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1.
Eman M. El-Serougy Nahla N. Eesa Hatem M. El-Azizi Hayat A. Badawi 《The Egyptian Rheumatologist》2019,41(1)
Background
Evaluation of remission in Rheumatoid Arthritis (RA) largely relies on composite scores based on clinical and laboratory assessments however, patients can fulfill clinical remission criteria as defined by composite scores, yet still have evidence of synovitis detectable on imaging.Aim of the work
To evaluate hand and wrist joints in patients with RA in clinical remission using power Doppler (PD) ultrasonography and to study the association between ultrasonographic findings and composite index scores.Patients and methods
This study was conducted on 50 RA patients in clinical remission. Ten matched healthy subjects were included as control. The modified health assessment questionnaire (MHAQ) was assessed in the patients; disease activity was calculated using a composite index score including disease activity score (DAS28) and clinical disease activity index (CDAI). Ultrasonographic assessment of the hand and wrist joints was performed.Results
The mean age of the patients was 50.9?±?9.2?years, disease duration was 10.6?±?5.5?years and were 38 females and 12 males. The mean DAS28 was 2.3?±?0.3. On ultrasonographic examination, 14 (28%) patients had normal synovium, while 18 (36%) showed synovial hypertrophy without evidence of inflammation and 18 (36%) had PD signals. DAS28 was higher in patients with PD signals (2.36?±?0.3) compared to those without synovitis (2.3?±?0.28). There was a significant correlation between PD activity and CDAI (p?=?0.005), MHAQ (p?=?0.002) and disease duration (p?=?0.023).Conclusion
Power Doppler ultrasound can detect residual inflammation in RA patients in clinical remission and its scores were signficantly associated with the clinical disease activity index and functional status. 相似文献2.
Shadia I. Allam Rehab A. Sallam Doaa M. Elghannam Atif I. El-Ghaweet 《The Egyptian Rheumatologist》2019,41(1):11-14
Background
The diagnosis of early rheumatoid arthritis (RA) is challenging. B-cell chemokine (CXCL13) plays a critical role in the disease pathogenesis.Aim of the work
To assess the diagnostic value of serum CXCL13 in early RA and compare it with rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies.Patients and methods
The study included 60 RA patients; 30 early, 30 established RA and 30 healthy controls. The modified health assessment questionnaire (MHAQ), modified Sharp-van der Heijde score (MSS) and disease activity score (DAS28) were assessed in RA patients. RF, anti-CCP and serum level of CXCL13 were measured.Results
Patients had a mean age of 39?±?7.4?years and disease duration of 4.4?±?5.7?years; they were 46 females and 12 males (F:M 3.8:1). Serum CXCL13 was significantly higher in early (191.7?±?74.4?pg/ml) compared to established (136.4?±?79?pg/ml) RA (p?=?0.007) which were not observed with RF and anti-CCP; both were higher than in control (30.4?±?13.5?pg/ml) (p?<?0.001). In early RA, the frequencies of CXCL13, RF and anti-CCP positivity were 90%, 73.3% and 56.7% while in the established cases the frequencies were 36.7%, 66.7% and 63.3% respectively. CXCL13 significantly correlated with DAS28 (early: 0.49, p?=?0.006; established: r?=?0.38, p?=?0.04) but not with MHAQ or MSS. The CXCL13 significantly correlated with both the RF and anti-CCP in both early and established cases (p?<?0.001).Conclusion
CXCL13 is an important for the diagnosis of early RA with a superior diagnostic performance compared to RF and anti-CCP. It may also be considered a potential biomarker of disease activity. 相似文献3.
