The effect of intestinal ischemia on plasma thiol/disulphide homeostasis in an experimental study

Aim: To investigate the effects of acute intestinal ischemia on plasma thiol/disulphide homeostasis (TDSH), which has been investigated in a limited number of studies in the related literature. Methods: Twenty-four rats were randomized into control (operation without ischemia, GIS), and ischemia groups (GII-60, GIII-180). For ischemia, the superior mesenteric artery was sutured and the rats were exposed to 60 and 180 minutes of intestinal ischemia, respectively. Plasma TDSH was measured in blood samples collected at the end of the ischemia, and the pathology of ileum segments resected was evaluated. Results: The experimental ischemic conditions provided were confirmed by the total histopathological scoring system statistically. The levels of serum human albumin and ischemia modified albumin (IMA) in groups were detected in quite a close range of each other. There was no found a statistically significant difference for IMA between groups (p>0.05).  The alternations on the levels of plasma TDSH parameters were observed in the study. According to ischemic conditions, the thiol/disulfide ratio fluctuations were detected in the plasma TDSH. The native thiol and total thiol levels seem to have decreased according to ischemia; no statistical difference was detected. In addition, the disulfide levels increasing according to ischemia either was not found significant statistically (p>0.05). Conclusion: Although this study showed the oxidative balance in intestinal ischemia had affected plasma TDSH, also it revealed that intestinal ischemia didn't create a statistically significant difference between plasma TDSH components

Spatial analysis of myocardial infarction in Iran: National report from the Iranian myocardial infarction registry

Background: Myocardial infarction (MI) is a leading cause of mortality and morbidity in Iran. No spatial analysis of MI has been conducted to date. The present study was conducted to determine the pattern of MI incidence and to identify the associated factors in Iran by province. Materials and Methods: This study has two parts. One part is prospective and hospital-based, and the other part is an ecological study. In this study, the data of 20,750 new MI cases registered in Iranian Myocardial Infarction Registry in 2012 were used. For spatial analysis in global and local, spatial autocorrelation, Moran's I, Getis-Ord, and logistic regression models were used. Data were analyzed by Stata software and ArcGIS 9.3. Results: Based on autocorrelation coefficient, a specific pattern was observed in the distribution of MI incidence in different provinces (Moran's I:0.75, P < 0.001). Spatial pattern of incidence was approximately the same in men and women. MI incidence was clustering in six provinces (North Khorasan, Yazd, Kerman, Semnan, Golestan, and Mazandaran). Out of the associated factors with clustered MI in six provinces, temperature, humidity, hypertension, smoking, and body mass index (BMI) could be mentioned. Hypertension, smoking, and BMI contributed to clustering with, respectively, 2.36, 1.31, and 1.31 odds ratio. Conclusion: Addressing the place-based pattern of incidence and clarifying their epidemiologic dimension, including spatial analysis, has not yet been implemented in Iran. Report on MI incidence rate by place and formal borders is useful and is used in the planning and prioritization in different levels of health system

Preparing for out of hospital cardiac arrests (OHCA) in Riyadh, Saudi Arabia: A GIS scenario-modeling approach

This study employed location-allocation modeling and a geographic information system (GIS) to study the current placement of automated external defibrillators (AEDs) in relationship to neighborhoods in Riyadh City, Saudi Arabia, and to determine the optimal locations for additional AEDs in the city. Using GIS to mathematically locate additional healthcare facilities for the placement of AEDs is more reliable than to select them using informed guesses. The objective of this research was to elaborate a mathematical and GIS model for placing AED devices so that people who need to use these devices in the City of Riyadh, Saudi Arabia, can access them within a time frame of three minutes or less, which is the international standard for such accessibility. The research employed street blocks as demand points; existing healthcare facilities, mosques, and schools as supply points; and the maximum coverage algorithm to model optimal locations for AED devices. Models were run for both vehicle and pedestrian travel times. Model results of current conditions indicated that 75% of household blocks were covered when vehicles were used to access AED sites, as compared to 9% of people when pedestrian travel to an AED is considered. Introduction of 1,371 mosques and 34 community colleges and universities as additional supply points for AEDs improved coverage to 94% for vehicular access, but only 34% for pedestrian traffic. Although mosques are considered to be focus points for Muslim communities, other facilities including, but not limited to, police stations, malls, primary and secondary schools, and playgrounds should be used to gain wider coverage. In addition, cluster analysis should be employed to avoid selecting AED supply points that are too close to each other and which are unlikely to improve accessibility. The study succeeded in elaborating a framework for conceptualizing the relationship between vehicular and pedestrian access to AEDs. It also demonstrates how GIS-based location-allocation modeling can be used for efficient placement of AEDs. The broad conceptual framework for AED placement used in this study has applicability to other countries in the Middle East

GIS in Healthcare

The landscape of healthcare is dynamic, gradually becoming more complicated with factors beyond simple supply and demand. Similar to the diversity of social, political and economic contexts, the practical utilization of healthcare resources also varies around the world. However, the spatial components of these contexts, along with aspects of supply and demand, can reveal a common theme among these factors. This book presents advancements in GIS applications that reveal the complexity of and solutions for a dynamic healthcare landscape

The Role of Social Determinants of Health in Cardiovascular Diseases: An Umbrella Review

