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1.
Hanan Ahmed Kotb Dina Abbas Effat Mohamed Reda Awad Shereen Hefny Derbala 《The Egyptian Rheumatologist》2018,40(1):67-72
Aim of the work
To assess the efficacy of CT-guided transforaminal epidural steroid injection (CT-TFESI) as compared to vertebral axial decompression (VAX-D), the combined effect of both and medical treatment in the management of acute lumbar disc herniation.Patients and methods
Forty-eight patients complaining of low back pain (LBP) with radicular symptoms due to lumbar disc herniation (<6 weeks duration) were enrolled. Patients were divided into 4 groups (12 patients each) and treated for one month; group I received three CT-TFESIs at 10 day intervals; group II received VAX-D sessions every other day; group III received three CT-TFESIs with simultaneous VAX-D sessions and group IV only received medical treatment. Evaluation of LBP intensity and its impact on activities of daily living was done using the Pain Visual Analogue Scale and the Oswestry Disability Index respectively at baseline, after 1 and 3 months from baseline.Results
Patients were 36 males and 12 females; their mean age was 38.6 ± 3.07 years, disease duration was 14.23 ± 6.51 days and body mass index was 44.9 ± 7.1. Patients who received CT-TFESIs had 87.8% improvement in pain intensity and 45.5% functional improvement. Patients who had combined CT-TFESIs and VAX-D sessions had the highest functional improvement (79.8%) after 3 months with significant pain control (77.5%), especially in patients with shorter disease duration. Medical treatment was the least effective.Conclusion
All treatment modalities showed a significant improvement in pain and function, however, the combined CT-TFESIs with regular VAX-D sessions was the most effective. Further studies with a larger sample size and a longer follow up are needed to support our findings. 相似文献2.
Eva Bernal Antoni Bayés-Genís Albert Ariza-Solé Francesc Formiga Maria T. Vidán Luis Alberto Escobar-Robledo Jaime Aboal Lídia Alcoberro Carme Guerrero Iván Ariza-Segovia Ana Hernández de Benito Pau Vilardell José Carlos Sánchez-Salado Victoria Lorente Antoni Bayés de Luna Manuel Martinez-Sellés 《Journal of electrocardiology》2018,51(1):1-7
Background
Interatrial block (IAB) is associated with atrial fibrillation (AF) in different clinical situations, but little information exists in elderly patients with myocardial infarction (MI) and its association with frailty.Methods
Consecutive MI patients aged ≥ 75 years were prospectively included. Frailty was assessed during the admission, as well as the prevalence of IAB. Main outcome measure was mortality and new onset AF at one year.Results
We included 254 patients. From 220 patients with sinus rythm (86.6%), 37 had partial IAB (16.8%) and 34 advanced IAB (15.5%). Patients with advanced IAB had lower values of handgrip strenght (19.8 vs 21.7 kg, p 0.073). These patients had a trend toward higher incidence of AF or mortality during follow up (HR 1.51, 95% CI 0.85–2.70, p = 0.164).Conclusions
Advanced IAB was associated with a trend toward higher prevalence of frailty. Elderly patients with MI and advanced IAB had a trend toward higher incidence of AF. 相似文献3.
4.
Nermeen Khairy Yasser Ezzat Nahla Naeem Radwa Taha Rasha Wesam 《The Egyptian Rheumatologist》2017,39(1):7-12
Background
Cardiovascular diseases (CVD) and atherosclerosis are over presented in patients with systemic lupus erythematosus (SLE).Aim of the work
The aim of this study is to determine the frequency of some atherosclerosis biomarkers in SLE patients with and without CVD compared with controls.Patients and methods
28 female SLE patients with a mean age of 30.1 ± 7.2 years and a history of CVD (SLE cases) were compared with 25 age matched SLE female patients but without a history of CVD (SLE controls) and 25 age matched population based control women (population controls). Intima, media thickness (IMT) was measured by B-mode ultrasound as a potential measure of atherosclerosis. Nontraditional biomarkers of atherosclerosis such as leptin, oxidized LDL (oxLDL) and homocysteine were also investigated.Results
SLE cases had significantly increased IMT compared with SLE controls and population controls (p < 0.001), whereas IMT of SLE controls did not differ from population controls. Compared to SLE controls, SLE cases had raised circulating levels of leptin (p < 0.001), homocysteine, dyslipidemia with raised triglycerides (p < 0.001), decreased HDL-cholesterol concentration, (p < 0.001), lupus anticoagulants (p = 0.01), and higher cumulative prednisone dose (p = 0.4). Disease duration was comparable between the two SLE groups and the blood pressure and body mass index (BMI) were similar among the 3 groups.Conclusion
A set of distinct CVD risk factors (biomarkers of atherosclerosis) separate SLE cases from SLE controls and normal population controls. If confirmed in a prospective study, they could be used to identify SLE patients at high risk of CVD in order to optimize treatment. 相似文献5.