Abbed K.M. Hameed Tamer O. El-Said Hamdia Y. Askar Basma A. ElKady 《The Egyptian Rheumatologist》2019,41(2)
Background
Numerous tools to assess activity of rheumatoid arthritis (RA) are available to use. For any marker to be a more appropriate indicator of disease activity, it should be more authentic to the patho-physiologic basis of the disease.Aim of the work
To determine the performance of serum adenosine deaminase (sADA) in measuring disease activity in RA.Patients and Methods
100 RA patients and 100 matched controls were included in the study. The disease activity score (DAS28) with erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. sADA level was determined by spectrophotometry. The sADA level was integrated in the DAS28 formulae and the corresponding values were determined.Results
The mean age of the RA patients was 61.8?±?9.7?years, 68% were females and they had a disease duration of 12.5?±?3.7?years. The mean DAS28-ESR was 4.2?±?1.3 and DAS28-CRP 3.5?±?1.1. The mean sADA was significantly higher in the patients (33.6?±?11.6?U/L) compared to the control (25.1?±?9.9?U/L) (p?<?0.001). The sADA level and DAS28-sADA did not differ according to the gender, methotrexate use, rheumatoid factor or anti-citrullinated protein autoantibodies positivity. The mean DAS28-sADA significantly increased in higher activity categories (p?<?0.001). sADA significantly correlated with the disease activity parameters. DAS28-sADA significantly correlated with DAS28-ESR (r?=?0.57, p?<?0.001) and DAS28-CRP (r?=?0.604, p?<?0.001). DAS28-sADA showed a sensitivity of 0.9 and specificity 0.69 for detection of disease activity measured with DAS28-ESR and was 0.88 and 0.65 when measured with DAS28-CRP.Conclusion
Integration of sADA in the DAS28 index can be a useful marker that reflects RA activity. 相似文献4.
Aim of the work
To measure serum peptidyl arginine deiminase (PADI4) enzyme level in rheumatoid arthritis (RA) patients and to assess its role in diagnosis and monitoring patient improvement.Patients and methods
The study included 31 RA patients and 10 age and sex matched healthy controls. Serum PADI4 and anti-cyclic citrullinated peptide (anti-CCP) were measured. Disease activity score (DAS28) was calculated. Patients were followed-up at 3 months with measurement of serum PADI4, anti-CCP and DAS28.Results
Mean age of the patients was 42.4?±?7.8 years, female:male?=?5.2:1 and disease duration 8.1?±?5.4 years. The DAS28 was 5?±?1.2 and modified health assessment questionnaire (MHAQ) was 0.8?±?0.6. Mean anti-CCP (129.3?±?74.8?ng/ml) and PADI-4 levels (532.9?±?240.9?pg/ml) in patients were significantly higher than in controls (8.4?±?4.4?ng/ml and 156?±?31?pg/ml respectively; p?<?0.001 both). At a cut-off value?≥?250?pg/ml, PADI4 was highly diagnostic for RA (sensitivity 90.3%, specificity 100%; area under curve?=?0.97 with no significant difference from anti-CCP at a cut-off of 15 ng/ml (sensitivity 93.5%, specificity 100%; AUC ?=?0.99). Serum PADI4 level showed a significant correlation with DAS28 (r?=?0.49, p?=?0.047). At follow up (n?=?20), no significant difference in PADI4, anti-CCP level or DAS28 scores was found but changes in serum PADI4 level significantly correlated with changes in DAS28 (r?=?0.82, p?<?0.001). Mean serum PADI4 level was significantly lower in improved patients (184.4?±?10.2?pg/ml) compared to unimproved (563.3?±?251.9?pg/ml, p?<?0.001).Conclusion
Serum PADI4 was diagnostic for RA and comparable with anti-CCP. It correlated with disease activity and could be a promising follow up marker of remission. 相似文献5.
