Coronary artery disease (CAD) is well known to be associated with dementia, motoric cognitive risk syndrome (MCR) has been identified as a predictor of dementia, with MCR and CAD potentially sharing common pathophysiological mechanisms. Identifying MCR in CAD patients is beneficial for the prevention of dementia. This study aims to investigate the incidence and identify the risk factors of MCR in CAD patients, and further establish a visual risk prediction model.

A cross-sectional study. From September 2023 to December 2023, we enrolled 413 CAD patients for this study. Patients were randomly grouped into a training cohort (80%) and a validation cohort (20%). The least absolute shrinkage and selection operator regression model and multivariate logistic regression analysis were used to select variables and develop a prediction model in the training cohort. In both the training and validation cohorts: ROC curve was used to evaluate the differentiation of the nomogram model; the calibration curve was used to evaluate the consistency of the model; the decision curve analysis was used to evaluate the efficiency of the nomogram.

In this study, the prevalence of MCR was 13.8%. Four risk predictors, namely polypharmacy, handgrip strength, Gensini score, and neutrophil counts, were screened and used to develop a nomogram model. The ROC curve of the training set was 0.781 (95%CI: 0.71, 0.86). Similar ROC curve was achieved at validation set 0.780 (95%CI: 0.62, 0.94). The Hosmer-Lemeshow test in the training, and testing cohorts were p = 0.993, and p = 0.782, calibration curve analysis demonstrated that the model was well-calibrated. DCA exhibited this model with clinical utility.

We developed a nomogram that could help clinicians identify high-risk groups of MCR in middle-aged and elderly CAD patients for early intervention.

The long-term effect of superficial temporal artery-middle cerebral artery (STA-MCA) bypass and corresponding hemodynamics in hemorrhagic moyamoya disease (MMD) remained unclear. This study aimed to investigate the incidence of long-term rebleeding events, bypass patency, neovascularization, and changes in hemispheric prefusion in hemorrhagic MMD patients.

Clinical and radiographic images for 35 hemorrhagic MMD patients (45 hemispheres) using STA-MCA bypass were recorded. The patients' demographic information, clinical presentation, associated medical conditions, hemispheric perfusion status, and clinical course were obtained from reviewing medical records, cerebral angiography, and CT perfusion (CTP) during long-term follow-up.

Of the 45 cases with an average follow-up of 38 months, 7 cases (15.5%, 2.08% per year) experienced new cerebral hemorrhages. The latest cerebral angiography indicated patent bypass in 32 cases (71.1%) and Matsushima grade A in 16 cases (35.6%). Distribution analysis of modified Suzuki stages and moyamoya vessels patterns showed significant changes (P < 0.05), with a higher proportion of patients progressing to advanced stages and a decrease in moyamoya vessels. There was a significant improvement in neurological outcomes (P = 0.004), with 80.0% of cases achieving normal neurological function. Long-term CTP analysis revealed no significant differences in rCBF compared to preoperative values (P > 0.05). However, rCBV significantly decreased in the caudate nucleus, parietal lobe, and striatum (P < 0.05). Significant decrease in rMTT and rTmax parameters were noted in several regions, including the genu of the corpus callosum, caudate nucleus, dorsal thalamus, and multiple cortical regions, indicating a reduction in microcirculation time (P < 0.05).

STA-MCA bypass could improve long-term neurological outcomes in hemorrhagic MMD patients, facilitating advancements in Suzuki stages and reducing moyamoya vessels. Long-term CTP results indicated a slight decrease in rCBF in several areas and shortened microcirculation time.

Not applicable.

To provide a review of current transcatheter structural heart interventions in women, with a focus on sex-specific considerations in diagnosis, treatment and outcomes.

Transcatheter interventions have transformed structural heart disease treatment, including valvular heart disease and left atrial appendage closure. Historically, low female enrollment in cardiovascular trials has limited sex-specific data integration into clinical guidelines. Recently, the changing landscape of female representation has provided insight into distinct pathophysiology, high-risk features, clinical characteristics, disease surveillance, referral barriers, and treatment responses. The success of transcatheter structural heart interventions relies on judicious patient selection and timely intervention. This review evaluates contemporary female representation in transcatheter studies, highlighting sex-specific prevalence, anatomic and physiologic variations, clinical presentations and both short- and long-term outcomes. Knowledge gaps and future research directions are identified to address diagnostic and therapeutic disparities, ultimately improving individualized lifetime care in women with structural heart disease.

