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Resumen A pesar de que la violencia de pareja íntima (VPI) presenta en la mujer una variedad de síntomas evidenciables, varios de los actores involucrados en el sistema de salud no cuentan con mecanismos de evaluación temprana, ni de reconocimiento de los tipos de secuelas psicológicas, entre los que se incluye una diversa sintomatología psicofisiológica. Con el objetivo de conocer las características de somatización, ansiedad y depresión en mujeres víctimas de VPI, como parte de una investigación macro de corte transversal no experimental de campo, se realizó el presente estudio cuantitativo correlacional a través de las variables del Inventario de Evaluación de la Personalidad (PAI). Los datos obtenidos se sometieron a análisis estadístico con métodos descriptivos e inferenciales. La muestra consta de 50 mujeres de la población de víctimas de VPI de la sierra ecuatoriana. Los resultados obtenidos son bastante contradictorios en cuanto al bajo porcentaje de mujeres con afectación típica relacionada con este tipo de violencia, en comparación con los datos presentados por otros autores sobre los niveles de somatización, ansiedad y depresión en ellas. A pesar de esto, se obtuvieron tres factores independientes presentes en esta muestra: trastorno ansioso-depresivo, con elementos de estrés postraumático; trastorno obsesivo compulsivo, con elementos de ansiedad, y quejas somáticas. Al momento de finalizar este estudio, se puede concluir que el PAI, sin su validación previa en esta población, no muestra una idoneidad suficiente para evaluar mujeres víctimas de VPI en el Ecuador. Se recomiendan nuevas investigaciones en otras muestras, en las que se utilicen diversos esquemas empíricos que incluyan varios instrumentos y medios cualitativos.
Abstract Various studies have noticed that women victims of intimate partner violence (IPV) also report having various types of health-related problems. However, health systems do not appear to have established procedures to recognize these problems (i. e., psychophysiological) in women. This study assessed somatic symptoms, anxiety, and depressive characteristics in women who have been victims of IPV. These symptoms were assessed using the scales of the Personality Assessment Inventory (PAI). The sample consisted of 50 women victims of IPV from the Ecuadorian sierra. Group participants came from two different cities: the first group included 28 women victims of IPV from Riobamba. Their ages ranged from 15 to 58. These women were receiving psychological services from a not-for-profit organization in the city. The second group included 22 women with similar characteristics between the ages of 27-63. This group of women came from the southern regions of Quito, the capital city of Ecuador. Women in this group were receiving services from two different places offering help to women experiencing IPV. Sixteen percent of women reported having a medium level of "anxiety" (some level of stress), and 14 % reported having a high level of tension and stress. Thirty-four percent of women reported medium levels of "anxiety-related disorders". These women reported having specific fears, little confidence in themselves and negative perspectives of their future. Sixteen percent of the women reported high levels of anxiety. They reported imitations in daily life (i. e., specific fears and feelings of insecurity in social situations). Thirty percent of women reported having medium levels of "depression" (sensitivity, pessimism, and feeling unhappy part of the time). Eighteen percent of women reported having high levels of "depression" (notable unhappiness and dysphoria). Forty-four percent of women in this study reported having some type of physical problem. These findings suggest that women who are victims of IPV could benefit from receiving mental health services aimed at managing their tension, stress, specific fears, and symptoms of depression. They also suggest that women victims of IPV could benefit from receiving training to increase their social competency and medical assistance to address their somatic complaints. Findings in this study are somewhat divergent from the results observed in previous investigations. Previous studies identified that most women who experienced IPV report symptoms of depression and anxiety. However, in this study, only a relatively low percentage of women reported having these symptoms. The sole utilization of the PAI as a method of evaluation may not have been sufficient to identify these symptoms. These results suggest the importance of using qualitative methods (i. e., clinical interview) or more holistic methodologies (i. e., clinical interview and tests) to better assess mental health symptoms in this group of women. It is also possible that the PAI might not be the most adequate tool to assess these symptoms in this population. The results of this investigation do reveal the importance of evaluating other mental health symptoms in women victims of IPV: post-traumatic stress, and obsessive-compulsive disorder. Future studies should focus on assessing these symptoms using other assessment methodologies (e. g. instruments designed to assess post-traumatic stress and obsessive-compulsive disorder). The efficiency of health systems evaluations and interventions depends on the methodologies used to assess problems. The sole use of one instrument such as the PAI may not provide sufficient information about symptoms experienced by women experiencing IPV. Health systems should use batteries of instruments in conjunction with the clinical interviewing processes to readily assess symptoms. However, such an alternative may not be entirely feasible taking into account that such methodology requires more time and likely financial support to acquire tests.
