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91.
MONIRAH A. ALBABTAIN M.Sc. ALI ALMASOOD M.D. HYTHAM ALSHURAFAH M.D. HUSSAIN ALAMRI M.D. HANI TAMIM Ph.D. 《Journal of interventional cardiology》2013,26(1):90-96
Background
Antioxidant drugs such as N‐acetylcysteine (NAC) and ascorbic acid have been evaluated in interventional studies to prevent contrast‐induced nephropathy (CIN), however, there are limited data on comparing either or both, with background of standard intravenous saline hydration versus the standard intravenous saline hydration alone in preventing CIN.Methods
We conducted a single‐center randomized trial among patients undergoing coronary angiography or percutaneous coronary intervention who had serum creatinine ≥ 1.3 mg/dL or were on diabetes mellitus medication. Eligible patients were randomly assigned to one of the following 4 groups: (1) NAC, (2) ascorbic acid, (3) combination of both drugs, and (4) control group. Additionally, all the groups received the standard intravenous saline hydration. Creatinine was measured 4–5 days after procedure.Results
A total of 243 patients were randomized; 62 to NAC, 57 to ascorbic acid, 58 to both drugs, and 66 to placebo. The development of 0.5 mg/dL absolute increase of serum creatinine, 25% relative decrease of creatinine clearance, or either (CIN) were measured in the ascorbic acid group (3.6% for all), NAC group (6.8%, 3.4%, 8.5%, respectively), combined group (5.5%, 5.5%, 9.1%, respectively), and control group (6.2%, 6.2%, 7.7%, respectively). None of these differences were significant (P = 0.896 for serum creatinine, P = 0.863 for creatinine clearance, and P = 0.684 for CIN).Conclusions
In a cohort of patients at risk of developing CIN, we could not detect any significant benefit of the use of ascorbic acid, NAC, or a combination of both drugs over the standard hydration regimen in preventing CIN. (J Interven Cardiol 2013;26:90–96)92.
TAMAM MOHAMAD M.D. SIDAKPAL S. PANAICH M.D. ANAS ALANI M.D. APURVA BADHEKA M.D. MAITHILI SHENOY M.D. BASHAR MOHAMAD M.D. EYAS KANAAN M.D. OMAIMA ALI M.D. MAHIR ELDER M.D. THEODORE L. SCHREIBER M.D. 《Journal of interventional cardiology》2013,26(1):43-48
Background
Left main coronary artery (LMCA) disease is associated with significant cardiovascular mortality. The data on patient characteristics' predicting outcomes after LMCA revascularization is sparse.Methods
A retrospective study of 227 patients with LMCA disease documented on coronary angiography from March 2000 to December 2008. Data included demographic variables, co‐morbidities, cardiac function, and medications. Race was self‐identified. The study outcome was a composite end‐point including myocardial infarction (MI) and all‐cause mortality. Cox proportional hazard analysis was performed to study the effect of various patient attributes including race and gender on the composite end‐point.Results
Baseline characteristics were specifically compared between individuals who had the study outcome versus those who did not. Mean age was higher in the group with study outcomes when compared to the group without any outcomes (64.3 ± 11.8 years versus 59.2 ± 13.6 years; p = 0.013). After the final multivariate regression analysis, only African American (AA) race and age were found to be independent predictors of adverse cardiac outcome at the end of the first year (race—hazard ratio (HR) 3.82, 95% confidence interval (CI) 1.38–10.62, p = 0.010; age—HR 1.08, 95% CI 1.04–1.13, p < 0.001) and at the end of the study (race—HR 2.71, 95% CI 1.44–5.10, p = 0.002; age—HR 1.03, 95% CI 1.01–1.08, p = 0.017).Conclusion
In our study of patients with unprotected LMCA disease, AA race, and age were significantly predictive of poor prognosis following revascularization, while gender had no predictive value in prognosticating cardiovascular mortality.93.
