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  • Author: Victoria Rus x
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Abstract

Background. It is well-known that the exposure during pregnancy to lifestyle risk factors can affect thehealth both for the mother and the fetus. There are many risk factors for pregnancy, including: smoking, alcohol consumption, sedentary pattern, irregular daily meal serving plan, lack of knowledge regarding health prevention. The main objective of our study was to assess the practices, knowledge and attitudes towards lifestyle risk behaviors during pregnancy in a group of women from Tirgu-Mures area.

Materials and methods. We used a cross-sectional study based on a questionnaire, assessingsmoking behavior and lifestyle patterns during pregnancy, on a group of 481 women from the urban area (58.84%), as well as from the rural area (41.16%) from Mures county.

Results. In the study group, 190 women (39.5%) used to smoke before pregnancy; among which 37.36% continued to smoke even after they found out they are pregnant. In the group of pregnant women that continued to smoke during pregnancy, we have studied other behavioral factors related to lifestyle, identifying the following: 5,73% have been consuming alcohol weekly, 56.33% reduced greatly their physical activity level, 3.63% have been consuming at least 3 cups of coffee a day. During pregnancy, 12.72% did not have a regular, daily meal serving plan, and 67.26% was a little or not at all concerned about their eating habits. Only 30.9% from the smoking pregnant women group have received information from the family doctor (GP) regarding the risk factors of smoking habits, while 38.18% did not receive any information.

Conclusions. Behavioral risk factors in pregnancy have to be followed closely by the HealthCare System in order to avoid complications for the mother and the child. The best way of accomplishing that is through an efficient community intervention.

Abstract

The aim of our study was to investigate the correlation between volumes of thoracic fat distributed in different compartments and the geometry of vulnerable coronary plaques assessed by coronary computed tomography angiography (CCTA), in patients with acute chest pain.

Methods: This was a non-randomized, observational, single-center study, including 50 patients who presented in the emergency department with acute chest pain who underwent 128-slice single-source CCTA. Plaque geometry was evaluated in transversal and longitudinal planes, and the assessment of adipose tissue was performed using the Syngo.via Frontier (Siemens AG, Healthcare Sector, Forchheim, Germany) research platform.

Results: Eccentric plaques presented a significantly higher incidence of spotty calcification (40% vs. 22%, p = 0.018), whereas positive remodeling, volume of low attenuation plaque, and incidence of napkin-ring sign were not significantly different between the study groups or in ascending versus descending plaques. The volume of pericoronary fat around the plaque was significantly larger near eccentric lesions (707.68 ± 454.08 mm3 vs. 483.25 ± 306.98 mm3, p = 0.046) and descendent plaques (778.26 ± 479.37 mm3 vs. 473.60 ± 285.27 mm3, p = 0.016). Compared to ascending lesions, descendent ones presented a significantly larger volume of thoracic fat (1,599.25 ± 589.12 mL vs. 1,240.71 ± 291.50 mL), while there was no significant correlation between thoracic fat and cross-sectional eccentricity.

Conclusions: The phenotype of plaque distribution and geometry seems to be associated with a higher vulnerability of coronary lesions and may be influenced by the local accumulation of inflammatory mediators released by the pericoronary epicardial adipose tissue.

Abstract

Objectives: To evaluate the relationship between the frequency of self-declared status regarding smoking in a group of pregnant women from Mures county, Romania and the high levels of Salivary Cotinine (SC) like biomarkers. Material and methods: It was conducted a retrospective study among 230 pregnant women presented for prenatal care at 50 General Practitioners cabinets in Mures county, Romania, in 2015. Data were collected with a validated questionnaire which included age, level of education, socioeconomic status and ethnicity, also the self-reported smoking status. The Salivary Cotinine level was evaluated using NicAlert Saliva test kits. Results: Using salivary test we identified a high prevalence of involuntary exposure to cigarette smoke among both non-smokers and those who quit smoking before pregnancy. Also we registered pregnant women that although declared smoking cessation before pregnancy their salivary Cotinine levels were high, almost like to an active smoker, probably because of second-hand exposure or because they didn’t say the truth about their habit. Conclusions: We underline the importance of implementing more efficient community interventions among this vulnerable group in order to reduce the frequency of smoking and sustain quitting.

Abstract

Introduction. Due to a busy and exhausting urban lifestyle parents do not always have the necessary time to pay sufficient attention to the quality of the dietary habits of their children.

Objective. Starting from the premise that teenagers have insufficient information about healthy eating, the present study aimed to highlight eating behaviours and nutrition knowledge deficits in a group of 427 high school students from Tîrgu Mures.

