Journal of Translational Internal Medicine

Open Access Published by De Gruyter Open Access

Volume 4 Issue 1 - Special Issue Title: A special issue on cardiovascular disease (Guest Editor: Yaling Han)

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Contents
Journal Overview

Editorial

Open Access April 14, 2016

Identifying the optimal blood pressure target for ideal health

Xianglin Zhang, Fangfang Fan, Yong Huo, Xiping Xu

Page range: 1-6

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Perspective

Open Access April 14, 2016

Aspirin resistance in coronary heart disease: Current understandings and strategies

Ya-ling Han

Page range: 7-10

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Perspective

Open Access April 14, 2016

China may hold answers to addressing cardiovascular disease epidemic

Richard A. Chazal

Page range: 11-13

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Perspective

Open Access April 14, 2016

Pay for performance and the management of hypertension

Rachel Foskett-Tharby, Nick Hex, Paramjit Gill

Page range: 14-19

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Review Article

Open Access April 14, 2016

Dietary cholesterol and egg yolk should be avoided by patients at risk of vascular disease

J. David Spence

Page range: 20-24

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Abstract

Recent recommendations that limits to dietary cholesterol be dropped were probably heavily influenced by propaganda from the egg industry. After conviction for false advertising, the industry has spent hundreds of millions of dollars to convince the public, physicians, and policy makers that dietary cholesterol and egg yolk are harmless. However, there are good reasons for longstanding recommendations that dietary cholesterol be limited to <200 mg/ day in persons at risk of vascular disease. It is seldom understood that this essentially means all people in developed countries who expect to attain an advanced age. There is abundant evidence that dietary cholesterol increases cardiovascular risk. The misdirection of the egg industry focuses on fasting levels of LDL cholesterol, which are only raised by ~ 10% by consumption of egg yolks. However, the main effect of diet is on the post-prandial state: for ~ 4 hours after a high fat/high cholesterol meal, there is oxidative stress, endothelial dysfunction, and arterial inflammation. One large (65 g) egg yolk contains 237 mg of cholesterol, well above the recommended limit—nearly as much as a 12-ounce hamburger. Besides the very high cholesterol content of egg yolk, the phosphatidylcholine in egg yolk leads, via action of the intestinal microbiome, to production of trimethylamine n-oxide (TMAO), which causes atherosclerosis in animal models. Levels of TMAO in the top quartile after a test dose of two egg yolks were associated with a 2.5-fold increase in the 3-year risk of stroke, death, or myocardial infarction among patients referred for coronary angiography. Persons at risk of cardiovascular disease should limit their intake of cholesterol and egg yolk.

Original Article

Open Access April 14, 2016

Anticoagulant therapy for non-ST-segment elevation acute coronary syndrome in China: A multi-center observational study

Xiao-huan Gong, Jin-ming Yu, Yong Mao, Da-yi Hu

Page range: 25-28

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Abstract

Objective To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. Methods A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI. Results A lower incidence rate ( P < 0.05) was noted for efficacy and safety in patients with unstable angina (UA) than those with non-ST-segment elevation myocardial infarction (NSTE-MI). The prescription rate of unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), fondaparinux, PCI, and single medication was 0.61%, 66.42%, 30.61%, 69.64%, and 70.74%, respectively. Conclusion Compared with NSTE-MI, UA is featured with better prognosis, less severity, and different outcome. However, in clinical practice, the therapies for NSTE-MI and UA show no differences, which deserves great attention. In China, the most common anticoagulant therapies for NSTE-ACS are single medication, mainly based on LMWH and PCI.

Original Article

Open Access April 14, 2016

Medicolegal implications of radial and femoral access for coronary angiography and intervention in 2016: Focus on retroperitoneal hemorrhage

Konstantinos V. Voudris, Mladen I. Vidovich

Page range: 29-34

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Abstract

Background and Objectives Retroperitoneal hemorrhage is a rare but serious complication of transfemoral approach (TFA) and TFA percutaneous coronary intervention (PCI). Radial approach for coronary angiography and intervention (transradial approach, TRA) is associated with lower access site complications and reduced blood transfusion rates. Retroperitoneal bleeding has not been described with TRA. This study sought to evaluate the relationship between femoral access for coronary angiography (TFA) and PCI-induced retroperitoneal hemorrhage and the resulting medical litigation in the United States. Methods From 342 lawsuit claim records identified in LexisNexis database search, 17 cases of TFA and TFAPCI-related retroperitoneal hemorrhage decided between 1995 and 2015 were included in the study. Claims were thoroughly reviewed and information about the date the case was decided, patient outcome, the plaintiff, the defendant, the claim, and the trial outcome were extracted. Results The most common filled claim was medical malpractice (53% of the cases), followed by wrongful death (18%) and review of the Commissioner's decision to deny the application for supplemental security income (12%). Forty-seven percent of the cases were won by the defense, 29% by the plaintiff, and 24% were remanded for a new trial. In 82% of the cases, physicians were sued, but only 14% of the cases were won by the plaintiff. In 59% of the claims, the patient died; however, 70% of those cases were decided in favor of the defending physician and hospital. Conclusion Retroperitoneal hemorrhage is an uncommon complication of TFA and TFA PCI and is associated with high mortality rates. Physicians should able to identify this complication early and address it in a timely manner based on the applicable standard of care. TRA and TRA PCI is a reliable alternative and may potentially reduce medicolegal liability related to access site choice.

