简介:ObstructiveSleepApnea(OSA)isacommonchronicdisorderthataffects5–10%oftheUSpopulationwithahigherprevalenceinmencomparedtowomenby2:1inpopulationstudies.Bycontrast,inpatientswithcardiovasculardisease,itsprevalencecanexceed50%dependingonthespecificdisordersurveyed.Althoughsexdifferenceshavebeenwelldescribedforcardiovascularriskfactors;existingdataregardingtheimpactofsexontherelationshipbetweenOSAandcardiovascularoutcomesiscontroversial.Similarly,whilethereisstrongevidenceforincreasedprevalenceofcardiovascularconditions,suchassystemichypertension,atrialfibrillation,aswellasheartfailureamongstpatientssufferingfromOSA;conflictingevidenceexistsregardingtheincidenceandbidirectionalrelationshipbetweenthemaswellastheimpactoftreatmentofOSAoncardiovascularoutcomes.Inthispaper,wewillreviewtheassociationsbetweenOSAandcardiovasculardiseasesinwomen.Thedataonsexdifferencesislimited,duetoanumberofreasons,including,butnotlimitedtolatepresentationofOSAinwomen,difficultiesindiagnosingbothOSAandcardiovasculardiseasesinwomenandstillsuboptimalinclusionofadequatenumberofwomeninclinicaltrials.MorestudiesareneededtobetterdelineatesexdifferencesintheclinicalpresentationaswellasthepathophysiologyoftheassociationsbetweenOSAandcardiovasculardiseasessothatwecanprovidepatientswithmorepersonalizedcare.
简介:Depression/anxiety-relateddisordersandpsychosocialstresshavebeenimplicatedascardiovasculardisease(CVD)riskfactors.Womenareatconsiderableriskforaffectivedisordersandreportgreaterseverityfrompsychosocialstress,comparedtomen.Affectivedisordersandcardiovasculardiseaselikelyshareunderlyingpathophysiologicalmechanismsthatarepotentiatedamongwomen–especiallyyoungerwomen.Environmentalstressorsthatthreatenthesafety,security,andstatusofanindividualareappraisedbythebrain,producingacascadeofevokedphysiologicalandcognitiveresponses.Intheshortterm,theseprocessesovercomestressors,butcomewithlong-termhealthimplications.Chronicpsychosocialstressleadstoadysregulationofthestressresponsesystemsthatcanleadtoaheightenedstressappraisalschemacalledtheunpredictabilityschema,aconstructthatmightarguablyplacewomenatheightenedriskforCVD.
简介:Peripartumcardiomyopathy(PPCM)isadisorderinwhichheartfailuredevelopsinthelastmonthofpregnancyorwithinthefirstfivemonthspostpartum.Theexactetiologyisnotknownalthoughrecentstudiessuggestangiogenicimbalanceisakeyfactorwithsolublefms-liketyrosinekinase-1(sFlt1)andacleavedformofprolactinpossiblyplayingimportantroles.Thisreviewdiscussestheepidemiology,riskfactors,diagnosis,treatmentandprognosisofPPCMandhighlightsrecentadvancesinourunderstandingofthisdisorder.
简介:Conventionalrecommendationsfordiagnostictestingfortheevaluationofstableischemicheartdiseaseinwomenhavelargelyparalleledthoseinmen.Althoughtheyaredesignedprimarilyfortheidentificationofobstructivecoronaryarterydisease(CAD),traditionalapproachescanleadtoovertestinginwomenwithoutdifferentiatingwhoistrulyatrisk.Severaluniquefactorsrelatedtothepresentation,diagnosis,andunderlyingpathophysiologyofstableischemicheartdiseaseinwomennecessitateamorespecificapproachtotheassessmentoftheirrisk,completewithseparateguidelineswhenappropriate.Thisoverviewhighlightshowadvancednoninvasiveimagingtools,includingcardiaccomputedtomographyangiography,positronemissiontomography,andcardiacmagneticresonanceimaging,areenablingverysensitiveassessmentsofanatomicatheroscleroticplaqueburden,macrovessel-andmicrovessel-relatedischemia,andmyocardialfibrosis,respectively.Movingforward,effectivediagnostictestingwillneedtoidentifywomenathighriskofadversecardiovascularevents(notanatomicallyobstructiveCADperse)withoutovertestingthoseatlowrisk.JudiciousapplicationofnovelimagingapproacheswillbecriticaltobroadeningthedefinitionsofCADandischemiatobetterreflectthewholespectrumofpathologicalphenotypesinwomen,includingnonobstructiveCADandcoronarymicrovasculardysfunction,andaidinthedevelopmentofneededevidence-basedstrategiesfortheirmanagement.