Marwa Fathy Ebraheem Rehab Abd-El Raouf Sallam Mona A. Mohsen Basma Ahmed El-Kady Galal E. El-Hawary Azza A Baiomy 《The Egyptian Rheumatologist》2019,41(2)
Background
There is risk of premature atherosclerosis in juvenile idiopathic arthritis (JIA) patients which predisposes to cardiovascular disease (CVD) in adulthood. This can be assessed by flow mediated dilatation (FMD) and carotid intima media thickness (IMT) of the arterial wall and by soluble vascular cell adhesion molecule (sVCAM-1).Aim of the work
To assess endothelial dysfunction in JIA children and to correlate sVCAM with FMD of brachial artery and carotid IMT.Patients and methods
The study was conducted on 55 JIA patients. The following was assessed: body mass index (BMI), blood pressure, juvenile arthritis disease activity score (JADAS27). Childhood Health Assessment Questionnaire (C-HAQ), physical activity questionnaire (PAQ), fatigue assessment using The Pediatric Quality of Life (PedsQL) inventory, full blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), serum creatinine and lipid profile, sVCAM-1, FMD and IMT.Results
The patients’ age was 10.9?±?3.9?years and were 28 (50.9%) females. JADAS-27 and CRP was higher in systemic JIA, but fatigue scores were significantly lower. CHAQ was significantly lower in patients with polyarticular disease. Patients with high disease activity had significantly younger age of onset, lower BMI, shorter disease duration, lower fatigue scale and physical activity scores and higher CHAQ. sVCAM-1 significantly correlated with CHAQ, low-density lipoprotein, CRP and ESR while FMD significantly correlated with PedsQL and PAQ.Conclusion
JIA patients had impaired endothelial function and increased cIMT with increased sVCAM-1, impaired lipid profile, decreased physical activity and increased fatigue with a potentially higher cardiovascular risk in this pediatric population. 相似文献6.
Naglaa S. Ghazy Rasha A. Abdel Noor Maaly M. Mabrouk Wael F. Mohammed 《The Egyptian Rheumatologist》2019,41(2)
Background
End stage renal disease can decrease lupus activity especially after renal replacement therapy, so assessment of activity after starting hemodialysis (HD) is essential to avoid immunosuppressive complications and prevent flares.Aim of the work
To assess lupus activity in patients on regular HD and determine the differences in activity and number of lupus flares between patients who were maintained on steroids and immunosuppressives and those not.Patients and methods
Thirty-five systemic lupus erythematosus (SLE) patients on regular HD. were recruited from 14 hemodialysis centers in five cities in Gharbia Governorate, Egypt. The patient?s files were reviewed and SLE disease activity index (SLEDAI) was measured.Results
The mean age of patients was 30.7?±?9.2?years and were 29 females and 6 males with a median disease duration of 6?years and SLEDAI of 3. 57.1% of the cases did not record lupus flare after dialysis while 42.9% were active; 11 (31.4%) of them had 1 flare, 3 (8.6%) had 2 flares and 1 (2.9%) had 3 flares. and according to the SLEDAI grading, 77.2% had no flare, 11.4% had mild flare and 11.4% moderate; none had a severe flare. There was no significant difference between those maintained on steroids or immunosuppressives and patients who stopped treatment after HD as regard number of flares and disease activity grading.Conclusions
Lupus activity is not uncommon after starting hemodialysis but giving a prolonged immunosuppressive therapies is not necessary in all cases and should be given cautiously to avoid their side effects. 相似文献7.
Gianluca Rigatelli Marco Zuin Kiril Karamfilof Daniele Cavazzini Gabriele Braggion Stefano Perilli Dobrin Vassilev 《Cardiovascular Revascularization Medicine》2019,20(2):108-112
Background
The optimal final optimization technique to be used in patients after Cross Over Left main stenting remainsdebatable.Aim
We evaluate the impact of the post-optimization technique (POT), kissing balloon (KB) and the POT-side-POT techniques on both cardiovascular mortality and event-free survival in patients receiving left main (LM) cross-over stenting for an isolated/distal bifurcation LM disease.Methods
Clinical and instrumental records of 128 consecutive patients (102 males, mean age 73.39?±?9.54?years old) with isolated distal/bifurcation LM disease and bypass surgery contraindications or refusal enrolled to receive LM cross-over stenting between the 1st January 2012 and the 1st January 2017 at two institutions: the Rovigo General Hospital (Rovigo, Italy) and the Alexandrovka Hospital University School of Medicine (Sofia, Bulgaria). Patients has been divided into three groups (POT, KB and POT-side-POT) according the optimal final optimization technique used while the 5-year cardiovascular mortality has been evaluated using the log-rank (Mantel-Cox) analysis.Results
Baseline angiographic characteristics of the LM disease were mostly equivalent among the three groups. Over a global follow-up of 61.03?±?0.92?months, the rates of target vessel revascularization, acute myocardial infarction, and stent thrombosis, were not different among groups. Patients treated with POT had a slightly better long-term survival.Conclusions
None of these optimization techniques appeared to have clearly better long-term outcomes after LM Cross-over stenting in our retrospective study. POT resulted in a slightly better survival compared to Pot-sid-POT and KB. 相似文献8.
