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   2020| July-September  | Volume 4 | Issue 3  
    Online since September 29, 2020

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Cardiovascular complications of COVID-19
Joana Brito, Beatriz Valente Silva, Pedro Alves da Silva, Nuno Cortez-Dias, Doroteia Silva, João R Agostinho, Tatiana Guimar, Dulce Brito, Fausto J Pinto
July-September 2020, 4(3):67-74
Coronavirus disease 19 (COVID-19) has rapidly expanded to a global pandemic, resulting in significant morbidity and mortality. Even though predictors of infection remain unclear, age and preexisting cardiovascular conditions have been clearly identified as predictors of adverse outcomes and higher fatality rates. Since the virus infects host cells through angiotensin-converting enzyme 2 receptors, a key player in the renin-angiotensin-aldosterone system, the interaction between the cardiovascular system and the progression of COVID-19 is nowadays a focus of huge interest. In this review, the authors analyze the available and very recent evidence on the risk factors and mechanisms of the most relevant cardiovascular complications associated with COVID-19, including acute cardiac injury, myocarditis, stress-cardiomyopathy, ischemic myocardial injury, cytokine release syndrome, thrombotic disease, cardiac arrhythmias, heart failure, and cardiogenic shock. Finally, we discuss the cardiovascular impact of the therapies under investigation for COVID-19 treatment.
  19,084 1,725 4
Mental health challenges raised by rapid socioeconomic transformations in China: Lessons learned and prevention strategies
Yankun Sun, Yanping Bao, Arun Ravindran, Yan Sun, Jie Shi, Lin Lu
July-September 2020, 4(3):59-66
China's rapid economic development has contributed to health improvement, such as increasing life expectancy, reducing communicable diseases, and mortality rate. However, the sustainable social and economic transformations, including industrialization, urbanization, globalization, and informatization, have triggered huge challenges to population health in China, particularly to mental health. This review discussed the mental health problems due to socioeconomic changes such as population, life-style, and environment changes, as well both the economic and disease burden of mental disorders. With awareness of these challenges, the following three possible responses are proposed: identify social and economic impact on mental health based on high-quality qualitative and quantitative analysis; improve mental health awareness and literacy; and enhance mental health-care system and promote implementation research. Lessons from China can be a great reference for other low- and middle-income countries. With efforts overcoming the current and potential challenges on mental health, the Sustainable Development Goals on mental health can be possibly achieved by 2030.
  14,777 1,694 4
Program planning in education and light exercise training for atrial fibrillation patients: A feasibility study
Connor Tripp, Zachary Force, Nichelle L Huber, J Paul Mounsey, Aditi Naniwadekar, Rajasekhar Nekkanti, Samuel F Sears
July-September 2020, 4(3):80-84
Background: Contemporary management of patients with atrial fibrillation (AF) indicates the need for educational and self-care programs to address lifestyle factors. Aims: This study examined the clinical need and interest in programming for risk factor modification in AF patients residing in a mostly rural area. Methods: Participants with AF (n = 86) were recruited during university-based cardiac electrophysiology appointments and asked to complete a 10-min survey battery assessing a range of risk factors spanning physical activity, knowledge, ability, interest, and engagement, as well as psychologic function. Results: AF risk factor reports indicated broad potential need for AF programming with an average CHADS-VASC of 3.8, with approximately 67% reporting low physical activity, and 38% significant anxiety. Related to self-care topics, education on physical activity was the highest-rated program, but weight-loss programming was rated as the most likely to attend. Distance to the clinic was the most often cited barrier, 50% of sample. Conclusions: AF patients demonstrated a need and view educational programming in the realm of physical activity and weight-loss as desirable. Increased research is needed to determine format and duration of treatment deemed efficacious and able to overcome specific barriers such as distance to care.
