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1.
Viveka Kumar Vivek Kumar Kajal Kumari K.K. Talwar Divya Prasad Sunil Agarwal M.S. Yadav Hamed Bashir Suman Jatain S.K. Gupta 《The Egyptian Heart Journal》2018,70(4):375-378
Introduction
Dual antiplatelet treatment is recommended by current clinical practice guidelines for patients undergoing PCI. The PLATO trial showed superiority of ticagrelor to clopidogrel in reducing the rate of death from vascular causes, myocardial infarction and stroke without increase in the rate of overall major bleeding in ACS patients. However, real world evidence in Indian patients is limited. The objective of this study is to compare safety profile of ticagrelor with clopidogrel in real world settings.Methodology
In this single centered retrospective observational study, a total of 1208 serial patient records undergoing PCI (ACS and stable angina patients as well) treated with Ticagrelor or Clopidogrel were collected and analyzed to look into in hospital outcomes. We excluded the patient’s data that were incomplete.Results
In total of 1208 patients, 604 patients received ticagrelor and similarly 604 patient received clopidogrel. No significant differences in the rates of major life threatening bleeding and any major bleeding were observed between ticagrelor and clopidogrel group (0.2% (n?=?1) vs. 0.7% (n?=?4), p?=?0.18 and 2.8% (n?=?17) vs. 3% (n?=?18), p?=?0.86 respectively). There was increase in minor bleeding rate with ticagrelor compared to clopidogrel (21.4% & 13.6%, p?=?0.00).Conclusion
In the real world settings, patients undergoing PCI treated with ticagrelor showed similar safety profile compared to clopidogrel but with increase in minor bleeding rate. The observed results were in alignment with PLATO clinical trial. 相似文献2.
Colleen Juricek Teruhiko Imamura Ann Nguyen Ben Chung Daniel Rodgers Nitasha Sarswat Gene Kim Jayant Raikhelkar Takeyoshi Ota Tae Song Daniel Burkhoff Gabriel Sayer Valluvan Jeevanandam Nir Uriel 《Journal of cardiac failure》2018,24(4):249-254
Background
Recurrent gastrointestinal bleeding is one of the most significant adverse events in patients with left ventricular assist devices (LVADs).Methods
We enrolled LVAD patients who had received an intramuscular injection of 20?mg octreotide every 4 weeks as secondary prevention for recurrent gastrointestinal bleeding despite conventional medical therapies and repeated transfusions. The frequency of gastrointestinal bleeding and other associated clinical outcomes before and during octreotide therapy were compared.Results
Thirty LVAD patients (66.4?±?8.8 years old, 16 men [53%]) received octreotide therapy for 498.8?±?356.0 days without any octreotide-associated adverse events. The frequency of gastrointestinal bleeding was decreased significantly during octreotide therapy (from 3.4?±?3.1 to 0.7?±?1.3 events/year; P?<?.001), accompanied by significant reductions in red blood cell and flesh frozen plasma transfusions, days in hospital, and need for endoscopic procedures (P?<?.05 for all).Conclusions
Octreotide therapy reduced the frequency of recurrent gastrointestinal bleeding and may be considered for secondary prevention. 相似文献3.