Marwa A. Hammad Shaimaa M. Abdel-Latif Omaima Z. Shehata Amany M. Mohiey El-Din 《The Egyptian Rheumatologist》2019,41(1)
Background
Endothelial cell dysfunction has been described in Behçet disease (BD) not only as a cause of major vascular events but also related to chronic inflammation in different organ systems.Aim of the work
To study the relation of serum endocan, a marker of endothelial dysfunction, with clinical manifestations and disease activity in BD patients.Patients and methods
This study included 23 BD patients and 23 matched controls. Disease activity was assessed by the Behcet Disease Current Activity Form (BDCAF). Serum endocan was measured in all subjects.Results
The mean age of the patients was 32.5?±?6.8?years and they were 16 males and 7 females (M:F 2.3:1) with mean disease duration of 7?±?5.2?years. Their mean BDCAF was 2.26?±?1.32. A significant difference was found between serum endocan level among active patients 328.24?±?195.3?ng/L, inactive patients (169.8?±?35.7?ng/L) and controls (160.6?±?39.7?ng/L)(p?=?0.001). Patients with genital ulcers, papulopastular lesions and arthritis at the time of the study had higher serum endocan level than those without (p?=?0.002, p?=?0.006 and p?=?0.0001 respectively). Serum endocan levels correlated significantly with the BDCAF, neutrophil/lymphocyte ratio, platelet lymphocyte ratio and C-reactive protein (r?=?0.94, p?=?0.0001; r?=?0.82, p?=?0.0001, r?=?0.44, p?=?0.04 and r?=?0.48, p?=?0.02 respectively). The optimum serum endocan cut-off point for active BD was 191.5?ng/L with a sensitivity and specificity of 100% and 86% respectively (area under curve 0.99, 95% confidence interval 0.96-1).Conclusion
Serum endocan may serve as a potential marker of disease activity in BD. Patients with genital ulcers, papulopastular lesions and arthritis showed higher serum endocan levels. 相似文献9.
Aim of the work
To study patterns and disease subsets of Behcet’s disease (BD) patients admitted to Cairo University Hospitals and to detect whether relapse of the disease will affect the same system every time or not.Patients and methods
A retrospective study involving 82 BD patients admitted to Cairo University Hospitals, from January 2000 to December 2014. They were reviewed to analyze the frequency of different disease manifestations and to find out disease patterns and subsets.Results
75 men and 7 women were included in the study, with a mean age of 34.2?±?9.7?years. Their disease duration ranged from 1 to 34?years with a mean of 9.1?±?6.9?years. Mucocutaneous manifestations were present in 82 patients (100%), ocular manifestations in 53 patients (64.4%), vascular manifestations in 49 patients (59.8%), and neurological manifestations in 9 patients (11%). Most of our patients, 48 (58.5%) had the same one system pattern throughout the disease course, 25 patients (30.5%) had two systems patterns and 9 patients (11%) had three systems patterns.Conclusion
BD usually affects the same system throughout the disease course whether mucocutaneous, vascular, ocular or neurological and the most common pattern is the one system affection. This will help to predict the system that will be affected in each time the patient presents with a disease relapse. Also, it will help in differentiation between disease relapse and any associated other disease minimizing the need for and the cost of investigations. However, future studies on larger number of patients are recommended. 相似文献10.
