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  • 1
    Online Resource
    Online Resource
    Cardiac Computed Tomography Angiography in CAD Risk Stratification and Revascularization Planning
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 18 ( 2023-09-11), p. 2902-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 18 ( 2023-09-11), p. 2902-
    Abstract: Purpose of Review: Functional stress testing is frequently used to assess for coronary artery disease (CAD) in symptomatic, stable patients with low to intermediate pretest probability. However, patients with highly vulnerable plaque may have preserved luminal patency and, consequently, a falsely negative stress test. Cardiac computed tomography angiography (CCTA) has emerged at the forefront of primary prevention screening and has excellent agency in ruling out obstructive CAD with high negative predictive value while simultaneously characterizing nonobstructive plaque for high-risk features, which invariably alters risk-stratification and pre-procedural decision making. Recent Findings: We review the literature detailing the utility of CCTA in its ability to risk-stratify patients with CAD based on calcium scoring as well as high-risk phenotypic features and to qualify the functional significance of stenotic lesions. Summary: Calcium scores ≥ 100 should prompt consideration of statin and aspirin therapy. Spotty calcifications 〈 3 mm, increased non-calcified plaque 〉 4 mm3 per mm of the vessel wall, low attenuation 〈 30 HU soft plaque and necrotic core with a rim of higher attenuation 〈 130 HU, and a positive remodeling index ratio 〉 1.1 all confer additive risk for acute plaque rupture when present. Elevations in the perivascular fat attenuation index 〉 −70.1 HU are a strong predictor of all-cause mortality and can further the risk stratification of patients in the setting of a non-to-minimal plaque burden. Lastly, a CT-derived fractional flow reserve (FFRCT) 〈 0.75 or values from 0.76 to 0.80 in conjunction with additional risk factors is suggestive of flow-limiting disease that would benefit from invasive testing. The wealth of information available through CCTA can allow clinicians to risk-stratify patients at elevated risk for an acute ischemic event and engage in advanced revascularization planning.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13182902
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 2
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    Online Resource
    Mutational Analysis of EGFR Mutations in Non-Small Cell Lung Carcinoma—An Indian Perspective of 212 Patients
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 1 ( 2022-12-31), p. 758-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 1 ( 2022-12-31), p. 758-
    Abstract: Lung cancer is the world’s leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is one of the critical oncogenes and plays a significant role in tumor proliferation and metastasis. Patients with sensitizing mutations in the EGFR gene have better clinical outcomes when treated with tyrosine kinase inhibitors (TKI). This study expands our knowledge of the spectrum of EGFR mutations among lung cancer patients in the Indian scenario. This is a retrospective descriptive study of all newly diagnosed patients with lung cancer in tertiary care hospital in India. All the samples were subjected to real-time PCR (q-PCR) analysis and confirmation of rare novel mutations was done using Sanger sequencing. Clinicopathological characteristics, mutational EGFR status, and location on the exon and metastatic sites were evaluated. An analysis of total 212 samples showed mutations in 38.67% of cases. Among these, five (5.9%) samples had mutations in exon 18, 41 (48.8%) samples had mutations in exon 19, 12 (14.28%) samples had mutations in exon 20, and 26 (30.95%) samples had mutations in exon 21. Eleven (13.41%) were found to be uncommon EGFR mutations. Additionally, six (21.4%) samples that had EGFR mutations were also positive for brain metastasis. Future testing on bigger panels will help to characterize the incidence of genetic mutations and to determine the appropriate targeted treatment choices for NSCLC patients.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20010758
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 3
    Online Resource
    Online Resource
    Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence
    MDPI AG ; 2015
    In:  Nutrients Vol. 7, No. 10 ( 2015-10-06), p. 8424-8430
    Details
    In: Nutrients, MDPI AG, Vol. 7, No. 10 ( 2015-10-06), p. 8424-8430
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu7105404
    Language: English
    Publisher: MDPI AG
    Publication Date: 2015
    detail.hit.zdb_id: 2518386-2
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  • 4
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    Online Resource
    An Epidemiological Analysis of SARS-CoV-2 Genomic Sequences from Different Regions of India
    MDPI AG ; 2021
    In:  Viruses Vol. 13, No. 5 ( 2021-05-17), p. 925-
    Details
    In: Viruses, MDPI AG, Vol. 13, No. 5 ( 2021-05-17), p. 925-
    Abstract: The number of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases is increasing in India. This study looks upon the geographic distribution of the virus clades and variants circulating in different parts of India between January and August 2020. The NPS/OPS from representative positive cases from different states and union territories in India were collected every month through the VRDLs in the country and analyzed using next-generation sequencing. Epidemiological analysis of the 689 SARS-CoV-2 clinical samples revealed GH and GR to be the predominant clades circulating in different states in India. The northern part of India largely reported the ‘GH’ clade, whereas the southern part reported the ‘GR’, with a few exceptions. These sequences also revealed the presence of single independent mutations—E484Q and N440K—from Maharashtra (first observed in March 2020) and Southern Indian States (first observed in May 2020), respectively. Furthermore, this study indicates that the SARS-CoV-2 variant (VOC, VUI, variant of high consequence and double mutant) was not observed during the early phase of virus transmission (January–August). This increased number of variations observed within a short timeframe across the globe suggests virus evolution, which can be a step towards enhanced host adaptation.
