This study evaluates the effectiveness of refined nursing care in improving psychological well-being, medication adherence, and quality of life in patients with coronary heart disease (CHD) and angina pectoris and examines the moderating influence of social support on these outcomes. A retrospective cohort study was conducted involving CHD patients who received either refined nursing care or standard nursing during hospitalization and follow-up. Refined nursing care included psychological counseling, structured health education, personalized lifestyle guidance, and family-centered support. Patients were assessed for anxiety and depression using the GAD-7 and PHQ-9 scales, respectively. Medication adherence and quality of life were measured using validated tools. Propensity score matching (PSM) was applied to minimize baseline differences. Comparative and regression analyses were used to assess outcomes and interaction effects. A total of 90 matched patients (45 in each group) were included in the final analysis. Patients receiving refined nursing care showed greater reductions in anxiety (mean change: -2.2, P < .05) and depression scores (-3.0, P < .05) compared to controls. Social support significantly enhanced the psychological benefits of refined nursing care (P < .001). Medication adherence improved notably in the refined care group (P < .05), with moderate correlations observed between reduced psychological distress and better adherence. Quality of life also improved more significantly in the refined group (P = .03). Notably, psychological benefits were evident even among patients without improvements in cardiac function. Refined nursing care effectively improves psychological status, enhances medication adherence, and promotes quality of life in CHD patients. Strong social support amplifies these effects. These findings support the integration of comprehensive, patient-centered nursing models into routine cardiovascular care.

To assess the effect of nurse-led cardiac rehabilitation programs on improving the quality of life of elderly patients with coronary artery disease (CAD). This single-center retrospective cohort study included elderly CAD patients hospitalized and followed at our hospital from June 2022 to June 2024. Based on receipt of a nurse-led rehabilitation program, patients were assigned to a rehabilitation or conventional group. Propensity score matching (1:1 nearest neighbor) was performed using variables including age, gender, major comorbidities (hypertension, diabetes, and hyperlipidemia), body mass index, smoking status, NYHA class, left ventricular ejection fraction, history of percutaneous coronary intervention/coronary artery bypass grafting, and baseline medication use. The program comprised individualized assessment and goal setting before discharge, plus remote support, and self-management training after discharge. Primary outcome was the SF-36 quality of life score; secondary outcomes were Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Six-Minute Walk Test. Assessments were at discharge, 3 months, and 6 months. After matching, baseline characteristics were balanced between the 2 groups. There were no significant differences between the rehabilitation group and the conventional group in age (71.6 ± 6.4 vs 72.1 ± 6.1 years), gender (male 61.3% vs 64.5%), comorbidity of hypertension (72.6% vs 75.8%), and percutaneous coronary intervention ratio (50.0% vs 48.4%) (all P > .05). At 6 months of follow-up, the rehabilitation group showed a significant improvement in SF-36 total score (from 58.2 ± 7.4-75.6 ± 5.8), which was better than the conventional group (from 57.6 ± 6.9-65.2 ± 6.5) (interaction P = .023). The most significant improvements were observed in physical function and social function (interaction P = .017 and 0.026, respectively). The physical function score in the rehabilitation group at 6 months was 78.9 ± 6.2, significantly higher than the conventional group's score of 68.5 ± 6.9. The Generalized Anxiety Disorder-7 score in the rehabilitation group decreased from a median of 7 at discharge to 3 at 6 months (IQR 2-5), while the conventional group remained at 6 (IQR 4-8), with a significant difference (P < .01). A similar trend was observed in Patient Health Questionnaire-9 scores. The 6-minute walking distance also showed greater improvement in the rehabilitation group (from 298.5 ± 45.2-385.7 ± 38.4 m, P < .001). Nurse-led cardiac rehabilitation significantly improves quality of life, reduces anxiety and depression, and enhances functional capacity in elderly CAD patients, supporting its broader clinical application.

