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Correlation between metabolic syndrome and sleep apnea

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World Journal of Diabetes 2018年第4期9卷 66-71页

作者： Alejandro Castaneda Edgar Jauregui-Maldonado Iqbal Ratnani Joseph Varon Salim Surani Dorrington Medical Associates HoustonTX 77030United States debakey heart and vascular center Houston MethodistHoustonTX 77030United States Department of Acute and Continuing Care.The University of Texas Health Science center houston TX 77030United States Division of Pulmonary Critical Care and Sleep MedicineTexas A and M UniversityHealth Science CenterCorpus ChristiTX 78404United States

The so-called "metabolic syndrome"(MS),constitutes a cluster of metabolic and cardiovascular abnormalities,including fasting glucose,blood pressure,triglycerides,high density lipoprotein cholesterol(HDL-C),and waist circumference that arise from insulin resistance. Obstructive sleep apnea(OSA) syndrome is characterized by recurrent episodes of partial or complete obstruction of the upper airway,involving cessation or significant decreased airflow,with intermittent hypoxemia,frequent arousals from sleep and recurrent oxyhemoglobin desaturations that interfere with normal sleep patterns generating difficulty falling asleep,unrefreshing sleep and loud snoring. The relation between these two entities is known as "Syndrome Z",and there is no question about the impact of these risk factors on health and disease. This clinical condition presents a growing epidemic Worldwide,affecting approximately 60% of the general population with both MS and OSA due to the constant increase of body mass index in humans. This article presents evidence-based data that focuses on the direct relationship between MS and OSA.

关键词： Obstructive sleep apnea Metabolic syndrome Sleep apnea Obesity Syndrome Z

Rock1 Inhibitor Abrogates Chronic Rejection in Rat Cardiac Model System

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Open Journal of Organ Transplant Surgery 2012年第4期2卷 46-51页

作者： Li Zhang Malgorzata Kloc Neelam Tejpal Junping You Andrea M. Cordero-Reyes Keith A. Youker Rafik M. Ghobrial Department of Surgery The Methodist Hospital The methodist debakey heart & vascular center Houston TX USA

Background: We have shown previously that the abrogation of acute and chronic rejection of rat cardiac allografts occurs through the down-regulation of RhoA pathway and involves the changes in RhoA kinase (ROCK)-dependent actin cytoskeleton and T cell motility. Here we studied the ability of the Y-27632, a highly selective inhibitor of Rho-associated protein kinase p160ROCK (ROCK1), to abrogate chronic rejection of the allograft and influence T cell infiltration. Methods: Heterotopic cardiac transplants were performed between donor Wistar Furth (WF) and ACI recipient rats. Controls received sub-therapeutic dose of cyclosporine (CsA, 10 mg/kg) for 3 days or 7 days therapeutic dose of cyclosporine. The experimental groups of ACI recipient received one preoperative dose of the Y-27632 inhibitor (2 mg/kg, gavage feed) in conjunction with the sub-therapeutic dose of CsA for 3 days or inhibitor alone for 7 days. The cardiac grafts were harvested at 100 days of post-transplantation for histological and immunohistochemical assessment of chronic rejection, vascular sclerosis, and infiltration by different T cell subtypes. Results: Cardiac allografts from recipients exposed to Y-27632 inhibitor in conjunction with sub-therapeutic dose of CsA showed drastically reduced vascular sclerosis, minimal myocardial total cellular infiltration, and were selectively infiltrated with Foxp3+ T regulatory (Treg) cells. Conclusions: Our novel finding that a single dose of the ROCK1 inhibitor Y-27632 attenuates chronic rejection in rat cardiac model system by promoting development of Treg cells warrants its potential as a novel therapeutic agent specific for the inhibition of chronic rejection.

关键词： Chronic Rejection Transplantation ROCK1 RhoA T Cell

Unmodified autologous stem cells at point of care for chronic myocardial infarction

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World Journal of Stem Cells 2019年第10期11卷 831-858页

作者： Alexander Haenel Mohamad Ghosn Tahereh Karimi Jody Vykoukal Dipan Shah Miguel Valderrabano Daryl G Schulz Albert Raizner Christoph Schmitz Eckhard U Alt heart and vascular Institute Department of MedicineTulane University Health Science CenterNew OrleansLA 70112United States The methodist Hospital Research Institute HoustonTX 77030United States Department of Radiology and Nuclear Medicine University Hospital Schleswig-HolsteinLübeck D-23562Germany houston methodist debakey heart and vascular center HoustonTX 77030United States Department of Translational Molecular Pathology MD Anderson Cancer CenterThe University of TexasHoustonTX 77030United States Institute of Anatomy Faculty of MedicineLMU MunichMunich D-80336Germany Isar Klinikum Munich Munich D-80331Germany

