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Blum A.,Baruch Padeh Poria Hospital
American journal of orthopedics (Belle Mead, N.J.)

Angiogenesis is an important step in bone fracture healing. In this article, we report on the healing of long bone fractures, and the involvement of the vascular and the inflammatory systems in the process. We conducted a prospective study of 20 healthy adults with traumatic long bone fracture. One week after fracture, and then 1 month later, we evaluated markers of inflammation: vascular responsiveness (brachial endothelial function and ankle brachial index) and inflammatory and cytokine levels osteopontin [OPN], E-selectin, and vascular endothelial growth factor [VEGF]). Long bone fractures caused intense vascular and inflammatory responses, represented by high levels of OPN, Eselectin, and VEGF. In vivo measurements demonstrated severe endothelial dysfunction, which could support the idea that the vascular system is recruited to build new blood vessels that support bone regeneration. Source

Blum A.,Baruch Padeh Poria Hospital | Nahir M.,Baruch Padeh Poria Hospital
Journal of Geriatric Cardiology

Atherosclerosis underlies the major causes of death in the Western World. Our main goal is to detect early changes of atherosclerosis and to identify subjects at highest cardiovascular risk that may aid in the development of prevention approaches and better management that will decrease cardiovascular morbidity and mortality. The new methods that are of interest include the advanced vascular ultrasound methods, the infra red and near infra red imaging techniques, the EndoPat device that reflects peripheral arterial tone, the electron beam computed tomography, the magnetic resonance imaging, and the molecular imaging techniques. In this review we will focus on the future of advanced imaging techniques that are being developed to detect early (pre-clinical) development of atherosclerosis. ©2013 JGC All rights reserved. Source

Blum A.,Baruch Padeh Poria Hospital | Tamir S.,Galilee Technology Center | Hazzan D.,Carmel Medical Center | Podvitzky O.,Baruch Padeh Poria Hospital | And 6 more authors.
European Cytokine Network

Studies have shown that mortality was reduced by 31.6% in patients that underwent bariatric surgery compared with the non-operative control group. However, in most surgical series the majority of patients were women, and men had higher post-operative mortality rates and a higher postoperative morbidity, regardless of weight. Our primary end point was to study gender effects on vascular inflammation following bariatric surgery for weight loss. Methods. A prospective study evaluated vascular inflammation in obese patients before and three months after bariatric surgery. Markers of vascular inflammation were measured - before surgery and three months afterwards. Results.One hundred and two patients (73 women and 29 men, 40.5±12.3 years old) underwent bariatric surgery. Correlation was found between BMI change and waist circumference change (r = 0.658, P<0.001). Three months post-surgery, BMI was significantly decreased (p<0.001) (a decrease of 8.82), waist circumference was reduced (p<0.001) (a decrease of 17.33 cm). ICAM-1 levels and hs-CRP levels were decreased (both P = 0.0001). Gender differences seem to be borderline significant with respect to the prevalence of type II diabetes mellitus (men > women; P = 0.05) and hypertension (men > women; P = 0.06). In women, following bariatric surgery, BMI was decreased (p<0.001) (a decrease of 9.25), waist circumference was reduced (p<0.001) (a decrease of 18.8cm). ICAM- 1 levels were decreased (p = 0.002) and hs-CRP levels were also decreased (P = 0.0001). In men, following bariatric surgery, BMI was decreased (p = 0.001) (a decrease of 8.1), waist circumference was reduced (p<0.005) (a decrease of 14.6cm); however, although ICAM-1 levels and hs-CRP levels were decreased the decreases were non-significant (both P = 0.09). Discussion. Our study examined gender effects of bariatric surgery on vascular inflammation. Bariatric surgery had no significant effect on biochemical inflammatory markers in male patients, while females undergoing the same kind of bariatric surgery for weight loss showed a significant decrease in these markers of inflammation. These results may explain the epidemiological data that described higher morbidity and mortality among obese men undergoing bariatric operation for weight loss. This is the first study that has demonstrated a gender difference in the inflammatory responses that may affect clinical outcome, and cardiovascular morbidity and mortality. Source

Blum A.,Baruch Padeh Poria Hospital | Sirchan R.,Baruch Padeh Poria Hospital | Abu-Shkara F.,Baruch Padeh Poria Hospital | Keinan-Boker L.,Israel Center for Disease Control | Keinan-Boker L.,Haifa University
Experimental and Clinical Cardiology

BACKGROUND: In patients with heart failure, low body mass index has been associated with increased mortality. The hypothesis for the present study was that asymptomatic peripheral artery disease (PAD) could have an effect on the in-hospital mortality of patients admitted with acute heart failure. METHODS: The effect of PAD (documented by ankle-brachial index [ABI]) on in-hospital mortality was examined among 143 patients who were admitted with acute heart failure (mean [± SD] age 75±12 years; 76 women and 67 men). The mean body mass index was 29.5±7.4 kg/m 2, the mean ABI was 0.9±0.2 and the mean abdominal circumference was 107.7±22.5 cm. RESULTS: Nine patients died (one man and eight women; P=0.02). Forty patients had PAD (documented by an ABI of lower than 0.9); among them, five patients (12.5%) died, while among the 103 patients who did not have PAD (ABI of 0.9 or greater), four patients (3.9%) died (P=0.05). No statistically significant difference was observed in the body mass index of patients who died compared with those who survived (27.14±7.93 kg/m 2 versus 29.79±7.56 kg/m 2, respectively) (P=0.38). Patients who died had a lower abdominal circumference (94.87±26.96 cm versus 109.25±20.29 cm) (P=0.05). Recurrent hospitalizations were more prevalent among patients who died (six patients were readmitted and four of them died [66%], while only five patients died among 133 patients who were not rehospitalized [3.8%]; P=0.001). In a multiple regression analysis, abdominal circumference and rehospitalization had an independent impact on in-hospital mortality, while PAD did not. CONCLUSIONS: In-hospital mortality of patients admitted with acute heart failure is dependent on abdominal circumference and recurrent hospitalizations. PAD does not affect the in-hospital clinical outcome. ©2011 Pulsus Group Inc. All rights reserved. Source

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