This study investigates the clinical characteristics and prognosis of convulsive status epilepticus combined with deep venous thrombosis (CSE-DVT) in children. We retrospectively analyzed the data of CSE-DVT (n = 10) and nonconvulsive DVT (n = 31) admitted to Wuhan Children's Hospital between January 2014 and May 2023. In the CSE-DVT group, 10 cases (5 males, 5 females) were studied, with a median age of 3.2 years (range 0.2-12.5 years). All of them developed unilateral lower extremity DVT and had markedly elevated levels of serum D-dimers. In the nonconvulsive DVT group, 31 cases (20 males, 11 females) were studied, with a median age of 2.0 years (range 0.1-13.0 years). Fifteen cases (48.3%) developed unilateral lower extremity DVT. Twenty-three cases (74.2%) had markedly elevated levels of serum D-dimers. Compared with the nonconvulsive DVT group, the CSE-DVT group had a larger case number of ventilator support, infection, and intravenous nutrition support (P < .05). The CSE-DVT group also had a higher blood platelet count and antithrombin-III, but the activated partial thromboplastin time was shorter than that in the nonconvulsive DVT group (P < .05). The mean period of follow-up was 6 ± 2 months. In the CSE-DVT group, none of them had a pulmonary embolism, and 5 cases (50%) had a thrombus-absorbed state. In the nonconvulsive DVT group, 16 patients (51.6%) had a thrombus-absorbed state, and 2 cases (6.4%) had a pulmonary embolism. The deep vein of the lower extremity is the most common site in children diagnosed with CSE-DVT whose D-dimers are markedly elevated. The effective methods to improve prognosis in patients are early diagnosis and timely treatment.

The association between hypertension and kidney stones remains inconsistent. This research investigated the relationship between hypertension and the risk and progression of kidney stones.

A cross-sectional analysis was performed using data from the National Health and Nutrition Examination Survey (NHANES). The association was assessed with a multivariable logistic regression model. Furthermore, a two-sample Mendelian randomization (MR) analysis was conducted to evaluate causality. Methods included inverse-variance weighted (IVW), weighted median, and sensitivity analyses. Summary-level data for kidney stones were obtained from the UK Biobank, and for hypertension from a genome-wide association study (GWAS)analysis.

The NHANES analysis included 21,740 participants. After full adjustment, hypertension was significantly associated with a higher prevalence of kidney stones (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.19-1.56, p < 0.001). In the MR analysis, the IVW method indicated a causal effect of hypertension on kidney stones (OR = 1.01, 95% CI: 1.00-1.01, p = 0.013), supported by the weighted median method (OR = 1.01, 95% CI: 1.00-1.02, p = 0.002). Sensitivity analyses revealed no significant heterogeneity or pleiotropy.

Our investigation revealed a heightened risk of kidney stones linked to hypertension, which necessitates validation through further large-scale prospective cohort studies.

To explore the feasibility and safety of performing a complete thoracoscopic ultrasonic scalpel procedure to harvest the left internal mammary artery (LIMA) during minimally invasive coronary artery bypass grafting (CABG) in high-risk patients.

This retrospective study compiled data from patients who underwent minimally invasive CABG with LIMA harvesting via thoracoscopic ultrasonic scalpel at the Department of Cardiothoracic Surgery, D'E Hospital, from January 2022 to July 2023.

The study comprised eight patients with STS scores ≥ 7, among whom three were over 80 years old and five had low left ventricular ejection fractions (LVEF). The median operation duration was 220 min (range: 175-270), and all patients underwent single-vessel grafting. For patients with multiple lesions in addition to left anterior descending (LAD) lesions, 5 patients underwent hybrid procedures; for non-LAD lesions, elective Percutaneous Coronary Intervention (PCI) was performed. The LIMA pulsatility index exceeded 1.0 in all cases. Median blood loss was 26 ml (range: 7-300). The median durations of endotracheal intubation and chest drainage were 69 h (range: 12-144) and 25 h (range: 16-36), respectively. Immediate postoperative LVEF averaged 34% (range: 20%-70%). ICU stay and hospitalization lasted for a median of 132.5 h (range: 71-212) and 7 days (range: 6-16), respectively. Complications included atrial fibrillation in one patient, as well as pneumonia and new-onset heart failure in another.

