12 weeks, 28.9 kg/m(2), 24.6 to 34.2). Significant improvements (p <0.0001) were also found in composite scores for energy and well-being. Compliance with PA guideline recommendations increased from 15.8% to 21.4%. Program weeks completed (p = 0.03), energy (p = 0.04), and well-being (p = 0.002) were significantly associated with achieving guideline compliance. In women reporting no PA at baseline (n = 88), program participation resulted in 54.6% achieving some PA and another 9.1% achieving total compliance with recommendations. In conclusion, in this national cohort of women, a 12-week Web-based intervention improved PA and QOL measurements, resulting in higher short-term PA guideline compliance and better QOL. Increasing use of this simple Web-based tool could improve PA and promote disease prevention.

  20. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association.

    PubMed

    Goldstein, Benjamin I; Carnethon, Mercedes R; Matthews, Karen A; McIntyre, Roger S; Miller, Gregory E; Raghuveer, Geetha; Stoney, Catherine M; Wasiak, Hank; McCrindle, Brian W

    2015-09-01

    In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications.

  1. Genetic Syndromes associated with Congenital Heart Disease

    PubMed Central

    2015-01-01

    Recent research has demonstrated that genetic alterations or variations contribute considerably to the development of congenital heart disease. Many kinds of genetic tests are commercially available, and more are currently under development. Congenital heart disease is frequently accompanied by genetic syndromes showing both cardiac and extra-cardiac anomalies. Congenital heart disease is the leading cause of birth defects, and is an important cause of morbidity and mortality during infancy and childhood. This review introduces common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome, Williams syndrome, and Noonan syndrome. Although surgical techniques and perioperative care have improved substantially, patients with genetic syndromes may be at an increased risk of death or major complications associated with surgery. Therefore, risk management based on an accurate genetic diagnosis is necessary in order to effectively plan the surgical and medical management and follow-up for these patients. In addition, multidisciplinary approaches and care for the combined extra-cardiac anomalies may help to reduce mortality and morbidity accompanied with congenital heart disease. PMID:26413101

  2. Prognostic Value of Stress Echocardiography in Patients With Low-Intermediate or High Short-Term (10 Years) Versus Low (<39%) or High (≥39%) Lifetime Predicted Risk of Cardiovascular Disease According to the American College of Cardiology/American Heart Association 2013 Cardiovascular Risk Calculator.

    PubMed

    Yao, Siu-Sun; Supariwala, Azhar; Yao, Amanda; Dukkipati, Sai Sreenija; Wyne, Jamshad; Chaudhry, Farooq A

    2015-09-01

    This study evaluates the prognostic value of stress echocardiography (Secho) in short-term (10 years) and lifetime atherosclerotic cardiovascular disease risk-defined groups according to the American College of Cardiology/American Heart Association 2013 cardiovascular risk calculator. The ideal risk assessment and management of patients with low-to-intermediate or high short-term versus low (<39%) or high (≥39%) lifetime CV risk is unclear. The purpose of this study was to evaluate the prognostic value of Secho in short-term and lifetime CV risk-defined groups. We evaluated 4,566 patients (60 ± 13 years; 46% men) who underwent Secho (41% treadmill and 59% dobutamine) with low-intermediate short-term (<20%) risk divided into low (<39%, n = 368) or high (≥39%, n = 661) lifetime CV risk and third group with high short-term risk (≥20%, n = 3,537). Follow-up (3.2 ± 1.5 years) for nonfatal myocardial infarction (n = 102) and cardiac death (n = 140) were obtained. By univariate analysis, age (p <0.001) and ≥3 new ischemic wall motion abnormalities (WMAs, p <0.001) were significant predictors of cardiac events. Cumulative survival in patients was significantly worse in patients with ≥3 WMA versus <3 WMA in low-intermediate short-term and low (3.3% vs 0.3% per year, p <0.001) or high (2.0% vs 0% per year, p <0.001) lifetime risk and also in those with high short-term CV risk group (3.5% vs 1.0% per year, p <0.001). Multivariate Cox proportional hazards analysis identified ≥3 new ischemic WMAs as the strongest predictor of cardiac events (hazard ratio 3.0, 95% confidence interval 2.3 to 3.9, p <0.001). In conclusion, Secho results (absence or presence of ≥3 new ischemic segments) can further refine risk assessment in patients with low-intermediate or high short-term versus low or high lifetime cardiovascular risk. Event rate with normal Secho is low (≤1% per year) but higher in patients with high short-term CV risk by the American College of

  3. Biogeographic ancestry, self-identified race, and admixture-phenotype associations in the Heart SCORE Study.

    PubMed

    Halder, Indrani; Kip, Kevin E; Mulukutla, Suresh R; Aiyer, Aryan N; Marroquin, Oscar C; Huggins, Gordon S; Reis, Steven E

    2012-07-15

    Large epidemiologic studies examining differences in cardiovascular disease (CVD) risk factor profiles between European Americans and African Americans have exclusively used self-identified race (SIR) to classify individuals. Recent genetic epidemiology studies of some CVD risk factors have suggested that biogeographic ancestry (BGA) may be a better predictor of CVD risk than SIR. This hypothesis was investigated in 464 African Americans and 771 European Americans enrolled in the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) Study in March and April 2010. Individual West African and European BGA were ascertained by means of a panel of 1,595 genetic ancestry informative markers. Individual BGA varied significantly among African Americans and to a lesser extent among European Americans. In the total cohort, BGA was not found to be a better predictor of CVD risk factors than SIR. Both measures predicted differences in the presence of the metabolic syndrome, waist circumference, triglycerides, body mass index, very low density lipoprotein cholesterol, lipoprotein A, and systolic and diastolic blood pressure between European Americans and African Americans. These results suggest that for most nongenetic cardiovascular epidemiology studies, SIR is sufficient for predicting CVD risk factor differences between European Americans and African Americans. However, higher body mass index and diastolic blood pressure were significantly associated with West African BGA among African Americans, suggesting that BGA should be considered in genetic cardiovascular epidemiology studies carried out among African Americans.

  4. Treatment of heart failure in African Americans--a call to action.

    PubMed

    Mitchell, Judith E; Ferdinand, Keith C; Watson, Karol E; Wenger, Nanette K; Watkins, Laurence O; Flack, John M; Gavin, James R; Reed, James W; Saunders, Elijah; Wright, Jackson T

    2011-02-01

    Advances in heart failure treatment have not necessarily translated into equity in improved outcomes for African Americans. Heart failure in African Americans is characterized by a higher prevalence, especially at younger ages; more-adverse course with more frequent hospitalizations; and higher mortality rates compared to the general population. Despite this distinct disease profile, African Americans are remarkably underrepresented in large heart failure trials. This paper reviews the unique course of heart failure in African Americans and discusses treatment in the context of clinical trial evidence. African Americans with heart failure may respond differently to some standard therapies compared to whites, but low levels of enrollment of AAs in large clinical trials preclude valid conclusions in certain cases. An important exception is the African American Heart Failure Trial (AHeFT), a well-designed, prospective, randomized, placebo-controlled, double-blind study, that added a combination of fixed-dose isosorbide dinitrate/hydralazine (ISDN/ HYD) to standard therapy and showed a 43% improvement in survival and a 33% reduction in first hospitalizations. Despite compelling evidence from AHeFT, post hoc secondary analyses, and recommendations from current practice guidelines, ISDN/HYD remains underutilized in African Americans with heart failure. In this paper, we put forth a call to action for racial equity in clinical research and treatment in African Americans with heart failure.

  5. Perceived Risks of Certain Types of Cancer and Heart Disease among Asian American Smokers and Non-Smokers.

    ERIC Educational Resources Information Center

    Ma, Grace X; Tan, Yin; Feeley, Rosemary M.; Thomas, Priya

    2002-01-01

    Assessed Asian Americans' knowledge levels regarding the health risks of tobacco use. Surveys of Korean, Chinese, Vietnamese, and Cambodian smokers and nonsmokers indicated that most respondents recognized the association between smoking and increased risk for lung, mouth, throat, and esophageal cancer and heart disease. There were significant…

  6. A new dietary strategy for long-term treatment of the metabolic syndrome is compared with the American Heart Association (AHA) guidelines: the MEtabolic Syndrome REduction in NAvarra (RESMENA) project.

    PubMed

    de la Iglesia, Rocio; Lopez-Legarrea, Patricia; Abete, Itziar; Bondia-Pons, Isabel; Navas-Carretero, Santiago; Forga, Luis; Martinez, J Alfredo; Zulet, M Angeles

    2014-02-01

    The long-term effects of dietary strategies designed to combat the metabolic syndrome (MetS) remain unknown. The present study evaluated the effectiveness of a new dietary strategy based on macronutrient distribution, antioxidant capacity and meal frequency (MEtabolic Syndrome REduction in NAvarra (RESMENA) diet) for the treatment of the MetS when compared with the American Heart Association guidelines, used as Control. Subjects with the MetS (fifty-two men and forty-one women, age 49 (se 1) years, BMI 36·11 (se 0·5) kg/m²) were randomly assigned to one of two dietary groups. After a 2-month nutritional-learning intervention period, during which a nutritional assessment was made for the participants every 15 d, a 4-month self-control period began. No significant differences were found between the groups concerning anthropometry, but only the RESMENA group exhibited a significant decrease in body weight ( - 1·7%; P= 0·018), BMI ( - 1·7%; P= 0·019), waist circumference ( - 1·8%; P= 0·021), waist:hip ratio ( - 1·4%; P= 0·035) and android fat mass ( - 6·9%; P= 0·008). The RESMENA group exhibited a significant decrease in alanine aminotransferase and aspartate aminotransferase (AST) concentrations ( - 26·8%; P= 0·008 and - 14·0%; P= 0·018, respectively), while the Control group exhibited a significant increase in glucose (7·9%; P= 0·011), AST (11·3%; P= 0·045) and uric acid (9·0%; P< 0·001) concentrations. LDL-cholesterol (LDL-C) concentrations were increased (Control group: 34·4%; P< 0·001 and RESMENA group: 33·8%; P< 0·001), but interestingly so were the LDL-C:apoB ratio (Control group: 28·7%; P< 0·001, RESMENA group: 17·1%; P= 0·009) and HDL-cholesterol concentrations (Control group: 21·1%; P< 0·001, RESMENA group: 8·7; P= 0·001). Fibre was the dietary component that most contributed to the improvement of anthropometry, while body-weight loss explained changes in some biochemical markers. In conclusion, the RESMENA diet is a good

  7. Relation Between Hospital Length of Stay and Quality of Care in Patients With Acute Coronary Syndromes (from the American Heart Association's Get With the Guidelines--Coronary Artery Disease Data Set).

    PubMed

    Tickoo, Sumit; Bhardwaj, Adarsh; Fonarow, Gregg C; Liang, Li; Bhatt, Deepak L; Cannon, Christopher P

    2016-01-15

    Worries regarding short length of stay (LOS) adversely impacting quality of care prompted us to assess the relation between hospital LOS and inpatient guideline adherence in patients with acute coronary syndrome. We used the American Heart Association's Get with The Guidelines (GWTG)--Coronary Artery Disease data set. Data were collected from January 2, 2000, to March 21, 2010, for patients with acute coronary syndrome from 405 different sites. Of the 119,398 patients in the study, the mean LOS was 5.5 days with a median of 4 days. There was no difference in the LOS on the basis of hospital size, hospital type, or cardiac surgery availability. The population with an LOS <4 days were younger (63.8 ± 14.1 vs 70 ± 14.5, p <0.0001), men (63.8% vs 55.3%, p <0.0001) and had fewer clinical co-morbidities. The overall adherence was high in the GWTG participating hospitals. Those with the LOS <4 days were more likely to receive aspirin (adjusted odds ratio [OR] 1.12, 95% CI 1.06 to 1.19; p <0.001), clopidogrel (OR 1.77, 95% CI 1.60 to 1.95; p <0.001), lipid-lowering therapy if indicated (OR 1.13, 95% CI 1.05 to 1.21; p <0.001), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker for left ventricular systolic dysfunction (OR 1.10, 95% CI 1.01 to 1.21; p = 0.04) and smoking cessation counseling (OR 1.17, 95% CI 1.1 to 1.24; p <0.001) compared to those with the LOS ≥ 4 days. In contrast, those with the LOS <4 days were less likely to receive beta blockers (OR 0.88, 95% CI 0.84 to 0.93; p <0.001). The odds of receiving defect-free care were greater for patients with the LOS <4 days (OR 1.15, 95% CI 1.1 to 1.21; p <0.001). In conclusion, in GWTG participating hospitals, a shorter LOS did not appear to adversely affect adherence to discharge quality of care measures.

  8. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 appropriateness criteria for stress echocardiography: a report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine.

    PubMed

    Douglas, Pamela S; Khandheria, Bijoy; Stainback, Raymond F; Weissman, Neil J; Peterson, Eric D; Hendel, Robert C; Stainback, Raymond F; Blaivas, Michael; Des Prez, Roger D; Gillam, Linda D; Golash, Terry; Hiratzka, Loren F; Kussmaul, William G; Labovitz, Arthur J; Lindenfeld, JoAnn; Masoudi, Frederick A; Mayo, Paul H; Porembka, David; Spertus, John A; Wann, L Samuel; Wiegers, Susan E; Brindis, Ralph G; Douglas, Pamela S; Hendel, Robert C; Patel, Manesh R; Peterson, Eric D; Wolk, Michael J; Allen, Joseph M

    2008-03-18

    The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research.

  9. American Evaluation Association Guiding Principles for Evaluators

    SciTech Connect

    2009-01-18

    Five principles developed by American Evaluation Associ intended to guide professional practice of evaluators & to inform evaluation clients and the general public about principles they can expect to be upheld by professional evaluators.

  10. American Speech-Language-Hearing Association

    MedlinePlus

    ... Practice Management Research American Speech-Language-Hearing Association (ASHA) Making effective communication, a human right, accessible and ... for focused information and more. Join a SIG ASHA Corporate Partners Become A Corporate Partner Policies  About ...

  11. European Heart Rhythm Association Summit report 2014.

    PubMed

    Sutton, Richard; Leclercq, Christophe; Kuck, Karl-Heinz

    2016-05-01

    Across Europe, the role of the welfare state is constantly being questioned and even eroded. At the same time, funding sources for post-graduate medical education and training are under attack as regulators review the working relationships between physicians and industry. Both of these issues have profound consequences for cardiologists and their patients, and were, therefore, chosen as the themes of the European Heart Rhythm Association (EHRA) 2014 Spring Summit held at Heart House, Sophia Antipolis, 25-26 March 2014. The meeting noted that some of the changes are already affecting patient care standards and that this is exacerbated by a reduction in research and education programmes. The principle conclusion was that EHRA must find better means of engagement with the authorities across Europe to ensure that its views are considered and that ethical patient care is preserved. Participants were particularly alarmed by the example from Sweden in which future healthcare planning appears to exclude the views of physicians, although this is not yet the case in other countries. The demand for greater transparency in relationships between physicians and industry was also discussed. Although intended to eliminate corruption, concern was expressed that such moves would cause long-term damage to education and research, threatening the future of congresses, whose role in these areas appears underestimated by the authorities. PMID:26467405

  12. European Heart Rhythm Association Summit report 2014.

    PubMed

    Sutton, Richard; Leclercq, Christophe; Kuck, Karl-Heinz

    2016-05-01

    Across Europe, the role of the welfare state is constantly being questioned and even eroded. At the same time, funding sources for post-graduate medical education and training are under attack as regulators review the working relationships between physicians and industry. Both of these issues have profound consequences for cardiologists and their patients, and were, therefore, chosen as the themes of the European Heart Rhythm Association (EHRA) 2014 Spring Summit held at Heart House, Sophia Antipolis, 25-26 March 2014. The meeting noted that some of the changes are already affecting patient care standards and that this is exacerbated by a reduction in research and education programmes. The principle conclusion was that EHRA must find better means of engagement with the authorities across Europe to ensure that its views are considered and that ethical patient care is preserved. Participants were particularly alarmed by the example from Sweden in which future healthcare planning appears to exclude the views of physicians, although this is not yet the case in other countries. The demand for greater transparency in relationships between physicians and industry was also discussed. Although intended to eliminate corruption, concern was expressed that such moves would cause long-term damage to education and research, threatening the future of congresses, whose role in these areas appears underestimated by the authorities.

  13. Behavioral treatment of hypertensive heart disease in African Americans: rationale and design of a randomized controlled trial.

    PubMed

    Schneider, R H; Castillo-Richmond, A; Alexander, C N; Myers, H; Kaushik, V; Aranguri, C; Norris, K; Haney, C; Rainforth, M; Calderon, R; Nidich, S

    2001-01-01

    African Americans experience higher morbidity and mortality than Whites do as a result of hypertension and associated cardiovascular disease. Chronic psychosocial stress has been considered an important contributing factor to these high rates. The authors describe the rationale and design for a planned randomized controlled trial comparing Transcendental Meditation, a stress-reduction technique, with lifestyle education in the treatment of hypertension and hypertensive heart disease in urban African Americans. They pretested 170 men and women aged 20 to 70 years over a 3-session baseline period, with posttests at 6 months. Outcomes included clinic and ambulatory blood pressure, quality of life, left ventricular mass measured by M-mode echocardiography, left ventricular diastolic function measured by Doppler, and carotid atherosclerosis measured by beta-mode ultrasound. This trial was designed to evaluate the hypothesis that a selected stress reduction technique is effective in reducing hypertension and hypertensive heart disease in African Americans.

  14. American Camping Association Annual Report, 1999.

    ERIC Educational Resources Information Center

    American Camping Association, Martinsville, IN.

    Founded in 1910 as the Camp Directors' Association of America, the American Camping Association (ACA) is the largest organization serving the organized camping industry. Over 5,500 members come from all segments of the camp profession. This annual report for 1999 describes ACA activities in support of organizational commitments. These commitments…

  15. American Association of Nurse Anesthetists

    MedlinePlus

    ... and SRNAs alike. Topics include pharmacokinetic and pharmacodynamics principles related to the drug class. 150 Assembly of ... AANA Available Positions Corporate Opportunities Affiliates AANA Foundation Certification / Recertification (NBCRNA) Accreditation (COA) IFNA State Associations Certification ...

  16. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

    PubMed

    Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

  17. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

    PubMed

    Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors. PMID:27337622

  18. Sleep Troubles, Heart Troubles?

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_161037.html Sleep Troubles, Heart Troubles? American Heart Association says it's ... 19, 2016 MONDAY, Sept. 19, 2016 (HealthDay News) -- Sleep disorders -- including too little or too much sleep -- ...

  19. Advanced Congestive Heart Failure Associated With Disseminated Intravascular Coagulopathy.

    PubMed

    Sarcon, Annahita; Liu, Xiaoli; Ton, David; Haywood, James; Hitchcock, Todd

    2015-01-01

    Background. Disseminated intravascular coagulopathy (DIC) is a complication of an underlying disease and not a primary illness. It is most commonly associated with sepsis, trauma, obstetrical complications, and malignancies. There are very few cases in the literature illustrating the association between DIC and congestive heart failure. Findings. In this report, we present a case of severe congestive heart failure, leading to biventricular thrombi and subsequently DIC. Conclusion. We suggest that the association between congestive heart failure and DIC is an underrecognized one. Congestive heart failure continues to remain a major cause of morbidity and mortality despite advances in medical therapies. Thus far, the precise role of coagulation factors in congestive heart failure is unknown. Further investigations are needed to elucidate the pathophysiology of congestive heart failure and coagulation factors.

  20. Smoking-attributable mortality in American Indians: findings from the Strong Heart Study.

    PubMed

    Zhang, Mingzhi; An, Qiang; Yeh, Fawn; Zhang, Ying; Howard, Barbara V; Lee, Elisa T; Zhao, Jinying

    2015-07-01

    Cigarette smoking is the leading preventable cause of death worldwide. American Indians have the highest proportion of smoking in the United States. However, few studies have examined the impact of cigarette smoking on disease mortality in this ethnically important but traditionally understudied minority population. Here we estimated the association of cigarette smoking with cardiovascular disease (CVD), cancer and all-cause mortality in American Indians participating in the Strong Heart Study, a large community-based prospective cohort study comprising of 4549 American Indians (aged 45-74 years) followed for about 20 years (1989-2008). Hazard ratio and population attributable risk (PAR) associated with cigarette smoking were estimated by Cox proportional hazard model, adjusting for sex, study site, age, educational level, alcohol consumption, physical activity, BMI, lipids, renal function, hypertension or diabetes status at baseline, and interaction between current smoker and study site. We found that current smoking was significantly associated with cancer mortality (HR 5.0, [1.9-13.4]) in men, (HR 3.9 [1.6-9.7] in women) and all-cause mortality (HR 1.8, [1.2-2.6] in men, HR 1.6, [1.1-2.4] in women). PAR for cancer and all-cause mortality in men were 41.0 and 18.4 %, respectively, whereas the corresponding numbers in women were 24.9 and 10.9 %, respectively. Current smoking also significantly increases the risk of CVD deaths in women (HR 2.2 [1.1, 4.4]), but not men (HR 1.2 [0.6-2.4]). PAR for CVD mortality in women was 14.9 %. In summary, current smoking significantly increases the risk of CVD (in women), cancer and all-cause mortality in American Indians, independent of known risk factors. Culturally specific smoking cessation programs are urgently needed to reduce smoking-related premature deaths.

  1. American Association of Community Colleges FACTS 2008

    ERIC Educational Resources Information Center

    American Association of Community Colleges (NJ1), 2008

    2008-01-01

    "Community College Facts" includes American Association of Community Colleges (AACC) mission statement, information about AACC as an organization, AACC departments, contacts, annual revenues and expenditures. Also included is "Community College Facts at a Glance," which provides statistics on the number and type of colleges, enrollment,…

  2. American Evaluation Association: Guiding Principles for Evaluators

    ERIC Educational Resources Information Center

    American Journal of Evaluation, 2009

    2009-01-01

    The American Evaluation Association (AEA) strives to promote ethical practice in the evaluation of programs, products, personnel, and policy. This article presents the list of principles which AEA developed to guide evaluators in their professional practice. These principles are: (1) Systematic Inquiry; (2) Competence; (3) Integrity/Honesty; (4)…

  3. Update on the American Mosquito Control Association

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The American Mosquito Control Association in a non-profit scientific organization dedicated to promoting the highest standard in professional mosquito control. It is comprised of more than 1300 members representing students, scientists, regulators, industry, mosquito control employees and many other...

  4. American Psychological Association: Annual Report, 2008

    ERIC Educational Resources Information Center

    American Psychologist, 2009

    2009-01-01

    This article presents the 2008 annual reports from the various directorates and offices of the American Psychological Association (APA). In 2008, APA continued to work on initiatives, programs, and products that lend value to the member's psychology career, support the future of their discipline, and serve the public. APA's goal is to strengthen…

  5. The Future of the American Historical Association.

    ERIC Educational Resources Information Center

    Harlan, Louis R.

    1990-01-01

    Reviews the state of the American Historical Association, urging that the organization take a more active interest in the current debate over social studies in the public schools. Proposes that historians spend more time with elementary and secondary teachers, talking about the latest developments in the field. (SLM)

  6. American Association of University Women 2013 Bylaws

    ERIC Educational Resources Information Center

    American Association of University Women, 2013

    2013-01-01

    The American Association of University Women (AAUW) Bylaws contain governance history, policies and procedures for managing the organization, and information to conduct AAUW's affairs. The 2013 bylaws are divided into the following articles: (1) Name and Office; (2) Purpose; (3) Use of Name; (4) Membership and Dues; (5) Nominations and Elections;…

  7. Metabolic Profiles of Obesity in American Indians: The Strong Heart Family Study

    PubMed Central

    Best, Lyle G.; Umans, Jason G.; Uppal, Karan; Tran, ViLinh T.; Jones, Dean P.; Lee, Elisa T.; Howard, Barbara V.; Zhao, Jinying

    2016-01-01

    Obesity is a typical metabolic disorder resulting from the imbalance between energy intake and expenditure. American Indians suffer disproportionately high rates of obesity and diabetes. The goal of this study is to identify metabolic profiles of obesity in 431 normoglycemic American Indians participating in the Strong Heart Family Study. Using an untargeted liquid chromatography–mass spectrometry, we detected 1,364 distinct m/z features matched to known compounds in the current metabolomics databases. We conducted multivariate analysis to identify metabolic profiles for obesity, adjusting for standard obesity indicators. After adjusting for covariates and multiple testing, five metabolites were associated with body mass index and seven were associated with waist circumference. Of them, three were associated with both. Majority of the obesity-related metabolites belongs to lipids, e.g., fatty amides, sphingolipids, prenol lipids, and steroid derivatives. Other identified metabolites are amino acids or peptides. Of the nine identified metabolites, five metabolites (oleoylethanolamide, mannosyl-diinositol-phosphorylceramide, pristanic acid, glutamate, and kynurenine) have been previously implicated in obesity or its related pathways. Future studies are warranted to replicate these findings in larger populations or other ethnic groups. PMID:27434237

  8. Metabolic Profiles of Obesity in American Indians: The Strong Heart Family Study.

    PubMed

    Zhao, Qi; Zhu, Yun; Best, Lyle G; Umans, Jason G; Uppal, Karan; Tran, ViLinh T; Jones, Dean P; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2016-01-01

    Obesity is a typical metabolic disorder resulting from the imbalance between energy intake and expenditure. American Indians suffer disproportionately high rates of obesity and diabetes. The goal of this study is to identify metabolic profiles of obesity in 431 normoglycemic American Indians participating in the Strong Heart Family Study. Using an untargeted liquid chromatography-mass spectrometry, we detected 1,364 distinct m/z features matched to known compounds in the current metabolomics databases. We conducted multivariate analysis to identify metabolic profiles for obesity, adjusting for standard obesity indicators. After adjusting for covariates and multiple testing, five metabolites were associated with body mass index and seven were associated with waist circumference. Of them, three were associated with both. Majority of the obesity-related metabolites belongs to lipids, e.g., fatty amides, sphingolipids, prenol lipids, and steroid derivatives. Other identified metabolites are amino acids or peptides. Of the nine identified metabolites, five metabolites (oleoylethanolamide, mannosyl-diinositol-phosphorylceramide, pristanic acid, glutamate, and kynurenine) have been previously implicated in obesity or its related pathways. Future studies are warranted to replicate these findings in larger populations or other ethnic groups.

  9. Metabolic Profiles of Obesity in American Indians: The Strong Heart Family Study.

    PubMed

    Zhao, Qi; Zhu, Yun; Best, Lyle G; Umans, Jason G; Uppal, Karan; Tran, ViLinh T; Jones, Dean P; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2016-01-01

    Obesity is a typical metabolic disorder resulting from the imbalance between energy intake and expenditure. American Indians suffer disproportionately high rates of obesity and diabetes. The goal of this study is to identify metabolic profiles of obesity in 431 normoglycemic American Indians participating in the Strong Heart Family Study. Using an untargeted liquid chromatography-mass spectrometry, we detected 1,364 distinct m/z features matched to known compounds in the current metabolomics databases. We conducted multivariate analysis to identify metabolic profiles for obesity, adjusting for standard obesity indicators. After adjusting for covariates and multiple testing, five metabolites were associated with body mass index and seven were associated with waist circumference. Of them, three were associated with both. Majority of the obesity-related metabolites belongs to lipids, e.g., fatty amides, sphingolipids, prenol lipids, and steroid derivatives. Other identified metabolites are amino acids or peptides. Of the nine identified metabolites, five metabolites (oleoylethanolamide, mannosyl-diinositol-phosphorylceramide, pristanic acid, glutamate, and kynurenine) have been previously implicated in obesity or its related pathways. Future studies are warranted to replicate these findings in larger populations or other ethnic groups. PMID:27434237

  10. Essential features of designating out-of-hospital cardiac arrest as a reportable event: a scientific statement from the American Heart Association Emergency Cardiovascular Care Committee; Council on Cardiopulmonary, Perioperative, and Critical Care; Council on Cardiovascular Nursing; Council on Clinical Cardiology; and Quality of Care and Outcomes Research Interdisciplinary Working Group.

    PubMed

    Nichol, Graham; Rumsfeld, John; Eigel, Brian; Abella, Benjamin S; Labarthe, Darwin; Hong, Yuling; O'Connor, Robert E; Mosesso, Vincent N; Berg, Robert A; Leeper, Barbara Bobbi; Weisfeldt, Myron L

    2008-04-29

    The 2010 impact goal of the American Heart Association is to reduce death rates from heart disease and stroke by 25% and to lower the prevalence of the leading risk factors by the same proportion. Much of the burden of acute heart disease is initially experienced out of hospital and can be reduced by timely delivery of effective prehospital emergency care. Many patients with an acute myocardial infarction die from cardiac arrest before they reach the hospital. A small proportion of those with cardiac arrest who reach the hospital survive to discharge. Current health surveillance systems cannot determine the burden of acute cardiovascular illness in the prehospital setting nor make progress toward reducing that burden without improved surveillance mechanisms. Accordingly, the goals of this article provide a brief overview of strategies for managing out-of-hospital cardiac arrest. We review existing surveillance systems for monitoring progress in reducing the burden of out-of-hospital cardiac arrest in the United States and make recommendations for filling significant gaps in these systems, including the following: 1. Out-of-hospital cardiac arrests and their outcomes through hospital discharge should be classified as reportable events as part of a heart disease and stroke surveillance system. 2. Data collected on patients' encounters with emergency medical services systems should include descriptions of the performance of cardiopulmonary resuscitation by bystanders and defibrillation by lay responders. 3. National annual reports on key indicators of progress in managing acute cardiovascular events in the out-of-hospital setting should be developed and made publicly available. Potential barriers to action on cardiac arrest include concerns about privacy, methodological challenges, and costs associated with designating cardiac arrest as a reportable event. PMID:18413503

  11. History of the american college health association.

    PubMed

    Mack, Rachel

    2011-01-01

    Following Dr Edward Hitchcock's lead at Amherst College in 1861, soon other institutions of higher education established physical education departments that evolved into independent college health programs. As the field of college health expanded, leaders from numerous campuses began meeting to share information and discuss formation of a national organization. As a result, the American Student Health Association was founded in 1920 to promote campus health care for students and advance the interests of college health. The name was changed to the American College Health Association in 1948. The past history of this organization has been well documented in the literature, so this review will focus more on ACHA's accomplishments over the past 20 years.(1)(,) (2)(,) (3)(,) (4). PMID:21660802

  12. [Association between level of intelligence and heart rate variability].

    PubMed

    Mukhin, V N; Iakovlev, N M

    2011-08-01

    Earlier we discovered that heart rate variability was associated with the level of intelligence. The purpose of this study is to confirm this association using more reliable method and to define more precisely the frequency band within which the amplitude of the heart rate modulations is related to intelligence. 13 males (aged 14 to 17) were the study subjects. The total score of the computer game Tetris was taken as a general measure of the intelligence level. Heart rate was recorded electrocardiographically both at rest and during playing Tetris. Frequency analysis of heart rate was carried out with digital Fourier transformation. Correlation analysis showed that there was positive association between the level of intelligence and the amplitude of heart rate modulation at the frequencies 0.30 and 0.15 modulations per RR interval. This association is closer for the heart rate at rest than for the heart rate during mental work and for the frequency 0.30 than for the 0.15 modulations per RR interval.

  13. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-11-23

    The American College of Cardiology Foundation, along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:20975004

  14. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate use criteria for cardiac computed tomography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D; Kramer, Christopher M; Berman, Daniel; Brown, Alan; Chaudhry, Farooq A; Cury, Ricardo C; Desai, Milind Y; Einstein, Andrew J; Gomes, Antoinette S; Harrington, Robert; Hoffmann, Udo; Khare, Rahul; Lesser, John; McGann, Christopher; Rosenberg, Alan; Schwartz, Robert; Shelton, Marc; Smetana, Gerald W; Smith, Sidney C

    2010-11-23

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21087721

  15. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance.

    PubMed

    Taylor, Allen J; Cerqueira, Manuel; Hodgson, John McB; Mark, Daniel; Min, James; O'Gara, Patrick; Rubin, Geoffrey D

    2010-01-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac computed tomography (CCT) is frequently considered. The present document is an update to the original CCT/cardiac magnetic resonance (CMR) appropriateness criteria published in 2006, written to reflect changes in test utilization, to incorporate new clinical data, and to clarify CCT use where omissions or lack of clarity existed in the original criteria (1). The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Ninety-three clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of CCT angiography for diagnosis and risk assessment in patients with low or intermediate risk or pretest probability for coronary artery disease (CAD) was viewed favorably, whereas testing in high-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Use of noncontrast computed tomography (CT) for calcium scoring was rated as appropriate within intermediate- and selected low-risk patients. Appropriate applications of CCT are also within the category of cardiac structural and functional evaluation. It is anticipated that these results will have an impact on physician decision making, performance, and reimbursement policy, and that they will help guide future research. PMID:21232696

  16. Fibrocytes are associated with the fibrosis of coronary heart disease.

    PubMed

    Lei, Pu-Ping; Qu, Yong-Qiang; Shuai, Qun; Tao, Si-Ming; Bao, Yu-Xia; Wang, Yu; Wang, Shang-Wen; Wang, Dian-Hua

    2013-01-15

    Fibrocytes contribute significantly to fibrosis in many cardiac diseases. However, it is not clear whether fibrocytes are associated with the fibrosis in coronary heart disease (CHD). The aim of this study was to determine whether fibrocytes are involved in cardiac fibrosis in CHD. We identified the presence of fibrocytes in CHD heart by immunofluorescence and confocal microscopy, examined the collagen volume fraction by Masson's Trichrome staining, and evaluated the correlation between fibrocytes and cardiac fibrosis. In conjunction, we examined the location of CXCL12, a homing factor and specific ligand for CXCR4, by immunohistochemistry. Fibrocytes were identified in 26 out of 27 CHD hearts and in 10 out of 11 normal hearts. Combinations, including CD34/αSMA, CD34/procollagen-I, CD45/αSMA, CXCR4/procollagen-I and CXCR4/αSMA, stained significantly more fibrocytes in CHD hearts as compared with those in normal hearts (p<0.05). There were positive correlations between the collagen volume fraction and the amount of fibrocytes (r=0.558; p=0.003<0.01) and between the number of CXCR4(+) fibrocytes and the CXCL12(+) cells (r=0.741; p=0.000<0.01) in CHD hearts. Based upon these findings, we conclude that fibrocytes, likely recruited through the CXCR4/CXCL12 axis, may contribute to the increase in the fibroblast population in CHD heart. PMID:23177618

  17. The Impact of Personalized Risk Feedback on Mexican Americans' Perceived Risk for Heart Disease and Diabetes

    ERIC Educational Resources Information Center

    Hovick, Shelly R.; Wilkinson, Anna V.; Ashida, Sato; de Heer, Hendrik D.; Koehly, Laura M.

    2014-01-01

    Little is known about the effect of personalized risk information on risk perceptions over time, particularly among ethnically diverse subpopulations. The present study examines Mexican American's (MAs) risk perceptions for heart disease and diabetes at baseline and following receipt of risk feedback based on family health history. Participants…

  18. Heart Disease and Stroke Statistics

    MedlinePlus

    ... Nutrition (PDF) Obesity (PDF) Peripheral Artery Disease (PDF) ... statistics, please contact the American Heart Association National Center, Office of Science & Medicine at statistics@heart.org . Please direct all ...

  19. Metabolic profiles of biological aging in American Indians: the Strong Heart Family Study.

    PubMed

    Zhao, Jinying; Zhu, Yun; Uppal, Karan; Tran, ViLinh T; Yu, Tianwei; Lin, Jue; Matsuguchi, Tet; Blackburn, Elizabeth; Jones, Dean; Lee, Elisa T; Howard, Barbara V

    2014-03-01

    Short telomere length, a marker of biological aging, has been associated with age-related metabolic disorders. Telomere attrition induces profound metabolic dysfunction in animal models, but no study has examined the metabolome of telomeric aging in human. Here we studied 423 apparently healthy American Indians participating in the Strong Family Heart Study. Leukocyte telomere length (LTL) was measured by qPCR. Metabolites in fasting plasma were detected by untargeted LC/MS. Associations of LTL with each metabolite and their combined effects were examined using generalized estimating equation adjusting for chronological age and other aging-related factors. Multiple testing was corrected using the q-value method (q<0.05). Of the 1,364 distinct m/z features detected, nineteen metabolites in the classes of glycerophosphoethanolamines, glycerophosphocholines, glycerolipids, bile acids, isoprenoids, fatty amides, or L-carnitine ester were significantly associated with LTL, independent of chronological age and other aging-related factors. Participants with longer (top tertile) and shorter (bottom tertile) LTL were clearly separated into distinct groups using a multi-marker score comprising of all these metabolites, suggesting that these newly detected metabolites could be novel metabolic markers of biological aging. This is the first study to interrogate the human metabolome of telomeric aging. Our results provide initial evidence for a metabolic control of LTL and may reveal previously undescribed new roles of various lipids in the aging process.

  20. Metabolic profiles of biological aging in American Indians: the Strong Heart Family Study.

    PubMed

    Zhao, Jinying; Zhu, Yun; Uppal, Karan; Tran, ViLinh T; Yu, Tianwei; Lin, Jue; Matsuguchi, Tet; Blackburn, Elizabeth; Jones, Dean; Lee, Elisa T; Howard, Barbara V

    2014-03-01

    Short telomere length, a marker of biological aging, has been associated with age-related metabolic disorders. Telomere attrition induces profound metabolic dysfunction in animal models, but no study has examined the metabolome of telomeric aging in human. Here we studied 423 apparently healthy American Indians participating in the Strong Family Heart Study. Leukocyte telomere length (LTL) was measured by qPCR. Metabolites in fasting plasma were detected by untargeted LC/MS. Associations of LTL with each metabolite and their combined effects were examined using generalized estimating equation adjusting for chronological age and other aging-related factors. Multiple testing was corrected using the q-value method (q<0.05). Of the 1,364 distinct m/z features detected, nineteen metabolites in the classes of glycerophosphoethanolamines, glycerophosphocholines, glycerolipids, bile acids, isoprenoids, fatty amides, or L-carnitine ester were significantly associated with LTL, independent of chronological age and other aging-related factors. Participants with longer (top tertile) and shorter (bottom tertile) LTL were clearly separated into distinct groups using a multi-marker score comprising of all these metabolites, suggesting that these newly detected metabolites could be novel metabolic markers of biological aging. This is the first study to interrogate the human metabolome of telomeric aging. Our results provide initial evidence for a metabolic control of LTL and may reveal previously undescribed new roles of various lipids in the aging process. PMID:24799415

  1. Languages of the heart: the biomedical and the metaphorical in American fiction.

    PubMed

    Oldfield, Benjamin J; Jones, David S

    2014-01-01

    The role of heart disease in American fiction has received less attention from scholars of literature, history, and medicine than have portrayals of tuberculosis, cancer, or HIV/AIDS, despite the fact that heart disease topped mortality charts for most of the 20th century. This article surveys manifestations of coronary artery disease in popular works of 20th-century American fiction to trace how authors and their protagonists grappled with the disease while knowledge of pathophysiology and therapeutics evolved. Countering Susan Sontag's mechanistic vision of patient encounters-where disease is absent of metaphor-we pair popular fiction with concurrent historical analysis to show that the proliferation of technological narratives of cardiac therapeutics could not displace the deeply symbolic nature of characters' encounters with heart disease. Because of the limited ability of the biomedical narrative to convey the meanings of disease and treatments, doctors and patients need to communicate through the rich possibilities of metaphor. PMID:25959354

  2. The American Kinesiology Association Undergraduate Core Curriculum©

    ERIC Educational Resources Information Center

    Chodzko-Zajko, Wojtek

    2014-01-01

    This article describes the elements of the undergraduate core in kinesiology that have been established by the American Kinesiology Association. The American Kinesiology Association also describes a set of ten student-learning outcomes that emanate from the four core content elements. This information has been developed by the American Kinesiology…

  3. Catecholamine effects on blood pressure and heart rate in the American bullfrog, Rana catesbeiana.

    PubMed

    Herman, C A; Sandoval, E J

    1983-10-01

    The effects of catecholamines and adrenergic blocking agents were studied in vivo on the blood pressure and heart rate of the unanaesthetized American bullfrog, Rana catesbeiana. Bullfrogs were chronically cannulated with a T cannula in the right sciatic artery. The mean systemic arterial blood pressure prior to the infusion of catecholamines was 18.5 +/- 1.5 mm Hg. Mean preinfusion heart rate was 30.9 +/- 2.0 beats/min. Epinephrine elicited the largest increase in blood pressure, with an accompanying decrease in heart rate. Norepinephrine and phenylephrine were less effective. Isoproterenol was the only catecholamine tested which elevated heart rate in a dose-dependent manner. It had no effect on blood pressure. The beta adrenergic antagonist, propranolol, blocked the increase in heart rate elicited by isoproterenol but had no effect on the blood pressure increases elicited by the other catecholamines. The alpha adrenergic antagonist, phentolamine, partially blocked the blood pressure increase by epinephrine, norepinephrine, and phenylephrine as well as the elevation of heart rate by isoproterenol. Atropine alone elevated heart rate 19 +/- 3 beats/min, and prevented slowing of the heart due to epinephrine, norepinephrine, and phenylephrine. Stimulatory effects of epinephrine on heart rate were observed only after atropine had been administered. Beta adrenergic receptors, therefore, appear to function in heart rate regulation; however, the predominant effect of catecholamines is reflex slowing of the heart due to stimulation of the vagus nerve. In contrast, the alpha receptor, stimulated by epinephrine, appears to be the main adrenergic receptor controlling blood pressure changes.

  4. Irritable heart syndrome in Anglo-American medical thought at the end of the nineteenth century.

    PubMed

    Vilarinho, Yuri C

    2014-01-01

    This paper examines the characteristics and the conditions for the emergence of the nosological category known as irritable heart syndrome to be found in Anglo-American medical literature in the second half of the nineteenth century. In the context of the American Civil War, it looks at some of the socio-historical elements, which comprised the medical care given to certain cardiac symptoms shown by soldiers. It emphasizes the moral values influencing the medical attitudes of military physicians towards symptoms of fear experienced by combatants, as well as the British and American etiological theories, which contributed to the nosological characterization of the suffering of soldiers afflicted with palpitations. Finally, it offers a brief analysis of the specific nature of the medical category known as irritable heart syndrome in the light of the categories of fear described by current psychiatric nosology. PMID:25606722

  5. Minimal changes in heart rate of incubating American Oystercatchers (Haematopus palliatus) in response to human activity

    USGS Publications Warehouse

    Borneman, Tracy E.; Rose, Eli T.; Simons, Theodore R.

    2014-01-01

    An organism's heart rate is commonly used as an indicator of physiological stress due to environmental stimuli. We used heart rate to monitor the physiological response of American Oystercatchers (Haematopus palliatus) to human activity in their nesting environment. We placed artificial eggs with embedded microphones in 42 oystercatcher nests to record the heart rate of incubating oystercatchers continuously for up to 27 days. We used continuous video and audio recordings collected simultaneously at the nests to relate physiological response of birds (heart rate) to various types of human activity. We observed military and civilian aircraft, off-road vehicles, and pedestrians around nests. With the exception of high-speed, low-altitude military overflights, we found little evidence that oystercatcher heart rates were influenced by most types of human activity. The low-altitude flights were the only human activity to significantly increase average heart rates of incubating oystercatchers (12% above baseline). Although statistically significant, we do not consider the increase in heart rate during high-speed, low-altitude military overflights to be of biological significance. This noninvasive technique may be appropriate for other studies of stress in nesting birds.

  6. Aldosterone, Renin, and Diabetes Mellitus in African Americans: The Jackson Heart Study.

    PubMed

    Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Kalyani, Rita R; Yeh, Hsin-Chieh; Bertoni, Alain G; Effoe, Valery S; Casanova, Ramon; Sims, Mario; Correa, Adolfo; Wu, Wen-Chih; Wand, Gary S; Golden, Sherita H

    2016-04-01

    We examined the association of both aldosterone and renin, with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. Renin-angiotensin-aldosterone system with higher levels of aldosterone and renin is associated with insulin resistance, compensatory increased β-cell function and incident diabetes in African Americans.

  7. Aldosterone, Renin, and Diabetes Mellitus in African Americans: The Jackson Heart Study.

    PubMed

    Joseph, Joshua J; Echouffo-Tcheugui, Justin B; Kalyani, Rita R; Yeh, Hsin-Chieh; Bertoni, Alain G; Effoe, Valery S; Casanova, Ramon; Sims, Mario; Correa, Adolfo; Wu, Wen-Chih; Wand, Gary S; Golden, Sherita H

    2016-04-01

    We examined the association of both aldosterone and renin, with insulin resistance, β-cell function, and incident diabetes in a large African American cohort. Renin-angiotensin-aldosterone system with higher levels of aldosterone and renin is associated with insulin resistance, compensatory increased β-cell function and incident diabetes in African Americans. PMID:26908112

  8. South American Heart Transplantation Registry of patients receiving everolimus in their immunosuppressive regimens.

    PubMed

    Bortman, G V; Ceruti, B; Ahualli, L; Colque, R; Amuchástegui, M; Sgrosso, J L; Muñoz, J; Vulcano, N; Burgos, C; Diez, F; Rodriguez, M C; Perrone, S V

    2010-01-01

    The increasing number of heart transplant recipients receiving immunosuppression with mammalian target of rapamycin inhibitors prompted the implementation of a South American Transplant Physicians Group to register these patients in a database. Everolimus (EVL) is a signal proliferation inhibition that reduces graft vascular disease when used de novo. Recently, its administration has expanded to subjects with resistant rejection or with side effects due to other immunosuppressive drugs (calcineurin inhibitors and/or steroids), allowing for better regulation of the immunosuppressive regimen. Herein we have shown the data collected from patients receiving EVL in ten South American Heart Transplant Centers. We have concluded that the administration of EVL is a useful adjunctive therapy that allows the reduction or suspension of other immunosuppressive drugs that caused unwanted side effects, without a loss of immunosuppressive efficacy, with manageable side effects, and constituting a valuable therapeutic option. PMID:20172342

  9. Impact of biological aging on arterial aging in American Indians: findings from the Strong Heart Family Study.

    PubMed

    Peng, Hao; Zhu, Yun; Yeh, Fawn; Cole, Shelley A; Best, Lyle G; Lin, Jue; Blackburn, Elizabeth; Devereux, Richard B; Roman, Mary J; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2016-08-01

    Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD). Increased arterial stiffness, an indicator of arterial aging, predicts adverse CVD outcomes. However, the relationship between telomere length and arterial stiffness is less well studied. Here we examined the cross-sectional association between leukocyte telomere length (LTL) and arterial stiffness in 2,165 American Indians in the Strong Heart Family Study (SHFS). LTL was measured by qPCR. Arterial stiffness was assessed by stiffness index β. The association between LTL and arterial stiffness was assessed by generalized estimating equation model, adjusting for sociodemographics (age, sex, education level), study site, metabolic factors (fasting glucose, lipids, systolic blood pressure, and kidney function), lifestyle (BMI, smoking, drinking, and physical activity), and prevalent CVD. Results showed that longer LTL was significantly associated with a decreased arterial stiffness (β=-0.070, P=0.007). This association did not attenuate after further adjustment for hsCRP (β=-0.071, P=0.005) or excluding participants with overt CVD (β=-0.068, P=0.012), diabetes (β=-0.070, P=0.005), or chronic kidney disease (β=-0.090, P=0.001). In summary, shorter LTL was significantly associated with an increased arterial stiffness, independent of known risk factors. This finding may shed light on the potential role of biological aging in arterial aging in American Indians.

  10. Impact of biological aging on arterial aging in American Indians: findings from the Strong Heart Family Study.

    PubMed

    Peng, Hao; Zhu, Yun; Yeh, Fawn; Cole, Shelley A; Best, Lyle G; Lin, Jue; Blackburn, Elizabeth; Devereux, Richard B; Roman, Mary J; Lee, Elisa T; Howard, Barbara V; Zhao, Jinying

    2016-08-01

    Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD). Increased arterial stiffness, an indicator of arterial aging, predicts adverse CVD outcomes. However, the relationship between telomere length and arterial stiffness is less well studied. Here we examined the cross-sectional association between leukocyte telomere length (LTL) and arterial stiffness in 2,165 American Indians in the Strong Heart Family Study (SHFS). LTL was measured by qPCR. Arterial stiffness was assessed by stiffness index β. The association between LTL and arterial stiffness was assessed by generalized estimating equation model, adjusting for sociodemographics (age, sex, education level), study site, metabolic factors (fasting glucose, lipids, systolic blood pressure, and kidney function), lifestyle (BMI, smoking, drinking, and physical activity), and prevalent CVD. Results showed that longer LTL was significantly associated with a decreased arterial stiffness (β=-0.070, P=0.007). This association did not attenuate after further adjustment for hsCRP (β=-0.071, P=0.005) or excluding participants with overt CVD (β=-0.068, P=0.012), diabetes (β=-0.070, P=0.005), or chronic kidney disease (β=-0.090, P=0.001). In summary, shorter LTL was significantly associated with an increased arterial stiffness, independent of known risk factors. This finding may shed light on the potential role of biological aging in arterial aging in American Indians. PMID:27540694

  11. Impact of biological aging on arterial aging in American Indians: findings from the Strong Heart Family Study

    PubMed Central

    Peng, Hao; Zhu, Yun; Yeh, Fawn; Cole, Shelley A.; Best, Lyle G.; Lin, Jue; Blackburn, Elizabeth; Devereux, Richard B.; Roman, Mary J.; Lee, Elisa T.; Howard, Barbara V.; Zhao, Jinying

    2016-01-01

    Telomere length, a marker of biological aging, has been associated with cardiovascular disease (CVD). Increased arterial stiffness, an indicator of arterial aging, predicts adverse CVD outcomes. However, the relationship between telomere length and arterial stiffness is less well studied. Here we examined the cross-sectional association between leukocyte telomere length (LTL) and arterial stiffness in 2,165 American Indians in the Strong Heart Family Study (SHFS). LTL was measured by qPCR. Arterial stiffness was assessed by stiffness index β. The association between LTL and arterial stiffness was assessed by generalized estimating equation model, adjusting for sociodemographics (age, sex, education level), study site, metabolic factors (fasting glucose, lipids, systolic blood pressure, and kidney function), lifestyle (BMI, smoking, drinking, and physical activity), and prevalent CVD. Results showed that longer LTL was significantly associated with a decreased arterial stiffness (β=-0.070, P=0.007). This association did not attenuate after further adjustment for hsCRP (β=-0.071, P=0.005) or excluding participants with overt CVD (β=-0.068, P=0.012), diabetes (β=-0.070, P=0.005), or chronic kidney disease (β=-0.090, P=0.001). In summary, shorter LTL was significantly associated with an increased arterial stiffness, independent of known risk factors. This finding may shed light on the potential role of biological aging in arterial aging in American Indians. PMID:27540694

  12. ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 appropriate use criteria for cardiac radionuclide imaging: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine.

    PubMed

    Hendel, Robert C; Berman, Daniel S; Di Carli, Marcelo F; Heidenreich, Paul A; Henkin, Robert E; Pellikka, Patricia A; Pohost, Gerald M; Williams, Kim A

    2009-06-01

    The American College of Cardiology Foundation (ACCF), along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical scenarios where cardiac radionuclide imaging (RNI) is frequently considered. This document is a revision of the original Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging (SPECT MPI) Appropriateness Criteria, published 4 years earlier, written to reflect changes in test utilization and new clinical data, and to clarify RNI use where omissions or lack of clarity existed in the original criteria. This is in keeping with the commitment to revise and refine appropriate use criteria (AUC) on a frequent basis. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Sixty-seven clinical scenarios were developed by a writing group and scored by a separate technical panel on a scale of 1 to 9 to designate appropriate use, inappropriate use, or uncertain use. In general, use of cardiac RNI for diagnosis and risk assessment in intermediate- and high-risk patients with coronary artery disease (CAD) was viewed favorably, while testing in low-risk patients, routine repeat testing, and general screening in certain clinical scenarios were viewed less favorably. Additionally, use for perioperative testing was found to be inappropriate except for high selected groups of patients. It is anticipated that these results will have a significant impact on physician decision making, test performance, and reimbursement policy, and will help guide future research. PMID:19451357

  13. Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science).

