Role of vitamin D in blood pressure homeostasis.

Hypovitaminosis D is suspected to be linked to several types of cancer, metabolic syndrome, cardiovascular disease, and all-cause mortality. This review explores the relationship of vitamin D to blood pressure and hypertension, a major cardiovascular disease risk factor. The literature up to June 2009 was searched without language or time restrictions from MEDLINE and PubMed, and it was supplemented with references from included studies.

Effect of niacin therapy on cardiovascular outcomes in patients with coronary artery disease.

Background: Niacin or nicotinic acid (vitamin B3) raises the levels of high-density lipoprotein cholesterol (HDL) by about 30% to 35%. In patients with prior coronary disease, 7 trials have been published on clinical cardiovascular disease outcomes and the results, not surprisingly, are inconsistent. Hence, we performed this meta-analysis of randomized placebo-controlled trials (RCTs) to evaluate the effect of niacin on cardiovascular outcomes in patients with coronary artery disease.

Cardiac syndrome X: current concepts.

Cardiac syndrome X is a heterogeneous entity, both clinically and pathophysiologically, encompassing a variety of pathogenic mechanisms. Management of this syndrome represents a major challenge to the treating physician. They often seek medical care because of recurring and disabling chest pain, which may imply repetitive and costly invasive and non-invasive investigations.

Combination therapy in hypertension: A focus on angiotensin receptor blockers and calcium channel blockers.

Every third adult in the United States has hypertension. Hypertension is a continuous, independent, potent risk factor for cardiovascular events like stroke, myocardial infarction, and heart failure. The blood pressure control achieved with most hypertensives is way below the recommended goal.

Role of angiotensin-converting enzyme inhibitors in vascular modulation: beyond the hypertensive effects.

Angiotensin-converting enzyme (ACE) inhibitors are being widely used as antihypertensives by clinicians worldwide. One in every three Americans has hypertension. Hypertension, diabetes, obesity, active smoking, hypercholesterolemia, and inactivity are the major cardiovascular risk factors, which can produce compounding effects on human health, leading to cardiovascular morbidity and mortality.

Enthesiopathy of the flexor carpi ulnaris at the pisiform: findings of high-frequency sonography.

Objectives: Acute or chronic pain at the pisiform may be due to tendinopathy of the flexor carpi ulnaris tendon (FCU) insertion, mechanical overuse, bony fractures, and osteoarthritis of the pisiform-triquetral joint. Enthesiopathy of the FCU at the pisiform might exhibit abnormalities assessable for sonographic characterization. This study aimed to determine the most relevant sonographic features of tendinopathy of the FCU insertion at the pisiform.

[Stabilization of perilunate and transscaphoid perilunate fracture-dislocations via a combined palmar and dorsal approach].

Objective: Restoration of the intercarpal alignment and the radio- and ulnocarpal joint in order to avoid the development of a carpal collapse with concomitant arthritis of the radiocarpal and midcarpal joint.

Indications: All perilunate and transscaphoid perilunate fracture-dislocations. An exception is a pure ligamentous injury with anatomic carpal alignment following closed reduction (computed tomography scan).

Bisphosphonate use in women and the risk of atrial fibrillation: a systematic review and meta-analysis.

Background: Bisphosphonates are used for the prevention and treatment of osteoporosis, but there have been concerns about a potential link between bisphosphonate therapy and atrial fibrillation. Data on the effects of bisphosphonate on the risk of atrial fibrillation are conflicting and the association of serious atrial fibrillation (defined as events resulting in hospitalization or disability or judged to be life-threatening) with the use of bisphosphonates is uncertain.

Hypothesis: We aimed to systematically evaluate the association of bisphosphonate use with the risk of atrial fibrillation.

Comparison of low molecular weight heparin with unfractionated heparin during percutaneous coronary interventions: a meta-analysis.

To conduct a meta-analysis of the current evidence to evaluate the safety and efficacy of low molecular weight heparin (LMWH) as compared to unfractionated heparin (UFH). Several studies have demonstrated the therapeutic advantage of LMWH over UFH in the medical management of acute coronary syndromes. However, evidence comparing the 2 in percutaneous coronary interventions (PCI) is inconclusive.

Association of statins and diabetes mellitus.

For years, statins have been used to lower elevated total and low-density lipoprotein cholesterol levels while raising high-density lipoprotein cholesterol levels. Statins work by inhibiting HMG-CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase, thus stopping the conversion of HMG-CoA to mevalonate, which is found in the cholesterol synthesis cascade. Unfortunately, several studies have shown increased diagnosis and lack of glycemic control of diabetes mellitus when patients are taking high and/or long-term doses of statins, and several mechanisms have been identified that may help explain this side effect.

Comparison of dilute acid and ionic liquid pretreatment of switchgrass: Biomass recalcitrance, delignification and enzymatic saccharification.

The efficiency of two biomass pretreatment technologies, dilute acid hydrolysis and dissolution in an ionic liquid, are compared in terms of delignification, saccharification efficiency and saccharide yields with switchgrass serving as a model bioenergy crop. When subject to ionic liquid pretreatment (dissolution and precipitation of cellulose by anti-solvent) switchgrass exhibited reduced cellulose crystallinity, increased surface area, and decreased lignin content compared to dilute acid pretreatment. Pretreated material was characterized by powder X-ray diffraction, scanning electron microscopy, Fourier transform infrared spectroscopy, Raman spectroscopy and chemistry methods.

Leptin and the clinical cardiovascular risk.