Methods. An observational study based on lifestyle and food frequency consumption was conducted. In 2017, students in fifteen classes from several High School Institutions from Targu Mures, Romania, were asked to complete a questionnaire with questions relating to the current state of health, lifestyle characteristics, anthropometric indicators, frequency of daily meal consumption, significance and intake of food additives, leisure activities performed and also teenagers’ preferences for food products.

Results. The average age of the respondents was 16.1 years old, 72.6% were boys, and 82% lived in the city. 43.6% of respondents stated that food is a necessity, while 22% asserted that food characterizes a pleasure for them. Concerning the calorific value of foods, 32.8% stated that they have no interest in the calorie content of different food products while only 26%, mainly girls, took notice of these. 31.10% of respondents indicated that they include the recommended amount of vegetables in their daily diet, 22% prefer to eat preserved foods while increased consumption of sweets was observed in 39.80%. 55.50% of respondents ate breakfast on a regular basis, and 37% read food labels.

Conclusions. The results emphasise the necessity to develop more effective educational programs designed to create necessary background information for a young generation, change adolescent dietary behaviours for the better, and thus prevent dietary related diseases.

Abstract

Background: Epicardial adipose tissue (EAT) has been recently identified as a major player in the development of the atherosclerotic process. This study aimed to investigate the role of EAT as a marker associated with a higher vulnerability of atheromatous coronary plaques in patients with acute myocardial infarction (AMI) as compared to patients with stable angina.

Material and methods: This analysis enrolled a total of 89 patients, 47 with stable angina (SA) and 42 with AMI, who underwent echocardiographic investigations and epicardial fat measurement in 2D-parasternal long axis view. The study lot was divided as follows: Group 1 included patients with prior AMI, and Group 2 included patients with SA.

Results: There were no significant differences between the two groups regarding cardiovascular risk factors, excepting smoking status, which was recorded more frequently in Group 1 as compared to Group 2 (36.17% vs. 11.63%, p = 0.02). The mean epicardial fat diameter was 9.12 ± 2.28 mm (95% CI: 8.45–9.79 mm) in Group 1 and 6.30 ± 2.03 mm (95% CI: 5.675–6.93 mm) in Group 2, the difference being highly significant statistically (p <0.0001). The mean value of left ventricular ejection fraction was significantly lower in patients with AMI (Group 1 – 47.60% ± 7.96 vs. Group 2 – 51.23% ± 9.05, p = 0.04). EAT thickness values showed a weak but significant positive correlation with the level of total cholesterol (r = −0.22, p = 0.03) and with the value of end-systolic left ventricle diameter (r = 0.33, = 0.001).

Conclusions: The increased thickness of EAT was associated with other serum- or image-based biomarkers of disease severity, such as the left ventricular ejection fraction, end-systolic diameter of the left ventricle, and total cholesterol. Our results indicate that EAT is significantly higher in patients with acute coronary syndrome, proving that EAT could serve as a marker of vulnerability in cardiovascular diseases.

Abstract

Background: The impact of nutritional status on the early outcome of subjects with acute myocardial infarction (AMI) is still not completely elucidated. This study aimed to assess the correlation between nutritional status, as expressed by the CONUT and PIN scores, and (1) clinical and laboratory characteristics, (2) complication rates, and (3) length of hospitalization, in patients with AMI.

Materials and methods: We included 56 consecutive patients with AMI who underwent primary percutaneous intervention and stenting. Evaluation of the nutritional status was comprised in the calculation of the CONUT and PNI scores. The study population was divided into 2 groups according to the calculated CONUT score, as follows: group 1 – CONUT score <3 points (normal to mildly impaired nutritional status) and group 2 – CONUT score ≥3 points (moderate to severe malnutrition). The primary end-point of the study was the rate of in-hospital complications (left ventricular free wall rupture, hemodynamic instability requiring inotropic medication, high-degree atrioventricular block, the need for temporary cardiostimulation, supraventricular and ventricular arrhythmias and in-hospital cardiac arrest). The secondary end-points included the duration of hospitalization and the length of stay in the intensive cardiac care unit.