ANTONIO NAVARRETE M.D. FRANK CONTE M.D. MICHAEL MORAN M.D. ISHTI ALI M.D. NATHAN MILIKAN M.D. 《Journal of cardiovascular electrophysiology》2011,22(1):34-38
AF Ablation in Patients With Only Documentation of Atrial Flutter. Objectives: The aim of the study was to evaluate whether isolation of the pulmonary veins (PVs) at the time of cavotricuspid isthmus (CTI) ablation is beneficial in patients with lone atrial flutter (AFL). Background: A high proportion of patients with lone persistent AFL have recurrent episodes of atrial fibrillation (AF) after CTI ablation. However, the benefit of AF ablation in patients with only documentation of AFL has not been determined. Methods: Forty‐eight patients with typical lone persistent AFL (age 56 ± 6; 90% male) were randomized to CTI ablation (Group A; n = 25) or to CTI + PV isolation (PVI) (Group B; n = 23). In addition to PVI, some patients in group B underwent ablation of complex fractionated electrograms and/or creation of left atrial roof and mitral isthmus ablation line in a stepwise approach when AF was induced and sustained for more than 2 minutes. Mean follow‐up was 16 ± 4 months with a 48‐hour ambulatory monitor every 2 months. Results: There were no recurrences of AFL in either group. Six patients in group B (22%) underwent a stepwise ablation protocol. AF organized and terminated in 5 patients during ablation (83%). Complication rate was not significantly different among the groups. Twenty patients in group B (87%) and 11 patients in group A (44%) were free of arrhythmias on no medications at the end of follow‐up (P < 0.05). Conclusions: Ablation of AF at the time of CTI ablation results in a significantly better long‐term freedom from arrhythmias. (J Cardiovasc Electrophysiol, Vol. 22, pp. 34‐38, January 2011) 相似文献
94.
ABOU-DONIA MOHAMED B.; WILMARTH KENNETH R.; ABDEL-RAHMAN ALI A.; JENSEN KARL F.; OEHME FREDERICK W.; KURT THOMAS L. 《Toxicological sciences》1996,34(2):201-222
The operating environment of the service personnel during thePersian Gulf War involved psychological, biological, and chemicalelements including exposure to pesticides such as the insectrepellent DEET (N,N-diethyl-m-toluamide) and the insecticidechlorpyrifos (O,O-diethyl O-3,5,6-trichloropyridinyl phosphorothioate)and to pyridostigmine bromide (PB, 3-dimethylaminocarbonyloxy-N-methylpyridiniumbromide) that was administered as a prophylactic agent againstpossible nerve gas attack. The present study was designed todetermine the toxicity produced by individual or coexposureof hens 5 days/week for 2 months to 5 mg PB/kg/day in water,by gavage; 500 mg DEET/kg/day, neat, sc; and 10 mg chlorpyrifoskg/day in corn oil, sc. Coexposure to various binary treatmentsproduced greater neurotoxicity than that caused by individualexposures and was characterized by severe neurologic deficitand neuropathological alterations. Also, neurotoxicity was furtherenhanced following concurrent administration of the three chemicals.Severe inhibition of plasma butyrylcholinesterase (BuChE) activitywas produced in hens treated with PB (activity 17% of control)compared to those treated with chlorpyrifos (activity 51% ofcontrol) or DEET (activity 83% of control). BuChE inhibitionwas further increased in binary and tertiary treatment groupscompared to individual treatment groups. In contrast, a significantinhibition of brain acetylcholinesterase (AChE) was producedin hens administered chlorpyrifos alone (activity 67% of control),while those given chlorpyrifos in combination with other compoundsexhibited a significant inhibition of brain AChE activity rangingfrom 43 to 76%. Brain neurotoxicity target esterase (NTE) wasnot inhibited in any of the individual treatment groups or PBIDEET,but was significantly inhibited and had activity expressed asa percentage of control in groups administered combined chlorpyrifoswith PB of 73% or DEET of 74% and in the tertiary treatmentgroup of 71%. We hypothesize that test compounds may competefor xenobiotic metabolizing enzymes in the liver and blood andmay also compromise the integrity of the blood-brain barrier,leading to an increase in their "effective con centrations"in the nervous system to levels equivalent to the toxic dosesof individual compounds. This is consistent with the presentobservation of increases in (1) the inhibition of brain AChEand NTE, (2) the extent of neurologic dysfunction, and (3) theseverity and frequency of neuropathologic lesions in the combinedtreat ment groups compared to those administered individualcompounds. 相似文献
95.