Background
Acute coronary syndrome (ACS) refers to a spectrum of symptoms compatible with acute myocardial ischemia. Plasma markers of inflammation have been recently identified as diagnostic aid and risk predictors. The present study, conducted in Slemani Cardiac Hospital (SCH), Sulaimaniyah, Iraq aimed to recognize some risk factors for ACS in Iraqi adults younger than 40.Methodology
This is a prospective case-control study of 100 patients with ACS vs. a control group of 100 healthy volunteers. The study began at 1st January 2014 and ended at 31st December 2016. All patients were subjected to full history taking, clinical examination including measurement of waist circumference and body mass index (BMI). Investigations included electrocardiography (ECG), echocardiography, full blood count, measurement of lipid profile and C-reactive protein (CRP). The patients were managed by percutaneous coronary intervention (PCI).Results
The mean age of the patients was 36?years (range 28–40). Eighty-five% of patients were male. The mean BMI (29?kg/m2) and waist circumference (98?cm) of the patients were higher than the controls (24?kg/m2 and 72?cm respectively). The leukocytes, lymphocytes and neutrophil counts as well as CRP in both groups were within the normal range. The most prevalent risk factor was obesity (n?=?86). Other risk factors were smoking (n?=?62), hypertension (n?=?26), diabetes mellitus (n?=?22) and positive family history of ACS (n?=?24). Most patients (n?=?83) had multi-vessel coronary artery disease (2–3 vessels).Conclusion
ACS in young adults is an increasing health problem. Obesity was found to be the most prevalent risk factor. 相似文献4.
Maya Fayfman Georgia Davis Elizabeth W. Duggan Maria Urrutia David Chachkhiani Joanna Schindler Francisco J. Pasquel Rodolfo J. Galindo Priyathama Vellanki David Reyes-Umpierrez Heqiong Wang Guillermo E. Umpierrez 《Journal of diabetes and its complications》2018,32(12):1091-1096
Aim
We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery.Methods
This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n?=?44) or placebo (n?=?36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140?mg/dL and >180?mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications.Results
BG >140?mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in hyperglycemia between placebo and sitagliptin (56% vs. 55%, p?=?0.93). BG >180?mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p?=?0.36. Both treatment groups had resulted in similar postoperative BG (148.9?±?29.4?mg/dL vs. 146.9?±?35.2?mg/dL, p?=?0.73). There were no differences in length-of-stay (4 vs. 3?days, p?=?0.84), ICU transfer (3% vs. 5%, p?=?1.00), hypoglycemia <70?mg/dL (6% vs. 11%, p?=?0.45), and complications (14% vs. 18%, p?=?0.76).Conclusion
Preoperative treatment with sitagliptin did not prevent stress hyperglycemia or complications in individuals without diabetes undergoing surgery. 相似文献5.
Abdus Samad Ansari Simon de Lusignan William Hinton Neil Munro Simon Taylor Andrew McGovern 《Journal of diabetes and its complications》2018,32(6):602-608
Aim
To characterize the risk uveitis, scleritis or episcleritis in relation to diabetes, glycaemic control, and co-existence of retinopathy.Methods
Using the Royal College of General Practitioners Research and Surveillance Centre database, we established the prevalence of acute uveitis and scleritis or episcleritis over a six-year period among populations without(n?=?889,856) and with diabetes(n?=?48,584). We evaluated the impact of glycaemic control on disease risk. Regression modeling was used to identify associations, adjusting for clinical and demographic confounders.Results
Incidence of acute uveitis was higher among patients with diabetes; Type 1 OR:2.01 (95% CI 1.18–3.41; p?=?0.009), and Type 2 OR:1.23 (1.05–1.44; p?=?0.01). Glycaemic control was established as an important effect modifier for uveitis risk, whereby those with poorer control suffered higher disease burden. Results confirmed a dose-response relationship such that very poor glycaemic control OR:4.72 (2.58–8.65; p?<?0.001), poor control OR:1.57 (1.05–2.33; p?=?0.03) and moderate control OR:1.20 (0.86–1.68; p?=?0.29) were predictive of uveitis. Similar results were observed when evaluating retinopathy staging: proliferative retinopathy OR:2.42 (1.25–4.69; p?=?0.01). These results were not maintained for scleritis or episcleritis.Conclusion
Acute uveitis is more common in patients with diabetes; at highest risk are those with type 1 disease with poor glycaemic control. Glycaemic improvements may prevent recurrence. 相似文献6.