Hamdi Wafa Alaya Raja Kaffel Dhia Boughanmi Nada Zouche Imene Kchir Mohamed Montacer 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To investigate the bone mineral density (BMD) in rheumatoid arthritis (RA) Tunisian patients, to identify the risk factors associated with its decrease and to assess the fracture risk.Patients and methods
The study included 173 patients and 173 matched healthy controls. BMD was assessed by the dual-energy X-ray absorptiometry. The risk of hip fracture (HF) and major osteoporotic fracture (MOF) were assessed using the fracture risk assessment tool (FRAX). The disease activity, radiological severity and functional status were investigated.Results
The mean age of patients was 54.1?±?11.04?years and 141 were females; 71.6% menopausal. Disease duration was 8.2?±?8?years and disease activity score was 5.54?±?1.26. Sharp van-der-Heijde (SvdH) score was 113.9?±?106.8, health assessment questionairre (HAQ) score 1.03?±?0.9. The BMD was significantly reduced in 138 (79.8%) patients and FRAX was higher compared to control (p?<?.001). The frequency of osteoporosis (48% vs. 18.5%), the risk of MOF (1.8?±?2.6 vs. 0.6?±?0.3) and HF (0.7?±?1.7 vs. 0.08?±?0.1) were significantly higher in RA patients than in controls. Bone loss in RA was significantly associated with age, low body mass index (BMI), longer disease duration, rheumatoid factor, SvdH, atlantoaxial subluxation and corticosteroids use. Menopause, low calcium intake, erythrocyte sedimentation rate and HAQ were risk factors for reduced BMD. The risk of MOF and HF was associated with age, menopause, calcium intake, BMI, disease duration, HAQ, SvdH, cumulative dose and duration of corticosteroids.Conclusion
bone loss and fragility fracture are frequent in RA and related to disease severity, function impairment and corticosteroids use. 相似文献11.
Nermeen A. Fouad Maha H. Nassr Hanan M. Fathi Othman M. Zaki Ahmed A. Negm Soha H. Senara 《The Egyptian Rheumatologist》2019,41(2):93-97
Aim of the work
To determine the serum progranulin levels in rheumatoid arthritis (RA) patients and to study its relation with disease activity assessed clinically and by ultrasound (US).Patients and methods
The study included 52 RA patients and 19 age and sex matched controls. Disease activity score (DAS-28) and modified health assessment questionaire were assessed. Progranulin was measured by ELISA. Ultrasound examination was performed and the German US7 score (USS) recorded.Results
The patients mean age was 42.8?±?10.5?years; disease duration was 4.9?±?5.02?years; 47 females and 5 males with a mean DAS28 of 4.4?±?0.9 (3 in remission; 5 low activity; 31 moderate and 13 high). The mean serum progranulin level in patients (9.5?±?45.5?ng/ml) was significantly elevated compared to control (32.74?±?9.2?ng/ml) (p?<?0.0001). There was a significant difference in the progranulin levels and USS according to the grades of disease activity (p?<?0.0001 and p?=?0.037 respectively). The progranulin and USS significantly correlated with the DAS28 (r?=?0.64, r?=?0.58; p?<?0.0001 respectively) and erythrocyte sedimentation rate (p?<?0.0001). The progranulin and USS significantly correlated with each other (r?=?0.32, p?=?0.02). At a cut-off value 51.5?ng/ml, progranulin would discriminate between patients and control at sensitivity 96.2%, specificity 100% and accuracy 99%.Conclusion
Serum progranulin levels were higher in RA patients than age and sex matched controls. It significantly correlated with disease activity measured by DAS28, ESR and ultrasound activity measured by German US7 score. Serum progranulin levels may be a useful biomarker in RA disease. Ultrasound correlated with ESR and DAS28 in RA patients. 相似文献12.
Abdullah Nasser Alhuzaimi Abdulrahman Mohamed Bahkley Ahmed Mohammed Aljadeed Abdullah Abdlatif Alghaiheb 《Journal of the Saudi Heart Association》2019,31(2):88-93
Objectives
To assess the physicians’ knowledge and practice attitudes toward the infective endocarditis antibiotics prophylaxis guidelines in Saudi Arabia. Moreover, to determine whether there is knowledge-to-practice discrepancy.Methods
A cross-sectional study was performed using a self-administered questionnaire. A questionnaire was distributed among physicians dealing with congenital heart disease patients in Saudi Arabia, from January 7, 2016 to August 30, 2016. The questionnaire designed to calculate three scores: a knowledge score, a practice score, and a knowledge-to-practice discrepancy score. A t test was used for a mean comparison between the three scores and a Pearson correlation coefficient for correlation.Results
A total of 121 physicians completed the survey. The respondents were predominantly pediatric cardiologists (84%). The mean knowledge score for infective endocarditis prophylaxis in various cardiac lesions was 8.6?±?3.2 SD out of 14, and the mean practice score was 7.6?±?3 SD out of 14. The mean discrepancy score was 1.1?±?3 SD. There was a positive significant correlation between knowledge and discrepancy scores, r?=?0.533, n?=?121, p?=?0.001, using Pearson correlation analysis. Almost 39% of our population had a discrepancy score of +1 or more.Conclusions
The knowledge about antibiotics prophylaxis of infective endocarditis in various cardiac lesions was less than optimal. Even in the presence of knowledge, there is a practice-to-knowledge discrepancy, with an overprescribing attitude for low-risk cardiac lesions that correlates significantly with more knowledgeable physicians. We recommend that physicians be up-to-date and follow the most recent guidelines. 相似文献13.
