• Title/Summary/Keyword: Cerebrovascular and cardiovascular disease

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Effects of a Comprehensive Lifestyle Improvement Program for Middle-aged Women with Cardio-cerebrovascular Disease-related Risk Factors (심뇌혈관질환 위험요인을 가진 중년여성을 위한 통합적 생활습관개선 프로그램의 효과)

  • Park, Mi-Kyoung;Kim, Jeong-Hee
    • Research in Community and Public Health Nursing
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    • v.24 no.2
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    • pp.111-122
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    • 2013
  • Purpose: This study was conducted to evaluate effects of a comprehensive lifestyle improvement program for middle-aged women with cardio-cerebrovascular disease (CVD)-related risk factors. Methods: The research adopted a non-equivalent control group pretest-posttest design. The number of participants was 18 in the experimental group and 16 in the control group sampled among middle-aged women who had CVD-related risk factors residing in a community. The experimental group participated in a four-session comprehensive lifestyle promotion program, which consisted of lectures, demonstrations, small-group meetings and telephone-counseling. The effects of the program were evaluated by measuring knowledge, attitude, health behavior, and self-efficacy for CVD prevention. Results: The experimental group showed a significant increase in self-efficacy for CVD prevention compared to the control group. There was no significant increase in knowledge, attitude, and health behavior. Conclusion: The results suggest that the comprehensive lifestyle improvement program was effective in improving self-efficacy for CVD prevention. There is a need to develop more effective lifestyle improvement programs designed to improve knowledge, attitude, and health behavior for CVD prevention. In further research, a follow-up evaluation is also needed to investigate any delayed effects on targeted variables among which no significant differences emerged immediately after the completion of the program.

Surgical Outcomes of Forearm Loop Arteriovenous Fistula Formation Using Tapered versus Non-Tapered Polytetrafluoroethylene Grafts

  • Han, Sun;Seo, Pil Won;Ryu, Jae-Wook
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.30-35
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    • 2017
  • Background: Tapered grafts, which have a smaller diameter on the arterial side, have been increasingly used for arteriovenous fistula (AVF) formation. We compared the outcomes of 4-6-mm tapered and 6-mm straight forearm loop arteriovenous grafts. Methods: A total of 103 patients receiving forearm loop arteriovenous grafts between March 2005 and March 2015 were retrospectively analyzed and separated into 2 groups (group A, 4- to 6-mm tapered grafts, n=78; group B, 6-mm straight grafts, n=25). In each group, complications and patency rates after surgery were assessed. Results: Clinical characteristics and laboratory results, except for cerebrovascular disease history (group A, 7.7%; group B, 28.0%; p=0.014), were similar between the groups. No significant differences were found for individual complications. Kaplan-Meier survival analysis revealed no significant differences in 1-year, 3-year, and 5-year patency rates between groups (61.8%, 44.9%, and 38.5% vs. 62.7%, 41.1%, and 35.3%, respectively). Conclusion: We found no significant differences in complication and patency rates between the tapered and straight graft groups. If there are no differences in complication and patency between the two graft types, tapered grafts may be a valuable option for AVF formation in light of their other advantages.

The Literature Review on Life style Intervention Program for the Prevention of Cardiovascular Disease (심뇌혈관질환 예방을 위한 생활습관 개선 프로그램에 관한 문헌분석 연구)

  • Yang, Hye Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.1
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    • pp.157-166
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    • 2022
  • This study is a literature analysis study that analyzed program intervention research papers to understand the characteristics of lifestyle intervention programs to prevent cardiovascular disease. The final 18 papers were selected by applying search terms such as "cardio-cerebrovascular disease" and "intervention" through electronic databases such as Pubmed. As for the criteria for selecting program participants in the study, physiological criteria were mainly used, and there were many programs that mediated physical activity and eating habits. Education was the most widely used intervention type, and there were many studies that combined and applied several interventions. During the intervention period, long-term interventions averaged more than 22 weeks, and biophysical indicators were most frequently used as effect indicators for measuring the intervention effect. Through this study, it is suggested that environmental and social support is needed to develop intervention programs considering the interrelationship of various lifestyle habits and maintain healthy lifestyle habits.