Yuusaku Sugihara Shin-ei Kudo Hideyuki Miyachi Masashi Misawa Shogo Okoshi Hiroyuki Okada Kazuhide Yamamoto 《Gut and liver》2016,10(2):244-249
Background/Aims
Diverticular bleeding can occasionally cause massive bleeding that requires urgent colonoscopy (CS) and treatment. The aim of this study was to identify significant risk factors for colonic diverticular hemorrhage.Methods
Between January 2009 and December 2012, 26,602 patients underwent CS at our institution. One hundred twenty-three patients underwent an urgent CS due to acute lower gastrointestinal hemorrhage. Seventy-two patients were diagnosed with colonic diverticular hemorrhage. One hundred forty-nine age- and sex-matched controls were selected from the patients with nonbleeding diverticula who underwent CS during the same period. The relationship of risk factors to diverticular bleeding was compared between the cases and controls.Results
Uni- and multivariate conditional logistic regression analyses demonstrated that the use of nonsteroidal anti-inflammatory drugs (odds ratio [OR], 14.70; 95% confidence interval [CI], 3.89 to 55.80; p<0.0001), as well as the presence of cerebrovascular disease (OR, 8.66; 95% CI, 2.33 to 32.10; p=0.00126), and hyperuricemia (OR, 15.5; 95% CI, 1.74 to 138.00; p=0.014) remained statistically significant predictors of diverticular bleeding.Conclusions
Nonsteroidal anti-inflammatory drugs, cerebrovascular disease and hyperuricemia were significant risks for colonic diverticular hemorrhage. The knowledge obtained from this study may provide some insight into the diagnostic process for patients with lower gastrointestinal bleeding. 相似文献7.
Samia Salah-El-Din Mahmoud Doaa Ghaith Yomna Farag Bishoy Ibrahim 《The Egyptian Rheumatologist》2018,40(4):273-276
Introduction
Ferritin is an acute-phase reactant that is elevated in several autoimmune disorders. Serum ferritin levels have been correlated with disease activity scores of juvenile systemic lupus erythematosus (JSLE). Furthermore, enhanced levels of ferritin have also been described in lupus nephritis (LN).Aim of the work
To evaluate serum ferritin as a cheap and available marker of disease activity and renal involvement in Egyptian children with JSLE.Patients and methods
Forty-eight JSLE cases recruited from the Pediatric Rheumatology Clinic in Cairo University Specialized Children’s Hospital and 43 matched healthy children were enrolled in the study. SLE disease activity score-2000 (SLEDAI-2K) and renal activity score were assessed. Serum levels of ferritin, was quantified by enzyme-linked immunosorbent assay.Results
The mean age of the patients was 12.6?±?3.02?years and disease duration 3.4?±?2.5?years. Serum ferritin significantly higher in patients (416.1?±?1022.9?ng/ml) compared with control (36.1?±?18.2?ng/ml) (p?<?0.001). Serum ferritin was significantly higher in active (n?=?20) (890.4?±?1474.8?ng/ml) compared to inactive (n?=?28) (77.4?±?74.1?ng/ml) patients (p?<?0.001). A significant correlation was found between serum ferritin with SLEDAI-2K (r?=?0.35, p?=?0.014), renal-SLEDAI-2K (r?=?0.49, p?<?0.001) and with renal activity score (r?=?0.38, p?=?0.008). A significant correlation was found between serum ferritin and anti-double stranded-DNA (r?=?0.44, p?=?0.002) and complement 3 (r?=??0.42, p?=?0.003).Conclusion
Serum ferritin level can be considered a reliable biomarker for monitoring disease and renal activity in children with JSLE and LN. This may lead to improvement of management and consequently prognosis of JSLE patients as serum ferritin is an available and relatively cheap marker. 相似文献8.
