Search PubMed⌕ Search

Biomedical subjects

L Mosca

Publications and source records attributed to L Mosca.

At least 37 records · Page 2Linked to original sources
PubMed2000

Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention.

A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality from cardiovascular diseases; levels and trends in risk factors for cardiovascular diseases; disparities in cardiovascular diseases by race/ethnicity, socioeconomic status, and geography; trends in cardiovascular disease preventive and treatment services; and strategies for efforts to reduce cardiovascular diseases overall and to reduce disparities among subpopulations. The conference concluded that coronary heart disease mortality is still declining in the United States as a whole, although perhaps at a slower rate than in the 1980s; that stroke mortality rates have declined little, if at all, since 1990; and that there are striking differences in cardiovascular death rates by race/ethnicity, socioeconomic status, and geography. Trends in risk factors are consistent with a slowing of the decline in mortality; there has been little recent progress in risk factors such as smoking, physical inactivity, and hypertension control. There are increasing levels of obesity and type 2 diabetes, with major differences among subpopulations. There is considerable activity in population-wide prevention, primary prevention for higher risk people, and secondary prevention, but wide disparities exist among groups on the basis of socioeconomic status and geography, pointing to major gaps in efforts to use available, proven approaches to control cardiovascular diseases. Recommendations for strategies to attain the year 2010 health objectives were made.

Cardiovascular Diseases↗
PubMed2000

Usefulness of brachial artery reactivity to isometric handgrip exercise in identifying patients at risk and with coronary artery disease.

The change in brachial artery (BA) diameter after release of an occluding cuff has been used as a measure of endothelial function, to characterize atherosclerotic risk factors, and as a surrogate marker for coronary artery disease (CAD). We compared the change in BA diameter to isometric handgrip (IHG) with the occlusion release method to determine if a physiologic stress could be used to distinguish patients at risk and with CAD. BA diameter was measured by ultrasound during and after IHG, and after occlusion release in 93 subjects. At 120 seconds after release of IHG, BA diameter increased by 9.99 +/- 8.3% (p <0.001) in 26 average-risk patients, increased 1.84 +/- 5.7% in 37 high-risk patients, and decreased 3.9 +/- 5.6% in 30 patients with CAD (p = 0.0001 for trend and p < 0.01 between groups). There was a good correlation between change in BA diameter to IHG and occlusion release (r = 0.763 and p = 0.0001). The capacity for IHG and BA occlusion to characterize subjects by group was comparable with the exception of high-risk patients versus patients with CAD (80.5% for IHG vs 71.6% for occlusion and release, p = 0.086). BA response to IHG may be useful for identifying risk factors, patients at risk and with preclinical CAD, and the assessment of treatment strategies.

Adult↗
PubMed2000

Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and Stroke Campaign Task Force.

CONTEXT: One of 2 women in the United States dies of heart disease or stroke, yet women are underdiagnosed and undertreated for these diseases and their risk factors. Informed decisions to prevent heart disease and stroke depend on awareness of risk factors and knowledge of behaviors to prevent or detect these diseases. OBJECTIVE: Assess (1) knowledge of risks of heart disease and stroke and (2) perceptions of heart disease and its prevention among women in the United States. DESIGN AND SETTING: Telephone survey conducted in 1997 of US households, including an oversample of African American and Hispanic women. PARTICIPANTS: One thousand respondents 25 years or older; 65.8% white, 13.0% African American, and 12.6% Hispanic. MAIN OUTCOME MEASURES: Knowledge of heart disease and stroke risks, perceptions of heart disease, and knowledge of symptoms and preventive measures. RESULTS: Only 8% of the respondents identified heart disease and stroke as their greatest health concerns; less than 33% identified heart disease as the leading cause of death. More women aged 25 to 44 years identified breast cancer as the leading cause of death than women 65 years or older. Women aged 25 to 44 years indicated they were not well informed about heart disease and stroke. Although 90% of the women reported that they would like to discuss heart disease or risk reduction with their physicians, more than 70% reported that they had not. CONCLUSIONS: Most women do not perceive that heart disease is a substantial health concern and report that they are not well informed about their risk. Age influenced knowledge to a greater extent than ethnicity. Programs directed at young women that address the effects of lifestyle behaviors on long-term health are needed. Better communication between physicians and patients is also warranted.