    PubMed

    Kumanyika, Shiriki K; Obarzanek, Eva; Stettler, Nicolas; Bell, Ronny; Field, Alison E; Fortmann, Stephen P; Franklin, Barry A; Gillman, Matthew W; Lewis, Cora E; Poston, Walker Carlos; Stevens, June; Hong, Yuling

    2008-07-22

    Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted.

  14. Creation of the American Board of Ophthalmology: The Role of the American Medical Association.

    PubMed

    Williams, Ruth D

    2016-09-01

    In the early 20th century, the American Medical Association (AMA), specifically its Section on Ophthalmology, played a central role in the founding of America's first medical specialty board, the American Board of Ophthalmology. With the American Ophthalmological Society and the American Academy of Ophthalmology and Otolaryngology, the AMA's contributions to the formation of the American Board of Ophthalmology led to the establishment of sound educational standards for practicing ophthalmologists and helped to advance the culture of medical excellence within the profession that is synonymous with board certification today.

  15. Association between oral variables and heart rate variability.

    PubMed

    Santana, Milana Drumond Ramos; de Souza, Ana Cecilia Amorim; de Abreu, Luiz Carlos; Valenti, Vitor E

    2013-12-27

    The heart rate variability is a useful method to assess cardiac autonomic modulation in patients undergoing dental procedures, because knowledge of physiological conditions provides greater security to the professional as well as the possibility of a better plan treatment to patient benefit. The aim of our study was to describe the association between cardiac autonomic control and dental variables. We consulted the databases Medline, SciELO, Lilacs and Cochrane, using the terms "autonomic", "dentistry", "heart rate variability", "cardiovascular physiology." The selected studies indicated a strong relationship between dental variables and HRV. There was an association between malocclusion, TMD, dental procedures cirugia and low HRV. Thus, they become more studies that relate to HRV in dental science, especially in clinical practice.

  16. What Are Heart Disease and Stroke?

    MedlinePlus

    ... American Heart area Search by State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) ... may help me? ©2015, American Heart Association Multi-language Fact Sheet Topics Heart-related Conditions What is ...

  17. Community Health Representatives: A Valuable Resource for Providing Coronary Heart Disease Health Education Activities for Native Americans.

    ERIC Educational Resources Information Center

    Cleaver, Vicki L.

    1989-01-01

    This article addresses select health issues of Native Americans, emphasizing coronary heart disease (CHD). The link between lifestyle and CHD is discussed. CHD risk data from a study of 67 Community Health Representatives is presented, and the role these paraprofessionals can play in health education among Native Americans is discussed. (IAH)

  18. American Lung Association`s radon public information program

    SciTech Connect

    McCurdy, L.E.

    1992-12-31

    The American Lung Association (ALA), the nation`s oldest voluntary health organization, is dedicated to the conquest of lung disease and the promotion of lung health. The objective of the ALA Radon Public Information Program is to reduce public exposure to elevated indoor radon levels through implementing grassroots-based radon public awareness campaigns by 22 local ALA groups. The program, which is funded by a grant from the US Environmental Protection Agency (EPA), was initiated in December 1989; the first phase will continue until May, 1991. Activities of local Lung Associations include distribution of free or reduced-cost radon kits; presenting programs in elementary and secondary schools; presenting information on TV news series and talk shows, and on radio Public Service Announcements and talk shows; presenting articles and feature stories in the print media; holding conferences, workshops, and displays at fairs and other exhibitions; distributing radon fact sheets through libraries and utility company mailings; and distributing videos through video chains and libraries. The local Lung Associations also serve as promoters for the EPA/Advertising Council Radon Public Service Announcement Campaign. We will highlight the activities of the groups in communicating radon health risks to the public; we will describe the results obtained and will attempt to evaluate the merits of the various approaches on the basis of the initial results.

  19. [Pulmonary hypertension associated with congenital heart disease and Eisenmenger syndrome].

    PubMed

    Calderón-Colmenero, Juan; Sandoval Zárate, Julio; Beltrán Gámez, Miguel

    2015-01-01

    Pulmonary arterial hypertension is a common complication of congenital heart disease (CHD). Congenital cardiopathies are the most frequent congenital malformations. The prevalence in our country remains unknown, based on birthrate, it is calculated that 12,000 to 16,000 infants in our country have some cardiac malformation. In patients with an uncorrected left-to-right shunt, increased pulmonary pressure leads to vascular remodeling and endothelial dysfunction secondary to an imbalance in vasoactive mediators which promotes vasoconstriction, inflammation, thrombosis, cell proliferation, impaired apotosis and fibrosis. The progressive rise in pulmonary vascular resistance and increased pressures in the right heart provocated reversal of the shunt may arise with the development of Eisenmenger' syndrome the most advanced form de Pulmonary arterial hypertension associated with congenital heart disease. The prevalence of Pulmonary arterial hypertension associated with CHD has fallen in developed countries in recent years that is not yet achieved in developing countries therefore diagnosed late as lack of hospital infrastructure and human resources for the care of patients with CHD. With the development of targeted medical treatments for pulmonary arterial hypertension, the concept of a combined medical and interventional/surgical approach for patients with Pulmonary arterial hypertension associated with CHD is a reality. We need to know the pathophysiological factors involved as well as a careful evaluation to determine the best therapeutic strategy.

  20. Breast Cancer Chemotherapy and Your Heart

    MedlinePlus

    ... of the American Heart Association Cardiology Patient Page Breast Cancer Chemotherapy and Your Heart Christine Unitt , Kamaneh Montazeri , ... Disclosures Footnotes Figures & Tables Info & Metrics eLetters Introduction Breast cancer is the most commonly diagnosed cancer in women. ...

  1. Analysis of the prevalence of cardiovascular disease and associated risk factors for European-American and African-American populations in the state of Pennsylvania 2005-2009.

    PubMed

    Long, Yong; Gracely, Edward J; Newschaffer, Craig J; Liu, Longjian

    2013-01-01

    We examined the burden of cardiovascular disease (CVD) and its associated risk factors using statewide representative data from the Pennsylvania Behavior Risk Factors Surveillance System. The data from 35,576 subjects aged ≥ 18 years participating in the Pennsylvania Behavior Risk Factors Surveillance System in 2005, 2007, and 2009 were analyzed. The age-adjusted prevalence rates of CVD were computed. Logistic regression analysis was applied to examine associations between the risk factors and CVD prevalence, with adjustment for confounding variables. The results showed that no significant changes in the prevalence of CVD, coronary heart disease, and stroke were observed in either European Americans or African Americans from 2005 to 2009 (p >0.05). African Americans had significantly greater CVD rates than European Americans. Although smoking rates significantly decreased, several other CVD risk factors (i.e., obesity, hypertension, and hypercholesterolemia) significantly increased from 2005 to 2009 in European Americans. Similar changes were observed in African Americans, although these changes did not reach statistical significance. Logistic regression analysis indicated that African Americans had a 35% greater risk of CVD. Education level less than high school, smoking, obesity, hypertension, and diabetes were significantly and positively associated with CVD. In conclusion, no significant achievements in CVD control and risk factor reduction were observed from 2005 to 2009 in Pennsylvania. Additional aggressive control of hypertension, obesity, and diabetes for both European and African Americans must be made to reduce the burden of CVD.

  2. Heart failure - discharge

    MedlinePlus

    ... College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation . 2013 Oct 15;128(16):e240-327. Epub 2013 Jun 5. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/ ...

  3. Heart failure - home monitoring

    MedlinePlus

    ... College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation . 2013 Oct 15;128(16):e240-327. Epub 2013 Jun 5. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/ ...

  4. Sleep-associated movement disorders and heart failure.

    PubMed

    Schaffernocker, Troy; Ho, Julia; Hayes, Don

    2009-09-01

    Sleep-associated movement disorders are a broad group of sleep disorders characterized by involuntary movements that may disrupt sleep. Relatively little is known about the clinical consequences of sleep-associated movement disorders on cardiovascular health. Because these disorders manifest mostly during sleep, recognizing a movement disorder can be particularly difficult. Nevertheless, patients can have frequent arousals and suffer from similar sleep deprivation, fragmentation, and autonomic disruption as occurs in sleep-disordered breathing. Subsequently, these disorders may have a serious impact on daytime function and perception of health in patients with chronic heart failure.

  5. Macro- and micronutrients in patients with congestive heart failure, particularly African-Americans.

    PubMed

    Newman, Kevin P; Bhattacharya, Syamal K; Munir, Ahmad; Davis, Richard C; Soberman, Judith E; Ramanathan, Kodangudi B

    2007-01-01

    Not all patients with heart failure, defined as a reduced ejection fraction, will have an activation of the RAAS, salt and water retention, or the congestive heart failure (CHF) syndrome. Beyond this cardiorenal perspective, CHF is accompanied by a systemic illness that includes oxidative stress, a proinflammatory phenotype, and a wasting of soft tissues and bone. A dyshomeostasis of calcium, magnesium, zinc, selenium, and vitamin D contribute to the appearance of oxidative stress and to compromised endogenous defenses that combat it. A propensity for hypovitaminosis D, given that melanin is a natural sunscreen, and for secondary hyperparathyroidism in African-Americans make them more susceptible to these systemic manifestations of CHF-a situation which is further threatened by the calcium and magnesium wasting that accompanies the secondary aldosteronism of CHF and the use of loop diuretics. PMID:18078025

  6. Risk Behaviors Associated with Cigarette Use among Asian American Adolescents

    ERIC Educational Resources Information Center

    Kwon, Harry T.; Wang, Min Qi; Valmidiano, Lillian L.

    2005-01-01

    Asian Americans are one of the fastest growing minority groups in the United States. This study examined the association between several common youth risk behaviors, including cigarette use among Asian American adolescents, using data (N=408) from the 2001 Youth Risk Behavior Survey (YRBS). The weighted univariate and multivariate logistic…

  7. American Kinesiology Association: A National Effort to Promote Kinesiology

    ERIC Educational Resources Information Center

    Morrow, James R., Jr.; Thomas, Jerry R.

    2010-01-01

    The American Academy of Kinesiology and Physical Education (AAKPE) and The American Kinesiology Association (AKA) should work together to help kinesiology thrive. Data are provided about kinesiology that reflects its visibility in PubMed and Google. Survey data from AKA show the rapid growth of the undergraduate major and graduate programs. In…

  8. Comparative Evaluation of American Cancer Society and American Lung Association Smoking Cessation Clinics.

    ERIC Educational Resources Information Center

    Lando, Harry A.; And Others

    1990-01-01

    Compared the effectiveness of the American Cancer Society's "FreshStart," the American Lung Association's "Freedom from Smoking," and a laboratory smoking cessation clinic. A one-year followup favored the more intensive laboratory and "Freedom from Smoking" clinics over the "FreshStart" method. (FMW)

  9. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

    PubMed

    Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J

    2005-02-01

    Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

  10. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.

    PubMed

    Pickering, Thomas G; Hall, John E; Appel, Lawrence J; Falkner, Bonita E; Graves, John; Hill, Martha N; Jones, Daniel W; Kurtz, Theodore; Sheps, Sheldon G; Roccella, Edward J

    2005-01-01

    Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

  11. Identification of heart rate–associated loci and their effects on cardiac conduction and rhythm disorders

    PubMed Central

    den Hoed, Marcel; Eijgelsheim, Mark; Esko, Tõnu; Brundel, Bianca J J M; Peal, David S; Evans, David M; Nolte, Ilja M; Segrè, Ayellet V; Holm, Hilma; Handsaker, Robert E; Westra, Harm-Jan; Johnson, Toby; Isaacs, Aaron; Yang, Jian; Lundby, Alicia; Zhao, Jing Hua; Kim, Young Jin; Go, Min Jin; Almgren, Peter; Bochud, Murielle; Boucher, Gabrielle; Cornelis, Marilyn C; Gudbjartsson, Daniel; Hadley, David; Van Der Harst, Pim; Hayward, Caroline; Heijer, Martin Den; Igl, Wilmar; Jackson, Anne U; Kutalik, Zoltán; Luan, Jian’an; Kemp, John P; Kristiansson, Kati; Ladenvall, Claes; Lorentzon, Mattias; Montasser, May E; Njajou, Omer T; O’Reilly, Paul F; Padmanabhan, Sandosh; Pourcain, Beate St.; Rankinen, Tuomo; Salo, Perttu; Tanaka, Toshiko; Timpson, Nicholas J; Vitart, Veronique; Waite, Lindsay; Wheeler, William; Zhang, Weihua; Draisma, Harmen H M; Feitosa, Mary F; Kerr, Kathleen F; Lind, Penelope A; Mihailov, Evelin; Onland-Moret, N Charlotte; Song, Ci; Weedon, Michael N; Xie, Weijia; Yengo, Loic; Absher, Devin; Albert, Christine M; Alonso, Alvaro; Arking, Dan E; de Bakker, Paul I W; Balkau, Beverley; Barlassina, Cristina; Benaglio, Paola; Bis, Joshua C; Bouatia-Naji, Nabila; Brage, Søren; Chanock, Stephen J; Chines, Peter S; Chung, Mina; Darbar, Dawood; Dina, Christian; Dörr, Marcus; Elliott, Paul; Felix, Stephan B; Fischer, Krista; Fuchsberger, Christian; de Geus, Eco J C; Goyette, Philippe; Gudnason, Vilmundur; Harris, Tamara B; Hartikainen, Anna-liisa; Havulinna, Aki S; Heckbert, Susan R; Hicks, Andrew A; Hofman, Albert; Holewijn, Suzanne; Hoogstra-Berends, Femke; Hottenga, Jouke-Jan; Jensen, Majken K; Johansson, Åsa; Junttila, Juhani; Kääb, Stefan; Kanon, Bart; Ketkar, Shamika; Khaw, Kay-Tee; Knowles, Joshua W; Kooner, Angrad S; Kors, Jan A; Kumari, Meena; Milani, Lili; Laiho, Päivi; Lakatta, Edward G; Langenberg, Claudia; Leusink, Maarten; Liu, Yongmei; Luben, Robert N; Lunetta, Kathryn L; Lynch, Stacey N; Markus, Marcello R P; Marques-Vidal, Pedro; Leach, Irene Mateo; McArdle, Wendy L; McCarroll, Steven A; Medland, Sarah E; Miller, Kathryn A; Montgomery, Grant W; Morrison, Alanna C; Müller-Nurasyid, Martina; Navarro, Pau; Nelis, Mari; O’Connell, Jeffrey R; O’Donnell, Christopher J; Ong, Ken K; Newman, Anne B; Peters, Annette; Polasek, Ozren; Pouta, Anneli; Pramstaller, Peter P; Psaty, Bruce M; Rao, Dabeeru C; Ring, Susan M; Rossin, Elizabeth J; Rudan, Diana; Sanna, Serena; Scott, Robert A; Sehmi, Jaban S; Sharp, Stephen; Shin, Jordan T; Singleton, Andrew B; Smith, Albert V; Soranzo, Nicole; Spector, Tim D; Stewart, Chip; Stringham, Heather M; Tarasov, Kirill V; Uitterlinden, André G; Vandenput, Liesbeth; Hwang, Shih-Jen; Whitfield, John B; Wijmenga, Cisca; Wild, Sarah H; Willemsen, Gonneke; Wilson, James F; Witteman, Jacqueline C M; Wong, Andrew; Wong, Quenna; Jamshidi, Yalda; Zitting, Paavo; Boer, Jolanda M A; Boomsma, Dorret I; Borecki, Ingrid B; Van Duijn, Cornelia M; Ekelund, Ulf; Forouhi, Nita G; Froguel, Philippe; Hingorani, Aroon; Ingelsson, Erik; Kivimaki, Mika; Kronmal, Richard A; Kuh, Diana; Lind, Lars; Martin, Nicholas G; Oostra, Ben A; Pedersen, Nancy L; Quertermous, Thomas; Rotter, Jerome I; van der Schouw, Yvonne T; Verschuren, W M Monique; Walker, Mark; Albanes, Demetrius; Arnar, David O; Assimes, Themistocles L; Bandinelli, Stefania; Boehnke, Michael; de Boer, Rudolf A; Bouchard, Claude; Caulfield, W L Mark; Chambers, John C; Curhan, Gary; Cusi, Daniele; Eriksson, Johan; Ferrucci, Luigi; van Gilst, Wiek H; Glorioso, Nicola; de Graaf, Jacqueline; Groop, Leif; Gyllensten, Ulf; Hsueh, Wen-Chi; Hu, Frank B; Huikuri, Heikki V; Hunter, David J; Iribarren, Carlos; Isomaa, Bo; Jarvelin, Marjo-Riitta; Jula, Antti; Kähönen, Mika; Kiemeney, Lambertus A; van der Klauw, Melanie M; Kooner, Jaspal S; Kraft, Peter; Iacoviello, Licia; Lehtimäki, Terho; Lokki, Marja-Liisa L; Mitchell, Braxton D; Navis, Gerjan; Nieminen, Markku S; Ohlsson, Claes; Poulter, Neil R; Qi, Lu; Raitakari, Olli T; Rimm, Eric B; Rioux, John D; Rizzi, Federica; Rudan, Igor; Salomaa, Veikko; Sever, Peter S; Shields, Denis C; Shuldiner, Alan R; Sinisalo, Juha; Stanton, Alice V; Stolk, Ronald P; Strachan, David P; Tardif, Jean-Claude; Thorsteinsdottir, Unnur; Tuomilehto, Jaako; van Veldhuisen, Dirk J; Virtamo, Jarmo; Viikari, Jorma; Vollenweider, Peter; Waeber, Gérard; Widen, Elisabeth; Cho, Yoon Shin; Olsen, Jesper V; Visscher, Peter M; Willer, Cristen; Franke, Lude; Erdmann, Jeanette; Thompson, John R; Pfeufer, Arne; Sotoodehnia, Nona; Newton-Cheh, Christopher; Ellinor, Patrick T; Stricker, Bruno H Ch; Metspalu, Andres; Perola, Markus; Beckmann, Jacques S; Smith, George Davey; Stefansson, Kari; Wareham, Nicholas J; Munroe, Patricia B; Sibon, Ody C M; Milan, David J; Snieder, Harold; Samani, Nilesh J; Loos, Ruth J F

    2013-01-01

    Elevated resting heart rate is associated with greater risk of cardiovascular disease and mortality. In a 2-stage meta-analysis of genome-wide association studies in up to 181,171 individuals, we identified 14 new loci associated with heart rate and confirmed associations with all 7 previously established loci. Experimental downregulation of gene expression in Drosophila melanogaster and Danio rerio identified 20 genes at 11 loci that are relevant for heart rate regulation and highlight a role for genes involved in signal transmission, embryonic cardiac development and the pathophysiology of dilated cardiomyopathy, congenital heart failure and/or sudden cardiac death. In addition, genetic susceptibility to increased heart rate is associated with altered cardiac conduction and reduced risk of sick sinus syndrome, and both heart rate–increasing and heart rate–decreasing variants associate with risk of atrial fibrillation. Our findings provide fresh insights into the mechanisms regulating heart rate and identify new therapeutic targets. PMID:23583979

  12. Position of the American Dietetic Association: vegetarian diets.

    PubMed

    Craig, Winston J; Mangels, Ann Reed

    2009-07-01

    It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence- based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients

  13. Position of the American Dietetic Association: vegetarian diets.

    PubMed

    Craig, Winston J; Mangels, Ann Reed

    2009-07-01

    It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence- based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients

  14. Policy Statements of the American Association of Dental Schools[.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1986

    1986-01-01

    The American Association of Dental Schools' policy statements on education (preprofessional, predoctoral, advanced, continuing, and auxiliary), government relations regarding education, research, delivery of care, and public health concerns as amended in March 1986 are presented. (MSE)

  15. 15. Historic American Buildings Survey California Automobile Association Original: 1932 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    15. Historic American Buildings Survey California Automobile Association Original: 1932 Re-photo: January 1940 CONVENTO - VIEW FROM NORTHWEST - Mission San Jose de Guadalupe, Mission & Washington Boulevards, Fremont, Alameda County, CA

  16. Community lay rescuer automated external defibrillation programs: key state legislative components and implementation strategies: a summary of a decade of experience for healthcare providers, policymakers, legislators, employers, and community leaders from the American Heart Association Emergency Cardiovascular Care Committee, Council on Clinical Cardiology, and Office of State Advocacy.

    PubMed

    Aufderheide, Tom; Hazinski, Mary Fran; Nichol, Graham; Steffens, Suzanne Smith; Buroker, Andrew; McCune, Robin; Stapleton, Edward; Nadkarni, Vinay; Potts, Jerry; Ramirez, Raymond R; Eigel, Brian; Epstein, Andrew; Sayre, Michael; Halperin, Henry; Cummins, Richard O

    2006-03-01

    Cardiovascular disease is a leading cause of death for adults > or =40 years of age. The American Heart Association (AHA) estimates that sudden cardiac arrest is responsible for about 250,000 out-of-hospital deaths annually in the United States. Since the early 1990s, the AHA has called for innovative approaches to reduce time to cardiopulmonary resuscitation (CPR) and defibrillation and improve survival from sudden cardiac arrest. In the mid-1990s, the AHA launched a public health initiative to promote early CPR and early use of automated external defibrillators (AEDs) by trained lay responders in community (lay rescuer) AED programs. Between 1995 and 2000, all 50 states passed laws and regulations concerning lay rescuer AED programs. In addition, the Cardiac Arrest Survival Act (CASA, Public Law 106-505) was passed and signed into federal law in 2000. The variations in state and federal legislation and regulations have complicated efforts to promote lay rescuer AED programs and in some cases have created impediments to such programs. Since 2000, most states have reexamined lay rescuer AED statutes, and many have passed legislation to remove impediments and encourage the development of lay rescuer AED programs. The purpose of this statement is to help policymakers develop new legislation or revise existing legislation to remove barriers to effective community lay rescuer AED programs. Important areas that should be considered in state legislation and regulations are highlighted, and sample legislation sections are included. Potential sources of controversy and the rationale for proposed legislative components are noted. This statement will not address legislation to support home AED programs. Such recommendations may be made after the conclusion of a large study of home AED use.

  17. The Associations of Indices of Obesity with Lipoprotein Subfractions in Japanese American, African American and Korean Men

    PubMed Central

    Hirooka, Nobutaka; Shin, Chol; Masaki, Kamal H.; Edmundowicz, Daniel; Choo, Jina; Barinas-Mitchell, Emma J.M.; Willcox, Bradley J.; Sutton-Tyrrell, Kim; El-Saed, Aiman; Miljkovic-Gacic, Iva; Ohkubo, Takayoshi; Miura, Katsuyuki; Ueshima, Hirotsugu; Kuller, Lewis H.; Sekikawa, Akira

    2013-01-01

    Background Both indices of obesity and lipoprotein subfractions contribute to coronary heart disease risk. However, associations between indices of obesity and lipoprotein subfractions remain undetermined across different ethnic groups. This study aims to examine the associations of indices of obesity in Japanese Americans (JA), African Americans (AA) and Koreans with lipoprotein subfractions. Methods A population-based sample of 230 JA, 91 AA, and 291 Korean men aged 40–49 was examined for indices of obesity, i.e., visceral and subcutaneous adipose tissue (VAT and SAT, respectively), waist circumference (WC), and body-mass index (BMI), and for lipoprotein subfractions by nuclear-magnetic-resonance spectroscopy. Multiple regression analyses were performed in each of the three ethnic groups to examine the associations of each index of obesity with lipoprotein. Results VAT had significant positive associations with total and small low-density lipoprotein (LDL) and a significant negative association with large high-density lipoprotein (HDL) in all three ethnicities (p < 0.01). SAT, WC, and BMI had significant positive associations with total and small LDL in only JA and Koreans, while these indices had significant inverse associations with large HDL in all ethnic groups (p < 0.01). Compared to SAT, VAT had larger R2 values in the associations with total and small LDL and large HDL in all three ethnic groups. Conclusions VAT is significantly associated with total and small LDL and large HDL in all three ethnic groups. The associations of SAT, WC, and BMI with lipoprotein subfractions are weaker compared to VAT in all three ethnic groups. PMID:25068101

  18. American Association of Community Colleges 2010 Fact Sheet

    ERIC Educational Resources Information Center

    American Association of Community Colleges (NJ1), 2010

    2010-01-01

    The American Association of Community Colleges (AACC) is the primary advocacy organization for the nation's community colleges, representing nearly 1,200 two-year, associate degree-granting institutions and more than 11 million students. Founded in 1920, AACC is a 501(c)(3) nonprofit association. AACC is governed by a 32-member board of directors,…

  19. American Association of Community Colleges 2009 Fact Sheet

    ERIC Educational Resources Information Center

    American Association of Community Colleges (NJ1), 2009

    2009-01-01

    The American Association of Community Colleges (AACC) is the primary advocacy organization for the nation's community colleges, representing nearly 1,200 two-year, associate degree-granting institutions and more than 11 million students. Founded in 1920, AACC is a 501(c)(3) nonprofit association. This paper presents several facts about ACCC.

  20. Directory of the Association of American Library Schools: 1979.

    ERIC Educational Resources Information Center

    Journal of Education for Librarianship, 1979

    1979-01-01

    The Association of American Library Schools lists 103 library schools and over 1,900 educators in two major sections: a listing by school of faculty and subject areas, and an alphabetical roster of personnel with title and school. Phone numbers, names of 682 Association members, and Association bylaws are included. (FM)

  1. Fontan-associated liver disease: Implications for heart transplantation.

    PubMed

    Greenway, Steven C; Crossland, David S; Hudson, Mark; Martin, Steven R; Myers, Robert P; Prieur, Tim; Hasan, Asif; Kirk, Richard

    2016-01-01

    Chronic liver diseases are associated with multiple complications, including cirrhosis, portal hypertension, ascites, synthetic dysfunction and hepatocellular carcinoma, and these processes are increasingly recognized in post-Fontan patients. Fontan-associated liver disease (FALD) can be defined as abnormalities in liver structure and function that result from the Fontan circulation and are not related to another disease process. FALD arises due to chronic congestion of the liver created by the elevated venous pressure and low cardiac output of the Fontan circulation, which may be superimposed on previous liver injury. Pathology studies have generally shown that FALD worsens as time post-Fontan increases, but the prevalence of FALD is not well defined because the majority of Fontan patients, even those with significant hepatic fibrosis, appear to be asymptomatic and biochemical or functional hepatic abnormalities are usually subtle or absent. Alternate non-invasive investigations, derived from the study of other chronic liver diseases, have been tested in small series of pediatric and adult Fontan patients, but they have been confounded by congestion and do not correlate well with liver biopsy findings. Liver disease can complicate Fontan circulatory failure and may even be significant enough to be considered a contraindication to heart transplantation or require combined heart-liver transplantation. The search for the optimal management strategy continues in the setting of increasing numbers of Fontan patients surviving to adulthood and being referred for heart transplantation. Thus, in this review we attempt to define the scope and significance of FALD and address transplant-related assessment and management of this challenging disorder. PMID:26586487

  2. Pulmonary Hypoplasia Associated with Congenital Heart Diseases: A Fetal Study

    PubMed Central

    Ruchonnet-Metrailler, Isabelle; Bessieres, Bettina; Bonnet, Damien; Vibhushan, Shamila; Delacourt, Christophe

    2014-01-01

    Background Abnormalities of the fetal pulmonary vasculature may affect lung morphogenesis. Postnatal studies have suggested that pulmonary hypoplasia (PH) may be associated with congenital heart diseases (CHDs). Objective To determine the prevalence of PH associated with CHDs, and to evaluate whether CHDs with right outflow obstruction were associated with the highest risk of lung growth impairment. Methods Between January 2006 and December 2010, fetuses with CHD obtained following the termination of pregnancies due to fetal abnormalities were examined in a prospective manner for the detection of heart and lung defects. CHDs were classified into five pathophysiological groups. Lung weight (LW), body weight (BW), and LW/BW ratio were analyzed for each case. The expression of CD31 and VEGF in the lung was evaluated by immunohistochemistry. Results Fetuses with CHDs and right outflow obstruction had significantly lower LW for a given BW, and significantly lower LW/BW ratios for a given gestational age. When defining PH as a fetal LW/BW ratio <0.015 before 28 weeks, and <0.012 after 28 weeks, PH was detected in 15 of the 119 fetuses analyzed (13%). It was significantly associated with CHD with right outflow obstruction, independently of chromosomal abnormalities and associated extracardiac abnormalities (p<0.03). Right outflow obstruction was detected in 60% of the fetuses with CHD and PH, but in only 32% of those with CHD but no PH. In fetuses with right outflow obstruction, no difference was observed between those with PH and those without PH, in terms of the ratio of pulmonary artery diameter to aortic diameter, lung CD31 expression, or lung VEGF expression. Conclusion CHDs with right outflow obstruction are a significant risk factor for prenatally acquired PH. The occurrence of fetal PH is not correlated with abnormalities of the pulmonary vasculature, suggesting the involvement of perfusion-independent mechanisms. PMID:24699523

  3. The Impact of Lifecourse Socioeconomic Position on Cardiovascular Disease Events in African Americans: The Jackson Heart Study

    PubMed Central

    Gebreab, Samson Y; Diez Roux, Ana V; Brenner, Allison B; Hickson, DeMarc A; Sims, Mario; Subramanyam, Malavika; Griswold, Michael E; Wyatt, Sharon B; James, Sherman A

    2015-01-01

    Background Few studies have examined the impact of lifecourse socioeconomic position (SEP) on cardiovascular disease (CVD) risk among African Americans. Methods and Results We used data from the Jackson Heart Study (JHS) to examine the associations of multiple measures of lifecourse SEP with CVD events in a large cohort of African Americans. During a median of 7.2-year follow-up, 362 new or recurrent CVD events occurred in a sample of 5301 participants aged 21 to 94. Childhood SEP was assessed by using mother’s education, parental home ownership, and childhood amenities. Adult SEP was assessed by using education, income, wealth, and public assistance. Adult SEP was more consistently associated with CVD risk in women than in men: age-adjusted hazard ratios for low versus high income (95% CIs), 2.46 (1.19 to 5.09) in women and 1.50 (0.87 to 2.58) in men, P for interaction=0.1244, and hazard ratio for low versus high wealth, 2.14 (1.39 to 3.29) in women and 1.06 (0.62 to 1.81) in men, P for interaction=0.0224. After simultaneous adjustment for all adult SEP measures, wealth remained a significant predictor of CVD events in women (HR=1.73 [1.04, 2.85] for low versus high). Education and public assistance were less consistently associated with CVD. Adult SEP was a stronger predictor of CVD events in younger than in older participants (HR for high versus low summary adult SEP score 3.28 [1.43, 7.53] for participants ≤50 years, and 1.90 (1.36 to 2.66) for participants >50 years, P for interaction 0.0846). Childhood SEP was not associated with CVD risk in women or men. Conclusions Adult SEP is an important predictor of CVD events in African American women and in younger African Americans. Childhood SEP was not associated with CVD events in this population. PMID:26019130

  4. Linkage Analysis of Glomerular Filtration Rate in American Indians: The Strong Heart Family Study

    PubMed Central

    Mottl, Amy K.; Vupputuri, Suma; Cole, Shelley A.; Almasy, Laura; Göring, Harald HH; Diego, Vincent P.; Laston, Sandra; Franceschini, Nora; Shara, Nawar; Lee, Elisa T.; Best, Lyle G.; Fabsitz, Richard R.; MacCluer, Jean W.; Umans, Jason G.; North, Kari E.

    2009-01-01

    American Indians have a disproportionately high rate of kidney disease likely due to a combination of increased environmental and genetic risk factors. In an attempt to localize genes influencing kidney disease risk factors, we performed a genome wide scan of estimated glomerular filtration rate on participants of the Strong Heart Family Study. Over 3 600 men and women from 13 American Indian tribes were recruited from 3 centers (Arizona, North and South Dakota, Oklahoma). Using SOLAR 2.1.2, multipoint variance component linkage analysis was performed in each center as well as the entire cohort after controlling for center effects. Two modeling strategies were utilized: model 1 incorporated age, sex and interaction terms and model 2 additionally controlled for diabetic status, systolic and diastolic blood pressure, body mass index, low density lipoproteins, high density lipoproteins, triglycerides and smoking status. Significant evidence for linkage in Arizona lay on 12p12.2 at 39cM nearest marker D12S310 (LOD=3.5). Additional loci with suggestive evidence for linkage were detected at 1p36.31 (LOD=2.0–2.3), 2q33.3 (LOD=1.8) and 9q34.2 (LOD=2.4). No significant evidence for additive interaction with diabetes, hypertension or obesity was noted. In conclusion, we found evidence for linkage of a quantitative trait locus influencing estimated glomerular filtration rate to a region of chromosome 12p in a large cohort of American Indians. PMID:18854848

  5. Anoxic performance of the american eel (Anguilla rostrata L.) heart requires extracellular glucose.

    PubMed

    Bailey, J R; MacDougall, R; Clowe, S; Driedzic, W R

    2000-06-01

    The importance of extracellular glucose in the maintenance of performance of the heart of the American eel (Anguilla rostrata Le Sueur (L.) Under anoxia was assessed under a variety of experimental conditions. Ventricular strips, electrically paced at 36 bpm, in N(2)-gassed medium maintained the imposed pace rate and generated approximately 25% of the initial twitch force of contraction for at least 60 min when glucose was present in the medium. But ventricular strips challenged without glucose in the medium failed to maintain the pacing rate within 5-10 min. Isolated and intact, perfused hearts maintained pressure and followed an imposed pace rate of 24 bpm for at least 2 hr, under anoxic conditions, if glucose was present in the medium. But without glucose in the medium isolated hearts failed within 30 min. Endogenous glycogen stores were utilized in hearts perfused with medium containing NaCN to impair oxidative phosphorylation. The presence of glucose in the medium did not protect against glycogen mobilization. The data indicate that exogenous glucose is necessary to maintain performance under anoxia at high workloads and physiological Ca(2+) levels. Finally, ventricular strips treated with NaCN and forced to contract at 24 bpm lost 70% of initial twitch force. Increasing extracellular Ca(2+) concentration stepwise from 1.5 to 9.5 mM restored twitch force to approximately 50% of the initial level and this response was not dependent on exogenous glucose. However, glucose was required to maintain resting tension even under normoxic conditions in the face of a Ca(2+) challenge.

  6. 2010 Annual Report of the American Psychological Association

    ERIC Educational Resources Information Center

    American Psychologist, 2011

    2011-01-01

    This report presents the 2010 annual report of the American Psychological Association (APA). It provides the highlights of the association's and individual directorate's activities to APA members. APA continued its efforts to advance psychological practice and ensure the public's access to high-quality psychological services, apply psychological…

  7. 2005 Annual Report of the American Psychological Association

    ERIC Educational Resources Information Center

    American Psychologist, 2006

    2006-01-01

    This annual report of the American Psychological Association (APA) describes the association's activities and accomplishments in 2005. The examples provided in this report are a small sampling of all that APA is doing to advance the discipline of psychology in an ever-changing world.

  8. 2009 Annual Report of the American Psychological Association

    ERIC Educational Resources Information Center

    American Psychologist, 2010

    2010-01-01

    This annual report of the American Psychological Association (APA) describes the association's activities and accomplishments in 2009. It describes strides made toward the goal of infusing psychology into the health care marketplace and of bringing psychology--and the unique skills of psychologists--to the attention of the public. This report aims…

  9. Federal Legislative Policy of the American Library Association.

    ERIC Educational Resources Information Center

    American Library Association, Chicago, IL. Legislation Committee.

    The American Library Association's policy on federal legislation is based on its objectives of promoting and improving library service and librarianship. Representing those who use libraries as well as those who operate them, the Association is a source of information on libraries and information services for those concerned with formulating and…

  10. An Association Perspective: Responding to the American Dental Association's Future of Dentistry Project.

    ERIC Educational Resources Information Center

    Hutchinson, Rowland A.; Haden, N. Karl; Valachovic, Richard W.

    2000-01-01

    In response to the American Dental Association's (ADA) Future of Dentistry Project, the American Dental Education Association (ADEA) provided perspective on the most critical issues facing the dental profession. ADEA responded in six areas, each corresponding to areas of focus in the ADA project. This report reflects comments provided to the ADEA…

  11. Psychosocial factors associated with weight control expectancies in treatment-seeking African American smokers.

    PubMed

    Webb, Monica S; Carey, Michael P

    2009-08-01

    African Americans are disproportionately affected by tobacco smoking and obesity. As weight control expectancies can reinforce smoking maintenance, the purpose of this study was to explore psychosocial factors related to expectancies for weight control among African Americans seeking cessation treatment. African American smokers (N = 117) provided information on demographics, family medical history, personal risk factors, smoking, weight control expectancies and concerns, perceived stress, and acculturation. Multivariate analyses examined hypotheses regarding determinants of weight control expectancies. Fifty-one percent of participants were concerned about gaining weight upon cessation. Positive expectations for weight control through smoking were associated with older age, a family history of heart disease, greater perceived stress, and a lower level of acculturation. In conclusion, many African American smokers are concerned about postcessation weight gain: expectations for weight control through smoking are most evident those with elevated perceived stress, traditional African American cultural values, and a family history of chronic illness. Needed are culturally specific smoking cessation interventions that include weight management strategies as an adjunct to smoking cessation treatments. PMID:19715043

  12. Associated noncardiac congenital anomalies among cases with congenital heart defects.

    PubMed

    Stoll, Claude; Dott, Beatrice; Alembik, Yves; Roth, Marie-Paule

    2015-02-01

    Cases with congenital heart defects (CHD) often have other associated anomalies. The purpose of this investigation was to assess the prevalence and the types of associated anomalies in CHD in a defined population. The anomalies associated with CHD were collected in all live births, stillbirths and terminations of pregnancy during 26 years in 346,831 consecutive pregnancies of known outcome in the area covered by our population based registry of congenital anomalies. Of the 4005 cases with CHD born during this period (total prevalence of 115.5 per 10,000), 1055 (26.3%) had associated major anomalies. There were 354 (8.8%) cases with chromosomal abnormalities including 218 trisomies 21, and 99 (2.5%) nonchromosomal recognized dysmorphic conditions. There were no predominant recognized dysmorphic conditions, but VACTERL association. However, other recognized dysmorphic conditions were registered including Noonan syndrome, fetal alcohol syndrome, and skeletal dysplasias. Six hundred and two (15.0%) of the cases had non syndromic, non chromosomal multiple congenital anomalies (MCA). Anomalies in the urinary tract, the musculoskeletal, the digestive, and the central nervous systems were the most common other anomalies. Prenatal diagnosis was obtained in 18.7% of the pregnancies. In conclusion the overall prevalence of associated anomalies, which was one in four infants, emphasizes the need for a thorough investigation of cases with CHD. A routine screening for other anomalies may be considered in infants and in fetuses with CHD. One should be aware that the anomalies associated with CHD can be classified into a recognizable anomaly, syndrome or pattern in one out of nine cases with CHD. PMID:25497206

  13. Toxoplasmic encephalitis associated with meningitis in a heart transplant recipient.

    PubMed

    Baliu, C; Sanclemente, G; Cardona, M; Castel, M A; Perez-Villa, F; Moreno, A; Cervera, C

    2014-08-01

    Toxoplasma gondii is an opportunistic pathogen that causes neurologic and extraneurologic manifestations in immunosuppressed patients. Encephalitis and intracranial mass lesions are easily recognized as typical manifestations of toxoplasmosis. However, meningitis caused by T. gondii is a rare condition with very few cases described in the literature. We present the case of a heart transplant recipient who developed toxoplasmic encephalitis associated with meningitis. After an extensive review of the medical literature, we found only 1 case of meningitis in solid organ transplant recipients and <25 cases in immunosuppressed patients, such as patients infected with human immunodeficiency virus or those with Hodgkin's disease. In this report, we consider toxoplasmosis in the differential diagnosis of meningitis in immunocompromised individuals.

  14. [Association between function of selenium and heart disease].

    PubMed

    Hiraoka, Yuji

    2016-07-01

    An excessive oxidative stress is considered to be responsible for the development and progression of heart disease. Deficiency of trace elements with antioxidative activities is present in patients with heart disease. Selenium (Se) is an integral part of the enzyme glutathione peroxidase(GPx), one of the central players of the heart's antioxidant system, and it's deficiency is implicated in certain types of heart disease. Our study suggests that myocardial oxidative stress in chronic heart failure may be augmented at least in part by concomitant GPx deficiency, and that the administration of Se could rescue the exhaustion of this selenoprotein, resulting in improved left ventricular function. PMID:27455811

  15. Blood pressure control and perceived health status in African Americans with subclinical hypertensive heart disease.

    PubMed

    Burla, Michael J; Brody, Aaron M; Ference, Brian A; Flack, John M; Mahn, James J; Marinica, Alexander L; Carroll, Justin A; Nasser, Samar A; Zhang, Shiling; Levy, Phillip D

    2014-05-01

    The role of antihypertensive therapy in reducing the risk of cardiovascular complications such as heart failure is well established, but the effects of different blood pressure goals on patient-perceived health status has not been well defined. We sought to determine if adverse effects on perceived health status will occur with lower blood pressure goals or more intensive antihypertensive therapy. Data were prospectively collected as a part of a single center, randomized controlled trial designed to evaluate standard (Seventh Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure-compliant) versus intense (<120/80 mm Hg) blood pressure goals for patients with uncontrolled hypertension and subclinical hypertensive heart disease. Blood pressure management was open label, and health status was measured at 3-month intervals over 1 year of follow-up using the short-form (SF)-36. Mixed linear models were constructed for each of the SF-36 summary scores. One hundred twenty-three (mean age 49.4 ± 8.2; 65% female; 95.1% African American) patients were randomized, 88 of whom completed the protocol. With the exception of a decrease in perceived health transition, health status did not change significantly on repeat measurement. Lower blood pressure goals and more intensive antihypertensive therapy appear to be well tolerated with limited effects on patients' perception of health status.

  16. Cloning, sequence analysis and phylogeny of connexin43 isolated from American black bear heart.

    PubMed

    Van Der Heyden, Marcel A G; Kok, Bart; Kouwenhoven, Evelyn N; Toien, Oivind; Barnes, Brian M; Fedorov, Vadim G; Efimov, Igor R; Opthof, Tobias

    2007-10-01

    Conduction in the heart requires gap junctions. In mammalian ventricular myocytes these consist of connexin43 (Cx43). Hearts of non-hibernating species display conduction disturbances at reduced temperatures. These may exacerbate into lethal arrhythmias. Hibernating species are protected against these arrhythmias by a non-resolved mechanism. To analyze whether the amino acid composition of Cx43 from the hibernating American black bear displays specific features, we cloned the full coding sequence of Ursus americanus Cx43 and compared with that of other (non)hibernating species. UaCx43 displays 99.7% identity to rabbit Cx43 at the amino acid level. No specific features were observed in UaCx43 when compared to previously cloned Cx43 from hibernating and non-hibernating mammals. Phylogenetic tree reconstruction of this and other published full-length Cx43 sequences reveals a very high level of conservation from fish to men. Finally, one of the previously identified six mammalian characteristic amino acids, is not conserved in the black bear. PMID:17654014

  17. Life disruption, life continuation: contrasting themes in the lives of African-American elders with advanced heart failure.

    PubMed

    Hopp, Faith Pratt; Thornton, Nancy; Martin, Lindsey; Zalenski, Robert

    2012-01-01

    This study addresses the need for more information about how urban African-American elders experience advanced heart failure. Participants included 35 African Americans aged 60 and over with advanced heart failure, identified through records from a community hospital in Detroit, Michigan. Four focus groups (n = 13) and 22 individual interviews were conducted. We used thematic analysis to examine qualitative focus groups and interviews. Themes identified included life disruption, which encompassed the sub-themes of living scared, making sense of heart failure, and limiting activities. Resuming life was a contrasting theme involving culturally relevant coping strategies, and included the sub-themes of resiliency, spirituality, and self-care that helped patients regain and maintain a sense of self amid serious illness. Participants faced numerous challenges and invoked a variety of strategies to cope with their illness, and their stories of struggles, hardship, and resilience can serve as a model for others struggling with advanced illness. PMID:22352363

  18. Stress May Take Greatest Toll on Younger Women's Hearts

    MedlinePlus

    ... flow to the heart, said study leader Dr. Viola Vaccarino. She is chair of epidemiology at Emory ... spokesperson, Go Red for Women, American Heart Association; Viola Vaccarino, M.D., Ph.D., professor and chair, ...

  19. FastStats: Heart Disease

    MedlinePlus

    ... or Pacific Islander Population Health of Black or African American non-Hispanic Population Health of Hispanic or Latino ... diagnostic categories [PDF - 58 KB] Hospitalization for Congestive Heart Failure: United States, ... Association Get Email Updates To receive email ...

  20. Rare variant associations with waist-to-hip ratio in European-American and African-American women from the NHLBI-Exome Sequencing Project.

    PubMed

    Kan, Mengyuan; Auer, Paul L; Wang, Gao T; Bucasas, Kristine L; Hooker, Stanley; Rodriguez, Alejandra; Li, Biao; Ellis, Jaclyn; Adrienne Cupples, L; Ida Chen, Yii-Der; Dupuis, Josée; Fox, Caroline S; Gross, Myron D; Smith, Joshua D; Heard-Costa, Nancy; Meigs, James B; Pankow, James S; Rotter, Jerome I; Siscovick, David; Wilson, James G; Shendure, Jay; Jackson, Rebecca; Peters, Ulrike; Zhong, Hua; Lin, Danyu; Hsu, Li; Franceschini, Nora; Carlson, Chris; Abecasis, Goncalo; Gabriel, Stacey; Bamshad, Michael J; Altshuler, David; Nickerson, Deborah A; North, Kari E; Lange, Leslie A; Reiner, Alexander P; Leal, Suzanne M

    2016-08-01

    Waist-to-hip ratio (WHR), a relative comparison of waist and hip circumferences, is an easily accessible measurement of body fat distribution, in particular central abdominal fat. A high WHR indicates more intra-abdominal fat deposition and is an established risk factor for cardiovascular disease and type 2 diabetes. Recent genome-wide association studies have identified numerous common genetic loci influencing WHR, but the contributions of rare variants have not been previously reported. We investigated rare variant associations with WHR in 1510 European-American and 1186 African-American women from the National Heart, Lung, and Blood Institute-Exome Sequencing Project. Association analysis was performed on the gene level using several rare variant association methods. The strongest association was observed for rare variants in IKBKB (P=4.0 × 10(-8)) in European-Americans, where rare variants in this gene are predicted to decrease WHRs. The activation of the IKBKB gene is involved in inflammatory processes and insulin resistance, which may affect normal food intake and body weight and shape. Meanwhile, aggregation of rare variants in COBLL1, previously found to harbor common variants associated with WHR and fasting insulin, were nominally associated (P=2.23 × 10(-4)) with higher WHR in European-Americans. However, these significant results are not shared between African-Americans and European-Americans that may be due to differences in the allelic architecture of the two populations and the small sample sizes. Our study indicates that the combined effect of rare variants contribute to the inter-individual variation in fat distribution through the regulation of insulin response.

  1. Clinical factors associated with early readmission among acutely decompensated heart failure patients

    PubMed Central

    Pierre-Louis, Bredy; Rodriques, Shareen; Gorospe, Vanessa; Guddati, Achuta K.; Ahn, Chul; Wright, Maurice

    2016-01-01

    Introduction Congestive heart failure (CHF) is a common cause of hospital readmission. Material and methods A retrospective study was conducted at Harlem Hospital in New York City. Data were collected for 685 consecutive adult patients admitted for decompensated CHF from March, 2009 to December, 2012. Variables including patient demographics, comorbidities, laboratory studies, and medical therapy were compared between CHF patient admissions resulting in early CHF readmission and not resulting in early CHF readmission. Results Clinical factors found to be independently significant for early CHF readmission included chronic obstructive pulmonary disease (odds ratio (OR) = 6.4), HIV infection (OR = 3.4), African-American ethnicity (OR = 2.2), systolic heart failure (OR = 1.9), atrial fibrillation (OR = 2.3), renal disease with glomerular filtration rate < 30 ml/min (OR = 2.7), evidence of substance abuse (OR = 1.7), and absence of angiotensin-converting enzyme inhibitors or angiotensin receptor blocker therapy after discharge (OR = 1.8). The ORs were used to develop a scoring system regarding the risk for early readmission. Conclusions Identifying patients with clinical factors associated with early CHF readmission after an index hospitalization for CHF using the proposed scoring system would allow for an early CHF readmission risk stratification protocol to target particularly high-risk patients. PMID:27279845

  2. Admixture mapping of serum vitamin D and parathyroid hormone concentrations in the African American-Diabetes Heart Study.

    PubMed

    Palmer, Nicholette D; Divers, Jasmin; Lu, Lingyi; Register, Thomas C; Carr, J Jeffrey; Hicks, Pamela J; Smith, S Carrie; Xu, Jianzhao; Judd, Suzanne E; Irvin, Marguerite R; Gutierrez, Orlando M; Bowden, Donald W; Wagenknecht, Lynne E; Langefeld, Carl D; Freedman, Barry I

    2016-06-01

    Vitamin D and intact parathyroid hormone (iPTH) concentrations differ between individuals of African and European descent and may play a role in observed racial differences in bone mineral density (BMD). These findings suggest that mapping by admixture linkage disequilibrium (MALD) may be informative for identifying genetic variants contributing to these ethnic disparities. Admixture mapping was performed for serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, vitamin D-binding protein (VDBP), bioavailable vitamin D, and iPTH concentrations and computed tomography measured thoracic and lumbar vertebral volumetric BMD in 552 unrelated African Americans with type 2 diabetes from the African American-Diabetes Heart Study. Genotyping was performed using a custom Illumina ancestry informative marker (AIM) panel. For each AIM, the probability of inheriting 0, 1, or 2 copies of a European-derived allele was determined. Non-parametric linkage analysis was performed by testing for association between each AIM using these probabilities among phenotypes, accounting for global ancestry, age, and gender. Fine-mapping of MALD peaks was facilitated by genome-wide association study (GWAS) data. VDBP levels were significantly linked in proximity to the protein coding locus (rs7689609, LOD=11.05). Two loci exhibited significant linkage signals for 1,25-dihydroxyvitamin D on 13q21.2 (rs1622710, LOD=3.20) and 12q13.2 (rs11171526, LOD=3.10). iPTH was significantly linked on 9q31.3 (rs7854368, LOD=3.14). Fine-mapping with GWAS data revealed significant known (rs7041 with VDBP, P=1.38×10(-82)) and novel (rs12741813 and rs10863774 with VDBP, P<6.43×10(-5)) loci with plausible biological roles. Admixture mapping in combination with fine-mapping has focused efforts to identify loci contributing to ethnic differences in vitamin D-related traits. PMID:27032714

  3. Independent Consulting and the American Evaluation Association: Twenty Years Later

    ERIC Educational Resources Information Center

    Bonnet, Deborah G.

    2006-01-01

    This article reviews the evolution of American Evaluation Association's (AEA) Independent Consulting Topical Interest Group (IC TIG). The TIG goes back a joint meeting held in San Francisco in 1984 of the Evaluation Network (ENet) and the Evaluation Research Society (ERS), two years before the organizations merged to become the AEA. On the fringes…

  4. American Association of Dental Schools Curricular Guidelines for Oral Radiology.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1980

    1980-01-01

    Oral radiology curricular guidelines developed by the American Association of Dental Schools are provided. The guidelines describe minimal conditions under which a satisfactory educational experience can be offered. Principles of x-radiation, radiobiological concepts, radiological health, radiographic technique, radiographic quality, and darkroom…

  5. Position Papers of the American Association of Dental Schools[.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1986

    1986-01-01

    Position papers of the American Association of Dental Schools are presented concerning peer review in dentistry, individual and institutional freedoms and responsibilities, national health programs, the definition of interdisciplinary education, use of ionizing radiation in dental schools, and due process in student evaluation disputes. (MSE)

  6. American Dental Education Association Annual Proceedings, 2001-2002.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 2002

    2002-01-01

    Reports activities of the American Dental Education Association (ADEA) from the end of the 2001 Annual Session and Exposition (March 9, 2001) through the 2002 Annual Session and Exposition (March 7, 2002). Consists of: president's annual report, president-elect's address, executive director's report, proceedings of the 2002 House of Delegates,…

  7. American Association of Dental Schools Annual Session & Exposition.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 2000

    2000-01-01

    The planned program of the 77th annual meeting of the American Association of Dental Schools, "Strengthening Alliances, Expanding Horizons," comprises this special issue, which includes information on plenary session speakers, daily programs, TechnoFair clinics and workshops, section programs and meetings, faculty development workshops, exposition…

  8. 2007 American Association of Community Colleges (AACC) Facts

    ERIC Educational Resources Information Center

    American Association of Community Colleges (NJ1), 2007

    2007-01-01

    "Community College Facts" includes American Association of Community Colleges (AACC) mission statement, information about AACC as an organization, AACC departments, contacts, annual revenues and expenditures. Also included is "Community College Facts at a Glance," which provides statistics on the number and type of colleges, enrollment,…

  9. American Osteopathic Association Commitment to Quality and Lifelong Learning

    ERIC Educational Resources Information Center

    Tunanidas, Amelia G.; Burkhart, Diane N.

