Susan "Ney"in arkasından

Taha Toros Arşivi, Dosya No: 62-Neyzen Tevfikİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033

'Diet and lifestyle' in the management of dyslipidaemia and prevention of CVD - Understanding the level of knowledge and interest of European Atherosclerosis Society members.

Abstract To better understand the level of knowledge and interest in 'diet and lifestyle' for cholesterol management and CVD prevention, European Atherosclerosis Society (EAS) members were invited to take part in an online survey. In total, 269 EAS members participated of which 64 (24%) were students/postdocs, 102 (38%) researchers involved with CVD-related research and 103 (38%) doctors and clinicians who directly interact with patients. All (99%) of the participants either agreed or strongly agreed that 'diet and lifestyle' have a role to play in cholesterol management, with 80% indicating that 'diet and lifestyle' is very or extremely important. Of the clinicians, 75% indicated that their patients voluntarily ask for 'diet and lifestyle' advice and over 80% said they continuously provide 'diet and lifestyle advice' to their patients. Of the surveyed clinicians, 91% feel sufficiently educated and confident to provide expert advice and over 90% recommend medication, diet change, frequent exercise and smoking cessation to their patients. In view of more specific dietary advice, clinicians reportedly recommend a 'Mediterranean diet', and advise to avoid high-fat foods, and to increase intake of high-fibre foods. Interestingly, smoking cessation and alcohol avoidance were mentioned less frequently. In view of educational needs, over half of the surveyed EAS members use the internet and 'guidelines' to learn about 'diet and lifestyle' in relation to cholesterol and CVD risk management. Clinicians tend to use 'guidelines' more often, while students/postdocs tend to use the internet significantly more than clinicians and CVD researchers. Regarding unmet needs for educational tools addressing specifically 'diet and lifestyle', clinicians feel that patient-oriented leaflets and pocket guidelines would be most beneficial materials to introduce, while students/postdocs would prefer an app. In summary, the role of 'diet and lifestyle' as a cornerstone of cholesterol management and CVD risk prevention seems well recognised amongst EAS members surveyed

IL-4 inhibits LPS-, IL-1β- and TNFα-induced expression of tissue factor in endothelial cells and monocytes

AbstractInflammatory mediators such as endotoxin, interleukin-1β(IL-1β) and tumor necrosis factors-α (TNF-α) dose-dependently increased the expression of tissue factor on the surface of cultured bovine aortic endothelial cells (ABAE), human umbilical vein endothelial cells (HUVEC) and human monocytes. In ABAE, endotoxin-, IL-1β- and TNFα-induced tissue factor expression was suppressed by interleukin-4 (IL-4) which also neutralized the pyrogenic effect of endotoxin in HUVEC and monocytes. IL-4 did not alter TNF-α-induced procoagulant changes in HUVEC and monocytes but strongly protected the monocyte surface against IL-1β-induced procoagulant changes

Suppression of Adaptive Immune Cell Activation Does Not Alter Innate Immune Adipose Inflammation or Insulin Resistance in Obesity

Obesity-induced inflammation in visceral adipose tissue (VAT) is a major contributor to insulin resistance and type 2 diabetes. Whereas innate immune cells, notably macrophages, contribute to visceral adipose tissue (VAT) inflammation and insulin resistance, the role of adaptive immunity is less well defined. To address this critical gap, we used a model in which endogenous activation of T cells was suppressed in obese mice by blocking MyD88-mediated maturation of CD11c⁺ antigen-presenting cells. VAT CD11c⁺ cells from Cd11cCre⁺Myd88^(fl/fl) vs. control Myd88^(fl/fl) mice were defective in activating T cells in vitro, and VAT T and B cell activation was markedly reduced in Cd11cCre⁺Myd88^(fl/fl) obese mice. However, neither macrophage-mediated VAT inflammation nor systemic inflammation were altered in Cd11cCre⁺Myd88^(fl/fl) mice, thereby enabling a focused analysis on adaptive immunity. Unexpectedly, fasting blood glucose, plasma insulin, and the glucose response to glucose and insulin were completely unaltered in Cd11cCre⁺Myd88^(fl/fl) vs. control obese mice. Thus, CD11c⁺ cells activate VAT T and B cells in obese mice, but suppression of this process does not have a discernible effect on macrophage-mediated VAT inflammation or systemic glucose homeostasis

Consequences of maternal morbidity on health-related functioning: a systematic scoping review.

