• Title/Summary/Keyword: cardiovascular disorders

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Considerations for dental treatment of Williams syndrome patients (윌리엄스 신드롬 환자의 치과치료를 위한 고려사항)

  • Shin, Jisun;Lee, Joonhaeng
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.238-241
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    • 2018
  • Williams syndrome is a rare congenital disorder with various physical abnormalities and characterized by facial, oral, and dental features. Individuals with Williams syndrome typically have eating disorders in the early childhood, which lead to prolonged night feeding. Prolonged night feeding is a risk factor for rampant dental caries. Williams syndrome is caused by the microdeletion of chromosome 7, resulting in elastin deficiency. Elastin is integral to cardiovascular health. Many patients with Williams syndrome have complex cardiovascular abnormalities that must be considered a part of dental management. Complications related to cardiovascular diseases may induce adverse effects such as dangerously elevated blood pressure. This may occur in patients during stressful dental treatment. In addition, characteristics of auditory hyperalgesia and anxiety disorders among patients with William syndrome, complicate receiving routine dental management. Therefore, dental treatment under sedation or general anesthesia may be preferable for patients with Williams syndrome; in particular, patients who are very uncooperative and/or needs extensive dental treatment. A thorough evaluation of each patient's physical condition is required before making decisions regarding dental treatment. Careful monitoring and preparation for emergencies are very important during and shortly after dental treatment under general anesthesia or sedation. Monitoring is critical until vital signs have stabilized and return to normal. A 28-month-old man diagnosed as having Williams syndrome, visited the Dental Hospital of ${\bigcirc}{\bigcirc}$ University for the management of rampant dental caries. We reported on the management of this patient who had peripheral pulmonic stenosis, and received dental treatment under general anesthesia. We also reviewed the characteristics of Williams syndrome and discussed considerations for dental treatment under general anesthesia.

Sex Differences in Cardiovascular Risk Factors for Dementia

  • Kim, Mi-Young;Kim, Kyeongjin;Hong, Chang Hyung;Lee, Sang Yoon;Jung, Yi-Sook
    • Biomolecules & Therapeutics
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    • v.26 no.6
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    • pp.521-532
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    • 2018
  • Dementia, characterized by a progressive cognitive decline and a cumulative inability to behave independently, is highly associated with other diseases. Various cardiovascular disorders, such as coronary artery disease and atrial fibrillation, are well-known risk factors for dementia. Currently, increasing evidence suggests that sex factors may play an important role in the pathogenesis of diseases, including cardiovascular disease and dementia. Recent studies show that nearly two-thirds of patients diagnosed with Alzheimer's disease are women; however, the incidence difference between men and women remains vague. Therefore, studies are needed to investigate sex-specific differences, which can help understand the pathophysiology of dementia and identify potential therapeutic targets for both sexes. In the present review, we summarize sex differences in the prevalence and incidence of dementia by subtypes. This review also describes sex differences in the risk factors of dementia and examines the impact of risk factors on the incidence of dementia in both sexes.

An Unusual Case of Todd's Paralysis Mimicking Large Cerebral Infarction after Open Heart Surgery (개심술 후 뇌경색과 비슷한 양상을 띠는 Todd 마비에 대한 치험 1예)

  • Park Han Gyu;Chang Won Ho;Roh Hak Jae;Youm Wook
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.237-240
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    • 2005
  • Improved operative, anesthetic, and cardiopulmonary bypass (CPB) techniques have significantly reduced postoperative complications; however, neurologic disorders remain a serious complication after open heart surgery. Possible explanations for neurologic complications are microembolism from CPB, decreased cerebral pefusion pressure due to intraoperative hypotension and unexpected metabolic changes. Amomg these, seizure has low incidence and Todd's paralysis after open heart surgery is extremely rare. Todd's paralysis is a complication of a seizure due to neuronal exhaustion mimicking large cerebral infarction after open heart surgery.

A Study on the Failed Rest After Work in Association with Cardiovascular and Other Diseases as Well as Physical disorders

  • Im, Chea-Eun;Kim, De-Hi
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.63-78
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    • 2000
  • This survey provides, at a participation rate of 70%, 4,790 examinees. The purpose of this study is to study the association of the failed rest after work with 34 diseases including cardiovascular diseases. The index of the failed rest after work was composed of 4 questions about "thinking of work for several hours", "feeling exhausted", feeling unsatisfied or depressed", and "needing to go to bed early for next day′s work". Estimation of correlation among 4 variables, factor analysis, and ANCOVA adjusted for sex, age and job were carried out. A self-rating questionnaire of one′s own disease history and the "London School of Hygiene Cardiovascular Questionnaire" were used in order to discriminate each morbid group from the opposite group. Brief explanations of the result are as follows: 1) Every variable of failed rest after work shows significant difference between the morbid group and the no morbid group for possible infarction; for angina pectoris in the total, and men. 2) Among 4 variables ′exhaustion′ best discriminates the infarction group from the no infarction group, and the angina group from the no angina group. 3) The factor of failed rest after work is a significant factor that distinguishes the infarction group from the no infarction group, and the angina pectoris group from the no angina group. Therefore, stress management through health education and promotion such as behavioral modification can be used to reduce cardiovascular diseases and stress as perceived by an individual.