The study suggests that the complete thoracoscopic ultrasonic scalpel-assisted LIMA harvesting in high-risk surgical patients undergoing minimally invasive single-vessel CABG surgery has the potential to be a feasible and safe approach. Further research and larger studies are warranted to confirm these preliminary results.

Physiologic pacing is increasingly used as an alternative when there is a failure in cardiac resynchronization therapy, with more challenging situations expected consequently.

An 83 year-old Caucasian man underwent attempted cardiac resynchronization therapy, but was found to have a persistent left superior vena cava and absence of a right superior vena cava. In addition, no suitable coronary sinus veins were found. Instead, conduction system pacing with a modified approach was used.

The presence of left superior vena cava is compatible with safe implantation of conduction system pacing, using conventional tools and with mild modification of typical technique.

Migraine-like headaches can accompany or be the initial manifestation of many neurological disorders. When a migraine-like headache develops or worsens in the presence of another neurological disorder, there is often uncertainty about whether the headache is true migraine (i.e., the primary headache) or is a secondary headache with migraine-like symptoms. To answer this question, we analyzed headache characteristics and the effect of treatment in several neurological disorders.

The study was a retrospective analysis of five existing datasets collected by the authors: 1) 670 patients with acute ischemic cerebrovascular disease (550 patients with first-ever ischemic stroke, mean age 63.1 years, 46% females and 120 patients with transient ischemic attacks-TIA, mean age 56.1 years, 54.2% females); 2) 199 patients with intracranial saccular aneurysms (mean age 43.2 years, 52% females); 3) 77 patients with newly diagnosed definite idiopathic intracranial hypertension (IIH) (mean age 28.8 years, 96% females); 4) 169 patients with post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI) (mean age 41.5 years, 52.1% females); 5) 59 patients with PTH followed prospectively with a focus on treatment response to prophylactic migraine medication (mean age 37.1 years, 78% females). Detailed information about headache characteristics and outcomes were collected.

Our results demonstrate that a headache phenotypically fulfilling the diagnostic criteria for 1.1 Migraine without aura and/or 1.2 Migraine with aura can be due to a causative disorder with the following incidence: 13.3% in TIA, 6.9% in ischemic stroke, 44.2% in saccular intracranial aneurysm, 51.9% in IIH, 70.8% in acute PTH, and 90% in persistent PTH. Among individuals who had acute headache following stroke, 45.4% developed persistent headache. These headaches attributed to a secondary cause often responded poorly to migraine treatment, at least suggesting that they differ from primary migraine. The migraine-like headaches disappeared after treatment or remission of the causative disorder in 38.5% of cases with IIH, and 47.7% after clipping of intracranial aneurysms, an outcome that would not be expected if the headaches were primary migraine.

Our study supports the ICHD-3 statement that migraine-like headache attributed to a secondary cause should be coded as a secondary headache of the migraine type and that it is a migraine mimic attributed to a causative disorder.

To address the limited evidence in Asian populations, we aimed to elucidate the association of weight changes from young to middle adulthood with blood pressure and hypertension among Chinese adults.

We used data from the China Health Evaluation and Risk Reduction Through Nationwide Teamwork (ChinaHEART) project conducted in Shandong Province, China between December 2015 and November 2022. Within the ChinaHEART project, participants aged 35 to 64 years were selected, and standardised measurements (including questionnaires, physical examinations, and laboratory measurements) were performed. We used multivariable adjusted restricted cubic splines, linear regression models and logistic regression models for analysis.