ALI A. MEHDIRAD KELLEY L. CLEM CHARLES J. LOVE STEVEN D. NELSON STEPHEN F. SCHAAL 《Pacing and clinical electrophysiology : PACE》1999,22(1):233-237
Background: Despite using different electrode positions, “conventional” external DC cardioversion in patients with atrial fibrillation is ineffective in 6%–50% of cases. An alternative when DC cardioversion is not successful is low energy internal cardioversion, which is performed at increased risk. We tested the hypothesis that optimization of electrode pad position under fluoroscopy to encompass as much atrial muscle as possible might improve the success rate of external cardioversion and thus minimize the need for internal cardioversion. Methods: Fifteen (9 males, 6 females) patients (age: 54 ± 15 years, weight: 124 ± 35 kg) with chronic atrial fibrillation (> 8 weeks) who had undergone unsuccessful conventional external cardioversion entered the study. Repeat conventional external cardioversion with electrodes in standard (right anterior and left posterior) positions was followed by “optimized” external cardioversion by positioning electrodes under fluoroscopy (using metallic markers). In case of failure, internal cardioversion was performed. Results: All 15 patients had undergone unsuccessful conventional external cardioversion with 360-J shocks. Eight patients (group A) reverted to sinus rhythm with one or two 360-J shocks using fluoroscopy-guided pad placement (53%). Six of the remaining 7 (86%) patients (group B) had successful internal cardioversion with biphasic shocks (12 ± 3 J). The body weight and body mass index were statistically lower in group A vs group B (106 ± 27 vs 145 ± 33 kg, p = 0.03 and 35 ± 8 vs 45 ± 8 kg/m2, P = 0.48, respectively). There was no statistically significant in age, height, body surface area, duration of atrial fibrillation, amiodarone therapy, ejection fraction, or underlying heart disease. Conclusion: Unsuccessful external DC cardioversion, in some patients, is in part due to suboptimal conventional positioning of electrode pads that can be improved under fluoroscopic guidance by achieving the best possible vector encompassing the right and left atria. The optimized external cardioversion technique may minimize the need for internal cardioversion, which remains an effective approach when external cardioversion fails. 相似文献
96.
ANIL K. GEHI M.D. RACHEL LAMPERT M.D. ‡ EMIR VELEDAR Ph.D. † FORRESTER LEE M.D. ‡ JACK GOLDBERG Ph .D.§ LINDA JONES B.S. † NANCY MURRAH R.N. † ALI ASHRAF M.D. † VIOLA VACCARINO M.D. Ph .D.† ¶ 《Journal of cardiovascular electrophysiology》2009,20(4):422-428
Introduction: One possible mechanism of higher cardiovascular mortality associated with the metabolic syndrome (MetS) may be through abnormal modulation in autonomic tone.
Methods and Results: We examined the association between the MetS and autonomic tone as measured by heart rate variability (HRV) among 288 twins from the Twins Heart Study (THS). Of the 288 participants, 151 (52%) had the MetS. The MetS was associated with decreased HRV across all frequency ranges, and each additional MetS risk factor was associated with lower HRV. After adjustment for several potential confounders, very-low frequency (P < 0.001), low frequency (P < 0.001), and total power (P = 0.02) spectra of HRV remained significantly lower in twins with a progressively higher number of MetS components (18–50% decrease comparing twins with 5 risk factors to those with no risk factors). Among 87 twin pairs who were discordant for the number of MetS components, a one-unit increment in MetS components was associated with an 8% smaller very-low frequency (p = 0.03) and a 15% smaller low frequency spectrum (P = 0.002) comparing each twin with his brother.