简介:Sex-specificdifferencesintheepidemiologyandpathophysiologyofcoronaryarterydiseaseandischemicheartdiseasearenowwellrecognized.Womenwithanginamoreoftenhavenonobstructivecoronaryarterydisease(NOCAD)comparedwithmen.Thispatientpopulationcarriesasignificantriskoffuturecardiovasculareventsthatisnotcommonlyappreciated,oftenleadingtodelayeddiagnosisandtreatment.WhilecoronarymicrovasculardysfunctionplaysacentralroleinthepathophysiologyofNOCADinwomen,othermechanismsofmyocardialischemiaarenowrecognized.RiskfactorssuchashypertensionandobesitydisparatelyaffectwomenandarelikelytoaccountforasignificantproportionofNOCADinthecomingyears.VascularinflammationisanimportantpathophysiologicpathwayinNOCADandisapotentialtherapeutictarget.CoronaryCTangiographyprovidesacomprehensiveassessmentofcoronaryanatomyandplaquemorphologyandisareasonablescreeningtestofchoiceforNOCAD.
简介:Adiscrepancyremainsinthefirsttwoleadingempiricalorthogonalfunction(EOF)modesofthetropicalPacificseasurfacetemperatureanomaly(SSTA)basedonobservationssincethe1980s.TheEOF1mode,representingtheElNino-SouthernOscillation(ENSO),isarobustresult.However,theEOF2featureseitherElNinoModoki(EM)orENSOevolutionduringdifferentperiods,whichisprobablyassociatedwiththeimpactsofglobalwarming.TheunderlyingquestioniswhattheEOF2modeofthetropicalPacificwouldbewithoutglobalwarming.UsingtheCMIP5preindustrialscenariotoexcludetheinfluenceofglobalwarming,wefindthattheEOF1modeofthetropicalPacificSSTArepresentsENSOandthattheEOF2modeisnotEM.Accordingtothelead–lagcorrelationbetweentheENSOandEOF2modes,thelinkagebetweenthesetwomodesisasfollows:…ElNino→EOF2→LaNina→–EOF2→ElNino….Byanalyzingtheevolutionofseasurfacetemperature,surfacewind,andsubsurfaceoceantemperatureanomalies,wefindthemechanismlinkingtheENSOandEOF2modesistheair–seainteractionassociatedwiththeENSOcycle.ThisresultsuggeststhattheEOF2moderepresentsanaspectofENSOevolutionunderpreindustrialconditions.Therefore,thisstudyfurtherindicatesthattheEMisprobablyduetotheinfluenceofglobalwarming.
简介:ThisstudydevelopedapopulationpharmacokineticmodelforsodiumtanshinoneIIAsulfonate(STS)inhealthyvolunteersandcoronaryheartdisease(CHD)patientsinordertoidentifysignificantcovariatesforthepharmacokineticsofSTS.Bloodsampleswereobtainedbyintensesamplingapproachfrom10healthyvolunteersandsparsesamplingfrom25CHDpatients,andapopulationpharmacokineticanalysiswasperformedbynonlinearmixed-effectmodeling.Thefinalmodelwasevaluatedbybootstrapandvisualpredictivecheck.Atotalof230plasmaconcentrationswereincluded,137fromhealthyvolunteersand93fromCHDpatients.Itwasatwo-compartmentmodelwithfirst-orderelimination.Thetypicalvalueoftheapparentclearance(CL)ofSTSinCHDpatientswithtotalbilirubin(TBIL)levelof10μmol(L?1was48.7L(h?1withinterindividualvariabilityof27.4%,whereasthatinhealthyvolunteerswiththesameTBILlevelwas63.1L(h?1.Residualvariabilitywasdescribedbyaproportionalerrormodelandestimatedat5.2%.TheCLofSTSinCHDpatientswaslowerthanthatinhealthyvolunteersanddecreasedwhenTBILlevelsincreased.Thebootstrapandvisualpredictivecheckconfirmedthestabilityandvalidityofthefinalmodel.TheseresultssuggestedthatSTSdosageadjustmentmightbeconsideredbasedonTBILlevelsinCHDpatients.
简介:美国加利福尼亚州圣克拉拉市的GlobalFoundries公司与一家为硅芯片提供光输入/输出(I/O)的初创公司AyarLabs宣布开展战略合作,共同开发和商业化硅光子技术差异化的解决方案。这两家公司将使用GF的45nmCMOS制造工艺开发和制造Ayar的新型CMOS光学I/O技术,这项技术提供了铜I/O的替代方案,可提供高达十倍的带宽和五倍的低功耗。这种经济高效的解决方案与ASIC作为多芯片模块集成在一起,可以提高云服务器,数据中心和超级计算机的数据速度和能效。作为协议的一部分,GF公司还在AyarLabs投资了一笔未公开的资金。