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Introduction: Blood pressure transient spikes have been considered to be noise and only a hindrance to a proper assessment of typical blood pressure, which is defined as the actual underlying average blood pres-sure over a long period of time. The current study aimed to see if the highest Self measured Systolic blood Pressure could be utilized to forecast the occurrence of Target organ damage and evaluate the independent association between the maximum Self measured Systolic blood Pressure and Target organ damage in indi-viduals with untreated hypertension. Method: We evaluated the urine albumin/creatinine ratio (UACR) and carotid intima-media thickness (IMT) using ultrasonography in 462 hypertensive individuals who had never taken treatment for their hypertension. Residential blood pressure was recorded. Result: The maximal Self measured Systolic blood Pressure had considerably higher association coefficients with left ventricular mass index (LVMI) and carotid intima-media thickness than the mean Self measured Sys-tolic blood Pressure. Irrespective of the mean Self measured Blood pressure level, multivariate regression studies showed that the maximal Self measured Systolic blood Pressure was independently related with left ventricular mass index and carotid intima-media thickness. Conclusion: Transiently high blood pressure measurements recorded at Self measured shouldn't be dis-missed as noise but rather taken seriously as significant warning signs of hypertensive Target organ damage in the heart and arteries.
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Objective:To discuss the effect of remnant cholesterol (RC) levels on carotid intima thickness (CIT) in patients with type 2 diabetes mellitus (T2DM) by ultra-high frequency ultrasound.Methods:A total of 60 patients with T2DM who received treatment in Henan Provincial People′s Hospital from May 2021 to July 2022 were prospectively recruited, and they were divided into a higher RC group (31 cases) and a lower RC group (29 cases) according to the RC levels. Thirty-one age, sex and body mass index(BMI)-matched healthy volunteers were selected as control group. Carotid CIT, carotid media thickness(CMT) and intima-media thickness(CIMT) were measured by 24 MHz ultra-high frequency ultrasound probe. The difference of general clinical data, laboratory indicators and CIMT, CIT, CMT among the three groups were compared, and the influencing factors of CIT in T2DM patients were explored by multivariate regression analysis.Results:①There were no statistical significances in gender, age, BMI, high-density lipoprotein cholesterol (HDL-C) and CMT among the three groups (all P>0.05). There were no statistical significances in duration of diabetes, fasting blood-glucose and glycated haemoglobin between the two subgroups of T2DM (all P>0.05). ②Compared with the control group, CIMT and CIT were thicker in the T2DM group (both P<0.05). ③CIT was thicker in the higher RC group than in the lower RC group ( P<0.05), while the difference of CIMT was not statistically significant the two groups ( P>0.05). ④Multivariate regression analysis showed that RC was the influence factor of CIT in patients with T2DM(β=0.610, P=0.005). Conclusions:CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC, and RC is the influence factor of CIT, which suggests that more attention should be paid to the detection of RC in T2DM patients.
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Objective:To investigate the correlation between residual cholesterol (RC) and carotid intima-media thickness (cIMT) in non-diabetic population.Methods:Non-diabetes population received health examination in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from January 1, 2018 to December 31, 2021 were retrospectively included. According to the carotid ultrasound results, they were divided into cIMT thickening group (≥1 mm) and non-thickening group (<1 mm). The RC level was calculated according to total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Multivariate logistic regression analysis was used to determine the correlation between RC and cIMT. Results:A total of 1 803 non-diabetes subjects, aged 58.3±15.6 years, including 1 100 males (61.0%), were enrolled. There were 916 patients (50.8%) in the cIMT thickening group and 887 (49.2%) in the non-cIMT thickening group. Compared with the non-cIMT thickening group, cIMT thickening group had significantly higher proportion of male, hypertension, hyperlipidemia, atrial fibrillation, past stroke history, smoking and alcohol consumption, as well as significantly higher age, blood glucose, triglyceride, RC, TC and LDL-C, and significantly lower HDL-C (all P<0.01). Multivariate logistic regression analysis showed that RC was independently associated with cIMT thickening ( Ptrend<0.001). Conclusion:RC is associated with cIMT thickening in non-diabetes population.
