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  • Rich Phelps posted an update 1 day, 5 hours ago

    One-way analysis of variance was done to assess the differences among emotion-focused, problem-solving, and seeking social support coping strategy. Correlations were calculated between various coping strategies and COVID-19 Stress. Results suggested that seeking social support was the most used coping strategy. No significant correlation was found between the use of any coping strategy and COVID-19 stress. The proposed VIRUS model adequately captures the stressful experience of COVID-19. Triciribine molecular weight COVID-19 Stress Scale (CSS), a 21-item scale has robust psychometric properties.COVID-19 has reached a pandemic level and affected both individual’s health and global healthcare systems. Although Taiwan has encountered a less severe COVID-19 pandemic than many other countries, it has impacted the workflow of all cardiovascular examinations and procedures. Compared to before January 21st, 2020 (the date of the first confirmed COVID-19 in Taiwan), the number of patients who have received echocardiography and cardiac catheterization has since fallen. However, the number of percutaneous coronary interventions being performed has remained at the usual level. Based on our experience, we suggest that healthcare providers in Taiwan should carefully evaluate the urgency of cardiovascular procedures and deferred non-emergent procedures. Given that the pandemic has not yet plateaued, we should remain prepared for future challenges to maintain our medical service.

    Exposure to arsenic is associated with various cardiovascular diseases. The imbalance between antioxidant and oxidant homeostasis plays a crucial role in the cardiovascular effects of arsenic. The aim of this study was to investigate the effect of arsenic exposure on diastolic function by measuring thiol and disulphide in arsenic-exposed workers.

    A total of 107 male arsenic-exposed workers and 36 healthy subjects were enrolled. Mitral inflow velocity and parameters of diastolic function were measured. As oxidative stress indicators, total thiol, native thiol, disulphide, and their percent ratios were determined. The mean age was 39.1 ± 9.5 years in the arsenic-exposed group and 37.4 ± 9.6 years in the controls. The median blood arsenic level was 42 μg/dL in the arsenic-exposed group and 3.75 μg/dL in the controls. E-wave, E/A ratio, and e’ wave were lower and left atrial diameter, A-wave, average E/e’ ratio, and tricuspid regurgitation velocity were higher in the arsenic-exposed group. Native and total thiol concentrations were lower, and disulphide/native and disulphide/total thiol ratios were higher in the arsenic-exposed group. Fourteen (13.1%) workers had diastolic dysfunction, 26 (24.3%) had indeterminate, and 67 (62.6%) had normal diastolic function, compared to 1 (2.8%), 2 (5.6%), and 33 (97.7%) in the control group, respectively. In regression analysis, disulphide/native thiol ratio (p < 0.001) and blood arsenic level (p < 0.001) predicted increased average E/e’ ratio in the arsenic-exposed group.

    This study showed strong associations among arsenic exposure, oxidative stress, and diastolic function, and revealed the influence of arsenic exposure on diastolic dysfunction through oxidative stress.

    This study showed strong associations among arsenic exposure, oxidative stress, and diastolic function, and revealed the influence of arsenic exposure on diastolic dysfunction through oxidative stress.

    Pulmonary arterial hypertension (PAH) is a progressive pulmonary vascular disease with a high mortality rate that can be divided into different groups according to etiology and prognosis. Few studies have investigated differences in the exercise capacity and quality of life (QOL) among the different groups of PAH patients. Therefore, we aimed to (1) compare the hemodynamic exercise responses between patients with idiopathic pulmonary arterial hypertension (IPAH) and PAH associated with other diseases (APAH), and (2) determine the factors associated with exercise capacity in patients with PAH.

    Six patients diagnosed with IPAH and eight with APAH [congenital heart disease (CHD)-dominant PAH] were included in this study. The main outcome measures included body composition, exercise capacity, hemodynamic measurements, physical activity levels, fatigue severity, and QOL.

    The CHD-dominant PAH group had a significantly lower predicted peak oxygen consumption (VO

    %), pressure of end-tidal carbon dioxide at the peak and at anaerobic threshold (PETCO

    and PETCO

    ), and significantly elevated ventilatory equivalent (VE/VCO

    and VE/VCO

    ) compared with the IPAH group. Multiple regression analysis indicated that PETCO

    was significantly associated with either VO

    (β = 0.805, adjusted R

    = 0.619, p = 0.001) or 6-minute walk distance (β = 0.816, adjusted R

    = 0.638, p < 0.001).

    Patients with CHD-dominant PAH had poor exercise capacity and exercise responses compared to those with IPAH. Evaluating exercise capacity and the patient response to exercise using cardiopulmonary exercise testing is increasingly important in view of the etiology of PAH.

    Patients with CHD-dominant PAH had poor exercise capacity and exercise responses compared to those with IPAH. Evaluating exercise capacity and the patient response to exercise using cardiopulmonary exercise testing is increasingly important in view of the etiology of PAH.

    In the secondary prevention of long-term coronary events, a target value of low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL is recommended as standard management in Japanese guidelines. However, the effectiveness of strict management on lowering LDL-C remains unclear.

    To clarify whether strict management of LDL-C < 70 mg/dL is more effective in preventing long-term coronary event recurrence than standard management.

    We retrospectively investigated 344 patients with previous percutaneous coronary interventions who underwent late coronary angiography to examine recurrence of cardiac ischemia beyond the early restenosis period from January 2007 to August 2019. Patients were stratified into three groups according to achieved LDL-C value; LDL-C < 70 mg/dL (n = 53), 70 to < 100 mg/dL (n = 130), and ≥ 100 mg/dL (n = 161). Endpoints were acute coronary syndrome (recurrent-ACS) and late coronary revascularization.

    After follow-up (median 6.0 years), 200 patients (58%) underwent late coronary revascularization, including 94 recurrent-ACS.

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