Results: In total, 56 patients (44.64% with STEMI, 55.35% with NSTEMI) with a mean age of 61.96 ± 13.42 years, 58.92% males were included in the study. Group distribution was: group 1 – 76.78% (n = 43), group 2 – 23.21% (n = 23). There were no differences between the two groups regarding age, gender, cardiovascular risk factors, or comorbidities. PNI index in group 1 was 54.4 ± 10.4 and in group 2 41.1 ± 2.8, p <0.0001. Serum albumin was significantly lower in group 1 – 4.1 ± 0.3 vs. group 2 – 3.6 ± 0.3 (p <0.0001), similarly to total cholesterol levels (group 1 – 194.9 ± 41.5 vs. group 2 – 161.2 ± 58.2, p = 0.02). The complete blood cell count showed that group 2 presented lower levels of hematocrit (p = 0.003), hemoglobin (p = 0.002), and lymphocytes (p <0.0001) compared to group 1, but a significantly higher platelet count (p = 0.001), mean platelet volume (p = 0.03), neutrophil/lymphocyte (p <0.0001) and platelet/lymphocyte (p <0.0001) ratios, indicating enhanced blood thrombogenicity and inflammation. Regarding in-hospital complications, group 2 presented a higher rate of hemodynamic instability (group 1 – 11.6% vs. group 2 – 38.4%, p = 0.02). The overall hospitalization period was 7.7 ± 1.4 days in group 1 vs. 10.2 ± 4.8 days in group 2, p = 0.06; while the duration of stay in the intensive cardiac care unit was 2.6 ± 0.5 days in group 1 vs. 4.0 ± 2.5 days in group 2, p = 0.02.

Conclusions: This study proved that nutritional deficit in acute myocardial patients who undergo revascularization is associated with an increased rate of in-hospital complications and with a longer observation time in a tertiary intensive cardiac care unit.

Abstract

Background: Adopting a healthy lifestyle, including a healthy diet, weight control, regular exercise, smoking cessation, and alcohol limitation, plays an important role in treating high blood pressure and cardiovascular and chronic diseases.

Aim: This study aimed to investigate adherence to the DASH diet in relation to the occurrence of high blood pressure and chronic disease risk factors, in a group of people from Tîrgu Mureș.

Material and methods: This was a cross-sectional study based on a food frequency and lifestyle questionnaire applied to a group of 2,010 people aged 15–92 years from Tîrgu Mureș.

Results: Individuals over the age of 45 had higher DASH scores (Q4, Q5) compared to subjects younger than 40 years (Q1 and Q2, p <0.001). An important percentage (19.3%) of subjects who preferred a meat-based diet (Q3) had significantly larger abdominal circumference (mean 92.2 ± 0.91 cm, p <0.001). An association between pure alcohol intake (mean 5.6 ± 0.43 g) and an unhealthy diet (Q1) was observed, compared to the average 1.7 ± 19 g of alcohol consumed by subjects with a healthy diet (Q5), alcohol consumption decreasing with an increasing DASH score (p <0.001).

Conclusion: This study shows that individuals diagnosed with at least one cardiovascular risk factor had a higher adherence to the DASH diet than individuals with no cardiovascular risk factors, most likely due to the fact that diagnosed individuals had changed their eating behavior and lifestyle from the time of diagnosis, with a positive impact on treatment outcomes and quality of life.

Abstract

Background: The independent role of each plaque feature in relation to plaque vulnerability is still the subject of ongoing research. This study aimed to compare the morphologic characteristics of vulnerable atheromatous coronary plaques with the ones of stable, non-vulnerable plaques, and in plaques with different locations in the coronary tree, in order to identify the most relevant imaging-based biomarkers associated with coronary plaque vulnerability.

Material and methods: This was a prospective observational, non-randomized study that included 50 patients with unstable angina who underwent computed tomography angiography for assessment of the entire coronary artery tree followed by complex morphologic analysis of all lesions, divided into two groups: group 1 – 25 patients with vulnerable plaque (VP) and group 2 – 25 age- and gender-matched patients with non-vulnerable plaque (NVP).

Results: Lesions with a stenosis degree >70% were significantly longer than those with a stenosis degree <70% (8.27 ± 2.74 mm vs. 5.56 ± 4.11 mm, p = 0.04). VP presented significantly higher values of plaque thickness (p = 0.0005), plaque burden (p = 0.0004), and higher total plaque volume (p = 0.0005) than NVP. The remodeling index was not significantly different between the groups (p = 0.6), but the eccentricity index was (0.24 ± 0.14 compared to 0.14 ± 0.17, p = 0.023). Linear regression analysis revealed a significant correlation between plaque burden and plaque components in VP (r = 0.76, p <0.0001 for necrotic core; r = 0.62, p = 0.0008 for fibro-fatty tissue; and r = 0.5, p = 0.01 for fibrotic tissue volume). Culprit plaques located in the right coronary artery presented significantly larger plaque burden volumes (91.17 ± 4.88 mm3 vs. 83.35 ± 8.47 mm3, p = 0.04), larger volumes of necrotic core (82.03 ± 47.85 mm3 vs. 45.84 ± 43.72 mm3, p = 0.02) and fibrofatty tissue (53.23 ± 31.92 mm3 vs. 23.76 ± 20.90 mm3, p = 0.02) than the ones situated in the left coronary artery.

Conclusions: VPs from the culprit lesions exhibit a different phenotype than non-vulnerable ones, and vulnerability features are present in a significantly larger extent in VPs from the right coronary artery as compared to those from the left coronary artery.