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Atherosclerosis is the main cause of cardiovascular diseases， while Carotid intima-media thickness is a biomarker of subclinical atherosclerosis. Numerous studies have confirmed that exercise can slow down or even reverse the formation and progression of carotid Intima-Media thickness. This paper provides a review of the effects of different exercise modalities， intensities， and populations on the vascular structure to provide a reference for the prevention of atherosclerosis with exercise.
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Background Evidence about the association between air pollution and carotid intima-media thickness (CIMT) is inconsistent, and limited studies have explored the relationship between gaseous pollutants and CIMT. Additionally, personal activity patterns and infiltrated ambient pollution are not comprehensively considered to estimate individual exposure to air pollutants. Objective To investigate the relationship between long-term time-weighted individual exposure to ambient pollutants [fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)] and the progression of CIMT. Methods This study was performed among 554 participants in the Beijing Health Management Cohort who were free of atherosclerotic lesions on carotid artery at baseline. Daily concentrations of pollutants were predicted at both residential and work addresses based on land-use regression model. With additional consideration of personal indoor and outdoor activity patterns at both addresses and exposure to ambient pollutants from traffic transportation, individual time-weighted concentration was calculated. Indoor exposure was estimated by infiltrated ambient pollutants (based on infiltration factors and land-use regression model). Personal activity patterns included type, time, location, and frequency. Exposure to ambient pollutants from different traffic transportations was estimated by the average outdoor pollutant concentrations at both residential and work addresses combined within filtration factors and time spent on commuting. Multiple linear regression was conducted to assess the association of time-weighted individual pollutant exposure and the central position of CIMT progression. Quantile regression was applied to explore the relationship between time-weighted individual pollutant exposure and the progression of CIMT on different percentiles. Results The median value of CIMT progression was 369.49 μm·year−1. PM2.5, PM10, SO2, and O3 were associated with CIMT progression in the multiple linear regression model. The largest effect sizes of PM2.5, PM10, and SO2 were obtained for one-year exposure (regression coefficient: 66.910, 64.077, and 191.070, respectively), and two-year exposure for O3 (regression coefficient: 62.197). The results of quantile regression demonstrated different effect sizes for pollutants among different percentiles on CIMT progression. Significant associations between CIMT progression and PM2.5 from P30 to P50, CO from P10 to P40, and PM10 from P30 to P60 were observed. Two-year and three-year exposures to NO2 (P10, P20 and P40) were also associated with CIMT progression. The association between SO2 and the progression of CIMT was proved on all percentiles, and larger effect sizes of one-year and two-year exposures to SO2 (except P90) were demonstrated with increasing percentiles. The upward trend for the coefficients was clearly presented from P50 to P80. Specifically, the coefficient of two-year exposure to SO2 ranged from 136.583 (P50) to 277.330 (P80). No statistically significant association was observed between O3 and CIMT progression on any percentile (P>0.05), and the results were inconsistent with those of the multiple linear regression. Conclusion Individual time-weighted exposures to PM2.5, PM10, SO2, NO2, and CO have the potential to promote the progression of CIMT, and the adverse effect of ambient pollution on atherosclerotic lesion is identified.
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Abstract Background Psoriasis is a chronic inflammatory disease that is associated with many inflammatory conditions such as atherosclerosis, hypertension, among others. SCUBE-1 is a protein that plays a role in angiogenesis. Objectives The present study aimed to investigate whether SCUBE-1 could indicate subclinical atherosclerosis in psoriatic patients, and to compare SCUBE-1 levels, measurement of carotid artery ıntima-media thickness (CIMT), and metabolic parameters in psoriasis patients and healthy controls. Methods Forty-six patients with psoriasis and 43 healthy controls were included. The severity of the disease was assessed with Psoriasis Area Severity Index (PASI) in the patient group. Levels of SCUBE-1, CRP, lipids, and fasting glucose were measured with the enzyme-linked ımmunosorbent assay (ELISA) method, and CIMT measurements were performed by the same cardiologist. Results SCUBE-1 levels and CIMT values were significantly higher in the patient group (for both p < 0.05). Moreover, systolic blood pressure, CRP levels, and waist circumference were higher in the patient group even though both groups had similar BMIs (for all p < 0.05). A positive correlation was found between SCUBE-1 and CIMT values among patients, and multiple regression analyses revealed that SCUBE-1 and CIMT are significantly associated with psoriasis as well. Study limitations A low number of participants and not including any other inflammatory marker related to angiogenesis or atherosclerosis such as VEGF, adiponectin are the main limitations of the present study. Conclusion Despite the severity of the disease, even in psoriasis patients with mild disease the SCUBE-1 level may be an indicator of subclinical atherosclerosis and indicate the risk of cardiovascular disease in the future.