Adult↗
PubMed2000

Hormone replacement therapy in the prevention and treatment of atherosclerosis.

As the population ages, the increasing number of women at risk for cardiovascular disease represents both a potential crisis and an opportunity in healthcare management. Although the overall death rate from cardiovascular disease in the general population is decreasing, the absolute numbers for women are increasing. A reduction in modifiable risk factors in women must be aggressively pursued by clinicians and health systems. Menopause is associated with many adverse effects on cardiovascular-disease risk factors in women. Estrogen replacement therapy has been shown to favorably influence many risk factors for cardiovascular disease. Despite this biologic plausibility and supporting evidence from epidemiologic studies, data from confirmatory clinical trials are lacking. Because of this, recommendations for hormone replacement therapy should be made on an individual basis.

Animals↗
PubMed2000

Use of a supermarket shelf-labeling program to educate a predominately minority community about foods that promote heart health.

OBJECTIVE: The purpose of this study was to evaluate the awareness and use of a supermarket-shelf labeling program designed to encourage shoppers to make food choices that promote heart health. DESIGN: A shelf-labeling program was implemented in 18 supermarkets serving minority communities in Detroit, Mich. Customers were given an exit survey to determine awareness and use of the program. SUBJECTS/SETTING: Three hundred sixty-one subjects were sampled. Sixty-six percent of the sample was female, 67% African-American, and the sample population had a mean age of 51.6 years +/- 18.5 SD. RESULTS: Overall awareness of the program was 28.8%. Awareness among minorities was significantly higher when compared with whites (35.3% vs 20.8%; P = .02). Gender, age, and education level were not predictive of program awareness but people screened for cardiovascular disease risk factors (elevated low-density lipoprotein or total cholesterol levels and/or elevated blood pressure) in the previous year had greater awareness than those not screened (32.6% vs 13.6%, P = .06). Use of the program was 56% among subjects aware of the program. This did not differ significantly by gender, age, or ethnicity. STATISTICAL ANALYSIS: Awareness and use were evaluated with respect to ethnicity, gender, education, race, age, and previous screening history. For purposes of analysis, African-American, Hispanic, and Asian-American respondents were combined into one group called "all minorities." The other group of respondents was called "whites." Between-group differences in categorical variables were analyzed using a chi 2 statistic. CONCLUSIONS: Awareness of the shelf-labeling program was modest, but highest among African-Americans. Subjects recently screened for cardiovascular disease risk had greater program awareness. This difference was not statistically significant. Use was relatively high among those aware of the program, suggesting that shelf labels have the potential to increase the selection of foods that promote heart health in predominately low-income, minority populations.

Adult↗
PubMed2000

Carotid artery vasoreactivity in response to sympathetic stress correlates with coronary disease risk and is independent of wall thickness.