OBJECTIVES: To assess the scope of the published literature on the consequences of maternal morbidity on health-related functioning at the global level and identify key substantive findings as well as research and methodological gaps. METHODS: We searched for articles published between 2005 and 2014 using Medline, Embase, Popline, CINAHL Plus and three regional bibliographic databases in January 2015. DESIGN: Systematic scoping review PRIMARY OUTCOME: Health-related functioning RESULTS: After screening 17 706 studies, 136 articles were identified for inclusion. While a substantial number of papers have documented mostly negative effects of morbidity on health-related functioning and well-being, the body of evidence is not spread evenly across conditions, domains or geographical regions. Over 60% of the studies focus on indirect conditions such as depression, diabetes and incontinence. Health-related functioning is often assessed by instruments designed for the general population including the 36-item Short Form or disease-specific tools. The functioning domains most frequently documented are physical and mental; studies that examined physical, mental, social, economic and specifically focused on marital, maternal and sexual functioning are rare. Only 16 studies were conducted in Africa. CONCLUSIONS: Many assessments have not been comprehensive and have paid little attention to important functioning domains for pregnant and postpartum women. The development of a comprehensive instrument specific to maternal health would greatly advance our understanding of burden of ill health associated with maternal morbidity and help set priorities. The lack of attention to consequences on functioning associated with the main direct obstetric complications is of particular concern. REVIEW REGISTRATION: CRD42015017774

Maternal mortality in the covid-19 pandemic: findings from a rapid systematic review

BACKGROUND: The COVID-19 pandemic is having significant direct and associated effects on many health outcomes, including maternal mortality. As a useful marker of healthcare system functionality, trends in maternal mortality provide a lens to gauge impact and inform mitigation strategies. OBJECTIVE: To report the findings of a rapid systematic review of studies on levels of maternal mortality before and during the COVID-19 pandemic. METHODS: We systematically searched for studies on the 1st March 2021 in MEDLINE and Embase, with additional studies identified through MedRxiv and searches of key websites. We included studies that reported levels of mortality in pregnant and postpartum women in time-periods pre- and during the COVID-19 pandemic. The maternal mortality ratio was calculated for each study as well as the excess mortality. RESULTS: The search yielded 3411 references, of which five studies were included in the review alongside two studies identified from grey literature searches. Five studies used data from national health information systems or death registries (Mexico, Peru, Uganda, South Africa, and Kenya), and two studies from India were record reviews from health facilities. There were increased levels of maternal mortality documented in all studies; however, there was only statistical evidence for a difference in maternal mortality in the COVID-19 era for four of these. Excess maternal mortality ranged from 8.5% in Kenya to 61.5% in Uganda. CONCLUSIONS: Measuring maternal mortality in pandemics presents many challenges, but also essential opportunities to understand and ameliorate adverse impact both for women and their newborns. Our systematic review shows a dearth of studies giving reliable information on levels of maternal mortality, and we call for increased and more systematic reporting of this largely preventable outcome. The findings help to highlight four measurement-related issues which are priorities for continuing research and development

Maternal mortality in the covid-19 pandemic: findings from a rapid systematic review

BACKGROUND: The COVID-19 pandemic is having significant direct and associated effects on many health outcomes, including maternal mortality. As a useful marker of healthcare system functionality, trends in maternal mortality provide a lens to gauge impact and inform mitigation strategies. OBJECTIVE: To report the findings of a rapid systematic review of studies on levels of maternal mortality before and during the COVID-19 pandemic. METHODS: We systematically searched for studies on the 1st March 2021 in MEDLINE and Embase, with additional studies identified through MedRxiv and searches of key websites. We included studies that reported levels of mortality in pregnant and postpartum women in time-periods pre- and during the COVID-19 pandemic. The maternal mortality ratio was calculated for each study as well as the excess mortality. RESULTS: The search yielded 3411 references, of which five studies were included in the review alongside two studies identified from grey literature searches. Five studies used data from national health information systems or death registries (Mexico, Peru, Uganda, South Africa, and Kenya), and two studies from India were record reviews from health facilities. There were increased levels of maternal mortality documented in all studies; however, there was only statistical evidence for a difference in maternal mortality in the COVID-19 era for four of these. Excess maternal mortality ranged from 8.5% in Kenya to 61.5% in Uganda. CONCLUSIONS: Measuring maternal mortality in pandemics presents many challenges, but also essential opportunities to understand and ameliorate adverse impact both for women and their newborns. Our systematic review shows a dearth of studies giving reliable information on levels of maternal mortality, and we call for increased and more systematic reporting of this largely preventable outcome. The findings help to highlight four measurement-related issues which are priorities for continuing research and development