  13,912 1,663 1
The role and importance of the tilt table test in pediatrics: Single-center experience and review of literature
Zijo Begic, Nedim Begic, Edin Begic, Naida Spahovic
July-September 2020, 4(3):75-79
Introduction: The head-up tilt table test is noninvasive diagnostic procedure, which is used in the diagnosis of syncope. Syncope presents a benign short-term disorder of cerebral circulation with the sudden loss of consciousness and muscle tone. Aim: The aim is to present not only the role and importance of orthostatic tests in the daily clinical practice of pediatric cardiology, neuropediatrics but also pediatrics in general. Patients and Methods: This study has retrospective descriptive character and included the period from April 1997 to June 2020, during which the registration and analysis of orthostatic stability tests (head-up/tilt table test, tilt table test) was performed. Medical documentation of outpatient and hospitalized patients on the Paediatric Clinic of Clinical Center University of Sarajevo (Register of Tilt Table Test) was used. Results: During this period, 1029 tests were registered and analyzed. Modification test (head-up) was performed in 132 (12.8%) patients, and since 2008, classic tilt table test was performed in 897 (87.1%) patients. Patients were 6.5–19 years old, with a predominance of female patients 611 (59.4%). There were 519 (50.4%) patients who were 15–19 years old and 510 (49.6%) patients who were under 15 years of age. Indications were syncope or suspected syncope in 671 (65.2%) patients, cardiovascular etiology (arrhythmias, chest pain, congenital heart defects [CHDs], surgically corrected CHDs, hypotension, and hypertension) in 195 (19%) patients, neuropediatric pathology (epilepsia, suspected epilepsia, headache, vertigo) in 101 (9.8%) patients, and other indications in 62 (6.03%) patients. From the total number of tests, 862 were first tests (83.4%) and 167 were control tests (16.3%). The positive test was found in 538 (52.3%) patients, most often vasovagal syncope (473 patients or 87.9%). Conclusion: Tilt table test is a reliable diagnostic tool in examining the etiology of syncope, primarily vasovagal, and is an extremely important method primarily in cardiopediatric and neuropediatric daily diagnostics.
  3,308 273 -
The role of brain-derived neurotrophic factor and serotonin polymorphisms in stress-related personality and psychiatric symptoms: Implications for cardiovascular health
Paul G Nestor, Hannah E Lapp, Sara B Boodai, Keira O'Donovan, Victoria Choate Hasler, Richard Hunter
July-September 2020, 4(3):85-91
Background: Diathesis-stress perspectives of cardiovascular (CV) health and disease have long identified the important role of a host of mental health risk and protective factors in both illness course and recovery. Few studies, however, have investigated these factors within the same sample of healthy people. Aims and Objectives: Accordingly, we focused on the inter-relationships among well-established CV mental health risk factors, specifically childhood adversity, stress-related adult personality traits and psychiatric symptoms, and naturally occurring genetic polymorphisms. Materials and Methods: Here 100 college students completed the NEO Five Factor Model of personality in conjunction with measures of childhood adversity, psychiatric symptoms as well as genetic variables derived from assays of the serotonin transporter (5-HTTLPR) and the brain-derived neurotrophic factor (BDNF). Results: Single gene comparisons pointed to lower CV risk, as reflected in personality and psychiatric symptom measures for BDNF Met versus Val/Val carriers. In addition, polygenic comparisons revealed a significant BDNF x 5-HTTLPR interactional effect, suggesting that this particular allelic combination may moderate the phenotypic expression of key personality traits, namely neuroticism and extraversion, as well as psychiatric symptoms, all linked to cardiovascular health. In fact, the data showed across personality and symptom measures, evidence of stress-resistance, resilience and protection for carriers of the allelic pair, BDNF Met and 5-HTTLPR-S. Conclusions: The findings suggested the Met variant of the BDNF gene had a risk-reducing and health-promoting effect when paired with the short serotonin allele, arguably reversing the commonly reported 5-HTTLPR-S association with stress vulnerability.
  3,002 205 3
Ticking bomb inside the thoracic cavity
Monish S Raut
July-September 2020, 4(3):92-93
  1,673 161 -