    2005-01-01

    The American Osteopathic Association (AOA) initiated programs to enhance quality for 54, 000 doctors of osteopathic medicine (DOs) practicing in the United States. Seven core competencies are required in undergraduate and graduate medical education standards. They include osteopathic philosophy and osteopathic manipulative medicine, medical…

  10. American Association of State Colleges and Universities Annual Report 2005

    ERIC Educational Resources Information Center

    American Association of State Colleges and Universities, 2005

    2005-01-01

    This annual report provides a comparative financial status of the the American Association of State Colleges and Universities (AASCU) at fiscal year end June 30, 2005 versus fiscal year end June 30, 2004. AASCU continues to maintain its financial condition while providing programs and services desired by its members. Membership support remains…

  11. American Association for Higher Education (AAHE) Bulletin, 1994-95.

    ERIC Educational Resources Information Center

    Marchese, Theodore J., Ed.

    1995-01-01

    The 10 issues of this organizational bulletin for the 1994/95 school year present articles, panel discussion, interviews, and essays on issues concerning the advancement of higher education. Some of the articles included are: an interview with American Association for Higher Education (AAHE) board chair Helen Astin; an article titled "Academic…

  12. American Educational Research Association Paper Abstracts, 1967 Annual Meeting.

    ERIC Educational Resources Information Center

    Page, Ellis B., Ed.

    This document contains abstracts of approximately 300 papers presented at the 1967 annual meeting of the American Educational Research Association. A sampling of the varied subjects covered includes: dynamics of the school board role, concept learning, programed instruction, administrative behavior and organizational characteristics, correlates of…

  13. American Art Therapy Association, Inc.: 2011 Membership Survey Report

    ERIC Educational Resources Information Center

    Elkins, David E.; Deaver, Sarah P.

    2013-01-01

    The American Art Therapy Association (AATA) surveys its members biennially to gather information on general demographics, employment-related characteristics, licensing, and professional affiliations. The surveys are used in the development of national media opportunities and public policy initiatives to help increase recognition for the field of…

  14. American Art Therapy Association, Inc.: 2013 Membership Survey Report

    ERIC Educational Resources Information Center

    Elkins, David E.; Deaver, Sarah P.

    2015-01-01

    The American Art Therapy Association (AATA) surveys its members biennially to collect data regarding membership demographics as well as variables concerning the work environment for art therapists. These surveys can provide a detailed description of these characteristics and how they may change over time. This article statistically compares the…

  15. Associations among Asian Americans' Enculturation, Emotional Experiences, and Depressive Symptoms

    ERIC Educational Resources Information Center

    Wong, Y. Joel; Tran, Kimberly K.; Lai, Andre

    2009-01-01

    Using a computer-based text analysis of 218 Asian Americans' writing samples, the authors found that enculturation as well as use of negative emotion and positive emotion words were associated with depressive symptoms. Enculturation was also found to moderate the relation between use of negative emotion words and cognitive--affective depressive…

  16. Association of beverage consumption with obesity in Mexican American children

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To determine the association of beverage consumption with obesity in Mexican American school-aged children. Cross-sectional study using the baseline data from a cohort study. Mothers and children answered questions about the frequency and quantity of the child's consumption of soda, diet soda, other...

  17. American Association of Physics Teachers Annual Report, 2008

    ERIC Educational Resources Information Center

    American Association of Physics Teachers (NJ1), 2008

    2008-01-01

    The American Association of Physics Teachers (AAPT) mission is to enhance the understanding and appreciation of physics through teaching. Aspiring to advance the greater good through physics, AAPT strives to be the leading voice, primary resource, advocate of choice, and driving force in physics education, serving professionals who teach physics…

  18. American Association of Dental Schools Curricular Guidelines for Orthodontics.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1980

    1980-01-01

    Guidelines reviewed and approved by the American Association of Dental Schools and sent to the Council on Dental Education in June 1979 are outlined. Educational goals and objectives and sequence of instruction (including growth and development, preclinical orthodontics, and clinical experience) are discussed. (MLW)

  19. Associations between DSM-IV mental disorders and subsequent heart disease onset: beyond depression

    PubMed Central

    Scott, Kate M.; de Jonge, Peter; Alonso, Jordi; Viana, Maria Carmen; Liu, Zhaorui; O’Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; de Girolamo, Giovanni; Florescu, Silvia E.; Hu, Chiyi; Taib, Nezar Ismet; Lépine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina-Mora, Maria Elena; Piazza, Marina; Posada-Villa, José A.; Uda, Hidenori; Wojtyniak, Bogdan J.; Lim, Carmen C. W.; Kessler, Ronald C.

    2013-01-01

    Background Prior studies on the depression-heart disease association have not usually used diagnostic measures of depression, nor taken other mental disorders into consideration. As a result, it is not clear whether the association between depression and heart disease onset reflects a specific association, or the comorbidity between depression and other mental disorders. Additionally, the relative magnitude of associations of a range of mental disorders with heart disease onset is unknown. Methods Face-to-face household surveys were conducted in 19 countries (n=52,095; person years=2,141,194). The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of 16 DSM-IV mental disorders. Heart disease was indicated by self-report of physician’s diagnosis, or self-report of heart attack, together with their timing (year). Survival analyses estimated associations between first onset of mental disorders and subsequent heart disease onset. Results After comorbidity adjustment, depression, panic disorder, specific phobia, post-traumatic stress disorder and alcohol use disorders were associated with heart disease onset (ORs 1.3–1.6). Increasing number of mental disorders was associated with heart disease in a dose-response fashion. Mood disorders and alcohol abuse were more strongly associated with earlier onset than later onset heart disease. Associations did not vary by gender. Conclusions Depression, anxiety and alcohol use disorders were significantly associated with heart disease onset; depression was the weakest predictor. If confirmed in future prospective studies, the breadth of psychopathology’s links with heart disease onset has substantial clinical and public health implications. PMID:23993321

  20. Prevalence, Determinants, and Clinical Significance of Masked Hypertension in a Population-Based Sample of African Americans: The Jackson Heart Study

    PubMed Central

    Veerabhadrappa, Praveen; Brown, Michael D.; Whited, Matthew C.; Dubbert, Patricia M.; Hickson, DeMarc A.

    2015-01-01

    BACKGROUND The disproportionate rates of cardiovascular disease in African Americans may, in part, be due to suboptimal assessment of blood pressure (BP) with clinic BP measurements alone. To date, however, the prevalence of masked hypertension in African Americans has not been fully delineated. The purpose of this study was to evaluate masked hypertension prevalence in a large population-based sample of African Americans and examine its determinants and association with indices of target organ damage (TOD). METHODS Clinic and 24-hour ambulatory BP monitoring were conducted in 972 African Americans enrolled in the Jackson Heart Study. Common carotid artery intima-media thickness, left ventricular mass index, and the urinary albumin:creatinine excretion ratio were evaluated as indices of TOD. RESULTS Masked hypertension prevalence was 25.9% in the overall sample and 34.4% in participants with normal clinic BP. All indices of TOD were significantly higher in masked hypertensives compared to sustained normotensives and were similar between masked hypertensives and sustained hypertensives. Male gender, smoking, diabetes, and antihypertensive medication use were independent determinants of masked hypertension in multivariate analyses. CONCLUSIONS In this population-based cohort of African Americans, approximately one-third of participants with presumably normal clinic BP had masked hypertension when BP was assessed in their daily environment. Masked hypertension was accompanied by a greater degree of TOD in this cohort. PMID:25499058

  1. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY 2016 OUTPATIENT GLUCOSE MONITORING CONSENSUS STATEMENT.

    PubMed

    Bailey, Timothy S; Grunberger, George; Bode, Bruce W; Handelsman, Yehuda; Hirsch, Irl B; Jovanovič, Lois; Roberts, Victor Lawrence; Rodbard, David; Tamborlane, William V; Walsh, John

    2016-02-01

    This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. PMID:26848630

  2. Micronutrients in African-Americans with decompensated and compensated heart failure.

    PubMed

    Arroyo, Maximiliano; Laguardia, Stephen P; Bhattacharya, Syamal K; Nelson, Maeda D; Johnson, Patti L; Carbone, Laura D; Newman, Kevin P; Weber, Karl T

    2006-12-01

    Heart failure is thought to be more common and of greater severity in African-Americans (AAs). Potential mechanisms remain uncertain. The importance of micronutrient deficiencies in the pathophysiologic expression of congestive heart failure (CHF) in AAs remains to be explored, including hypovitaminosis D, which can promote secondary hyperparathyroidism (SHPT), together with hypozincemia and hyposelenemia, the 2 most crucial trace minerals integral to diverse biologic functions. Serum parathyroid hormone (PTH), 25-hydroxyvitamin D (25(OH)D), Zn, and Se were monitored in 30 AAs hospitalized during June through December 2005, with decompensated failure and reduced ejection fraction (EF) (<35%) of predominantly nonischemic origin treated with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB), furosemide, and spironolactone. Based on their symptomatic status before hospitalization, 15 patients were stratified as having protracted (>or=4 weeks) CHF, whereas 15 patients had short-term (1-2 weeks) CHF. These hospitalized patients were compared with 10 AA outpatients with stable, similarly treated compensated failure and comparable EF, and 9 AA normal volunteers without cardiovascular disease. Serum PTH was elevated in all patients with protracted CHF and in 60% of patients with short-term CHF, but not in compensated patients or normal volunteers. However, serum 25(OH)D was reduced in all patients with >or=4 weeks and 80% with either 1-2 weeks CHF or compensated failure compared with volunteers. Serum Zn was below normal in 11 of 15 patients with protracted CHF, in 8 of 15 patients with shorter duration CHF, and in 5 of 10 patients with compensated failure. Serum Se was reduced in all patients with >or=4 weeks, 60% with short-term CHF, and 90% of compensated patients. Concomitant to hypovitaminosis D, hypozincemia, and hyposelenemia, SHPT is a covariant of CHF in housebound AAs. PMID:17162251

  3. The association between COPD and heart failure risk: a review

    PubMed Central

    de Miguel Díez, Javier; Morgan, Jorge Chancafe; García, Rodrigo Jiménez

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure (HF) in clinical practice since they share the same pathogenic mechanism. Both conditions incur significant morbidity and mortality. Therefore, the prognosis of COPD and HF combined is poorer than for either disease alone. Nevertheless, usually only one of them is diagnosed. An active search for each condition using clinical examination and additional tests including plasma natriuretic peptides, lung function testing, and echocardiography should be obtained. The combination of COPD and HF presents many therapeutic challenges. The beneficial effects of selective β1-blockers should not be denied in stable patients who have HF and coexisting COPD. Additionally, statins, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers may reduce the morbidity and mortality of COPD patients. Moreover, caution is advised with use of inhaled β2-agonists for the treatment of COPD in patients with HF. Finally, noninvasive ventilation, added to conventional therapy, improves the outcome of patients with acute respiratory failure due to hypercapnic exacerbation of COPD or HF in situations of acute pulmonary edema. The establishment of a combined and integrated approach to managing these comorbidities would seem an appropriate strategy. Additional studies providing new data on the pathogenesis and management of patients with COPD and HF are needed, with the purpose of trying to improve quality of life as well as survival of these patients. PMID:23847414

  4. Health economics and the European Heart Rhythm Association.

    PubMed

    Vardas, Panos; Boriani, Giuseppe

    2011-05-01

    The management of healthcare is becoming extremely complex in developed countries, as a result of increasing age of the population and increasing costs of care, coupled with diminishing resources due to global financial crisis. This situation threatens access to appropriate care, and a more or less explicit rationing of some types of treatment may occur in 'real world' clinical practice. This is particularly true for those treatments or interventions with a relatively high up-front cost, such as cardioverter defibrillators, devices for cardiac resynchronization therapy or ablation procedures for atrial fibrillation. The European Heart Rhythm Association (EHRA) is strongly convinced that the skills of electrophysiologists and cardiologists responsible for the management of rhythm disorders have to evolve, also embracing the knowledge of health economics, clinical epidemiology, health-care management and outcome research. These disciplines do not belong to what is considered as the conventional cultural background of physicians, but knowledge of comparative cost effectiveness and of other economic approaches nowadays appears fundamental for a dialogue with a series of stakeholders, such as policy makers, politicians, and administrators, involved in budgeting the activity of hospitals and health-care services, as well as in approaching health technology assessment.

  5. Health economics and the European Heart Rhythm Association.

    PubMed

    Vardas, Panos; Boriani, Giuseppe

    2011-05-01

    The management of healthcare is becoming extremely complex in developed countries, as a result of increasing age of the population and increasing costs of care, coupled with diminishing resources due to global financial crisis. This situation threatens access to appropriate care, and a more or less explicit rationing of some types of treatment may occur in 'real world' clinical practice. This is particularly true for those treatments or interventions with a relatively high up-front cost, such as cardioverter defibrillators, devices for cardiac resynchronization therapy or ablation procedures for atrial fibrillation. The European Heart Rhythm Association (EHRA) is strongly convinced that the skills of electrophysiologists and cardiologists responsible for the management of rhythm disorders have to evolve, also embracing the knowledge of health economics, clinical epidemiology, health-care management and outcome research. These disciplines do not belong to what is considered as the conventional cultural background of physicians, but knowledge of comparative cost effectiveness and of other economic approaches nowadays appears fundamental for a dialogue with a series of stakeholders, such as policy makers, politicians, and administrators, involved in budgeting the activity of hospitals and health-care services, as well as in approaching health technology assessment. PMID:21518741

  6. American College Health Association National College Health Assessment Spring 2006 Reference Group Data Report (Abridged): The American College Health Association

    ERIC Educational Resources Information Center

    Journal of American College Health, 2007

    2007-01-01

    Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey developed by the ACHA in 1998 to assist institutions of higher education in achieving this goal. The…

  7. Factors Associated With Isolated Right Heart Failure in Women

    PubMed Central

    Lagat, David K.; DeLong, Allison K.; Wellenius, Gregory A.; Carter, E. Jane; Bloomfield, Gerald S.; Velazquez, Eric J.; Hogan, Joseph; Kimaiyo, Sylvester; Sherman, Charles B.

    2015-01-01

    Background Small observational studies have found that isolated right heart failure (IRHF) is prevalent among women of sub-Saharan Africa. Further, several risk factors for the development of IRHF have been identified. However, no similar studies have been conducted in Kenya. Objective We hypothesized that specific environmental exposures and comorbidities were associated with IRHF in women of western Kenya. Methods We conducted a case-control study at a referral hospital in western Kenya. Cases were defined as women at least 35 years old with IRHF. Control subjects were similarly aged volunteers without IRHF. Exclusion criteria in both groups included history of tobacco use, tuberculosis, or thromboembolic disease. Participants underwent echocardiography, spirometry, 6-min walk test, rest/exercise oximetry, respiratory health interviews, and human immunodeficiency virus (HIV) testing. Home visits were performed to evaluate kitchen ventilation, fuel use, and cook smoke exposure time, all surrogate measures of indoor air pollution (IAP). A total of 31 cases and 65 control subjects were enrolled. Surrogate measures of indoor air pollution were not associated with IRHF. However, lower forced expiratory volume at 1 s percent predicted (adjusted odds ratio [AOR]: 2.02, 95% confidence interval [CI]: 1.27 to 3.20; p = 0.004), HIV positivity (AOR: 40.4, 95% CI: 3.7 to 441; p < 0.01), and self-report of exposure to occupational dust (AOR: 3.9, 95% CI: 1.14 to 14.2; p = 0.04) were associated with IRHF. In an analysis of subgroups of participants with and without these factors, lower kitchen ventilation was significantly associated with IRHF among participants without airflow limitation (AOR: 2.63 per 0.10 unit lower ventilation, 95% CI: 1.06 to 6.49; p = 0.04), without HIV (AOR: 2.55, 95% CI: 1.21 to 5.37; p = 0.02), and without occupational dust exposure (AOR: 2.37, 95% CI: 1.01 to 5.56; p = 0.05). Conclusions In this pilot study among women of western Kenya, lower kitchen

  8. Heart failure association of the European society of cardiology specialist heart failure curriculum.

    PubMed

    McDonagh, Theresa A; Gardner, Roy S; Lainscak, Mitja; Nielsen, Olav W; Parissis, John; Filippatos, Gerasimos; Anker, Stefan D

    2014-02-01

    It is well established that organized care of heart failure patients, including specialist management by cardiologists, improves patient outcomes. In response to this, other national training bodies (the UK and the USA) have developed heart failure subspecialty curricula within their Cardiology Training Curricula. In addition, European Society of Cardiology (ESC) subspecialty curricula exist for Interventional Cardiology and Heart Rhythm Management. The purpose of this heart failure curriculum is to provide a framework which can be used as a blueprint for training across Europe. This blueprint mirrors other ESC curricula. Each section has three components: the knowledge required, the skills which are necessary, and the professionalism (attitudes and behaviours) which should be attained. The programme is designed to last 2 years. The first year is devoted to the specialist heart failure module. The second year allows completion of the optional modules of advanced imaging, device therapy for implanters, cardiac transplantation, and mechanical circulatory support. The second year can also be devoted to continuation of specialist heart failure training and/or research for those not wishing to continue with the advanced modules.

  9. The American Library Association in Latin America: American Librarianship as a "Modern" Model during the Good Neighbor Policy Era.

    ERIC Educational Resources Information Center

    Maymi-Sugranes, Hector J.

    2002-01-01

    Through American Library Association (ALA) projects in Latin America, American librarianship progressed from conceptualization to implementation as the model in modernizing Latin American library practices and societies. Development of library practices was fundamental to pursuit of a "modern" society. In fighting fascist propaganda, the United…

  10. Association between Functional Variables and Heart Failure after Myocardial Infarction in Rats

    PubMed Central

    Polegato, Bertha F.; Minicucci, Marcos F.; Azevedo, Paula S.; Gonçalves, Andréa F.; Lima, Aline F.; Martinez, Paula F.; Okoshi, Marina P.; Okoshi, Katashi; Paiva, Sergio A. R.; Zornoff, Leonardo A. M.

    2016-01-01

    Background Heart failure prediction after acute myocardial infarction may have important clinical implications. Objective To analyze the functional echocardiographic variables associated with heart failure in an infarction model in rats. Methods The animals were divided into two groups: control and infarction. Subsequently, the infarcted animals were divided into groups: with and without heart failure. The predictive values were assessed by logistic regression. The cutoff values predictive of heart failure were determined using ROC curves. Results Six months after surgery, 88 infarcted animals and 43 control animals were included in the study. Myocardial infarction increased left cavity diameters and the mass and wall thickness of the left ventricle. Additionally, myocardial infarction resulted in systolic and diastolic dysfunction, characterized by lower area variation fraction values, posterior wall shortening velocity, E-wave deceleration time, associated with higher values of E / A ratio and isovolumic relaxation time adjusted by heart rate. Among the infarcted animals, 54 (61%) developed heart failure. Rats with heart failure have higher left cavity mass index and diameter, associated with worsening of functional variables. The area variation fraction, the E/A ratio, E-wave deceleration time and isovolumic relaxation time adjusted by heart rate were functional variables predictors of heart failure. The cutoff values of functional variables associated with heart failure were: area variation fraction < 31.18%; E / A > 3.077; E-wave deceleration time < 42.11 and isovolumic relaxation time adjusted by heart rate < 69.08. Conclusion In rats followed for 6 months after myocardial infarction, the area variation fraction, E/A ratio, E-wave deceleration time and isovolumic relaxation time adjusted by heart rate are predictors of heart failure onset. PMID:26815462

  11. Electrophysiological Remodeling in Heart Failure

    PubMed Central

    Wang, Yanggan; Hill, Joseph A.

    2010-01-01

    Heart failure affects nearly 6 million Americans, with a half-million new cases emerging each year. Whereas up to 50% of heart failure patients die of arrhythmia, the diverse mechanisms underlying heart failure-associated arrhythmia are poorly understood. As a consequence, effectiveness of antiarrhythmic pharmacotherapy remains elusive. Here, we review recent advances in our understanding of heart failure-associated molecular events impacting the electrical function of the myocardium. We approach this from an anatomical standpoint, summarizing recent insights gleaned from pre-clinical models and discussing their relevance to human heart failure. PMID:20096285

  12. How Can I Live with Heart Failure?

    MedlinePlus

    ... me? Should I stay in bed? ©2015, American Heart Association Multi-language Fact Sheet Topics Heart-related Conditions What is Angina? What is an ... a Coronary Angiogram? How Can I Recover From Heart Surgery? What is Carotid ... Do I Understand "Nutrition Facts" Labels? How Can I Quit Smoking? How Can ...

  13. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY POSITION STATEMENT ON THE ASSOCIATION OF TESTOSTERONE AND CARDIOVASCULAR RISK.

    PubMed

    Goodman, Neil; Guay, Andre; Dandona, Paresh; Dhindsa, Sandeep; Faiman, Charles; Cunningham, Glenn R

    2015-09-01

    This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.

  14. Relationships between Diet, Alcohol Preference, and Heart Disease and Type 2 Diabetes among Americans.

    PubMed

    Adjemian, Michael K; Volpe, Richard J; Adjemian, Jennifer

    2015-01-01

    Although excessive alcohol consumption is a recognized cause of morbidity and mortality, many studies have linked moderate alcohol consumption to improved cardiovascular health and a lower risk of Type 2 Diabetes (T2D). Self-reported alcohol and diet data used to generate these results suffer from measurement error due to recall bias. We estimate the effects of diet, alcohol, and lifestyle choices on the prevalence and incidence of cardiovascular disease and T2D among U.S. adults using a nationally representative cohort of households with scanner data representing their food-at-home, alcohol, and tobacco purchases from 2007-2010, and self-reported health surveys for the same study participants from 2010-2012. Multivariate regression models were used to identify significant associations among purchase data and lifestyle/demographic factors with disease prevalence in 2010, and with incidence of new disease from 2011-2012. After controlling for important confounders, respondents who purchased moderate levels of wine were 25% less likely than non-drinkers to report heart disease in 2010. However, no alcohol-related expenditure variables significantly affected the likelihood of reporting incident heart disease from 2011-2012. In contrast, many types of alcohol-related purchases were associated with a lower prevalence of T2D, and respondents who purchased the greatest volumes of wine or beer--but not liquor--were less likely to report being diagnosed with T2D in 2011-2012 than non-drinkers.

  15. Prophylactic arrhythmia surgery in association with congenital heart disease

    PubMed Central

    Deal, Barbara J.

    2016-01-01

    Certain congenital heart anomalies make patients more susceptible to arrhythmia development throughout their lives. This poses the question whether prophylactic arrhythmia surgery should be incorporated into reparative open heart procedures for congenital heart disease. There is currently no consensus on what constitutes a standard prophylactic procedure, owing to the questions that remain regarding lesions to be performed; energy sources to use; proximity of energy source or incisions to coronary arteries, sinoatrial node, atrioventricular node; circumstances for right atrial, left atrial, or biatrial appendectomy; and whether to perform a right, left, or biatrial maze procedure. These considerations are important because prophylactic arrhythmia procedures are performed without knowing if the patient will actually develop an arrhythmia in his or her lifetime. By reviewing and summarizing the literature, congenital heart disease patients who are at risk for developing atrial arrhythmias can be identified and lesion sets can be suggested in an effort to standardize experimental protocols for prophylactic arrhythmia surgery.

  16. Education is associated with physical activity among American Indian elders.

    PubMed

    Sawchuk, Craig N; Bogart, Andy; Charles, Steve; Goldberg, Jack; Forquera, Ralph; Roy-Byrne, Peter; Buchwald, Dedra

    2008-01-01

    Although educational attainment and physical activity levels tend to be positively associated in majority populations, this relationship has not been investigated in American Indian and Alaska Native (AI/AN) elders. This study examined the association between education and physical activity among AI/AN elders (N = 107) using self-report and behavioral outcomes. Regression models showed that higher education was significantly associated with total caloric expenditure for moderate intensity physical activities and distance traveled during a 6-minute walk test of fitness. Additional research is needed to understand modifiable personal, social, and environmental physical activity barriers in these populations. PMID:18493902

  17. 2012 Annual report of the American Psychological Association.

    PubMed

    2013-01-01

    Provides the 2012 Annual Report of the American Psychological Association. In 2012, APA celebrated its 120th anniversary. It has grown from its original 31 members to the largest association of psychologists in the United States and a worldwide leader within the discipline. This edition of the report introduces each directorate and office within APA and talks about their goals and objectives. the president of APA, Dr. Norman Anderson, also gives a brief report which updates you on the activities of the association during its 120th anniversary as the professional home for psychologists and an advocate for the discipline.

  18. Exploring feasibility of home telemanagement in African Americans with congestive heart failure.

    PubMed

    Finkelstein, Joseph; Cha, Eunme; Dennison, Cheryl R

    2010-01-01

    Existing telemonitoring systems provide limited support in implementing personalized treatment plans. We developed a Home Automated Telemanagement (HAT) system for patients with congestive heart failure (CHF) to provide support in following individualized treatment plans as well as to monitor symptoms, weight changes, and quality of life, while educating the patient on their disease. The system is designed to be placed in the patient's home and to communicate all patient data to a central server implementing real-time clinical decision support. The system questions the patient daily on their condition, monitors their weight, and provides the patient with instant feedback on their condition in the form of a 3-zone CHF action plan. Their medication regimen and suggested actions are determined by their care management team and integrated into the system, keeping a personalized approach to disease management while taking advantage of the technology available. The system is designed to be as simple as possible, making it usable by patients with no prior computer experience. A feasibility assessment in African American patients with CHF and without prior computer experience demonstrated high level of acceptance of the CHF HAT system. PMID:20841744

  19. Selected Papers from the 1990 Meeting of the American Journalism Historians' Association (Coeur d'Alene, Idaho, October 2-7, 1990): Part 1.

    ERIC Educational Resources Information Center

    American Journalism Historians' Association.

    The following 12 papers, on a variety of topics, were given at the 1990 meeting of the American Journalism Historians' Association: (1) "'Let Jim Handle It': President Dwight D. Eisenhower's First Heart Attack and Jim Hagerty's Handling of the Media" (Joseph V. Trahan, III); (2) "Eisenhower's Pyrrhic Victory in 1956: Mixed Lessons from the First…

  20. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  1. Diagnostic, Prognostic, and Therapeutic Value of Circulating miRNAs in Heart Failure Patients Associated with Oxidative Stress.

    PubMed

    Ali Sheikh, Md Sayed; Salma, Umme; Zhang, Baohai; Chen, Jimei; Zhuang, Jian; Ping, Zhu

    2016-01-01

    Heart failure is a major public health problem especially in the aging population (≥65 years old), affecting nearly 5 million Americans and 15 million European people. Effective management of heart failure (HF) depends on a correct and rapid diagnosis. Presently, BNP (brain natriuretic peptide) or N-terminal pro-brain natriuretic peptide (NT-proBNP) assay is generally accepted by the international community for diagnostic evaluation and risk stratification of patients with HF. However, regardless of its widespread clinical use, BNP is still encumbered by reduced specificity. As a result, diagnosis of heart failure remains challenging. Although significant improvement happened in the clinical management of HF over the last 2 decades, traditional treatments are ultimately ineffective in many patients who progress to advanced HF. Therefore, a novel diagnostic, prognostic biomarker and new therapeutic approach are required for clinical management of HF patients. Circulating miRNAs seem to be the right choice for novel noninvasive biomarkers as well as new treatment strategies for HF. In this review, we briefly discuss the diagnostic, prognostic, and therapeutic role of circulating miRNAs in heart failure patients. We also mentioned our own technique of extraction of RNA and detection of circulating miRNAs from human plasma and oxidative stress associated miRNAs with HF. PMID:27379177

  2. Diagnostic, Prognostic, and Therapeutic Value of Circulating miRNAs in Heart Failure Patients Associated with Oxidative Stress

    PubMed Central

    Ali Sheikh, Md Sayed; Salma, Umme; Zhang, Baohai; Chen, Jimei; Zhuang, Jian; Ping, Zhu

    2016-01-01

    Heart failure is a major public health problem especially in the aging population (≥65 years old), affecting nearly 5 million Americans and 15 million European people. Effective management of heart failure (HF) depends on a correct and rapid diagnosis. Presently, BNP (brain natriuretic peptide) or N-terminal pro-brain natriuretic peptide (NT-proBNP) assay is generally accepted by the international community for diagnostic evaluation and risk stratification of patients with HF. However, regardless of its widespread clinical use, BNP is still encumbered by reduced specificity. As a result, diagnosis of heart failure remains challenging. Although significant improvement happened in the clinical management of HF over the last 2 decades, traditional treatments are ultimately ineffective in many patients who progress to advanced HF. Therefore, a novel diagnostic, prognostic biomarker and new therapeutic approach are required for clinical management of HF patients. Circulating miRNAs seem to be the right choice for novel noninvasive biomarkers as well as new treatment strategies for HF. In this review, we briefly discuss the diagnostic, prognostic, and therapeutic role of circulating miRNAs in heart failure patients. We also mentioned our own technique of extraction of RNA and detection of circulating miRNAs from human plasma and oxidative stress associated miRNAs with HF. PMID:27379177

  3. White blood cell count and incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African-American and White men and women: atherosclerosis risk in communities study.

    PubMed

    Lee, C D; Folsom, A R; Nieto, F J; Chambless, L E; Shahar, E; Wolfe, D A

    2001-10-15

    The authors examined the association between white blood cell (WBC) count and incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in 13,555 African-American and White men and women from the Atherosclerosis Risk in Communities (ARIC) Study. Blood was drawn at the ARIC baseline examination, beginning in 1987-1989. During an average of 8 years of follow-up (through December 1996), there were 488 incident coronary heart disease events, 220 incident strokes, and 258 deaths from cardiovascular disease. After adjustment for age, sex, ARIC field center, and multiple risk factors, there was a direct association between WBC count and incidence of coronary heart disease (p < 0.001 for trend) and stroke (p for trend < 0.001) and mortality from cardiovascular disease (p for trend < 0.001) in African Americans. The African Americans in the highest quartile of WBC count (> or =7,000 cells/mm(3)) had 1.9 times the risk of incident coronary heart disease (95% confidence interval (CI): 1.19, 3.09), 1.9 times the risk of incident ischemic stroke (95% CI: 1.03, 3.34), and 2.3 times the risk of cardiovascular disease mortality (95% CI: 1.38, 3.72) as their counterparts in the lowest quartile of WBC count (<4,800 cells/mm(3)). These associations were similar in Whites and in never smokers. An elevated WBC count is directly associated with increased incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African-American and White men and women.

  4. The effectiveness of cardiac resynchronization therapy for patients with New York Heart Association class IV non-ambulatory heart failure

    PubMed Central

    Yamashita, Soichiro; Fukuzawa, Koji; Yoshida, Akihiro; Itoh, Mitsuaki; Imamura, Kimitake; Fujiwara, Ryudo; Suzuki, Atsushi; Nakanishi, Tomoyuki; Matsumoto, Akinori; Kanda, Gaku; Kiuchi, Kunihiko; Shimane, Akira; Okajima, Katsunori; Tanaka, Hidekazu; Hirata, Ken-ichi

    2015-01-01

    Background We reviewed the effectiveness and safety of cardiac resynchronization therapy (CRT) for patients with New York Heart Association (NYHA) class IV non-ambulatory heart failure (NAHF). Methods From 2006 to 2011, 310 patients underwent CRT at Kobe University Hospital and Himeji Cardiovascular Center because of heart failure. Of these, 29 NAHF patients were retrospectively analyzed. The control group comprised 21 age- and ejection fraction-matched patients with NAHF who did not undergo CRT from the ICU database of Kobe University Hospital. The primary endpoint was all-cause death and hospitalization for heart failure. Response was defined as a >15% reduction in left ventricular end-systolic volume (LVESV). Results CRT was performed successfully without serious complications in all patients. Twenty-three patients (79%) were discharged 19±15 days after CRT implantation, while 6 (21%) died during their hospital stay due to progressive heart failure. Compared with the control group, patients in the CRT group showed significant improvements in the primary endpoint (log-rank p=0.04). Six patients (21%) were defined as responders and the Kaplan–Meier curve showed that responders experienced a better outcome than non-responders (log-rank p=0.029). LV dyssynchrony before implantation was significantly related to the occurrence of the primary endpoint (p=0.02). Conclusions CRT can be safely used in patients with NAHF and can improve long-term patient outcomes, especially in treatment responders. PMID:26336563

  5. Association of American Indian cultural identity with physical activity

    PubMed Central

    Duncan, Glen E.; McDougall, Casey L.; Dansie, Elizabeth; Garroutte, Eva; Buchwald, Dedra; Henderson, Jeffrey A.

    2014-01-01

    Objective Cultural factors are associated with health behaviors among American Indians. Accordingly, the objective of this study was to investigate whether cultural identity, defined as the primary language spoken at home, is associated with (1) higher total physical activity levels and (2) levels of leisure-time physical activity recommended for health benefits in a diverse sample of American Indians. Design Cross-sectional analysis of 5,207 American Indian adults 18 to 82 years. Participants resided on the Oglala Sioux (n = 2,025) and Cheyenne River Sioux (n = 1,528) reservations in South Dakota, and the Gila River Indian Community (n = 1,654) in Arizona. Results Bicultural participants in South Dakota, but not Arizona, reported significantly higher total physical activity compared to the English-only group (p < 0.05). About 35% of English only speakers, 39% of American Indian/Alaska Native only speakers, and 39% of participants speaking both languages met the 150 minutes/week activity threshold. Odds of being sufficiently active were higher among bicultural respondents in both regions when compared to respondents endorsing only English, controlling for socio-demographic and health-related covariates (p < 0.05). Conclusion Bicultural respondents among tribal members in South Dakota had significantly higher total physical activity, and higher levels of sufficient leisure-time activity in both South Dakota and Arizona, compared to those who spoke either language exclusively. Interventions that encourage American Indians to develop their bicultural efficacy and to draw on resources for healthy living that may be available in all the cultures with which they identify are recommended. PMID:24620441

  6. Dietary Habits Moderate the Association between Heart Failure and Cognitive Impairment

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Colbert, Lisa H.; Josephson, Richard; van Dulmen, Manfred; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Cognitive impairment is common in heart failure patients. Poor dietary habits are associated with reduced neurocognitive function in other medical populations, including diabetes and Alzheimer’s disease. This study examined whether dietary habits help moderate the relationship between heart failure severity and cognitive function. A total of 152 persons with heart failure completed neuropsychological testing and a fitness assessment. Dietary habits were assessed using the Starting the Conversation-Diet questionnaire, a nutrition measure suggested for use in primary care settings. Moderation analyses showed that better dietary habits attenuated the adverse impact of heart failure severity on frontal functioning (b =1.28, p < .05). Follow-up analyses revealed consumption of foods high in sodium was associated with reduced cognitive function (p < .05). This study suggests dietary habits can moderate the association between heart failure and performance on tests of attention and executive function. Longitudinal studies are needed to confirm and clarify the mechanisms for our findings. PMID:23663211

  7. 77 FR 37678 - Medicare and Medicaid Programs; Application From American Association for Accreditation of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-22

    ... American Association for Accreditation of Ambulatory Surgery Facilities for Continued Approval of Its Ambulatory Surgery Facilities Accreditation Program AGENCY: Centers for Medicare and Medicaid Services, HHS... application from the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)...

  8. The IPA and the American Psychoanalytic Association: a perspective on the regional association agreement.

    PubMed

    Wallerstein, R S

    1998-06-01

    Ever since 1938 the American Psychoanalytic Association has had a special autonomous relationship within the IPA accorded to no other component organisation. This Regional Association status has had two main features: (1) total internal control over training standards and membership criteria, with no accountability to the IPA; and (2) an 'exclusive franchise', so that the IPA was barred from recognising any other component within the United States. This unique Regional Association status reflected the resolution at the time (1938) of the long-standing controversy between the IPA and the American over the issue of 'lay analysis', and remained unaltered for half a century until, with the resolution of the 3 1/2-year long law-suit against the American (and secondarily against the IPA) in 1988, the Regional Association agreement was modified (but not totally abrogated) by the American's giving up the 'exclusive franchise' aspect (thus permitting IPA recognition of psychoanalytic groups in the US organised outside the American), but still retaining its internal full control over training and membership. The meanings and consequences for psychoanalysis of this special status of the American are explored.

  9. Serum Uric Acid Is Associated with Carotid Plaques: The National Heart, Lung, and Blood Institute Family Heart Study

    PubMed Central

    NEOGI, TUHINA; ELLISON, R. CURTIS; HUNT, STEVEN; TERKELTAUB, ROBERT; FELSON, DAVID T.; ZHANG, YUQING

    2009-01-01

    Objective To examine the association of serum uric acid (SUA) with a marker of preclinical cardiovascular disease (CVD), carotid atherosclerotic plaques (PLQ), where early evidence of risk may be evident, focusing on individuals without CV risk factors. Methods The National Heart, Lung, and Blood Institute Family Heart Study is a multicenter study designed to assess risk factors for heart disease. PLQ were assessed with carotid ultrasound. We conducted sex-specific logistic regression to assess the association of SUA with presence of PLQ, including analyses among persons without risk factors related to both CVD and hyperuricemia. Results In total, 4866 participants had both SUA and carotid ultrasound assessed (54% women, mean age 52 yrs, mean body mass index 27.6). The association of SUA with PLQ increased with increasing SUA levels, demonstrating a dose-response relation for men [OR 1.0, 1.29, 1.61, 1.75, for SUA categories < 5 (reference), 5 to < 6, 6 to < 6.8, ≥ 6.8 mg/dl, respectively; p = 0.002]. Similar associations were found in men without CV risk factors. We found no relation of SUA with PLQ in women. Conclusion In this large study, SUA was associated with carotid atherosclerotic plaques in men. Results were similar in the absence of CV risk factors. These results suggest that SUA may have a pathophysiologic role in atherosclerosis in men. (J Rheumatol First Release Nov 15 2008; doi:10.3899/jrheum.080646) PMID:19012359

  10. The history of sections in the American College Health Association.

    PubMed

    Christmas, W A

    1992-11-01

    The founders of the American College Health Association (ACHA) recognized the importance of regional groups (affiliates) and worked actively to foster their formation and continued existence. In 1932, D. F. Smiley, MD, described the concept of establishing ACHA regions and suggested combining institutional membership in both the national and regional organizations. Significant affiliate representation in the association's governance structure finally became a reality in 1987, when regional representatives became permanent members of the board of directors. Standing committees of the association were transformed into the present ACHA sections in 1957, and a new category for individual membership established for college health professionals interested in participating in educational activities of the new sections. In many ways, the changes in the association's governance that occurred in 1987 are reminiscent of the original structure of the 1920-1970 era, when the organization was much smaller and essentially an association of college health center directors.

  11. Reversing heart failure-associated pathophysiology with exercise: what actually improves and by how much?

    PubMed

    Adams, Volker; Niebauer, Josef

    2015-01-01

    Until the late 1980s, physical exercise training was a contraindication in patients with heart failure. Extensive research has demonstrated that exercise training reverses heart failure-associated pathology at the clinical and molecular levels. Exercise training has emerged as a class I recommendation in all major national and international guidelines for the treatment of chronic heart failure. Knowledge gained in clinical trials and molecular research builds a strong case for exercise training as a key therapeutic component of an evidence-based treatment of chronic heart failure. It is long overdue to provide patients with an infrastructure that enables them to benefit from this class I intervention.

  12. Reversing heart failure-associated pathophysiology with exercise: what actually improves and by how much?

    PubMed

    Adams, Volker; Niebauer, Josef

    2015-01-01

    Until the late 1980s, physical exercise training was a contraindication in patients with heart failure. Extensive research has demonstrated that exercise training reverses heart failure-associated pathology at the clinical and molecular levels. Exercise training has emerged as a class I recommendation in all major national and international guidelines for the treatment of chronic heart failure. Knowledge gained in clinical trials and molecular research builds a strong case for exercise training as a key therapeutic component of an evidence-based treatment of chronic heart failure. It is long overdue to provide patients with an infrastructure that enables them to benefit from this class I intervention. PMID:25432471

  13. 3 CFR 8344 - Proclamation 8344 of February 2, 2009. American Heart Month, 2009

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... commitment to promoting heart disease awareness. It is never too late to start protecting heart health. Certain risk factors can lead to heart disease. These include: high blood pressure, high cholesterol, obesity, physical inactivity, smoking, and diabetes. Practicing the following “Big Four” habits can...

  14. Executive Dysfunction is Independently Associated with Reduced Functional Independence in Heart Failure

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Colbert, Lisa H.; Josephson, Richard; van Dulmen, Manfred; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Aims and Objectives To examine the independent association between executive function with instrumental activities of daily living and health behaviors in older adults with heart failure. Background Executive function is an important contributor to functional independence as it consists of cognitive processes needed for decision-making, planning, organizing, and behavioral monitoring. Impairment in this domain is common in heart failure patients and associated with reduced performance of instrumental activities of daily living in many medical and neurological populations. However, the contribution of executive functions to functional independence and healthy lifestyle choices in heart failure patients has not been fully examined. Design Cross-sectional analyses. Methods 175 heart failure patients completed a neuropsychological battery and echocardiogram. Participants also completed the Lawton-Brody instrumental activities of daily living scale and reported current cigarette use. Results Hierarchical regressions revealed reduced executive function was independently associated with worse instrumental activity of daily living performance with a specific association for decreased ability to manage medications. Partial correlations showed executive dysfunction was associated with current cigarette use. Conclusions Our findings suggest that executive dysfunction is associated with poorer functional independence and contributes to unhealthy behaviors in heart failure. Future studies should examine whether heart failure patients benefit from formal organization schemae (i.e., pill organizers) to maintain independence. Relevance to Clinical Practice Screening of executive function in heart failure patients may provide key insight into their ability to perform daily tasks, including management of treatment recommendations. PMID:23650879

  15. Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

    ERIC Educational Resources Information Center

    Schwandt, Hilary M.; Coresh, Josef; Hindin, Michelle J.

    2010-01-01

    Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine…

  16. Fetal heart rate changes associated with general anesthesia.

    PubMed

    Fedorkow, D M; Stewart, T J; Parboosingh, J

    1989-07-01

    Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake.

  17. The association of scoliosis and congenital heart defects.

    PubMed

    Reckles, L N; Peterson, H A; Weidman, W H; Bianco, A J

    1975-06-01

    The effects of cardiac surgery on patients with congenital heart defects and the subsequent development of scoliosis were studied. A group of 998 patients with congenital heart defects who were less than sixteen years old were operated on at the Mayo Clinic during the ten-year period 1950 through 1959. Standing roentgenograms of the spine were made of 377 of the patients ten years or more after surgery. The ages of the patients at follow-up ranged from ten years and seven months to thirty-five years and three months, with a mean age of twenty-one years and four months. The average length of follow-up was fourteen years and eleven months. Of the 377 patients, thirty-two (8.5 per cent) had curves greater than 20 degrees. The female:male ratio of patients with congenital heart defects was 1:1, whereas of those who developed scoliosis it was 5:3. There was no correlation between scoliosis and the following: patient's sex, cardiac abnormality, size or side of the heart, side of the aortic arch, presence of cyanosis, age at surgery, number and type of surgical incisions, number and side of ribs removed, or number and type of surgical procedures. PMID:1141253

  18. GENDER-ASSOCIATED DIFFERENCES IN ACUTE HEART FAILURE PATIENTS PRESENTING TO EMERGENCY DEPARTMENT.

    PubMed

    Potočnjak, Ines; Bodrožić-Džakić, Tomislava; Šmit, Ivana; Trbušić, Matias; Milošević, Milan; Degoricija, Vesna

    2015-09-01

    Little is known about gender-associated differences in characteristics and survival of acute heart failure patients. The increasing incidence calls for investigating the possibilities of improved management. The purpose of the study was to determine gender-associated differences among emergency department acute heart failure patients in order to improve treatment quality and survival. A prospective observational study on 22,713 patients was conducted at the University Hospital Center Emergency department during 2010 and included 726 consecutive acute heart failure patients. The most common cause of acute heart failure was worsening of chronic heart failure. Females suffered more frequently from hypertensive acute heart failure and males from acute heart failure associated with acute coronary syndrome. Females were older, with higher body mass index, atrial fibrillation, urinary tract infections, hypertension history, hypertension at admission, and SAPS II score at admission. Males had a higher frequency of ST-elevation myocardial infarction and dilated cardiomyopathy, confirmed by ultrasound as lower ejection fraction and left ventricle dilatation with reduced ejection fraction. Males were more frequently smokers with a history of chronic obstructive pulmonary disease. The importance of treating hypertension and atrial fibrillation in women and acute coronary syndrome and chronic obstructive pulmonary disease in men should be emphasized. Aggressive identification and management of all possible heart failure etiologies should be recommended in the emergency department.

  19. Inverse association of long-acting natriuretic peptide with metabolic syndrome in congestive heart failure patients

    PubMed Central

    2013-01-01

    Aims Long-acting natriuretic peptide (LANP) is one of the peptide hormones in atrial natriuretic peptide (ANP) pro-hormone. Low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients. The aim of this study was to investigate the relationship between fasting serum LANP level and the metabolic syndrome (MetS) among congestive heart failure (CHF) patients. Methods Fasting blood samples were obtained from 186 patients with normal renal function in cardiac clinic outpatients. CHF defined by the American College of Cardiology Foundation and the American Heart Association 2005 Guidelines. MetS and its components were defined using diagnostic criteria from the International Diabetes Federation. Results Ninety-eight patients (52.7%) had CHF. There was a tendency of increased fasting LANP levels as the NYHA CHF functional classes increased (p = 0.002). Forty-six of the CHF patients (46.9%) had MetS. Fasting LANP level negatively correlated with MetS among CHF patients (p < 0.001). Univariate linear regression analysis showed that BUN (p = 0.026) positively correlated with fasting serum LANP levels, while body weight (p = 0.009), BMI (p = 0.004), homeostasis model assessment of insulin resistance (HOMA-IR; p = 0.024) and HOMA-β (p = 0.001) negatively correlated with fasting serum LANP levels among the CHF patients. Multivariate forward stepwise linear regression analysis of the significant variables showed that the HOMA-β (R2 change = 0.292, p < 0.001) and HOMA-IR (R2 change = 0.081, p = 0.019) were independent predictors of fasting serum LANP levels in CHF patients. Conclusions LANP level is significantly reduced in CHF patients affected by MetS. HOMA-β and HOMA-IR were independent predictors of serum LANP levels in CHF patients. PMID:23566312

  20. Fetal and neonatal mortality in patients with isolated congenital heart diseases and heart conditions associated with extracardiac abnormalities.

    PubMed

    Marantz, Pablo; Sáenz Tejeira, M Mercedes; Peña, Gabriela; Segovia, Alejandra; Fustiñana, Carlos

    2013-10-01

    Congenital malformations are a known cause of intrauterine death; of them, congenital heart diseases (CHDs) are accountable for the highest fetal and neonatal mortality rates. They are strongly associated with other extracardiac malformations and an early fetal mortality. Two hundred and twenty fves cases of CHDs are presented. Of them, 155 were isolated CHDs (group A) and 70 were associated with extracardiac malformations, chromosomal disorders, or genetic syndromes (group B). The overall mortality in group B was higher than that observed in group A (p <0.01). Prenatal mortality was similar in both groups: A: 8.4% (13 out of 155); B: 15.7% (11 out of 70). Postnatal mortality was A: 16.8% (26 out of 155) (p <0.01), OR: 0.52 (95% CI: 0.16-1.7); B: 32.9% (23 out of 70) (p <0.01), OR: 0.41 (95% CI: 0.20-0.83). Heart diseases associated with extracardiac abnormalities had a higher mortality rate than isolated congenital heart diseases in the period up to 60 weeks of postmenstrual age (140 days post-term). No differences were observed between both groups of patients in terms of prenatal mortality.

  1. Policing the social boundaries of the American Medical Association, 1847-70.

    PubMed

    Haynes, Douglas M

    2005-04-01

    In May 1870 the American Medical Association (AMA) voted to deny the admission of black delegates and their white colleagues to the national meeting in Washington, D.C. Historians of race and medicine have customarily viewed this decision as marking a crucial milestone in the formation of the nexus between racism and the development of the American medical profession in the era after the Civil War (1861-64). This study recasts this narrative by locating the 1870 decision in relation to the antebellum practices of the association and their social consequences for American medicine. It argues that the viability of the AMA as the national voice of the profession was critically dependent on rejecting racial equality. Indeed, at a moment when the question of the abolition of slavery polarized the nation, the AMA was founded in 1847 to create a voluntary professional organization, national in scope, dedicated to raising the standards of medical training and practice. To this end, the AMA elected presidents and selected host cities for annual meetings in the North, South, and West. Seven out of the fourteen meetings and six out of fourteen presidents were from slave and/or border states. These institutional practices together with the representation of blacks as different and enjoying an appropriate status as slaves grounded the national identity of the profession in black subordination. Similarly, the gendered discourses about healing and practices of female exclusion privileged medical authority as male by drawing on and reinforcing patriarchy. In the wake of the war, leaders hoped to restore the national character of the organization by resuming antebellum practices. In response to the new possibilities for blacks in medicine--as represented by the biracial National Medical Society--the AMA took steps to vigorously police the racial boundaries of the national profession. As this study will show, the 1870 decision reflected the logic of the racial politics at the heart

  2. 3 CFR 8625 - Proclamation 8625 of January 31, 2011. American Heart Month, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... healthier hearts for the next generation by addressing the factors that contribute to childhood obesity and...: high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, tobacco use, and...

  3. Genetic variants associated with warfarin dose in African-American individuals: a genome-wide association study

    PubMed Central

    Perera, Minoli A; Cavallari, Larisa H; Limdi, Nita A; Gamazon, Eric R; Konkashbaev, Anuar; Daneshjou, Roxana; Pluzhnikov, Anna; Crawford, Dana C; Wang, Jelai; Liu, Nianjun; Tatonetti, Nicholas; Bourgeois, Stephane; Takahashi, Harumi; Bradford, Yukiko; Burkley, Benjamin M; Desnick, Robert J; Halperin, Jonathan L; Khalifa, Sherief I; Langaee, Taimour Y; Lubitz, Steven A; Nutescu, Edith A; Oetjens, Matthew; Shahin, Mohamed H; Patel, Shitalben R; Sagreiya, Hersh; Tector, Matthew; Weck, Karen E; Rieder, Mark J; Scott, Stuart A; Wu, Alan HB; Burmester, James K; Wadelius, Mia; Deloukas, Panos; Wagner, Michael J; Mushiroda, Taisei; Kubo, Michiaki; Roden, Dan M; Cox, Nancy J; Altman, Russ B; Klein, Teri E; Nakamura, Yusuke; Johnson, Julie A

    2013-01-01

    effect on warfarin dose in African Americans, independent of CYP2C9*2 and CYP2C9*3. Incorporation of this variant into pharmacogenetic dosing algorithms could improve warfarin dose prediction in this population. Funding National Institutes of Health, American Heart Association, Howard Hughes Medical Institute, Wisconsin Network for Health Research, and the Wellcome Trust. PMID:23755828

  4. Two case reports of anophthalmia and congenital heart disease: Adding a new dimension to this association.

    PubMed

    Wang, Jenny; Steelman, Charlotte K; Vincent, Robert; Richburg, Delene; Chang, Tiffany S; Shehata, Bahig M

    2010-01-01

    Anophthalmia is the congenital absence of ocular tissue from the orbit. Many syndromes and malformations (e.g., anophthalmia-esophageal-genital syndrome, Matthew-Wood syndrome, CHARGE syndrome, oculo-facial-cardio-dental-syndome, heterotaxy, and Fraser syndrome) have been associated with anophthalmia. However, its relation with congenital heart disease has not been fully elucidated. In this article, we discuss two cases of patients with anophthalmia and congenital heart defects, and we compare these findings with other syndromes with which anophthalmia has been associated. One of our two patients showed complex congenital heart disease with heterotaxia, polysplenia, and normal lung lobation. These findings may reflect a new dimension of anophthalmia, heterotaxia, and congenital heart disease associations.