Kai-Hsiang Wu Hsin-An Shih Ming-Szu Hung Cheng-Ting Hsiao Yi-Chuan Chen 《Arab Journal Of Gastroenterology》2018,19(4):143-147
Background and study aims
Azotaemia is commonly identified among patients with upper gastrointestinal bleeding (UGIB) due to absorption of blood products in the small bowel. Previous studies have found blood urea nitrogen-to-creatinine (BUN/Cr) ratio to be significantly elevated among patients UGIB bleeding compared to patients with lower GI bleeding. However, no studies have explored the relationship between BUN/Cr ratio and mortality. This study is aimed at investigating how BUN/Cr ratio relates to outcomes for UGIB patients.Patients and methods
This study was conducted prospectively at a university-affiliated teaching hospital with approximate 70,000 annual emergency department (ED) visits. Data from a total of 258 adult UGIB patients were collected between March 1, 2011 and March 1, 2012. Cox regression analysis was used to identify risk factors for 30-day mortality.Results
Malignancy and Rockall score were associated with increased risk of 30-day mortality (Unadjusted hazard ratio (HR): 3.87, 95% CI: 1.59–9.41, p?=?0.0029; HR: 1.31, 95% CI: 1.02–1.71, p?=?0.0476, respectively). However, BUN/Cr?>?30 was associated with lower risk of 30-day mortality (HR: 0.32, 95% CI: 0.11–0.97, p?=?0.0441).Conclusions
A BUN/Cr ratio of >30 was found to be an independent risk factor for mortality and may be useful for pre-endoscopic assessment. Development of future risk scoring systems might warrant consideration of including BUN/Cr ratio as a parameter for estimating risk. 相似文献9.
Tanaka Y Motomura Y Akahoshi K Iwao R Komori K Nakama N Osoegawa T Itaba S Kubokawa M Hisano T Ihara E Nakamura K Takayanagi R 《Gut and liver》2012,6(3):334-338
Background/Aims
Colonic diverticular bleeding can stop spontaneously or be stopped by endoscopic hemostasis. We analyzed the clinical and colonoscopic features of patients with colonic diverticular bleeding to establish the predictive factors for rebleeding.Methods
A total of 111 patients (median age, 72 years) with colonic diverticular bleeding in Aso Iizuka Hospital between April 2007 and July 2010 were enrolled. Age, sex, body mass index (BMI), comorbidity, medication, location of bleeding, colonoscopic findings and hemostatic methods were analyzed retrospectively from the hospital records.Results
The most common sites of bleeding were the ascending (39.6%) and sigmoid (29.7%) colon. Overt rebleeding occurred in 30 patients (27.0%). Spontaneous hemostasis was seen in 81 patients (73.0%), and endoscopic hemostatic treatment was performed in 30 patients. The BMI in the patients with colonic diverticular rebleeding was significantly higher than in patients without rebleeding. Colonoscopic findings of actively bleeding or nonbleeding visible vessels in the responsible diverticula were more frequent in the group with rebleeding.Conclusions
A higher BMI and colonoscopic findings of actively bleeding or nonbleeding visible vessels can be used as predictive factors for colonic diverticular rebleeding. Patients with such findings should be carefully followed up after hemostasis of the initial colonic diverticular bleeding. 相似文献10.
Tarek Youssef Shereen A. Saleh Angie Rund Iman Montasser Manal Mohsen Ola Hazem 《Arab Journal Of Gastroenterology》2018,19(3):116-120
Background and study aims
Studies have found increased expression of IL-23 in inflamed and non-inflamed mucosa of patients with ulcerative colitis (UC). We hypothesized that serum interleukin-23 as a non-invasive test has a role in pathogenesis of ulcerative colitis disease and correlates with the disease severity.Patients and methods
Forty patients with biopsy proven ulcerative colitis, recruited from Ain Shams University hospitals were included. Forty healthy subjects matched in age and gender were also included in the study as a control group. Serum IL-23 level was quantified using quantitative ELISA technique (Enzyme linked Immunosorbent Assay).Results
Patients with UC had higher level of interleukin 23 (234.5?±?161?pg/mL) compared to control subjects (54.2?±?15?pg/mL) and the level of IL-23 correlated with the disease severity. Cut off value of IL-23 at 68?pg/mL was the best to differentiate between cases and control subjects. Receiver operating characteristic curve (ROC) revealed that the best cut off for IL-23 to detect mild cases of ulcerative colitis was at105 pg/mL, to detect moderate cases at 200?pg/mL and to detect severe cases was at 270?pg/mL with sensitivity 80% to mild cases, 60% to moderate cases and 81% to severe cases.Conclusion
Our findings confirm the suggestion that IL-23 level measurement may be of value as a non-invasive test in the diagnosis and disease severity assessment in patients with UC. 相似文献11.