Mohammad M. Al-Daydamony Tamer M. Moustafaa 《Journal of the Saudi Heart Association》2017,29(4):276-282
Background
Pulmonary hypertension is a common complication of rheumatic mitral stenosis (MS). Patients with similar mitral valve (MV) areas may have different pulmonary artery pressures. Net atrioventricular compliance (Cn) was found to play an important role in the development of pulmonary hypertension.Aim
To test the value of Cn in predicting persistent pulmonary artery hypertension (PPAH) after percutaneous mitral balloon commissurotomy (PMBC).Patients and Methods
Eighty patients with severe MS, suitable for PMBC were included in the study. We excluded patients with contraindication to PMBC, atrial fibrillation, failure of PMBC, and restenosis. All patients had undergone electrocardiography, echocardiography with measurement of MV area, systolic pulmonary artery pressure (SPAP), and Cn, PMBC, and follow-up echocardiography.Results
Patients were divided into two groups: Group I: Cn < 4.2 mL/mmHg (36 patients), Group II: Cn ≥ 4.2 mL/mmHg (44 patients). Group I patients had significantly higher SPAP, and significantly lower SPAP reduction. Sensitivity of Cn < 4.2 mL/mmHg in prediction of PPAH was 88.9%, specificity was 88.6%, and accuracy was 88.8%. Independent predictors for PPAH were baseline Cn (p = 0.0027), and Cn improvement after PMBC (p = 0.0085). There was a significant negative correlation between Cn and baseline SPAP (r = ?0.349, p = 0.0015), and a significant positive correlation between Cn and percent SPAP reduction (r = 0.617, p < 0.00001).Conclusion
Measuring Cn can predict PPAH in MS patients after PMBC. It also may add value in evaluating MS patients undergoing PMBC and may help in predicting their prognosis. 相似文献6.
Introduction
Interleukin-34 (IL-34) is a newly discovered cytokine essential for skin homoeostasis. It is involved in macrophage differentiation, osteoclastogenesis and inflammation. This could suggest a potential role in the pathogenesis of psoriasis and psoriatic arthritis (PsA).Aim of the work
To assess serum IL-34 level in psoriatic patients with and without arthritis and to correlate it with disease activity and severity.Patients and methods
Serum IL-34 level was measured in 45 psoriasis patients (21 had PsA) and 20 healthy controls. Patients were clinically assessed using psoriasis skin area severity index (PASI), composite psoriasis disease activity index (CPDAI) and peripheral joint score (PJS). Radiological assessment of hands and feet was done using modified Sharp-van der Heijde (mSvH) scoring method for PsA.Results
The mean age of the PsA patients (47.4 ± 10.2 years) was comparable with the psoriasis only patients (42.5 ± 7.5 years) and control (43.4 ± 7 years). Serum IL-34 was significantly higher among PsA patients compared to those without arthritis and controls (median = 2500 ng/L, 512 ng/L and 325 ng/L, respectively). CPDAI was significantly higher in PsA compared to patients without arthritis. PASI scores were comparable between patients. Serum IL-34 level correlated significantly with each of PASI, CPDAI and PJS but not with the mSvH score. Receiver operator characteristic curve analysis revealed that serum IL-34 testing showed excellent diagnostic performance for PsA in psoriasis patients.Conclusion
The markedly elevated IL-34 serum level in PsA patients compared to non-arthritic ones and its remarkable correlation with PsA disease activity, suggest its importance as a marker for arthritis in psoriasis patients. 相似文献7.