Obesity is a universal health problem of increasing prevalence and represents a major public health concern. Obesity is associated with a high risk of developing cardiovascular and metabolic diseases such as hypertension, coronary atherosclerosis, myocardial hypertrophy, diabetes, dyslipidemia, and increased cardiovascular morbidity and mortality. There has been an ongoing search for mediators between obesity and cardiovascular disease.

Therapeutic implications of diabetes in cardiovascular disease.

Insulin-resistant diabetes is becoming more prevalent among the general U.S. population.

Outcomes of nonemergent percutaneous coronary intervention with and without on-site surgical backup: a meta-analysis.

Despite major advances in percutaneous coronary intervention (PCI) techniques, the current guidelines recommend against elective PCI at hospitals without on-site cardiac surgery backup. Nonetheless, an increasing number of hospitals without on-site cardiac surgery in the United States have developed programs for elective PCI. Studies evaluating outcome in this setting have yielded mixed results, leaving the question unanswered.

Mechanisms of flushing due to niacin and abolition of these effects.

There are many factors that increase the risk of cardiovascular disease, and a prominent factor among these is dyslipidemia. The following literature review focuses on the use of niacin therapy in order to treat dyslipidemia and how to control the associated "niacin flush." The associated studies gathered are reviews and randomized control trials.

Primary prevention of cardiovascular complications in type II diabetes patients using aspirin: a complicated tale.

Diabetes is a disease that affects 23 million in the United States alone. Within the past 20 years, there has been remarkable research performed concerning primary prevention of cardiovascular events in type II diabetes patients. The American Diabetes Association along with a government panel made recommendations that diabetes patients at a high risk of cardiovascular events should be on a low-dose aspirin regimen.

Safety and efficacy of prolonged use of unfractionated heparin after percutaneous coronary intervention.

The current guidelines for percutaneous coronary intervention do not address the prolonged postprocedural use of unfractionated heparin (UFH) to prevent acute occlusion. However, recently published small studies have yielded mixed results, leaving the question unanswered. Hence, we performed a meta-analysis of the existing evidence to assess the safety and efficacy of prolonged infusion of UFH after percutaneous coronary intervention.

Dronedarone for atrial fibrillation: a new therapeutic agent.

Atrial fibrillation is the most common of the serious cardiac rhythm disturbances and is responsible for substantial morbidity and mortality. Amiodarone is currently one of the most widely used and most effective antiarrhythmic agents for atrial fibrillation. But during chronic usage amiodarone can cause some serious extra cardiac adverse effects, including effects on the thyroid.

HIV protease inhibitors induced prolongation of the QT Interval: electrophysiology and clinical implications.

In recent years, there have been considerable advancements in our understanding of the role of ionic channels in mediating cardiac repolarization. Advances in ion channel cloning have generated great interest in the diagnosis and understanding of electrophysiological processes involved in ventricular repolarization, particularly the QT interval prolongation and abnormal T- and T/U-wave morphology associated with torsades de pointes. Unfortunately, a number of drugs are being increasingly recognized to alter the repolarization and, thus, increase the propensity for various cardiac arrhythmias, especially polymorphic ventricular tachycardia, syncope, and even ventricular fibrillation and sudden death.

Clopidogrel pharmacogenetics and its clinical implications.

Pharmacogenetics encompasses a range of phenomena ranging from pharmacology to therapeutics to toxicology and generally focuses on the study of genetic factors related to interindividual variability in drug response. Individual differences in the rate of platelet reactivity markedly influence normal hemostasis and the pathologic outcome of thrombosis. Response to clopidogrel varies widely, with nonresponse rates in various studies ranging from 4%-30% at 24 hours.

HIV-1 IN alternative molecular recognition of DNA induced by raltegravir resistance mutations.

Virologic failure during treatment with raltegravir, the first effective drug targeting HIV integrase, is associated with two exclusive pathways involving either Q148H/R/K, G140S/A or N155H mutations. We carried out a detailed analysis of the molecular and structural effects of these mutations. We observed no topological change in the integrase core domain, with conservation of a newly identified Omega-shaped hairpin containing the Q148 residue, in particular.

Screening guidelines for coronary heart disease in diabetes: current recommendations.

Diabetes and cardiovascular disease are so intertwined with one another that the presence of one prompts a search for the other. Diabetes has been considered to be equivalent to coronary heart disease (CHD), and conversely many patients with known CHD have concomitant diabetes or its pre-states. This review has been compiled based on the guidelines of the American Diabetes Association, the Third Report of the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III), the European Society of Cardiology, and the European Association for the Study of Diabetes.

Resveratrol: biologic and therapeutic implications.

Resveratrol (3,4',5 trihydroxystilbene), a naturally-occurring molecule known as a phytoalexin, is synthesized by plants in response to attacks by fungi, bacteria, or other injurious substances; it is also known to possess an array of cardioprotective effects. Recently, studies have shown resveratrol to protect against the metabolic changes associated with hypercaloric diets in mice with induced insulin resistance, hyperglycemia, and dyslipidemia. Despite impressive gains in diagnosis and treatment, cardiovascular disease (CVD) remains a serious clinical problem and threat to public health.

Adjunctive low molecular weight heparin during fibrinolytic therapy in acute ST-segment elevation myocardial infarction: a meta-analysis of randomized control trials.

Background: Recent data suggests that low molecular weight heparins (LMWHs) may be superior to unfractionated heparin (UFH) as an adjunct to fibrinolytic therapy in patients with acute ST-segment elevation myocardial infarction (STEMI).

Hypothesis: We evaluated cardiac outcomes and the risk of major bleeding with LMWHs vs UFH in the management of STEMI.

Methods: Seven randomized trials of patients with acute STEMI treated with fibrinolytic therapy and adjunctive LMWHs through the index hospitalization or weight-based UFH for at least 48 hours were identified.