Hana Sahli Asma Bachali Lamine Hamzaoui Mouna Medhioub Aida Bachrouch Khaled Bouzaidi Rawdha Tekaya Msaddak Azzouz 《The Egyptian Rheumatologist》2018,40(3):187-190
Aim of the work
To determine the frequency, clinical and radiological features of axial spondyloarthritis in patients with inflammatory bowel diseases (IBD) and to characterize differences between patients with and without axial spondyloarthritis.Patients and Methods
Patients included in this cross-sectional study were recruited from the Gastroenterology Department, University of Tunisia over six months. Sixty-four patients with IBD were questioned and examined for axial spondyloarthritis symptoms. Standard pelvic X-rays were performed for all and CT scans and MRI were done for some patients.Results
There were 42 men (65.6%) and 22 women (34.4%) with a mean age of 47?±?22 years. 32 patients (50%) had Crohn’s disease, 31 had ulcerative colitis and 1 patient has undifferentiated colitis. The disease was confined to the colon among a half of patients with ulcerative colitis. Regarding Crohn’s disease, all lesions were confined to the ileum and the colon. The mean IBD duration was 6.18±7.2 years. The occurrence of axial spondyloarthritis was 26.5% (17 patients who were symptomatic in 16 cases). The bowel disease preceded rheumatic manifestations in all cases. Nine patients (14.1%) had isolated sacroiliitis. The patients with and without axial spondyloarthritis had similar sociodemographic, anthropometric characteristics, comorbidities and bowel disease particularities except a higher percentage of corticosteroids use (p?=?.013).Conclusions
Due to the high frequency, an early diagnosis of spondyloarthritis in patients with inflammatory bowel disease by thorough clinical exam and standard pelvic X-rays should be recommended. 相似文献12.
Brian C. Helsel Joel E. Williams Kristen Lawson Jessica Liang Jonathan Markowitz 《Digestive diseases and sciences》2018,63(6):1392-1408
Background
Mobile applications and interactive websites are an increasingly used method of telemedicine, but their use lacks evidence in digestive diseases.Aim
This study aims to explore digestive disease studies that use telemedicine to effectively manage disease activity, help monitor symptoms, improve compliance to the treatment protocol, increase patient satisfaction, and enhance the patient-to-provider communication.Methods
EBSCO, PubMed, and Web of Science databases were searched using Medical Subject Headings and other keywords to identify studies that utilized telemedicine in patients with digestive disease. The PRISMA guidelines were used to identify 20 research articles that had data aligning with 4 common overlapping themes including, patient compliance (n?=?13), patient satisfaction (n?=?11), disease activity (n?=?15), and quality of life (n?=?13). The studies focused on digestive diseases including inflammatory bowel disease (n?=?7), ulcerative colitis (n?=?4), Crohn’s Disease (n?=?1), irritable bowel syndrome (n?=?6), and colorectal cancer (n?=?2).Results
From the studies included in this systematic review, patient compliance and patient satisfaction ranged between 25.7–100% and 74–100%, respectively. Disease activity, measured by symptom severity scales and physiological biomarkers, showed improvements following telemedicine interventions in several, but not all, studies. Similar to disease activity, general and disease-specific quality of life showed improvements following telemedicine interventions in as little as 12 weeks in some studies.Conclusion
Telemedicine and mobile health technology may be effective in managing disease activity and improving quality of life in digestive diseases. Future studies should explore both gastrointestinal and gastroesophageal diseases using these types of interventions.13.