  5. Asian/Pacific American Librarians Association--A History of APALA and Its Founders.

    ERIC Educational Resources Information Center

    Yamashita, Kenneth A.

    2000-01-01

    Describes the societal and professional, as well as the personal, contexts which motivated the creation of the Asian/Pacific American Librarians Association (APALA) and its predecessor, the Asian American Librarians Caucus/Association (AALC/A). Includes profiles of the Asian/Pacific American library leaders who established these organizations and…

  6. Anxiety Reporting and Culturally Associated Interpretation Biases and Cognitive Schemas: A Comparison of Mexican, Mexican American, and European American Families

    ERIC Educational Resources Information Center

    Varela, R. Enrique; Vernberg, Eric M.; Sanchez-Sosa, Juan Jose; Riveros, Angelica; Mitchell, Montserrat; Mashunkashey, Joanna

    2004-01-01

    This study examined whether Mexican (n = 53), Mexican American (n = 50), and European American (n = 51) children differed in their reporting of anxiety symptoms and whether parental influence and specific cognitive schemas associated with Mexican culture were related to differences in anxiety reporting. As expected, Mexican and Mexican American…

  7. First North American 50 cc Total Artificial Heart Experience: Conversion from a 70 cc Total Artificial Heart.

    PubMed

    Khalpey, Zain; Kazui, Toshinobu; Ferng, Alice S; Connell, Alana; Tran, Phat L; Meyer, Mark; Rawashdeh, Badi; Smith, Richard G; Sweitzer, Nancy K; Friedman, Mark; Lick, Scott; Slepian, Marvin J; Copeland, Jack G

    2016-01-01

    The 70 cc total artificial heart (TAH) has been utilized as bridge to transplant (BTT) for biventricular failure. However, the utilization of 70 cc TAH has been limited to large patients for the low output from the pulmonary as well as systemic vein compression after chest closure. Therefore, the 50 cc TAH was developed by SynCardia (Tucson, AZ) to accommodate smaller chest cavity. We report the first TAH exchange from a 70 to 50 cc due to a fit difficulty. The patient failed to be closed with a 70 cc TAH, although the patient met the conventional 70 cc TAH fit criteria. We successfully closed the chest with a 50 cc TAH.

  8. Heart failure in South America.

    PubMed

    Bocchi, Edimar Alcides

    2013-05-01

    Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries.

  9. Heart Failure in South America

    PubMed Central

    Bocchi, Edimar Alcides

    2013-01-01

    Continued assessment of temporal trends in mortality and epidemiology of specific heart failure in South America is needed to provide a scientific basis for rational allocation of the limited health care resources, and strategies to reduce risk and predict the future burden of heart failure. The epidemiology of heart failure in South America was reviewed. Heart failure is the main cause of hospitalization based on available data from approximately 50% of the South American population. The main etiologies of heart failure are ischemic, idiopathic dilated cardiomyopathy, valvular, hypertensive and chagasic etiologies. In endemic areas, Chagas heart disease may be responsible by 41% of the HF cases. Also, heart failure presents high mortality especially in patients with Chagas etiology. Heart failure and etiologies associated with heart failure may be responsible for 6.3% of causes of deaths. Rheumatic fever is the leading cause of valvular heart disease. However, a tendency to reduction of HF mortality due to Chagas heart disease from 1985 to 2006, and reduction in mortality due to HF from 1999 to 2005 were observed in selected states in Brazil. The findings have important public health implications because the allocation of health care resources, and strategies to reduce risk of heart failure should also consider the control of neglected Chagas disease and rheumatic fever in South American countries. PMID:23597301

  10. 3 CFR 8477 - Proclamation 8477 of February 1, 2010. American Heart Month, 2010

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... heart disease requires each of us to take responsibility for our health and that of our children—including exercising regularly, maintaining a healthy diet, avoiding tobacco, and raising our children to spend more time playing outside. Because obesity is a leading risk factor for heart disease,...

  11. American Gastroenterological Association: results of a membership poll.

    PubMed

    Switz, D M

    1986-02-01

    The Patient Care Committee of the American Gastroenterological Association determined that no data existed on the views or demographics of our rapidly growing membership. A 48-item questionnaire was developed and administered during 1982-1983. A random sample (232 of 2751 active members) was queried; 85% (196) replied and all returns were correctly completed. Respondents rate the American Gastroenterological Association as "somewhat responsive" to practitioners' needs but closer to "extremely responsive" to the needs of academic physicians. Full-time medical school faculty average 33% of their time in direct (digestive disease related) patient care, with 15% spent on endoscopy; non-faculty members spend 56% of their time on such care and 22% on endoscopy. Only 2% of the 22% of members who do some "bench research" are less than 35 yr old compared with 7% of the general membership. Most (97.9%) members have attended a Digestive Disease Week in the last 5 yr; they averaged 3.9 meetings and 2.5 courses. Members rank both Digestive Disease Week and GASTROENTEROLOGY a little toward the "research side" of a perfect balance.

  12. American woodcock (Scolopax minor) mortality associated with a reovirus

    USGS Publications Warehouse

    Docherty, D.E.; Converse, K.A.; Hansen, W.R.; Norman, G.W.

    1994-01-01

    A virus isolate associated with a 1989-90 die-off in American woodcock (Scolopax minor) was identified as a reovirus. Emaciation was a consistent necropsy finding in the woodcock involved in this die-off. This reovirus infection appeared to be systemic, had the potential for fecal-oral virus transmission, and was associated with deterioration of body condition. To our knowledge this is the first report of a virus isolate from wild American woodcock. A survey conducted in 1990-92 indicated that this virus was not present at detectable levels in the woodcock breeding and wintering population. /// Un virus asociado con la mortalidad de becadas o perdices americanas (Scolopax minor) en 1989-1990-fue identificado como reovirus. La emaciaci??n fue un resultado com??n a la necropsia de las aves que murieron. Esta infecci??n por reovirus pareci?? ser sist??mica, ten?-a el potencial de transmisi??n fecal-oral y estuvo asociada con el deterioro del ave. Creemos que este sea el primer reporte de aislamiento viral a partir de becadas americanas. Una encuesta hecha entre 1990 y 1992 indic?? que este virus no estaba presente en los niveles detectables en los reproductores y en las aves invernales.

  13. 2015 Annual Report of the American Psychological Association.

    PubMed

    2016-01-01

    Presents the 2015 Annual Report of the American Psychological Association. In his introduction, President Barry Anton describes how 2015 was among APA's most challenging. Although 2015 ushered in an era of greater transparency within the association and enhanced communications to members and the public, it also required painful self-reflection stemming from the revelations of an independent review by an outside law firm. The review examined the question of whether APA played any role related to the Bush administration's use of abusive interrogation techniques during the war on terror. Anton's introduction also discusses (1) the APA convention, (2) representing APA at a White House meeting with health care providers and insurance companies, (3) APA's effort to increase the number of APA-accredited internships, (4) international activities, and (5) the global summit on psychology and integrated care. (PsycINFO Database Record

  14. 2015 Annual Report of the American Psychological Association.

    PubMed

    2016-01-01

    Presents the 2015 Annual Report of the American Psychological Association. In his introduction, President Barry Anton describes how 2015 was among APA's most challenging. Although 2015 ushered in an era of greater transparency within the association and enhanced communications to members and the public, it also required painful self-reflection stemming from the revelations of an independent review by an outside law firm. The review examined the question of whether APA played any role related to the Bush administration's use of abusive interrogation techniques during the war on terror. Anton's introduction also discusses (1) the APA convention, (2) representing APA at a White House meeting with health care providers and insurance companies, (3) APA's effort to increase the number of APA-accredited internships, (4) international activities, and (5) the global summit on psychology and integrated care. (PsycINFO Database Record PMID:27504583

  15. A Prospective Study of the Association Between Dispositional Optimism and Incident Heart Failure

    PubMed Central

    Kim, Eric S.; Smith, Jacqui; Kubzansky, Laura D.

    2015-01-01

    Background Although higher optimism has been linked with an array of positive health behaviors, biological processes, and cardiovascular outcomes, the relationship between optimism and heart failure has not been examined. In the United States, 80% of heart failures occur in adults aged 65+. Therefore, we examined whether higher optimism was linked with a reduced incidence of heart failure among older adults. Methods and Results Prospective data were from the Health and Retirement Study, a nationally representative study of older U.S adults. Our sample included 6,808 participants who were followed for four years. Multiple logistic regression models were used to assess if optimism was independently associated with incident heart failure. We adjusted for sociodemographic, behavioral, biological, and psychological covariates. Higher optimism was associated with a lower risk of incident heart failure over the follow-up period. In a model that adjusted for sociodemographic factors, each standard deviation increase in optimism had an odds ratio of 0.74 (95% CI, 0.63–0.85) for heart failure. Effects of optimism persisted even after adjusting for a wide range of covariates. There was also evidence of a dose-response relationship. As optimism increased, risk of developing heart failure decreased monotonically, with a 48% reduced odds among people with the highest versus lowest optimism. Conclusions This is the first study to suggest that optimism is associated with a lower risk of heart failure. If future studies confirm these findings, they may be used to inform new strategies for preventing or delaying the onset of heart failure. PMID:24647117

  16. A Heavy Heart: The Association between Weight and Emotional Words.

    PubMed

    Zhao, Xueru; He, Xianyou; Zhang, Wei

    2016-01-01

    People often express emotion in language using weight (e.g., a heavy heart, light-hearted, light humor, or heavy-handed), but the question remains whether these expressions of emotion are rooted in the body. Six experiments used a priming paradigm to explore the metaphoric relation between weight perception and emotional words. Experiments 1 and 2 investigated the influence of weight perception on judgments of emotional words and the influence of emotional words on judgments of weight, respectively. A significant difference between the consistent condition (e.g., lightness corresponds to positive words and heaviness corresponds to negative words) and the inconsistent condition (e.g., lightness corresponds to negative words and heaviness corresponds to positive words) was found in Experiment 1 but not in Experiment 2. Experiments 3, 4, and 5 were conducted to exclude potential confounds. Experiment 6 was a repeated-measures study that was conducted to verify the weight-emotion effect. The study confirmed that weight perception affected judgments of emotional words. The results contribute to the growing literature on conceptual metaphor theory and embodied cognition theory.

  17. A Heavy Heart: The Association between Weight and Emotional Words.

    PubMed

    Zhao, Xueru; He, Xianyou; Zhang, Wei

    2016-01-01

    People often express emotion in language using weight (e.g., a heavy heart, light-hearted, light humor, or heavy-handed), but the question remains whether these expressions of emotion are rooted in the body. Six experiments used a priming paradigm to explore the metaphoric relation between weight perception and emotional words. Experiments 1 and 2 investigated the influence of weight perception on judgments of emotional words and the influence of emotional words on judgments of weight, respectively. A significant difference between the consistent condition (e.g., lightness corresponds to positive words and heaviness corresponds to negative words) and the inconsistent condition (e.g., lightness corresponds to negative words and heaviness corresponds to positive words) was found in Experiment 1 but not in Experiment 2. Experiments 3, 4, and 5 were conducted to exclude potential confounds. Experiment 6 was a repeated-measures study that was conducted to verify the weight-emotion effect. The study confirmed that weight perception affected judgments of emotional words. The results contribute to the growing literature on conceptual metaphor theory and embodied cognition theory. PMID:27445893

  18. A Heavy Heart: The Association between Weight and Emotional Words

    PubMed Central

    Zhao, Xueru; He, Xianyou; Zhang, Wei

    2016-01-01

    People often express emotion in language using weight (e.g., a heavy heart, light-hearted, light humor, or heavy-handed), but the question remains whether these expressions of emotion are rooted in the body. Six experiments used a priming paradigm to explore the metaphoric relation between weight perception and emotional words. Experiments 1 and 2 investigated the influence of weight perception on judgments of emotional words and the influence of emotional words on judgments of weight, respectively. A significant difference between the consistent condition (e.g., lightness corresponds to positive words and heaviness corresponds to negative words) and the inconsistent condition (e.g., lightness corresponds to negative words and heaviness corresponds to positive words) was found in Experiment 1 but not in Experiment 2. Experiments 3, 4, and 5 were conducted to exclude potential confounds. Experiment 6 was a repeated-measures study that was conducted to verify the weight-emotion effect. The study confirmed that weight perception affected judgments of emotional words. The results contribute to the growing literature on conceptual metaphor theory and embodied cognition theory. PMID:27445893

  19. Increase in the embedding dimension in the heart rate variability associated with left ventricular abnormalities

    NASA Astrophysics Data System (ADS)

    Andrés, D. S.; Irurzun, I. M.; Mitelman, J.; Mola, E. E.

    2006-10-01

    In the present study, the authors report evidence that the existence of premature ventricular contractions increases the embedding dimension of the cardiac dynamics. They also analyze patients with congestive heart failure, a severe clinical condition associated with abnormal left ventricular function. Results also show an increase in the embedding dimension of the heart rate variability. They used electrocardiograms collected by themselves with quality standards that make them comparable with other databases.

  20. 3 CFR 8775 - Proclamation 8775 of January 31, 2012. American Heart Month, 2012

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ....gov. To secure our children’s heart health and end childhood obesity within a generation, First Lady... inactivity, obesity, tobacco use, and alcohol abuse are major risk factors that can be prevented...

  1. Characteristics of American Psychological Association Division 40 (clinical neuropsychology) Fellows.

    PubMed

    Johnson-Greene, Doug; Collins, K C

    2011-11-01

    Fellow status is an honor bestowed on American Psychological Association (APA) members who have made unusual and outstanding contributions to the field of psychology that have had a national impact. Thus far no studies have examined the characteristics of the individuals who have received this honor. This study examined publicly available data for 157 Division 40 Fellows. Fellows comprise 3.7% of the 4273 members of the division compared to 5.7% of the entire APA membership. Fellows are predominantly male (73%). All but two fellows had earned a Ph.D. with the average time since granting of the doctoral degree of 17.1 ± 6 years (median=16 years) with a range of 7-40 years post-degree. Slightly over half of the fellows hold board certification (53%) in the American Board of Professional Psychology. The largest group of fellows reports their primary employment currently as a university-affiliated medical setting (48%). These data serve to characterize current Division 40 Fellows for the field of neuropsychology and may provide useful information to assist prospective fellow applicants.

  2. Factors Associated with Pregnancy among Incarcerated African American Adolescent Girls.

    PubMed

    Gray, Simone C; Holmes, Kristin; Bradford, Denise R

    2016-08-01

    The purpose of this study was to examine the social and behavioral factors associated with pregnancy history among a sample of African American adolescent girls recruited from a short-term juvenile detention center in order to better understand the needs of this vulnerable population. Data were collected from a sample of 188 detained African American, 13-17-year-old girls in Atlanta, Georgia, who participated in a larger HIV prevention study. An audio computer-assisted self-interviewing survey was completed by participants to obtain information on socioecological factors to include individual, parental/familial, sexual risk, psychosocial, and substance use factors. Among the 188 participants, 25.5 % reported a history of pregnancy. A multivariable logistic regression model showed that girls with a history of pregnancy were more likely to live in a household receiving government aid, use hormonal contraceptives at last sex, participate in sex trading, have casual sex partners, have condomless sex in the past 90 days, and have a history of physical abuse. Girls with no history of pregnancy were more likely to have been incarcerated at least twice and to have previously used alcohol. Detention-based interventions and pregnancy prevention programs for this vulnerable population may benefit by addressing factors related to sexual behavior and development, substance use, individual background, and psychosocial health. PMID:27271026

  3. Precipitating factors leading to decompensation of chronic heart failure in the elderly patient in South-American community hospital

    PubMed Central

    Diaz, Alejandro; Ciocchini, Cleto; Esperatti, Mariano; Becerra, Alberto; Mainardi, Sabrina; Farah, Alejandro

    2011-01-01

    Background Exacerbations of heart failure appear frequently associated with precipitating factors not directly related to the evolution of cardiac disease. There still a paucity of data on the proportional distribution of precipitating factors specifically in elderly patients. The aim of this study was to examine prospectively the precipitating factors leading to hospitalization in elderly patients with heart failure in our community hospital. Methods We evaluate elderly patients who need admissions for decompensate heart failure. All patients were reviewed daily by the study investigators at the first 24 h and closely followed-up. Decompensation was defined as the worsening in clinical NYHA class associated with the need for an increase in medical treatment (at minimum intravenously diuretics). Results We included 102 patients (mean age 79 ± 12 years). Precipitating factors were identified in 88.5%. The decompensation was sudden in 35% of the cases. Noncompliance with diet was identified in 52% of the patients, lack of adherence to the prescribed medications amounted to 30%. Others precipitating factors were infections (29%), arrhythmias (25%), acute coronary ischemia (22%), and uncontrolled hypertension (15%), miscellaneous causes were detected in 18% of the cases (progression of renal disease 60%, anemia 30% and iatrogenic factors 10%). Concomitant cause was not recognizable in 11.5%. Conclusions Large proportion heart failure hospitalizations are associated with preventable precipitating factors. Knowledge of potential precipitating factors may help to optimize treatment and provide guidance for patients with heart failure. The presence of potential precipitating factors should be routinely evaluated in patients presenting chronic heart failure. PMID:22783279

  4. Association of the Functional MICA-129 Polymorphism With the Severity of Chronic Chagas Heart Disease.

    PubMed

    Ayo, Christiane Maria; Oliveira, Amanda Priscila de; Camargo, Ana Vitória da Silveira; Mattos, Cinara Cássia Brandão de; Bestetti, Reinaldo Bulgarelli; Mattos, Luiz Carlos de

    2015-10-15

    MICA-129 polymorphism affects the binding affinity of MICA molecules with the NKG2D receptor and influences effector cell function. The genotype met/met was associated with the severity of left ventricular systolic dysfunction (LVSD) in patients with chronic Chagas heart disease, while the val/val genotype was associated with the absence of LVSD.

  5. Faculty application of the American Psychological Association style.

    PubMed

    Morse, Gwen Goetz

    2009-10-01

    This article explores current faculty methods with the application and evaluation of the American Psychological Association (APA) style. Specific aims were to determine concerns related to APA style, review faculty grading practices, identify institutional resources, and report potential solutions for improving application of APA style. A survey with an exploratory descriptive research design was developed and distributed online to academic chairs and deans, requesting their support in distributing the survey to their faculty. Responses (N = 704) were grouped into five categories: departmental and personal concerns; faculty grading practices; institutional resources; format, writing style, and grammar; and suggestions and potential solutions. Sixty percent reported that application and evaluation of APA style is a concern in their department. Content analysis identified four categories as proposed solutions: consistency, education, resources, and dialogue. On the basis of the feedback of the participants, the CRED program is proposed for the issues that were identified. PMID:19645365

  6. Faculty application of the American Psychological Association style.

    PubMed

    Morse, Gwen Goetz

    2009-10-01

    This article explores current faculty methods with the application and evaluation of the American Psychological Association (APA) style. Specific aims were to determine concerns related to APA style, review faculty grading practices, identify institutional resources, and report potential solutions for improving application of APA style. A survey with an exploratory descriptive research design was developed and distributed online to academic chairs and deans, requesting their support in distributing the survey to their faculty. Responses (N = 704) were grouped into five categories: departmental and personal concerns; faculty grading practices; institutional resources; format, writing style, and grammar; and suggestions and potential solutions. Sixty percent reported that application and evaluation of APA style is a concern in their department. Content analysis identified four categories as proposed solutions: consistency, education, resources, and dialogue. On the basis of the feedback of the participants, the CRED program is proposed for the issues that were identified.

  7. Associations of high HDL cholesterol level with all-cause mortality in patients with heart failure complicating coronary heart disease

    PubMed Central

    Cai, Anping; Li, Xida; Zhong, Qi; Li, Minming; Wang, Rui; Liang, Yingcong; Chen, Wenzhong; Huang, Tehui; Li, Xiaohong; Zhou, Yingling; Li, Liwen

    2016-01-01

    Abstract The aim of the present study was to evaluate the association between HDL cholesterol level and all-cause mortality in patients with ejection fraction reduced heart failure (EFrHF) complicating coronary heart disease (CHD). A total of 323 patients were retrospectively recruited. Patients were divided into low and high HDL cholesterol groups. Between-group differences and associations between HDL cholesterol level and all-cause mortality were assessed. Patients in the high HDL cholesterol group had higher HDL cholesterol level and other lipid components (P <0.05 for all comparison). Lower levels of alanine aminotransferase (ALT), high-sensitivity C-reactive protein (Hs-CRP), and higher albumin (ALB) level were observed in the high HDL cholesterol group (P <0.05 for all comparison). Although left ventricular ejection fraction (LVEF) were comparable (28.8 ± 4.5% vs 28.4 ± 4.6%, P = 0.358), mean mortality rate in the high HDL cholesterol group was significantly lower (43.5% vs 59.1%, P = 0.007). HDL cholesterol level was positively correlated with ALB level, while inversely correlated with ALT, Hs-CRP, and NYHA classification. Logistic regression analysis revealed that after extensively adjusted for confounding variates, HDL cholesterol level remained significantly associated with all-cause mortality although the magnitude of association was gradually attenuated with odds ratio of 0.007 (95% confidence interval 0.001–0.327, P = 0.012). Higher HDL cholesterol level is associated with better survival in patients with EFrHF complicating CHD, and future studies are necessary to demonstrate whether increasing HDL cholesterol level will confer survival benefit in these populations of patients. PMID:27428188

  8. The Association between Childhood Physical Abuse and Heart Disease in Adulthood: Findings from a Representative Community Sample

    ERIC Educational Resources Information Center

    Fuller-Thomson, Esme; Brennenstuhl, Sarah; Frank, John

    2010-01-01

    Objectives: Although, the relationship between childhood physical abuse and adult heart disease has been documented, very few studies have controlled for many of the known risk factors for heart disease. The objective of the current study, therefore, was to investigate the association between childhood physical abuse and adult heart disease while…

  9. Discovery of Genetic Variation on Chromosome 5q22 Associated with Mortality in Heart Failure

    PubMed Central

    Smith, J. Gustav; Felix, Janine F.; Morrison, Alanna C.; Trompet, Stella; Wilk, Jemma B.; Gidlöf, Olof; Morley, Michael; Joehanes, Roby; Ligthart, Symen; Shan, Xiaoyin; Bis, Joshua C.; Sjögren, Marketa; Ngwa, Julius; Stott, David J.; Aguilar, David; Rice, Kenneth M.; Sesso, Howard D.; Demissie, Serkalem; Buckley, Brendan M.; Taylor, Kent D.; Ford, Ian; Yao, Chen; Liu, Chunyu; Sotoodehnia, Nona; van der Harst, Pim; Stricker, Bruno H. Ch.; Kritchevsky, Stephen B.; Liu, Yongmei; Gaziano, J. Michael; Hofman, Albert; Moravec, Christine S.; Uitterlinden, André G.; Kellis, Manolis; van Meurs, Joyce B.; Margulies, Kenneth B.; Dehghan, Abbas; Levy, Daniel; Olde, Björn; Psaty, Bruce M.; Cupples, L. Adrienne; Jukema, J. Wouter; Djousse, Luc; Franco, Oscar H.; Boerwinkle, Eric; Boyer, Laurie A.; Newton-Cheh, Christopher; Butler, Javed; Vasan, Ramachandran S.; Cappola, Thomas P.; Smith, Nicholas L.

    2016-01-01

    Failure of the human heart to maintain sufficient output of blood for the demands of the body, heart failure, is a common condition with high mortality even with modern therapeutic alternatives. To identify molecular determinants of mortality in patients with new-onset heart failure, we performed a meta-analysis of genome-wide association studies and follow-up genotyping in independent populations. We identified and replicated an association for a genetic variant on chromosome 5q22 with 36% increased risk of death in subjects with heart failure (rs9885413, P = 2.7x10-9). We provide evidence from reporter gene assays, computational predictions and epigenomic marks that this polymorphism increases activity of an enhancer region active in multiple human tissues. The polymorphism was further reproducibly associated with a DNA methylation signature in whole blood (P = 4.5x10-40) that also associated with allergic sensitization and expression in blood of the cytokine TSLP (P = 1.1x10-4). Knockdown of the transcription factor predicted to bind the enhancer region (NHLH1) in a human cell line (HEK293) expressing NHLH1 resulted in lower TSLP expression. In addition, we observed evidence of recent positive selection acting on the risk allele in populations of African descent. Our findings provide novel genetic leads to factors that influence mortality in patients with heart failure. PMID:27149122

  10. [Case of congestive heart failure associated with hypereosinophilia developed during antibiotics treatment].

    PubMed

    Sato, Takeo; Hagiwara, Kiyofumi; Matsuno, Hiroaki; Akiyama, Osamu

    2005-10-01

    A 92-year-old man with a history of bronchial asthma and allergic rhinitis received antibiotics for sepsis by methicillin-resistant Staphylococcus aureus and multidrug-resistant Enterococcus gallinarum. During the antibiotics treatment, skin eruptions, liver dysfunction, and hypereosinophilia developed, followed by dyspnea, congestive heart failure, electrocardiographic abnormalities, and diffuse mild myocardial hypokinesis. After the discontinuation of the antibiotics and the administration of steroid, skin eruptions, liver dysfunction, and hypereosinophilia improved parallel with the improvement of the congestive heart failure. Vancomycin hydrochloride and teicoplanin were suspected as the causative drugs on the basis of the treatment course. Although congestive heart failure is rare in the case of drug-induced hypereosinophilia, it is one of life-threatening complications. We describe herein a case of congestive heart failure associated with hypereosinophilia developed during antibiotics treatment, successfully treated with steroid after the discontinuation of the causative drug. PMID:16407668

  11. Crisis and Opportunity: The Founding of the Association of American Colleges

    ERIC Educational Resources Information Center

    Curtis, Mark H.

    2014-01-01

    It is not a surprise that presidents of American colleges formed an association. What is cause for wonder is why it took them so long. By 1869, there were 563 colleges in this nation. Yet not until 1914 did a handful of presidents feel the need to band together and found the Association of American Colleges (AAC). The Association of American…

  12. 75 FR 11992 - Notice of Scheduling of Public Hearing; Association of American Railroads

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-12

    ... Federal Railroad Administration Notice of Scheduling of Public Hearing; Association of American Railroads... Association of American Railroads (AAR) had petitioned FRA for a waiver of compliance from certain... behalf of an association, business, labor union, etc.) You may review DOT's complete Privacy...

  13. Position of the American Dietetic Association: Food and water safety.

    PubMed

    Albrecht, Julie A; Nagy-Nero, Debe

    2009-08-01

    It is the position of the American Dietetic Association that the public has the right to a safe food and water supply. The Association supports collaboration among food and nutrition professionals, academics, representatives of the agricultural and food industries, and appropriate government agencies to ensure the safety of the food and water supply by providing education to the public and industry, promoting technological innovation and applications, and supporting further research. New food and water safety issues evolve as the environment changes. Food and nutrition professionals should collaborate with food and agriculture industries and members of the medical community in a joint effort to address these issues. Recent food- and waterborne illnesses have occurred in new settings and/or unique foods not traditionally associated with foodborne illness outbreaks. New issues associated with food safety and security that have emerged support the need for continued education and research. Government programs have developed powerful tools such as FoodNet and PulseNet to detect food- and waterborne illness outbreaks in the United States. These government programs have provided the data to enhance public policy and educational programs such as FightBac! Mandatory and voluntary adoption of Hazard Analysis Critical Control Points in the foodservice and processing industries have contributed to a decrease in foodborne illness outbreaks from traditional foods and some microorganisms usually associated with foodborne illnesses. Food and nutrition professionals are positioned to provide food and water safety education in community, clinical settings, and foodservice operations and food industries. With an aging population and an increased number of people at risk due to medical conditions for food- and waterborne illness, food and nutrition professionals should be involved in collaborative food and water safety issues in educational, research, and policy agenda settings. As

  14. Aftermath of a Crusade: World War I and the Enlarged Program of the American Library Association.

    ERIC Educational Resources Information Center

    Young, Arthur P.

    1980-01-01

    Considers the objectives, campaign strategy, ideology, and reception of the American Library Association's Enlarged Program to revitalize library services after World War I. Forty references are cited. (FM)

  15. Association of genes of lipid metabolism with measures of subclinical cardiovascular disease in the Diabetes Heart Study

    PubMed Central

    Burdon, K; Langefeld, C; Beck, S; Wagenknecht, L; Carr, J; Freedman, B; Herrington, D; Bowden, D

    2005-01-01

    Background: Dyslipidaemia is a well known risk factor for cardiovascular disease (CVD). Lipid metabolism is affected by a range of genes and proteins. This study investigated whether some of these genes are associated with measures of subclinical CVD. Methods: Polymorphisms of paraoxonase 1 and 2, cholesteryl ester transfer protein, hepatic lipase, and lipoprotein lipase were tested for associations with measures of subclinical CVD including carotid intima-media thickness measured by B-mode ultrasound and carotid and coronary arterial calcification measured by computed tomography. Analysis was performed in 620 European American participants in the Diabetes Heart Study, 83% of whom had type 2 diabetes mellitus. Associations of genotypes with subclinical CVD were tested by computing a series of generalised estimating equations. Results: The Q192R variant of paraoxonase 1 and rs285 of lipoprotein lipase were associated with carotid artery calcium (p values = 0.002 and 0.005, respectively). Paraoxonase 2 S311C was associated with coronary artery calcium (p value = 0.037). Conclusions: There is evidence for modest, but significant, association of multiple single nucleotide polymorphisms in lipid genes with measures of subclinical CVD. PMID:16141008

  16. Double Aneuploidy 48,XXY,+21 Associated with a Congenital Heart Defect in a Neonate.

    PubMed

    Shu, X; Zou, C; Shen, Z

    2013-12-01

    A neonate with a double aneuploidy associated with congenital heart defect (CHD) suffered from cyanosis after birth. He had typical features of Down syndrome (DS) including hypertelorism, slightly lowset ears with protruding pinna. Doppler echocardiography indicated complex congenital heart disease with an ostium secundum atrial septal defect, enlarged right ventricle, and mild tricuspid valve regurgitation. Further chromosomal analysis showed a karyotype of 48,XXY,+21: a double aneuploidy of DS and Klinefelter syndrome (KS). Until now, only seven cases of double aneuploidy associated with CHD defect have been reported. PMID:24778570

  17. “I Just Can’t Do It Anymore” Patterns of Physical Activity and Cardiac Rehabilitation in African Americans with Heart Failure: A Mixed Method Study

    PubMed Central

    McCarthy, Margaret; Katz, Stuart D.; Schipper, Judith; Dickson, Victoria Vaughan

    2015-01-01

    Physical activity and cardiac rehabilitation (CR) are components of heart failure (HF) self-care. The aims of this study were to describe patterns of physical activity in African Americans (n = 30) with HF and to explore experience in CR. This was a mixed method, concurrent nested, predominantly qualitative study. Qualitative data were collected via interviews exploring typical physical activity, and CR experience. It was augmented by quantitative data measuring HF severity, self-care, functional capacity and depressive symptoms. Mean age was 60 ± 15 years; 65% were New York Heart Association (NYHA) class III HF. Forty-three percent reported that they did less than 30 min of exercise in the past week; 23% were told “nothing” about exercise by their provider, and 53% were told to do “minimal exercise”. A measure of functional capacity indicated the ability to do moderate activity. Two related themes stemmed from the narratives describing current physical activity: “given up” and “still trying”. Six participants recalled referral to CR with one person participating. There was high concordance between qualitative and quantitative data, and evidence that depression may play a role in low levels of physical activity. Findings highlight the need for strategies to increase adherence to current physical activity guidelines in this older minority population with HF. PMID:27417807

  18. Acute Decompensated Heart Failure Update

    PubMed Central

    Teerlink, John R; Alburikan, Khalid; Metra, Marco; Rodgers, Jo E

    2015-01-01

    Acute decompensated heart failure (ADHF) continues to increase in prevalence and is associated with substantial mortality and morbidity including frequent hospitalizations. The American Heart Association is predicting that more than eight million Americans will have heart failure by 2030 and that the total direct costs associated with the disease will rise from $21 billion in 2012 to $70 billion in 2030. The increase in the prevalence and cost of HF is primarily the result of shifting demographics and a growing population. Although many large, randomized, controlled clinical trials have been conducted in patients with chronic heart failure, it was not until recently that a growing number of studies began to address the management of ADHF. It is the intent of this review to update the clinician regarding the evaluation and optimal management of ADHF. PMID:24251454

  19. Maintenance of resting tension in the american eel (Anguilla rostrata L.) heart is dependent upon exogenous fuel and the sarcoplasmic reticulum.

    PubMed

    Bailey, J R; Barter, T; Driedzic, W R

    2000-06-01

    The relationship between extracellular glucose and management of cell Ca(2+) in the heart of the American eel (Anguilla rostrata) was indirectly assessed by monitoring the performance of isolated ventricular strips at 20 degrees C. Twitch force increased in ventricular strips under specific conditions of 30 bpm pacing and an extracellular Ca(2+) challenge from 1.5 to 9.5 mM. The response was independent of any exogenous metabolic fuel in the medium. Resting tension was maintained when glucose was available, but in the absence of a metabolic fuel, resting tension increased in response to the increase in extracellular Ca(2+) level. When ventricular strips were treated with iodoacetate to inhibit glycolysis, a Ca(2+) challenge resulted in a decrease in twitch force in association with an approximately equivalent increase in resting tension even in the presence of exogenous glucose. However, when pyruvate (5 mM) was substituted as a metabolic fuel, twitch force increased as a function of extracellular Ca(2+), and resting tension was maintained in the presence of iodoacetate. Therefore, there is a need for an extracellular fuel but not a specific metabolic requirement for glucose to maintain the performance characteristics, which are presumably related to the management of intracellular Ca(2+) levels. Ventricular strips were treated with ryanodine to inhibit Ca(2+) release and uptake by the sarcoplasmic reticulum (SR). Ryanodine treatment impaired postrest potentiation at high extracellular Ca(2+) levels. In the presence of ryanodine, the protective effect of glucose on the increase in resting tension in the face of an extracellular Ca(2+) challenge was eliminated. Considered together, the results reveal that the heart of the American eel has a requirement for an extracellular fuel to manage intracellular Ca(2+) at high Ca(2+) loads, and that the SR plays a role in the beat-to-beat regulation of Ca(2+) at a frequency of 30 bpm, high Ca(2+) load, and 20 degrees C.

  20. Tacrolimus-associated hemolytic uremic syndrome in a pediatric heart transplant recipient.

    PubMed

    Gray, James M; Ameduri, Rebecca K

    2016-09-01

    HUS is a well-known entity primarily associated with bacterial infection and is characterized by a classic triad of anemia, thrombocytopenia, and kidney injury. Its atypical form has been associated with calcineurin inhibitors and has been extensively discussed in renal transplantation. We present a case of tacrolimus-associated HUS in a pediatric heart transplant recipient, which we believe to be previously unreported in the literature.

  1. Tacrolimus-associated hemolytic uremic syndrome in a pediatric heart transplant recipient.

    PubMed

    Gray, James M; Ameduri, Rebecca K

    2016-09-01

    HUS is a well-known entity primarily associated with bacterial infection and is characterized by a classic triad of anemia, thrombocytopenia, and kidney injury. Its atypical form has been associated with calcineurin inhibitors and has been extensively discussed in renal transplantation. We present a case of tacrolimus-associated HUS in a pediatric heart transplant recipient, which we believe to be previously unreported in the literature. PMID:27371345

  2. Mastery Motivational Climate: Influence on Physical Play and Heart Rate in African American Toddlers

    ERIC Educational Resources Information Center

    Parish, Loraine E.; Rudisill, Mary E.; St. Onge, Paul M.

    2007-01-01

    The purpose of this study was to determine the effectiveness of a planned mastery motivational physical play session on physical activity (i.e., heart rate [HR] and physical play intensity [PAHR greater than 50]) in toddlers (N = 21), as compared to a nonplanned free play session. Participants wore a monitor to measure HR over two, 30 min play…

  3. Age-associated pro-inflammatory remodeling and functional phenotype in the heart and large arteries.

    PubMed

    Wang, Mingyi; Shah, Ajay M

    2015-06-01

    The aging population is increasing dramatically. Aging-associated stress simultaneously drives proinflammatory remodeling, involving angiotensin II and other factors, in both the heart and large arteries. The structural remodeling and functional changes that occur with aging include cardiac and vascular wall stiffening, systolic hypertension and suboptimal ventricular-arterial coupling, features that are often clinically silent and thus termed a silent syndrome. These age-related effects are the result of responses initiated by cardiovascular proinflammatory cells. Local proinflammatory signals are coupled between the heart and arteries due to common mechanical and humoral messengers within a closed circulating system. Thus, targeting proinflammatory signaling molecules would be a promising approach to improve age-associated suboptimal ventricular-arterial coupling, a major predisposing factor for the pathogenesis of clinical cardiovascular events such as heart failure.

  4. Smoking influences the association between apolipoprotein E and lipids: the National Heart, Lung, and Blood Institute Family Heart Study.

    PubMed

    Djoussé, L; Myers, R H; Coon, H; Arnett, D K; Province, M A; Ellison, R C

    2000-08-01

    Apolipoprotein E allele 4 (apo epsilon4) and smoking each have been associated with an unfavorable lipid profile. We used data collected on 1,472 subjects in the National Heart, Lung, and Blood Institute Family Heart Study to assess whether smoking interacts with apo epsilon4 to influence the levels of plasma lipids. We dichotomized smoking and apo epsilon4 and used analysis of covariance to estimate the means of lipids. Smokers had lower body mass index, were younger, and consumed less fruits and vegetables. Among individuals without apo epsilon4, comparing nonsmokers with smokers, mean low density lipoprotein cholesterol (LDL) was 129.3 and 134.4 mg/dL, respectively, for women and 126.1 and 127.6 mg/dL, respectively, for men. Among subjects with an apo epsilon4 allele, corresponding means were 132.0, and 152.9 mg/dL, respectively, for women and 131.3 and 137.3 mg/dL, respectively, for men (Pfor interaction <0.001 for women and 0.11 for men). A similar interaction was observed for total cholesterol among women (P = 0.02). This study shows a statistically significant effect modification of the relation of apo epsilon4 to LDL and total cholesterol by smoking among women. Smoking may enhance genetic susceptibility to an unfavorable lipid profile among subjects with apo epsilon4. PMID:10984105

  5. Clinical pharmacy services in heart failure: an opinion paper from the Heart Failure Society of America and American College of Clinical Pharmacy Cardiology Practice and Research Network.

    PubMed

    Milfred-LaForest, Sherry K; Chow, Sheryl L; DiDomenico, Robert J; Dracup, Kathleen; Ensor, Christopher R; Gattis-Stough, Wendy; Heywood, J Thomas; Lindenfeld, JoAnn; Page, Robert L; Patterson, J Herbert; Vardeny, Orly; Massie, Barry M

    2013-05-01

    Heart failure (HF) care takes place in multiple settings, with a variety of providers, and generally involves patients who have multiple comorbidities. This situation is a "perfect storm" of factors that predispose patients to medication errors. The goals of this paper are to outline potential roles for clinical pharmacists in a multidisciplinary HF team, to document outcomes associated with interventions by clinical pharmacists, to recommend minimum training for clinical pharmacists engaged in HF care, and to suggest financial strategies to support clinical pharmacy services within a multidisciplinary team. As patients transition from inpatient to outpatient settings and between multiple caregivers, pharmacists can positively affect medication reconciliation and education, assure consistency in management that results in improvements in patient satisfaction and medication adherence, and reduce medication errors. For mechanical circulatory support and heart transplant teams, the Centers for Medicare and Medicaid Services considers the participation of a transplant pharmacology expert (e.g., clinical pharmacist) to be a requirement for accreditation, given the highly specialized and complex drug regimens used. Although reports of outcomes from pharmacist interventions have been mixed owing to differences in study design, benefits such as increased use of evidence-based therapies, decreases in HF hospitalizations and emergency department visits, and decreases in all-cause readmissions have been demonstrated. Clinical pharmacists participating in HF or heart transplant teams should have completed specialized postdoctoral training in the form of residencies and/or fellowships in cardiovascular and/or transplant pharmacotherapy, and board certification is recommended. Financial mechanisms to support pharmacist participation in the HF teams are variable. Positive outcomes associated with clinical pharmacist activities support the value of making this resource available

  6. Associations between Central Nervous System Serotonin, Fasting Glucose and Hostility in African American Females

    PubMed Central

    Boyle, Stephen H.; Georgiades, Anastasia; Brummett, Beverly H.; Barefoot, John C.; Siegler, Ilene C.; Matson, Wayne R.; Kuhn, Cynthia M.; Grichnik, Katherine; Stafford-Smith, Mark; Williams, Redford B.; Kaddurah-Daouk, Rima; Surwit, Richard S.

    2015-01-01

    Background Previous research has shown an association between hostility and fasting glucose in African American women. Central nervous system serotonin activity is implicated both in metabolic processes and in hostility related traits. Purpose To determine whether central nervous system serotonin influences the association between hostility and fasting glucose in African American women. Methods The study consisted of 119 healthy volunteers (36 African American women, 27 white women, 21 white males, and 35 African American males, mean age 34±8.5 years). Serotonin metabolites were measured in cerebrospinal fluid. Hostility was measured by the Cook-Medley Hostility Scale. Results Hostility was associated with fasting glucose and central nervous system serotonin metabolites in African American women only. Controlling for the serotonin metabolites significantly reduced the association of hostility to glucose. Conclusions The positive correlation between hostility and fasting glucose in African American women can partly be explained by central nervous system serotonin function. PMID:24806470

  7. Guidelines in electrodiagnostic medicine. American Association of Electrodiagnostic Medicine.

    PubMed

    1992-02-01

    The American Association of Electrodiagnostic Medicine (AAEM) is committed to the development of sound and clinically relevant guidelines through review of literature, expert opinion and consensus. In 1979, with the assistance of its Professional Practice Committee and association leaders, the association published its initial guidelines, Guidelines in Electrodiagnostic Medicine, covering the practice of electrodiagnostic medicine. The committee is charged with ongoing revision of the document, as needed, and the current version includes standards of practice in clinical electromyography, risks in electrodiagnostic medicine, basic equipment requirements, and the role of paramedical support. In 1988, Educational Guidelines for Electrodiagnostic Training Programs (Appendix A) was prepared by the AAEM Training Program Committee and added to aid training program directors in establishing new training programs or in reviewing the current status of the educational aspects of existing programs. In 1986, the AAEM charged its Quality Assurance Committee with the responsibility for the development of guidelines pertinent to electrodiagnostic medical consultations. The impetus for the charge was the requests received from members of the AAEM and other interested parties for educational material on indications for and conduct of electrodiagnostic medical consultations. As a result of the committee's efforts, Suggested Guidelines for Electrodiagnostic Medical Consultations (Appendix D), was published in 1989 and additional sections added subsequently. The current document includes (1) general indications for an electrodiagnostic medical consultation for patients with suspected myopathies, neuromuscular junction disorders, polyneuropathies, mononeuropathies, plexopathies, radiculopathies, neuronopathies and central nervous system disorders, (2) specific indications for patients with suspected lumbosacral or cervical radiculopathies, (3) general principles of electrodiagnostic

  8. Congenital heart disease protein 5 associates with CASZ1 to maintain myocardial tissue integrity.

    PubMed

    Sojka, Stephen; Amin, Nirav M; Gibbs, Devin; Christine, Kathleen S; Charpentier, Marta S; Conlon, Frank L

    2014-08-01

    The identification and characterization of the cellular and molecular pathways involved in the differentiation and morphogenesis of specific cell types of the developing heart are crucial to understanding the process of cardiac development and the pathology associated with human congenital heart disease. Here, we show that the cardiac transcription factor CASTOR (CASZ1) directly interacts with congenital heart disease 5 protein (CHD5), which is also known as tryptophan-rich basic protein (WRB), a gene located on chromosome 21 in the proposed region responsible for congenital heart disease in individuals with Down's syndrome. We demonstrate that loss of CHD5 in Xenopus leads to compromised myocardial integrity, improper deposition of basement membrane, and a resultant failure of hearts to undergo cell movements associated with cardiac formation. We further report that CHD5 is essential for CASZ1 function and that the CHD5-CASZ1 interaction is necessary for cardiac morphogenesis. Collectively, these results establish a role for CHD5 and CASZ1 in the early stages of vertebrate cardiac development.

  9. Are urinary polyaromatic hydrocarbons associated with adult hypertension, heart attack, and cancer? USA NHANES, 2011-2012.

    PubMed

    Shiue, Ivy

    2015-11-01

    Links between environmental chemicals and human health have emerged over the last few decades, but the effects from polyaromatic hydrocarbons were less studied, compared to other commonly known environmental chemicals such as heavy metals, phthalates, arsenic, phenols and pesticides. Therefore, it was aimed to study the relationships of urinary polyaromatic hydrocarbons and adult cardiovascular disease and cancer using human sample in a national and population-based study in recent years. Data was retrieved from US National Health and Nutrition Examination Surveys, 2011-2012, including demographics, self-reported health conditions and urinary polyaromatic hydrocarbons. Statistical analyses included chi-square test, t test, survey-weighted logistic regression modeling and population attributable risk (PAR) estimation. Of 5560 American adults aged 20-80 and included in the statistical analysis, urinary polyaromatic hydrocarbons (representatively in one-third sample) were observed to be higher in people with cardiovascular disease and total cancer. In particular, urinary 4-hydroxyphenanthrene was associated with hypertension (odds ratio (OR) 1.33, 95% confidence interval (CI) 1.00-1.76, P = 0.048, PAR 5.1%), urinary 1-hydroxypyrene was significantly associated with heart attack (OR 1.47, 95%CI 1.05-2.06, P = 0.027, PAR 1.7%), and urinary 2-hydroxynapthalene (2-naphthol) was associated with cancer (OR 1.46, 95%CI 1.12-1.90, P = 0.008, PAR 3.9%). Urinary polyaromatic hydrocarbons were associated with adult hypertension, heart attack and cancer, although the causality cannot be established. From the research perspective, future studies with a longitudinal or experimental approach would be suggested. From the law and public health perspectives, regulation on minimizing exposure to polyaromatic hydrocarbons might need to be considered in future health and environmental policies and intervention programs.

  10. Whole-exome imputation of sequence variants identified two novel alleles associated with adult body height in African Americans.

    PubMed

    Du, Mengmeng; Auer, Paul L; Jiao, Shuo; Haessler, Jeffrey; Altshuler, David; Boerwinkle, Eric; Carlson, Christopher S; Carty, Cara L; Chen, Yii-Der Ida; Curtis, Keith; Franceschini, Nora; Hsu, Li; Jackson, Rebecca; Lange, Leslie A; Lettre, Guillaume; Monda, Keri L; Nickerson, Deborah A; Reiner, Alex P; Rich, Stephen S; Rosse, Stephanie A; Rotter, Jerome I; Willer, Cristen J; Wilson, James G; North, Kari; Kooperberg, Charles; Heard-Costa, Nancy; Peters, Ulrike

    2014-12-15

    Adult body height is a quantitative trait for which genome-wide association studies (GWAS) have identified numerous loci, primarily in European populations. These loci, comprising common variants, explain <10% of the phenotypic variance in height. We searched for novel associations between height and common (minor allele frequency, MAF ≥5%) or infrequent (0.5% < MAF < 5%) variants across the exome in African Americans. Using a reference panel of 1692 African Americans and 471 Europeans from the National Heart, Lung, and Blood Institute's (NHLBI) Exome Sequencing Project (ESP), we imputed whole-exome sequence data into 13 719 African Americans with existing array-based GWAS data (discovery). Variants achieving a height-association threshold of P < 5E-06 in the imputed dataset were followed up in an independent sample of 1989 African Americans with whole-exome sequence data (replication). We used P < 2.5E-07 (=0.05/196 779 variants) to define statistically significant associations in meta-analyses combining the discovery and replication sets (N = 15 708). We discovered and replicated three independent loci for association: 5p13.3/C5orf22/rs17410035 (MAF = 0.10, β = 0.64 cm, P = 8.3E-08), 13q14.2/SPRYD7/rs114089985 (MAF = 0.03, β = 1.46 cm, P = 4.8E-10) and 17q23.3/GH2/rs2006123 (MAF = 0.30; β = 0.47 cm; P = 4.7E-09). Conditional analyses suggested 5p13.3 (C5orf22/rs17410035) and 13q14.2 (SPRYD7/rs114089985) may harbor novel height alleles independent of previous GWAS-identified variants (r(2) with GWAS loci <0.01); whereas 17q23.3/GH2/rs2006123 was correlated with GWAS-identified variants in European and African populations. Notably, 13q14.2/rs114089985 is infrequent in African Americans (MAF = 3%), extremely rare in European Americans (MAF = 0.03%), and monomorphic in Asian populations, suggesting it may be an African-American-specific height allele. Our findings demonstrate that whole-exome imputation of sequence variants can identify low-frequency variants

  11. The American Association for Physical Activity and Recreation: Tracing Our Roots to 1939

    ERIC Educational Resources Information Center

    Snyder, S. A.

    2009-01-01

    In January 2005, AAPAR was born from the American Association for Active Lifestyles and Fitness (AAALF) and the American Association for Leisure and Recreation (AALR), thus providing a home for special-interest subjects that do not fit neatly into the other units of the Alliance. This article includes a brief history of AAPAR with a focus on its…

  12. American Association of Women in Community and Junior Colleges Quarterly; Vol. XVI, Nos. 1-4.

    ERIC Educational Resources Information Center

    AAWCJC Quarterly, 1992

    1992-01-01

    The American Association of Women in Community and Junior Colleges (AAWCJC), an affiliated council of the American Association of Community and Junior Colleges (AACJC), produces the "Quarterly" to disseminate information pertinent to the AAWCJC membership and to provide a forum for the discussion of current issues and events. Each issue of the…

  13. 76 FR 22709 - Medicare and Medicaid Programs; Approval of the American Association for Accreditation of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ... to Comments On November 29, 2010, we published a proposed notice in the Federal Register (75 FR 73088... American Association for Accreditation of Ambulatory Surgery Facilities, Inc. for Deeming Authority for... decision to approve the American Association for Accreditation of Ambulatory Surgery Facilities...

  14. Association Between Toxoplasma gondii Exposure and Heart Disease: A Case-Control Study

    PubMed Central

    Alvarado-Esquivel, Cosme; Salcedo-Jaquez, Misael; Sanchez-Anguiano, Luis Francisco; Hernandez-Tinoco, Jesus; Rabago-Sanchez, Elizabeth; Beristain-Garcia, Isabel; Liesenfeld, Oliver; Estrada-Martinez, Sergio; Perez-Alamos, Alma Rosa; Alvarado-Soto, Ediyair

    2016-01-01

    Background The parasite Toxoplasma gondii causes infections all around the world. Infections with T. gondii are systemic and the parasite can persist in the heart muscle. Very little is known about the impact of T. gondii on patients with heart disease. We determined the association between T. gondii exposure and patients suffering from heart diseases attending in a public hospital in Durango, Mexico; the association of T. gondii exposure with socio-demographic, behavioral, and clinical characteristics of these patients was also investigated. Methods Through a case-control study, we examined the seroprevalence of anti-T. gondii IgG and IgM antibodies in 400 patients with heart diseases and 400 age- and gender-matched controls using enzyme-linked immunoassays. In addition, we analyzed the association of patient characteristics as determined by a standardized questionnaire with T. gondii exposure by bivariate and multivariate analyses. Results Fifty-five (13.8%) of 400 patients and 32 (8.0%) of 400 controls had anti-T. gondii IgG antibodies (odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.15 - 2.90; P = 0.01). High anti-T. gondii IgG levels (> 150 IU/mL) were found in 28 (50.9%) of the 55 positive cases and in 14 (43.8%) of the 32 positive controls (P = 0.51). Anti-T. gondii IgM antibodies were found in 13 (23.6%) of the 55 anti-T. gondii IgG positive patients and in 19 (59.4%) of 32 anti-T. gondii IgG positive controls (OR = 0.21; 95% CI: 0.08 - 0.54; P = 0.0008). Multivariate analysis showed that T. gondii exposure was positively associated with being born out of Durango State (OR = 2.93; 95% CI: 1.40 - 6.13; P = 0.004), and with consumption of alcohol (OR = 2.04; 95% CI: 1.01 - 4.12; P = 0.04). Conclusions Results obtained in this study indicate that T. gondii infection is associated with heart disease, and suggest that heart disease might be related with a chronic infection. This is the first report of an association of T. gondii exposure with alcohol

  15. Encephalitis-associated hospitalizations among American Indians and Alaska Natives.

    PubMed

    Mehal, Jason M; Holman, Robert C; Vora, Neil M; Blanton, Jesse; Gordon, Paul H; Cheek, James E

    2014-04-01

    Encephalitis produces considerable morbidity in the United States, but morbidity rates among American Indian/Alaska Native (AI/AN) people have not been described. Hospitalization records listing an encephalitis diagnosis were analyzed by using Indian Health Service direct/contract inpatient data. For 1998-2010, there were 436 encephalitis-associated hospitalizations among AI/AN people, an average annual age-adjusted hospitalization rate of 3.1/100,000 population. The rate for infants (11.9) was more than double that for any other age group. Death occurred for 4.1% of hospitalizations. Consistent with reports for the general U.S. population, the rate was high among infants and most (53.9%) hospitalizations were of unexplained etiology. The average annual rate during the study period appeared lower than for the general U.S. population, due particularly to lower rates in the elderly. Future community-based surveillance and mortality studies are needed to confirm these findings and examine reasons underlying the low rates of encephalitis in AI/AN people. PMID:24515941

  16. Encephalitis-Associated Hospitalizations among American Indians and Alaska Natives

    PubMed Central

    Mehal, Jason M.; Holman, Robert C.; Vora, Neil M.; Blanton, Jesse; Gordon, Paul H.; Cheek, James E.