Association between Periodontitis and Preeclampsia: a Systematic Review (임신기 치주질환과 자간전증 발생간의 연관성)

  • Ha, Jungeun
    • Journal of The Korean Society of Integrative Medicine
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    • v.6 no.1
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    • pp.55-62
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    • 2018
  • Purpose : Preeclampsia(PE) is a pregnancy-specific disease which is characterized by hypertension and proteinuria. This disease occurs in about 2-8 % of pregnancies in developing countries and remains among the major causes of maternal and neonatal mortality and morbidity throughout the world. Although the causes of PE are not fully understood, the infection has been considered as the main risk factor for this diseases. Periodontal disease may provide a chronic burden of endotoxin and inflammatory cytokines and the disease has been considered as risk factors of systemic illnesses including cardiovascular disease, atherosclerosis, and cerebrovascular ischemia. So, studies performed over the last 15 years have suggested that periodontal disease may be associated with adverse pregnancy outcomes such as PE. However, this association has not been found in all populations. The aim of this review article was to evaluate whether periodontal status and the presence of specific periodontal pathogens may influence the incidence of PE. Methods : Many research articles searched at the electronic databases(MEDLINE; 2000 to July 2017) including search term as periodontal disease and preeclampsia. Result : There were 10 case-control studies and 5 cohort studies meeting our inclusion criteria. The results showed that maternal periodontitis (adjusted odds ratio: 1.5 to 9.3) was associated with preeclampsia in 15 epidemiological studies. Conclusion : It is clear that maternal periodontitis is a risk factor associated with preeclampsia, emphasizing the importance of periodontal care in prenatal programs.

Mid-Term Results of Minimally Invasive Direct Coronary Artery Bypass Grafting

  • Seo, Dong Hyun;Kim, Jun Sung;Park, Kay-Hyun;Lim, Cheong;Chung, Su Ryeun;Kim, Dong Jung
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.8-14
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    • 2018
  • Background: Minimally invasive direct coronary artery bypass grafting (MIDCAB) has the advantage of allowing arterial grafting on the left anterior descending artery without a sternotomy incision. We present our single-center clinical experience of 66 consecutive patients. Methods: All patients underwent MIDCAB through a left anterior small thoracotomy between August 2007 and July 2015. Preoperative, intraoperative, postoperative and follow-up data - including major adverse cardiovascular and cerebrovascular events (MACCE), graft patency, and the need for re-intervention - were collected. Results: The mean age of the patients was $69.4{\pm}11.1years$ and 73% were male. There was no conversion to an on-pump procedure or a sternotomy incision. The 30-day mortality rate was 1.5%. There were no cases of stroke, although 2 patients had to be re-explored for bleeding, and 81.8% were extubated in the operating room or on the day of surgery. The median stay in the intensive care u nit and in the hospital were 1.5 and 9.6 days, respectively. The median follow-up period was 11 months, with a 5-year overall survival rate of $85.3%{\pm}0.09%$ and a 5-year MACCE-free survival rate of $72.8%{\pm}0.1%$. Of the 66 patients, 32 patients with 36 grafts underwent a postoperative graft patency study with computed tomography angiography or coronary angiography, and 88.9% of the grafts were patent at $9.7{\pm}10.8months$ postoperatively. Conclusion: MIDCAB is a safe procedure with low postoperative morbidity and mortality and favorable mid-term MACCE-free survival.

Dietary Reference Intakes of sodium for Koreans: focusing on a new DRI component for chronic disease risk reduction

  • Kim, Hyun Ja;Lee, Yeon-Kyung;Koo, Hoseok;Shin, Min-Jeong
    • Nutrition Research and Practice
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    • v.16 no.sup1
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    • pp.70-88
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    • 2022
  • Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.

Clinical Study of Composite Valve Graft Replacement of the Aortic Root (대동맥 근부 복합 인공 판막 도관 치환술에 관한 임상적 고찰)