G.S. Youssef H.H. Kassem O.A. Ameen H.S. Al Taaban H.H. Rizk 《The Egyptian Heart Journal》2017,69(3):177-181
Background
Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities.Objectives
To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country.Methods
Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay). We also recorded the time delay between the arrival to hospital and the institution of definitive therapy (hospital delay). Causes of pre-hospital delay are either patient- or transportation-related, while hospital delay causes are either staff- or system-related.Results
We recruited 315 patients, 200 (63.5%) were males, 194 (61.6%) hypertensives, 180 (57.1%) diabetics, 106 (33.7%) current smokers and 196 (62.2%) patients had prior history of cardiac diseases. The mean pre-hospital delay time was 8.7 ± 9.7 h. Sixty-six percent of this time was due to patient-related causes and 34% of pre-hospital delay time was spent in transportation. The mean hospital delay time was 2.3 ± 0.95 h. In 89.8% of cases, the hospital delay was system-related while in 10.2% the reason was staff-related. The mean total delay time to definitive therapy was 11.0 ± 9.8 h.Conclusion
Pre-hospital delay was mainly patient-related. Hospital delay was mainly related to healthcare resources. Governmental measures to promote ambulance emergency services may reduce the pre-hospital delay, while improving the utilization of healthcare resources may reduce hospital delay. 相似文献8.
Olfa Saidane Ines Mahmoud Leila Gafsi Ajleni Houda Rawdha Tekaya Leila Abdelmoula 《The Egyptian Rheumatologist》2018,40(3):183-185
Background
The work productivity loss due to ankylosing spondylitis (AS) has a notable socioeconomic impact.Aim of the work
To evaluate the professional characteristics of Tunisian AS patients and determine conditions that lead to absenteeism.Patients and methods
99 AS patients were included. Disease characteristics and specific AS indices were assessed; Bath AS disease activity index (BASDAI), Bath AS disease functional index (BASFI), Bath AS disease global index (BASG-s), Bath AS radiologic index (BASRI), hospital anxiety and depression (HAD) scale and Shorts Form-36 (SF-36). Visual analogue scale was used to evaluate pain and fatigue. Patients were questioned on their work situation, work sector, work conditions (rhythm, posture, working hours, distance to workplace, duration of rest) and whether they have missed work time during the last three months because of their disease.Results
Mean age of patients was 40.02 ± 11.78 years; 70 men and 29 women. The mean disease duration was 11.87 ± 10.7 years. Absenteeism was present in 23.2% of the cases. Only the deterioration of the mental component of the SF-36 was associated with absenteeism (p = 0.03). Depression and anxiety states seemed not to increase absenteeism, gender and work sector had no influence. Factors significantly associated with absenteeism were increased working hours (p = 0.037), bad posture (p = 0.001), stress at work (p = 0.035) and insufficient day rest duration (p = 0.007). Carrying heavy loads tended to be more frequent in the absenteeism group (p = 0.08).Conclusion
Absenteeism is high amongst Tunisian AS patients. Work conditions were important factors of absenteeism in Tunisian AS patients that directly influence productivity. 相似文献9.
Suvi Sirkku Tuohinen Jani Rankinen Tanja Skyttä Heini Huhtala Vesa Virtanen Pirkko-Liisa Kellokumpu-Lehtinen Pekka Raatikainen Kjell Nikus 《Journal of electrocardiology》2018,51(2):188-194
Background
ST segment depression (STD) and T wave inversion (TWI) are typical electrocardiographic (ECG) findings in non-ST elevation myocardial infarction (NSTEMI). In ST elevation myocardial infarction, ST changes represent transmural ischemia. The pathophysiological mechanisms of the ECG changes in NSTEMI are unclear.Purpose
We studied the associations between ECG and the echocardiographic findings in NSTEMI patients.Methods
Twenty patients with acute NSTEMI were recruited during their hospital stay. A comprehensive echocardiography study was performed. The findings were compared with blinded ECG analyses.Results
Nine (45%) patients had STD, and 16 (85%) patients had TWI. In multivariable analysis, STD was independently associated with a lower global early diastolic strain rate (β =-5.061, p = 0.033). TWI was independently associated with lower circumferential strain (β = 0.132, p = 0.032).Conclusions
The typical ECG changes in NSTEMI patients were associated with subtle echocardiographic changes. STD was related to changes in diastolic function, and TWI was associated with systolic deterioration. 相似文献10.