    2014-01-01

    Encephalitis produces considerable morbidity in the United States, but morbidity rates among American Indian/Alaska Native (AI/AN) people have not been described. Hospitalization records listing an encephalitis diagnosis were analyzed by using Indian Health Service direct/contract inpatient data. For 1998–2010, there were 436 encephalitis-associated hospitalizations among AI/AN people, an average annual age-adjusted hospitalization rate of 3.1/100,000 population. The rate for infants (11.9) was more than double that for any other age group. Death occurred for 4.1% of hospitalizations. Consistent with reports for the general U.S. population, the rate was high among infants and most (53.9%) hospitalizations were of unexplained etiology. The average annual rate during the study period appeared lower than for the general U.S. population, due particularly to lower rates in the elderly. Future community-based surveillance and mortality studies are needed to confirm these findings and examine reasons underlying the low rates of encephalitis in AI/AN people. PMID:24515941

  17. Indian Heart/White Man's Head: Native-American Teachers in Indian Schools, 1880-1930

    ERIC Educational Resources Information Center

    Gere, Anne Ruggles

    2005-01-01

    The figure of the Native-American teacher remains largely absent in histories of the teaching profession in this country and of the government-operated Indian schools that emerged and flourished at the turn of the last century. At a time when a growing literature is enlarging the understanding of what schooling has meant and means to minority…

  18. Political Economy of American Education: Democratic Citizenship in the Heart of Empire

    ERIC Educational Resources Information Center

    Falk, Thomas Michael

    2012-01-01

    Chief among the goals of American education is the cultivation of democratic citizens. Contrary to State catechism delivered through our schools, America was not born a democracy; rather it emerged as a republic with a distinct bias against democracy. Nonetheless we inherit a great demotic heritage. Abolition, the labor struggle, women's…

  19. A Preliminary Study of Potential Dietary Risk Factors for Coronary Heart Disease among Chinese American Adolescents.

    ERIC Educational Resources Information Center

    Sun, Wei Yue; Chen, W. William

    1994-01-01

    This study compared dietary knowledge, attitudes, behaviors, and patterns between Chinese American middle school students and their Chinese equivalents. Chinese students had less knowledge and less favorable attitudes but more positive behavioral factors affecting diet. They consumed less meat, dairy products, fat, sweets, and snacks and ate more…

  20. "My Heart Beats in Two Places": Immigration Stories in Korean-American Picture Books

    ERIC Educational Resources Information Center

    Yi, Joanne H.

    2014-01-01

    This article examines the impact of immigration on Korean children through a content and literary analysis of 14 children's picture books. A majority of published children's literature dealing with the subject of Korean Americans or Korean immigration contains culturally specific themes common to the Korean immigration experience. These…

  1. 76 FR 66929 - Medicare and Medicaid Programs; The American Association for Accreditation of Ambulatory Surgery...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... Association for Accreditation of Ambulatory Surgery Facilities for Approval of Deeming Authority for Rural... American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) for recognition as a... of Ambulatory Surgery Facilities (AAAASF's) request for deeming authority for RHCs. This notice...

  2. 77 FR 70446 - Medicare and Medicaid Programs; Approval of the American Association for Accreditation of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... a proposed notice in the Federal Register (77 FR 37678) announcing AAAASF's request for continued... American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) for Continuing CMS... Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) for continued recognition as...

  3. American Medical Association concepts of nutrition and health. Council on Scientific Affairs.

    PubMed

    1979-11-23

    Although human need for various nutrients is well-established, the exact requirements for the different nutrients are not well-known. Nutrient requirements are affected by genetics; environment; nature of the diet; and hemeostatic demands under changing physiological conditions expressed as growth, reproduction and response to the stress of injury or disease. Pregnant and lactating women should be properly nourished if well-nourished infants are desired. Nutrient and energy needs are considerably increased during pregnancy and lactation. The most rapid growth of infants occurs during the 1st 4 to 6 months of life. Because of the many advantages of breast milk over artificial milk, full-term newborn infants should be breastfed, unless there are specific contraindications or breastfeeding is unsuccessful. The American Medical Association (AMA) urges that better efforts be made to educate the public and the medical profession as to the advantages of breastfeeding. The 4th to the 6th months of life constitute the transitional period in infant feeding. The baby should be introduced to single-ingredient foods in small quantities, one at a time, to isolate food sensitivities. Good eating habits can be formed early in life through the proper and gradual introduction of varied and nutritional meal patterns. Energy balance is a nutritional problem in late childhood and once maturity is achieved, while calorically and nutritionally inadequate diets are a growing concern for the elderly. Immoderate eating habits (e.g., overeating) may aggravate or contribute to the development of degenerative diseases and should be discouraged. The AMA recommends that the American public focus on the achievement and maintenance of the most desirable body weight through a proper combination of dietary control and exercise. Specific dietary modifications (sodium restriction, weight control) are necessary in the management of hypertension, diabetes, coronary heart diseases and other medical

  4. Severity of systemic sclerosis-associated pulmonary arterial hypertension in African Americans.

    PubMed

    Blanco, Isabel; Mathai, Stephen; Shafiq, Majid; Boyce, Danielle; Kolb, Todd M; Chami, Hala; Hummers, Laura K; Housten, Traci; Chaisson, Neal; Zaiman, Ari L; Wigley, Fredrick M; Tedford, Ryan J; Kass, David A; Damico, Rachel; Girgis, Reda E; Hassoun, Paul M

    2014-07-01

    African Americans (AA) with systemic sclerosis (SSc) have a worse prognosis compared to Americans of European descent (EA). We conducted the current study to test the hypothesis that AA patients with SSc have more severe disease and poorer outcomes compared to EA patients when afflicted with pulmonary arterial hypertension (PAH). We studied 160 consecutive SSc patients with PAH diagnosed by right heart catheterization, comparing demographics, hemodynamics, and outcomes between AA and EA patients. The cohort included 29 AA and 131 EA patients with similar baseline characteristics except for increased prevalence of diffuse SSc in AA. AA patients had worse functional class (FC) (80% FC III-IV vs 53%; p = 0.02), higher brain natriuretic peptide (NT-pro-BNP) (5729 ± 9730 pg/mL vs 1892 ± 2417 pg/mL; p = 0.02), more depressed right ventricular function, a trend toward lower 6-minute walk distance (263 ± 111  m vs 333 ± 110  m; p = 0.07), and worse hemodynamics (cardiac index 1.95 ± 0.58 L/min/m vs 2.62 ± 0.80 L/min/m; pulmonary vascular resistance 10.3 ± 6.2 WU vs 7.6 ± 5.0 WU; p  < 0.05) compared with EA patients. Kaplan-Meier survival estimates for AA and EA patients, respectively, were 62% vs 73% at 2 years and 26% vs 44% at 5 years (p  > 0.05). In conclusion, AA patients with SSc-PAH are more likely to have diffuse SSc and to present with significantly more severe PAH compared with EA patients. AA patients also appear to have poorer survival, though larger studies are needed to investigate this association definitively.

  5. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.

    PubMed

    Barry, M J; Fowler, F J; O'Leary, M P; Bruskewitz, R C; Holtgrewe, H L; Mebust, W K; Cockett, A T

    1992-11-01

    A symptom index for benign prostatic hyperplasia (BPH) was developed and validated by a multidisciplinary measurement committee of the American Urological Association (AUA). Validation studies were conducted involving a total of 210 BPH patients and 108 control subjects. The final AUA symptom index includes 7 questions covering frequency, nocturia, weak urinary stream, hesitancy, intermittence, incomplete emptying and urgency. On revalidation, the index was internally consistent (Cronbach's alpha = 0.86) and the score generated had excellent test-retest reliability (r = 0.92). Scores were highly correlated with subjects' global ratings of the magnitude of their urinary problem (r = 0.65 to 0.72) and powerfully discriminated between BPH and control subjects (receiver operating characteristic area 0.85). Finally, the index was sensitive to change, with preoperative scores decreasing from a mean of 17.6 to 7.1 by 4 weeks after prostatectomy (p < 0.001). The AUA symptom index is clinically sensible, reliable, valid and responsive. It is practical for use in practice and for inclusion in research protocols.

  6. The mediating role of maternal warmth in the associations between harsh parental practices and externalizing and internalizing behaviors in Hispanic American, African American, and European American families.

    PubMed

    Yildirim, Elif Dede; Roopnarine, Jaipaul L

    2015-07-01

    Using data from the add-on 5-year cohort of In-Home Longitudinal Study of preschool aged Children of the Fragile Families and Child Well-Being Study (FFCWS), we examined the mediating role of maternal warmth in the associations between positive and harsh maternal practices and children's externalizing and internalizing behaviors. The sample consisted of 1,922 low-income Hispanic American, African American, and European American families. For European Americans, the links between maternal psychological aggression and hostility and children's externalizing behaviors were direct. Similarly, for Hispanic Americans, the links between maternal psychological aggression, physical assault, and hostility and externalizing behaviors were direct, as was the link between maternal physical assault and internalizing behaviors. For African Americans, maternal warmth partially mediated the links between maternal hostility and physical assault and externalizing behaviors. However, the associations between psychological aggression and externalizing and internalizing behaviors were direct. The data are discussed with respect to similarities in cultural pathways of influence between harsh maternal treatment and children's behavioral difficulties across ethnic groups. PMID:25364834

  7. The mediating role of maternal warmth in the associations between harsh parental practices and externalizing and internalizing behaviors in Hispanic American, African American, and European American families.

    PubMed

    Yildirim, Elif Dede; Roopnarine, Jaipaul L

    2015-07-01

    Using data from the add-on 5-year cohort of In-Home Longitudinal Study of preschool aged Children of the Fragile Families and Child Well-Being Study (FFCWS), we examined the mediating role of maternal warmth in the associations between positive and harsh maternal practices and children's externalizing and internalizing behaviors. The sample consisted of 1,922 low-income Hispanic American, African American, and European American families. For European Americans, the links between maternal psychological aggression and hostility and children's externalizing behaviors were direct. Similarly, for Hispanic Americans, the links between maternal psychological aggression, physical assault, and hostility and externalizing behaviors were direct, as was the link between maternal physical assault and internalizing behaviors. For African Americans, maternal warmth partially mediated the links between maternal hostility and physical assault and externalizing behaviors. However, the associations between psychological aggression and externalizing and internalizing behaviors were direct. The data are discussed with respect to similarities in cultural pathways of influence between harsh maternal treatment and children's behavioral difficulties across ethnic groups.

  8. The Association between Neuroticism and Heart Rate Variability Is Not Fully Explained by Cardiovascular Disease and Depression

    PubMed Central

    Čukić, Iva; Bates, Timothy C.

    2015-01-01

    Neuroticism is associated with cardiovascular disease, autonomic reactivity, and depression. Here we address the extent to which neuroticism accounts for the excess heart disease risk associated with depression and test whether cardiac autonomic tone plays a role as mediator. Subjects were derived from a nationally representative sample (n = 1,255: mean age 54.5, SD = 11.5). Higher neuroticism was associated with reduced heart rate variability equally under rest and stress. The baseline structural equation model revealed significant paths from neuroticism to heart rate variability, cardiovascular disease and depression, and between depression and cardiovascular disease, controlling for age, sex, height, weight, and BMI. Dropping both the neuroticism to heart rate variability, and neuroticism to heart disease paths significantly reduced the model fit (p < .001 in each case). We conclude that neuroticism has independent associations with both autonomic reactivity and cardiovascular disease, over and above its associations with depression and other related variables. PMID:25951236

  9. Heart Failure

    MedlinePlus

    ... of breath Common causes of heart failure are coronary artery disease, high blood pressure and diabetes. It is more common in people who are 65 years old or older, African Americans, people who are ... treatments fail. NIH: National Heart, Lung, and Blood Institute

  10. Congenital complete heart block in the newborn associated with maternal systemic lupus erythematosus and other connective tissue disorders.

    PubMed Central

    Hardy, J D; Solomon, S; Banwell, G S; Beach, R; Wright, V; Howard, F M

    1979-01-01

    Four babies with complete heart block associated with maternal systemic lupus erythematosus (SLE) are described, together with a 5th baby whose mother had serological abnormalities only. One baby had a rapidly fatal outcome, one has required digoxin for heart failure, and the remaining 3 are asymptomatic but remain in complete heart block. Additional manifestations were present in 2 of them. The spectrum of neonatal abnormalities that may occur in association with maternal SLE and related connective tissue disorders is discussed, together with the possible causes and the prognosis. We conclude that congenital heart block is more common than had previously been appreciated. Images Figure PMID:420526

  11. A Heart and A Mind: Self-distancing Facilitates the Association Between Heart Rate Variability, and Wise Reasoning

    PubMed Central

    Grossmann, Igor; Sahdra, Baljinder K.; Ciarrochi, Joseph

    2016-01-01

    Cardiac vagal tone (indexed via resting heart rate variability [HRV]) has been previously associated with superior executive functioning. Is HRV related to wiser reasoning and less biased judgments? Here we hypothesize that this will be the case when adopting a self-distanced (as opposed to a self-immersed) perspective, with self-distancing enabling individuals with higher HRV to overcome bias-promoting egocentric impulses and to reason wisely. However, higher HRV may not be associated with greater wisdom when adopting a self-immersed perspective. Participants were randomly assigned to reflect on societal issues from a self-distanced- or self-immersed perspective, with responses coded for reasoning quality. In a separate task, participants read about and evaluated a person performing morally ambiguous actions, with responses coded for dispositional vs. situational attributions. We simultaneously assessed resting cardiac recordings, obtaining six HRV indicators. As hypothesized, in the self-distanced condition, each HRV indicator was positively related to prevalence of wisdom-related reasoning (e.g., prevalence of recognition of limits of one’s knowledge, recognition that the world is in flux/change, consideration of others’ opinions and search for an integration of these opinions) and to balanced vs. biased attributions (recognition of situational and dispositional factors vs. focus on dispositional factors alone). In contrast, there was no relationship between these variables in the self-immersed condition. We discuss implications for research on psychophysiology, cognition, and wisdom. PMID:27092066

  12. A Heart and A Mind: Self-distancing Facilitates the Association Between Heart Rate Variability, and Wise Reasoning.

    PubMed

    Grossmann, Igor; Sahdra, Baljinder K; Ciarrochi, Joseph

    2016-01-01

    Cardiac vagal tone (indexed via resting heart rate variability [HRV]) has been previously associated with superior executive functioning. Is HRV related to wiser reasoning and less biased judgments? Here we hypothesize that this will be the case when adopting a self-distanced (as opposed to a self-immersed) perspective, with self-distancing enabling individuals with higher HRV to overcome bias-promoting egocentric impulses and to reason wisely. However, higher HRV may not be associated with greater wisdom when adopting a self-immersed perspective. Participants were randomly assigned to reflect on societal issues from a self-distanced- or self-immersed perspective, with responses coded for reasoning quality. In a separate task, participants read about and evaluated a person performing morally ambiguous actions, with responses coded for dispositional vs. situational attributions. We simultaneously assessed resting cardiac recordings, obtaining six HRV indicators. As hypothesized, in the self-distanced condition, each HRV indicator was positively related to prevalence of wisdom-related reasoning (e.g., prevalence of recognition of limits of one's knowledge, recognition that the world is in flux/change, consideration of others' opinions and search for an integration of these opinions) and to balanced vs. biased attributions (recognition of situational and dispositional factors vs. focus on dispositional factors alone). In contrast, there was no relationship between these variables in the self-immersed condition. We discuss implications for research on psychophysiology, cognition, and wisdom. PMID:27092066

  13. Intracardiac Origin of Heart Rate Variability, Pacemaker Funny Current and their Possible Association with Critical Illness

    PubMed Central

    Papaioannou, Vasilios E; Verkerk, Arie O; Amin, Ahmed S; de Bakker, Jaques MT

    2013-01-01

    Heart rate variability (HRV) is an indirect estimator of autonomic modulation of heart rate and is considered a risk marker in critical illness, particularly in heart failure and severe sepsis. A reduced HRV has been found in critically ill patients and has been associated with neuro-autonomic uncoupling or decreased baroreflex sensitivity. However, results from human and animal experimental studies indicate that intracardiac mechanisms might also be responsible for interbeat fluctuations. These studies have demonstrated that different membrane channel proteins and especially the so-called ‘funny’ current (If), an hyperpolarization-activated, inward current that drives diastolic depolarization resulting in spontaneous activity in cardiac pacemaker cells, are altered during critical illness. Furthermore, membrane channels kinetics seem to have significant impact upon HRV, whose early decrease might reflect a cellular metabolic stress. In this review article we present research findings regarding intracardiac origin of HRV, at the cellular level and in both isolated sinoatrial node and whole ex vivo heart preparations. In addition, we will review results from various experimental studies that support the interrelation between If and HRV during endotoxemia. We suggest that reduced HRV during sepsis could also be associated with altered pacemaker cell membrane properties, due to ionic current remodeling. PMID:22920474

  14. Native American Perceptions of the National Association for Native American Children of Alcoholics: In Their Own Words.

    ERIC Educational Resources Information Center

    Johnson, Jeannette L.; Plemons, Bradford W.; Starr, Edward; Reyes, Raymond; Fleming, Candace; Latimer, Anna; Trimble, Joseph E.

    The National Association for Native American Children of Alcoholics (NANACOA) initiated a strategy in 1995 to evaluate their programs and prevention efforts. The design and methodology of the project incorporated a "naturalistic" approach to help preserve cultural integrity and respect multiple perspectives. Data were gathered from archival…

  15. The association of atopy with incidence of ischemic heart disease, stroke, and diabetes.

    PubMed

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Thuesen, Betina Heinsbæk; Jeppesen, Jørgen; Linneberg, Allan

    2015-03-01

    Allergy is a systemic inflammatory disease that could theoretically affect the risk of cardiovascular disease (CVD) and diabetes through inflammatory pathways or mast cell-induced coronary spasm. Whether allergy is associated with an increased risk of CVD and diabetes is largely unknown. We investigated the association between atopy as assessed by IgE sensitization, a well-accepted biomarker of allergy, and incidence of ischemic heart disease, stroke, and diabetes in five Danish population-based cohorts. A total of 14,849 participants were included in the study. Atopy was defined as serum-specific IgE positivity to inhalant allergens. The Danish National Diabetes Register enabled identification of incident diabetes. Likewise, the Danish Registry of Causes of Death and the Danish National Patient Register provided information on fatal and non-fatal ischemic heart disease and stroke. Data were analyzed by Cox regression analyses with age as underlying time axis and adjusted for study cohort, gender, education, body mass index, alcohol intake, smoking habits, physical activity during leisure time, serum lipids, and blood pressure. The prevalence of atopy was 26.9 % (n = 3,994). There were 1,170, 817, and 1,063 incident cases of ischemic heart disease, stroke, and diabetes, respectively (median follow-up 11.2 years). The hazard ratios, HRs (95 % confidence intervals, CIs) for atopics versus non-atopics: for ischemic heart disease (HR 1.00, 95 % CI 0.86, 1.16), stroke (HR 1.18, 95 % CI 0.99, 1.41), and diabetes (HR 1.06, 95 % CI 0.91, 1.23). Our results did not support the hypothesis that atopy is associated with higher risk of ischemic heart disease, stroke, or diabetes. However, a small-moderately increased risk cannot be excluded from our data.

  16. Yogurt consumption is associated with better diet quality and metabolic profile in American men and women.

    PubMed

    Wang, Huifen; Livingston, Kara A; Fox, Caroline S; Meigs, James B; Jacques, Paul F

    2013-01-01

    The evidence-based Dietary Guidelines for Americans recommends increasing the intake of fat-free or low-fat milk and milk products. However, yogurt, a nutrient-dense milk product, has been understudied. This cross-sectional study examined whether yogurt consumption was associated with better diet quality and metabolic profile among adults (n = 6526) participating in the Framingham Heart Study Offspring (1998-2001) and Third Generation (2002-2005) cohorts. A validated food frequency questionnaire was used to assess dietary intake, and the Dietary Guidelines Adherence Index (DGAI) was used to measure overall diet quality. Standardized clinical examinations and laboratory tests were conducted. Generalized estimating equations examined the associations of yogurt consumption with diet quality and levels of metabolic factors. Approximately 64% of women (vs 41% of men) were yogurt consumers (ie, consumed >0 servings/week). Yogurt consumers had a higher DGAI score (ie, better diet quality) than nonconsumers. Adjusted for demographic and lifestyle factors and DGAI, yogurt consumers, compared with nonconsumers, had higher potassium intakes (difference, 0.12 g/d) and were 47%, 55%, 48%, 38%, and 34% less likely to have inadequate intakes (based on Dietary Reference Intake) of vitamins B2 and B12, calcium, magnesium, and zinc, respectively (all P ≤ .001). In addition, yogurt consumption was associated with lower levels of circulating triglycerides, glucose, and lower systolic blood pressure and insulin resistance (all P < .05). Yogurt is a good source of several micronutrients and may help to improve diet quality and maintain metabolic well-being as part of a healthy, energy-balanced dietary pattern.

  17. Associations between heart rate variability, metabolic syndrome risk factors, and insulin resistance.

    PubMed

    Stuckey, Melanie I; Kiviniemi, Antti; Gill, Dawn P; Shoemaker, J Kevin; Petrella, Robert J

    2015-07-01

    The purpose of this study was to examine differences in heart rate variability (HRV) in metabolic syndrome (MetS) and to determine associations between HRV parameters, MetS risk factors, and insulin resistance (homeostasis model assessment for insulin resistance (HOMA-IR)). Participants (n = 220; aged 23-70 years) were assessed for MetS risk factors (waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol) and 5-min supine HRV (time and frequency domain and nonlinear). HRV was compared between those with 3 or more (MetS+) and those with 2 or fewer MetS risk factors (MetS-). Multiple linear regression models were built for each HRV parameter to investigate associations with MetS risk factors and HOMA-IR. Data with normal distribution are presented as means ± SD and those without as median [interquartile range]. In women, standard deviation of R-R intervals 38.0 [27.0] ms, 44.5 [29.3] ms; p = 0.020), low-frequency power (5.73 ± 1.06 ln ms(2), 6.13 ± 1.05 ln ms(2); p = 0.022), and the standard deviation of the length of the Poincaré plot (46.8 [31.6] ms, 58.4 [29.9] ms; p = 0.014) were lower and heart rate was higher (68 [13] beats/min, 64 [12] beats/min; p = 0. 018) in MetS+ compared with MetS-, with no differences in men. Waist circumference was most commonly associated with HRV, especially frequency domain parameters. HOMA-IR was associated with heart rate. In conclusion, MetS+ women had a less favourable HRV profile than MetS- women, but there were no differences in men. HOMA-IR was associated with heart rate, not HRV.

  18. Proceedings from the American Association of Clinical Endocrinologists and American College of Endocrinology consensus conference on glucose monitoring.

    PubMed

    Grunberger, George; Bailey, Timothy; Camacho, Pauline M; Einhorn, Daniel; Garber, Alan J; Handelsman, Yehuda; Harrell, R Mack; Lando, Howard M; Law, Bill; Leffert, Jonathan D; Orzeck, Eric A

    2015-05-01

    This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.

  19. Proceedings from the American Association of Clinical Endocrinologists and American College of Endocrinology consensus conference on glucose monitoring.

    PubMed

    Grunberger, George; Bailey, Timothy; Camacho, Pauline M; Einhorn, Daniel; Garber, Alan J; Handelsman, Yehuda; Harrell, R Mack; Lando, Howard M; Law, Bill; Leffert, Jonathan D; Orzeck, Eric A

    2015-05-01

    This document represents the official position of the American Association of Clinical Endocrinologists and the American College of Endocrinology. Where there were no randomized controlled trials or specific U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician. PMID:25962091

  20. Long-term heart disease and stroke mortality among former American prisoners of war of World War II and the Korean Conflict: results of a 50-year follow-up.

    PubMed

    Page, W F; Brass, L M

    2001-09-01

    For the first 30 years after repatriation, former American prisoners of war (POWs) of World War II and the Korean Conflict had lower death rates for heart disease and stroke than non-POW veteran controls and the U.S. population, but subsequent morbidity data suggested that this survival advantage may have disappeared. We used U.S. federal records to obtain death data through 1996 and used proportional hazards analysis to compare the mortality experience of POWs and controls. POWs aged 75 years and older showed a significantly higher risk of heart disease deaths than controls (hazard ratio = 1.25; 95% confidence interval, 1.01-1.56), and their stroke mortality was also increased, although not significantly (hazard ratio = 1.13; 95% confidence interval, 0.66-1.91). These results suggest that circulatory disease sequelae of serious, acute malnutrition and the stresses associated with imprisonment may not appear until after many decades. PMID:11569446

  1. Associations between chromosomal anomalies and congenital heart defects: a database search.

    PubMed

    van Karnebeek, C D; Hennekam, R C

    1999-05-21

    Recent technical advances in molecular biology and cytogenetics, as well as a more developmental approach to congenital heart disorders (CHDs), have led to considerable progress in our understanding of their pathogenesis, especially of the important causative role of genetic factors. The complex embryology of the heart suggests the involvement of numerous genes, and hence, numerous chromosomal loci, such as the recently identified 22q11, in normal cardiomorphogenesis. In order to identify other loci, the Human Cytogenetics DataBase was searched for all chromosome anomalies associated with CHD. Through the application of several (arbitrary) criteria we have selected associations occurring so frequently that they may not be forfuituous, suggesting assignment of a gene or genes responsible for specific CHDs to certain chromosome regions. The results of this study may be a first step in the detection of specific chromosome defects responsible for CHD, which will be useful in daily patient care and may provide clues for further cytogenetic and molecular studies.

  2. Association between Characteristics of Hospitalized Heart Failure Patients with Their Needs

    PubMed Central

    Polikandrioti, Maria; Goudevenos, John; Michalis, Lampros K.; Koutelekos, Ioannis G.; Georgiadi, Elpida; Karakostas, Constantine; Elisaf, Moses

    2016-01-01

    Introduction: During recent years that life expectancy of heart failure patients has been increased, health professionals put more emphasis on assessing their needs in daily clinical practice. The aim of the present study was to explore the association between characteristics of hospitalized heart failure patients with their needs. Methods: A sample of 190 hospitalized patients with HF, recruited from public hospitals in Greece, was enrolled in the study. Data were collected by the completion of a questionnaire which included socio-demographic and clinical characteristics and the questionnaire “Needs of hospitalized patients with coronary artery disease” which is consisted of 6 subscales. Statistical methods used were Kruskal wallis-test or Mann-Whitney test and Spearmans’ rho coefficient. Multiple regression analysis was performed in order to evaluate the association between patients’ characteristics and the significance of their needs. Results: 124 (65.3%) of hospitalized heart failure participants were men and 89 (46.8%) of participants were more than 70 years old. 145 (76.3%) had prior experience of hospitalization due to heart failure. The need for support and guidance was statistically significantly associated with the degree of information, (p=<0.001). The need for information from the medical and nursing staff was significantly associated with marital status and degree of information (p=0.001 and p<0.001 respectively). The need for need for being in contact with other patient groups, and ensuring communication with relatives was statistically significantly associated with the professional status and degree of information, (p=0.037 and p=<0.001 respectively). The need for individualized treatment and the need for patient’s personal participation to his/her treatment as well as the need to meet the emotional and physical needs were statistically significant associated with the degree of information, (p=<0.001, p=<0.001 respectively). Lastly, the

  3. Embolization of Uterine Arteriovenous Malformations Associated with Cyanotic Congenital Heart Disease

    SciTech Connect

    Wijesekera, N. T. Padley, S. P.; Kazmi, F.; Davies, C. L.; McCall, J. M.

    2009-09-15

    Uterine arteriovenous malformation (AVM) is a rare cause of vaginal bleeding and miscarriage. We report two cases of uterine AVMs in patients with a history of complex congenital heart disease, an association that has not been previously described. Both patients were treated by selective uterine artery embolization, a minimally invasive therapy that has revolutionized the management of uterine AVMs, thus offering an alternative to conventional hysterectomy.

  4. The association between noise exposure and blood pressure and ischemic heart disease: a meta-analysis.

    PubMed Central

    van Kempen, Elise E M M; Kruize, Hanneke; Boshuizen, Hendriek C; Ameling, Caroline B; Staatsen, Brigit A M; de Hollander, Augustinus E M

    2002-01-01

    It has been suggested that noise exposure is associated with blood pressure changes and ischemic heart disease risk, but epidemiologic evidence is still limited. Furthermore, most reviews investigating these relations were not carried out in a systematic way, which makes them more prone to bias. We conducted a meta-analysis of 43 epidemiologic studies published between 1970 and 1999 that investigate the relation between noise exposure (both occupational and community) and blood pressure and/or ischemic heart disease (International Classification of Diseases, Ninth Revision, codes 410-414). We studied a wide range of effects, from blood pressure changes to a myocardial infarction. With respect to the association between noise exposure and blood pressure, small blood pressure differences were evident. Our meta-analysis showed a significant association for both occupational noise exposure and air traffic noise exposure and hypertension: We estimated relative risks per 5 dB(A) noise increase of 1.14 (1.01-1.29) and 1.26 (1.14-1.39), respectively. Air traffic noise exposure was positively associated with the consultation of a general practitioner or specialist, the use of cardiovascular medicines, and angina pectoris. In cross-sectional studies, road traffic noise exposure increases the risk of myocardial infarction and total ischemic heart disease. Although we can conclude that noise exposure can contribute to the prevalence of cardiovascular disease, the evidence for a relation between noise exposure and ischemic heart disease is still inconclusive because of the limitations in exposure characterization, adjustment for important confounders, and the occurrence of publication bias. PMID:11882483

  5. Maternal systemic lupus erythematosus associated with fetal congenital heart block. A case report.

    PubMed

    Moore, P J

    1981-08-15

    Congenital heart block (CHB) is a rare cause of fetal bradycardia and, if misinterpreted as fetal distress, may lead to detrimental obstetric intervention. There is a definite association between systemic lupus erythematosus (SLE), as well as other connective tissue disorders in the mother and CHB in her offspring. A case of CHB in the child of a mother with asymptomatic SLE is reported and a useful diagnostic investigation, the sonar-atropine test, is described.

  6. Catecholamine effects on blood pressure and heart rate in warm- and cold-acclimated American bullfrogs (Rana catesbeiana).

    PubMed

    Herman, C A; Mata, P L

    1985-09-01

    The effects of epinephrine (E), norepinephrine (NE), phenylephrine (PHE), and isoproterenol (ISO) were studied in vivo on the blood pressure and heart rate of the conscious American bullfrog, Rana catesbeiana. Bullfrogs were chronically cannulated with a T cannula in the right sciatic artery. In warm-acclimated (22 degrees, W-A) bullfrogs, baseline mean systemic arterial blood pressure (SAP) prior to catecholamine infusion was 16.8 +/- 1.1 mm Hg and mean preinfusion heart rate (HR) was 36.4 +/- 2.1 beats per min. In contrast, cold-acclimated bullfrogs (5 degrees, C-A) had baseline SAP values of 7.4 +/- 0.7 mm Hg and HR values of 6.9 +/- 0.3 beats per min. W-A bullfrogs infused with ISO (0.03 to 30 micrograms/kg body wt) demonstrated a dose-related increase in HR, while the HR of C-A bullfrogs did not respond to any tested dose of ISO. ISO administered to W-A bullfrogs exposed to 5 degrees for 60 min produced no significant HR increase. When the animals were returned to 22 degrees, the HR response to ISO was restored. ISO did not affect SAP in either group. E, NE, and PHE increased SAP in both W-A and C-A bullfrogs, with E the most effective. All three catecholamines affected the SAP of C-A animals less than the W-A group. In W-A bullfrogs, E, NE, and PHE decreased HR, while no effect on HR was observed in the C-A group.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Association between Spirituality and Adherence to Management in Outpatients with Heart Failure

    PubMed Central

    Alvarez, Juglans Souto; Goldraich, Livia Adams; Nunes, Alice Hoefel; Zandavalli, Mônica Cristina Brugalli; Zandavalli, Rafaela Brugalli; Belli, Karlyse Claudino; da Rocha, Neusa Sica; Fleck, Marcelo Pio de Almeida; Clausell, Nadine

    2016-01-01

    Background Spirituality may influence how patients cope with their illness. Objectives We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management. PMID:27192385

  8. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure.

    PubMed

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziębło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-01-01

    BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR - CSR_ [-] (n=110). RESULTS CSR_ [+] patients presented more advanced NYHA class (p<0.001) and more frequently had permanent atrial fibrillation (p=0.018). Moreover, they had: lower LVEF (p<0.0001); higher LVDd (p<0.0001), RVDd (p<0.001), and E/e' (p<0.001); lower SI (p<0.001) and CI (p=0.009); and higher HR (p=0.044) and SVRI (p=0.016). The following predictors of CSR_ [+] were identified: NYHA class (OR=3.34 per class, p<0.001, which was the only independent predictor); atrial fibrillation (OR=2.29, p=0.019); RV enlargement (OR=2.75, p=0.005); LVEF<35% (OR=3.38, p=0.001); E/e' (OR=3.15; p=0.003); and SI<35 ml/m2 (OR=2.96, p=0.003). CONCLUSIONS Presence of CSA/CSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR. PMID:27558771

  9. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure

    PubMed Central

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziebło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-01-01

    Background Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. Material/Methods In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I–III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e’) assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR – CSR_ [−] (n=110). Results CSR_ [+] patients presented more advanced NYHA class (p<0.001) and more frequently had permanent atrial fibrillation (p=0.018). Moreover, they had: lower LVEF (p<0.0001); higher LVDd (p<0.0001), RVDd (p<0.001), and E/e’ (p<0.001); lower SI (p<0.001) and CI (p=0.009); and higher HR (p=0.044) and SVRI (p=0.016). The following predictors of CSR_ [+] were identified: NYHA class (OR=3.34 per class, p<0.001, which was the only independent predictor); atrial fibrillation (OR=2.29, p=0.019); RV enlargement (OR=2.75, p=0.005); LVEF<35% (OR=3.38, p=0.001); E/e’ (OR=3.15; p=0.003); and SI<35 ml/m2 (OR=2.96, p=0.003). Conclusions Presence of CSA/CSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR. PMID:27558771

  10. Association of Central Sleep Apnea with Impaired Heart Structure and Cardiovascular Hemodynamics in Patients with Chronic Heart Failure.

    PubMed

    Kazimierczak, Anna; Krzesiński, Paweł; Gielerak, Grzegorz; Uziębło-Życzkowska, Beata; Smurzyński, Paweł; Ryczek, Robert; Cwetsch, Andrzej; Skrobowski, Andrzej

    2016-08-25

    BACKGROUND Advanced heart failure (HF) is commonly accompanied by central sleep apnea (CSA) with Cheyne-Stokes respiration (CSR). The aim of this study was to evaluate the relationship between CSA/CSR and other clinical features of HF, with particular emphasis on cardiovascular hemodynamics. MATERIAL AND METHODS In 161 stable HF patients with left ventricular ejection fraction (LVEF) ≤45% (NYHA class I-III; mean LVEF 32.8%) the clinical evaluation included: LVEF; left and right ventricular end-diastolic diameter (LVDd, RVDd); ratio of early transmitral flow velocity to early diastolic septal mitral annulus velocity (E/e') assessed by echocardiography; stroke index (SI); heart rate (HR); cardiac index (CI); and systemic vascular resistance index (SVRI) assessed by impedance cardiography (ICG). The comparison was performed between 2 subgroups: one with moderate/severe CSA/CSR - CSR_ [+] (n=51), and one with mild or no CSA/CSR - CSR_ [-] (n=110). RESULTS CSR_ [+] patients presented more advanced NYHA class (p<0.001) and more frequently had permanent atrial fibrillation (p=0.018). Moreover, they had: lower LVEF (p<0.0001); higher LVDd (p<0.0001), RVDd (p<0.001), and E/e' (p<0.001); lower SI (p<0.001) and CI (p=0.009); and higher HR (p=0.044) and SVRI (p=0.016). The following predictors of CSR_ [+] were identified: NYHA class (OR=3.34 per class, p<0.001, which was the only independent predictor); atrial fibrillation (OR=2.29, p=0.019); RV enlargement (OR=2.75, p=0.005); LVEF<35% (OR=3.38, p=0.001); E/e' (OR=3.15; p=0.003); and SI<35 ml/m2 (OR=2.96, p=0.003). CONCLUSIONS Presence of CSA/CSR in HF is associated with NYHA class, atrial fibrillation and more advanced impairment of cardiovascular structure and hemodynamics. Patient functional state remains the main determinant of CSR.

  11. Cardiac ablation of Rheb1 induces impaired heart growth, endoplasmic reticulum-associated apoptosis and heart failure in infant mice.

    PubMed

    Cao, Yunshan; Tao, Lichan; Shen, Shutong; Xiao, Junjie; Wu, Hang; Li, Beibei; Wu, Xiangqi; Luo, Wen; Xiao, Qi; Hu, Xiaoshan; Liu, Hailang; Nie, Junwei; Lu, Shuangshuang; Yuan, Baiyin; Han, Zhonglin; Xiao, Bo; Yang, Zhongzhou; Li, Xinli

    2013-12-13

    Ras homologue enriched in brain 1 (Rheb1) plays an important role in a variety of cellular processes. In this study, we investigate the role of Rheb1 in the post-natal heart. We found that deletion of the gene responsible for production of Rheb1 from cardiomyocytes of post-natal mice resulted in malignant arrhythmias, heart failure, and premature death of these mice. In addition, heart growth impairment, aberrant metabolism relative gene expression, and increased cardiomyocyte apoptosis were observed in Rheb1-knockout mice prior to the development of heart failure and arrhythmias. Also, protein kinase B (PKB/Akt) signaling was enhanced in Rheb1-knockout mice, and removal of phosphatase and tensin homolog (Pten) significantly prolonged the survival of Rheb1-knockouts. Furthermore, signaling via the mammalian target of rapamycin complex 1 (mTORC1) was abolished and C/EBP homologous protein (CHOP) and phosphorylation levels of c-Jun N-terminal kinase (JNK) were increased in Rheb1 mutant mice. In conclusion, this study demonstrates that Rheb1 is important for maintaining cardiac function in post-natal mice via regulation of mTORC1 activity and stress on the endoplasmic reticulum. Moreover, activation of Akt signaling helps to improve the survival of mice with advanced heart failure. Thus, this study provides direct evidence that Rheb1 performs multiple important functions in the heart of the post-natal mouse. Enhancing Akt activity improves the survival of infant mice with advanced heart failure.

  12. American ginseng suppresses inflammation and DNA damage associated with mouse colitis

    PubMed Central

    Jin, Yu; Kotakadi, Venkata S.; Ying, Lei; Cui, Xiangli; Wood, Patricia A.; Windust, Anthony; Matesic, Lydia E.; Pena, Edsel A.; Chiuzan, Codruta; Singh, Narendra P.; Nagarkatti, Mitzi; Nagarkatti, Prakash S.; Wargovich, Michael J.; Hofseth, Lorne J.

    2008-01-01

    Ulcerative colitis (UC) is a dynamic, idiopathic, chronic inflammatory condition associated with a high colon cancer risk. American ginseng has antioxidant properties and targets many of the players in inflammation. The aim of this study was to test whether American ginseng extract prevents and treats colitis. Colitis in mice was induced by the presence of 1% dextran sulfate sodium (DSS) in the drinking water or by 1% oxazolone rectally. American ginseng extract was mixed in the chow at levels consistent with that currently consumed by humans as a supplement (75 p.p.m., equivalent to 58 mg daily). To test prevention of colitis, American ginseng extract was given prior to colitis induction. To test treatment of colitis, American ginseng extract was given after the onset of colitis. In vitro studies were performed to examine mechanisms. Results indicate that American ginseng extract not only prevents but it also treats colitis. Inducible nitric oxide synthase and cyclooxygenase-2 (markers of inflammation) and p53 (induced by inflammatory stress) are also downregulated by American ginseng. Mucosal and DNA damage associated with colitis is at least in part a result of an oxidative burst from overactive leukocytes. We therefore tested the hypothesis that American ginseng extract can inhibit leukocyte activation and subsequent epithelial cell DNA damage in vitro and in vivo. Results are consistent with this hypothesis. The use of American ginseng extract represents a novel therapeutic approach for the prevention and treatment of UC. PMID:18802031

  13. Factors Associated with American Indian Teens' Self-Rated Health

    ERIC Educational Resources Information Center

    Parker, Tassy

    2004-01-01

    Factors related to American Indian (AI) high school students' self-rated health were examined. Self rated health was measured as a single-item with a four-point response option ranging from poor to excellent health. Of the 574 participants, 19% reported "fair" or "poor" health, a percentage more than twice that for U.S. high school students in…

  14. Factors Associated with Successful Functioning in American Indian Youths

    ERIC Educational Resources Information Center

    Silmere, Hile; Stiffman, Arlene Rubin

    2006-01-01

    This study examines environmental and cultural factors related to successful functioning in a stratified random sample of 401 American Indian youths. The success index included seven indicators: good mental health, being alcohol and drug free, absence of serious misbehavior, clean police record, good grades, positive psychosocial functioning, and…

  15. Diabetes, impaired glucose tolerance, and metabolic biomarkers in individuals with normal glucose tolerance are inversely associated with lung function: the Jackson Heart Study.

    PubMed

    Hickson, DeMarc A; Burchfiel, Cecil M; Liu, Jiankang; Petrini, Marcy F; Harrison, Kimystian; White, Wendy B; Sarpong, Daniel F

    2011-08-01

    The objectives of this study were to test the hypothesis that diabetes and impaired glucose tolerance (IGT), diabetes control and diabetes duration, and metabolic biomarkers in adults with normal glucose tolerance (NGT) are inversely associated with spirometry-measured lung function. We conducted a cross-sectional observational cohort study that included nonsmoking African American adults (n = 2,945; mean age = 52.5 ± 12.6 years; 69.2% female), who were free of cardiovascular disease, from the Jackson Heart Study. The interventions were diabetes, metabolic biomarkers and lung function. We measured the associations of glycemia with forced expiratory volume (FEV) in 1 s, FEV in 6 s, and vital capacity. Multivariable adjusted mean lung function values were lower among adults with diabetes and IGT (in women only, but not after adjustment for waist circumference) than adults with NGT. Among adults with diabetes, no associations were observed between lung function and diabetes control or duration. In women with NGT, lower lung function was consistently associated with higher glucose levels and less consistently with higher insulin levels and insulin resistance. Lower lung function was consistently associated with higher insulin levels and insulin resistance and less consistently associated with insulin and hemoglobin A1c in men with NGT. Overall, our findings generally support the hypothesis that diabetes, IGT, and increased levels of metabolic biomarkers in individuals with NGT are inversely associated with lung function in African Americans, independent of adiposity.

  16. Association between growth differentiation factor-15 and chronic heart failure in coronary atherosclerosis patients.

    PubMed

    Zhu, Z D; Sun, T

    2015-03-27

    We explored the association between plasma growth differentiation factor 15 (GDF-15) levels and chronic heart failure (CHF) in coronary heart disease patients. We measured plasma GDF-15 and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in 269 untreated coronary heart disease patients (98 with CHF, 84 without CHF, and 87 control patients) using an enzyme-linked immunosorbent assay. All subjects were examined by echocardiography and left ventricular ejection fraction. We found that plasma GDF-15 levels in coronary atherosclerosis patients with CHF [median 1622.48 (25-75th percentile: 887.53-1994.93) ng/L] were higher than those in coronary atherosclerosis patients without CHF [944.99 (856.12-999.78) ng/L] and control patients (P < 0.05). NT-proBNP showed the same trend as GDF-15. We also used the New York Heart Association functional classification to subgroup CHF patients and found that the GDF-15 level was higher in all subgroup patients with CHF. After adjusting for covariates, plasma GDF-15 levels were found to be positively related to NT-proBNP (r = 0.861, P < 0.001) and negatively related to left ventricular ejection fraction (r = -0.936, P < 0.001). Furthermore, receiver operating characteristic curves of GDF-15 and NT-proBNP were constructed and the area under the curve for the untransformed GDF-15 and NT-proBNP was 0.804 and 0.795, respectively. Plasma GDF-15 levels and NT-proBNP are associated with CHF in coronary atherosclerosis patients and can be used as biomarkers.

  17. The association of particulate air metal concentrations with heart rate variability.

    PubMed Central

    Magari, Shannon R; Schwartz, Joel; Williams, Paige L; Hauser, Russ; Smith, Thomas J; Christiani, David C

    2002-01-01

    Numerous studies show an association between particulate air pollution and adverse health effects. Particulate matter is a complex mixture of elemental carbon, ammonium, sulfates, nitrates, organic components, and metals. The mechanisms of action of particulate matter less than or equal to 2.5 micro m in mean aerodynamic diameter (PM(2.5)), as well as the constituents responsible for the observed cardiopulmonary health effects, have not been identified. In this study we focused on the association between the metallic component of PM(2.5) and cardiac autonomic function based on standard heart rate variability (HRV) measures in an epidemiologic study of boilermakers. Thirty-nine male boilermakers were monitored throughout a work shift. Each subject wore an ambulatory electrocardiogram (Holter) monitor and a personal monitor to measure PM(2.5). We used mixed-effects models to regress heart rate and SDNN index (standard deviation of the normal-to-normal) on PM(2.5) and six metals (vanadium, nickel, chromium, lead, copper, and manganese). There were statistically significant mean increases in the SDNN index of 11.30 msec and 3.98 msec for every 1 micro g/m(3) increase in the lead and vanadium concentrations, respectively, after adjusting for mean heart rate, age, and smoking status. Small changes in mean heart rate were seen with all exposure metrics. The results of this study suggest an association between exposure to airborne metals and significant alterations in cardiac autonomic function. These results extend our understanding of the adverse health effects of the metals component of ambient PM(2.5). PMID:12204821

  18. American Association of Dental Schools Curricular Guidelines for Practice Management and for Preventive Dentistry.

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1980

    1980-01-01

    Curricular guidelines developed by the American Association of Dental Schools for use by individual educational institutions as curriculum development aids are provided. The guidelines were developed by the Sections on Community and Preventive Dentistry and Practice Administration. (MLW)

  19. Training Standards of the American Mental Health Counselors Association: History, Rationale, and Implications.

    ERIC Educational Resources Information Center

    Seiler, Gary; And Others

    1987-01-01

    Traces historical development of training standards for mental health counseling and gives a detailed rationale of the importance of such standards. Presents newly adopted training standards of the American Mental Health Counselors Association and discusses implications of these standards. (Author)

  20. American Urological Association survey of transurethral prostatectomy and the impact of changing medicare reimbursement.

    PubMed

    Holtgrewe, H L

    1990-08-01

    The American Urological Association, in a survey of all American urologists, found that TURP accounts for 38 per cent of their major surgery and also found that activities associated with the operation account for nearly 25 per cent of their total patient workload. American urologists regard TURP as complex, and they believe proficiency requires more practical case experience during residency training than is required for any other urologic operation. American urologists assign TURP a significantly higher relative value than that proposed in the pending national Medicare Fee Schedule formulated by medical economists and the Physician Payment Review Commission. The legislated reductions in allowable Medicare fees for TURP and the possible shift in management of benign prostatic hyperplasia to nonsurgical methods create a financial vulnerability for American urologists who remain economically dependent on this dominant operation. Adjustments in practice patterns and manpower policy planning may well be required.

  1. Different attitudes toward humor between Chinese and American students: evidence from the Implicit Association Test.

    PubMed

    Jiang, Feng; Yue, Xiao Dong; Lu, Su

    2011-08-01

    Although cross-cultural research indicates that Chinese people demonstrate less humor than do Americans, little research addresses the reasons. This cross-cultural difference may be largely due to different implicit attitudes toward humor held by Chinese and Americans, deeply rooted in the two cultural traditions. Both self-report evaluation and the Implicit Association Test (IAT) were used to compare Chinese and American attitudes toward humor. Although 60 Chinese undergraduate students showed no significant difference from 33 American exchange students in explicit attitudes toward humor, the former associated humor more frequently with unpleasant adjectives and seriousness with pleasant adjectives on the IAT; the opposite pattern was found for the American group. This indicated a negative implicit attitude toward humor among the Chinese students.

  2. Cluster Differentiating 36 (CD36) Deficiency Attenuates Obesity-Associated Oxidative Stress in the Heart

    PubMed Central

    Gharib, Mohamed; Tao, Huan; Fungwe, Thomas V.; Hajri, Tahar

    2016-01-01

    Rationale Obesity is often associated with a state of oxidative stress and increased lipid deposition in the heart. More importantly, obesity increases lipid influx into the heart and induces excessive production of reactive oxygen species (ROS) leading to cell toxicity and metabolic dysfunction. Cluster differentiating 36 (CD36) protein is highly expressed in the heart and regulates lipid utilization but its role in obesity-associated oxidative stress is still not clear. Objective The aim of this study was to determine the impact of CD36 deficiency on cardiac steatosis, oxidative stress and lipotoxicity associated with obesity. Methods and Results Studies were conducted in control (Lean), obese leptin-deficient (Lepob/ob) and leptin-CD36 double null (Lepob/obCD36-/-) mice. Compared to lean mice, cardiac steatosis, and fatty acid (FA) uptake and oxidation were increased in Lepob/ob mice, while glucose uptake and oxidation was reduced. Moreover, insulin resistance, oxidative stress markers and NADPH oxidase-dependent ROS production were markedly enhanced. This was associated with the induction of NADPH oxidase expression, and increased membrane-associated p47phox, p67phox and protein kinase C. Silencing CD36 in Lepob/ob mice prevented cardiac steatosis, increased insulin sensitivity and glucose utilization, but reduced FA uptake and oxidation. Moreover, CD36 deficiency reduced NADPH oxidase activity and decreased NADPH oxidase-dependent ROS production. In isolated cardiomyocytes, CD36 deficiency reduced palmitate-induced ROS production and normalized NADPH oxidase activity. Conclusions CD36 deficiency prevented obesity-associated cardiac steatosis and insulin resistance, and reduced NADPH oxidase-dependent ROS production. The study demonstrates that CD36 regulates NADPH oxidase activity and mediates FA-induced oxidative stress. PMID:27195707

  3. Structural heart disease and ST2: cross-sectional and longitudinal associations with echocardiography.

    PubMed

    deFilippi, Christopher; Daniels, Lori B; Bayes-Genis, Antoni

    2015-04-01

    To further explore the potential role of sST2 in the progression of cardiac disease, this section reviews both the associations with cross-sectional findings and longitudinal changes in cardiac structure and function measured by echocardiography and cardiac magnetic resonance imaging with sST2 levels in a variety of patient populations with or at-risk for cardiovascular disease. In a Pro-Brain Natriuretic Peptide Investigation of Dyspnea in the Emergency Department substudy in patients with acute dyspnea, sST2 levels were found associated with left ventricular ejection fraction (LVEF), and both estimated right ventricular (RV) systolic pressure and RV hypokinesis. In a large cohort of ambulatory patients referred for echocardiograms, sST2 was predominantly associated with RV and not LV structural findings. In contrast, in the Framingham Heart Study, a community cohort of >3,300 participants, sST2 was not associated with either echocardiographic finding, although in the Cardiovascular Health Study, sST2 appeared strongly associated with the presence of diastolic dysfunction. Little evidence exists on the relation of sST2 levels with longitudinal change in cardiac structure and function. A substudy of Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) evaluated the association among LV remodeling (defined as an increase in LV end-systolic and -diastolic volumes), sST2, and the benefit of eplerenone and found that sST2 levels were good surrogates of left ventricular remodeling. In the same line, the ProBNP Outpatient Tailored Chronic Heart Failure (PROTECT) study found that more time spent with an sST2 level less than the cutoff of 35 ng/L identified patients with a greater probability of a decrease in LV diastolic index over 1 year.