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Resumo Fundamento A hipertensão causa inflamação subendotelial e disfunção na aterosclerose resultante. A espessura média-intimal da carótida (EMIC) é um marcador útil de disfunção endotelial e aterosclerose. A razão ácido úrico/albumina (RUA) emergiu como um novo marcador para prever eventos cardiovasculares. Objetivo Nosso objetivo foi investigar a associação da RUA com a EIMC em pacientes hipertensos. Método Duzentos e dezesseis pacientes hipertensos consecutivos foram incluídos neste estudo prospectivo. Todos os pacientes foram submetidos a ultrassonografia de carótida para classificar baixos (EMIC < 0,9 mm) e altos (EMIC≥0,9 mm) grupos de EMIC. A capacidade preditiva da RUA para EMIC alta foi comparada com o índice de inflamação imune sistêmica (IIS), razão neutrófilo/linfócito (RNL), razão plaqueta/linfócito (RPL) e razão proteína C reativa/albumina (RCA). Um valor de p bilateral <0,05 foi aceito como estatisticamente significativo. Resultados Os pacientes com EMIC alta eram mais velhos e tinham maior RUA, IIS, RNL e RCA do que baixo EMIC. Idade, RUA, IIS, RNL e RCA, mas não RPL, foram associados a EMIC alta. Na análise multivariada, idade, PCR, IIS e RUA foram preditores independentes de EMIC alta. A capacidade de discriminação de RUA foi maior do que ácido úrico, albumina, IIS, RNL e RCA, e RUA teve um ajuste de modelo maior do que essas variáveis. RUA teve maior melhoria aditiva na detecção de EMIC alta do que outras variáveis, conforme avaliado com melhoria de reclassificação líquida, MDI e estatísticas C. RUA também foi significativamente correlacionada com EMIC. Conclusão RUA pode ser usado para prever EMIC alta e pode ser útil para estratificação de risco em pacientes hipertensos.
Abstract Background Hypertension causes subendothelial inflammation and dysfunction in resulting atherosclerosis. Carotid intima-media thickness (CIMT) is a useful marker of endothelial dysfunction and atherosclerosis. The uric acid to albumin ratio (UAR) has emerged as a novel marker for predicting cardiovascular events. Objective We aimed to investigate the association of UAR with CIMT in hypertensive patients. Methods Two hundred sixteen consecutive hypertensive patients were enrolled in this prospective study. All patients underwent carotid ultrasonography to classify low (CIMT < 0.9 mm) and high (CIMT ≥ 0.9 mm) CIMT groups. The predictive ability of UAR for high CIMT was compared with systemic immune inflammation index (SII), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein/albumin ratio (CAR). A two-sided p-value <0.05 was accepted as statistically significant. Results Patients with high CIMT were older and had higher UAR, SII, NLR, and CAR than low CIMT. Age, UAR, SII, NLR, and CAR, but not PLR, were associated with high CIMT. In multivariable analysis, age, CRP, SII, and UAR were independent predictors of high CIMT. The discrimination ability of UAR was higher than uric acid, albumin, SII, NLR, and CAR, and UAR had a higher model fit than those variables. UAR had higher additive improvement in detecting high CIMT than other variables, as assessed with net-reclassification improvement, IDI, and C-statistics. UAR was also significantly correlated with CIMT. Conclusion UAR might be used to predict high CIMT and might be useful for risk stratification in hypertensive patients.