Nayera Z. Saber Sherif H. Maroof Dina A. Soliman Marwa S. Fathi 《The Egyptian Rheumatologist》2017,39(3):151-157
Background
Modern data suggest that interleukin 17 (Il-17) and Il-17 producing cells play an important role in the pathogenesis of lupus nephritis (LN). It was reported that T helper 17 migrate to the kidney and contribute to inflammatory processes.Aim of the work
To measure the frequencies of peripheral blood T helper-17 (Th17) cells and IL-17 concentration in urine in systemic lupus erythematosus (SLE) patients and to study their association with disease activity and renal involvement.Patients and methods
This work included 45 patients; 36 females and 9 males with 20 matching controls. Patients were subjected to clinical and laboratory assessments with emphasis on renal affection. The SLE disease activity index was also calculated. Expression of Th-17 cells in peripheral blood was measured by flow cytometry via the combined expression of CD3, IL-23R, intracellular IL-22, IL-17 and urinary IL-17 was measured by ELISA.Results
The patients’ mean age was 26.5 ± 7.6 years and disease duration was 6.03 ± 4.3 years. Th17 expression and urinary IL-17 were significantly higher in patients than controls (p = 0.04 and p < 0.001 respectively). Th17 cell frequencies and IL-17 levels significantly correlated with renal biopsy classification for LN (p = 0.02 and p = 0.04 respectively). Th17 cell expression and IL-17 levels were comparable in SLE patients with and without LN. Th17 cell frequencies significantly correlated with serum creatinine, SLEDAI and inversely with C3 (p = 0.003), while IL-17 significantly correlated with CD3 cells, proteinuria and erythrocyte sedimentation rate.Conclusion
Peripheral blood Th17 cell frequencies and IL-17 in urine are highly linked to LN in SLE and are promising markers of disease activity in LN. Both are valuable targets for future therapeutic applications. 相似文献11.
Muhammad O. Awiwi Zeynep Aslan Yagli Ferruh Elbir Ahmet Arif Aglar Erhan Guler Unsal Vural 《Journal of the Saudi Heart Association》2017,29(1):1-6
Introduction
Oral anticoagulation with warfarin is indicated for patients with prosthetic heart valves. The effects of religious fasting during Ramadan month (in the Islamic calendar) on anticoagulation aren’t clear.Objectives
To study the impact of Ramadan fasting on international normalized ratio (INR), quality of anticoagulation, dose of warfarin used and blood osmolarity.Methods
18 patients were followed-up prospectively for 3 months (pre- Ramadan, Ramadan and post-Ramadan months). Patients presented for weekly visits in which blood samples were obtained.Results
No significant difference in INR and warfarin dose was found between Ramadan month, and months before and after it. The post-Ramadan INR was significantly larger than pre-Ramadan (p = 0.004). Blood osmolarity was significantly lower during Ramadan compared to pre- and post-Ramadan months. A significantly better quality of anticoagulation was noticed during Ramadan (p < 0.001). A significantly larger ratio of supratherapeutic INR values occurred in the post-Ramadan month (p < 0.05). A significantly larger ratio of infra-therapeutic INR values was noticed in the pre-Ramadan month (p < 0.05).Conclusion
No significant difference in mean INR or warfarin dose was found and a better quality of anticoagulation was achieved during Ramadan. A tendency toward supra-therapeutic anticoagulation occurred after Ramadan, thus a closer follow up during this period may be reasonable. 相似文献12.
Sahar Fakhreldin Mohammed Mayada Ali Abdalla Wesam Mustafa Ismaeil Marwa Mohammed Sheta 《The Egyptian Rheumatologist》2018,40(1):23-27
Aim of the work
To evaluate serum leptin levels in systemic lupus erythematosus (SLE) patients and correlate these levels with clinical and laboratory parameters as well as disease activity using systemic lupus disease activity index (SLEDAI).Patients and methods
The study was conducted on sixty female subjects, forty SLE patients and twenty healthy controls. Patients were diagnosed according to the American College of Rheumatology (ACR) revised criteria for SLE. All patients were subjected to full history taking, thorough clinical examination, assessment of disease activity using SLEDAI and laboratory investigations including serum leptin levels (pg/ml) assessed by Enzyme Linked Immunosorbent Assay (ELISA). Patients were divided into two groups; group I with active SLE and group II with inactive SLE. Patients with SLEDAI ≥3 were considered active.Results
Significant statistical differences were found in serum leptin levels between SLE patients and controls (6229.65 vs. 2962.30 pg/ml, p < 0.001). Significant statistical correlation of serum leptin levels with body mass index (BMI) (p < 0.001) and total cholesterol (p = 0.014) in SLE patients. Non-significant statistical correlation between serum leptin levels and SLEDAI (p = 0.310). Non-significant statistical difference was found in levels of serum leptin between active and inactive SLE groups (p = 0.344).Conclusions
SLE patients had elevated serum leptin levels. Elevated leptin levels correlated significantly with BMI and total cholesterol. Serum leptin levels showed non-significant correlations with SLEDAI nor did they differentiate between active and inactive SLE patients. 相似文献13.