  4. American Thoracic Society and National Heart, Lung, and Blood Institute Implementation Research Workshop Report.

    PubMed

    Bender, Bruce G; Krishnan, Jerry A; Chambers, David A; Cloutier, Michelle M; Riekert, Kristin A; Rand, Cynthia S; Schatz, Michael; Thomson, Carey C; Wilson, Sandra R; Apter, Andrea; Carson, Shannon S; George, Maureen; Gerald, Joe K; Gerald, Lynn; Goss, Christopher H; Okelo, Sande O; Mularski, Richard A; Nguyen, Huong Q; Patel, Minal R; Szefler, Stanley J; Weiss, Curtis H; Wilson, Kevin C; Freemer, Michelle

    2015-12-01

    To advance implementation research (IR) in respiratory, sleep, and critical care medicine, the American Thoracic Society and the Division of Lung Diseases from the NHLBI cosponsored an Implementation Research Workshop on May 17, 2014. The goals of IR are to understand the barriers and facilitators of integrating new evidence into healthcare practices and to develop and test strategies that systematically target these factors to accelerate the adoption of evidence-based care. Throughout the workshop, presenters provided examples of IR that focused on the rate of adoption of evidence-based practices, the feasibility and acceptability of interventions to patients and other stakeholders who make healthcare decisions, the fidelity with which practitioners use specific interventions, the effects of specific barriers on the sustainability of an intervention, and the implications of their research to inform policies to improve patients' access to high-quality care. During the discussions that ensued, investigators' experience led to recommendations underscoring the importance of identifying and involving key stakeholders throughout the research process, ensuring that those who serve as reviewers understand the tenets of IR, managing staff motivation and turnover, and tackling the challenges of scaling up interventions across multiple settings.

  5. Factors Associated with Post-Surgical Delirium in Patients Undergoing Open Heart Surgery

    PubMed Central

    Jannati, Yadollah; Bagheri-Nesami, Masoumeh; Sohrabi, Maryam; Yazdani-Cherati, Jamshid; Mazdarani, Shahrzad

    2014-01-01

    Objective The objective of the present study is to determine the incidence of delirium and the associated factors in patients undergoing open heart surgery. Method This is an Analytic-descriptive study conducted on 404 patients undergoing elective open heart surgery in Fatemeh Zahra Heart Center, Sari, over the period of 6 months from July to December 2011. Sampling was achieved in a nonrandomized targeted manner and delirium was assessed using NeeCham questionnaire. A trained nurse evaluated the patients for delirium and completed the risk factor checklist on days 1 to 5 after surgery. Data analyses were accomplished using survival analysis (Kaplan-Meier and Cox regression) on SPSS software version 15. Results We found that variables, including ventilation time, increased drainage during the first 24 hours, the need for re-operation in the first 24 hours, dysrhythmias, use of inotropic agents, increased use of analgesics, increased arterial carbon dioxide, lack of visitors, and use of physical restrainers were associated with the development of delirium. In addition, we found a delirium incidence of 29%. Conclusion Diagnosis of cognitive disorders is of utmost value; therefore, further studies are required to clarify the risk factors because controlling them will help prevent delirium. PMID:25337310

  6. Hypertrophic response of the Association of Thyroid Hormone and Exercise in the Heart of Rats

    PubMed Central

    de Souza, Fernanda Rodrigues; Resende, Elmiro Santos; Lopes, Leandro; Gonçalves, Alexandre; Chagas, Rafaella; Fidale, Thiago; Rodrigues, Poliana

    2014-01-01

    Background Cardiac hypertrophy is a component of cardiac remodeling occurring in response to an increase of the activity or functional overload of the heart. Objective Assess hypertrophic response of the association of thyroid hormone and exercise in the rat heart. Methods We used 37 Wistar rats, male, adults were randomly divided into four groups: control, hormone (TH), exercise (E), thyroid hormone and exercise (H + E); the group received daily hormone levothyroxine sodium by gavage at a dose of 20 μg thyroid hormone/100g body weight, the exercise group took swimming five times a week, with additional weight corresponding to 20% of body weight for six weeks; in group H + E were applied simultaneously TH treatment groups and E. The statistics used was analysis of variance, where appropriate, by Tukey test and Pearson correlation test. Results The T4 was greater in groups TH and H + E. The total weight of the heart was greater in patients who received thyroid hormone and left ventricular weight was greater in the TH group. The transverse diameter of cardiomyocytes increased in groups TH, E and H + E. The percentage of collagen was greater in groups E and H + E Correlation analysis between variables showed distinct responses. Conclusion The association of thyroid hormone with high-intensity exercise produced cardiac hypertrophy, and generated a standard hypertrophy not directly correlated to the degree of fibrosis. PMID:24676374

  7. The maternal-age-associated risk of congenital heart disease is modifiable.

    PubMed

    Schulkey, Claire E; Regmi, Suk D; Magnan, Rachel A; Danzo, Megan T; Luther, Herman; Hutchinson, Alayna K; Panzer, Adam A; Grady, Mary M; Wilson, David B; Jay, Patrick Y

    2015-04-01

    Maternal age is a risk factor for congenital heart disease even in the absence of any chromosomal abnormality in the newborn. Whether the basis of this risk resides with the mother or oocyte is unknown. The impact of maternal age on congenital heart disease can be modelled in mouse pups that harbour a mutation of the cardiac transcription factor gene Nkx2-5 (ref. 8). Here, reciprocal ovarian transplants between young and old mothers establish a maternal basis for the age-associated risk in mice. A high-fat diet does not accelerate the effect of maternal ageing, so hyperglycaemia and obesity do not simply explain the mechanism. The age-associated risk varies with the mother's strain background, making it a quantitative genetic trait. Most remarkably, voluntary exercise, whether begun by mothers at a young age or later in life, can mitigate the risk when they are older. Thus, even when the offspring carry a causal mutation, an intervention aimed at the mother can meaningfully reduce their risk of congenital heart disease.

  8. Primary repair of interrupted aortic arch and associated heart lesions in newborns.

    PubMed

    Tláskal, T; Chaloupecky, V; Marek, J; Hŭcín, B; Kostelka, M; Tax, P; Kucera, V; Janousek, J; Skovránek, J; Reich, O

    1997-04-01

    Primary repair of interrupted aortic arch and associated heart lesions was performed in 13 patients aged from 1 to 85 days. The surgery was performed through the midline sternotomy approach in extracorporeal circulation and deep hypothermia. Hypothermic circulatory arrest at 14 to 19 degrees C was used for reconstruction of the aortic arch. In all patients it was possible to perform a direct anastomosis between the ascendent and descendent aorta. At the same time closure of the ventricular septal defect was performed in 11 patients, closure of the atrial septal defect in 4, correction of persistent truncus arteriosus in 3, resection of subaortic stenosis in 2, arterial switch repair of transposition of the great arteries in 1, correction of double outlet right ventricle in 1 and patch closure of aortico-pulmonary window in 1 patient. Three (23.1%) newborns died in the early postoperative period: two from sepsis and one from multiple organ failure. Ten patients (76.9%) were followed up for 1 to 29 months postoperatively. All of them are in very good condition with a nonrestrictive aortic anastomosis. Primary one-stage repair of interrupted aortic arch and associated heart lesions is preferred to the two-stage repair in all newborns with this critical congenital heart disease. PMID:9201119

  9. Diabetic ketoacidosis associated with acute pancreatitis in a heart transplant recipient treated with tacrolimus.

    PubMed

    Im, Moon-Sun; Ahn, Hyo-Suk; Cho, Hyun-Jai; Kim, Ki-Bong; Lee, Hae-Young

    2013-02-01

    New-onset diabetes mellitus after transplant is a well-recognized complication of tacrolimus immunosuppression and commonly occurs as a form of type 2 diabetes mellitus. However, tacrolimus-associated acute pancreatitis causing diabetic ketoacidosis has not been reported in heart transplant patients. We report a 22-year-old women hospitalized owing to diabetic ketoacidosis associated with acute pancreatitis 7 months after a heart transplant. Her immunosuppression included tacrolimus. She was admitted with complaints of polydipsia, anorexia, and abdominal pain of 3 days' duration. Her initial laboratory test revealed a toxic level of tacrolimus (> 30 ng/mL), severe hyperglycemia (39 mmol/L), severe metabolic acidosis (pH 6.9), and ketonuria, although diabetes mellitus had never been diagnosed. Serum amylase and lipase levels and abdominal computed tomography suggested the presence of acute pancreatitis. After correcting the diabetic ketoacidosis and getting the tacrolimus level to the normal range, she was discharged home. Three months later, insulin was replaced with oral hypoglycemic agents. Pancreatitis can present with diabetic ketoacidosis in the recipient of a heart transplant treated with tacrolimus. Clinicians should pay more attention to tacrolimus levels and the risk of pancreatitis.

  10. Association between Heart Rate Variability, Blood Pressure and Autonomic Activity in Cyclic Alternating Pattern during Sleep

    PubMed Central

    Kondo, Hideaki; Ozone, Motohiro; Ohki, Noboru; Sagawa, Yohei; Yamamichi, Keiichirou; Fukuju, Mitsuki; Yoshida, Takeshi; Nishi, Chikako; Kawasaki, Akiko; Mori, Kaori; Kanbayashi, Takashi; Izumi, Motomori; Hishikawa, Yasuo; Nishino, Seiji; Shimizu, Tetsuo

    2014-01-01

    Study Objectives: Cyclic alternating pattern (CAP) is frequently followed by changes in heart rate (HR) and blood pressure (BP), but the sequential associations between CAP and autonomic nerve activity have not been studied. The study aimed to reveal the precise changes in heart rate variability (HRV) during phase A of the CAP cycle. Design: Polysomnography was recorded according to the CAP Atlas (Terzano, 2002), and BP and electrocardiogram were simultaneously recorded. The complex demodulation method was used for analysis of HRV and evaluation of autonomic nerve activity. Setting: Academic sleep laboratory. Participants: Ten healthy males. Measurements and Results: The increase in HR (median [first quartile – third quartile]) for each subtype was as follows: A1, 0.64 (-0.30 to 1.69), A2, 1.44 (0.02 to 3.79), and A3, 6.24 (2.53 to 10.76) bpm (A1 vs. A2 P < 0.001, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). The increase in BP for each subtype was as follows: A1, 1.23 (-2.04 to 5.75), A2, 1.76 (-1.46 to 9.32), and A3, 12.51 (4.75 to 19.94) mm Hg (A1 vs. A2 P = 0.249, A1 vs. A3 P < 0.001, A2 vs. A3 P < 0.001). In all of phase A, the peak values for HR and BP appeared at 4.2 (3.5 to 5.4) and 8.4 (7.0 to 10.3) seconds, respectively, after the onset of phase A. The area under the curve for low-frequency and high-frequency amplitude significantly increased after the onset of CAP phase A (P < 0.001) and was higher in the order of subtype A3, A2, and A1 (P < 0.001). Conclusions: All phase A subtypes were accompanied with increased heart rate variability, and the largest heart rate variability was seen in subtype A3, while a tendency for less heart rate variability was seen in subtype A1. Citation: Kondo H; Ozone M; Ohki N; Sagawa Y; Yamamichi K; Fukuju M; Yoshida T; Nishi C; Kawasaki; Mori; Kanbayashi T; Izumi M; Hishikawa Y; Nishino S; Shimizu T. Association between heart rate variability, blood pressure and autonomic activity in cyclic alternating pattern during sleep

  11. American College Health Association-National College Health Assessment Spring 2008 Reference Group Data Report (Abridged): The American College Health Association

    ERIC Educational Resources Information Center

    Journal of American College Health, 2009

    2009-01-01

    Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The…

  12. Health and cost benefits associated with the use of metoprolol in heart attack patients.

    PubMed

    Fernández-Jiménez, Rodrigo; Ibanez, Borja

    2014-11-01

    Heart attack (myocardial infarction) is a highly prevalent entity worldwide. Widespread implementation of reperfusion strategies has dramatically reduced the mortality associated with infarction. Paradoxically, the mortality reduction has significantly increased the incidence of chronic heart failure (HF). Treatment of HF, once present, represents a huge socioeconomic burden on individuals and healthcare systems. The possibility of preventing rather than treating post-infarction HF would be of paramount importance. Given that infarct size is the main determinant of adverse post-infarction outcomes (including chronic HF), therapies able to reduce infarct size are needed. The single administration of intravenous metoprolol before reperfusion has been recently shown to reduce infarct size and reduce the cases of chronic HF in a proof-of-concept trial. If confirmed in larger trials, this low-cost therapy is expected to have a major health and socioeconomic impact.

  13. Heart Failure Functional Class Associated with Depression Severity But Not Anxiety Severity

    PubMed Central

    Celik, Etem; Cay, Serkan; Sensoy, Baris; Murat, Sani; Oksuz, Fatih; Cankurt, Tayyar; Ali Mendi, Mehmet

    2016-01-01

    Background Depression and anxiety are common in heart failure (HF) patients and associated with adverse clinical outcomes. However, there are little or no published data that focuses on the relationship between these commonly observed situations and HF classes. The aim of this study was to evaluate the relationship between these psychiatric co-morbidities and HF symptom classes. As a second objective of our study, the associations between patient characteristics and depression severity were also assessed. Methods Our study enrolled a total of 420 HF study participants. The severity of depressive and anxiety symptoms was evaluated by Beck’s depression and anxiety. The measured total scores were used to grade depression severity and anxiety as minimal/mild and moderate/severe. Results According to NYHA Functional Classification, 228 patients (51%) had class I symptoms, 101 (23%) had class II symptoms, 31 (7%) had class III symptoms, and class IV symptoms were noted in the remaining 60 patients (19%). The mean Beck’s depression and anxiety scores were 12.4 ± 11.1 and 13.4 ± 9.0, respectively. While no association between HF symptom classes and anxiety severity was observed, a significant positive relation between HF symptom class and depression score was found. Conclusions The results of our study suggested that HF symptom class was positively associated with severity of depression. On the other hand, there was no association between HF symptom class and anxiety score in a wide population of heart failure patients. PMID:27122931

  14. A Comprehensive Genetic Association Study of Alzheimer Disease in African Americans

    PubMed Central

    Logue, Mark W.; Schu, Matthew; Vardarajan, Badri N.; Buros, Jacki; Green, Robert C.; Go, Rodney C. P.; Griffith, Patrick; Obisesan, Thomas O.; Shatz, Rhonna; Borenstein, Amy; Cupples, L. Adrienne; Lunetta, Kathryn L.; Fallin, M. Daniele; Baldwin, Clinton T.; Farrer, Lindsay A.

    2012-01-01

    Objectives To evaluate the association of genetic variation with late-onset Alzheimer disease (AD) in African Americans, including genes implicated in recent genome-wide association studies of whites. Design We analyzed a genome-wide set of 2.5 million imputed markers to evaluate the genetic basis of AD in an African American population. Subjects Five hundred thirteen well-characterized African American AD cases and 496 cognitively normal African American control subjects. Setting Data were collected from multiple sites as part of the Multi-Institutional Research on Alzheimer Genetic Epidemiology (MIRAGE) Study and the Henry Ford Health System as part of the Genetic and Environmental Risk Factors for Alzheimer Disease Among African Americans (GenerAAtions) Study. Results Several significant single-nucleotide polymorphisms (SNPs) were observed in the region of the apolipoprotein E gene (APOE). After adjusting for the confounding effects of APOE genotype, one of these SNPs, rs6859 in PVRL2, remained significantly associated with AD (P=.0087). Association was also observed with SNPs in CLU, PICALM, BIN1, EPHA1, MS4A, ABCA7, and CD33, although the effect direction for some SNPs and the most significant SNPs differed from findings in data sets consisting of whites. Finally, using the African American genome-wide association study data set as a discovery sample, we obtained suggestive evidence of association with SNPs for several novel candidate genes. Conclusions Some genes contribute to AD pathogenesis in both white and African American cohorts, although it is unclear whether the causal variants are the same. A larger African American sample will be needed to confirm novel gene associations, which may be population specific. PMID:22159054

  15. Refining the association of MHC with multiple sclerosis in African Americans.

    PubMed

    McElroy, Joseph P; Cree, Bruce A C; Caillier, Stacy J; Gregersen, Peter K; Herbert, Joseph; Khan, Omar A; Freudenberg, Jan; Lee, Annette; Bridges, S Louis; Hauser, Stephen L; Oksenberg, Jorge R; Gourraud, Pierre-Antoine

    2010-08-01

    Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system mediated by autoimmune and neurodegenerative pathogenic mechanisms. Multiple genes account for its moderate heritability, but the only genetic region shown to have a large replicable effect on MS susceptibility is the major histocompatibility complex (MHC). Strong linkage disequilibrium (LD) across the MHC has made it difficult to fully characterize individual genetic contributions of this region to MS risk in previous studies. African Americans are at a lower risk for MS when compared with northern Europeans and Americans of European descent, but greater haplotypic diversity and distinct patterns of LD suggest that this population may be particularly informative for fine-mapping efforts. To examine the role of the MHC in African American MS, a case-control association study was performed with 499 African American MS patients and 750 African American controls that were genotyped for 6040 MHC region single nucleotide polymorphisms (SNPs). A replication data set consisting of 451 African American patients and 718 African American controls was genotyped for selected SNPs. Two MHC class II SNPs, rs2647040 and rs3135021, were significant in the replication cohort and partially tagged DRB1*15 alleles. Surprisingly, in comparison to similar studies of individuals of European descent, the MHC seems to play a smaller role in MS susceptibility in African Americans, consistent with pervasive genetic heterogeneity across ancestral groups, and may explain the difference in MS susceptibility between African Americans and individuals of European descent.

  16. Refining the association of MHC with multiple sclerosis in African Americans

    PubMed Central

    McElroy, Joseph P.; Cree, Bruce A. C.; Caillier, Stacy J.; Gregersen, Peter K.; Herbert, Joseph; Khan, Omar A.; Freudenberg, Jan; Lee, Annette; Bridges, S. Louis; Hauser, Stephen L.; Oksenberg, Jorge R.; Gourraud, Pierre-Antoine

    2010-01-01

    Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system mediated by autoimmune and neurodegenerative pathogenic mechanisms. Multiple genes account for its moderate heritability, but the only genetic region shown to have a large replicable effect on MS susceptibility is the major histocompatibility complex (MHC). Strong linkage disequilibrium (LD) across the MHC has made it difficult to fully characterize individual genetic contributions of this region to MS risk in previous studies. African Americans are at a lower risk for MS when compared with northern Europeans and Americans of European descent, but greater haplotypic diversity and distinct patterns of LD suggest that this population may be particularly informative for fine-mapping efforts. To examine the role of the MHC in African American MS, a case–control association study was performed with 499 African American MS patients and 750 African American controls that were genotyped for 6040 MHC region single nucleotide polymorphisms (SNPs). A replication data set consisting of 451 African American patients and 718 African American controls was genotyped for selected SNPs. Two MHC class II SNPs, rs2647040 and rs3135021, were significant in the replication cohort and partially tagged DRB1*15 alleles. Surprisingly, in comparison to similar studies of individuals of European descent, the MHC seems to play a smaller role in MS susceptibility in African Americans, consistent with pervasive genetic heterogeneity across ancestral groups, and may explain the difference in MS susceptibility between African Americans and individuals of European descent. PMID:20466734

  17. Neurohumoral mechanisms associated with orthostasis: reaffirmation of the significant contribution of the heart rate response

    PubMed Central

    Convertino, Victor A.

    2014-01-01

    The inability to compensate for acute central hypovolemia underlies the clinical development of orthostatic hypotension and instability (e.g., syncope). Although neuro-humoral control of both cardiac output and peripheral vascular resistance contributes to hemodynamic stability during orthostasis, a notion has been proposed that the failure of adequate peripheral vascular constriction rather than cardiac responses represents the primary mechanism underlying the development of orthostatic intolerance. This review article provides an opportunity to present compelling evidence captured over the past 30 years in our laboratory to support the concept that neural-mediated tachycardia during orthostasis in healthy individuals represents a critical response to tolerating acute reduction in central blood volume in addition to, and independent of, peripheral vascular constriction. In this review paper, data are presented from experiments using graded lower body negative pressure (LBNP) as a method to induce orthostatic intolerance in two experimental human models: (1) comparison of heart rate and autonomic responses in individuals with relatively high and low tolerance to LBNP; and (2) vagal and sympathetic blockade of cardiac neural control. These experiments revealed that: (1) greater elevations in heart rate are associated with higher orthostatic (LBNP) tolerance; (2) higher orthostatic heart rate is associated with greater sympathetic nerve activity and withdrawal of vagally-mediated cardiac baroreflex response; and (3) non-specific sympathetic blockade causes a pronounced reduction in heart rate and LBNP tolerance. Cardiac parasympathetic withdrawal contributes to protection against development of hypotension during the initial seconds of transition to an orthostatic challenge, while the primary mechanism by which tachycardia defends orthostatic stability in healthy subjects for extended durations is mediated predominantly through sympathetic adrenergic control. PMID

  18. Validation of the Framingham Heart Study and CHARGE-AF Risk Scores for Atrial Fibrillation in Hispanics, African-Americans, and Non-Hispanic Whites.

    PubMed

    Shulman, Eric; Kargoli, Faraj; Aagaard, Philip; Hoch, Ethan; Di Biase, Luigi; Fisher, John; Gross, Jay; Kim, Soo; Krumerman, Andrew; Ferrick, Kevin J

    2016-01-01

    A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart Study and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF consortium. However, validation of these risk scores in an inner-city population is uncertain. Thus, a validation model was built using the Framingham Risk Score for AF and CHARGE-AF covariates. An in and outpatient electrocardiographic database was interrogated from 2000 to 2013 for the development of AF. Patients were included if their age was >45 and <95 years, had <10-year follow-up, if their initial electrocardiogram was without AF, had ≥ 2 electrocardiograms, and declared a race and/or ethnicity as non-Hispanic white, African-American, or Hispanic. For the Framingham Heart Study, 49,599 patients met inclusion criteria, of which 4,860 developed AF. Discrimination analysis using area under the curve (AUC) for original risk equations: non-Hispanic white AUC = 0.712 (95% confidence interval [CI] 0.694 to 0.731), African-American AUC = 0.733 (95% CI 0.716 to 0.751), and Hispanic AUC = 0.740 (95% CI 0.723 to 0.757). For the CHARGE-AF, 45,571 patients met inclusion criteria, of which 4,512 developed AF. Non-Hispanic white AUC = 0.673 (95% CI 0.652 to 0.694), African-American AUC = 0.706 (95% CI 0.685 to 0.727), and Hispanic AUC = 0.711 (95% CI 0.691 to 0.732). Calibration analysis showed qualitative similarities between cohorts. In conclusion, this is the first study to validate both the Framingham Heart Study and CHARGE-AF risk scores in both a Hispanic and African-American cohort. All models predicted AF well across all race and ethnic cohorts. PMID:26589820

  19. Validation of the Framingham Heart Study and CHARGE-AF Risk Scores for Atrial Fibrillation in Hispanics, African-Americans, and Non-Hispanic Whites.

    PubMed

    Shulman, Eric; Kargoli, Faraj; Aagaard, Philip; Hoch, Ethan; Di Biase, Luigi; Fisher, John; Gross, Jay; Kim, Soo; Krumerman, Andrew; Ferrick, Kevin J

    2016-01-01

    A risk score for atrial fibrillation (AF) has been developed by the Framingham Heart Study and Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF consortium. However, validation of these risk scores in an inner-city population is uncertain. Thus, a validation model was built using the Framingham Risk Score for AF and CHARGE-AF covariates. An in and outpatient electrocardiographic database was interrogated from 2000 to 2013 for the development of AF. Patients were included if their age was >45 and <95 years, had <10-year follow-up, if their initial electrocardiogram was without AF, had ≥ 2 electrocardiograms, and declared a race and/or ethnicity as non-Hispanic white, African-American, or Hispanic. For the Framingham Heart Study, 49,599 patients met inclusion criteria, of which 4,860 developed AF. Discrimination analysis using area under the curve (AUC) for original risk equations: non-Hispanic white AUC = 0.712 (95% confidence interval [CI] 0.694 to 0.731), African-American AUC = 0.733 (95% CI 0.716 to 0.751), and Hispanic AUC = 0.740 (95% CI 0.723 to 0.757). For the CHARGE-AF, 45,571 patients met inclusion criteria, of which 4,512 developed AF. Non-Hispanic white AUC = 0.673 (95% CI 0.652 to 0.694), African-American AUC = 0.706 (95% CI 0.685 to 0.727), and Hispanic AUC = 0.711 (95% CI 0.691 to 0.732). Calibration analysis showed qualitative similarities between cohorts. In conclusion, this is the first study to validate both the Framingham Heart Study and CHARGE-AF risk scores in both a Hispanic and African-American cohort. All models predicted AF well across all race and ethnic cohorts.

  20. Association Between Valvular Surgery and Mortality Among Patients With Infective Endocarditis Complicated by Heart Failure

    PubMed Central

    Kiefer, Todd; Park, Lawrence; Tribouilloy, Christophe; Cortes, Claudia; Casillo, Roberta; Chu, Vivian; Delahaye, Francois; Durante-Mangoni, Emanuele; Edathodu, Jameela; Falces, Carlos; Logar, Mateja; Miró, José M.; Naber, Christophe; Tripodi, Marie Françoise; Murdoch, David R.; Moreillon, Philippe; Utili, Riccardo; Wang, Andrew

    2016-01-01

    Context Heart failure (HF) is the most common complication of infective endocarditis. However, clinical characteristics of HF in patients with infective endocarditis, use of surgical therapy, and their associations with patient outcome are not well described. Objectives To determine the clinical, echocardiographic, and microbiological variables associated with HF in patients with definite infective endocarditis and to examine variables independently associated with in-hospital and 1-year mortality for patients with infective endocarditis and HF, including the use and association of surgery with outcome. Design, Setting, and Patients The International Collaboration on Endocarditis–Prospective Cohort Study, a prospective, multicenter study enrolling 4166 patients with definite native- or prosthetic-valve infective endocarditis from 61 centers in 28 countries between June 2000 and December 2006. Main Outcome Measures In-hospital and 1-year mortality. Results Of 4075 patients with infective endocarditis and known HF status enrolled, 1359 (33.4% [95% CI, 31.9%–34.8%]) had HF, and 906 (66.7% [95% CI, 64.2%–69.2%]) were classified as having New York Heart Association class III or IV symptom status. Within the subset with HF, 839 (61.7% [95% CI, 59.2%–64.3%]) underwent valvular surgery during the index hospitalization. In-hospital mortality was 29.7% (95% CI, 27.2%–32.1%) for the entire HF cohort, with lower mortality observed in patients undergoing valvular surgery compared with medical therapy alone (20.6% [95% CI, 17.9%–23.4%] vs 44.8% [95% CI, 40.4%–49.0%], respectively; P<.001). One-year mortality was 29.1% (95% CI, 26.0%–32.2%) in patients undergoing valvular surgery vs 58.4% (95% CI, 54.1%–62.6%) in those not undergoing surgery (P<.001). Cox proportional hazards modeling with propensity score adjustment for surgery showed that advanced age, diabetes mellitus, health care–associated infection, causative microorganism (Staphylococcus aureus or

  1. Risk factors associated with West Nile virus mortality in American Crow populations in Southern Quebec.

    PubMed

    Ludwig, Antoinette; Bigras-Poulin, Michel; Michel, Pascal; Bélanger, Denise

    2010-01-01

    Soon after the appearance of West Nile virus (WNV) in North America, a number of public health authorities designated the American Crow (Corvus brachyrhynchos) a sentinel for WNV detection. Although preliminary studies have suggested a positive association between American Crow mortality and increased risk of WNV infection in humans, we still know little about dynamic variation in American Crow mortality, both baseline levels and mortality associated with WNV. We hypothesized that the complex social behavior of American Crows, which is shaped by age and seasonal factors, influences both baseline mortality and WNV mortality in American Crow populations. We examined American Crow mortality data from Quebec for the 2005 WNV surveillance year, which lasted from 5 June to 17 September 2005. The variables of interest were age, gender, body condition index, time of year, and land cover. We used a log-linear model to examine baseline mortality. Logistic regression and general linear regression models were constructed to examine variables associated with mortality due to WNV. We found that both age and time of year were key variables in explaining baseline mortality. These two variables were also risk factors for WNV mortality. The probability that a carcass tested positive for WNV increased with the age of the dead bird and as summer progressed. WNV-positive carcasses also had a lower body condition index than WNV-negative carcasses. We believe that the first major wave of American Crow mortality observed in the early summer of 2005 was the result of natural mortality among young American Crows. Because this mortality was not linked to WNV, it appears that American Crow may not be a good species for early detection of WNV activity. Our data also suggest that second-year American Crows play a major role in propagating WNV during their movements to urban land covers during midsummer.

  2. APOL1 associations with nephropathy, atherosclerosis, and all-cause mortality in African Americans with type 2 diabetes.

    PubMed

    Freedman, Barry I; Langefeld, Carl D; Lu, Lingyi; Palmer, Nicholette D; Smith, S Carrie; Bagwell, Benjamin M; Hicks, Pamela J; Xu, Jianzhao; Wagenknecht, Lynne E; Raffield, Laura M; Register, Thomas C; Carr, J Jeffrey; Bowden, Donald W; Divers, Jasmin

    2015-01-01

    Albuminuria and reduced estimated glomerular filtration rate (eGFR) associate with two apolipoprotein L1 gene (APOL1) variants in nondiabetic African Americans (AAs). Whether APOL1 associates with subclinical atherosclerosis and survival remains unclear. To determine this, 717 African American-Diabetes Heart Study participants underwent computed tomography to determine coronary artery-, carotid artery-, and aorta-calcified atherosclerotic plaque mass scores in addition to the urine albumin:creatinine ratio (UACR), eGFR, and C-reactive protein (CRP). Associations between mass scores and APOL1 were assessed adjusting for age, gender, African ancestry, body mass index (BMI), hemoglobin A1c, smoking, hypertension, use of statins and angiotensin-converting enzyme inhibitors, albuminuria, and eGFR. Participants were 58.9% female with mean age 56.5 years, eGFR 89.5 ml/min per 1.73 m(2), UACR 169.6 mg/g, and coronary artery-, carotid artery-, and aorta-calcified plaque mass scores of 610, 171, and 5378, respectively. In fully adjusted models, APOL1 risk variants were significantly associated with lower levels of carotid artery-calcified plaque (β=-0.42, s.e. 0.18; dominant model) and marginally lower coronary artery plaque (β=-0.36, s.e. 0.21; dominant model), but not with aorta-calcified plaque, CRP, UACR, or eGFR. By the end of a mean follow-up of 5.0 years, 89 participants had died. APOL1 nephropathy risk variants were significantly associated with improved survival (hazard ratio 0.67 for one copy; 0.44 for two copies). Thus, APOL1 nephropathy variants associate with lower levels of subclinical atherosclerosis and reduced risk of death in AAs with type 2 diabetes mellitus. PMID:25054777

  3. APOL1 associations with nephropathy, atherosclerosis, and all-cause mortality in African Americans with type 2 diabetes.

    PubMed

    Freedman, Barry I; Langefeld, Carl D; Lu, Lingyi; Palmer, Nicholette D; Smith, S Carrie; Bagwell, Benjamin M; Hicks, Pamela J; Xu, Jianzhao; Wagenknecht, Lynne E; Raffield, Laura M; Register, Thomas C; Carr, J Jeffrey; Bowden, Donald W; Divers, Jasmin

    2015-01-01

    Albuminuria and reduced estimated glomerular filtration rate (eGFR) associate with two apolipoprotein L1 gene (APOL1) variants in nondiabetic African Americans (AAs). Whether APOL1 associates with subclinical atherosclerosis and survival remains unclear. To determine this, 717 African American-Diabetes Heart Study participants underwent computed tomography to determine coronary artery-, carotid artery-, and aorta-calcified atherosclerotic plaque mass scores in addition to the urine albumin:creatinine ratio (UACR), eGFR, and C-reactive protein (CRP). Associations between mass scores and APOL1 were assessed adjusting for age, gender, African ancestry, body mass index (BMI), hemoglobin A1c, smoking, hypertension, use of statins and angiotensin-converting enzyme inhibitors, albuminuria, and eGFR. Participants were 58.9% female with mean age 56.5 years, eGFR 89.5 ml/min per 1.73 m(2), UACR 169.6 mg/g, and coronary artery-, carotid artery-, and aorta-calcified plaque mass scores of 610, 171, and 5378, respectively. In fully adjusted models, APOL1 risk variants were significantly associated with lower levels of carotid artery-calcified plaque (β=-0.42, s.e. 0.18; dominant model) and marginally lower coronary artery plaque (β=-0.36, s.e. 0.21; dominant model), but not with aorta-calcified plaque, CRP, UACR, or eGFR. By the end of a mean follow-up of 5.0 years, 89 participants had died. APOL1 nephropathy risk variants were significantly associated with improved survival (hazard ratio 0.67 for one copy; 0.44 for two copies). Thus, APOL1 nephropathy variants associate with lower levels of subclinical atherosclerosis and reduced risk of death in AAs with type 2 diabetes mellitus.

  4. Position of the American Dietetic Association, School Nutrition Association, and Society for Nutrition Education: Comprehensive School Nutrition Services

    ERIC Educational Resources Information Center

    Briggs, Marilyn; Fleischhacker, Sheila; Mueller, Constance G.

    2010-01-01

    It is the position of the American Dietetic Association (ADA), School Nutrition Association (SNA), and Society for Nutrition Education (SNE) that comprehensive, integrated nutrition services in schools, kindergarten through grade 12, are an essential component of coordinated school health programs and will improve the nutritional status, health,…

  5. Aspirin and heart disease

    MedlinePlus

    ... the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology ... NE, et al. Antithrombotic and thrombolytic therapy for ischemic ... of coronary heart disease. In: Mann DL, Zipes DP, Libby P, et ...

  6. Functional importance of cardiac enhancer-associated noncoding RNAs in heart development and disease

    PubMed Central

    Ounzain, Samir; Pezzuto, Iole; Micheletti, Rudi; Burdet, Frédéric; Sheta, Razan; Nemir, Mohamed; Gonzales, Christine; Sarre, Alexandre; Alexanian, Michael; Blow, Matthew J.; May, Dalit; Johnson, Rory; Dauvillier, Jérôme; Pennacchio, Len A.; Pedrazzini, Thierry

    2015-01-01

    The key information processing units within gene regulatory networks are enhancers. Enhancer activity is associated with the production of tissue-specific noncoding RNAs, yet the existence of such transcripts during cardiac development has not been established. Using an integrated genomic approach, we demonstrate that fetal cardiac enhancers generate long noncoding RNAs (IncRNAs) during cardiac differentiation and morphogenesis. Enhancer expression correlates with the emergence of active enhancer chromatin states, the initiation of RNA polymerase II at enhancer loci and expression of target genes. Orthologous human sequences are also transcribed in fetal human hearts and cardiac progenitor cells. Through a systematic bioinformatic analysis, we identified and characterized, for the first time, a catalog of IncRNAs that are expressed during embryonic stem cell differentiation into cardiomyocytes and associated with active cardiac enhancer sequences. RNA-sequencing demonstrates that many of these transcripts are polyadenylated, multi-exonic long noncoding RNAs. Moreover, knockdown of two enhancer-associated IncRNAs resulted in the specific downregulation of their predicted target genes. Interestingly, the reactivation of the fetal gene program, a hallmark of the stress response in the adult heart, is accompanied by increased expression of fetal cardiac enhancer transcripts. Altogether, these findings demonstrate that the activity of cardiac enhancers and expression of their target genes are associated with the production of enhancer-derived IncRNAs. PMID:25149110

  7. Functional importance of cardiac enhancer-associated noncoding RNAs in heart development and disease

    DOE PAGESBeta

    Ounzain, Samir; Pezzuto, Iole; Micheletti, Rudi; Burdet, Frédéric; Sheta, Razan; Nemir, Mohamed; Gonzales, Christine; Sarre, Alexandre; Alexanian, Michael; Blow, Matthew J.; et al

    2014-08-19

    We report here that the key information processing units within gene regulatory networks are enhancers. Enhancer activity is associated with the production of tissue-specific noncoding RNAs, yet the existence of such transcripts during cardiac development has not been established. Using an integrated genomic approach, we demonstrate that fetal cardiac enhancers generate long noncoding RNAs (lncRNAs) during cardiac differentiation and morphogenesis. Enhancer expression correlates with the emergence of active enhancer chromatin states, the initiation of RNA polymerase II at enhancer loci and expression of target genes. Orthologous human sequences are also transcribed in fetal human hearts and cardiac progenitor cells. Throughmore » a systematic bioinformatic analysis, we identified and characterized, for the first time, a catalog of lncRNAs that are expressed during embryonic stem cell differentiation into cardiomyocytes and associated with active cardiac enhancer sequences. RNA-sequencing demonstrates that many of these transcripts are polyadenylated, multi-exonic long noncoding RNAs. Moreover, knockdown of two enhancer-associated lncRNAs resulted in the specific downregulation of their predicted target genes. Interestingly, the reactivation of the fetal gene program, a hallmark of the stress response in the adult heart, is accompanied by increased expression of fetal cardiac enhancer transcripts. Altogether, these findings demonstrate that the activity of cardiac enhancers and expression of their target genes are associated with the production of enhancer-derived lncRNAs.« less

  8. Functional importance of cardiac enhancer-associated noncoding RNAs in heart development and disease

    SciTech Connect

    Ounzain, Samir; Pezzuto, Iole; Micheletti, Rudi; Burdet, Frédéric; Sheta, Razan; Nemir, Mohamed; Gonzales, Christine; Sarre, Alexandre; Alexanian, Michael; Blow, Matthew J.; May, Dalit; Johnson, Rory; Dauvillier, Jérôme; Pennacchio, Len A.; Pedrazzini, Thierry

    2014-08-19

    We report here that the key information processing units within gene regulatory networks are enhancers. Enhancer activity is associated with the production of tissue-specific noncoding RNAs, yet the existence of such transcripts during cardiac development has not been established. Using an integrated genomic approach, we demonstrate that fetal cardiac enhancers generate long noncoding RNAs (lncRNAs) during cardiac differentiation and morphogenesis. Enhancer expression correlates with the emergence of active enhancer chromatin states, the initiation of RNA polymerase II at enhancer loci and expression of target genes. Orthologous human sequences are also transcribed in fetal human hearts and cardiac progenitor cells. Through a systematic bioinformatic analysis, we identified and characterized, for the first time, a catalog of lncRNAs that are expressed during embryonic stem cell differentiation into cardiomyocytes and associated with active cardiac enhancer sequences. RNA-sequencing demonstrates that many of these transcripts are polyadenylated, multi-exonic long noncoding RNAs. Moreover, knockdown of two enhancer-associated lncRNAs resulted in the specific downregulation of their predicted target genes. Interestingly, the reactivation of the fetal gene program, a hallmark of the stress response in the adult heart, is accompanied by increased expression of fetal cardiac enhancer transcripts. Altogether, these findings demonstrate that the activity of cardiac enhancers and expression of their target genes are associated with the production of enhancer-derived lncRNAs.

  9. Associations between reasons for living and diminished suicide intent among African-American female suicide attempters.

    PubMed

    Flowers, Kelci C; Walker, Rheeda L; Thompson, Martie P; Kaslow, Nadine J

    2014-08-01

    African-American women are at high risk for suicide ideation and suicide attempts and use emergency psychiatric services at disproportionately high rates relative to men and other ethnic groups. However, suicide death rates are low for this population. Cultural variables in the African-American community may promote resilience and prevent fatal suicidal behavior among African-American women. The present study evaluated self-reported reasons for living as a protective factor against suicidal intent and suicide attempt lethality in a sample of African-American female suicide attempters (n = 150). Regression analyses revealed that reasons for living were negatively associated with suicidal intent, even after controlling for spiritual well-being and symptoms of depression. These results indicate that the ability to generate and contemplate reasons for valuing life may serve as a protective characteristic against life-threatening suicidal behavior among African-American women. Implications for research and clinical practice are further discussed. PMID:25010106

  10. Genetic abnormalities in FOXP1 are associated with congenital heart defects.

    PubMed

    Chang, Sheng-Wei; Mislankar, Mona; Misra, Chaitali; Huang, Nianyuan; Dajusta, Daniel G; Harrison, Steven M; McBride, Kim L; Baker, Linda A; Garg, Vidu

    2013-09-01

    The etiology for the majority of congenital heart defects (CHD) is unknown. We identified a patient with unbalanced atrioventricular septal defect (AVSD) and hypoplastic left ventricle who harbored an ~0.3 Mb monoallelic deletion on chromosome 3p14.1. The deletion encompassed the first four exons of FOXP1, a gene critical for normal heart development that represses cardiomyocyte proliferation and expression of Nkx2.5. To determine whether FOXP1 mutations are found in patients with CHD, we sequenced FOXP1 in 82 patients with AVSD or hypoplastic left heart syndrome. We discovered two patients who harbored a heterozygous c.1702C>T variant in FOXP1 that predicted a potentially deleterious substitution of a highly conserved proline (p.Pro568Ser). This variant was not found in 287 controls but is present in dbSNP at a 0.2% frequency. The orthologous murine Foxp1 p.Pro596Ser mutant protein displayed deficits in luciferase reporter assays and resulted in increased proliferation and Nkx2.5 expression in cardiomyoblasts. Our data suggest that haploinsufficiency of FOXP1 is associated with human CHD.

  11. Cardiac Remodeling, Adaptations and Associated Myocardial Mechanics in Hypertensive Heart Diseases

    PubMed Central

    Lai, Yau-Huei; Lo, Chi-In; Wu, Yih-Jer; Hung, Chung-Lieh; Yeh, Hung-I

    2013-01-01

    Hypertension is the leading cause of heart failure and cardiovascular comorbidities in developed countries. Left ventricular structural/functional alterations such as concentric remodeling or hypertrophy have been extensively studied in hypertensive heart diseases. Furthermore, it is also well-recognized that diastolic function actually deteriorates in hypertensive subjects prior to overt heart failure. Novel imaging modality techniques such as myocardial deformation have allowed for early detection of regional/global myocardial contractile dysfunction. Myocardial deformation, which can be quantified by measuring the systolic strain and strain rate in three different directions (longitudinal, circumferential and radial), has facilitated new insights into the understanding of cardiac systolic mechanics in subjects with early stage myocardial damage. Previous studies had shown that longitudinal function remains the most sensitive parameter in identifying hypertension-related myocardial dysfunction, particularly for those patients who had developed LV hypertrophy. Instead, preserved or enhanced short-axis function, when presented as circumferential or radial strains, may remain relatively preserved or enhanced in order to compensate for longitudinal functional decline. In this manner, global cardiac pumping in terms of ejection fraction may remain relatively unchanged. The early recognition of subclinical systolic dysfunction and associated mechanical compensation in the context of hypertension is crucial, which potentially helps to identify a disease stage that is still responsive to therapeutic intervention. PMID:27122686

  12. Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls

    PubMed Central

    Keenan, Kate; Culbert, Kristen; Grimm, Kevin J.; Hipwell, Alison; Stepp, Stephanie

    2014-01-01

    The relative contribution of pubertal timing and tempo to the development of depression has not been tested in a large, representative sample, nor has the interface among pubertal maturation, depression, and race. Participants were a community-based sample of 2,450 girls from the Pittsburgh Girls Study (PGS) who were interviewed annually from ages 9 to 17 years. Pubertal timing and tempo were characterized as a unitary construct and also separately for pubic hair and breast development using child and maternal report. Depression symptoms were assessed annually. African-American females had higher depression symptoms and progressed through puberty earlier, but at a slower tempo than European American girls. Girls with earlier timing had higher levels of depression symptoms at age 10 years. Slower tempo was associated with higher depression symptoms at age 10, and faster tempo was associated with increases in depression from ages 10 to 13. As well, race moderated the associations among timing, tempo, and depression symptoms, and the association between race and depression was partially mediated by pubertal timing and tempo. Pubertal timing and tempo and race contribute to the developmental course of depression from early to late adolescence. The pattern of association varies as a function of the developmental window within which depression is assessed. Thus, repeated measures of depression symptoms and puberty across the span of pubertal development are necessary for exploring the relative importance of dimensions of pubertal development to depression etiology. PMID:25314262

  13. Timing and tempo: Exploring the complex association between pubertal development and depression in African American and European American girls.

    PubMed

    Keenan, Kate; Culbert, Kristen M; Grimm, Kevin J; Hipwell, Alison E; Stepp, Stephanie D

    2014-11-01

    The relative contribution of pubertal timing and tempo to the development of depression has not been tested in a large, representative sample, nor has the interface among pubertal maturation, depression, and race been tested. Participants were a community-based sample of 2,450 girls from the Pittsburgh Girls Study who were interviewed annually from ages 9 to 17 years. Pubertal timing and tempo were characterized as a unitary construct and also separately for pubic hair and breast development using child and maternal report. Depression symptoms were assessed annually. African American girls had higher depression symptoms and progressed through puberty earlier, but at a slower tempo than European American girls. Girls with earlier timing had higher levels of depression symptoms at age 10 years. Slower tempo was associated with higher depression symptoms at age 10, and faster tempo was associated with increases in depression from ages 10 to 13. As well, race moderated the associations among timing, tempo, and depression symptoms, and the association between race and depression was partially mediated by pubertal timing and tempo. Pubertal timing and tempo and race contribute to the developmental course of depression from early to late adolescence. The pattern of association varies as a function of the developmental window within which depression is assessed. Thus, repeated measures of depression symptoms and puberty across the span of pubertal development are necessary for exploring the relative importance of dimensions of pubertal development to depression etiology.

  14. A Study of Color Association Differences between Americans and Japanese.

    ERIC Educational Resources Information Center

    Kitao, Kenji; Kitao, S. Kathleen

    1986-01-01

    In intercultural communication, linguistic competence must be accompanied by an understanding of the associations that the speakers share. For communicating in a foreign language, the most important kind of association is indicative association, which is related to the literature, customs, and history of a people. When Japanese people communicate…

  15. Close association between valvar heart disease and central nervous system manifestations in the antiphospholipid syndrome

    PubMed Central

    Krause, I; Lev, S; Fraser, A; Blank, M; Lorber, M; Stojanovich, L; Rovensky, J; Chapman, J; Shoenfeld, Y

    2005-01-01

    Background: Heart valves lesions and central nervous system involvement are among the most common manifestations of the antiphospholipid syndrome (APS). Objective: To evaluate possible interrelations between these manifestations in a large group of APS patients. Methods: 284 APS patients were evaluated retrospectively, 159 of whom had primary APS. Cardiac–CNS associations were determined for the entire study population, and for subgroups of patients with primary APS or APS associated with systemic lupus erythematosus (SLE). Results: Significant associations where found between cardiac vegetations and epilepsy (p<0.02), and between cardiac valve thickening or dysfunction and migraine (p = 0.002). Borderline association was found between valvar vegetations and migraine (p = 0.09). A significant association was also found between all valvar lesions and stroke or transient ischaemic attacks. Subanalyses showed that patients with primary APS had significant associations between cardiac valve pathology and all CNS manifestations, while patients with APS associated with SLE had no such associations. Conclusions: The study suggests potential differences in biological behaviour between primary APS and APS associated with SLE. The presence of cardiac valve pathology may be a risk factor for several types of CNS involvement in PAPS. PMID:15778242

  16. Cardiac fatty acid oxidation in heart failure associated with obesity and diabetes.

    PubMed

    Fukushima, Arata; Lopaschuk, Gary D

    2016-10-01

    Obesity and diabetes are major public health problems, and are linked to the development of heart failure. Emerging data highlight the importance of alterations in cardiac energy metabolism as a major contributor to cardiac dysfunction related to obesity and diabetes. Increased rates of fatty acid oxidation and decreased rates of glucose utilization are two prominent changes in cardiac energy metabolism that occur in obesity and diabetes. This metabolic profile is probably both a cause and consequence of a prominent cardiac insulin resistance, which is accompanied by a decrease in both cardiac function and efficiency, and by the accumulation of potentially toxic lipid metabolites in the heart that can further exaggerate insulin resistance and cardiac dysfunction. The high cardiac fatty acid oxidation rates seen in obesity and diabetes are attributable to several factors, including: 1) increased fatty acid supply and uptake into the cardiomyocyte, 2) increased transcription of fatty acid metabolic enzymes, 3) decreased allosteric control of mitochondrial fatty acid uptake and fatty acid oxidation, and 4) increased post-translational acetylation control of various fatty acid oxidative enzymes. Emerging evidence suggests that therapeutic approaches aimed at switching the balance of cardiac energy substrate preference from fatty acid oxidation to glucose use can prevent cardiac dysfunction associated with obesity and diabetes. Modulating acetylation control of fatty acid oxidative enzymes is also a potentially attractive strategy, although presently this is limited to precursors of nicotinamide adenine or nonspecific activators of deacetylation such as resveratrol. This review will focus on the metabolic alterations in the heart that occur in obesity and diabetes, as well as on the molecular mechanisms controlling these metabolic changes. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk. PMID:26996746

  17. Age- and Hypertension-Associated Protein Aggregates in Mouse Heart Have Similar Proteomic Profiles.

    PubMed

    Ayyadevara, Srinivas; Mercanti, Federico; Wang, Xianwei; Mackintosh, Samuel G; Tackett, Alan J; Prayaga, Sastry V S; Romeo, Francesco; Shmookler Reis, Robert J; Mehta, Jawahar L

    2016-05-01

    Neurodegenerative diseases are largely defined by protein aggregates in affected tissues. Aggregates contain some shared components as well as proteins thought to be specific for each disease. Aggregation has not previously been reported in the normal, aging heart or the hypertensive heart. Detergent-insoluble protein aggregates were isolated from mouse heart and characterized on 2-dimensional gels. Their levels increased markedly and significantly with aging and after sustained angiotensin II-induced hypertension. Of the aggregate components identified by high-resolution proteomics, half changed in abundance with age (392/787) or with sustained hypertension (459/824), whereas 30% (273/901) changed concordantly in both, each P<0.05. One fifth of these proteins were previously associated with age-progressive neurodegenerative or cardiovascular diseases, or both (eg, ApoE, ApoJ, ApoAIV, clusterin, complement C3, and others involved in stress-response and protein-homeostasis pathways). Because fibrosis is a characteristic of both aged and hypertensive hearts, we posited that aging of fibroblasts may contribute to the aggregates observed in cardiac tissue. Indeed, as cardiac myofibroblasts "senesced" (approached their replicative limit) in vitro, they accrued aggregates with many of the same constituent proteins observed in vivo during natural aging or sustained hypertension. In summary, we have shown for the first time that compact (detergent-insoluble) protein aggregates accumulate during natural aging, chronic hypertension, and in vitro myofibroblast senescence, sharing many common proteins. Thus, aggregates that arise from disparate causes (aging, hypertension, and replicative senescence) may have common underlying mechanisms of accrual.