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ABSTRACT Objective: In this study, we aimed to evaluate subclinical atherosclerosis in patients with obesity who had cardiovascular disease risk indicators such as arterial stiffness, which is evaluated using pulse wave velocity (PWV), carotid intima-media thickness (CIMT), and biomarkers of endothelial dysfunction such as endocan, ADAMTS97, and ADAMTS9. Subjects and methods: Sixty obese subjects, including 23 subjects with body mass index (BMI) ≥ 40, 37 subjects with BMI ≥ 30 but < 40, and 60 age-and sex-matched control subjects, were included in our study. Serum endocan, ADAMTS97, and ADAMTS9 levels as well as PWV and CIMT measurements of the subjects in the obese and control groups were performed. Results: In the obesity group, PWV levels were significantly higher than they were in the control group and endocan levels were significantly lower than they were in the control group. When we compared the obese group with BMI ≥ 40 and the control group, the BMI ≥ 40 group had significantly higher PWV and CIMT levels than the control group had, whereas endocan, ADAMTS7, and ADAMTS9 levels were similar to those of the control group. When we compared the obese group with BMI ≥ 30 < 40 to the control group, endocan levels were lower in the group with BMI ≥ 30 < 40, and PWV and CIMT levels were similar to the control group. Conclusions: We found that arterial stiffness and CIMT increased in obese patients with BMI ≥ 40 and that increased arterial stiffness was associated with age, systolic blood pressure, and HBA1C. In addition, we found that the endocan levels were lower in obese patients than they were in nonobese control individuals.
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ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.
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The longitudinal association between psoriasis and carotid intima-media thickness (CIMT) has not yet been established. This study aimed do compare CIMT and its change (∆CIMT) after an 8-year follow-up according to psoriasis diagnosis and the association with risk factors in the ELSA-Brasil study. Data from 7564 participants were analyzed (median age of 50.0 [44.0-57.0] years, 56.9% women). CIMT was assessed by ultrasound and ∆CIMT was calculated by subtracting baseline values from follow-up values. Psoriasis participants were identified by self-reported medical diagnosis (n=143) and compared with matched participants without disease (n=572) and with the entire sample without psoriasis (n=7421). Baseline CIMT explained the 8-year CIMT increase only in 36.9% among psoriasis participants and in ∼43.0% in participants without disease. CIMT was associated with age (β=0.002, P=0.002) and hypertension (β=0.029, P=0.034) in psoriasis participants. Among participants without psoriasis, CIMT was associated with age, male sex, low educational attainment, past smoking, obesity, diabetes, hypertension, and dyslipidemia (P<0.05). There was an inverse association of CIMT with private health insurance (β=-0.004, P=0.042) and White ethnicity (β=-0.006, P=0.004) in the entire sample without psoriasis but not in matched participants. Psoriasis participants showed an inverse association between ∆CIMT and diabetes (β=-0.214, P=0.011), while the entire sample without psoriasis showed an inverse association between ∆CIMT and age (β=-0.005, P<0.001), past smoking (β=-0.048, P=0.009), and hypertension (β=-0.048, P=0.009). In conclusion, psoriasis was not associated with CIMT after an 8-year follow-up. The inverse association of ∆CIMT with diabetes in psoriasis participants needs further clarification.
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Abstract Introduction: The association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval - 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. Results: After the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). Discussion: Diabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected.
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Introduction: Infidelity is a breach of trust or a crossing of the boundaries of the primary relationship and it influences intimate relationships. It can be categorised as either sexual or emotional infidelity. In Portugal, there have been few studies on this subject using suitable instruments. Objective: This study aimed to analyse the factor structure, psychometric properties, and gender invariance of the Infidelity Scale (IS) in Portuguese adults. Method: The sample comprised 660 Portuguese adults (455 women and 205 men) between 18 and 79 years of age who had been unfaithful in their relationships. Results: The confirmatory analysis showed a structure with two factors (sexual and emotional infidelity), and good values for convergent and discriminant validity were found. The results displayed a satisfactory model fit and the non-invariance of the factor structure between women and men. Conclusion: This is the first Portuguese version of the IS, an instrument for the study of intimate relationships which contributes to the development of multicultural research.
Introducción: La infidelidad es una ruptura de la confianza que influye en las relaciones íntimas. Se puede dividir en infidelidad sexual o emocional. En Portugal, hay pocos estudios sobre este tema con medidas adecuadas. Objetivo: Esta investigación tiene como objetivo analizar la estructura factorial, las propiedades psicométricas y la invariancia de género de la Escala de Infidelidad (IS) entre adultos portugueses. Método: Se aplicó el protocolo de investigación a 660 adultos portugueses (455 mujeres y 205 hombres) de entre 18 y 79 años que fueron infieles en sus relaciones. Resultados: El análisis confirmatorio mostró una estructura con dos factores (infidelidad física y emocional), y se encontraron buenos valores de validez convergente y discriminante. Los resultados mostraron un ajuste satisfactorio del modelo y la no invariabilidad de la estructura factorial entre mujeres y hombres. Conclusión: Esta es la primera versión en portugués de la IS, como medida que permite estudiar las relaciones íntimas, contribuyendo para el desarrollo de la investigación multicultural.