Background
The diagnosis of coronary artery disease (CAD) in patients with LBBB represents a clinical challenge. The presence of fragmented QRS (fQRS) complex on surface ECG may be related to myocardial ischemia, scarring or fibrosis.Objectives
To investigate the relation between fQRS and the presence and severity of CAD in patients with LBBB.Patients and methods
56 patients with symptoms suggesting CAD and complete LBBB were submitted to full history taking and clinical examination, complete 12-leads electrocardiography (ECG) to confirm the diagnosis of LBBB and to diagnose the fragmented wide QRS (f-wQRS) complex, echocardiography, and coronary angiography; lesions with ?70% narrowing in major epicardial artery or ?50% narrowing in the left main coronary artery were considered significant; and Gensini score was calculated. Patients were classified into two groups according to the presence or absence of f-wQRS.Results
There were significantly more patients with obstructive CAD among patients with f-wQRS (p = 0.000053). Gensini score was significantly higher in patients with than in patients without fwQRS (p < 0.00001). f-wQRS was the only significant independent predictor of obstructive CAD. Sensitivity of f-wQRS in predicting obstructive CAD was 80.1%, specificity was 73.3%, positive predictive value was 72.4%, negative predictive value was 81.5%, and overall accuracy was 76.8%, p = 0.0022.Conclusion
Seeking for f-wQRS in patients with LBBB and suspected CAD is a simple, easy, available, method that may be helpful in noninvasive prediction of obstructive CAD. 相似文献14.
Sherif M. Gamal Samar M. Fawzy Marwa Abdo Fatema T. Elgengehy Shada Ghoniem Alkhateeb Alkemry 《The Egyptian Rheumatologist》2017,39(2):89-92
Aim of the work
To study the relation of the immune profile to dyslipidemia in a cohort of Egyptian Systemic Lupus Erythematosus (SLE) patients.Patients and methods
This study included 221 SLE patients with a disease duration >6 months at study entry. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI) and severity using the Systemic Lupus International Collaborating Clinics/Damage Index (SLICC/DI). Patients were investigated for the anti-nuclear antibody (ANA), anti-double stranded deoxy-ribonucleic acid (anti-dsDNA), anti-cardiolipin (ACL) antibodies (IgG and IgM), anti Ro (SSA) and anti La (SSB). Dyslipidemia was considered if the high density lipoproteins (HDL), low density lipoproteins (LDL), total cholesterol (TC) or triglycerides (TG) were abnormal.Results
The mean age of the patients was 28.8 ± 7.8 years and the median disease duration was 5 years. The clinical manifestations of the patients were pleurisy (52.9%), pericarditis (24.9%), nephritis (68.3%), CNS lupus (23.1%), vasculitis (14.9%) and musculoskeletal manifestations (57.9%). All patients were on corticosteroids (median dose 35 mg/day; range 5–80 mg/day), while 92 (43.4%) of them received cyclophosphamide during their disease course. The mean SLEDAI was 12.1 ± 7.4 and SLICC/DI was 1.4 ± 1.6. Patients with positive anti-Ro (n = 44; 19.9%) showed statistically significant lower level of HDL (p = 0.01).Conclusion
Positive anti-Ro may be associated with increased incidence of low HDL in lupus patients which in turn may increase the incidence of cardiovascular accidents. 相似文献15.