BACKGROUND Numerous studies investigated cell-based therapies for myocardial infarction(MI).The conflicting results of these studies have established the need for developing innovative approaches for applying cell-based therapy for MI.Experimental studies on animal models demonstrated the potential of fresh,uncultured,unmodified,autologous adipose-derived regenerative cells(UAADRCs)for treating acute MI.In contrast,studies on the treatment of chronic MI(CMI;>4 wk post-MI)with UA-ADRCs have not been published so far.Among several methods for delivering cells to the myocardium,retrograde delivery into a temporarily blocked coronary vein has recently been demonstrated as an effective option.AIM To test the hypothesis that in experimentally-induced chronic myocardial infarction(CMI;>4 wk post-MI)in pigs,retrograde delivery of fresh,uncultured,unmodified,autologous adipose-derived regenerative cells(UA-ADRCs)into a temporarily blocked coronary vein improves cardiac function and structure.METHODS The left anterior descending(LAD)coronary artery of pigs was blocked for 180 min at time point T0.Then,either 18×106 UA-ADRCs prepared at“point of care”or saline as control were retrogradely delivered via an over-the-wire balloon catheter placed in the temporarily blocked LAD vein 4 wk after T0(T1).Effects of cells or saline were assessed by cardiac magnetic resonance(CMR)imaging,late gadolinium enhancement CMR imaging,and post mortem histologic analysis 10 wk after T0(T2).RESULTS Unlike the delivery of saline,delivery of UA-ADRCs demonstrated statistically significant improvements in cardiac function and structure at T2 compared to T1(all values given as mean±SE):Increased mean LVEF(UA-ADRCs group:34.3%±2.9%at T1 vs 40.4±2.6%at T2,P=0.037;saline group:37.8%±2.6%at T1 vs 36.2%±2.4%at T2,P>0.999),increased mean cardiac output(UA-ADRCs group:2.7±0.2 L/min at T1 vs 3.8±0.2 L/min at T2,P=0.002;saline group:3.4±0.3 L/min at T1 vs 3.6±0.3 L/min at T2,P=0.798),increased mean mass of the left ventricle(UA-ADRCs group:55.3±5.0 g at T1

关键词： Adipose tissue-derived regenerative cells Chronic myocardial infarction heart failure Stem cells Translational medicine Point of care cell therapy

Spontaneous Heparin-Induced Thrombocytopenia Presenting as Concomitant Bilateral Cerebrovascular Infarction and Acute Coronary Syndrome

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Cardiovascular Innovations and Applications 2023年第1期7卷 44-48页

作者： Jong Kun Park Ilan Vavilin Jacob Zaemes Araba Ofosu-Somuah Raghav Gattani Camila Sahebi Alexander G.Truesdell The University of Texas Health Science center at houston HoustonTXUSA MedStar Georgetown University Hospital Washington D.C.USA Inova heart and vascular Institute Falls ChurchVAUSA Inova Fairfax Hospital Department of Hematology and Oncology Falls ChurchVAUSA

Background:Spontaneous heparin-induced thrombocytopenia is a pro-thrombotic syndrome in which anti-heparin antibodies develop without heparin exposure.Case presentation:A 78-year-old man who underwent a successful lumbar laminectomy presented to the hospital 5 days after discharge for stroke-like symptoms and was found to have acute infarcts of the bilateral frontal lobes.The patient was found to be severely thrombocytopenic and was incidentally found to have an inferior wall myocardial infarction.Further investigation led to the diagnosis of bilateral lower extremity deep vein thromboses.His overall clinical presentation prompted a detailed hematologic workup that indicated positivity for heparin-induced thrombocy-topenia despite no previous exposure to heparin products.Conclusions:This case illustrates a patient with no prior lifetime heparin exposure who underwent laminectomy with subsequent development of acute infarcts of the bilateral frontal lobes,an inferior wall myocardial infarction,and bilateral lower extremity deep vein thromboses,with concern for sequelae of spontaneous heparin-induced thrombo-cytopenia.

关键词： Acute coronary syndrome deep vein thrombosis myocardial infarction cerebrovascular infarction spontaneous heparin-induced thrombocytopenia

Elevated cardiovascular risk and acute events in hospitalized colon cancer survivors:A decade-apart study of two nationwide cohorts

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World Journal of Clinical Oncology 2024年第4期15卷 548-553页

作者： Rupak Desai Avilash Mondal Vivek Patel Sandeep Singh Shaylika Chauhan Akhil Jain Independent Researcher AtlantaGA 30079United States Department of Internal Medicine Nazareth HospitalPhiladelphiaPA 19152United States Department of Clinical Epidemiology Biostatistics and Bio-informaticsAmsterdam UMCAmsterdam 7057Netherlands Department of Internal Medicine Geisinger Health SystemWikes-BarrePA 18702United States Division of Leukemia The University of Texas MD Anderson Cancer CenterHoustonTX 77079United States