Training Course

Open Access April 14, 2016

Aortic aneurysm

Atul Mathur, Varun Mohan, Deepak Ameta, Bhardwaj Gaurav, Pradeep Haranahalli

Page range: 35-41

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Special Focus

Open Access April 14, 2016

Zika virus: A pandemic in progress

Sankalp Yadav, Gautam Rawal, Mudit Baxi

Page range: 42-45

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Abstract

The world is facing a number of emerging infections. The latest outbreak of Zika virus infection has only added to the suffering. The WHO declared a state of emergency in the affected countries and has issued alarms worldwide. The paucity of literature leading to lack of clear guidelines is one of the most important factors resulting in a higher number of cases. The absence of clinical vaccine and an antiviral drug may prove to be a really grave situation. The present paper throws some light on this new emerging virus that has been known to man since 1947.

Special Focus

Open Access April 14, 2016

Corticosteroids, the oldest agent in the prevention of chemotherapy-induced nausea and vomiting: What about the guidelines?

Florence Van Ryckeghem

Page range: 46-51

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Abstract

Chemotherapy-induced nausea and vomiting (CINV) remains one of the most disturbing side effects of cancer treatment. Research in antiemetic therapy has progressed gradually since the early eighties, and the development of antiemetic agents continues. This review focuses on the current management of CINV based on the most recent guidelines, and adherence to the latter is examined more carefully. Setrons (5HT3 receptor antagonists), corticosteroids, and NK-1 receptor antagonists are the cornerstones of antiemetic therapy. Corticosteroids are one of the oldest agents in the prevention of CINV. They are highly effective, increase the effect of other antiemetic agents, and are cost-effective. The latest developed 5HT3 receptor antagonist palonosetron led to an update of the guidelines of CINV. Other types include benzodiazepines, cannabinoids, and olanzapine. Various factors contribute to the overall risk of developing CINV, such as patient characteristics, emetogenic potency of the chemotherapeutic agents, and correct prevention of CINV. Current guidelines determine which is the right preventive regimen for each cancer patient at risk for experiencing CINV. Adherence to these guidelines and implementation in daily practice seem to be below the optimal level. In Belgium, authorities use the guidelines as a base for reimbursement and this has increased the level of implementation.

Commentary

Open Access April 14, 2016

A little help from steroids in oncology

Dominique Lossignol

Page range: 52-54

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Abstract

Steroids are widely used in oncology and have been demonstrated to possess an anticancer effect or antiswelling effect. They are considered to improve refractory symptoms such as dyspnea or gastrointestinal (GI) obstruction. However, their roles in nonspecific indications are not well proved. Clinical practice and several studies suggest that corticosteroids may be effective in the treatment of bone and neuropathic pain, when administered along with opioids and with other adjuvant analgesics. The decrease in pain intensity is probably connected with both anti-inflammatory and antiswelling effects as well as modulation of neuroimmune interactions and an inhibition of angiogenesis.

About this journal

Print ISSN 2450-131X
Online ISSN 2224-4018

Journal of Translational Internal Medicine (JTIM), launched in Dec 2013, is an open access journal publishing articles in all areas of translational internal medicine. The journal focuses on information derived from human disease-related experimentations so as to optimize the communication between basic scientific research and clinical science. It has a cycling nature, namely from basic research to clinical practice and then from clinical practice back to basic research.

Aims and Scope

Journal of Translational Internal Medicine (JTIM) is devoted to promoting science and practice in translational medicine and internal medicine in the world. To this end, JTIM publishes articles from all areas of internal medicine. The journal publishes original articles, rapid communications, editorials, reviews, highlights, perspective and other information closed relevant to translational medicine, internal medicine and related fields. Other types of articles include advanced experience, ideological highlights, and Q&A from scholars and scientists in related fields. JTIM will also launch Special Issues in rapid response to the newest development directions of scientific research fields.

JTIM has the ambition to and will become the EXCELLENT international platform for the publication of outstanding studies from all over the world. JTIM is designed to report research progress and the most recent findings in Translational Internal Medicine field, accelerating successful transformation from basic research results to clinically practical theories，diagnosis and treatment techniques, methodologies and drug discovery. With the aims of health care delivery and policy making, JTIM will help to best balance benefits, qualities and costs of medications. At JTIM, we have a challenging mission: to improve the quality of human life and enable people live longer by facilitating disease prevention, treatment and eventually the CURE.

Journal of Translational Internal Medicine is academically supported by:

International Society of Translational Sciences,
Infectious Diseases Society of China,
Chinese Hypertension Committee of Chinese Medical Doctors Association,
China Alliance of COPD, China RTI Optimal Treatment Committee,
Drug Clinical Assessment Committee of Chinese Pharmaceutical Association.