Cardiovascular disease (CVD) is the leading cause of mortality worldwide. Addressing social determinants of health (SDoH) may be the next forefront of reducing the enormous burden of CVD. SDoH can be defined as any social, economic, or environmental factor that influences a health outcome. Comprehensive evidence of the role of SDoH in CVD is lacking, nevertheless. This umbrella review aims to give a comprehensive overview of the role of SDoH in CVD. We searched systematic reviews (with or without meta-analyses) using 8 databases and included review reference lists. Four themes (economic circumstances, social/community context, early childhood development, and neighbourhood/built environment) and health literacy in the health/health care theme were considered. Seventy reviews were eligible. Despite the quality of the included reviews being low or critically low, there was consistent evidence that factors relating to economic circumstances and early childhood development themes were associated with an increased risk of CVD and CVD mortality. We also found evidence that factors in the social/community context and neighbourhood/built environment themes, such as social isolation, fewer social roles, loneliness, discrimination, ethnicity, neighborhood socioeconomic status, violence, and environmental attributes, had a role in CVD. SDoH factors without (or with minimal) evidence synthesis for CVD were also identified. In sum, this umbrella review offers evidence that SDoH, especially economic circumstance and early childhood development, play a significant role in CVD. This calls for the strengthening of nonmedical interventions that address multiple factors simultaneously and the inclusion of SDoH in future CVD risk prediction models. Registration URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42022346994

Pesticides and health: A review of evidence on health effects, valuation of risks, and benefit‐cost analysis

In this paper, we provide reviews of recent scientific findings on health effects and preference valuation of health risks related to pesticides, and the role of benefit‐cost analysis in policies related to pesticides. Our reviews reveal that whereas the focus of the health literature has been on individuals with direct exposure to pesticides, e.g. farmers, the literature on preference elicitation has focused on those with indirect exposure, e.g. consumers. Our discussion of pesticides policies emphasizes the need to clarify the rationale for regulation and the role of risk perceptions in benefit‐cost analysis, and stress the importance of inter‐disciplinary research in this area

The use of satellite data, meteorology and land use data to define high resolution temperature exposure for the estimation of health effects in Italy

Introduction. Despite the mounting evidence on heat-related health risks, there is limited evidence in suburban and rural areas. The limited spatial resolution of temperature data also hinders the evidence of the differential heat effect within cities due to individual and area-based characteristics. Methods. Satellite land surface temperature (LST), observed meteorological and spatial and spatio-temporal land use data were combined in mixed-effects regression models to estimate daily mean air temperature with a 1x1km resolution for the period 2000-2010. For each day, random intercepts and slopes for LST were estimated to capture the day-to-day temporal variability of the Ta–LST relationship. The models were also nested by climate zones to better capture local climates and daily weather patterns across Italy. The daily exposure data was used to estimate the effects and impacts of heat on cause-specific mortality and hospital admissions in the Lazio region at municipal level in a time series framework. Furthermore, to address the differential effect of heat within an urban area and account for potential effect modifiers a case cross-over study was conducted in Rome. Mean temperature was attributed at the individual level to the Rome Population Cohort and the urban heat island (UHI) intensity using air temperature data was calculated for Rome. Results. Exposure model performance was very good: in the stage 1 model (only on grid cells with both LST and observed data) a mean R2 value of 0.96 and RMSPE of 1.1°C and R2 of 0.89 and 0.97 for the spatial and temporal domains respectively. The model was also validated with regional weather forecasting model data and gave excellent results (R2=0.95 RMSPE=1.8°C. The time series study showed significant effects and impacts on cause-specific mortality in suburban and rural areas of the Lazio region, with risk estimates comparable to those found in urban areas. High temperatures also had an effect on respiratory hospital admissions. Age, gender, pre-existing cardiovascular disease, marital status, education and occupation were found to be effect modifiers of the temperature-mortality association. No risk gradient was found by socio-economic position (SEP) in Rome. Considering the urban heat island (UHI) and SEP combined, differential effects of heat were observed by UHI among same SEP groupings. Impervious surfaces and high urban development were also effect modifiers of the heat-related mortality risk. Finally, the study found that high resolution gridded data provided more accurate effect estimates especially for extreme temperature intervals. Conclusions. Results will help improve heat adaptation and response measures and can be used predict the future heat-related burden under different climate change scenarios.Open Acces

Pesticides and health: A review of evidence on health effects, valuation of risks, and benefit‐cost analysis

In this paper, we provide reviews of recent scientific findings on health effects and preference valuation of health risks related to pesticides, and the role of benefit‐cost analysis in policies related to pesticides. Our reviews reveal that whereas the focus of the health literature has been on individuals with direct exposure to pesticides, e.g. farmers, the literature on preference elicitation has focused on those with indirect exposure, e.g. consumers. Our discussion of pesticides policies emphasizes the need to clarify the rationale for regulation and the role of risk perceptions in benefit‐cost analysis, and stress the importance of inter‐disciplinary research in this area

Venous Thrombosis

According to Virchow's triad, venous thrombosis can occur as a result of one or more of three factors: changes in the dynamics of the blood flow, endothelial injury/dysfunction of the blood vessel and hypercoagulability. The blood in the veins is constantly forming microscopic thrombi that are routinely broken down by the body, and significant clotting can occur only when the balance of thrombus formation and resolution is altered. This book is a fresh synthesis of venous thromboembolism care and considers the opinions and studies from different fields of medicine. As venous thrombosis spectrum is wide and can affect many organ systems, from deep veins of the leg to the cerebral venous system, our intent is for this to be a comprehensive, up-to-date and readable book. We tried to present a synthesis of existing material infused with new ideas and perspectives and authors own clinical studies and even case-reports