  • Park, Kwon-Jae;Woo, Jong-Soo;Cho, Gwang-Jo;Bang, Jung-Hee;Jeong, Sang-Seok
    • Journal of Chest Surgery
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    • v.43 no.3
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    • pp.260-265
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    • 2010
  • Background: A composite valve graft replacement has been used for a variety of aortic root diseases. The aim of this study was to evaluate the mid-term results of this technique. Material and Method: We conducted a retrospective analysis of aortic root composite valve graft replacements in 39 patients and these procedures were done at our institution between 1992 and 2009. The mean age of the patients was $49.2{\pm}16.4$ years. The mean follow-up was $64.2{\pm}53.4$ months (maximum: 176 months). Result: There were 4 hospital deaths (8.6%) due to emergency aortic dissection and 4 late deaths owing to several causes. The causes of late death were 2 ruptures of a remnant aneurysm, 1 subdural hemorrhage and 1 paravalvular leakage. The calculated survival rate was 93.5%, 85.0% and 85.0% at 1, 5 and 10 years, respectively. There were 3 cerebrovascular accidents during the follow up period. The rate of freedom from cerebrovascular accidents was 97.0%, 92.0% and 80.0% at 1, 5 and 10 years, respectively. All of these brain accidents were hemorrhage-related complications. Conclusion: A composite valve graft replacement of the aortic root was associated with favorable results. So, this technique seems to be a good method to treat various aortic root diseases.

Comparison of Coronary Artery Bypass Graft-First and Percutaneous Coronary Intervention-First Approaches for 2-Stage Hybrid Coronary Revascularization

  • Choi, Hang Jun;Kang, Joonkyu;Song, Hyun;Kim, Do Yeon;Choi, Kuk Bin
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.247-254
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    • 2017
  • Background: Hybrid coronary revascularization (HCR) was developed to combine the advantages of coronary artery bypass graft (CABG) with percutaneous coronary intervention (PCI). However, it is still controversial whether it is more optimal to perform CABG or PCI first. The purpose of this study was to compare the clinical outcomes of these 2 approaches. Methods: Eighty patients who underwent HCR from May 2010 to December 2015 were enrolled in this retrospective analysis. The CABG-first group comprised 12 patients and the PCI-first group comprised 68 patients. Outcomes of interest included in-hospital perioperative factors, major adverse cardiac and cerebrovascular events (MACCEs), and the incidence of repeated revascularization, especially for the target vessel lesion. Results: No significant difference was found in the amount of postoperative bleeding (p=0.239). The incidence of MACCEs was similar between the CABG-first and PCI-first groups (1 of 12 [8.3%] vs. 5 of 68 [7.4%], p>0.999). Repeated revascularization was performed on 3 patients (25%) in the CABG-first and 9 patients (13.2%) in the PCI-first group (p=0.376). Conclusion: There were no significant differences in postoperative and medium-term outcomes between the CABG-first and PCI-first groups. Based on these results, it can be inferred that it is safe to opt for either CABG or PCI as the primary procedure in 2-stage HCR.

Optimized Feature Selection using Feature Subset IG-MLP Evaluation based Machine Learning Model for Disease Prediction (특징집합 IG-MLP 평가 기반의 최적화된 특징선택 방법을 이용한 질환 예측 머신러닝 모델)

  • Kim, Kyeongryun;Kim, Jaekwon;Lee, Jongsik
    • Journal of the Korea Society for Simulation
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    • v.29 no.1
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    • pp.11-21
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    • 2020
  • Cardio-cerebrovascular diseases (CCD) account for 24% of the causes of death to Koreans and its proportion is the highest except cancer. Currently, the risk of the cardiovascular disease for domestic patients is based on the Framingham risk score (FRS), but accuracy tends to decrease because it is a foreign guideline. Also, it can't score the risk of cerebrovascular disease. CCD is hard to predict, because it is difficult to analyze the features of early symptoms for prevention. Therefore, proper prediction method for Koreans is needed. The purpose of this paper is validating IG-MLP (Information Gain - Multilayer Perceptron) evaluation based feature selection method using CCD data with simulation. The proposed method uses the raw data of the 4th ~ 7th of The Korea National Health and Nutrition Examination Survey (KNHANES). To select the important feature of CCD, analysis on the attributes using IG-MLP are processed, finally CCD prediction ANN model using optimize feature set is provided. Proposed method can find important features of CCD prediction of Koreans, and ANN model could predict more accurate CCD for Koreans.

Relationship Between Blood Mercury Concentration and Waist-to-Hip Ratio in Elderly Korean Individuals Living in Coastal Areas

  • You, Chang-Hun;Kim, Byoung-Gwon;Kim, Jung-Man;Yu, Seung-Do;Kim, Yu-Mi;Kim, Rock-Bum;Hong, Young-Seoub
    • Journal of Preventive Medicine and Public Health
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    • v.44 no.5
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    • pp.218-225
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    • 2011
  • Objectives: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. Methods: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. Results: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) ${\mu}g$/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) ${\mu}g$/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] ${\mu}g$/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. Conclusions: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.