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The Intoxication of Beta Blocker with Psychiatric Drugs Focused on the Cardiovascular Adverse Effects (베타차단제를 포함한 정신과적 약물 중독: 심혈관계 영향을 중심으로)

  • Joo, Sung Woo;Min, Young-Gi;Choi, Sang-Cheon;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.100-106
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    • 2016
  • Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

Clinical Assessment of Usefulness, Effectiveness and Safety of Kyejibokryung-hwan on Various Neuropathies

  • Park, Seong-Uk;Jung, Woo-Sang;Kim, Yun-Kyung;Moon, Sang-Kwan;Kim, Young-Suk;Bae, Hyung-Sup;Cho, Ki-Ho;Ko, Chang-Nam
    • The Journal of Korean Medicine
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    • v.27 no.4
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    • pp.135-141
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    • 2006
  • We were to assess clinical effectiveness, safety and usefulness of Kyejibokryung-hwan (KBH), which has been used for Er-hyul similar with vascular or neurologic disorders causing sensory or motor abnormalities. This study is a retrospective single case series. Two hundred ninety five patients were treated with KBH for various neuropathies in our hospital. Of them, 120 cases were excluded because of insufficient medical records or failure to follow up; the remaining 175 were included in the analysis. There were 18 patients with sensory abnormalities and 28 with motor abnormalities after stroke. Of peripheral type, there were 14 with diabetic neuropathy, 12 with carpal tunnel syndrome, 41 with spinal radiculopathies, and 62 with idiopathic neuropathies, for which the effectiveness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 56.5%, respectively. Adverse effects including indigestion or diarrhea were seen in 3.4% of the total patients. Taking the effectiveness and the safety together into consideration, the usefulness was assessed as 55.6%, 21.4%, 64.3%, 83.3%, 45.0%, and 54.8% for treating post-stroke sensory and motor abnormalities, diabetic neuropathy, carpal tunnel syndrome, spinal radiculopathies, and idiopathic neuropathies, respectively. In conclusion, we suggest that KBH is a useful herbal medicine for various neuropathies, especially of sensory type.

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Clinical Outcomes of Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension: 12-Year Experience

  • Oh, Se Jin;Bok, Jin San;Hwang, Ho Young;Kim, Kyung-Hwan;Kim, Ki Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.46 no.1
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    • pp.41-48
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    • 2013
  • Background: We present our 12-year experience of pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Materials and Methods: Between January 1999 and March 2011, 16 patients underwent pulmonary thromboendarterectomy. Eleven patients (69%) were classified as functional class III or IV based on the New York Heart Association (NYHA) classification. Seven patients had a history of inferior vena cava filter insertion, and 5 patients showed coagulation disorders. Pulmonary thromboendarterectomy was performed during total circulatory arrest with deep hypothermia in 14 patients. Results: In-hospital mortality and late death occurred in 2 patients (12.5%) and 1 patient (6.3%), respectively. Extracorporeal membrane oxygenation support was required in 4 patients who developed severe hypoxemia after surgery. Thirteen of the 14 survivors have been followed up for 54 months (range, 2 to 141 months). The pulmonary arterial systolic pressure and cardiothoracic ratio on chest radiography was significantly decreased after surgery ($76{\pm}26$ mmHg vs. $41{\pm}17$ mmHg, p=0.001; $55%{\pm}8%$ vs. $48%{\pm}3%$, p=0.003). Tricuspid regurgitation was reduced from $2.1{\pm}1.1$ to $0.7{\pm}0.6$ (p=0.007), and the NYHA functional class was also improved to I or II in 13 patients (81%). These symptomatic and hemodynamic improvements maintained during the late follow-up period. Conclusion: Pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension shows good clinical outcomes with acceptable early and long term mortality.

Age-, sex-, and height-based blood pressure reference charts, Yazd children 6-18 years, Iran

