The prevalence, disability-adjusted life years, and mortality of hypertensive heart disease and its attributable risk factors: results from the Global Burden Disease study 2019.

Introduction: No survey has evaluated hypertensive heart disease (HHD) burden with statistics from the Risk Factors Study, Injuries, and the Global Burden of Diseases (GBD) 2019. Material and methods: The evaluated annual percentage changes (EAPCs) were obtained to assess the trend in prevalence standardized by age, mortality rates standardized by age, and DALYs standardized by age between 1990 and 2019. We also evaluated the contribution of risk factors to HHD-associated DALYs and mortality. Results: Between 1990 and 2019, the worldwide prevalence rate standardized by age increased (EAPC = 0.17; 95% confidence interval (CI) 0.15 to 0.18), but the death rate standardized by age (EAPC = -0.74; 95% CI: -0.91 to -0.57) and DALYs standardized by age rate decreased (EAPC = -1.02; 95% CI: -1.18 to -0.86). The prevalence rate of HHD standardized by age increased the most in the high-middle areas of SDI (EAPC = 0.43). The biggest increases in the prevalence rate standardized by age were in Andean Latin America (EAPC = 0.43), Western Sub-Saharan Africa (EAPC = 0.30), and the Middle East and North Africa (EAPC = 0.24). The largest decrease in mortality that could be attributed to rate and DALYs in both sexes between 1990 and 2019 was consistent with a high BMI. Conclusion: The worldwide prevalence rate standardized by age increased during 1990-2019, especially in Andean Latin America, North Africa, the Middle East, and Western Sub-Saharan Africa. Future HHD prevention tactics should be focused on males, high-risk areas, and control of high BMI.

The REM microarousal and REM duration as the potential indicator in paradoxical insomnia.

OBJECTIVE: Although paradoxical insomnia is a prevalent subtype of chronic insomnia, the etiology of it is unclear. Contrary to complaints of little or no sleep, polysomnography (PSG) findings show that paradoxical insomnia patients have near normal sleep macrostructure. The purpose of this study is to determine the changes of microstructure and explore the etiology of paradoxical insomnia. METHODS: The PSG findings of 89 paradoxical insomnia patients were compared with those of 41 gender balanced healthy controls without sleep complaints. All subjects underwent nocturnal PSG recordings. Conventional PSG measures and microarousals were quantified and statistically analyzed. Receiver operating characteristic curve and correlation analysis were used to evaluate the potential of REM sleep microarousals and REM duration as indicators of paradoxical insomnia. RESULTS: Compared with the controls, paradoxical insomnia patients had no significant differences in sleep macrostructures. Statistical analysis showed that non-rapid eye movement (NREM) microarousals revealed no significant differences between paradoxical insomnia patients and controls. Noticeably, more spontaneous microarousals appeared in rapid eye movement (REM) stage for paradoxical insomnia patients. Based on receiver operating characteristic curve (ROC), the optimal cutoff value of REM sleep microarousals could predict paradoxical insomnia. Furthermore, a positive correlation between microarousals in REM sleep and the duration of REM sleep was presented in paradoxical insomnia patients. CONCLUSIONS: The frequency of REM microarousals and the duration of REM sleep could reflect the real sleep state of paradoxical insomnia patients. That suggested PSG investigation extended to microarousal could be helpful to understand the etiology in paradoxical insomnia.

Evolution of MRI characteristics of heatstroke in a patient with schizophrenia maintained with antipsychotic drugs.

Although heatstroke commonly occurs in summer, herein, we present a case of heatstroke that occurred in March. The patient has been schizophrenic for over 20 years and has been receiving long-term medications, such as lithium carbonate, clozapine, and lorazepam. We analyzed the evolution of her cerebellar magnetic resonance imaging characteristics to determine the association of heatstroke in schizophrenia. Patients with schizophrenia are at high risk for developing heatstroke, possibly due to the use of antipsychotic drugs.

Ivermectin induces cell cycle arrest and apoptosis of HeLa cells via mitochondrial pathway.

OBJECTIVES: The aim of study was to investigate the anticancer activities of Ivermectin (IVM) and the possible mechanisms in cells level via cell proliferation inhibition, apoptosis and migration inhibition in model cancer cell HeLa. MATERIALS AND METHODS: The MTT assay was used to study the inhibitory effect of IVM on the proliferation of Hela cells, and the cell cycle was analysed by flow cytometry. The neutral comet assay was used to study the DNA damage. The presence of apoptosis was confirmed by DAPI nuclear staining and flow cytometry. Changes in mitochondrial membrane potential and reactive oxygen species (ROS) levels were determined using Rhodamine 123 staining and DCFH-DA staining. Western blot analysis for apoptosis-related proteins was carried out. We use scratch test to analyse the antimigration potential of IVM. RESULTS: Ivermectin can inhibit the viability of HeLa cells significantly. In addition, treatment with IVM resulted in cell cycle arrest at the G1/S phase which partly account for the suppressed proliferation. Typical apoptosis morphological changes were shown in IVM treatment cells including DNA fragmentation and chromatin condensation. At the same time, the results of flow cytometry analysis showed that the number of apoptotic cells increased significantly with the increase of IVM concentration. Moreover, we observed that the mitochondrial membrane potential collapses and the ratio of Bax/Bcl-2 in the cytoplasm increases, which induces cytochrome c release from the mitochondria to the cytoplasm, activates caspase-9/-3 and finally induces apoptosis. We also found that IVM can significantly increase intracellular ROS content. At the same time, we determined that IVM can significantly inhibit the migration of HeLa cells. CONCLUSIONS: Our experimental results show that IVM might be a new potential anticancer drug for therapy of human cancer.

Necrosis of the Glabella After Injection With Hyaluronic Acid Into the Forehead.

Skin necrosis is a rare but severe potential complication after injection of hyaluronic acid (HA). Based on the understanding of the causes and mechanisms of this complication, many precautions have been proposed. Still, this adverse reaction happened from time to time. Here, the authors present a patient with glabellar skin necrosis following an injection into the forehead using HA filler. Although not uncommon, this patient might suggest an alternative cause or mechanism of tissue necrosis following HA injection besides intravascular injection or extravascular compression directly by HA filler. Further study is needed to examine other possible causes in order to eliminate this risk.