  18. Cardiac fatty acid oxidation in heart failure associated with obesity and diabetes.

    PubMed

    Fukushima, Arata; Lopaschuk, Gary D

    2016-10-01

    Obesity and diabetes are major public health problems, and are linked to the development of heart failure. Emerging data highlight the importance of alterations in cardiac energy metabolism as a major contributor to cardiac dysfunction related to obesity and diabetes. Increased rates of fatty acid oxidation and decreased rates of glucose utilization are two prominent changes in cardiac energy metabolism that occur in obesity and diabetes. This metabolic profile is probably both a cause and consequence of a prominent cardiac insulin resistance, which is accompanied by a decrease in both cardiac function and efficiency, and by the accumulation of potentially toxic lipid metabolites in the heart that can further exaggerate insulin resistance and cardiac dysfunction. The high cardiac fatty acid oxidation rates seen in obesity and diabetes are attributable to several factors, including: 1) increased fatty acid supply and uptake into the cardiomyocyte, 2) increased transcription of fatty acid metabolic enzymes, 3) decreased allosteric control of mitochondrial fatty acid uptake and fatty acid oxidation, and 4) increased post-translational acetylation control of various fatty acid oxidative enzymes. Emerging evidence suggests that therapeutic approaches aimed at switching the balance of cardiac energy substrate preference from fatty acid oxidation to glucose use can prevent cardiac dysfunction associated with obesity and diabetes. Modulating acetylation control of fatty acid oxidative enzymes is also a potentially attractive strategy, although presently this is limited to precursors of nicotinamide adenine or nonspecific activators of deacetylation such as resveratrol. This review will focus on the metabolic alterations in the heart that occur in obesity and diabetes, as well as on the molecular mechanisms controlling these metabolic changes. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk.

  19. Prolonged Sitting is Associated with Attenuated Heart Rate Variability during Sleep in Blue-Collar Workers.

    PubMed

    Hallman, David M; Sato, Tatiana; Kristiansen, Jesper; Gupta, Nidhi; Skotte, Jørgen; Holtermann, Andreas

    2015-11-19

    Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies.

  20. Association between 5, 10-methylenetetrahydrofolate reductase (MTHFR) polymorphisms and congenital heart disease: A meta-analysis☆

    PubMed Central

    Wang, Wenju; Hou, Zongliu; Wang, Chunhui; Wei, Chuanyu; Li, Yaxiong; Jiang, Lihong

    2013-01-01

    Background Inconsistent results were reported in recent literature regarding the association between methylenetetrahydrofolate reductase (MTHFR) C677T/A1298C polymorphisms and the susceptibility of congenital heart disease (CHD). In this study, we performed a meta-analysis to investigate the associations by employing multiple analytical methods. Methods Literature search was performed and published articles were obtained from PubMed, Embase and CNKI databases based on the exclusion and inclusion criteria. Data were extracted from eligible studies and the crude odds ratios and their corresponding 95% confidence intervals (CIs) were calculated using random or fix effects model to evaluate the associations between the MTHFR C677T/A1298C polymorphisms and CHD development. Subgroup based analysis was performed by Hardy–Weinberg equilibrium, ethnicity, types of CHD, source of control and sample size. Results Twenty-four eligible studies were included in this meta-analysis. Significant association was found between fetal MTHFR C677T polymorphism and CHD development in all genetic models. The pooled ORs and 95% CIs in all genetic models indicated that MTHFR C677T polymorphism was significantly associated with CHD in Asian, but not Caucasian in subgroup analysis. The maternal MTHFR C677T polymorphism was not associated with CHD except for recessive model. Moreover, neither maternal nor fetal MTHFR A1298C polymorphism was associated with CHD. Conclusion The fetal MTHFR C677T polymorphism may increase the susceptibility to CHD. Fetal MTHFR C677T polymorphism was more likely to affect Asian fetus than Caucasian. The MTHFR A1298C polymorphism may not be a risk of congenital heart disease. PMID:25606381

  1. Prolonged Sitting is Associated with Attenuated Heart Rate Variability during Sleep in Blue-Collar Workers

    PubMed Central

    Hallman, David M; Sato, Tatiana; Kristiansen, Jesper; Gupta, Nidhi; Skotte, Jørgen; Holtermann, Andreas

    2015-01-01

    Prolonged sitting is associated with increased risk for cardiovascular diseases and mortality. However, research into the physiological determinants underlying this relationship is still in its infancy. The aim of the study was to determine the extent to which occupational and leisure-time sitting are associated with nocturnal heart rate variability (HRV) in blue-collar workers. The study included 138 blue-collar workers (mean age 45.5 (SD 9.4) years). Sitting-time was measured objectively for four days using tri-axial accelerometers (Actigraph GT3X+) worn on the thigh and trunk. During the same period, a heart rate monitor (Actiheart) was used to sample R-R intervals from the electrocardiogram. Time and frequency domain indices of HRV were only derived during nighttime sleep, and used as markers of cardiac autonomic modulation. Regression analyses with multiple adjustments (age, gender, body mass index, smoking, job-seniority, physical work-load, influence at work, and moderate-to-vigorous physical activity) were used to investigate the association between sitting time and nocturnal HRV. We found that occupational sitting-time was negatively associated (p < 0.05) with time and frequency domain HRV indices. Sitting-time explained up to 6% of the variance in HRV, independent of the covariates. Leisure-time sitting was not significantly associated with any HRV indices (p > 0.05). In conclusion, objectively measured occupational sitting-time was associated with reduced nocturnal HRV in blue-collar workers. This indicates an attenuated cardiac autonomic regulation with increasing sitting-time at work regardless of moderate-to-vigorous physical activity. The implications of this association for cardiovascular disease risk warrant further investigation via long-term prospective studies and intervention studies. PMID:26610534

  2. Obstructive heart defects associated with candidate genes, maternal obesity, and folic acid supplementation.

    PubMed

    Tang, Xinyu; Cleves, Mario A; Nick, Todd G; Li, Ming; MacLeod, Stewart L; Erickson, Stephen W; Li, Jingyun; Shaw, Gary M; Mosley, Bridget S; Hobbs, Charlotte A

    2015-06-01

    Right-sided and left-sided obstructive heart defects (OHDs) are subtypes of congenital heart defects, in which the heart valves, arteries, or veins are abnormally narrow or blocked. Previous studies have suggested that the development of OHDs involved a complex interplay between genetic variants and maternal factors. Using the data from 569 OHD case families and 1,644 control families enrolled in the National Birth Defects Prevention Study (NBDPS) between 1997 and 2008, we conducted an analysis to investigate the genetic effects of 877 single nucleotide polymorphisms (SNPs) in 60 candidate genes for association with the risk of OHDs, and their interactions with maternal use of folic acid supplements, and pre-pregnancy obesity. Applying log-linear models based on the hybrid design, we identified a SNP in methylenetetrahydrofolate reductase (MTHFR) gene (C677T polymorphism) with a main genetic effect on the occurrence of OHDs. In addition, multiple SNPs in betaine-homocysteine methyltransferase (BHMT and BHMT2) were also identified to be associated with the occurrence of OHDs through significant main infant genetic effects and interaction effects with maternal use of folic acid supplements. We also identified multiple SNPs in glutamate-cysteine ligase, catalytic subunit (GCLC) and DNA (cytosine-5-)-methyltransferase 3 beta (DNMT3B) that were associated with elevated risk of OHDs among obese women. Our findings suggested that the risk of OHDs was closely related to a combined effect of variations in genes in the folate, homocysteine, or glutathione/transsulfuration pathways, maternal use of folic acid supplements and pre-pregnancy obesity. PMID:25846410

  3. Obstructive Heart Defects Associated with Candidate Genes, Maternal Obesity, and Folic Acid Supplementation

    PubMed Central

    Tang, Xinyu; Cleves, Mario A.; Nick, Todd G.; Li, Ming; MacLeod, Stewart L.; Erickson, Stephen W.; Li, Jingyun; Shaw, Gary M.; Mosley, Bridget S.; Hobbs, Charlotte A.

    2015-01-01

    Right-sided and left-sided obstructive heart defects (OHDs) are subtypes of congenital heart defects, in which the heart valves, arteries, or veins are abnormally narrow or blocked. Previous studies have suggested that the development of OHDs involved a complex interplay between genetic variants and maternal factors. Using the data from 569 OHD case families and 1644 control families enrolled in the National Birth Defects Prevention Study (NBDPS) between 1997 and 2008, we conducted an analysis to investigate the genetic effects of 877 single nucleotide polymorphisms (SNPs) in 60 candidate genes for association with the risk of OHDs, and their interactions with maternal use of folic acid supplements, and pre-pregnancy obesity. Applying log-linear models based on the hybrid design, we identified a SNP in methylenetetrahydrofolate reductase (MTHFR) gene (C677T polymorphism) with a main genetic effect on the occurrence of OHDs. In addition, multiple SNPs in betaine-homocysteine methyltransferase (BHMT and BHMT2) were also identified to be associated with the occurrence of OHDs through significant main infant genetic effects and interaction effects with maternal use of folic acid supplements. We also identified multiple SNPs in glutamate-cysteine ligase, catalytic subunit (GCLC) and DNA (cytosine-5-)-methyltransferase 3 beta (DNMT3B) that were associated with elevated risk of OHDs among obese women. Our findings suggested that the risk of OHDs was closely related to a combined effect of variations in genes in the folate, homocysteine, or glutathione/transsulfuration pathways, maternal use of folic acid supplements and pre-pregnancy obesity. PMID:25846410

  4. Obstructive heart defects associated with candidate genes, maternal obesity, and folic acid supplementation.

    PubMed

    Tang, Xinyu; Cleves, Mario A; Nick, Todd G; Li, Ming; MacLeod, Stewart L; Erickson, Stephen W; Li, Jingyun; Shaw, Gary M; Mosley, Bridget S; Hobbs, Charlotte A

    2015-06-01

    Right-sided and left-sided obstructive heart defects (OHDs) are subtypes of congenital heart defects, in which the heart valves, arteries, or veins are abnormally narrow or blocked. Previous studies have suggested that the development of OHDs involved a complex interplay between genetic variants and maternal factors. Using the data from 569 OHD case families and 1,644 control families enrolled in the National Birth Defects Prevention Study (NBDPS) between 1997 and 2008, we conducted an analysis to investigate the genetic effects of 877 single nucleotide polymorphisms (SNPs) in 60 candidate genes for association with the risk of OHDs, and their interactions with maternal use of folic acid supplements, and pre-pregnancy obesity. Applying log-linear models based on the hybrid design, we identified a SNP in methylenetetrahydrofolate reductase (MTHFR) gene (C677T polymorphism) with a main genetic effect on the occurrence of OHDs. In addition, multiple SNPs in betaine-homocysteine methyltransferase (BHMT and BHMT2) were also identified to be associated with the occurrence of OHDs through significant main infant genetic effects and interaction effects with maternal use of folic acid supplements. We also identified multiple SNPs in glutamate-cysteine ligase, catalytic subunit (GCLC) and DNA (cytosine-5-)-methyltransferase 3 beta (DNMT3B) that were associated with elevated risk of OHDs among obese women. Our findings suggested that the risk of OHDs was closely related to a combined effect of variations in genes in the folate, homocysteine, or glutathione/transsulfuration pathways, maternal use of folic acid supplements and pre-pregnancy obesity.

  5. Association of ischemic heart disease to global and regional longitudinal strain in asymptomatic aortic stenosis.

    PubMed

    Carstensen, Helle Gervig; Larsen, Linnea Hornbech; Hassager, Christian; Kofoed, Klaus Fuglsang; Jensen, Jan Skov; Mogelvang, Rasmus

    2015-03-01

    Longitudinal deformation has been shown to deteriorate with progressive aortic stenosis as well as ischemic heart disease. Despite that both conditions share risk factors and are often coexisting, studies have not assessed the influence on longitudinal deformation for both conditions simultaneously. Thus the purpose of this study was to evaluate the association between subclinical ischemic heart disease and global and regional longitudinal strain in asymptomatic patients with significant aortic stenosis. Prevalent patients with a diagnosis of aortic stenosis at six hospitals in the Greater Copenhagen area were screened for inclusion. A total of 104 asymptomatic patients with moderate-severe aortic stenosis (aortic valve area ≤1.5 cm(2)) fulfilled study criteria and underwent advanced echocardiographic analysis and coronary angiography by multi-detector computed tomography. Angiography revealed coronary stenosis >50% in 31% (n = 32). All regional longitudinal strain measures (apical, mid and basal longitudinal strain) were significant predictors of significant coronary stenosis (>70% stenosis), but only apical and mid longitudinal strain were significant predictors in multivariable analyses independent of aortic valve area, stroke volume index, pro-BNP, valvulo-arterial impedance, body mass index and heart rate. In linear regression models with both aortic valve area and significant coronary stenosis, apical (p < 0.001) and mid (p < 0.01) longitudinal strain were associated to significant coronary stenosis but not aortic valve area. Conversely, basal longitudinal strain was significantly associated to aortic valve area (p = 0.001), but not to significant coronary stenosis. Subclinical coronary artery disease is frequent in moderate and severe aortic stenosis, and should be suspected when regional longitudinal dysfunction is predominant in the apical and mid ventricular segments.

  6. Elevated high sensitivity C-reactive protein is associated with type 2 diabetes mellitus: the Persian Gulf Healthy Heart Study.

    PubMed

    Nabipour, Iraj; Vahdat, Katayoun; Jafari, Seyed Mojtaba; Beigi, Saeideh; Assadi, Majid; Azizi, Fatemeh; Sanjdideh, Zahra

    2008-08-01

    Previous studies have suggested that low-grade systemic inflammation is involved in the pathogenesis of type 2 diabetes mellitus. However, limited information is available about the relationship of diabetes mellitus and inflammation in Asia. We examined the association between high-sensitivity C-reactive protein (CRP) levels and diabetes in a general Iranian population. In an ancillary study to the Persian Gulf Healthy Heart Study, a cohort study of men and women aged > or = 25 years, a random sample of 1754 (49.2 percent males, 50.8 percent females) subjects were evaluated. High sensitivity C-reactive protein was measured by enzyme-linked immunosorbent assay. Elevated serum CRP was defined as more than 3.0 mg/l. The diabetes classification was based on the criteria of the American Diabetes Association. A total of 8.6 percent of the subjects (8.0 percent of males & 9.1 percent of females; p>0.05) had type 2 diabetes mellitus. Geometric mean of CRP was 1.94 mg/l (3.80 SD) in the studied population. The subjects with diabetes had a higher geometric mean of CRP levels than the subjects with no diabetes [3.67 (SD 3.71) versus 1.85 (3.83) respectively; p<0.0001)]. In multiple logistic regression analysis, diabetes showed a significant age-adjusted association with elevated CRP levels [Odds Ratio = 2.03, Confidence Interval (1.38-2.98); p<0.0001] after adjusting for sex, LDL-cholesterol, HDL-cholesterol blood pressure, smoking and body mass index. In conclusion, beyond traditional cardiovascular risk factors, elevated CRP is significantly correlated with diabetes in general population of the northern Persian Gulf. Further insight into the specific effects of proinflammatory cytokines and acute-phase proteins will be essential for the development of new preventive strategies for diabetes mellitus. PMID:18493107

  7. [An investigation on the association between incidence of coronary heart disease and stroke and meteorological factors].

    PubMed

    Wu, Y

    1990-04-01

    Analysis of association between acute onset of coronary heart disease, stroke and meteorological factors, including temperature, atmospheric pressure, relative humidity etc, was done by simple correlation and multiple stepwise regression analysis, for a period of 2 years, 1984 to 1985. This study covered a population approximately of 700,000, scattered in defined areas of Beijing. The result showed that there was a negative correlation between incidence of stroke and acute myocardial infarction and some meteorological factors, such as temperature and clouds. A negative correlation between coronary sudden death and temperature had been observed by simple correlation analysis.

  8. Occupational exposure to non-ionizing radiation and an association with heart disease: an exploratory study.

    PubMed

    Hamburger, S; Logue, J N; Silverman, P M

    1983-01-01

    Exploratory analyses for dose-related exposure to non-ionizing radiation and adverse health effects among male physical therapists were done from a mail questionnaire survey. The cohort consisted of 3004 respondents who were stratified into subgroups according to exposure across and within the various types of non-ionizing radiation energy emitted from diathermy equipment. The radiation modalities considered were ultrasound, microwave, shortwave, and infrared. An association between heart disease and exposure to shortwave radiation was the only consistently significant finding when high and low exposure groups were compared. PMID:6643646

  9. The association between orthostatic increase in pulse pressure and ischemic heart disease.

    PubMed

    Takata, Munenori; Amiya, Eisuke; Watanabe, Masafumi; Yamada, Namie; Watanabe, Aya; Kawarasaki, Shuichi; Ozeki, Atsuko; Nakao, Tomoko; Hosoya, Yumiko; Ando, Jiro; Komuro, Issei

    2016-01-01

    The clinical meaning of changes in PP with posture remains unclear. We performed treadmill exercise testing on 144 subjects to diagnose ischemic heart disease, and measured the PPs in the supine and standing positions. The differences in the two PPs ranged between -35 and 45 mmHg. Eleven subjects were diagnosed with significant coronary ischemia. The differences in the PPs were significantly increased, and PP in the standing position was significantly elevated in these subjects. A large difference in the PPs in the standing and supine positions was associated with significant coronary ischemia, independent of significant covariables.

  10. The association between orthostatic increase in pulse pressure and ischemic heart disease.

    PubMed

    Takata, Munenori; Amiya, Eisuke; Watanabe, Masafumi; Yamada, Namie; Watanabe, Aya; Kawarasaki, Shuichi; Ozeki, Atsuko; Nakao, Tomoko; Hosoya, Yumiko; Ando, Jiro; Komuro, Issei

    2016-01-01

    The clinical meaning of changes in PP with posture remains unclear. We performed treadmill exercise testing on 144 subjects to diagnose ischemic heart disease, and measured the PPs in the supine and standing positions. The differences in the two PPs ranged between -35 and 45 mmHg. Eleven subjects were diagnosed with significant coronary ischemia. The differences in the PPs were significantly increased, and PP in the standing position was significantly elevated in these subjects. A large difference in the PPs in the standing and supine positions was associated with significant coronary ischemia, independent of significant covariables. PMID:26287795

  11. Categorization of Fetal Heart Rate Decelerations in American and European Practice: Importance and Imperative of Avoiding Framing and Confirmation Biases

    PubMed Central

    Sholapurkar, Shashikant L.

    2015-01-01

    Interpretation of electronic fetal monitoring (EFM) remains controversial and unsatisfactory. Fetal heart rate (FHR) decelerations are the commonest aberrant feature on cardiotocographs and considered “center-stage” in the interpretation of EFM. A recent American study suggested that the lack of correlation of American three-tier system to neonatal acidemia may be due to the current peculiar nomenclature of FHR decelerations leading to loss of meaning. The pioneers like Hon and Caldeyro-Barcia classified decelerations based primarily on time relationship to contractions and not on etiology per se. This critical analysis debates pros and cons of significant anchoring/framing and confirmation biases in defining different types of decelerations based primarily on the shape (slope) or time of descent. It would be important to identify benign early decelerations correctly to avoid unnecessary intervention as well as to improve the positive predictive value of the other types of decelerations. Currently the vast majority of decelerations are classed as “variable”. This review shows that the most common rapid decelerations during contractions with trough corresponding to peak of contraction cannot be explained by “cord-compression” hypothesis but by direct/pure (defined here as not mediated through baro-/chemoreceptors) or non-hypoxic vagal reflex. These decelerations are benign, most likely and mainly a result of head-compression and hence should be called “early” rather than “variable”. Standardization is important but should be appropriate and withstand scientific scrutiny. Significant framing and confirmation biases are necessarily unscientific and the succeeding three-tier interpretation systems and structures embodying these biases would be dysfunctional and clinically unhelpful. Clinical/pathophysiological analysis and avoidance of flaws/biases suggest that a more physiological and scientific categorization of decelerations should be based on

  12. Categorization of Fetal Heart Rate Decelerations in American and European Practice: Importance and Imperative of Avoiding Framing and Confirmation Biases.

    PubMed

    Sholapurkar, Shashikant L

    2015-09-01

    Interpretation of electronic fetal monitoring (EFM) remains controversial and unsatisfactory. Fetal heart rate (FHR) decelerations are the commonest aberrant feature on cardiotocographs and considered "center-stage" in the interpretation of EFM. A recent American study suggested that the lack of correlation of American three-tier system to neonatal acidemia may be due to the current peculiar nomenclature of FHR decelerations leading to loss of meaning. The pioneers like Hon and Caldeyro-Barcia classified decelerations based primarily on time relationship to contractions and not on etiology per se. This critical analysis debates pros and cons of significant anchoring/framing and confirmation biases in defining different types of decelerations based primarily on the shape (slope) or time of descent. It would be important to identify benign early decelerations correctly to avoid unnecessary intervention as well as to improve the positive predictive value of the other types of decelerations. Currently the vast majority of decelerations are classed as "variable". This review shows that the most common rapid decelerations during contractions with trough corresponding to peak of contraction cannot be explained by "cord-compression" hypothesis but by direct/pure (defined here as not mediated through baro-/chemoreceptors) or non-hypoxic vagal reflex. These decelerations are benign, most likely and mainly a result of head-compression and hence should be called "early" rather than "variable". Standardization is important but should be appropriate and withstand scientific scrutiny. Significant framing and confirmation biases are necessarily unscientific and the succeeding three-tier interpretation systems and structures embodying these biases would be dysfunctional and clinically unhelpful. Clinical/pathophysiological analysis and avoidance of flaws/biases suggest that a more physiological and scientific categorization of decelerations should be based on time relationship to

  13. Chronic heart failure: a review for the primary care physician.

    PubMed

    Rodríguez-Escudero, José A; Zayas-Torres, Carlos; Banchs-Pieretti, Hector

    2003-01-01

    Heart failure is a complex clinical syndrome. The pharmacological therapy for chronic heart failure has been changing in the past decade with acquired knowledge of the pathophysiology of this medical condition. Primary care physicians currently treat a significant number of patients. This article summarizes core topics of heart failure including epidemiological information, etiology, pathophysiology, clinical features and diagnostic tools. Also, we review some of the most relevant research studies that have led to the current recommendations for the pharmacological therapeutic strategies in the management of chronic heart failure. We make reference to the latest guidelines in the management of chronic heart failure submitted by the American College of Cardiology and the American Heart Association (ACC/AHA). New technological advances, such as the biventricular-pacing devices, are an important adjuvant to the established pharmacological therapies for chronic heart failure.

  14. Perception of binary acoustic events associated with the first heart sound

    NASA Technical Reports Server (NTRS)

    Spodick, D. H.

    1977-01-01

    The resolving power of the auditory apparatus permits discrete vibrations associated with cardiac activity to be perceived as one or more events. Irrespective of the vibratory combinations recorded by conventional phonocardiography, in normal adults and in most adult patients auscultators tend to discriminate only two discrete events associated with the first heart sound S1. It is stressed that the heart sound S4 may be present when a binary acoustic event associated with S1 occurs in the sequence 'low pitched sound preceding high pitched sound', i.e., its components are perceived by auscultation as 'dull-sharp'. The question of S4 audibility arises in those individuals, normal and diseased, in whom the major components of S1 ought to be, at least clinically, at their customary high pitch and indeed on the PCG appear as high frequency oscillations. It is revealed that the apparent audibility of recorded S4 is not related to P-R interval, P-S4 interval, or relative amplitude of S4. The significant S4-LFC (low frequency component of S1) differences can be related to acoustic modification of the early component of S1.

  15. The association between heart rate reactivity and fluid intelligence in children.

    PubMed

    Gao, Yu; Borlam, Deborah; Zhang, Wei

    2015-04-01

    This study aimed to examine (a) whether findings of increased cardiovascular reactivity in relation to cognitive ability seen in infants, young adults and the elderly can be extended to middle childhood and (b) which specific aspect(s) of intelligence is related to cardiovascular reactivity. We examined cardiovascular activity in 340 8- and 9-year-old children during a number judgment task and measured fluid and crystallized IQ using the WISC-IV (Wechsler, 2003). Regression analyses revealed that heart rate (HR) reactivity was positively associated with fluid intelligence and perceptual reasoning in particular, after controlling for the effects of sex, age, task performance, social adversity, and resting HR. Intelligence scores were not associated with respiratory sinus arrhythmia (RSA) reactivity. Findings are consistent with prior literature in infants and older populations and for the first time suggest that the association between HR reactivity and cognitive ability is specific for fluid reasoning.

  16. The Association between Heart Rate Reactivity and Fluid Intelligence in Children

    PubMed Central

    Gao, Yu; Borlam, Deborah; Zhang, Wei

    2015-01-01

    This study aimed to examine (a) whether findings of increased cardiovascular reactivity in relation to cognitive ability seen in infants, young adults and the elderly can be extended to middle childhood, and (b) which specific aspect(s) of intelligence is related to cardiovascular reactivity. We examined cardiovascular activity in 340 8- and 9-year-old children during a number judgment task and measured fluid and crystalized IQ using the WISC-IV (Wechsler, 2003). Regression analyses revealed that heart rate (HR) reactivity was positively associated with fluid intelligence and perceptual reasoning in particular, after controlling for the effects of sex, age, task performance, social adversity, and resting HR. Intelligence scores were not associated with respiratory sinus arrhythmia (RSA) reactivity. Findings are consistent with prior literature in infants and older populations and for the first time suggest that the association between HR reactivity and cognitive ability is specific for fluid reasoning. PMID:25782406

  17. Genome-wide association analysis of cardiovascular-related quantitative traits in the Framingham Heart Study.

    PubMed

    Roslin, Nicole M; Hamid, Jemila S; Paterson, Andrew D; Beyene, Joseph

    2009-12-15

    Multivariate linear growth curves were used to model high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and systolic blood pressure (SBP) measured during four exams from 1659 independent individuals from the Framingham Heart Study. The slopes and intercepts from each of two phenotype models were tested for association with 348,053 autosomal single-nucleotide polymorphisms from the Affymetrix Gene Chip 500 k set. Three regions were associated with LDL intercept, TG slope, and SBP intercept (p < 1.44 x 10-7). We observed results consistent with previously reported associations between rs599839, on chromosome 1p13, and LDL. We note that the association is significant with LDL intercept but not slope. Markers on chromosome 17q25 were associated with TG slope, and a single-nucleotide polymorphism on chromosome 7p11 was associated with SBP intercept. Growth curve models can be used to gain more insight on the relationships between SNPs and traits than traditional association analysis when longitudinal data has been collected. The power to detect association with changes over time may be limited if the subjects are not followed over a long enough time period.

  18. Cadmium exposure in association with history of stroke and heart failure

    SciTech Connect

    Peters, Junenette L.; Perlstein, Todd S.; Perry, Melissa J.; McNeely, Eileen; Weuve, Jennifer

    2010-02-15

    Background: It is unclear whether environmental cadmium exposure is associated with cardiovascular disease, although recent data suggest associations with myocardial infarction and peripheral arterial disease. Objective: The objective of this study was to evaluate the association of measured cadmium exposure with stroke and heart failure (HF) in the general population. Methods: We analyzed data from 12,049 participants, aged 30 years and older, in the 1999-2006 National Health and Nutrition Examination Survey (NHANES) for whom information was available on body mass index, smoking status, alcohol consumption, and socio-demographic characteristics. Results: At their interviews, 492 persons reported a history of stroke, and 471 a history of HF. After adjusting for demographic and cardiovascular risk factors, a 50% increase in blood cadmium corresponded to a 35% increased odds of prevalent stroke [OR: 1.35; 95% confidence interval (CI): 1.12-1.65] and a 50% increase in urinary cadmium corresponded to a 9% increase in prevalent stroke [OR: 1.09; 95% CI: 1.00-1.19]. This association was higher among women [OR: 1.38; 95% CI: 1.11-1.72] than men [OR: 1.30; 95% CI: 0.93-1.79] (p-value for interaction=0.05). A 50% increase in blood cadmium corresponded to a 48% increased odds of prevalent HF [OR: 1.48; 95% CI: 1.17-1.87] and a 50% increase in urinary cadmium corresponded to a 12% increase in prevalent HF [OR: 1.12; 95% CI: 1.03-1.20], with no difference in sex-specific associations. Conclusions: Environmental exposure to cadmium was associated with significantly increased stroke and heart failure prevalence. Cadmium exposure may increase these important manifestations of cardiovascular disease.

  19. Longitudinal associations between experienced racial discrimination and depressive symptoms in African American adolescents.

    PubMed

    English, Devin; Lambert, Sharon F; Ialongo, Nicholas S

    2014-04-01

    While recent evidence has indicated that experienced racial discrimination is associated with increased depressive symptoms for African American adolescents, most studies rely on cross-sectional and short-term longitudinal research designs. As a result, the direction and persistence of this association across time remains unclear. This article examines longitudinal associations between experienced racial discrimination and depressive symptoms among a community sample of African American adolescents (N = 504) from Grade 7 to Grade 10, while controlling for multiple alternative causal pathways. Sex was tested as a moderator of the link between experienced racial discrimination and later depressive symptoms. Structural equation modeling revealed that experienced racial discrimination was positively associated with depressive symptoms 1 year later across all waves of measurement. The link between experienced racial discrimination at Grade 7 and depressive symptoms at Grade 8 was stronger for females than males. Findings highlight the role of experienced racial discrimination in the etiology of depressive symptoms for African Americans across early adolescence.

  20. Biotechnology and the American agricultural industry. Council on Scientific Affairs, American Medical Association.

    PubMed

    1991-03-20

    To meet the needs of a rapidly growing population and minimize the toxic influences of traditional farming practices on the environment, the American agricultural industry has applied molecular technology to the development of food crops and livestock. By placing genes specific for highly desirable phenotypes into the DNA of plants, animals, and bacteria, farmers have increased crop and livestock survival, enhanced the nutritional quality of foods, increased industry productivity, and reduced the need for toxic pesticides and herbicides. However, introduction of genetically modified foods into the marketplace has raised a spectrum of public health issues. Physicians, as the most proximal scientific resource for most individuals, are uniquely positioned to address patient concerns regarding the safety of genetically altered foods. This report provides an overview of the inherent risks and benefits of "agrogenetics" and offers a series of recommendations designed to promote the education of the medical community and dispel public misconception regarding genetic manipulation.

  1. Rates and factors associated with falls in older European Americans, Afro-Caribbeans, African-Americans, and Hispanics

    PubMed Central

    Vieira, Edgar Ramos; Tappen, Ruth; Engstrom, Gabriella; da Costa, Bruno R

    2015-01-01

    Purpose To evaluate rates and factors associated with older adult falls in different ethnic groups. Participants and methods Information on demographics, medical and falls history, and pain and physical activity levels was collected from 550 community-dwelling older adults (75±9 years old, 222 European Americans, 109 Afro-Caribbeans, 106 African-Americans, and 113 Hispanics). Results Taking medications for anxiety (risk ratio [RR] =1.4, 95% confidence interval [CI] =1.1–2.0), having incontinence (RR =1.4, 95% CI =1.1–1.8, P=0.013), back pain (RR =1.4, 95% CI =1.0–1.8), feet swelling (RR =1.3, 95% CI =1.1–1.7), and age ≥75 years (RR =1.3, 95% CI =1.0–1.6) were associated with falls. The associations were stronger for Afro-Caribbeans, but they presented approximately 40% lower prevalence of falls than the other groups. Conclusion Taking anxiety medication, incontinence, back pain, feet swelling, and age ≥75 years were associated with falls, and Afro-Caribbeans presented lower prevalence of falls. These findings need to be taken into consideration in clinical interventions in aging. PMID:26604718

  2. American Association of Dental Schools 1998-99 Annual Proceedings (March 6, 1998-March 10, 1999).

    ERIC Educational Resources Information Center

    Journal of Dental Education, 1999

    1999-01-01

    The proceedings of the annual meeting of the American Association of Dental Schools include the president's annual report, president-elect's and executive director's addresses, a summary of proceedings, the revised constitution, a list of competencies for entry into the dental hygiene profession, association bylaws, member administrators,…

  3. Longitudinal Associations between Experienced Racial Discrimination and Depressive Symptoms in African American Adolescents

    ERIC Educational Resources Information Center

    English, Devin; Lambert, Sharon F.; Ialongo, Nicholas S.

    2014-01-01

    While recent evidence has indicated that experienced racial discrimination is associated with increased depressive symptoms for African American adolescents, most studies rely on cross-sectional and short-term longitudinal research designs. As a result, the direction and persistence of this association across time remains unclear. This article…

  4. Policy Statements of the American Association of Community and Junior Colleges.

    ERIC Educational Resources Information Center

    American Association of Community and Junior Colleges, Washington, DC.

    The policy statements presented in this collection were adopted by the American Association of Community and Junior Colleges (AACJC) between 1973 and 1987. The statements cover the following issues: (1) accreditation of associate degree granting institutions; (2) specialized programmatic accreditation; (3) access to education; (4) affirmative…

  5. Risk and Protective Factors Associated with Asian American Students' Suicidal Ideation: A Multicampus, National Study

    ERIC Educational Resources Information Center

    Wong, Y. Joel; Brownson, Chris; Schwing, Alison E.

    2011-01-01

    Risk and protective factors associated with suicidal ideation among 1,377 Asian American college students across 66 U.S. campuses were examined. The results indicated a variety of factors were associated with morbid thoughts: medication for mental health concerns, gender, GPA, undergraduate status, religious affiliation, living with a family…

  6. Officers, Boards, Committees, and Representatives of the American Psychological Association, 2007

    ERIC Educational Resources Information Center

    American Psychologist, 2007

    2007-01-01

    The Council of Representatives is composed of the Board of Directors, the American Psychological Association of Graduate Students (APAGS) representative, division representatives, and state, provincial, and territorial association representatives. Then representatives for the current year, with terms of office, are listed in this article.

  7. Different Approaches to Teaching the Mechanics of American Psychological Association Style

    ERIC Educational Resources Information Center

    Franz, Timothy M.; Spitzer, Tam M.

    2006-01-01

    Students have to learn two distinctly different tasks when writing research papers: a) creating and organizing prose, and b) formatting a manuscript according to the nuances and mechanics of a pre-determined format, such as Modern Language Association (MLA) or American Psychological Association (APA) guidelines. Two studies examined different…

  8. 78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... Association Guidelines for the Euthanasia of Animals: 2013 Edition SUMMARY: The National Institutes of Health... the American Veterinary Medical Association (AVMA) Guidelines for the Euthanasia of Animals: 2013... updated Guidelines. DATES: Public concerns regarding the updated AVMA Guidelines for the Euthanasia...

  9. 77 FR 38378 - Hours of Service (HOS) of Drivers; Revision of Exemption; American Pyrotechnics Association (APA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... carriers and added 9 new APA-member carriers (76 FR 37876 and 76 FR 37880, June 28, 2011) for their... published on June 28, 2011 (76 FR 37876-37882). Issued on: June 21, 2012. Larry W. Minor, Associate... Exemption; American Pyrotechnics Association (APA) AGENCY: Federal Motor Carrier Safety...

  10. Valuation and the American Evaluation Association: Helping 100 Flowers Bloom, or at Least Be Understood?

    ERIC Educational Resources Information Center

    Morris, Michael

    2012-01-01

    The author explores the challenges encountered when organizations attempt to facilitate evaluation and improvement through policy statements of professional associations. The American Evaluation Association (AEA) is used as an example. Various AEA statements are described as general and avoiding particular value preferences. The author concludes…

  11. Maternal dietary patterns are associated with risk of neural tube and congenital heart defects.

    PubMed

    Sotres-Alvarez, Daniela; Siega-Riz, Anna Maria; Herring, Amy H; Carmichael, Suzan L; Feldkamp, Marcia L; Hobbs, Charlotte A; Olshan, Andrew F

    2013-06-01

    Studying empirically derived dietary patterns is useful in understanding dietary practice. We classified women by their dietary patterns using latent class analysis of 66 foods and studied the association of these patterns with neural tube defects (NTDs) and congenital heart defects (CHDs) in the U.S. National Birth Defects Prevention Study (1997-2005). Logistic regression models used data from 1,047 with an NTD, 6,641 with a CHD, and 6,123 controls that were adjusted for maternal characteristics and tested the effect modification of multivitamin supplement use. Four latent dietary patterns were identified: prudent, Western, low-calorie Western, and Mexican. Among participants who did not use supplements, those in the Mexican, Western, and low-calorie Western classes were significantly more likely (odds ratios of 1.6, 1.5, and 1.4, respectively) to have offspring born with NTDs than were those in the prudent class after adjustment of for dietary folic acid intake. In contrast, among supplement users, there was no difference in the incidence of NTDs between classes. Associations between dietary class and CHD subgroups were not modified by supplement use except for tetralogy of Fallot; among supplement users, those in the Western class were twice as likely (95% confidence interval: 1.4, 2.8) as the prudent class to have offspring with tetralogy of Fallot. Women who adhered to a Western diet were 1.2 (95% confidence interval: 1.03, 1.35) times more likely to have an infant with septal heart defect than were women who adhered to a prudent diet. A prudent dietary pattern, even with folate fortification, may decrease the risk of NTDs and some heart defects.

  12. Stress-associated cardiovascular reaction masks heart rate dependence on physical load in mice.

    PubMed

    Andreev-Andrievskiy, A A; Popova, A S; Borovik, A S; Dolgov, O N; Tsvirkun, D V; Custaud, M; Vinogradova, O L

    2014-06-10

    When tested on the treadmill mice do not display a graded increase of heart rate (HR), but rather a sharp shift of cardiovascular indices to high levels at the onset of locomotion. We hypothesized that under test conditions cardiovascular reaction to physical load in mice is masked with stress-associated HR increase. To test this hypothesis we monitored mean arterial pressure (MAP) and heart rate in C57BL/6 mice after exposure to stressful stimuli, during spontaneous locomotion in the open-field test, treadmill running or running in a wheel installed in the home cage. Mice were treated with β1-adrenoblocker atenolol (2mg/kg ip, A), cholinolytic ipratropium bromide (2mg/kg ip, I), combination of blockers (A+I), anxiolytic diazepam (5mg/kg ip, D) or saline (control trials, SAL). MAP and HR in mice increased sharply after handling, despite 3weeks of habituation to the procedure. Under stressful conditions of open field test cardiovascular parameters in mice were elevated and did not depend on movement speed. HR values did not differ in I and SAL groups and were reduced with A or A+I. HR was lower at rest in D pretreated mice. In the treadmill test HR increase over speeds of 6, 12 and 18m/min was roughly 1/7-1/10 of HR increase observed after placing the mice on the treadmill. HR could not be increased with cholinolytic (I), but was reduced after sympatholytic (A) or A+I treatment. Anxiolytic (D) reduced heart rate at lower speeds of movement and its overall effect was to unmask the dependency of HR on running speed. During voluntary running in non-stressful conditions of the home cage HR in mice linearly increased with increasing running speeds. We conclude that in test situations cardiovascular reactions in mice are governed predominantly by stress-associated sympathetic activation, rendering efforts to evaluate HR and MAP reactions to workload unreliable.

  13. Cardiovascular Aspects of Space Shuttle Flights: At the Heart of Three Decades of American Spaceflight Experience

    NASA Technical Reports Server (NTRS)

    Charles, John B.; Platts, S. H.

    2011-01-01

    The advent of the Space Shuttle era elevated cardiovascular deconditioning from a research topic in gravitational physiology to a concern with operational consequences during critical space mission phases. NASA has identified three primary cardiovascular risks associate with short-duration (less than 18 d) spaceflight: orthostatic intolerance; decreased maximal oxygen uptake; and cardiac arrhythmias. Orthostatic hypotension (OH) was observed postflight in Mercury astronauts, studied in Gemini and Apollo astronauts, and tracked as it developed in-flight during Skylab missions. A putative hypotensive episode in the pilot during an early shuttle landing, and well documented postflight hypotension in a quarter of crewmembers, catalyzed NASA's research effort to understand its mechanisms and develop countermeasures. Shuttle investigations documented the onset of OH, tested mechanistic hypotheses, and demonstrated countermeasures both simple and complex. Similarly, decreased aerobic capacity in-flight threatened both extravehicular activity and post-landing emergency egress. In one study, peak oxygen uptake and peak power were significantly decreased following flights. Other studies tested hardware and protocols for aerobic conditioning that undergird both current practice on long-duration International Space Station (ISS) missions and plans for interplanetary expeditions. Finally, several studies suggest that cardiac arrhythmias are of less concern during short-duration spaceflight than during long-duration spaceflight. Duration of the QT interval was unchanged and the frequency of premature atrial and ventricular contractions was actually shown to decrease during extravehicular activity. These investigations on short-duration Shuttle flights have paved the way for research aboard long-duration ISS missions and beyond. Efforts are already underway to study the effects of exploration class missions to asteroids and Mars.

  14. Low resting heart rate is associated with violence in late adolescence: a prospective birth cohort study in Brazil

    PubMed Central

    Murray, Joseph; Hallal, Pedro C; Mielke, Gregore I; Raine, Adrian; Wehrmeister, Fernando C; Anselmi, Luciana; Barros, Fernando C

    2016-01-01

    Background: Youth violence is a major global public health problem. Three UK and Swedish studies suggest that low resting heart rate predicts male youth violence, but this has not been tested in other social settings nor for females. Methods: A prospective, population-based birth cohort study was conducted in Pelotas, Brazil. Heart rate was measured using a wrist monitor at ages 11, 15 and 18 years. Violent crime and non-violent crime were measured at age 18 in self-reports and official records (N = 3618). Confounding variables were assessed in the perinatal period and at age 11, in interviews with mothers and children. Logistic regression was used to estimate associations between quartiles of heart rate at each age, and violent and non-violent crime at age 18, separately for males and females. Results: Lower resting heart rate was a robust correlate of violent and non-violent crime for males. Comparing males in the lowest and top quartiles of heart rate at age 15 years, adjusted odds ratios were 1.9 for violent crime [95% confidence interval (CI) 1.4–2.7] and 1.7 for non-violent crime (95% CI 1.1–2.6). For females, crime outcomes were associated only with low resting heart rate at age 18. Associations were generally linear across the four heart rate quartiles. There was no evidence that associations differed according to socioeconomic status at age 15. Conclusions: Low resting heart rate predicted violent and non-violent crime for males, and was cross-sectionally associated with crime for females. Biological factors may contribute to individual propensity to commit crime, even in a middle-income setting with high rates of violence. PMID:26822937

  15. Association analysis of GWAS and candidate gene loci in a Chinese population with coronary heart disease

    PubMed Central

    Gao, Min; Tang, Haiqin; Zheng, Xiaodong; Zhou, Fusheng; Lu, Wensheng

    2015-01-01

    Objective: Coronary heart disease (CHD), the most severe form of coronary artery disease (CAD), is a complex disease that involves a variety of genetic and environmental factors. Recently, multiple single nucleotide polymorphisms (SNPs) have been associated with CAD in Caucasians by genome-wide association (GWA) studies.However, the association of these SNPs with CHD in Asian populations has not yet been established. Here, we aim to investigate the genetic etiology of CHD in a Chinese population by genotyping SNPs previously been associated with CHD in other ethic origin in GWAS or candidate gene studies. Methods: Five SNPs, rs17114036, rs9369640, rs515135, rs579459 and rs8055236, from 5 different loci were genotyped using a sequenom Mass array system in 545CHD patients and 1008 unrelated controls from a Chinese population. Results: Our study showed that SNP rs515135 is strongly associated with CHD in a Chinese Han population (P-value=0.00333, OR=1.48). We also detected significant difference of SNP rs579459 in APOB gene in patients withsevere CAD compared to patients with mild CAD. Conclusion: SNP rs515135 is associated with the susceptibility of CHD in Chinese Han population. The location of rs515135 in the APOB gene supports its potential involvement in the pathogenesis of CAD. Our study data also support that SNP rs579459 may be associated with the severity of CHD. PMID:26221293

  16. Inducible Nitric Oxide Synthase in Heart Tissue and Nitric Oxide in Serum of Trypanosoma cruzi-Infected Rhesus Monkeys: Association with Heart Injury

    PubMed Central

    Carvalho, Cristiano Marcelo Espinola; Silverio, Jaline Coutinho; da Silva, Andrea Alice; Pereira, Isabela Resende; Coelho, Janice Mery Chicarino; Britto, Constança Carvalho; Moreira, Otacílio Cruz; Marchevsky, Renato Sergio; Xavier, Sergio Salles; Gazzinelli, Ricardo Tostes; da Glória Bonecini-Almeida, Maria; Lannes-Vieira, Joseli

    2012-01-01

    Background The factors contributing to chronic Chagas' heart disease remain unknown. High nitric oxide (NO) levels have been shown to be associated with cardiomyopathy severity in patients. Further, NO produced via inducible nitric oxide synthase (iNOS/NOS2) is proposed to play a role in Trypanosoma cruzi control. However, the participation of iNOS/NOS2 and NO in T. cruzi control and heart injury has been questioned. Here, using chronically infected rhesus monkeys and iNOS/NOS2-deficient (Nos2−/−) mice we explored the participation of iNOS/NOS2-derived NO in heart injury in T. cruzi infection. Methodology Rhesus monkeys and C57BL/6 and Nos2−/− mice were infected with the Colombian T. cruzi strain. Parasite DNA was detected by polymerase chain reaction, T. cruzi antigens and iNOS/NOS2+ cells were immunohistochemically detected in heart sections and NO levels in serum were determined by Griess reagent. Heart injury was assessed by electrocardiogram (ECG), echocardiogram (ECHO), creatine kinase heart isoenzyme (CK-MB) activity levels in serum and connexin 43 (Cx43) expression in the cardiac tissue. Results Chronically infected monkeys presented conduction abnormalities, cardiac inflammation and fibrosis, which resembled the spectrum of human chronic chagasic cardiomyopathy (CCC). Importantly, chronic myocarditis was associated with parasite persistence. Moreover, Cx43 loss and increased CK-MB activity levels were primarily correlated with iNOS/NOS2+ cells infiltrating the cardiac tissue and NO levels in serum. Studies in Nos2−/− mice reinforced that the iNOS/NOS2-NO pathway plays a pivotal role in T. cruzi-elicited cardiomyocyte injury and in conduction abnormalities that were associated with Cx43 loss in the cardiac tissue. Conclusion T. cruzi-infected rhesus monkeys reproduce features of CCC. Moreover, our data support that in T. cruzi infection persistent parasite-triggered iNOS/NOS2 in the cardiac tissue and NO overproduction might contribute to CCC

  17. An examination of the association between demographic and educational factors and African American achievement in science

    NASA Astrophysics Data System (ADS)

    Cottledge, Michael Christopher

    Objective of the Study: The objective of this research study was to investigate whether an association exists between teacher demographic factors (years of teaching experience and gender), 2 educational factors (certification type and certification pathway) and the percent passing rate of tenth grade African American male students on the 2010 science TAKS. Answers to the following questions were sought: 1. Is there an association between teacher demographic factors and the percent passing rate of their tenth grade African American male students on the 2010 science TAKS? 2. Is there an association between teacher educational factors and the percent passing rate of their tenth grade African American male students on the 2010 science TAKS? 3. Is there an association between teacher demographic factors, educational factors and the percent passing rate of their tenth grade African American male students on the 2010 science TAKS? Status of the Question: According to the Bureau of Labor Statistics (BLS), science and engineering jobs in the U.S. have increased steadily over recent years and by the year 2016 the number of STEM (Science, Technology, Engineering and Math) jobs will have grown by more than 21 percent. This increase in science and engineering jobs will double the growth rate of all other workforce sectors combined. The BLS also reports that qualified minority applicants needed to fill these positions will be few and far between. African Americans, Latinos, and other minorities constitute 24 percent of the U.S. population but only 13 percent of college graduates and just 10 percent of people with college degrees who work in science and engineering (Education Trust, 2009). Drawing on the above information, I proposed the following hypotheses to the research questions: H01: There will be no significant statistical association between the demographic factors teacher gender and years of teaching experience and the percent passing rate of their tenth grade African

  18. Opportunity costs associated with caring for older Mexican-Americans

    PubMed Central

    Brown, H. Shelton; Herrera, Angelica P.; Angel, Jacqueline L.

    2013-01-01

    Long-term care use among older Mexican-Americans is poorly understood, despite the adverse effects on health and economic disadvantage in this vulnerable population. This study examines gender-based risk of long-term care use in 628 women and 391 men, age 70 and over in the 2000-01 and 2004-05 waves of the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Logistic regression models are employed to assess the impact of the opportunity cost implications of family support (kin availability and co-residence) relative to health care needs (quality-adjusted life years (QALY) weighted scores and functional limitations) on women's risk of entry into a nursing home. A small percentage (∼5%) of men and women had entered a long-term care facility. Women had lower weights for QALY weights and greater disability than men, but on average were more likely to live with or in closer proximity to an adult child. Higher disability rates (p < .01) increased the risk of institutionalization regardless of gender because disability increases time burdens. Families with fewer adult children faced higher time burdens per child in caring for elderly parents; particularly for elderly mothers. Demographic trends suggest that the number of adult children available to share the caregiving load may decrease long-term care use. PMID:23979263

  19. Opportunity costs associated with caring for older Mexican-Americans.

    PubMed

    Brown, H Shelton; Herrera, Angelica P; Angel, Jacqueline L

    2013-09-01

    Long-term care use among older Mexican-Americans is poorly understood, despite the adverse effects on health and economic disadvantage in this vulnerable population. This study examines gender-based risk of long-term care use in 628 women and 391 men, age 70 and over in the 2000-2001 and 2004-2005 waves of the Hispanic Established Populations for Epidemiologic Studies of the Elderly. Logistic regression models are employed to assess the impact of the opportunity cost implications of family support (kin availability and co-residence) relative to health care needs (quality-adjusted life years (QALY) weighted scores and functional limitations) on women's risk of entry into a nursing home. A small percentage (~5%) of men and women had entered a long-term care facility. Women had lower weights for QALY weights and greater disability than men, but on average were more likely to live with or in closer proximity to an adult child. Higher disability rates (p < 0.01) increased the risk of institutionalization regardless of gender because disability increases time burdens. Families with fewer adult children faced higher time burdens per child in caring for elderly parents; particularly for elderly mothers. Demographic trends suggest that the number of adult children available to share the caregiving load may decrease long-term care use. PMID:23979263

  20. Depressive Symptomatology, Exercise Adherence and Fitness are Associated with Reduced Cognitive Performance in Heart Failure

    PubMed Central

    Alosco, Michael L.; Spitznagel, Mary Beth; van Dulmen, Manfred; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H.; Colbert, Lisa H.; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2016-01-01

    Objectives Depression is common in heart failure (HF) and associated with reduced cognitive function. The current study used Structrual Equation Modeling to examine whether depression adversely impacts cognitive function in HF through its adverse affects on exercise adherence and cardiovascular fitness. Methods 158 HF patients completed neuropsychological testing, physical fitness test, Beck Depression Inventory-II (BDI-II), and measures assessing exercise adherence, and physical exertion. Results The model demonstrated excellent model fit and increased scores on the BDI-II negatively affected exercise adherence and cardiovascular fitness. There was a strong inverse association between cardiovascular fitness and cognitive function. Sobel test showed a significant indirect pathway between the BDI-II and cognitive function through cardiovascular fitness. Discussion This study suggests depression in HF may adversely impact cognitive function through reduced cardiovascular fitness. Prospective studies are needed to determine whether treatment of depression can lead to better lifestyle behaviors and ultimately improve neurocognitive outcomes in HF. PMID:23378527

  1. Cardiovascular conditions and the evaluation of the heart in pregnancy-associated autopsies.

    PubMed

    Herbst, Jonathon; Winskog, Calle; Byard, Roger W

    2010-11-01

    Pregnancy-associated death is defined as the death of a woman from any cause during pregnancy or in the year after delivery. This review concentrates on cardiac conditions that may result in pregnancy-associated death including, but not limited to, acute myocardial infarction, endocarditis, peripartum cardiomyopathy, and prolonged QT syndrome. Lethal vascular conditions may also occur involving arterial dissection and thromboembolism, on occasion exacerbated by hypercoagulability, and altered hormonal and physiologic states. The autopsy evaluation of these patients includes a careful assessment of the medical history particularly for prior pregnancy-related conditions, fetal loss, and episodes of unexplained collapse. A family history of sudden death at an early age may be significant. At autopsy, evaluation for underlying syndromes such as Marfan, or evidence of intravenous narcotism should be undertaken. Autopsy examination involves careful dissection of the heart and vessels with consideration of conduction tract studies and possible genetic evaluation for prolonged QT syndrome.