  • ahmadi, Nastaran;Namayandeh, Seyedeh Mahdieh;Bafghi, Seyed Mahmood Sadr;Mohammadi, Mohammad Reza;Mirzaei, Masoud;Sarebanhassanabadi, Mohammadtaghi;Mehrparvar, Amir Houshang;Faraji, Reza;Nilforoshan, Neda;Karimi, Ahmad
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.321-328
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    • 2020
  • Background: Pediatric hypertension is the main cause of morbidity and mortality in pediatric populations. Purpose: To examine pediatric hypertension in a clinical setting, we used the percentile rank approach and defined hypertension as that above the 95th percentile. Methods: The present study was linked to the a national analytical cross-sectional community-based Iranian Children and Adolescents' Psychiatric Disorders (IRCAP) survey. The survey was nationwide and funded by the National Institute of Medical Research Development. The IRCAP survey included 31,000 children and adolescents aged 6-18 years in all 31 Iran provinces. The current study included 1,035 children and adolescents and linked the data of the risk factors of cardiovascular disease only in Yazd province via random cluster sampling. Results: Of the total participants, 456 (44.1%) were male and 579 (55.9%) were female. The mean age was 11.2±3.8 years (11.7±3.7 years for males, 11.0±3.6 years for females), while mean height was 146±20.0 cm overall, 147.2±22.0 cm for males, and 144.6±17.0 cm for females (P=0.009). The blood pressure distributions and percentiles were evaluated. Conclusion: Here we determined age- and height-specific 50th, 90th, 95th, and 99th percentiles of systolic and diastolic blood pressures in Yazd boys and girls using 10-cm height intervals.

Determinants of depression in non-cardiac chest pain patients: a cross sectional study

  • Roohafza, Hamidreza;Yavari, Niloufar;Feizi, Awat;Khani, Azam;Saneian, Parsa;Bagherieh, Sara;Sattar, Fereshteh;Sadeghi, Masoumeh
    • The Korean Journal of Pain
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    • v.34 no.4
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    • pp.417-426
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    • 2021
  • Background: Non-cardiac chest pain (NCCP) is a common patient complaint imposing great costs on the healthcare system. It is associated with psychological factors such as depression. The aim of the present study is determining depression predictors in NCCP patients. Methods: The participants of this cross-sectional study were 361 NCCP patients. Patients filled out questionnaires concerning their sociodemographic, lifestyle, and clinical factors (severity of pain, type D personality, somatization, cardiac anxiety, fear of body sensations, and depression). Results: Based on multiple ordinal logistic regression, lack of physical activity (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.09-2.87), sleep quality (OR, 2.98; 95% CI, 1.15-7.69), being a smoker (OR, 1.33; 95% CI, 2.41-4.03), present pain intensity (OR, 1.08; 95% CI, 1.05-1.11), type D personality (OR, 2.43; 95% CI, 1.47-4.03), and somatization (OR, 1.22; 95% CI, 1.15-1.3) were significant predictors of depression in NCCP patients. Additionally, multiple linear regression showed that being unmarried (β = 1.51, P = 0.008), lack of physical activity (β = 1.22, P = 0.015), sleep quality (β = 2.26, P = 0.022), present pain intensity (β = 0.07, P = 0.045), type D personality (β = 1.87, P < 0.001), somatization (β = 0.45, P < 0.001), and fear of bodily sensation (β = 0.04, P = 0.032) increased significantly depression scores in NCCP patients. Conclusions: Physicians should consider the predictors of depression in NCCP patients which can lead to receiving effective psychological consultations and reducing the costs and ineffectual referrals to medical centers.

The Study about the Changes of the Fire and Heat Related Symptoms and Signs On the Acute Cerebral Infarction Patients. (급성기 뇌경색 환자에서 화열 관련 증상과 증후의 변화에 관한 연구)

  • Kwak, Seung-hyuk;Park, Su-kyung;Woo, Su-kyung;Lee, Eun-chan;Park, Joo-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Cho, Seung-yeon;Park, Sung-wook;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.12 no.1
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    • pp.24-31
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    • 2011
  • Objective : Fire and heat related symptoms and signs are considered common in acute stage of diseases. The purpose of this study is to evaluate the occurrences and changes of fire and heat related symptoms and signs in acute cerebral infarction patients. Method & subjects : 40 acute cerebral infarction patients hospitalized in Oriental medicine hospital, Kyung-Hee University, who had examined and diagnosed 2 or 3 times based on oriental medical diagnosis were selected. We chose 23 as fire and heat related symptoms and signs from 94 diagnostic articles, and we added all those scores together of each patient. We analysed the scores of fire and heat related symptoms and signs as the time passed, and depending on oriental medical diagnosis. Result : In acute cerebral infarction patients of this study, 4 of fire and heat related symptoms and signs were took 1st, 2nd, 4th and 8th places in most changeable 10 articles of total 94 articles. The mean score of fire and heat related symptoms and signs of all patients were decreased significantly over the 3 times of measurements. The 8 patients diagnosed as fire and heat diagnosis at visit1 were samely diagnosed as fire and heat diagnosis at visit2, and at visit3 5 patients of them except for 3 patients excluded between visit2 and visit3, were still diagnosed as fire and heat diagnosis. At all of 3 measuring times, the scores of fire and heat related symptoms and signs of fire and heat diagnosis group were higher than non-fire and heat diagnosis group. Conclusion : This study indicated that fire and heat related symptoms and signs were very changeable phenomenon in acute cerebral infarction patients. And they decreased as time goes on.

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