Neonatal hyperbilirubinemia is extremely common, because almost every newborn develops an unconjugated serum bilirubin level more than 30µmol/l (1.8 mg/dl) during the first week of life. Incidence figures are difficult to compare. Hyperbilirubinemia may be conjugated or unconjugated. Hyperbilirubinemia may require therapy, which is mainly in the form of phototherapy or exchange transfusion. Unconjugated hyperbilirubinemia may result in severe medical conditions when left untreated. The most serious of them is encephalopathy. Cardiac affection due to unconjugated hyperbilirubinemia was reported. Left ventricle (LV) systolic dysfunction was detected in full-term neonates with unconjugated hyperbilirubinemia. In this book, the effects of unconjugated hyperbilirubinemia on the cardiovascular status and myocardial function in jaundiced neonates were documented. We studied the impact of different clinical parameters (e.g. mode of delivery,gestational age,admission weight, etc.)and laboratory parameters (e.g. level of total and unconjugated bilirubin on admission and after 48 hours, hemoglobin, etc.) on the cardiac functions measured by echocardiography.
Most of newborn infants develop hyperbilirubinemia in the first week of life. Moreover, jaundice is the most common cause of neonatal rehospitalization. Excessive hyperbilirubinemia may lead to irreversible bilirubin-induced neurologic dysfunction. Early identification of infants with high bilirubin levels requiring intervention is the key issue in the management of neonatal hyperbilirubinemia. Transcutaneous measurement of bilirubin concentration is an objective, noninvasive method, which provides real-time results and avoids pain due to blood sampling. It is a screening test for identifying the need for laboratory assessment of total serum bilirubin concentration. This book provides overview of neonatal hyperbilirubinemia and its management, and possibilities of noninvasive assessment of jaundice. The presented study evaluates the accuracy of a bilirubinometer with two optical paths in European newborn infants, and assesses the effect of gestational age, phototherapy and measurement site on reliability of transcutaneous measurements. The book should be useful to neonatologists, pediatricians, medical students and nurses, and it aims to serve as a resource for further studies.
Diabetes mellitus constitutes a major cardiovascular risk factor with associated increased morbidity and mortality amongst affected women. Recently it has been shown, that although initially thought to be rare, cardiovascular disease and associated complications is on the rise among female Nigerians. However, studies on the effect of hypertension on the ECG parameters and evidence to support the related complications and particularly the cardiovascular complications of diabetes and/or hypertension among female diabetic subjects in our environment (Nigeria) are still relatively scanty and not well documented. The present study determined changes and complications in a cohort of susceptible ECG and the occurrence, prevalence, characterization of ECG patterns and abnormalities in female hypertensive diabetics as compared to normotensive diabetics. This book has been able to document the pattern of ECG changes in female hypertensive diabetic Nigerians compared to normotensive diabetics, indicating that both subject groups are at higher risk of developing cardiovascular disease complications which might be a reflection of environmental associated increases in body fat.
Some drugs which are not aimed at treating heart disease have nevertheless been found to have profound effects on heart muscle. Cardiotoxicity is one of the major forms of toxicity seen in drugs and it accounts for most drug recalls and delays experienced in regulatory approvals.In recent years a number of non-cardiac blockbuster drugs such as terfenadine have been withdrawn from major markets because of cardiotoxicity concerns, while other drugs have either been withdrawn prior to marketing or required labelling changes that significantly restricted their use. In Cardiotoxicity of Non-Cardiovascular Drugs international experts describe the molecular mechanisms and clinical read-outs of cardiac events induced by a broad variety of noncardiovascular drugs. Particular emphasis is paid to the preclinical screening of drug cardiotoxicity. Topics include: metabolic targets of cardiotoxicity regulatory aspects translating molecular mechanisms into clinical trials structure-activity relationships in arrhythmias by antihistamines and psychoactive drugs cardiovascular toxicity of antitumor drugs cardiovascular toxicities of non-steroidal anti-inflammatory drugs cardiovascular toxicities of antiretroviral therapies Cardiotoxicity of Non-Cardiovascular Drugs is an essential guide to this important area of drug development. It will find a place on the bookshelves of researchers, regulators and students in medicinal chemistry, drug development, pharmacology, pharmacy and cardiovascular disease.