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Abstract Objective: To investigate vascular and perivascular abnormalities in the carotid arteries using ultrasound, as well as to evaluate their association with mortality and clinical variables in hospitalized patients with coronavirus disease 2019 (COVID-19). Materials and Methods: This was a prospective study in which 53 hospitalized patients with severe COVID-19 were evaluated and underwent carotid ultrasound. We documented the carotid ultrasound findings in these patients. Clinical, demographic, laboratory, and imaging features were analyzed and compared by statistical analysis to detect correlations between them. Results: Carotid ultrasound demonstrated luminal surface irregularity in 29 patients (55%), carotid plaques in 30 (57%), perivascular infiltration in four (8%), and increased intima-media thickness (IMT) in 31 (58%). Of the 31 patients with increased IMT, 19 (61%) died, and the association between increased IMT and COVID-19-related mortality was significant (p = 0.03). Logistic regression showed that the risk of death was 85% in patients who had increased IMT in combination with acute kidney injury at admission or a history of chronic kidney disease (p < 0.05). Conclusion: In hospitalized patients with severe COVID-19, carotid ultrasound can show increased IMT, luminal surface irregularity, carotid plaques, and perivascular infiltrates. The combination of increased IMT and kidney damage appears to increase the risk of death in such patients.
Resumo Objetivo: Investigar anormalidades vasculares e perivasculares nas artérias carótidas por meio de ultrassonografia e avaliar sua associação com mortalidade e variáveis clínicas em pacientes hospitalizados com COVID-19. Materiais e Métodos: Neste estudo prospectivo, 53 pacientes hospitalizados com COVID-19 grave foram avaliados e submetidos a ultrassonografia de carótida. Descrevemos os achados ultrassonográficos de carótida nesses pacientes. As correlações de características clínicas, demográficas, laboratoriais e de imagem foram analisadas e comparadas por meio de análise estatística. Resultados: A ultrassonografia carotídea demonstrou irregularidade da superfície luminal em 29 pacientes (55%), placas carotídeas em 30 pacientes (57%), infiltração perivascular em quatro pacientes (7,5%) e aumento da espessura médio-intimal (EMI) em 31 pacientes (58%). Dos pacientes com EMI aumentada, 19 (61%) morreram, com associação observada entre EMI aumentada e mortalidade por COVID-19 (p = 0,03). Um modelo de regressão logística mostrou que a probabilidade de óbito foi de 85% em pacientes com EMI aumentada e história de nefropatia crônica ou lesão renal aguda na internação (p < 0,05). Conclusão: Aumento da EMI, irregularidade da superfície luminal, placas carotídeas e infiltrados perivasculares foram encontrados na ultrassonografia carotídea em pacientes hospitalizados com COVID-19 grave. O aumento da EMI associado a danos nos rins pode aumentar o risco de morte.
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Resumo Fundamento Pacientes pré-diabéticos têm um risco aumentado de doença cardiovascular aterosclerótica, e, portanto, a detecção precoce é importante. Objetivo Nosso estudo teve o objetivo de revelar a usabilidade dos níveis de endocan sérico como biomarcador no diagnóstico de aterosclerose subclínica em pacientes pré-diabéticos, com base em medições de EIMC. Métodos Os participantes foram classificados de acordo com a presença (n=42) ou ausência (n=42) de pré-diabetes. Os valores de endocan sérico, glicemia em jejum, insulina em jejum e hemoglobina glicada (HbA1c) dos pacientes foram examinados e a EIMC foi medida. O nível de significância para a análise estatística foi 0,05. Resultados Apesar de se ter determinado que os níveis de endocan sérico são mais baixos em pacientes pré-diabéticos em comparação com o grupo de controle (p=0,042), determinou-se que os valores de EIMC são mais altos (p=0,046). A avaliação do endocan sérico por análise regressiva multivariada detectou que seu nível estava associado à EIMC, independentemente de outros parâmetros (p=0,007). Encontramos uma correlação negativa entre insulina plasmática em jejum e níveis de endocan (r=-0,320, p=0,001). Conclusões Este estudo demonstrou que a espessura íntima-média de carótida é mais alta e o nível de endocan sérico é mais baixo em pacientes pré-diabéticos. Os níveis de endocan sérico diminuídos em pacientes pré-diabéticos podem ser um fator que contribui para os mecanismos de formação de aterosclerose.