BACKGROUND Over the years,strides in colon cancer detection and treatment have boosted survival rates;yet,post-colon cancer survival entails cardiovascular disease(CVD)risks.Research on CVD risks and acute cardiovascular events in colorectal cancer survivors has been limited.AIM To compare the CVD risk and adverse cardiovascular outcomes in current colon cancer survivors compared to a decade ago.METHODS We analyzed 2007 and 2017 hospitalization data from the National Inpatient Sample,studying two colon cancer survivor groups for CVD risk factors,mortality rates,and major adverse events like pulmonary embolism,arrhythmia,cardiac arrest,and stroke,adjusting for confounders via multivariable regression analysis.RESULTS Of total colon cancer survivors hospitalized in 2007(n=177542)and 2017(n=178325),the 2017 cohort often consisted of younger(76 vs 77 years),male,African-American,and Hispanic patients admitted non-electively vs the 2007 cohort.Furthermore,the 2017 cohort had higher rates of smoking,alcohol abuse,drug abuse,coagulopathy,liver disease,weight loss,and renal failure.Patients in the 2017 cohort also had higher rates of cardiovascular comorbidities,including hypertension,hyperlipidemia,diabetes,obesity,peripheral vascular disease,congestive heart failure,and at least one traditional CVD(Pvascular events(stroke 28%,PE 47%,arrhythmia 41%,and cardiac arrest 63%).It is vital to regularly screen colon can

关键词： Colon cancer Colorectal cancer Cardiovascular diseases Cardiovascular disease risk Cardiac events Stroke

Diagnosis and treatment of hypertensive crises in the elderly patients

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Journal of Geriatric Cardiology 2007年第1期4卷 50-55页

作者： Joseph Varon Neil E. Strickman University of Texas Health Science center at houston Houston Texas USA Peripheral vascular Lab at HGCA Peripheral Vascular Interventional Cardiology at Texas Heart Institute / St Lukes Episcopal Hospital Houston Texas USA

Hypertension is a common clinical problem in the elderly worldwide and physicians of all types are likely to encounter patients with hypertensive urgencies and emergencies in these patients. Although various terms have been applied to these conditions, they are all characterized by acute elevations in blood pressure and evidence of end-organ injury. Prompt, but carefully considered therapy is necessary to limit morbidity and mortality. A wide range of pharmacologic alternatives are available to the practitioner to control blood pressure and treat complications in these patients. The management of the elderly patient with hypertensive crises needs to include close monitoring and a gentle decline in blood pressure to avoid catastrophic complications, exacerbation of ischemic myopathy, and vascular insufficiency.

关键词： hypertension hypertensive crises hypertensive encephalopathy aortic dissection beta-blocker calcium channel blocker clevidipine fenoldopam nitroprusside labetalol nicardipine elderly

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Carbon dioxide-angiography for patients with peripheral arterial disease at risk of contrast-induced nephropathy

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World Journal of Cardiology 2020年第2期12卷 76-90页

作者： Amol Gupta Akinsansoye K Dosekun Vinod Kumar Department of Cardiology HeartVascular and Leg CenterBakersfieldCA 93309United States Department of Nephrology University of TexasHoustonTX 77030United States

Patients with peripheral arterial disease(PAD)and critical limb ischemia are at risk for limb amputation and require urgent management to restore blood flow.Patients with PAD often have several comorbidities,including chronic kidney disease,diabetes mellitus,and hypertension.Diagnostic and interventional angiography using iodinated contrast agents provides excellent image resolution but can be associated with contrast-induced nephropathy(CIN).The use of carbon dioxide(CO2)as a contrast agent reduces the volume of iodine contrast required for angiography and reduces the incidence of CIN.However,CO2 angiography has been underutilized due to concerns regarding safety and image quality.Modern CO2 delivery systems with advanced digital subtraction angiography techniques and hybrid angiography have improved imaging accuracy and reduced the incidence of CIN.Awareness of the need for optimal imaging conditions,contraindications,and potential complications have improved the safety of CO2 angiography.This review aims to highlight current technological advances in the delivery of CO2 in vascular angiography for patients with PAD and critical limb ischemia,which result in limb preservation while preventing kidney damage.