    Type of Medium: Online Resource
    ISSN: 1999-4915
    URL: Article
    DOI: 10.3390/v13050925
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2516098-9
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  • 5
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    Online Resource
    Sugar-Sweetened Beverage Consumption and Calcified Atherosclerotic Plaques in the Coronary Arteries: The NHLBI Family Heart Study
    MDPI AG ; 2021
    In:  Nutrients Vol. 13, No. 6 ( 2021-05-22), p. 1775-
    Details
    In: Nutrients, MDPI AG, Vol. 13, No. 6 ( 2021-05-22), p. 1775-
    Abstract: Background: Sugar-sweetened beverage (SSB) intake is associated with higher risk of weight gain, diabetes, hypertension, cardiovascular disease, and cardiovascular mortality. However, the association of SSB with subclinical atherosclerosis in the general population is unknown. Objective: Our primary objective was to investigate the association between SSB intake and prevalence of atherosclerotic plaque in the coronary arteries in The National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. Methods: We studied 1991 participants of the NHLBI Family Heart Study without known coronary heart disease. Intake of SSB was assessed through a semi-quantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac Computed Tomography (CT) and prevalent CAC was defined as an Agatston score ≥100. We used generalized estimating equations to calculate adjusted prevalence ratios of CAC. A sensitivity analysis was also performed at different ranges of cut points for CAC. Results: Mean age and body mass index (BMI) were 55.0 years and 29.5 kg/m2, respectively, and 60% were female. In analysis adjusted for age, sex, BMI, smoking, alcohol use, physical activity, energy intake, and field center, higher SSB consumption was not associated with higher prevalence of CAC [prevalence ratio (95% confidence interval) of: 1.0 (reference), 1.36 (0.70–2.63), 1.69 (0.93–3.09), 1.21 (0.69–2.12), 1.05 (0.60–1.84), and 1.58 (0.85–2.94) for SSB consumption of almost never, 1–3/month, 1/week, 2–6/week, 1/day, and ≥2/day, respectively (p for linear trend 0.32)] . In a sensitivity analysis, there was no evidence of association between SSB and prevalent CAC when different CAC cut points of 0, 50, 150, 200, and 300 were used. Conclusions: These data do not provide evidence for an association between SSB consumption and prevalent CAC in adult men and women.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu13061775
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 6
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    Online Resource
    Application of a Scorecard Tool for Assessing and Engaging Media on Responsible Reporting of Suicide-Related News in India
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 12 ( 2021-06-08), p. 6206-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 12 ( 2021-06-08), p. 6206-
    Abstract: Background: Each year there are more than 800,000 deaths by suicide across the world, while India alone accounts for one third of female suicides and one fourth of male suicides worldwide. Responsible media reporting of suicide is an important suicide prevention intervention at the population level. There is sufficient evidence to show that the way suicide is reported and portrayed in the media can have a significant impact on individuals experiencing suicidal thoughts and behaviors. Recognizing the important role of the media in suicide prevention, the World Health Organization (WHO) issued guidelines for responsible reporting of suicides by the media. The Press Council of India, in 2019 endorsed WHO’s guidelines for media reporting of suicides, however there is no evidence that the Indian media is complying with these guidelines. Methods: To encourage responsible media reporting, we developed a scorecard to assess and rate media reports on suicide. We reviewed several resource documents that contained guidelines on responsible reporting of suicide. After consulting with a team of experts, we arrived at a scorecard that consisted of 10 positive and 10 negative parameters. Results: We applied the scorecard to 1318 reports on suicide from 9 English language newspapers, with the highest readership in India between the dates of 1 April to 30 June 2020. For the articles analyzed, the average positive score across all newspapers was 1.32 and the average negative score was 3.31. Discussion: The scorecard can be a useful tool to assess media reports on suicide and provide metrics for the same. It can facilitate improved monitoring and engagement with media organizations, who can quickly check their own reporting compliance to the WHO guidelines and compare how well they are performing compared to their peers over time.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18126206
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 7
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    Sodium Intake and Heart Failure
    MDPI AG ; 2020
    In:  International Journal of Molecular Sciences Vol. 21, No. 24 ( 2020-12-13), p. 9474-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 21, No. 24 ( 2020-12-13), p. 9474-
    Abstract: Sodium is an essential mineral and nutrient used in dietary practices across the world and is important to maintain proper blood volume and blood pressure. A high sodium diet is associated with increased expression of β—myosin heavy chain, decreased expression of α/β—myosin heavy chain, increased myocyte enhancer factor 2/nuclear factor of activated T cell transcriptional activity, and increased salt-inducible kinase 1 expression, which leads to alteration in myocardial mechanical performance. A high sodium diet is also associated with alterations in various proteins responsible for calcium homeostasis and myocardial contractility. Excessive sodium intake is associated with the development of a variety of comorbidities including hypertension, chronic kidney disease, stroke, and cardiovascular diseases. While the American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines recommend limiting sodium intake to both prevent and manage heart failure, the evidence behind such recommendations is unclear. Our review article highlights evidence and underlying mechanisms favoring and contradicting limiting sodium intake in heart failure.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms21249474
