Psychosocial characteristics predict the development and course of coronary heart disease (CHD). In this review, the authors discussed human and animal research on psychophysiological mechanisms influencing coronary artery disease and its progression to CHD. They then reviewed literature on personality and characteristics of the social environment as risk factors for CHD. Hostility confers increased risk, and a group of risk factors involving depression and anxiety may be especially important following myocardial infarction. Social isolation, interpersonal conflict, and job stress confer increased risk. Psychosocial interventions may have beneficial effects on CHD morbidity and mortality, although inconsistent results and a variety of methodological limitations preclude firm conclusions. Finally, they discussed implications for clinical care and the agenda for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
A variety of studies have suggested that the 4b/a polymorphism in the endothelial nitric oxide synthase (eNOS) was associated with coronary artery disease (CAD) risk. However, the data remain conflicting. The aim of the present meta-analysis was to estimate the overall association between risk of CAD and eNOS 4b/a polymorphism. Case-control, cohort or cross-sectional studies evaluating the association between eNOS 4b/a polymorphism and CAD susceptibility were systematically identified in PubMed up to 31 October 2013. Pooled odds ratios (OR) and corresponding 95% confidence intervals (CIs) were calculated to assess the association in overall and subgroup analyses. A total of 10,617 cases and 8302 controls from 37 studies were included in the study. The results of overall analysis revealed significant positive associations between CAD risk and eNOS 4b/a polymorphism in homozygote comparisons (OR = 1.47, 95% CI = 1.16–1.87), heterozygote comparisons (OR = 1.14, 95% CI = 1.02–1.27) and dominant models (OR = 1.18, 95% CI = 1.06–1.33). In subgroup analyses, similar associations were identified in African individuals, as determined using population-based source subgroups and noted in small-and-moderate sample size subgroups (case sample size or control sample size <500). The current meta-analysis revealed that eNOS 4b/a polymorphisms could be a risk factor for developing CAD, particularly in African populations and population-based subgroups. 相似文献
Endotracheal stenting is a common treatment for tracheal disorders as stenosis, cronic cough or dispnoea episodes. However, medical treatment and surgery are still challenging due to the difficulties in overcoming potential prosthesis complications. In this work we analyze the response of the tracheal wall during breathing and coughing conditions under different stent implantations. A finite element model of a human trachea was developed and used to analyze tracheal deformability after prosthesis implantation under normal breathing and coughing using a fluid-structure interaction approach (FSI). The geometry of the trachea is obtained from computed tomography (CT) images of a healthy patient. A structured hexahedral-based grid for the tracheal wall and an unstructured tetrahedral-based mesh with coincident nodes for the fluid were used to perform the simulations with a finite element-based commercial software code. Tracheal wall is modeled as a fiber reinforced hyperelastic solid material in which the anisotropy due to the orientation of the fibers is taken into account. Deformations of the tracheal cartilage rings and of the muscle membrane, as well as the maximum principal stresses in the wall, are analyzed and compared with those of the healthy trachea in absence of prosthesis. The results showed that, the presence of the stent prevents tracheal muscle deflections especially during coughing. In addition, we proposed a methodology to evaluate, through numerical simulations, the predisposition of the stent to migrate. 相似文献
A new approach is described for reconstructing coronary arteries from two sequences of projection images. The estimation of motion is performed on three-dimensional line segments (or centrelines), and is based on a ‘predictionprojection-optimization’ loop. The method copes with time varying properties, deformations and superpositions of vessels. Experiments using simulated and real data have been carried out. and the results found to be robust over a full cycle of a human heart. Local and global kinetic features can then be derived to obtain a greater insight on the cardiac functional state 相似文献
Soft coatings are widely used to tailor the surface chemistry of materials without altering their bulk properties. However, the strength of adhesion between the coating and the substrate must be high enough for long‐term applications. This has become a major challenge in the medical field, especially for polymer‐coated stents, mainly due to several coating failures reported after mechanical expansion during clinical implantation. In this work, the applicability of current polymer‐metal adhesion tests to polymer‐coated stents is discussed. The small punch test was proposed as an adhesion test that allows fundamental studies on the adhesion and coating properties. This adhesion test was applied to thin fluorocarbon coatings deposited by plasma on 316L stainless steel.