Conclusion: MetS was associated with lower HRV in a well-characterized sample of middle-aged male twins. This association persisted even after controlling for genetic and shared environmental factors accounted for by comparison within twin pairs. Abnormalities of autonomic tone, as evidenced by lower HRV, may be partly responsible for the higher rate of atrial fibrillation, coronary heart disease, cardiac death, and overall mortality seen in patients with the MetS. 相似文献
Methods and Results: We examined the association between the MetS and autonomic tone as measured by heart rate variability (HRV) among 288 twins from the Twins Heart Study (THS). Of the 288 participants, 151 (52%) had the MetS. The MetS was associated with decreased HRV across all frequency ranges, and each additional MetS risk factor was associated with lower HRV. After adjustment for several potential confounders, very-low frequency (P < 0.001), low frequency (P < 0.001), and total power (P = 0.02) spectra of HRV remained significantly lower in twins with a progressively higher number of MetS components (18–50% decrease comparing twins with 5 risk factors to those with no risk factors). Among 87 twin pairs who were discordant for the number of MetS components, a one-unit increment in MetS components was associated with an 8% smaller very-low frequency (p = 0.03) and a 15% smaller low frequency spectrum (P = 0.002) comparing each twin with his brother.
Conclusion: MetS was associated with lower HRV in a well-characterized sample of middle-aged male twins. This association persisted even after controlling for genetic and shared environmental factors accounted for by comparison within twin pairs. Abnormalities of autonomic tone, as evidenced by lower HRV, may be partly responsible for the higher rate of atrial fibrillation, coronary heart disease, cardiac death, and overall mortality seen in patients with the MetS. 相似文献
97.
Nozomu KUROSAKA Marina ALI Karen BYTH Nicholas MANOLIOS 《International journal of rheumatic diseases》2007,10(3):198-203
Aim: A synthetic nonapeptide (core peptide [CP]) was tested as a potential therapeutic agent for the treatment of acute onset arthritis. Differing modes of delivery (subcutaneous [SCI]vs. intraperitoneal [IP]) and lipid conjugation of CP were examined. Methods: Wistar rats aged 9–12 weeks were injected SCI in the tail with 1 mg of heat‐killed Mycobacterium tuberculosis (MTB) to bring about adjuvant induced arthritis. After development of arthritis (day 12), 6 mg of CP, 6 mg of CP‐lipid conjugate (LP), or 1.2 mg cyclosporin A (Csp; 3 mg/kg) in 100 µL of diluent were given SCI or IP for 4 consecutive days. Severity of arthritis was assessed by changes in body weight, paw thickness, paw and ankle width, and the total number of arthritic joints involved up to 7 days after the first onset of arthritis and the commencement of treatment. Results: Core peptide and LP given either SCI or IP were effective in the treatment of acute adjuvant induced arthritis. IP administration of LP was significantly better than that of control and CP‐treated rats (P < 0.05) when examined at two separate time points, day 4 and day 7, after commencement of treatment. The effectiveness of IP‐administered LP was comparable to cyclosporin. Conclusions: CP‐lipid conjugate and CP have a therapeutic benefit in the treatment of acute arthritis. The mode of delivery and lipid conjugation of CP influences the efficacy and outcome of arthritis. 相似文献
98.
R. ALI S. PERFUMO C. della ROCCA L. AMICONE L. POZZI P. McCULLAGH H. MILLWARD-SADLER Y. EDWARDS S. POVEY M. TRIPODI 《Annals of human genetics》1994,58(4):305-320
We have attempted to produce a transgenic mouse model of the neonatal liver disease associated with the human PIZ allele. Analysis of a number of transgenic mouse lines carrying either a normal human PIM gene construct or the mutant Z is reported. Using isoelectric focusing analysis of plasma from transgenic mice, we have shown that the human AAT proteins produced in mice are processed in a similar way to their counterparts in humans. By comparing the level of M and Z mRNA in liver with the levels of M and Z proteins in plasma we have inferred that, as in humans, the mutant protein tends to accumulate within the hepatocyte. Accumulation of Z protein has also been demonstrated by immunocytochemistry. Two of the M transgenic lines produce such high levels of the human protein that it, like the Z protein, accumulates as globules. Histological features of livers from 116 mice of different ages and genotypes were examined: 37 non-transgenic, 62 Z transgenic (23 low expressing and 39 high expressing) and 17 M transgenic mice, all high expressing. Cirrhosis or fibrosis was not seen in any animal and we were unable to find any evidence for neonatal liver disease. Some necrosis was seen in all genotypes and this increased significantly with age with one Z line showing significantly more frequent necrosis than any other group. This line, the highest expressing Z line, was back crossed onto 7 different genetic backgrounds but no major differences between the back crosses with respect to liver disease were observed. The mouse model we have developed is compared with other transgenic Z mouse models; none of these is representative of human neonatal liver disease. Our view is that the transgenic animals generated in these experiments may be most useful for investigating the liver manifestations that almost invariably occur in ZZ adults. Alteration of additional factors other than accumulation of Z protein, for example inactivation of the endogenous mouse genes or some environmental challenge, might produce a mouse model with more relevance to neonatal liver disease. 相似文献
99.