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 8
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    Online Resource
    Enhanced Throughput for Electrokinetic Manipulation of Particles and Cells in a Stacked Microfluidic Device
    MDPI AG ; 2016
    In:  Micromachines Vol. 7, No. 9 ( 2016-09-01), p. 156-
    Details
    In: Micromachines, MDPI AG, Vol. 7, No. 9 ( 2016-09-01), p. 156-
    Type of Medium: Online Resource
    ISSN: 2072-666X
    URL: Article
    DOI: 10.3390/mi7090156
    Language: English
    Publisher: MDPI AG
    Publication Date: 2016
    detail.hit.zdb_id: 2620864-7
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  • 9
    Online Resource
    Online Resource
    Mediterranean, DASH, and Alternate Healthy Eating Index Dietary Patterns and Risk of Death in the Physicians’ Health Study
    MDPI AG ; 2021
    In:  Nutrients Vol. 13, No. 6 ( 2021-05-31), p. 1893-
    Details
    In: Nutrients, MDPI AG, Vol. 13, No. 6 ( 2021-05-31), p. 1893-
    Abstract: Objective: Our primary objective was to examine the associations of the Mediterranean (MED), the Dietary Approaches to Stop Hypertension (DASH), and the Alternate Healthy Eating Index (AHEI) diet with total mortality. Our secondary objective was to examine the association of these three dietary patterns with cardiovascular disease (CVD) and cancer mortality. Research: Design and Methods: We prospectively studied 15,768 men from the Physicians’ Health Study who completed a semi-quantitative food-frequency questionnaire. Scores from each dietary pattern were divided into quintiles. Multivariable Cox regression models were used to estimate hazard ratio’s (95% confidence intervals) of mortality. Results: At baseline, average age was 65.9 ± 8.9 years. There were 1763 deaths, including 488 CVD deaths and 589 cancer deaths. All diet scores were inversely associated with risk for all-cause mortality: Hazard ratios (95% CI) of all-cause mortality from lowest to highest quintile for MED diet were 1.0 (reference), 0.85 (0.73–0.98), 0.80 (0.69–0.93), 0.77 (0.66–0.90), and 0.68 (0.58–0.79); corresponding values were 1.0 (reference), 0.96 (0.82–1.12), 0.95 (0.82–1.11), 0.88 (0.75–1.04), and 0.83 (0.71–0.99) for DASH diet and 1.0 (reference), 0.88 (0.77–1.02), 0.82 (0.71–0.95), 0.69 (0.59, 0.81), and 0.56 (0.47–0.67) for AHEI diet, after adjusting for age, energy, smoking, exercise, BMI, hypertension, coronary heart disease, congestive heart failure, diabetes, and atrial fibrillation. For cause-specific mortality, MED and AHEI scores were inversely associated with lower risk for CVD mortality, whereas AHEI and MED scores were inversely associated with lower risk for cancer mortality. Conclusion: Within this cohort of male physicians, AHEI, MED, and DASH scores were each inversely associated with mortality from all causes.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu13061893
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 10
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    Advancement in Solubilization Approaches: A Step towards Bioavailability Enhancement of Poorly Soluble Drugs
    MDPI AG ; 2023
    In:  Life Vol. 13, No. 5 ( 2023-04-27), p. 1099-
    Details
    In: Life, MDPI AG, Vol. 13, No. 5 ( 2023-04-27), p. 1099-
    Abstract: A drug’s aqueous solubility is defined as the ability to dissolve in a particular solvent, and it is currently a major hurdle in bringing new drug molecules to the market. According to some estimates, up to 40% of commercialized products and 70–90% of drug candidates in the development stage are poorly soluble, which results in low bioavailability, diminished therapeutic effects, and dosage escalation. Because of this, solubility must be taken into consideration when developing and fabricating pharmaceutical products. To date, a number of approaches have been investigated to address the problem of poor solubility. This review article attempts to summarize several conventional methods utilized to increase the solubility of poorly soluble drugs. These methods include the principles of physical and chemical approaches such as particle size reduction, solid dispersion, supercritical fluid technology, cryogenic technology, inclusion complex formation techniques, and floating granules. It includes structural modification (i.e., prodrug, salt formation, co-crystallization, use of co-solvents, hydrotrophy, polymorphs, amorphous solid dispersions, and pH variation). Various nanotechnological approaches such as liposomes, nanoparticles, dendrimers, micelles, metal organic frameworks, nanogels, nanoemulsions, nanosuspension, carbon nanotubes, and so forth have also been widely investigated for solubility enhancement. All these approaches have brought forward the enhancement of the bioavailability of orally administered drugs by improving the solubility of poorly water-soluble drugs. However, the solubility issues have not been completely resolved, owing to several challenges associated with current approaches, such as reproducibility in large scale production. Considering that there is no universal approach for solving solubility issues, more research is needed to simplify the existing technologies, which could increase the number of commercially available products employing these techniques.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life13051099
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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