OBJECTIVES: We designed a study to determine the carotid artery (CA) response to sympathetic activity and to determine whether the response correlates with coronary risk and is independent of wall thickness (IMT). BACKGROUND: Brachial artery reactivity in response to wall stress correlates with coronary risk and coronary disease (CAD). The reactivity of the CA, which is susceptible to atherosclerosis, has not been evaluated. METHODS: The change in diameter of the CA (deltaCAdiam) during a cold pressor test and after nitroglycerin and IMT were measured with ultrasound in 93 men and women at average risk, high risk and with CAD. RESULTS: At 90 s during a cold pressor test average-risk subjects increased CAdiam by 7.9+/-3.3%, which was significantly less in the high-risk group (1.5+/-1.8%), and vasoconstriction occurred in the group of subjects with CAD (-6.9+/-2.7%) (p < 0.01 for comparisons). There were no differences in response to nitroglycerin. Coronary risk was an independent predictor of the %deltaCAdiam (p < 0.0001). Wall thickness, age, systolic pressure and triglycerides each correlated negatively, and high-density lipoprotein cholesterol correlated positively with %deltaCAdiam. The major variable associated with the %deltaCAdiam, was group (p = 0.0001). After adjusting for smoking, age and high-density lipoprotein cholesterol, there was no association between the %deltaCAdiam, and IMT and %deltaCAdiam, but not IMT, was predictive of groups. CONCLUSIONS: The CA response to a sympathetic stimulus is altered in the presence of coronary risk factors and CAD and appears to reflect endothelial function independent of IMT. Carotid artery reactivity may be a valuable adjunctive noninvasive method to assess coronary risk.

Adult↗
PubMed2000

Enzymatic assay for the determination of olive oil polyphenol content: assay conditions and validation of the method.

A new spectrophotometric assay for the determination of the polyphenolic content of olive oil is presented. It is a substrate-recycling assay for phenolic compounds that employs tyrosinase in the presence of excess NADH. The reaction of various phenols with the enzyme produces an o-quinone, which is detected by recycling between reactions with the enzyme and NADH. The method offers some advantages over the classical methods employed to determine the polyphenolic content of olive oil, that is, ease and reproducibility of the analysis, highly increased sensitivity, and selectivity toward phenolic compounds. The amount of total polyphenols was determined in virgin olive oils both with the Folin-Ciocalteu reagent and with the proposed enzymatic method. The results suggest a better estimation of the polyphenol content, as compared with the colorimetric method. This has to be attributed to the different reactivities of the two methods toward phenols and catechols. Finally, the enzymatic method demonstrates that there is a linear relationship between the olive oil phenolic content and the antioxidative capacity of oil extracts.

Flavonoids↗
PubMed2000

Prevention of heart disease in women: recommendations for management of risk factors.

Coronary heart disease is the leading cause of death and disability in women in the U.S. Unfortunately, efforts for primary and secondary prevention of coronary heart disease are less than optimal. The need to emphasize prevention of coronary heart disease in women in important because first events are often fatal in women. Factors that are unique in terms of their influence on risk for coronary heart disease in women include age, reproductive and hormonal status, high density lipoprotein cholesterol and triglyceride levels, and the presence of diabetes. A consistent plan to address risk factor management of each woman is the key to long term risk reduction. Nurses and nurse practitioners, working in any setting, can use the recommendations presented in this paper to help women reduce their risk for coronary heart disease.

Aged↗
PubMed1999

Fluorescence properties of melanins from opioid peptides.

Recently our group synthesized a new class of melanins obtained by the tyrosinase-catalyzed oxidation of opioid peptides (opiomelanins). Owing to the presence of the peptide moiety such pigments exhibit high solubility in hydrophilic solvents, which allows spectroscopic investigations. In particular, the absence of solid-state quenching effects enables the study of melanin fluorescence properties, till now poorly investigated due to the complete insolubility of melanins produced from tyrosine or Dopa. Opiomelanins dissolved in aqueous medium show a characteristic emission peaked at 440 and 520 nm when excited around 330 nm, where a maximum is observed in the absorption spectrum. Kinetic measurements performed on the tyrosinase-catalyzed oxidation of opioid peptides show that the 440-nm fluorescence band arises in the early stages of peptide oxidation, whereas the 520-nm band appears in later stages of oxidation, i.e., during the polymerization of indole-quinone units. Moreover, molecular sieve fractionation shows that in the opiomelanin fraction with a molecular weight lower than 10 kDa the 440-nm band is dominant in the fluorescence spectrum. The breakdown of the polymer induced by hydrogen peroxide and light (i.e., the photobleaching of melanin pigments) produces a marked enhancement of the 440-nm fluorescence band while the 520-nm band disappears. Hence, our findings suggest that the observed fluorescence contains contributions from both oligomeric units (440-nm band) and high-molecular-weight polymers (520-nm band).