Abstract Background Patients with prediabetes have an increased risk of atherosclerotic cardiovascular disease; therefore, early detection is important. Objective The present study aimed to reveal the usability of serum endocan levels as a biomarker in the diagnosis of subclinical atherosclerosis in patients with prediabetes, based on CIMT measurements. Methods Participants were classified according to the presence (n=42) or absence (n=42) of prediabetes. Serum endocan, fasting blood sugar, fasting insulin, and glycated hemoglobin (HbA1c) values of patients were examined, and CIMT was measured. The level of significance for statistical analysis was 0.05. Results While serum endocan levels were found to be lower in patients with prediabetes, when compared to the control group (p=0.042), CIMT values were found to be higher (p=0.046). When evaluated by multivariate regression analysis, the serum endocan level was found to be associated with CIMT, regardless of other parameters (p=0.007). A negative correlation was found between plasma fasting insulin and endocan levels (r=-0.320, p=0.001). Conclusions Carotid intima media thickness was found to be high and the serum endocan level was low in patients with prediabetes. Decreased serum endocan levels in patients with prediabetes may be a contributing factor to atherosclerosis formation mechanisms.
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Abstract Introduction: Patients with psoriasis have an increased prevalence of cardiovascular risk factors as well as cardiovascular disease. Objective: To determine if patients with psoriasis and metabolic syndrome (MS) have a higher frequency of subclinical atherosclerosis compared with those with psoriasis without MS. Materials and Methods: A cross-sectional study was conducted in patients with psoriasis; MS was defined according to ATP III criteria. Demographic, clinical, and anthropometric data were obtained. Blood chemistry, high sensitive C-reactive protein (hs-CRP), and insulin were measure. Subclinical atherosclerosis was defined as high carotid intima-media thickness (CIMT) by Mode B ultrasound. Results: 92 patients with psoriasis were included, 67 (72.8%) with MS and 25 (27.2%) without MS. Subjects with psoriasis and MS had significantly higher weight, body mass index, waist circumference, systolic blood pressure, glucose, insulin, triglycerides, insulin resistance, hs-CRP, and lower level of high-density lipoprotein cholesterol, compared with subjects without MS. High CIMT was greater in patients with psoriasis and MS than in those without MS. Age and MS were independent predictors of increased CIMT after multiple linear regression analysis. Conclusions: MS is associated with greater inflammation and subclinical atherosclerosis in patients with psoriasis.
Resumen Introducción: Los pacientes con psoriasis tienen prevalencia incrementada de factores de riesgo y enfermedad cardiovascular. Objetivo: Determinar si los pacientes con psoriasis y síndrome metabólico (SM) tienen mayor frecuencia de ateroesclerosis subclínica comparados con pacientes con psoriasis y sin SM. Material y Métodos: Estudio transversal, en pacientes con psoriasis; SM fue definido con base en criterios ATP III. Se obtuvieron datos demográficos, clínicos y antropométricos. Se realizó química sanguínea, proteína C reactiva de alta sensibilidad (PCR-hs) e insulina. Ateroesclerosis subclínica fue definida como grosor de íntima-media carotídeo (GIMC) elevado, medido por ultrasonido tipo B. Resultados: Se incluyeron 92 pacientes con psoriasis, 67 (72.8 %) con SM y 25 (27.2 %) sin SM. Los sujetos con psoriasis y SM tuvieron valores significativamente más elevados de peso, índice de masa corporal, circunferencia de cintura, tensión arterial sistólica, glucosa, insulina, triglicéridos, resistencia a insulina, PCR-hs y menores niveles de colesterol de alta densidad, comparados con sujetos sin SM. El GIMC fue mayor en pacientes con psoriasis y SM. La edad y el SM fueron predictores independientes de mayor GIMC después de realizar múltiples análisis de regresión lineal. Conclusiones: Síndrome metabólico está asociado con mayor inflamación y ateroesclerosis subclínica en pacientes con psoriasis.