The association between waist circumference (WC) and hypertension, and if this association varies by sex or by body mass index (BMI) categories have not deeply been assessed in the American continent. We aimed to evaluate whether an association between abdominal obesity and hypertension exists and if sex and BMI configure effect modifiers of such association. A secondary analysis of the Peruvian Demographic Family Health Survey data was conducted. Subjects aged from 20 to 69 years were included. Hypertension, defined by the Eighth Joint National Committee, was chosen as the outcome, whereas abdominal obesity (using WC cutoffs based on the 2001 National Cholesterol Education Program Adult Treatment Panel III) was selected as exposure. Poisson regression was used to report prevalence ratios (PR) and 95% confidence intervals (95%CI). Data from 144,156 subjects [mean age 41.4 (SD = 13.4), 54.8% of whom were women] were analyzed. Prevalence of abdominal obesity and hypertension totaled 45.4 and 19.5%, respectively. The adjusted model associated abdominal obesity with greater hypertension prevalence (PR = 1.31; 95%CI: 1.24-1.39). BMI, but nor sex, was an effect modifier of the association. Thus, those obese by BMI and abdominally obese had the strongest association with hypertension (PR = 2.76; 95%CI: 2.58-2.94) than those with normal BMI and no abdominal obesity. Our results evince a positive association between abdominal obesity and hypertension depending on BMI category. Those obese by both BMI and WC had the strongest association with hypertension. Our results suggest that BMI and WC offer useful markers for hypertension.

Aim: To study the consistency of opinions of participants in the treatment process of coronary heart disease with comorbid conditions with further analysis of the quality of pharmaceutical care and development of a strategy for improving interprofessional interaction of pharmacists in integrated care teams.

Materials and Methods: The materials of the study were the results of a survey, conducted among the pharmacists of pharmaceutical stores, patients with coronary heart disease with comorbid conditions and doctors, according to the specified criteria for providing pharmaceutical care. The following research methods were used: analysis, deduction, induction, comparison, systematization, generalization, forecasting, statistical and bibliographic.

Results: An intermediately satisfactory level of pharmaceutical care was determined. It was found that the implementation of pharmaceutical care requires the development of clinical competencies and communication skills of pharmacists with patients and the improvement of regulatory and legal support. Kendall's consistency coefficient W = 0.85.

Conclusions: A sufficiently high level of agreement of opinions (W = 0.85) of doctors, pharmacists and patients regarding the criteria for providing pharmaceutical care has been reliably confirmed. Directions for the development and improvement of mechanisms for providing pharmaceutical care have been identified. It is proposed to develop standards for providing pharmaceutical care to patients with coronary heart disease with comorbid conditions in accordance with the ESC/AHA recommendations and taking into account the compatibility of medicines of different pharmacological groups used to cure the cardiovascular diseases.

Aim: The purpose of the study is to study changes in Lp-PLA2 in the blood of patients in the early recovery period of atherothrombotic stroke depending on the degree of stenosis and type of atherosclerotic plaque.

Materials and Methods: A clinical and laboratory analysis of 130 patients in the early recovery period of atherothrombotic stroke was conducted. Among those examined were 69 men and 61 women aged (60.42±7.4) years. The control group consisted of 30 practically healthy persons (16 men and 14 women) without a history of severe somatic pathology, aged (58.7±6.3) years. Ultrasound scanning of the vessels of the neck was performed on a Siemens Acuson X 300 device. The amount of lipoprotein-associated phospholipase A2 (Lp-PLA2) was determined by the immunoenzymatic method. STATISTICA 8 software was used for statistical processing.

Results: In all examined patients, an increase in the content of Lp-PLA2 in the blood up to 260 (220.4; 295.7) ng/ml was found compared to individuals of the control group (p<0.05). Increased levels of Lp-PLA2 in stroke patients were associated with an increased degree of atherosclerotic stenosis and depended on the type of atherosclerotic plaque, reflecting its instability.

Conclusions: Increased concentrations of Lp-PLA2 in patients with cerebral atherosclerosis can be considered as circulating biomarkers of atherosclerotic plaque vulnerability. Patients in the early recovery period of an ischemic stroke with a soft atherosclerotic plaque according to ultrasound data in combination with an increase in Lp-PLA2 indicators in the blood belong to the group of high risk of developing a repeated stroke.

Aim: To analyze the prevalence and severity of depression in patients who suffered from cerebral stroke (CS).

Materials and Methods: A psychological study enrolled 300 patients after CS (main group [MG]: mean age [mean ± standard deviation] 56,7 ± 10,37 years; 134 [44,7%] males and 166 [55,3%] females) and 200 people without CS (control group [CG]: 57,2 ± 10,79 years; 64 [32,0%] males and 136 [68,0%] females). The levels of depression (LD) were assessed using the T.I. Balashova Depression Scale.