Maha A. Mohammed Shaimaa A.K. Rady Moustafa O. El-Mokadem Samia M.H. Fadda 《The Egyptian Rheumatologist》2018,40(3):173-178
Aim of the work
To assess the echocardiographic changes using Trans Thoracic Echocardiograghy in systemic lupus erythematosus (SLE) patients with and without antiphospholipid syndrome (APS) and to study the relation of the changes to the disease activity and damage.Patients and methods
This study was conducted on 50 SLE patients (25 with and 25 without APS) and 50 controls. The SLE disease activity index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage index (SLICC/DI) were assessed. Laboratory investigations were performed and transthoracic echocardiography (TTE) was done.Results
The mean age of the patients was 27.7?±?8.5?years and disease duration 4.1?±?3.7?years; 44 females and 6 males; 7.3:1. There was a high frequency of mitral (64%), aortic (22%) and tricuspid (24%) valve regurges as well as pericardial effusion (22%). Left ventricular hypertrophy and atrial dilation was present in 10% of the patients. The frequency of mitral, aortic and tricuspid regurge in SLE patients with APS tended to be higher (84%, 32% and 36%) than in those without (44%, 12% and 12%, respectively). There was a significant correlation between SLEDAI and pericardial effusion (p?=?0.001), between the SLICC/DI with the left ventricular diastolic dysfunction (LVDD) (p?=?0.001), the presence of lupus nephritis with the ejection fraction (p?=?0.02) and between hypertension with the LVDD (p?=?0.001).Conclusion
All SLE patients especially those with APS should be screened for the presence of structural cardiac abnormalities. TTE can be helpful as a noninvasive diagnostic tool for early detection of the abnormalities, resulting in earlier treatment and reduction in mortality and morbidity. 相似文献14.
Background
Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).Aim of work
Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.Methodology
IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).Results
As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p?=?0.001) with higher total cholesterol level (194.6?±?35.3 vs 174.4?±?28.5?mg/dl, p?=?0.001) and higher LDL-C (145.3?±?27.1 vs 123.2?±?31.4, p?=?0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4?±?7.4 vs 16.3?±?7.9?mm, p?=?0.002) with higher plaque burden (60.8?±?15.3 vs 54.8?±?14.0, p 0.002) and more area stenosis percentage (60.8?±?15.6 vs 55.6?±?14.1, p?=?0.008). Structurally, the diabetic group lesions had more lipid content (19.8?±?8.8 vs 16.8?±?8.7, p?=?0.008) and more necrotic core (17.6?±?7.4 vs 14.7?±?4.8, p?=?0.008) but less calcification (6.9?±?3.6 vs 11.8?±?6.3, p?=?0.001). The RI was negative in both groups, 0.95?±?0.13 in the diabetic group vs 0.98?±?0.19 in non-diabetic group (p?=?0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23.?±?5.2 vs 14.6?±?8.6, p?=?0.01) but less fibrotic component (48.6?±?4.7 vs 59.1?±?13.6%, p?=?0.01) and less calcification (10.9?±?6.8% vs 14.07?±?3.8%, p?=?0.02) as compared to the nondyslipidaemic subgroup.Conclusions
Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. 相似文献15.