Deepakraj Gajanana Manisha Ganapathi Raikar Pradhum Ram Vikas Bhalla Vincent Figueredo Sean Janzer Jon C. George 《Cardiovascular Revascularization Medicine》2019,20(3):207-209
Introduction
There is scarcity of data validating portable digital ankle-brachial index (ABI) with contrast angiography in peripheral arterial disease (PAD). Our aim was to provide an objective analysis of the relationship between digital ABI (dABI) and peripheral angiographic data.Methods
Consecutive patients with symptoms of PAD between May 2014 to May 2015 at Einstein Medical Center, Philadelphia, who were undergoing simultaneous dABI and peripheral angiography, were evaluated. Measurements were made using the FloChec? Digital ABI system (Bard) prior to the scheduled peripheral angiogram.Results
The final cohort consisted of 51 patients. Mean age was 68.8?±?9.5?years with 55% being male. Aorto-iliac disease accounted for 13% of the total lesions, while femoro-popliteal lesions comprised 55%. The FloChec? digital ABI had a sensitivity of 84% and a positive predictive value of 84%. The area under the receiver operating characteristic curve was 0.74 (p?=?0.007). On multivariate analysis, FloChec? digital ABI was still an independent predictor of PAD, Odds ratio 6.8 (2.3–20.6, p?=?0.001).Conclusion
A portable, point-of-care digital ABI system can be used as a valuable, simple, cost-effective and reliable screening tool with high sensitivity and accuracy. To date, ours is the first study validating FloChec? digital ABI with the gold standard angiographic data. 相似文献14.
Background
The burden of the patients with idiopathic inflammatory myopathies (IIM) including their admissions, diagnostic and therapeutic cares is similar to other severe diseases.Aim of the work
To evaluate the different aspects of the disease in IIM patients in our region.Patients and methods
All of patients with a diagnosis of IIM admitted to the wards in Shiraz University of Medical Sciences between 2001 and 2011 were evaluated.Results
There were 117 (70.5%) female and 49 (29.5%) male patients. The mean age of the patients was 38.5?±?16.8?years (range: 4–78?years). Among all admissions, proximal muscle weakness was the most frequent presenting symptom, however, 23 (13.9%) of patients did not report any limb weaknesses. The present study showed evidence of involvement of different systems including, pulmonary, gastrointestinal and cardiac. 35 (21.1%) patients came with polyarthralgia, 58 (34.9%) with dysphagia and regurgitation, and 8 (4.8%) with arthritis. Unexplained fever was noted in 33 (19.9%), myalgia in 25 (15%) and cough and dyspnea in 28 (16.8%) patients. Elevated serum creatine kinase and lactate dehydrogenase were detected in 105 (63.25%) and 153 (92.17%) patients respectively. Electromyogram findings were seen in 113 (91.8%). 35% of the patients had recurrent admissions and mean duration of their admissions was 10?days. During the study period, 8 (4.8%) patients died, mostly with respiratory and then cardiac and infectious complications.Conclusion
IIMs cause various complications and morbidities, with recurrent admissions due to disease flare-up and respiratory and infectious complications. Further prospective studies are recommended to elucidate the predisposing risk factors. 相似文献15.