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Resumo Fundamento A espessura médio-intimal (EMI) da artéria aorta abdominal (EMI-A) pode ser um marcador precoce de aterosclerose subclínica e um indicador objetivo de estresse oxidativo em pacientes com talassemia menor. Objetivo Avaliar se as EMIs da artéria aorta e da artéria carótida (EMI-C) se alteram com estresse oxidativo, e examinar a relação entre esses parâmetros em pacientes com talassemia menor. Métodos O estudo incluiu 80 pacientes diagnosticados com talassemia menor, e 50 indivíduos sadios com idade e sexo similares. Após procedimentos de rotina, as amostras de sangue foram coletadas dos grupos de estudo para a medida da homeostase tiol/dissulfeto e da albumina modificada pela isquemia (AMI). As medidas da EMI-C foram realizadas a partir de quatro regiões diferentes (artéria carótida externa direita e esquerda e artéria carótida interna direita e esquerda) por ultrassonografia, e a medida da EMI-A foi realizada por ultrassonografia abdominal. Um valor de p<0,05 foi definido como estatisticamente significativo. Resultados Nos pacientes com talassemia menor, os níveis de tiol nativo e tiol total, e a razão tiol nativo/tiol total foram mais baixos, e os valores de AMI, razão dissulfeto/tiol nativo, e razão dissulfeto/tiol total foram mais altos que no grupo controle. A EMI-A foi significativamente maior no grupo de pacientes com talassemia menor que nos controles (1,46±0,37 vs 1,23±0,22 e p<0,001). Quando os parâmetros associados com EMI-A na análise univariada foram avaliados por regressão linear multivariada, EMI-A apresentou uma relação positiva, e os níveis de tiol nativo e tiol total apresentaram uma forte relação negativa com AMI (p<0,01). Conclusão Nós demonstramos, pela primeira vez, um aumento no estresse oxidativo com a elevação da EMI-A, e valores inalterados da EMI-C em pacientes com talassemia menor.
Abstract Background Abdominal aortic intima media thickness (A-IMT) may be an early marker of subclinical atherosclerosis and an objective indicator of increased oxidative stress in beta-thalassemia minor patients. Objective To evaluate whether aortic and carotid IMTs change with oxidative stress and to assess the relationship between these parameters in beta-thalassemia minor patients. Methods The study included 80 patients diagnosed with beta-thalassemia minor, and 50 healthy individuals with similar age and gender. After routine procedures, blood samples were collected from the study groups for thiol-disulfide hemostasis and ischemia-modified albumin (IMA). C-IMT measurements were performed in four different regions (right and left internal and external carotid artery) by ultrasonography. In addition, A-IMT measurement was performed by abdominal ultrasonography. Statistically significant p value was set as <0.05 for all comparisons. Results In beta-thalassemia minor patients, native thiol, total thiol and native thiol / total thiol ratio were lower, and the IMA, disulfide / native thiol ratio and disulfide / total thiol ratios were higher than in healthy control group. A-IMT measurement was significantly higher in beta-thalassemia minor group than controls (1.46±0.37 vs 1.23±0.22 and p<0.001). When the parameters associated with A-IMT in univariate analysis were evaluated by multivariate linear regression analysis, A-IMT was positively related, and native thiol and total thiol levels were negatively and closely related to IMA (p<0.01). Conclusion We demonstrated, for the first time, that oxidative stress status increased with increased A-IMT, while C-IMT remained unchanged in beta-thalassemia minor patients.
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Background:Peripheral arterial disease (PAD) is one of the major macrovascular complications of diabetes mellitus (DM) which is largely neglected by clinicians. DM-associated atherosclerosis can lead to complications in all major of vascular beds, including the coronary arteries, carotid vessels, and lower extremity arteries. Aims and objective were tostudy the prevalence of PAD in patients with type 2 DMand to study the correlation with carotid artery intima-media thicknessMethods:Hospital based cross-sectional study was conducted among the 124 patients admitted with type 2 diabetes (age >25 year) from Dec 2019 to Oct 2021 in the various units of department of medicineor surgery, KPS institute, GSVM medical college Kanpur. Color doppler of limbs and carotid artery was done in study population.Results:In our study based on doppler ultrasound, the prevalence of PAD was found in 31 patients (25%) out of 124 with men having a higher prevalence (24 out of 74; 77.4%), as compared to women (7 out of 50; 22.6%) (p=0.020). The mean Carotid IMT (mm) (Average) was 0.82±0.16 in all diabetics. Patients with PAD have more increase in CIMT (0.95±0.12) as compare to non-PAD (0.77±0.15) p<0.001.Conclusions:By using doppler, we found evidence of PAD in 25% of type 2 diabetics (M>>F). Patients with PAD have more increase in CIMT as compare to non-PAD.