Nihal Fathi Samar H. Goma Nadia M. Ismail Abeer M. Ghandour Sally S. Youssef Nisreen A. Mohammed Eman Mosad 《The Egyptian Rheumatologist》2018,40(1):45-49
Background
Systemic sclerosis (SSc) is an autoimmune connective tissue disease with vascular, fibrotic and immune changes of skin and some internal organs. Anti-heterogeneous nuclear ribonucleoproteins (anti-hnRNP) were found in SSc patients.Aim of the work
To assess anti-hnRNP A1 and A2 autoantibodies in limited SSc patients and to find their relation to clinical and hand radiographic characteristics.Patients and methods
26 limited SSc patients and 16 matched control were studied. Skin thickness was scored according to the modified Rodnan skin score method (mRss) and radiologic examination by plain X-ray of the hand and wrist was performed anti-hnRNP A1 and A2 were measured in patients and control.Results
All patients were females with a mean age of 37.5 ± 11.24 years and mean disease duration of 7.84 ± 1.19 years. 96.2% of cases showed juxta-articular osteoporosis, 38.5% with marginal erosions, 73.1% with surface erosions, 42.3% with subchondral cyst, 42.3% with metacarpophalangeal subluxation, 11.5% with marginal sclerosis, 80.8% with resorption of distal phalanges, 38.5% with resorption of distal ulna and 34.6% with calcinosis. Anti-hnRNPA1 was positive in all the patients but the anti-hnRNPA2 was positive in 21 (80.8%). Anti-hnRNP A1 and A2 showed significant difference between patients and control (5.66 ± 4.18 ng/ml vs 2.88 ± 0.82; p < 0.01 and 1.82 ± 0.36 vs 0.73 ± 0.08; p < 0.02, respectively). There was no significant correlation between the markers with the mRss or radiographic changes.Conclusion
Joint affection in SSc is more frequent than expected. Anti-hnRNP A1 and anti hnRNP A2 antigens may be useful markers for SSc patient although no significant relation was found with radiologic findings. 相似文献16.
Mohamed Ibrahim Maha Behairy Marwa El-Ashry Ahmad E. Mostafa 《The Egyptian Heart Journal》2018,70(1):27-33
Background
Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality in patients with end stage renal disease (ESRD). Circulating endotoxins may have toxic effect on myocardial functions and are speculated as pathogens of accelerated atherosclerosis and hemodialysis (HD) patients.Objective
We aimed to assess the possible relation between circulating endotoxin levels and left ventricular functions parameters, common carotid artery intimal media thickness (CIMT) in prevalent HD patients.Patients and Methods
Forty stable prevalent HD patients with mean age (47.97 ± 14.42) year using regular conventional hemodialysis sessions in Ain shams university hemodialysis unit, Cairo, Egypt were randomly selected. Diabetics, congestive heart failure and those with history of myocardial infarction or coronary artery disease were excluded from the study. All patients were studied by CBC and routine chemistry, as well as hs CRP, Intact PTH, lipid profile and endotoxin level by ELISA before and after the HD session, Delta change of endotoxin (pre dialysis endotoxin-post dialysis endotoxin) was calculated, resting Doppler echocardiographic and carotid duplex.Results
Mean of Pre-HD session serum endotoxin level was (0.356 ± 0.090) EU/mL and the mean of post -HD endotoxin levels was (0.367 ± 0.110) EU/mL. Significant positive correlation between post dialysis endotoxin, MV E/A ratio and grades of left ventricular diastolic dysfunction (P < 0.05) and significant correlation between delta change in endotoxin and EF% (r = ?0.36,P = 0.02). By stepwise linear regression analysis for determinants of MVE/A post –HD endotoxin level independently associated with MV E/A ratio (ß = 0.350, P = 0.027). We did not detect any significant correlation between CCA atherosclerosis and neither pre nor post- HD endotoxin level nor with delta change of pre and post HD endotoxin levels.Conclusion
Acute increase in post dialytic circulating endotoxin level in prevalent HD patients may be associated with both left ventricular systolic and diastolic dysfunction and that attempts to reduce endotoxin level may have a positive impact on cardiovascular complications in HD Patients. 相似文献17.