Background and study aims
Acute upper gastrointestinal bleeding is one of the main causes of hospitalisation. The purpose of this study was to determine the prognostic factors in non-variceal upper gastrointestinal bleeding.Patients and methods
Clinical outcomes, demographic and laboratory variables of the subjects were collected from the HIS software and national code with the SQL format from three hospitals in Qazvin. The data were linked to the database software designed by the author. Clinical and upper endoscopic findings of patients’ records were collected through a questionnaire form in the designed software database.Results
In this study, 29.2% of patients with favourable outcome and 64.2% of patients with unfavourable clinical outcomes had a history of anticoagulant drug use before hospitalisation (p?<?0.001). The prevalence of chronic cardiovascular disease, chronic liver disease, chronic lung disease, diabetes and dialysis was higher in subjects with poor clinical outcomes than those with a favourable clinical outcome.53.1% of subjects with favourable clinical outcome and 90.5% of subjects with undesirable clinical outcomes received packed red blood cell transfusion (p?<?0.001). 16.1% of subjects with desirable clinical outcome and 86.3% of subjects with undesirable clinical outcomes received endoscopic haemostatic treatment which was statistically significant (p?<?0.001).Conclusion
Undesirable clinical outcome in patients with acute non-variceal upper gastrointestinal bleeding has a significant statistical association with longer hospitalisation, chronic underlying disease, anticoagulant administration, packed red blood cell infusion, higher Forrest stage, low systolic blood pressure, higher age, low haemoglobin, low platelet count, high INR and high BUN at the onset of diagnosis. 相似文献16.
Adel M. Elsayed Abdelazeim M. Elhefny Mervat M. Abogabal Sameh A. Mobasher Amr Abdelzaher Khaled F. Alhassanein Safaa Sayed Maysa M. Haroon Hatem M. Soliman 《The Egyptian Rheumatologist》2019,41(1)
Aim of the work
To present the clinical and laboratory disease characteristics in Egyptian patients with progressive systemic sclerosis (SSc) and their nail fold capillaroscopy findings.Patients and methods
50 SSc patients were included. For all patients detailed history taking and clinical and rheumatological examination were performed. The modified Rodnan skin score (mRSS) and nail fold capillaroscopy were assessed.Results
The mean age was 41.4?±?12.7?years (range 16–67?years) and median disease duration was 5?years (range 1–40?years). Eight patients (16%) were males and 42 (84%) females (M:F 1:5.25). Skin tightness was present in all patients; mean mRSS was 17.5?±?10.4 (ranges 4–45). 44 (88%) patients had abnormal pulmonary function tests; 42 (84%) restrictive and 2 (4%) obstructive; 25 (50%) presented with interstitial lung disease. Pulmonary artery hypertension was recorded in 9 (18%) patients. Renal manifestations were the least common recorded system involvement (20%). Antinuclear antibodies were positive in 98%, rheumatoid factor in 4%, antitopoisomerase I in 36% and anticentromere in 8% of patients. 96% of patient had abnormal nail fold capillaroscopy. There was a significant negative correlation between mRSS with forced expiratory volume (r?=??0.46, p?=?0.001), forced volume capacity (r?=??0.47, p?=?0.001) and positively with the FEV1/FVC (r?=?0.3, p?=?0.035).Conclusion
Almost all patients have ANA seropositivity, abnormal PFTs and abnormal nailfold capillaroscopy. Antitopoisomerase I antibody seropositivity, ILD, abnormal PFT, worsening skin score, late pattern of nailfold capillaroscopy are more common in dcSSc. Extensive clinical examination and investigations should be considered for early diagnosis and follow up of Egyptian SSc patients. 相似文献17.