HUMAN LEARNING DURING GENERAL ANAESTHESIA AND SURGERY 总被引:2,自引:2,他引:0
BLOCK R. I.; GHONEIM M. M.; PING S. T. SUM; ALI M. A. 《British journal of anaesthesia》1991,66(2):170-178
To determine if learning occurs during general anaesthesia,72 women undergoing surgery were given postoperative implicitmemory tests in which performance could be influenced by auditoryinformation presented during general anaesthesia. Two methodsof anaesthesia were used: nitrous oxide and opioids (n = 24)or nitrous oxide and isoflurane (1, 1.3 and 1.5 MAC for n =12, 24 and 12, respectively). Three tests showed some retention,apparently unconscious, of information presented during anaesthesia:in Behavioural Suggestions tests, patients who were instructedduring anaesthesia to touch a particular body part (ear or nose)during later questioning touched the "correct" (suggested) bodypart longer than the "incorrect" (not suggested) body part duringa postoperative interview on the day of surgery (means 2.5 vs0.2 s); in Word Completion tests, patients shown a page containingthe first three letters of words and asked to give words beginningwith those letters gave more words from a list that had beenplayed during anaesthesia than from a list not played (means0.48 vs 0.27 words); in Nonsense Word tests, patients who wereplayed different nonsense words between two and 16 times duringanaesthesia preferred and guessed more accurately those thathad been played most often (16 times) relative to those playedless often in subsequent preference and recognition tests (means56% vs 46% for preference and 62% vs 48% for recognition), whileshowing no such patterns in additional control tests. Learningdid not vary with the method of anaesthesia, as might have beenexpected if learning was a monotonic function of brain depression.Some information processing functions of the brain evidentlycontinue to function during adequate general anaesthesia.
Presented in part at the First International Symposium on Memoryand Awareness in Anaesthesia, University of Glasgow, Glasgow,Scotland, April 69, 1989 and the American Society ofAnesthesiologists annual meeting, New Orleans, Louisiana, October1418, 1989. 相似文献
100.
ALI A. MEHDIRAD CHARLES J. LOVE MARSHALL S. STANTON S. ADAM STRICKBERGER † JAMES L. DUNCAN ‡ MARK W. KROLL‡ 《Pacing and clinical electrophysiology : PACE》1999,22(4):594-599
Biphasic defibrillation waveforms have provided a reduction in defibrillation thresholds in transvenous ICD systems. Although a variety of biphasic waveforms have been tested, the optimal pulse durations and tilts have yet to be identified. A multicenter clinical study was conducted to evaluate the performance of a new ICD biphasic waveform and new RV active fixation steroid eluting lead system. Fifty-three patients were entered into the study. Mean age was 63 years with a mean ejection fraction of 36.8%. Primary indication for implantation was monomorphic ventricular tachycardia alone (54.7%). Forty-eight patients (90.6%) were implanted with an RV shocking lead and active can alone as the anodal contact. The ICD can was the cathode. In four cases (7.5%), an additional SVC or CS had was used due to a high DFT with the RV lead alone. In an additional case, a chronic SVC lead was used although the RV-Can DFT was acceptable. DFT for all cases at implant was 9.8 ± 3.7 J. Repeat testing at 3 months for a subset of patients showed a reduction in DFT (7.4 ± 3.0 J), P value = 0.03. Sensing and pacing characteristics of the RV lead system remained excellent during the study period (acute 0.047 ± 0.005 ms at 5.4 V and 9.9 ± 6.2 mV R wave; chronic 0.067 ± 0.11 ms at 5.4 V and 9.3 ± 5.4 mV R wave). It is concluded that this lead system provides good acute and chronic sensing and pacing characteristics with good DFT values in combination with this waveform. 相似文献