Ahmed Bendary Mohamed El-Husseiny Tarek Aboul Azm Ahmed Abdoul Moneim 《The Egyptian Heart Journal》2018,70(4):415-419
Background
Coronary no-reflow (NR) is a dreadful complication of primary percutaneous coronary intervention (pPCI) that is seen in nearly 50% of cases. A great effort is being done to discover simple tools that could predict such a complication. We aimed primarily to study the predictive power of R-wave peak time (RWPT) on NR.Methods
From October 2017 to March 2018, we enrolled 123 patients with STEMI treated with pPCI at Benha University Hospital and National Heart Institute. We measured RWPT from infarct-related artery (IRA) leads and assessed the development of NR in all finally included 100 patients (after exclusions).Results
Based on occurrence of NR, patients were divided into 2 groups; Group I (n?=?39) with NR and group II (n?=?61) without NR. Smoking, DM, HTN, longer reperfusion times and higher thrombus burden were significantly associated with NR. Both pre- and postprocedural RWPT were significantly higher in group I than Group II. Preprocedural RWPT?>?46?ms predicted NR with a sensitivity and specificity of 79.5% and 86.9% respectively (AUC 0.891, 95% CI 0.82–0.962, P?<?0.001). In adjusted multivariate analysis, preprocedural RWPT was found to be among independent predictors for NR (OR: 26.2, 95% CI: 6.5–105.1, P?<?0.001). The predictive power of preprocedural RWPT was statistically non-inferior to ST-resolution (STR)% (difference between area under curves?=?0.029, P?=?0.595).Conclusion
RWPT is strongly associated with and significantly predicts the development of NR. This association was statistically non-inferior to the well-known association between STR% and NR. 相似文献16.
Nico Reinsch Ute Ruprecht Jochen Buchholz Rolf R. Diehl Hagen Kälsch Kars Neven 《Journal of electrocardiology》2018,51(5):751-755
Introduction
Implantable loop recorders (ILR) are leadless subcutaneous devices that allow cardiac monitoring for up to 3?years and are a valuable tool in the diagnosis of arrhythmias, cryptogenic stroke and unexplained syncope. The Biotronik BioMonitor 2 is a novel, insertable ILR allowing long-term continuous monitoring with wireless telemetry options.Methods
A single-center, prospective, observational study investigating the reliability of sensing quality and detection performance in the BioMonitor 2 ILR, as well as post-implantation patient satisfaction. R-wave amplitude was recorded immediately post implantation and 1?day post implantation, followed by extensive patient instruction. Follow-up was scheduled after 3?months, or after an event. Data from the ILR were retrieved, with documentation of all episodes, R-wave amplitude and noise burden. The anatomical position of the ILR was determined 1?day post implantation and after 3?months. A patient questionnaire was conducted after 3?months.Results
30 consecutive patients (mean age 71?±?12?years, 56% male) were analyzed. Indications for ILR implantation were: unexplained syncope (n?=?24, 80%), suspected atrial fibrillation (n?=?4, 13%), cryptogenic stroke (n?=?1, 3%) and palpitations (n?=?1, 3%). Median time from skin cut to suture was 8?min. No complications occurred. Mean R-wave amplitude at implantation was 0.84?±?0.32?mV, at day 1 post implantation 0.96?±?0.31?mV, and after a mean follow-up of 85?±?24?days 1.02?±?0.47?mV (p?=?0.01). The mean noise burden was 1.4?±?2%.Conclusion
Implantation of the novel BioMonitor 2 ILR is fast and uncomplicated. Initial sensing values are good and improve over time. 相似文献17.
Reem Waziry Asmaa Gomaa Imam Waked Gregory J. Dore 《Arab Journal Of Gastroenterology》2018,19(1):26-32
Background and Study Aims
In this study we assessed rates and determinants of survival in people with untreated chronic HCV infection and hepatocellular carcinoma (HCC) in an Egyptian liver clinic setting.Patients and Methods
This is a prospective cohort study of patients diagnosed with HCV-related HCC and undergoing HCC management at a national liver centre in Egypt in 2013–2014 and with a follow-up through 2016.Results
A total of 345 patients diagnosed with HCV-related liver cirrhosis complicated by HCC were included. Median age at diagnosis was 57?years (IQR?=?52, 62), the majority were male (78%) and Child-Turcotte-Pugh (CTP) class A (64%). At diagnosis Barcelona Clinic Liver Cancer staging (BCLC) was 0 (8%), A (48%), B (20%), C (17%), and D (7%). Most common HCC management modalities were transarterial chemoembolization (TACE) (42%), and radiofrequency ablation (RFA) (21%). Median survival following HCC was 22.8?months. Factors associated with poorer survival in adjusted analyses were INR (HR?=?1.81, p?=?0.01), alpha-foeto protein (AFP) ≥200 (HR?=?1.41, p?=?0.02), higher CTP score (HR?=?2.48, p?<?0.01), and advanced BCLC stage (HR?=?1.85, p?<?0.01). One year survival in patients with CTP A, B, and C was 85%, 71% and 32%, respectively. One year survival following RFA, TACE, combination RFA/TACE, and sorafenib was 93%, 79%, 80% and 60%, respectively.Conclusion
Survival following HCV-HCC in Egyptian patients undergoing HCC management in a specialised clinic setting is poor, although similar to high income country settings. CTP score is a key determinant of survival, even following adjustment for BCLC stage and HCC management. 相似文献18.