  2. Twentieth anniversary of American Vascular Association/Lifeline Foundation: a celebration.

    PubMed

    Pearce, William H; Mannick, John A; Clowes, Alexander W; Yao, James S T

    2008-06-01

    The American Vascular Association/Lifeline Foundation is celebrating its 20th anniversary this year. This remarkable two-decade journey represents a cumulative effort by the leaders and members of the Society for Vascular Surgery (SVS). For the historical record, we would like to chart the sequence of events leading to various programs. In 1986, the Executive Council of SVS approved the formation of an Education/Research Foundation, from which the Lifeline Foundation evolved, with the mission to support the career development of young research-oriented vascular surgeons. Since that time, Lifeline has awarded 141 Student Fellowships, 21 Wylie Traveling Fellowships, 17 Mentored Clinical Scientist Development (K08) Awards, and three Mentored Patient-Oriented Research Career Development (K23) Awards. In 2001, the American Vascular Association (AVA) was established under the aegis of American Association for Vascular Surgery (formerly International Society for Cardiovascular Surgery-North American Chapter). In 2004, with the merger of the SVS and the American Association of Vascular Surgery into a single entity (SVS), Lifeline and the AVA merged into a single foundation, the AVA. As AVA/Lifeline is poised to launch a campaign for an endowment fund, we hope this report will let the members of the SVS know what has been accomplished, what we plan to do, and, most importantly, what we need to do in the future.

  3. Association between household income and overweight of Korean and American children: trends and differences.

    PubMed

    Kwon, Yongju; Oh, Sangwoo; Park, Sangshin; Park, Yongsoon

    2010-07-01

    The prevalence of overweight in children has been dramatically increasing worldwide, and socioeconomic status is an important risk factor. The purpose of this study was to examine the hypothesis that household income is negatively associated with overweight in Korean and American girls and boys. In the study, 2117 children 7 to 12 years of age from the Korean National Health and Nutrition Examination Survey between 2001 and 2007 and 3016 children from the US National Health and Nutrition Examination Survey between 2001 and 2006 were included. Overweight is defined as the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. Lower household income significantly increased the risk for overweight in Korean boys, irrespective of adjustments. The negative association between household income and overweight of American boys disappeared after adjusting for the frequency of dining out and TV viewing time. There was no significant association between household income and overweight of Korean and American girls. As household income increased, the intake of energy from protein was increased, but energy from carbohydrates was decreased in Korean boys. On the other hand, as household income increased, energy intake from carbohydrates was increased and energy intake from proteins decreased in American boys. In conclusion, positive association between household income and overweight was found in Korean boys, but not in Korean girls and American boys and girls. Effects solely targeting reduction in income disparities cannot effectively reduce sex disparities in overweight of children. PMID:20797479

  4. Report of a National Heart, Lung, And Blood Institute Workshop: heterogeneity in cardiometabolic risk in Asian Americans In the U.S. Opportunities for research.

    PubMed

    Narayan, K M Venkat; Aviles-Santa, Larissa; Oza-Frank, Reena; Pandey, Mona; Curb, J David; McNeely, Marguerite; Araneta, Maria Rosario G; Palaniappan, Latha; Rajpathak, Swapnil; Barrett-Connor, Elizabeth

    2010-03-01

    The Asian and Pacific Islander population (Asian Americans) in the U.S. has increased dramatically in the last few decades. Yet, data on cardiovascular disease (CVD) in this population are scarce. The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health conducted an Expert Workshop to: 1) assess the importance of studying CVD in Asian Americans in the U.S.; and 2) consider strategic options for further investigations of CVD in this population. There is considerable geographical, ethnic, cultural, and genetic diversity within this population. Limited data also suggest striking differences in the risk of CVD, obesity, type 2 diabetes mellitus, and other CVD risk factors across the Asian-American population. The Asian-American population is a new diverse pool with less contemporary genetic and cultural admixture relative to groups that have lived in the U.S. for generations, plus it is diverse in lifestyle including culture, diet, and family structure. This diversity provides a window of opportunity for research on genes and gene-environment interactions and also to investigate how acculturation/assimilation to U.S. lifestyles affects health and CVD risk among relatively homogenous groups of recent immigrants. Given the heterogeneity in body weight, body size, and CVD risk, the Asian-American population in the U.S. offers a unique model to study the interaction and relationships between visceral adiposity and adipose tissue distribution and beta cell function, insulin resistance, and atherosclerosis. PMID:20202512

  5. Report of a National Heart, Lung, And Blood Institute Workshop: heterogeneity in cardiometabolic risk in Asian Americans In the U.S. Opportunities for research.

    PubMed

    Narayan, K M Venkat; Aviles-Santa, Larissa; Oza-Frank, Reena; Pandey, Mona; Curb, J David; McNeely, Marguerite; Araneta, Maria Rosario G; Palaniappan, Latha; Rajpathak, Swapnil; Barrett-Connor, Elizabeth

    2010-03-01

    The Asian and Pacific Islander population (Asian Americans) in the U.S. has increased dramatically in the last few decades. Yet, data on cardiovascular disease (CVD) in this population are scarce. The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health conducted an Expert Workshop to: 1) assess the importance of studying CVD in Asian Americans in the U.S.; and 2) consider strategic options for further investigations of CVD in this population. There is considerable geographical, ethnic, cultural, and genetic diversity within this population. Limited data also suggest striking differences in the risk of CVD, obesity, type 2 diabetes mellitus, and other CVD risk factors across the Asian-American population. The Asian-American population is a new diverse pool with less contemporary genetic and cultural admixture relative to groups that have lived in the U.S. for generations, plus it is diverse in lifestyle including culture, diet, and family structure. This diversity provides a window of opportunity for research on genes and gene-environment interactions and also to investigate how acculturation/assimilation to U.S. lifestyles affects health and CVD risk among relatively homogenous groups of recent immigrants. Given the heterogeneity in body weight, body size, and CVD risk, the Asian-American population in the U.S. offers a unique model to study the interaction and relationships between visceral adiposity and adipose tissue distribution and beta cell function, insulin resistance, and atherosclerosis.

  6. Type D personality negatively associated with self-care in Chinese heart failure patients

    PubMed Central

    Cao, Xi; Wang, Xiu-Hua; Wong, Eliza ML; Chow, Choi Kai; Chair, Sek Ying

    2016-01-01

    Background Little is known about the association between type D personality and self-care behaviors in heart failure (HF) patients. We examined the effect of type D personality on self-care behaviors and self-efficacy among Chinese HF patients. Methods A cross-sectional study with a convenience sample was conducted. All participants completed the questionnaires of the self-care of HF index (V6) and type D personality scale. Demographic and clinical variables were obtained from medical records and patient interviews. The methods used for data analysis included descriptive analysis, independent-sample t-test, χ2 test, and multiple linear regression. Results A total of 127 HF patients were included and 61.4% of them were male. The average age for this study sample was 64.9 ± 12.34 years. The majority of the participants were in a New York Heart Association class III or IV (87%), and the average length of living with HF was 38.24 ± 41.1 months. A total of 33.1% of the participants were identified as having type D personality. No significant differences were determined in the demographic and clinical variables between type D and non-type D patients, except for the mean age and the length of living with HF. Type D patients were younger and had a shorter time of living with HF than their non-type D counterparts. Multiple regression demonstrated significant associations between type D personality and self-care maintenance and self-efficacy after adjusting the demographic and clinical factors. However, type D personality was not significantly associated with self-care management behaviors. Conclusions Type D personality was negatively related to self-care maintenance and self-efficacy in Chinese HF patients. Future study is warranted to develop a tailored intervention to improve engagement in self-care behaviors in HF patients with type D personality. PMID:27594867

  7. Incidence, Severity, and Association With Adverse Outcome of Hyponatremia in Children Hospitalized With Heart Failure.

    PubMed

    Price, Jack F; Kantor, Paul F; Shaddy, Robert E; Rossano, Joseph W; Goldberg, Jason F; Hagan, Joseph; Humlicek, Timothy J; Cabrera, Antonio G; Jeewa, Aamir; Denfield, Susan W; Dreyer, William J; Akcan-Arikan, Ayse

    2016-10-01

    Hyponatremia is a common finding in adults hospitalized with heart failure (HF) and is associated with longer hospital stays and increased mortality. The significance of hyponatremia in children with HF is not known. We sought to determine the incidence of hyponatremia and association with clinical outcome in children hospitalized with HF. Admission and inpatient serum sodium concentrations were analyzed in 141 consecutive children hospitalized with acute decompensated HF. Inclusion criteria include patients (age, birth to 21 years) with biventricular hearts who were hospitalized for HF from January 2007 to December 2012. The primary composite end point was death, cardiac transplantation, or the use of mechanical circulatory support (MCS) during hospitalization. Data for 141 patients were included in the analysis. The cohort included 48 patients (34%) with preexisting HF. Mean serum sodium at admission was 136 ± 4 mmol/L (range 124 to 150 mmol/L). Hyponatremia (serum sodium <135 mmol/L) was present in 45 patients (32%) at admission. Seventy-one patients (75%) with normal serum sodium concentrations at admission subsequently developed acquired hyponatremia during their hospitalization. Hyponatremia persisted at discharge in 17 of 66 patients (26%). Fifty-eight patients (41%) reached the composite end point during hospitalization (death, n = 15; cardiac transplantation, n = 27; MCS, n = 46). Hyponatremia at admission was independently associated with death, cardiac transplantation, or the use of MCS during hospitalization (odds ratio 3.1, p = 0.02). In conclusion, hyponatremia occurs commonly in children hospitalized with acute decompensated HF and is associated with increased risk of in-hospital mortality, cardiac transplantation, and need for MCS. PMID:27530824

  8. HLA disease association and protection in HIV infection among African Americans and Caucasians.

    PubMed

    Cruse, J M; Brackin, M N; Lewis, R E; Meeks, W; Nolan, R; Brackin, B

    1991-01-01

    In a previous investigation, we demonstrated an increased progression of overt AIDS in the African American population compared to the Caucasian population as reflected by the significantly lower absolute number of CD4+ lymphocytes detected in the African American population in an earlier study. The present study elucidates some of the possible genetic factors which may contribute to disease association or protection against HIV infection. The HLA phenotypes expressed as A, B, C, DR and DQw antigens were revealed by the Amos-modified typing procedure. NIH scoring was utilized to designate positive cells taking up trypan blue. A test of proportion equivalent to the chi 2 approximation was used to compare the disease population (n = 62; 38 African Americans, 24 Caucasians) to race-matched normal heterosexual local controls (323 African Americans, 412 Caucasians). Significant p values were corrected for the number of HLA antigens tested. HLA markers associated with possible protection from infection for African Americans were Cw4 and DRw6, whereas Caucasians expressed none. Disease association markers present in the African American population were A31, B35, Cw6, Cw7, DR5, DR6, DRw11, DRw12, DQw6 and DQw7, whereas in the Caucasian population A28, Aw66, Aw48, Bw65, Bw70, Cw7, DRw10, DRw12, DQw6 and DQw7 were demonstrated. The highest phenotypic frequency for a disease association marker in the study was for HLA-DR5 (62.9%) in the HIV-infected African American population without Kaposi's sarcoma compared to a frequency of 28.9% for the regional control group (p = 0.0012). We conclude that genetic factors do have a role in HIV infection since only 50-60% of those exposed to the AIDS virus will become infected. PMID:1910527

  9. Bibliographic Services of the American Historical Association: Recently Published Articles and Writings on American History. A Report of the ABH/AHA Task Force.

    ERIC Educational Resources Information Center

    McCrank, Lawrence J.; And Others

    The American Historical Association (AHA) has been providing bibliographic services for its membership by reviewing the monographic literature in the "American Historical Review" (AHR), using a list of books the AHA receives, and employing its periodical current awareness service comprised of "Recently Published Articles" (RPA) and its spinoff,…

  10. Recent opinions of the Judicial Council of the American Medical Association.

    PubMed

    1984-04-27

    The text is provided of six opinions, or interpretations, of the American Medical Association's Principles of Medical Ethics, that were approved by the Judicial Council after the publication of the 1982 edition of Current Opinions of the Judicial Council of the American Medical Association. The opinions deal briefly with the physician's ethical responsibilities in relation to accreditation of health facilities and programs, screening of semen donors for use in artificial insemination, safeguarding of confidentiality in the physician patient relationship, genetic counseling, in vitro fertilization, interprofessional relations with nurses, and sports medicine. PMID:6708251

  11. A genetic association study of activated partial thromboplastin time in European Americans and African Americans: the ARIC Study.

    PubMed

    Weng, Lu-Chen; Cushman, Mary; Pankow, James S; Basu, Saonli; Boerwinkle, Eric; Folsom, Aaron R; Tang, Weihong

    2015-04-15

    Reduced activated partial thromboplastin time (aPTT) is a risk marker for incident and recurrent venous thromboembolism (VTE). Genetic factors influencing aPTT are not well understood, especially in populations of non-European ancestry. The present study aimed to identify aPTT-related gene variants in both European Americans (EAs) and African Americans (AAs). We conducted a genetic association study for aPTT in 9719 EAs and 2799 AAs from the Atherosclerosis Risk in Communities (ARIC) study. Using the Candidate Gene Association Resource (CARe) consortium candidate gene array, the analyses were based on ∼50 000 SNPs in ∼2000 candidate genes. In EAs, the analyses identified a new independent association for aPTT in F5 (rs2239852, P-value = 1.9 × 10(-8)), which clusters with a coding variant rs6030 (P-value = 7.8 × 10(-7)). The remaining significant signals were located on F5, HRG, KNG1, F11, F12 and ABO and have been previously reported in EA populations. In AAs, significant signals were identified in KNG1, HRG, F12, ABO and VWF, with the leading variants in KNG1, HRG and F12 being the same as in the EAs; the significant variant in VWF (rs2229446, P-value = 1.2 × 10(-6)) was specific to the AA sample (minor allele frequency = 19% in AAs and 0.2% in EAs) and has not been previously reported. This is the first study to report aPTT-related genetic variants in AAs. Our findings in AAs demonstrate transferability of previously reported associations with KNG1, HRG and F12 in EAs. We also identified new associations at F5 in EAs and VWF in AAs that have not been previously reported for aPTT. PMID:25552651

  12. A genetic association study of activated partial thromboplastin time in European Americans and African Americans: the ARIC Study

    PubMed Central

    Weng, Lu-Chen; Cushman, Mary; Pankow, James S.; Basu, Saonli; Boerwinkle, Eric; Folsom, Aaron R.; Tang, Weihong

    2015-01-01

    Reduced activated partial thromboplastin time (aPTT) is a risk marker for incident and recurrent venous thromboembolism (VTE). Genetic factors influencing aPTT are not well understood, especially in populations of non-European ancestry. The present study aimed to identify aPTT-related gene variants in both European Americans (EAs) and African Americans (AAs). We conducted a genetic association study for aPTT in 9719 EAs and 2799 AAs from the Atherosclerosis Risk in Communities (ARIC) study. Using the Candidate Gene Association Resource (CARe) consortium candidate gene array, the analyses were based on ∼50 000 SNPs in ∼2000 candidate genes. In EAs, the analyses identified a new independent association for aPTT in F5 (rs2239852, P-value = 1.9 × 10−8), which clusters with a coding variant rs6030 (P-value = 7.8 × 10−7). The remaining significant signals were located on F5, HRG, KNG1, F11, F12 and ABO and have been previously reported in EA populations. In AAs, significant signals were identified in KNG1, HRG, F12, ABO and VWF, with the leading variants in KNG1, HRG and F12 being the same as in the EAs; the significant variant in VWF (rs2229446, P-value = 1.2 × 10−6) was specific to the AA sample (minor allele frequency = 19% in AAs and 0.2% in EAs) and has not been previously reported. This is the first study to report aPTT-related genetic variants in AAs. Our findings in AAs demonstrate transferability of previously reported associations with KNG1, HRG and F12 in EAs. We also identified new associations at F5 in EAs and VWF in AAs that have not been previously reported for aPTT. PMID:25552651

  13. Genetic Loci Associated With Atrial Fibrillation: Relation to Left Atrial Structure in the Framingham Heart Study

    PubMed Central

    Magnani, Jared W.; Yin, Xiaoyan; McManus, David D.; Chuang, Michael L.; Cheng, Susan; Lubitz, Steven A.; Arora, Garima; Manning, Warren J.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2014-01-01

    Background Atrial fibrillation (AF) results in significant morbidity and mortality. Genome‐wide association studies (GWAS) have identified genetic variants associated with AF. Whether genetic variants associated with AF are also associated with atrial structure, an intermediate phenotype for AF, has had limited investigation. We sought to investigate associations between single nucleotide polymorphisms (SNPs) and atrial structure obtained by cardiovascular imaging in the Framingham Heart Study. Methods and Results We selected 11 SNPs that have been associated with AF in GWAS. We examined the SNPs' relations to cross‐sectional left atrial (LA) dimensions (determined by transthoracic echocardiography) and LA volume (determined by cardiovascular magnetic resonance [CMR]) employing linear regression. The total sample included 1555 participants with CMR LA volume (age 60±9 years, 53% women) and 6861 participants with echocardiographic LA diameter (age 48±13 years, 52% women) measured. We employed a significance threshold of P<0.0023 to account for multiple testing of the 11 SNPs and 2 LA measures. In a primary analysis, no SNPs were significantly related to the LA measures. Likewise, in secondary analyses excluding individuals with prevalent AF (n=77, CMR sample; n=105, echocardiography sample) no SNPs were related to LA volume or diameter. Conclusion In a community‐based cohort, we did not identify a statistically significant association between selected SNPs associated with AF and measures of LA anatomy. Further investigations with larger longitudinally assessed samples and a broader array of SNPs may be necessary to determine the relation between genetic loci associated with AF and atrial structure. PMID:24695651

  14. 2011 Annual Report of the American Psychological Association

    ERIC Educational Resources Information Center

    American Psychologist, 2012

    2012-01-01

    As we have throughout the association's history, we focused in 2011 on multiple initiatives--all designed to further, support, and communicate the important work that psychologists do. This year we had the benefit of APA's first-ever strategic plan as well as funding for the following seven initiatives that are specifically designed to execute the…

  15. The American Dental Association and the value of membership.

    PubMed

    Bauman, Mark

    2013-01-01

    The Chair of the ADA Council on Membership presents a snapshot of current membership numbers and trends and association membership initiatives. ADA programs include advocacy, science to enhance care, a portfolio of member benefits, attention to the concerns of young professionals, and a tripartite organizational structure.

  16. Heritability and Genetic Association Analysis of Neuroimaging Measures in the Diabetes Heart Study

    PubMed Central

    Raffield, Laura M; Cox, Amanda J; Hugenschmidt, Christina E; Freedman, Barry I; Langefeld, Carl D; Williamson, Jeff D; Hsu, Fang-Chi; Maldjian, Joseph A; Bowden, Donald W

    2014-01-01

    Patients with type 2 diabetes are at increased risk of age-related cognitive decline and dementia. Neuroimaging measures such as white matter lesion volume, brain volume, and fractional anisotropy may reflect the pathogenesis of these cognitive declines, and genetic factors may contribute to variability in these measures. This study examined multiple neuroimaging measures in 465 participants from 238 families with extensive genotype data in the type 2 diabetes enriched Diabetes Heart Study-Mind cohort. Heritability of these phenotypes and their association with candidate single nucleotide polymorphisms (SNPs) and SNP data from genome-and exome-wide arrays was explored. All neuroimaging measures analysed were significantly heritable (ĥ2 =0.55–0.99 in unadjusted models). Seventeen candidate SNPs (from 16 genes/regions) associated with neuroimaging phenotypes in prior studies showed no significant evidence of association. A missense variant (rs150706952, A432V) in PLEKHG4B from the exome-wide array was significantly associated with white matter mean diffusivity (p=3.66×10−7) and gray matter mean diffusivity (p=2.14×10−7). This analysis suggests genetic factors contribute to variation in neuroimaging measures in a population enriched for metabolic disease and other associated comorbidities. PMID:25523635

  17. Extracellular Vesicle Proteins Associated with Systemic Vascular Events Correlate with Heart Failure: An Observational Study in a Dyspnoea Cohort

    PubMed Central

    Zhang, Ya-Nan; Vernooij, Flora; Ibrahim, Irwani; Ooi, Shirley; Gijsberts, Crystel M.; Schoneveld, Arjan H.; Sen, Kuan Win; den Ruijter, Hester M.; Timmers, Leo; Richards, Arthur Mark; Jong, Chun Tzen; Mazlan, Ibrahim; Wang, Jiong-Wei; Lam, Carolyn S. P.; de Kleijn, Dominique P. V.

    2016-01-01

    Background SerpinF2, SerpinG1, CystatinC and CD14 are involved in inflammatory processes and plasma extracellular vesicle (EV) -levels of these proteins have been reported to be associated with systemic vascular events. Evidence is accumulating that inflammatory processes may play a pivotal role both in systemic vascular events and in heart failure. Therefore, we studied the association between plasma extracellular vesicle SerpinF2-, SerpinG1-, CystatinC and CD14-levels and the occurrence of acute heart failure in patients. Methods and Result Extracellular vesicle protein levels of SerpinG1, SerpinF2, CystatinC and CD14 were measured in an observational study of 404 subjects presenting with dysponea at the emergency department (4B-cohort). Plasma extracellular vesicles were precipitated in a total extracellular vesicles (TEX)-fraction and in separate LDL- and HDL-subfractions. Extracellular vesicle protein levels were measured with a quantitative immune assay in all 3 precipitates. Out of 404 subjects, 141 (35%) were diagnosed with acutely decompensated heart failure. After correction for confounders (including comorbidities and medications), levels of CD14 in the HDL-fraction (OR 1.53, p = 0.01), SerpinF2 in the TEX-and LDL-fraction (ORs respectively 0.71 and 0.65, p<0.05) and SerpinG1 in the TEX-fraction (OR 1.55, p = 0.004) were statistically significantly related to heart failure. Furthermore, extracellular vesicle CD14- and SerpinF2-levels were significantly higher in heart failure patients with preserved ejection fraction than in those with reduced ejection fraction. Conclusion Extracellular vesicle levels of CD14, SerpinG1 and SerpinF2 are associated with the occurrence of heart failure in subjects suspected for acute heart failure, suggesting common underlying pathophysiological mechanisms for heart failure and vascular events. PMID:26820481

  18. Coronary artery disease affects cortical circuitry associated with brain-heart integration during volitional exercise.

    PubMed

    Norton, Katelyn N; Badrov, Mark B; Barron, Carly C; Suskin, Neville; Heinecke, Armin; Shoemaker, J Kevin

    2015-08-01

    This study tested the hypothesis that coronary artery disease (CAD) alters the cortical circuitry associated with exercise. Observations of changes in heart rate (HR) and in cortical blood oxygenation level-dependent (BOLD) images were made in 23 control subjects [control; 8 women; 63 ± 11 yr; mean arterial pressure (MAP): 90 ± 9 mmHg] (mean ± SD) and 17 similarly aged CAD patients (4 women; 59 ± 9 yr; MAP: 87 ± 10 mmHg). Four repeated bouts each of 30%, 40%, and 50% of maximal voluntary contraction (MVC) force (LAB session), and seven repeated bouts of isometric handgrip (IHG) at 40% MVC force (fMRI session), were performed, with each contraction lasting 20 s and separated by 40 s of rest. There was a main effect of group (P = 0.03) on HR responses across all IHG intensities. Compared with control, CAD demonstrated less task-dependent deactivation in the posterior cingulate cortex and medial prefrontal cortex, and reduced activation in the right anterior insula, bilateral precentral cortex, and occipital lobe (P < 0.05). When correlated with HR, CAD demonstrated reduced activation in the bilateral insula and posterior cingulate cortex, and reduced deactivation in the dorsal anterior cingulate cortex, and bilateral precentral cortex (P < 0.05). The increased variability in expected autonomic regions and decrease in total cortical activation in response to the IHG task are associated with a diminished HR response to volitional effort in CAD. Therefore, relative to similarly aged and healthy individuals, CAD impairs the heart rate response and modifies the cortical patterns associated with cardiovascular control during IHG.

  19. The Development of Functional Overreaching Is Associated with a Faster Heart Rate Recovery in Endurance Athletes

    PubMed Central

    Aubry, Anaël; Hausswirth, Christophe; Louis, Julien; Coutts, Aaron J.

    2015-01-01

    Purpose The aim of the study was to investigate whether heart rate recovery (HRR) may represent an effective marker of functional overreaching (f-OR) in endurance athletes. Methods and Results Thirty-one experienced male triathletes were tested (10 control and 21 overload subjects) before (Pre), and immediately after an overload training period (Mid) and after a 2-week taper (Post). Physiological responses were assessed during an incremental cycling protocol to exhaustion, including heart rate, catecholamine release and blood lactate concentration. Ten participants from the overload group developed signs of f-OR at Mid (i.e. -2.1 ± 0.8% change in performance associated with concomitant high perceived fatigue). Additionally, only the f-OR group demonstrated a 99% chance of increase in HRR during the overload period (+8 ± 5 bpm, large effect size). Concomitantly, this group also revealed a >80% chance of decreasing blood lactate (-11 ± 14%, large), plasma norepinephrine (-12 ± 37%, small) and plasma epinephrine peak concentrations (-51 ± 22%, moderate). These blood measures returned to baseline levels at Post. HRR change was negatively correlated to changes in performance, peak HR and peak blood metabolites concentrations. Conclusion These findings suggest that i) a faster HRR is not systematically associated with improved physical performance, ii) changes in HRR should be interpreted in the context of the specific training phase, the athletes perceived level of fatigue and the performance response; and, iii) the faster HRR associated with f-OR may be induced by a decreased central command and by a lower chemoreflex activity. PMID:26488766

  20. Association of hypothyroidism with adverse events in patients with heart failure receiving cardiac resynchronization therapy.

    PubMed

    Sharma, Ajay K; Vegh, Eszter; Orencole, Mary; Miller, Alexandra; Blendea, Dan; Moore, Stephanie; Lewis, Gregory D; Singh, Jagmeet P; Parks, Kimberly A; Heist, E Kevin

    2015-05-01

    Hypothyroidism is associated with an adverse prognosis in cardiac patients in general and in particular in patients with heart failure (HF). The aim of this study was to evaluate the impact of hypothyroidism on patients with HF receiving cardiac resynchronization therapy (CRT). Additionally, the impact of level of control of hypothyroidism on risk of adverse events after CRT implantation was also evaluated. We included consecutive patients in whom a CRT device was implanted from April 2004 to April 2010 at our institution with sufficient follow-up data available for analysis; 511 patients were included (age 68.5±12.4 years, women 20.4%); 84 patients with a clinical history of hypothyroidism, on treatment with thyroid hormone repletion or serum thyroid-stimulating hormone level≥5.00 μU/ml, were included in the hypothyroid group. The patients were followed for up to 3 years after implant for a composite end point of hospitalization for HF, left ventricular assist device placement, or heart transplant and cardiac death; 215 composite end point events were noted in this period. In a multivariate model, hypothyroidism (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.027 to 2.085, p=0.035), female gender (HR 0.64, 95% CI 0.428 to 0.963, p=0.032), and creatinine (HR 1.26, 95% CI 1.145 to 1.382, p<0.001) were significantly associated with occurrence of the composite end point; 53.6% of patients with hypothyroidism at baseline developed the composite end point compared with 39.8% of those with euthyroidism (p=0.02). In conclusion, hypothyroidism is associated with a worse prognosis after CRT implantation.

  1. Factors associated with willingness to participate in biospecimen research among Chinese Americans.

    PubMed

    Gao, Wanzhen; Ma, Grace X; Tan, Yin; Fang, Carolyn; Weaver, JoEllen; Jin, Ming; Lai, Philip

    2014-04-01

    A paucity of information exists on the recruitment of Asian Americans for biospecimen research. Although studies show that Chinese Americans are at high risk for hepatitis B virus (HBV) infection, little is known about their willingness to participate in HBV-related biospecimen research and how knowledge, attitudes, and cultural factors impact their willingness to participate. The study was guided by Community-Based Participatory Research principles. Data were derived from an assessment study on HBV-related biospecimen research participation among Chinese Americans in the Philadelphia region. The assessment was conducted with 415 Chinese Americans recruited from eight Chinese community-based organizations. Cultural beliefs, knowledge, and attitudes toward biospecimen research were examined for associations with their willingness to participate in biospecimen banking research. Overall, 192 (46.3%) of 415 participants who completed the assessment indicated they were willing to participate if they were invited to donate blood to be frozen and stored for future HBV biospecimen studies. Cultural variables significant in bivariate analysis included collectivism, knowledge about biospecimen research, and Yin-Yang beliefs. Fatalism and individualism were not associated with participation willingness. In multivariate analysis, age, health care attitudes, and trust were significantly associated with willingness to participate in biospecimen banking research. Asian American communities have little knowledge of biospecimen banking and will benefit from educational campaigns that emphasize collective benefits and attitudes towards and trust in the health care system. Understanding cultural factors is important for improving Chinese Americans' knowledge, awareness, and intentions of participation in biospecimen research. Similar efforts need to be undertaken to develop culturally appropriate educational intervention programs to increase participation in biospecimen research

  2. Factors associated with willingness to participate in biospecimen research among Chinese Americans.

    PubMed

    Gao, Wanzhen; Ma, Grace X; Tan, Yin; Fang, Carolyn; Weaver, JoEllen; Jin, Ming; Lai, Philip

    2014-04-01

    A paucity of information exists on the recruitment of Asian Americans for biospecimen research. Although studies show that Chinese Americans are at high risk for hepatitis B virus (HBV) infection, little is known about their willingness to participate in HBV-related biospecimen research and how knowledge, attitudes, and cultural factors impact their willingness to participate. The study was guided by Community-Based Participatory Research principles. Data were derived from an assessment study on HBV-related biospecimen research participation among Chinese Americans in the Philadelphia region. The assessment was conducted with 415 Chinese Americans recruited from eight Chinese community-based organizations. Cultural beliefs, knowledge, and attitudes toward biospecimen research were examined for associations with their willingness to participate in biospecimen banking research. Overall, 192 (46.3%) of 415 participants who completed the assessment indicated they were willing to participate if they were invited to donate blood to be frozen and stored for future HBV biospecimen studies. Cultural variables significant in bivariate analysis included collectivism, knowledge about biospecimen research, and Yin-Yang beliefs. Fatalism and individualism were not associated with participation willingness. In multivariate analysis, age, health care attitudes, and trust were significantly associated with willingness to participate in biospecimen banking research. Asian American communities have little knowledge of biospecimen banking and will benefit from educational campaigns that emphasize collective benefits and attitudes towards and trust in the health care system. Understanding cultural factors is important for improving Chinese Americans' knowledge, awareness, and intentions of participation in biospecimen research. Similar efforts need to be undertaken to develop culturally appropriate educational intervention programs to increase participation in biospecimen research

  3. Pancreatic hypoplasia presenting with neonatal diabetes mellitus in association with congenital heart defect and developmental delay.

    PubMed

    Balasubramanian, M; Shield, J P H; Acerini, C L; Walker, J; Ellard, S; Marchand, M; Polak, M; Vaxillaire, M; Crolla, J A; Bunyan, D J; Mackay, D J G; Temple, I K

    2010-02-01

    Congenital pancreatic hypoplasia is a rare cause of neonatal diabetes. We report on a series of three patients with pancreatic agenesis and congenital heart defects. All had abdominal scan evidence of pancreatic agenesis. In addition, Patient 1 had a ventricular septal defect, patent ductus arteriosus and pulmonary artery stenosis; Patient 2 had a truncus arteriosus and Patient 3 had tetralogy of Fallot. Two of the three patients have developmental delay. All three patients were isolated cases within the family. Investigations included sequencing of GCK, ABCC8, IPF1, NEUROD1, PTF1A, HNF1B, INS, ISL1, NGN3, HHEX, G6PC2, TCF7L2, SOX4, FOXP3 (Patients 1 and 2), GATA4 and KCNJ11 genes (all three patients), but no mutations were found. Genetic investigation to exclude paternal UPD 6, methylation aberrations and duplications of 6q24 was also negative in all three. 22q11 deletion was excluded in all three patients. Array CGH in Patient (1) showed a approximately 250 kb, paternally inherited duplication of chromosome 12q [arr cgh 12q24.33 (B35:CHR12:131808577-132057649++) pat], not found in the other two patients. Permanent neonatal diabetes mellitus due to pancreatic hypoplasia with congenital heart defects has been reported before and may represent a distinct condition. We discuss this rare association and review previously reported literature. PMID:20082465

  4. Changes underlying arrhythmia in the transgenic heart overexpressing Refsum disease gene-associated protein.

    PubMed

    Koh, Jeong Tae; Jeong, Byung Chul; Kim, Jae Ha; Ahn, Young Keun; Lee, Hyang Sim; Baik, Yung Hong; Kim, Kyung Keun

    2004-01-01

    Previously, we identified a novel neuron-specific protein (PAHX-AP1) that binds to Refsum disease gene product (PAHX), and we developed transgenic (TG) mice that overexpress heart-targeted PAHX-AP1. These mice have atrial tachycardia and increased susceptibility to aconitine-induced arrhythmia. This study was undertaken to elucidate the possible changes in ion channels underlying the susceptibility to arrhythmia in these mice. RT-PCR analyses revealed that the cardiac expression of adrenergic beta(1)-receptor (ADRB1) was markedly lower, whereas voltage-gated potassium channel expression (Kv2.1) was higher in PAHX-AP1 TG mice compared with non-TG mice. However, the expression of voltage-sensitive sodium and calcium channels, and muscarinic receptor was not significantly different. Propranolol pretreatment, a non-specific beta-adrenoceptor antagonist, blocked aconitine-induced arrhythmia in non-TG mice, but not in PAHX-AP1 TG mice. Our results indicate that, in the PAHX-AP1 TG heart, the modulation of voltage-gated potassium channel and ADRB1 expression seem to be important in the electrophysiological changes associated with altered ion channel functions, but ADRB1 is not involved in the greater susceptibility to aconitine-induced arrhythmia.

  5. Congestive heart failure with preserved ejection fraction is associated with severely impaired dynamic Starling mechanism

    PubMed Central

    Shibata, Shigeki; Hastings, Jeff L.; Prasad, Anand; Fu, Qi; Bhella, Paul S.; Pacini, Eric; Krainski, Felix; Palmer, M. Dean; Zhang, Rong

    2011-01-01

    Sedentary aging leads to increased cardiovascular stiffening, which can be ameliorated by sufficient amounts of lifelong exercise training. An even more extreme form of cardiovascular stiffening can be seen in heart failure with preserved ejection fraction (HFpEF), which comprises ∼40∼50% of elderly patients diagnosed with congestive heart failure. There are two major interrelated hypotheses proposed to explain heart failure in these patients: 1) increased left ventricular (LV) diastolic stiffness and 2) increased arterial stiffening. The beat-to-beat dynamic Starling mechanism, which is impaired with healthy human aging, reflects the interaction between ventricular and arterial stiffness and thus may provide a link between these two mechanisms underlying HFpEF. Spectral transfer function analysis was applied between beat-to-beat changes in LV end-diastolic pressure (LVEDP; estimated from pulmonary artery diastolic pressure with a right heart catheter) and stroke volume (SV) index. The dynamic Starling mechanism (transfer function gain between LVEDP and the SV index) was impaired in HFpEF patients (n = 10) compared with healthy age-matched controls (n = 12) (HFpEF: 0.23 ± 0.10 ml·m−2·mmHg−1 and control: 0.37 ± 0.11 ml·m−2·mmHg−1, means ± SD, P = 0.008). There was also a markedly increased (3-fold) fluctuation of LV filling pressures (power spectral density of LVEDP) in HFpEF patients, which may predispose to pulmonary edema due to intermittent exposure to higher pulmonary capillary pressure (HFpEF: 12.2 ± 10.4 mmHg2 and control: 3.8 ± 2.9 mmHg2, P = 0.014). An impaired dynamic Starling mechanism, even more extreme than that observed with healthy aging, is associated with marked breath-by-breath LVEDP variability and may reflect advanced ventricular and arterial stiffness in HFpEF, possibly contributing to reduced forward output and pulmonary congestion. PMID:21310890

  6. Male pattern baldness and its association with coronary heart disease: a meta-analysis

    PubMed Central

    Yamada, Tomohide; Hara, Kazuo; Umematsu, Hitomi; Kadowaki, Takashi

    2013-01-01

    Objective To confirm the association between male pattern baldness and coronary heart disease (CHD). Design Meta-analysis of observational studies. Data sources Medline and the Cochrane Library were searched for articles published up to November 2012 using keywords that included both ‘baldness’ and ‘coronary heart disease’ and the reference lists of those studies identified were also searched. Study selection Observational studies were identified that reported risk estimates for CHD related to baldness. Two observers independently assessed eligibility, extracted data and assessed the possibility of bias. Data synthesis The adjusted relative risk (RR) and 95% CI were estimated using the DerSimonian-Laird random-effect model. Results 850 possible studies, 3 cohort studies and 3 case–control studies were selected (36 990 participants). In the cohort studies, the adjusted RR of men with severe baldness for CHD was 1.32 (95% CI 1.08 to 1.63, p=0.008, I2=25%) compared to those without baldness. Analysis of younger men (<55 or ≤60 years) showed a similar association of CHD with severe baldness (RR 1.44, 95% CI 1.11 to 1.86, p=0.006, I2=0%). In three studies employing the modified Hamilton scale, vertex baldness was associated with CHD and the relation depended on the severity of baldness (severe vertex: RR 1.48 (1.04 to 2.11, p=0.03); moderate vertex: RR 1.36 (1.16 to 1.58, p<0.001); mild vertex: RR 1.18 (1.04 to 1.35, p<0.001)). However, frontal baldness was not associated with CHD (RR 1.11 (0.92 to 1.32, p=0.28)). Conclusions Vertex baldness, but not frontal baldness, is associated with an increased risk of CHD. The association with CHD depends on the severity of vertex baldness and also exists among younger men. Thus, vertex baldness might be more closely related to atherosclerosis than frontal baldness, but the association between male pattern baldness and CHD deserves further investigation. PMID:23554099

  7. Association of Sex Hormones, Aging and Atrial Fibrillation in Men: The Framingham Heart Study

    PubMed Central

    Magnani, Jared W.; Moser, Carlee B.; Murabito, Joanne M.; Sullivan, Lisa M.; Wang, Na; Ellinor, Patrick T.; Vasan, Ramachandran S.; Benjamin, Emelia J.; Coviello, Andrea D.

    2014-01-01

    Background Endogenous sex hormones have been related to cardiovascular outcomes and mortality. We hypothesized that sex hormones are related to atrial fibrillation (AF) in a community-based cohort of middle-aged to older men. Methods and Results We examined testosterone, estradiol, and dehydroepiandrosterone sulfate [DHEA-S]) in relation to incident AF in men participating in the Framingham Heart Study. We assessed the 10-year risk of AF in multivariable-adjusted hazard models. The cohort consisted of 1251 men (age 68.0±8.2), of whom 275 developed incident AF. We identified a significant interaction between age and testosterone, and therefore stratified men into age 55–69 (n=786), 70–79 (n=351), and ≥80 (n=114). In men 55–69 each 1-standard deviation (SD) decrease in testosterone was associated with hazard ratio (HR) 1.30 (95% confidence interval [CI], 1.07 to 1.59) for incident AF. The association between testosterone and 10-year incident AF in men 70–79 did not reach statistical significance. In men ≥80 years a 1-SD decrease in testosterone was associated with HR 3.53 (95% CI, 1.96 to 6.37) for AF risk. Estradiol was associated with incident AF (HR, 1.12; 95% CI, 1.01 to 1.26). DHEA-S had a borderline association with risk of AF that was not statistically significant (HR, 1.12; 95% CI, 0.99 to 1.28). Conclusions Testosterone and estradiol are associated with incident AF in a cohort of older men. Testosterone deficiency in men ≥80 is strongly associated with AF risk. The clinical and electrophysiologic mechanisms underlying the associations between sex hormones and AF in older men merit continued investigation. PMID:24610804

  8. Sex-related differences in habitat associations of wintering American Kestrels in California's Central Valley

    USGS Publications Warehouse

    Pandolfino, E.R.; Herzog, M.P.; Smith, Z.

    2011-01-01

    We used roadside survey data collected from 19 routes over three consecutive winters from 200708 to 200910 to compare habitat associations of male and female American Kestrels (Falco sparverius) in the Central Valley of California to determine if segregation by sex was evident across this region. As a species, American Kestrels showed positive associations with alfalfa and other forage crops like hay and winter wheat, as well as grassland, irrigated pasture, and rice. Habitat associations of females were similar, with female densities in all these habitats except rice significantly higher than average. Male American Kestrels showed a positive association only with grassland and were present at densities well below those of females in alfalfa, other forage crops, and grassland. Males were present in higher densities than females in most habitats with negative associations for the species, such as orchards, urbanized areas, and oak savannah. The ratio of females to males for each route was positively correlated with the overall density of American Kestrels on that route. Our findings that females seem to occupy higher quality habitats in winter are consistent with observations from elsewhere in North America. ?? 2011 The Raptor Research Foundation, Inc.

  9. Associations between adolescents' perceived discrimination and prosocial tendencies: the mediating role of Mexican American values.

    PubMed

    Brittian, Aerika S; O'Donnell, Megan; Knight, George P; Carlo, Gustavo; Umaña-Taylor, Adriana J; Roosa, Mark W

    2013-03-01

    Experiences with perceived discrimination (e.g., perceptions of being treated unfairly due to race or ethnicity) are expected to impact negatively youths' prosocial development. However, resilience often occurs in light of such experiences through cultural factors. The current longitudinal study examined the influence of perceived discrimination on the emergence of Mexican American adolescents' later prosocial tendencies, and examined the mediating role of Mexican American values (e.g., familism, respect, and religiosity). Participants included 749 adolescents (49 % female) interviewed at 5th, 7th, and 10th grade. Results of the current study suggested that, although perceived discrimination was associated negatively with some types of prosocial tendencies (e.g., compliant, emotional, and dire) and related positively to public prosocial helping, the associations were mediated by youths' Mexican American values. Directions for future research are presented and practical implications for promoting adolescents' resilience are discussed.

  10. Associations Between Adolescents’ Perceived Discrimination and Prosocial Tendencies: The Mediating Role of Mexican American Values

    PubMed Central

    O’Donnell, Megan; Knight, George P.; Carlo, Gustavo; Umaña-Taylor, Adriana J.; Roosa, Mark W.

    2012-01-01

    Experiences with perceived discrimination (e.g., perceptions of being treated unfairly due to race or ethnicity) are expected to impact negatively youths’ prosocial development. However, resilience often occurs in light of such experiences through cultural factors. The current longitudinal study examined the influence of perceived discrimination on the emergence of Mexican American adolescents’ later prosocial tendencies, and examined the mediating role of Mexican American values (e.g., familism, respect, and religiosity). Participants included 749 adolescents (49 % female) interviewed at 5th, 7th, and 10th grade. Results of the current study suggested that, although perceived discrimination was associated negatively with some types of prosocial tendencies (e.g., compliant, emotional, and dire) and related positively to public prosocial helping, the associations were mediated by youths’ Mexican American values. Directions for future research are presented and practical implications for promoting adolescents’ resilience are discussed. PMID:23152074

  11. Joint Effects of Smoking and Sedentary Lifestyle on Lung Function in African Americans: The Jackson Heart Study Cohort

    PubMed Central

    Campbell Jenkins, Brenda W.; Sarpong, Daniel F.; Addison, Clifton; White, Monique S.; Hickson, DeMarc A.; White, Wendy; Burchfiel, Cecil

    2014-01-01

    This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle was defined as the lowest quartile of the total physical activity score. The results of linear and logistic regression analyses revealed that non smokers with non sedentary lifestyles had the highest level of lung function, and smokers with sedentary lifestyles had the lowest level. The female non-smokers with sedentary lifestyles had a significantly higher FEV1% predicted and FVC% predicted than smokers with non sedentary lifestyles (93.3% vs. 88.6%; p = 0.0102 and 92.1% vs. 86.9%; p = 0.0055 respectively). FEV1/FVC ratio for men was higher in non smokers with sedentary lifestyles than in smokers with non sedentary lifestyles (80.9 vs. 78.1; p = 0.0048). Though smoking is inversely associated with lung function, it seems to have a more deleterious effect than sedentary lifestyle on lung function. Physically active smokers had higher lung function than their non physically active counterparts. PMID:24477212

  12. Joint effects of smoking and sedentary lifestyle on lung function in African Americans: the Jackson Heart Study cohort.

    PubMed

    Campbell Jenkins, Brenda W; Sarpong, Daniel F; Addison, Clifton; White, Monique S; Hickson, Demarc A; White, Wendy; Burchfiel, Cecil

    2014-02-01

    This study examined: (a) differences in lung function between current and non current smokers who had sedentary lifestyles and non sedentary lifestyles and (b) the mediating effect of sedentary lifestyle on the association between smoking and lung function in African Americans. Sedentary lifestyle was defined as the lowest quartile of the total physical activity score. The results of linear and logistic regression analyses revealed that non smokers with non sedentary lifestyles had the highest level of lung function, and smokers with sedentary lifestyles had the lowest level. The female non-smokers with sedentary lifestyles had a significantly higher FEV1% predicted and FVC% predicted than smokers with non sedentary lifestyles (93.3% vs. 88.6%; p = 0.0102 and 92.1% vs. 86.9%; p = 0.0055 respectively). FEV1/FVC ratio for men was higher in non smokers with sedentary lifestyles than in smokers with non sedentary lifestyles (80.9 vs. 78.1; p = 0.0048). Though smoking is inversely associated with lung function, it seems to have a more deleterious effect than sedentary lifestyle on lung function. Physically active smokers had higher lung function than their non physically active counterparts. PMID:24477212

  13. Ageism and Body Esteem: Associations With Psychological Well-Being Among Late Middle-Aged African American and European American Women

    PubMed Central

    2015-01-01

    Objectives. Social expectancy theory posits that cultural values shape how individuals perceive and evaluate others, and this influences how others evaluate themselves. Based on this theory, ageism may shape older individuals’ self-evaluations. Given the cultural focus on beauty and youth, perceptions of age discrimination may be associated with lower body esteem, and this may be associated with poor psychological well-being. Because discrimination has been associated with poor health, and perceptions of health can affect body perceptions, subjective health status may also contribute to lower body esteem. Method. These associations are assessed in a structural equation model for 244 African American and European American women in their early 60s. Results. Perceptions of age discrimination and body esteem were associated with lower psychological well-being for both ethnic groups. Body esteem partially mediated the association between age discrimination and psychological well-being among European American women but not among African American women. Discussion. Age-related discrimination is one source of psychological distress for older adults, though ageism’s associations with body esteem, health, and psychological well-being vary significantly for European American and African American women. Examining body perceptions and health in the contexts of ageism and ethnicity is necessary when considering the psychological well-being of older women. PMID:24013801

  14. Go to the hospital or stay at home? A qualitative study of expected hospital decision making among older African Americans with advanced heart failure.

    PubMed

    Hopp, Faith Pratt; Marsack, Christina; Camp, Jessica K; Thomas, Shirley

    2014-01-01

    To address the need for more information concerning hospital decision making, we conducted in-depth interviews among African Americans with heart failure and their family caregivers (n = 11 dyads). Using a case scenario, we asked participants about their anticipated hospitalization decisions. Most patients indicated that they would seek care to avoid further deterioration or death from their worsening condition. Many family caregivers anticipated having an active influence on hospitalization decisions. Findings suggest that social workers should encourage the development of adequate home-based services, recognize diverse communication styles, and use this information to facilitate medical decision making by these patients and their caregivers.

  15. A Text Messaging Intervention to Improve Heart Failure Self-Management After Hospital Discharge in a Largely African-American Population: Before-After Study

    PubMed Central

    Razi, Rabia R; Dick, Jonathan J; Smith, Bryan; Mayo, Ainoa; O'Connor, Anne; Meltzer, David O

    2013-01-01

    Background There is increasing interest in finding novel approaches to reduce health disparities in readmissions for acute decompensated heart failure (ADHF). Text messaging is a promising platform for improving chronic disease self-management in low-income populations, yet is largely unexplored in ADHF. Objective The purpose of this pre-post study was to assess the feasibility and acceptability of a text message–based (SMS: short message service) intervention in a largely African American population with ADHF and explore its effects on self-management. Methods Hospitalized patients with ADHF were enrolled in an automated text message–based heart failure program for 30 days following discharge. Messages provided self-care reminders and patient education on diet, symptom recognition, and health care navigation. Demographic and cell phone usage data were collected on enrollment, and an exit survey was administered on completion. The Self-Care of Heart Failure Index (SCHFI) was administered preintervention and postintervention and compared using sample t tests (composite) and Wilcoxon rank sum tests (individual). Clinical data were collected through chart abstraction. Results Of 51 patients approached for recruitment, 27 agreed to participate and 15 were enrolled (14 African-American, 1 White). Barriers to enrollment included not owning a personal cell phone (n=12), failing the Mini-Mental exam (n=3), needing a proxy (n=2), hard of hearing (n=1), and refusal (n=3). Another 3 participants left the study for health reasons and 3 others had technology issues. A total of 6 patients (5 African-American, 1 White) completed the postintervention surveys. The mean age was 50 years (range 23-69) and over half had Medicaid or were uninsured (60%, 9/15). The mean ejection fraction for those with systolic dysfunction was 22%, and at least two-thirds had a prior hospitalization in the past year. Participants strongly agreed that the program was easy to use (83%), reduced pills

  16. Position of the American Dietetic Association and Dietitians of Canada: vegetarian diets.

    PubMed

    2003-01-01

    It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life-cycle including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fibre, magnesium, potassium, folate, antioxidants such as vitamins C and E, and phytochemicals. Vegetarians have been reported to have lower body mass indices than non-vegetarians, as well as lower rates of death from ischemic heart disease, lower blood cholesterol levels, lower blood pressure, and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. While a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable for vegans at this time. Because

  17. Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets.

    PubMed

    2003-06-01

    It is the position of the American Dietetic Association and Dietitians of Canada that appropriately planned vegetarian diets are healthful, nutritionally adequate, and provide health benefits in the prevention and treatment of certain diseases. Approximately 2.5% of adults in the United States and 4% of adults in Canada follow vegetarian diets. A vegetarian diet is defined as one that does not include meat, fish, or fowl. Interest in vegetarianism appears to be increasing, with many restaurants and college foodservices offering vegetarian meals routinely. Substantial growth in sales of foods attractive to vegetarians has occurred, and these foods appear in many supermarkets. This position paper reviews the current scientific data related to key nutrients for vegetarians, including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, n-3 fatty acids, and iodine. A vegetarian, including vegan, diet can meet current recommendations for all of these nutrients. In some cases, use of fortified foods or supplements can be helpful in meeting recommendations for individual nutrients. Well-planned vegan and other types of vegetarian diets are appropriate for all stages of the life cycle, including during pregnancy, lactation, infancy, childhood, and adolescence. Vegetarian diets offer a number of nutritional benefits, including lower levels of saturated fat, cholesterol, and animal protein as well as higher levels of carbohydrates, fiber, magnesium, potassium, folate, and antioxidants such as vitamins C and E and phytochemicals. Vegetarians have been reported to have lower body mass indices than nonvegetarians, as well as lower rates of death from ischemic heart disease; vegetarians also show lower blood cholesterol levels; lower blood pressure; and lower rates of hypertension, type 2 diabetes, and prostate and colon cancer. Although a number of federally funded and institutional feeding programs can accommodate vegetarians, few have foods suitable

  18. Resting heart rate variability is associated with inhibition of conditioned fear.

    PubMed

    Wendt, Julia; Neubert, Jörg; Koenig, Julian; Thayer, Julian F; Hamm, Alfons O

    2015-09-01

    Startle blink as well as skin conductance responses (SCR) are widely used indices of learning processes associated with fear conditioning and extinction. During safety learning, the amygdala is under top-down inhibitory control by the prefrontal cortex (PFC). The capacity of the PFC to exert inhibitory control over subcortical brain structures may be indexed by resting state vagally mediated heart rate variability (HRV). The present study investigated the association of resting HRV with startle blink and SCR during conditioned fear inhibition and extinction. Participants first learned to discriminate a threat cue (A) signaling an aversive unconditioned stimulus from a safety signal (B), which were each presented together with a third stimulus X (AX+/BX-). Then, both the threat and safety signal were presented together (AB) to test whether the presence of the learned safety signal inhibits the fear response to the danger signal. Finally, AX was presented without reinforcement (AX-) to investigate fear extinction. Higher HRV was associated with pronounced fear inhibition and fear extinction. Resting HRV levels were associated with fear extinction as indexed by startle blink potentiation but not SCR, which presumably reflect more co