Cardiovascular disease is one of the leading causes of death in the world and the number of patients increases worldwide. To investigate the cardiovascular disease in early stage, reliable model predictions are required. In computational cardiovascular models parameters are one of the major sources of uncertainty, which make the models unreliable and less predictive. In order to achieve predictive models that allow the investigations of the cardiovascular diseases, sensitivity analysis (SA) can be used to quantify and reduce the output uncertainty caused by model parameters.
Neonatal jaundice, an extremely common occurrence among neonates in the first week of life. In the present study, a group of hundred infants (84 patients, from various clinical subpopulations + 16 controls) were included. The quantification of the morphological shape changes revealed that G-6-PD deficient neonates had a significant increase in echinocytes as well as in the morphological index (p < 0.01), when compared with the data from healthy neonates or G-6-PD non-deficient ones. The dielectric properties of neonatal erythrocytes have been studied in the frequency range 20 Hz to 100 KHz. The combined application of dielectric spectroscopy and scanning electron microscope can be used as an efficient manner for monitoring abnormalities in blood due to these pathological cases. The rheological and durability properties of the erythrocytes were investigated using spectral analysis and osmotic fragility. Absorption spectra of erythrocytes shows a significant decrease of splitting factor (SF) as bilirubin (Bb) conc. increases, indicating that the cells tend to convert from oxygenated to deoxygenated state with a peak at 560 nm which is confirmed by SF values.
Low Birth Weight is one of the important cause of mortality and morbidity in neonates because of zinc deficient and that might adversely affect postnatal growth. The present investigation was to compare the effect of oral zinc supplementation on growth of low birth weight neonates by randomized controlled trail. 100 LBW neonates between 1501-2499gm were randomized into zinc and placebo groups. Supplemented zinc 10mg/day to zinc group and multivitamin drops to placebo group for 28 days. Measure the weight and length according to study schedule. Primary outcome was increment in weight and length and data were analysed by SPSS. The mean birth weight was 1850.4±302.59gm and 1813±271.25gm for zinc and placebo groups respectively. After 28days 2595±503.32gm with mean weight gain of 25.99±11.0gm/day in zinc group and 2322.4±472.12gm with mean weight gain of 18.3±9.38gm/day in placebo group, which was statistically significant. A significant length gain in zinc group compare to placebo group. Zinc group experienced fewer problems like sepsis, hospitalization, jaundice and no adverse effects. Zinc supplementation for LBW neonates was found effective to enhance growth in neonatal period.
According to WHO data, in 2014, more than 1.9 billion (39%) of adults aged 18 and older have an overweight (OW). Of this number there are more than 600 million (13%) people suffering from obesity. Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome closely associated with OW, insulin resistance. Morphological component of NAFLD is the triglycerides delaying in hepatocytes and the following lipid atherogenic changes. NAFLD and OW lead to compensatory hemodynamic changes of vascular structural and functional characteristics and further development of cardiovascular diseases. Gender indicator has a significant impact on the cardio-vascular risk due to the complexity of the system hormones. But gender factor is not the isolated risk leading to cardiovascular diseases if it not complemented by the other chronic diseases or chronic systemic abuses. Age-related changes also carry the load on the vascular structure when in a later age period the atherogenic risk of cardio-vascular pathology is increased. Ultrasound marker of subclinical atherosclerosis is an intima media thickness (IMT) and hemodynamic data of main neck arteries.