Agaricales↗
PubMed1999

Family history of early cardiovascular disease in children with moderate to severe hypercholesterolemia: relationship to lipoprotein (a) and low-density lipoprotein cholesterol levels.

Lipoprotein (a) (Lp(a)) is an established cardiovascular risk factor in adults. We sought to evaluate whether raised Lp(a) levels were predictive of a family history of early cardiovascular disease (CVD) in children already at increased risk for premature atherosclerosis because of elevated low-density lipoprotein (LDL) cholesterol levels. Lp(a) and serum lipid levels were measured in 69 children and offspring with established moderate to severe hypercholesterolemia (serum cholesterol > 170 mg/dL) who were aged 10.7 +/- 4.3 years (range 1.5 to 21 years) and had been referred to a pediatric lipid center. The children represented families with a positive (n = 27) or negative (n = 42) history for premature CVD (<55 years of age in parent or grandparent). In all children, Lp(a) levels ranged from 1 to 140 mg/dL, with a median of 29 mg/dL. Mean total cholesterol, LDL cholesterol, and high-density lipoprotein (HDL) cholesterol levels were 234 mg/dL, 166 mg/dL, and 45 mg/dL, respectively. There was no difference in median Lp(a) levels between the children with a positive family history and those with a negative family history (29.9 mg/dL vs 29.0 mg/dL, respectively). In contrast, children with a positive family history showed significantly higher LDL cholesterol levels (186 +/- 61 mg/dL vs 153 +/- 52 mg/dL, P = .02). Thus, in this group of hypercholesterolemic children, LDL cholesterol but not Lp(a) levels were associated with a family history of premature CVD. Further studies are needed to identify additional specific risk factors associated with the development of CVD in this population.

Adolescent↗
PubMed1999

Lipoxygenase/H2O2-catalyzed oxidation of dihdroxyindoles: synthesis of melanin pigments and study of their antioxidant properties.

5,6-Dihydroxyindole (DHI) and 5,6-dihydroxyindole-2-carboxylic acid (DHICA), which are important intermediates in melanogenesis, can be converted into the corresponding melanin pigments by the action of the lipoxygenase/H2O2 system. Kinetic and HPLC analyses indicate that both DHI and DHICA are good substrates for this enzymatic system. Enzyme activity on both substrates was measured in comparison with peroxidase and tyrosinase; the oxidizing behaviour of lipoxygenase is more similar to that of peroxidase rather than that of tyrosinase. The antioxidant properties of DHI- and DHICA-melanins have been investigated in comparison with other kinds of melanins. DHICA-melanin shows a more pronounced antioxidant effect than that of DHI-melanin and this behaviour can be ascribed to the different structure and solubility of the two pigments. The mixed polymer synthesized from DHI and DHICA is the most effective one. Some implications about the possible explanation of the above mentioned behaviour are discussed.

Antioxidants↗
PubMed1999

The impact of a disease-management program on the symptom experience of older women with heart disease.

This study describes the symptom experience of 570 older women with heart disease and evaluates a disease-management program's impact on symptoms over time. Women were randomly assigned to either usual care or a 4-week program ("Women take PRIDE") designed to improve self-regulation skills by focusing on increasing physical activity. At 4 months follow-up, program women, compared to controls, reported fewer total symptoms (p = 0.01) and decreased symptom frequency (p = 0.02) and bothersomeness (p = 0.02). By 12 months, positive intervention effects emerged within the common cardiac and sleep and rest symptom categories. Program group women reported more improvements in symptoms likely to be affected by increasing physical activity at both follow-ups (p < 0.05).

Aged↗