We included 56 459 participants for analysis. Compared to stable normal weight, all other weight trajectories (maximum overweight, obesity to non-obesity, non-obesity to obesity, and stable obesity) showed positive associations with systolic and diastolic blood pressure. Hypertension risk increased progressively across these groups, with adjusted odds ratios (OR) of 1.83 (95% confidence interval (CI) = 1.73, 1.94), 2.29 (95% CI = 1.81, 2.89), 3.88 (95% CI = 3.62, 4.17), and 4.96 (95% CI = 4.09, 6.00), respectively.

Weight gain from young to middle adulthood independently predicts elevated blood pressure and hypertension. Public health strategies should prioritise weight management across the life course to mitigate hypertension burden.

Impaired cerebrospinal fluid (CSF) dynamics may contribute to dementia, but human evidence is limited. We examined associations between magnetic resonance imaging-based proxies of CSF dynamics and incident dementia, and whether CSF dysfunction mediates links between cardiovascular risk and dementia.

Using the UK Biobank, we measured CSF dynamics: perivascular space (PVS) volume, diffusion tensor image analysis along the PVS (DTI-ALPS), blood oxygen level-dependent CSF (BOLD-CSF) coupling, and choroid plexus (CP) volume. We assessed cardiovascular risk factors and their associations with CSF dynamics and dementia based on general practitioner, mortality, and hospital records. Mediation analysis evaluated CSF dysfunction in cardiovascular risk-dementia relationships.

Lower DTI-ALPS, lower BOLD-CSF coupling, and higher CP volume predicted dementia, but PVS volume did not. DTI-ALPS and CP volume mediated the effect of white matter hyperintensities and diabetes duration on dementia.

Impaired CSF dynamics may lead to dementia and partially mediate cardiovascular risk-dementia associations.

We developed fully automated methods for quantifying diffusion tensor image analysis along the perivascular space (DTI-ALPS) and blood oxygen level-dependent cerebrospinal fluid (BOLD-CSF) coupling. Three CSF dynamics markers-BOLD-CSF coupling, DTI-ALPS, and choroid plexus (CP) volume-were predictive of incident dementia, whereas PVS volume was not. Magnetic resonance imaging proxies of CSF dynamics markers were associated with cardiovascular injury. CP volume and DTI-ALPS mediated the associations of both white matter hyperintensities and diabetes with dementia.

Hypertension (HTN) and atrial fibrillation (AF) are prevalent cardiovascular disorders that significantly increase the risk of serious complications such as stroke and heart failure, leading to elevated mortality rates. Despite the established relationship between HTN and AF, there is a lack of comprehensive evidence on mortality trends and disparities across various demographic groups in the United States.

This study aims to analyze the nationwide mortality trends due to HTN-AF from 1999 to 2020 and to identify disparities across different demographics. The goals include understanding the impact of HTN-AF on public health and informing targeted screening and therapeutic strategies.

Data on mortality figures related to HTN and AF were obtained from the Centers for Disease Control and Prevention's (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) database. The analysis included age-adjusted mortality rates (AAMR) and crude mortality rates (CMR) stratified by gender, age, race/ethnicity, and geographic regions. The Joinpoint software was used to analyze temporal trends in age-adjusted mortality rate (AAMR). Data were obtained from publicly available multiple causes of death records via the CDC WONDER database.

From 1999 to 2020, the AAMR due to hypertension-attributable factors rose sharply from 2.89 to 23.98 per 100,000 (APC: 4.8 %). Males had higher AAMRs than females, with Black or African American populations seeing the steepest increases. Regionally, the West had the highest AAMR, and rural areas experienced the most significant rise, with micropolitan areas showing the highest APC.

HTN-AF mortality has been increasing steadily across all genders, races, and regions. The study underscores the importance of improving healthcare policies, bridging coverage gaps, and enhancing education and awareness to curb these alarming trends. Addressing the disparities in healthcare access and promoting cardiovascular health initiatives are crucial for reducing HTN-AF-related mortality.