Mahmoud Ali Hesham Salah El-Din Sameh Bakhoum Amal El-Sisi Kareem Mahmood Heba Farouk Hossam Kandil 《Journal of the Saudi Heart Association》2018,30(1):21-27
Background
Closure of atrial septal defect (ASD) among adults under transthoracic echocardiography (TTE) guidance using devices other than the Amplatzer Septal Occluder has not been extensively tested.Aim of work
Assessment of the safety and efficiency of secundum ASD closure using the Occlutech Figulla ASD Occluder under TTE guidance in adult patients with hemodynamically significant secundum ASD.Methods
Twenty patients (mean age, 32.9 ± 9.7, 75% of them females) were enrolled in the study. All patients underwent TTE and transoesophageal echocardiography (TEE) to assess the characteristics of the ASD prior to percutaneous closure. Procedures were performed using the Figulla Occluder device under both fluoroscopic and TTE guidance. Follow-up clinical and TTE examinations were done at 1, 3, and 6 months following the procedure.Results
TTE estimated mean ASD size was 21.7 ± 7.3 mm with adequate rims except for the aortic rim (deficient in one third of cases). Mean device size was 28.1 ± 8.6 mm with mean procedure and fluoroscopic times of 46.2 ± 16.4 and 15.7 ± 5.4 minutes respectively. ASD was successfully closed in all patients. Two patients showed a small residual shunt immediately after the device placement that disappeared by the end of the 2nd followup TTE examination. Transient complications were detected in 2 patients. All patients were asymptomatic during the follow-up period.Conclusion
Transcatheter closure of secundum ASD in adults under TTE guidance using the Occlutech Figulla ASD occluder device is safe and effective when performed in a tertiary center and by expert echocardiographers and interventional cardiologists. 相似文献18.
Alexey Tsyganov Erik Wissner Andreas Metzner Sergey Mironovich Maria Chaykovskaya Vitaly Kalinin Mikhail Chmelevsky Christine Lemes Karl-Heinz Kuck 《Journal of electrocardiology》2018,51(1):92-98
Introduction
The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias.Methods
Eight patients (2 females, mean age 50 ± 17 years) with ischemic (n = 3) and nonischemic (n = 5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data. Arrhythmia patterns were analyzed using noninvasive phase mapping.Results
Macro-reentrant VT circuits were observed in 3 ischemic and 1 nonischemic cardiomyopathy patient, respectively. In the remaining 4 patients, phase mapping revealed relatively stable rotor activity and multiple wavelets.Conclusions
Noninvasive cardiac mapping was able to visualize the macro-reentrant circuits in patients with scar-related VT. In patients without myocardial scar only polymorphic VT or VF was inducible, and rotor activity and multiple wavelets were observed. 相似文献19.
Samia Z. Hassan Rasha E. Gheith Ahmed A. Baz Zeinab M. Afifi 《The Egyptian Rheumatologist》2017,39(3):165-170
Aim of the work
Evaluation of asymptomatic venous disease in patients with Behçet’s disease (BD) using venous Doppler ultrasonography (US) and its relation to different disease manifestations and activity.Patients and methods
Twenty-two BD patients (20 males and 2 females) with a mean age of 36.9 ± 10.6 years and disease duration of 10.8 ± 11.3 years without any known vascular disease and 22 age and sex matched controls were enrolled in this study. The Behçet’s disease current activity form (BDCAF) was used to assess disease activity. Patients and controls were subjected to venous Doppler US for both upper and lower limbs as well as the inferior vena cavae (IVC). The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) severity score was used to evaluate the severity of venous insufficiency.Results
The 22 patients had a mean BDCAF score of 2.2 ± 0.2. No venous thrombosis or thrombophlebitis was detected in patients or controls. Three patient (13.6%) and one control (4.5%) revealed venous-insufficiency (venous reflux >1 s) in the lower extremities. The venous-insufficiency involved the superficial venous system and involved the deep venous system in 1 patients and the control. The lower limb veins were normal on both sides as regards compressibility, wall thickness and competency of perforator veins. Upper extremity veins were totally normal in all subjects.Conclusion
No superficial, deep venous dysfunction on both lower or upper limbs and/or IVC thrombosis was found in BD patients. Further follow-up venous Doppler for BD patients even without vascular complications is recommended to detect subclinical cases that may predict future thrombotic events. 相似文献20.
Nashwa M. Abd-Allah Gihan Omar Nadia Elameen Rabab A.S. Mousa 《The Egyptian Rheumatologist》2018,40(3):191-195