Results: The MG, as compared to the CG, demonstrated a higher depression score (52,6 ± 7,46 vs. 47,6 ± 6,88 points, respectively; p < 0,001) and had fewer patients without depression (35,7% vs. 68,0%, respectively; p < 0,001), as well as a higher frequency of mild depression (36,7% vs. 24,0%, respectively; p = 0,003) and subdepressive state (27,7% vs. 8,0%, respectively; p < 0,001). There were no significant associations between LD and factors such as age, sex, and dwelling in the MG. In contrast, CG males were more prevalent in the mild depression and subdepressive state categories compared to those free from depression. Also, mild depression in the CG was more frequently observed among urban dwellers than in the group without depression.

Conclusions: Patients who suffered from CS demonstrated a higher prevalence of more significant depressive disorders, namely mild depression and subdepression, compared to their CS-free counterparts.

Aim: To evaluate the outcomes of patients who underwent two different high-frequency techniques of varicose vein endovenous ablation in the great saphenous vein (GSV) region (radiofrequency ablation [RFA] or high-frequency endovenous welding [HFEW]), and to find out the options to improve long-term results.

Materials and Methods: The retrospective study enrolled 120 patients with primary varicose veins in the GSV region with CEAP stages C2-C6, treated in two private centers and operated on by a single operator from 2019 to 2021. The enrolled sample was subdivided into RFA (VNUS ClosureFast [n=58]) and HFEW ("SVARMED", Ukraine [n=62]) groups. Primary (such as occlusion rates) and secondary outcomes (such as postoperative pain [by VAS scale], complications, and recurrence rates) were assessed at 7 days, and at 3, 6, and 12 months postprocedurally.

Results: Both RFA and HFEW techniques showed high occlusion rates at 12 months postoperatively (96% and 97%, respectively [p=1,000]). The adverse events and perioperative complication rates were low and comparable between the two studied groups. Recurrence of varicose veins at the 12-month follow-up was numerically, but non-significantly, higher in the RFA group compared to HFEW (total: 14% vs. 6%, respectively [p=0,230]; junction source: 10% vs. 3%, respectively [p=0,154]).

Conclusions: Ablation of the GSV in patients with varicose vein disease by RFA and HFEW showed comparable early and midterm results with high occlusion rates at 12 months postoperatively. Recurrences in the RFA group, being numerically higher compared to the HFEW group, were primarily caused by new reflux coming from the femoral junction. HFEW requires further research for technical improvement and widespread implementation in practice.

Trained immunity (TRIM) is the process through which the innate immune system undergoes memory-like epigenetic and metabolic reprogramming following an earlier infectious challenge. Trained immunity can be induced, in a similar fashion to microbial structures, by various endogenous compounds: oxidized low-density lipoproteins, lipoprotein(a), glucose and uric acid, and monosodium urate. Lipids, glucose, and protein metabolic dysfunction have the potential to perpetuate a proinflammatory feedback loop through the induction of maladaptive trained immunity programs, as shown in cardiovascular diseases, diabetes, and hyperuricemia. Molecular mechanisms leading to TRIM are susceptible to homeostatic disruptions of advanced age, and maladaptive TRIM may be the link between immune aging and age-associated pathologies. The present review discusses the current knowledge on metabolic pathways in adaptive and maladaptive trained immunity and its deleterious consequences of inappropriate activation during aging. Finally, we discuss how several dietary patterns modulate immunometabolism and influence trained immunity in aging.

This article analyzes the continuity of care in the relational domain based on user experience. This is a qualitative case study based on 45 interviews with person living with HIV (PLH) followed-up in polyclinics and 38 interviews with users diagnosed with systemic arterial hypertension (SAH) registered in basic health units (BHU) in a large city in the state of Rio de Janeiro, Brazil. The results were analyzed according to two dimensions of relational continuity: trust-based relationship and availability of personalized information. The strongest trust-based relationships and the protagonism in the availability of health information were established with the family health team (FHT) physician and the infectious disease specialist in the polyclinics. Among the differences, according to users with SAH, the relationship bonds were broken by health care provider turnover. In the absence of relationships with other FHT professionals, continuity and access were simultaneously affected. Among PLH users, nursing professionals played an important role in care. In both cases, the results showed a care with little concern for interprofessional practices, collective actions and promotional initiatives to strengthen continuity. The lack of technology-mediated communication required users to attend health care services to solve their demands and contact professionals. The results indicate the importance of a regular point of care for establishment of the bond and consequent relational continuity. However, health care work management-related problems in the Brazilian Unified National Health System aggravate health care provider turnover and favor disruptions in therapeutic follow-up.