Cardiovascular response is a criterion in determining suitability and safety in exercise testing and training. Howbeit, there is a paucity of studies on cardiovascular response to back muscles'' endurance tests in health and disease. Considering that the back extensor muscles are one of the largest muscle groups in the body, and that the magnitude of cardiovascular response to contraction to muscular endurance is reportedly greater than muscular strength testing, it is therefore important to determine the cardiovascular entropy to static and dynamic endurance testing and training of back extensor muscles as it could add to the ability of clinicians to feel more confident in the safety of using these tests and exercise on their patients. This book presents the cardiovascular response to static and dynamic endurance tests of back extensors and also the influence of demographics and anthropometric parameters on the cardiovascular response to the tests in apparently healthy individuals.
The book represents the English version, with modifications and additions, of the university course entitled "Kinetotherapy in cardiovascular diseases" published by “Alexandru Ioan Cuza” University Publishing House, Iasi, Romania, in 2014, the author Bogdan-Alexandru Hagiu. Is addressed to physical therapy specialists, providing basic information about cardiovascular diseases and their possible treatments. The last chapter, "The role of isometric contractions in treating cardiovascular disease" includes therapeutic applications of barbell-expander devices, invented by the author.
Cardiovascular diseases are the leading cause of death in patients on chronic dialysis. Numerous epidemiologic researches have proved a significant frequency of cardiovascular diseases in patients with chronic kidney disease. Multicentric studies have shown great incidence of cardiovascular complications in patients on dialysis. Patients with chronic kidney diseases have 10-20 times greater risk of developing cardiovascular disease in comparison to general population. Risk for starting cardiovascular diseases can be differentiated in patients on continuous ambulatory peritoneal dialysis and patients on hemodialysis, especially in patients who remain on peritoneal dialyses for more than two years and loose the remaining kidney function. Part of cardiovascular damage in patients treated with dialyses is caused by the use of residual renal therapy and question which therapy is more harmful, hemodialysis or peritoneal is very important. Despite the importance of the subject only several studies have been done in comparing cardiovascular test of patients treated with peritoneal dialyses and patients treated by hemodialysis. Our research deals with this issue in particular.
Cardiovascular diseases remain a paramount focus of basic and clinical investigation. They are the leading cause of death in developed countries and their prevalence is increasing in the developing countries. Early detection of the formation and progression of atherosclerotic plaques is therefore essential. Proteomics is a tool designed to address this need at the level of signal transduction, organelle and cellular mechanism and biomarker development. This review examines the increasing use of traditional and novel biomarkers that are transforming cardiovascular medicine.
The Habilitation work reflects the author's activity performed between 2005 and 2013 years, after PhD work, and it is based on the original contributions achieved during research activities in the Institute of Cellular Biology and Pathology ‘Nicolae Simionescu’ of Romanian Academy. Also, there are highlighted author’s managerial competence and presentation ability. The author’s researches in the field of cardiovascular disease bring new scientific contributions for a better understanding of the vascular dysfunction, cardiovascular risk factors, cellular and molecular biomarkers and corresponding therapy. The original articles are in the field of endothelial function/dysfunction, endothelial vasoactive factors, microparticles (MPs) and endothelial progenitor cells (EPCs) as a signature of vascular dysfunction and a repair mechanism in cardiovascular diseases. Also, the effect of some drugs as enoxaparin, nebivolol, irbesartan on the endothelial dysfunction were intensively investigated.
This comprehensive and concise presentation of genetic factors in cardiovascular disease and their response to therapy consolidates knowledge of this high-interest and emerging topic. Covering broad areas of contemporary genomic medicine and specific cardiovascular diseases, this book is a must for anyone seeking to better understand this rapidly developing field.
Preterm birth is associated with several complications and serious infections including sepsis which has been reported among the most important causes of infant death in Saudi Arabia. Gentamicin is an essential drug for proven and suspected sepsis.The main Objective Of this work was done to optimize the use of gentamicin in neonates during the first week of life.And to identify the mosr factors infleuence in pharmacokinetic parametres in this diffeculte group of age.