Objectives
To assess safety, efficacy and follow-up results of transcatheter closure of ventricular septal defect (VSD) using Nit-Occlud_ Lê VSD Coil (pfm medical, KÖln, Germany).Background
Transcatheter VSD closure has achieved encouraging results but more follow-up studies are needed.Patients and methods
Between January 2012 and December 2013 in the cardiology department, Tanta University Hospital, Tanta, Egypt, 80 patients underwent percutaneous VSD closure using Nit-Occlud_ Lê VSD Coil. Early and mid- term follow-up was done for 3 years, follow-up was concluded in 2016.Results
The mean age of patients was 5.34?±?3 years, and their mean weight was 17.24?±?8.17 kg. Overall, 77 of 80 patients had perimembranous VSD with aneurysmal tissue; eight had multiple right ventricular exits, 14 had deficient aortic rim, two had high outlet muscular, and one had Gerbode defect. The procedure was successful in 98.75% of patients, and was aborted in one patient because of the development of complete heart block and the coil had to be removed. The mean procedure time was 104.98?±?9.50 minutes. The mean fluoroscopy time was 30.58?±?2.79 minutes. The immediate complete occlusion rate was 62%, which increased to 82.3% on the second day, and 94.9% by the 3rd month, and 97.5% by 1 year. There was a significant decrease in mitral incompetence after 6 months of follow-up (p?=?0.002), and only one patient had trivial aortic incompetence prior to the procedure that remained the same during follow-up period.Conclusion
Using Nit-Occlud_ Lê VSD-Coil to close VSD is safe and feasible in VSDs with various morphology. 相似文献18.
Arthur Shiyovich Tamir Bental Ygal Plakht Hana Vaknin-Assa Gabriel Greenberg Eli I. Lev Ran Kornowski Abid Assali 《Cardiovascular Revascularization Medicine》2019,20(2):96-100
Introduction & objective
Recently we developed and internally-validated the Soroka Acute Myocardial Infarction (SAMI) Score for prediction of all-cause long-term mortality (c-statistic 0.83–0.94) among hospital-survivors of AMI. We aimed to perform an external-validation of the SAMI score for long-term risk-stratification of STEMI patients undergoing PCI.Methods & settings
A prospective registry of 1273 STEMI patients treated using primary PCI and discharged alive from Rabin Medical Center in Israel between 2004 and 2014 (age 60.8?±?12.5?years, 83% males) was utilized for the validation. Chi-square test and logistic regression were used for calibration, and c-statistic (ROC procedure) for discrimination assessment of the SAMI score.Results
All-cause mortality following one- and 5-years post-discharge was 3.8% and 8.1%, respectively. SAMI score values ranged between (?5) and (+15) points (median 2-points). In a univariate analysis the SAMI score variables were significantly associated with 1- and 5-years mortality. Higher SAMI score was associated with increased risk for dying: a one-point increase was associated with OR of 1.33 (95%CI: 1.24–1.42, p?<?0.001) and 1.37 (95%CI: 1.29–1.44, p?<?0.001) for 1- and 5-years mortality respectively. No statistically significant difference was found in the currently observed mortality rates by groups of SAMI score and the expected mortality rates as per the SAMI score index. The c-statistics were 0.82 and 0.83 for 1- and 5-year mortality, respectively.Conclusions
The SAMI score is a simple, robust and now also externally-validated prognostic tool for prediction of long-term all-cause mortality in hospital survivors of STEMI. 相似文献19.
Gina Patel Parameswaran Hari Aniko Szabo Lisa Rein Lisa Baumann Kreuziger Saurabh Chhabra Binod Dhakal Anita D&#x;Souza 《Hematology/oncology and stem cell therapy》2019,12(1):10-14
Introduction
Systemic light chain (AL) amyloidosis can lead to an acquired coagulopathy secondary to acquired factor X (aFX) deficiency. However, it is not very clear who develops aFX deficiency in AL amyloidosis.Methods
We therefore undertook this single centre, retrospective study to better characterize AL amyloidosis-associated aFX deficiency.Results
Out of 121 AL patients who had FX testing at the time of their first evaluation at our institution, including 17 patients on warfarin at the time of testing, 10 out of 104 patients (9.6%) with systemic AL amyloidosis were found to have FX levels below 50%. Acquired FX deficiency was associated with advanced stage of AL amyloidosis and elevated cardiac biomarkers. Lower FX activity, advanced stage, and cardiac involvement by disease were associated with higher hazard of death on univariate analysis. On multivariate analysis, stage of AL amyloidosis was the only significant predictor of survival. Median survival time of patients with FX deficiency was 9.3 months compared to 118.4 months in those without.Conclusions
We conclude that while aFX deficiency is rare in systemic AL amyloidosis, it is a marker of advanced disease. 相似文献20.
Mazen M. Alsheikh Abeer M. El-Shafey Heba H. Gawish Enas T. El-Desoky 《The Egyptian Rheumatologist》2019,41(2)