关键词： Endovascular procedures Angiography Digital subtraction Chronic kidney disease Peripheral artery disease Carbon dioxide

糖尿病相关的足病的定义和标准(2023年更新版)

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感染、炎症、修复 2024年第1期25卷 80-85页

作者： Jaap J.van Netten Sicco A.Bus Jan Apelqvist Pam Chen Vivienne Chuter Robert Fitridge Frances Game Robert J.Hinchliffe Peter A.Lazzarini Joseph Mills Matilde Monteiro-Soares Edgar J.G.Peters Katherine M.Raspovic Eric Senneville Dane K.Wukich Nicolaas C.Schaper on behalf of the International Working Group on the Diabetic Foot 张会峰(译) 许樟荣(审校) Department of Rehabilitation Medicine Amsterdam UMCLocation University of AmsterdamAmsterdamthe Netherlands Amsterdam Movement Sciences Program RehabilitationAmsterdamthe Netherlands Department of Endocrinology University Hospital of MalmöMalmöSweden Joondalup Health Campus Ramsay HealthcareSydneyAustralia Faculty of Health University of TasmaniaHobartAustralia School of Health Sciences Western Sydney UniversitySydneyAustralia Faculty of Health and Medical Sciences University of AdelaideAdelaideAustralia vascular and Endovascular Service Royal Adelaide HospitalAdelaideAustralia Department of Diabetes and Endocrinology University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK Department of vascular Surgery University of BristolBristolUK School of Public Health and Social Work Queensland University of TechnologyBrisbaneAustralia Allied Health Research Collaborative The Prince Charles HospitalBrisbaneAustralia Michael E.debakey Department of Surgery Division of Vascular Surgery and Endovascular TherapyBaylor College of MedicineHoustonTexasUSA Portuguese Red Cross School of Health–Lisbon LisbonPortugal MEDCIDS–Departamento de Medicina da Comunidade Informação e Decisão em Saúde Faculty of Medicine of the University of PortoPortoPortugal RISE@CINTESIS Faculty of Medicine Oporto UniversityPortoPortugal Department of Internal Medicine Amsterdam UMCVrije Universiteit AmsterdamSection of Infectious DiseasesAmsterdamthe Netherlands Department of Orthopaedic Surgery University of Texas Southwestern Medical CenterDallasTexasUSA Department of Infectious Diseases Gustave Dron Hospital Tourcoing Univ-lilleTourcoingFrance Div.Endocrinology MUMC+CARIM and CAPHRI InstituteMaastrichtThe Netherlands 不详河南省人民医院内分泌科河南郑州450003 战略支援部队特色医学中心北京100101

糖尿病相关的足病管理涉及多个学科,通用的专业词汇对于各学科间准确沟通交流至关重要。国际糖尿病足工作组(IWGDF)对相关文献进行了系统综述,构成了制定IWGDF指南的基础,并且明确了糖尿病相关的足病的一系列定义、标准及名词解释。本... 详细信息

糖尿病相关的足病管理涉及多个学科,通用的专业词汇对于各学科间准确沟通交流至关重要。国际糖尿病足工作组(IWGDF)对相关文献进行了系统综述,构成了制定IWGDF指南的基础,并且明确了糖尿病相关的足病的一系列定义、标准及名词解释。本文介绍2023年IWGDF对这些定义和标准的更新,并建议在临床实践和研究中一致使用,以利于世界各地不同学科人员针对糖尿病相关的足病的专业性交流。

关键词：定义糖尿病糖尿病相关的足病国际糖尿病足工作组

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Molecular signal transduction in vascular cell apoptosis

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Cell Research 2001年第4期11卷 253-264页

作者： GENG YONG JIAN center for Cardiovascular Biology and Atherosclerosis Research, Division of Cardiology, Department of Internal Medicine, University of Texas houston Health Science center Medical School, 6431 Fannin Street, MSB 6.045, houston, TX 77030, USA Division of Cardiology Department of Internal Medicine Center for Cardiovascular Biology and Atherosclerosis Research University of Texas Houston Health Science Center Medical School Houston USA

Apoptosis is a form of genetically programmed cell death, which plays a key role in regulation of cellularity in a variety of tissue and cell types including the cardiovascular tissues. Under both physiological and pathophysiological conditions, various biophysiological and biochemical factors, including mechanical forces, reactive oxygen and nitrogen species, cytokines, growth factors, oxidized lipoproteins, etc., ma influence apoptosis of vascular cells. The Fas/Fas ligand/caspase death-signaling pathway, Bcl-2 protein family/mitochondria, the tumor suppressive gene p53, and the proto-oncogene c-myc may be activated in atherosclerotic lesions, and mediates vascular apoptosis during the development of atherosclerosis. Abnormal expression and dysfunction of these apoptosis-regulating genes may attenuate or accelerate vascular cell apoptosis and affect the integrity and stability of atherosclerotic plaques. Clarification of the molecular mechanism that regulates apoptosis may help design a new strategy for treatment of atherosclerosis and ii major complication, the acute vascular syndromes.

关键词： Apoptosis vascular cells caspases atherosclerosis cytokines.