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71.
Sophie Wells Ethan J. Rowin Griffin Boll Hassan Rastegar Wendy Wang Martin S. Maron Barry J. Maron 《The American journal of medicine》2018,131(6):e235-e239
Background
Surgical myectomy reverses heart failure symptoms in the vast majority of obstructive hypertrophic cardiomyopathy patients. However, a small subgroup fails to experience sustained postoperative improvement despite relief of obstruction. Clinical profile of such patients has not been well defined.Methods
Consecutive obstructive hypertrophic cardiomyopathy patients undergoing myectomy at Tufts Medical Center for drug-refractory New York Heart Association III/IV heart failure symptoms, 2004 to 2017, were followed postoperatively for 2.5 ± 2.8 years and assessed for outcome.Results
Of the 503 patients, there were 4 postoperative deaths (0.8%); 480 patients (96%) had sustained improvement to New York Heart Association classes I or II (responders), but 19 (3.8%) developed advanced symptoms (classes III or IV) in the absence of obstruction (nonresponders). Compared with responders, nonresponders were younger (40 ± 13 vs 53 ± 14 years; P < .001) and had greater septal thickness (25 ± 9 vs 20 ± 4 mm; P < .001). Massive hypertrophy (≥30 mm) was 5-fold more common in nonresponders (P < .01). Seven nonresponders developed systolic dysfunction (ejection fraction 20%-47%), 2 days to 6.1 years postoperatively. Four nonresponders underwent heart transplant 3.4 to 9.2 years after myectomy, and 2 others have been listed.Conclusions
Surgical myectomy is highly effective at reversing heart failure symptoms in the vast majority of patients with obstructive hypertrophic cardiomyopathy. However, a small minority experience persistent functional limitation despite surgical relief of outflow obstruction. Predictors of adverse postoperative course were substantial/massive septal thickness and youthful age. Patients who failed to respond symptomatically to myectomy were considered for advanced heart failure treatment, including heart transplantation. 相似文献72.
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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75.
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Abolfazl Mollalo Abbas Alimohammadi Mohsen Shahrisvand Mohammad Reza Shirzadi Mohammad Reza Malek 《亚太热带病杂志(英文版)》2014,4(3):176-180
Objective
To investigate the relations between the vegetation cover and occurrence of cutaneous leishmaniasis (CL) in Golestan province during 2010-2012.Methods
Data of monthly CL incidence and remote sensing normalized difference vegetation index (NDVI) of moderate resolution imaging spectroradiometer sensor were used in the study. Pearson''s correlation analysis was conducted to examine the type and strength of relationships between the spatially averaged NDVI variables (i.e. minimum, maximum and mean NDVI values) and CL incidence in township level. Spearman rank correlation was carried out to explain associations between the monthly CL incidence and NDVI variables at 0, 1, 2, 3 and 4 months lagged periods. Locations of CL cases at village level were geocoded and compared with frequency of CL cases in each NDVI-derived vegetation categories.Results
Pearson''s analysis revealed significant associations between the NDVI variables and CL incidence at the township level (P<0.05). Results of Spearman analysis indicated that the highest correlations between NDVI variables and monthly CL incidence were established when the NDVI time-series lagged the CL incidence series NDVI variables. Purely spatial analysis demonstrated that despite majority of cases occurred at partially-vegetated areas, the possibility of CL occurrence was higher in bare soil areas by taking into account area of each vegetation zones.Conclusions
lack or low vegetation cover is a major determinant of CL frequencies in Golestan province. The decrease of the mean vegetation density in townships is accompanied by increase of CL occurrence and vice versa. 相似文献80.
A green approach was developed for synthesizing a series of (isatin‐3‐ylidene)‐hydrazonamides 3a–j from the reaction between isatin, (isatin‐3‐ylidene)malononitrile, or 2‐cyano‐2‐(2‐isatin‐3‐ylidene)acetate and benzohydrazonamide in ethyl acetate solutions at ambient temperature. The structures of the new compounds were confirmed on the basis of spectral data. In this eco‐friendly medium, a variety of (isatin‐3‐ylidene)hydrazonamides were obtained free of catalyst in good to excellent yields. All the synthesized products were evaluated for their antimicrobial activity. Among the compounds tested, 3b and 3d exhibited good antibacterial activity against Staphylococcus aureus, whereas others responded moderately with reference to the standard drug ciprofloxacin. 相似文献