Niikura R Nagata N Akiyama J Shimbo T Uemura N 《International journal of colorectal disease》2012,27(9):1137-1143
Purpose
Colonic diverticular bleeding is a major cause of lower gastrointestinal bleeding. However, a limited number of studies have been reported on the risk factors for diverticular bleeding. Our aim was to identify risk factors for diverticular bleeding.Methods
Our study design is a case (diverticular bleeding)–control (diverticulosis) study. We prospectively collected information of habits, comorbidities, history of medications and symptoms by a questionnaire, and diagnosed diverticular bleeding and diverticulosis by colonoscopy. Logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (CI).Results
A total of 254 patients (diverticular bleeding, 45; diverculosis, 209) were selected for analysis. Cluster (≥10 diverticula) type (OR, 4.0; 95% CI, 1.8–8.9), hypertension (OR, 2.2; 95% CI, 1.0–4.6), ischemic heart disease (OR, 2.4; 95% CI, 1.1–5.4), and chronic renal failure (OR, 6.4; 95% CI, 1.3–32) were independent risk factors for diverticular bleeding.Conclusions
Large number of diverticula, hypertension, and concomitant arteriosclerotic diseases including ischemic heart disease and chronic renal failure are risk factors for diverticular bleeding. This study identifies new information on the risk factors for diverticular bleeding. 相似文献19.
Okamoto T Watabe H Yamada A Hirata Y Yoshida H Koike K 《International journal of colorectal disease》2012,27(9):1161-1166
Purpose
We previously reported that hypertension is related to colonic diverticular bleeding, suggesting the involvement of arteriosclerosis. The recurrence of diverticular bleeding has been little investigated. We aimed to elucidate additional risk factors for diverticular bleeding and also to investigate the incidence rates and risk factors for re-bleeding.Methods
Between January 2006 and September 2010, 62 patients with diverticular bleeding were admitted to our hospital. We then selected 124 control subjects with non-bleeding diverticula from the colonoscopy database of our department. Additionally, a retrospective cohort study was conducted using these case patients to estimate the re-bleeding rate after initial diverticular bleeding and the risk factors for re-bleeding. Odds ratios for diverticular bleeding were calculated by multivariate logistic regression in a case–control study. Cumulative re-bleeding rates since initial bleeding and hazard ratios of risk factors were estimated by Kaplan–Meier method and Cox proportional hazard model.Results
Sixty-two patients presented 99 bleeding episodes including the initial ones. Diabetes mellitus (OR 2.5, 95?% CI 1.2–5.2, P?=?0.03), cardio- or cerebrovascular diseases (OR 4.2, 95?% CI 1.7–11.3, P?=?0.003), and NSAID use (OR 3.7, 95?% CI 1.3–11.6, P?=?0.02) were shown to be independent risk factors. The cumulative re-bleeding rates were 21?%, 34?%, and 40?% at 1, 2, and 3?years, respectively, in which NSAID use (HR 6.3, 95?% CI 1.7–20.7, P?=?0.007) was a risk factor for re-bleeding.Conclusions
Diabetes mellitus and vascular diseases were risk factors for diverticular bleeding, suggesting systemic metabolic disorders and arteriosclerosis might play an important role. 相似文献20.
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