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901.
902.
Background:Biomarkers of manganese (Mn) exposure and manganism are poorly understood. Blood Mn levels are often used to assess exposure, while brain Mn accumulation may be demonstrated by pallidal hyperintensity at magnetic resonance imaging (MRI). Mn-containing electrodes used in manual metal arc welding may be associated with the welder’s lungs.Methods:A cross-sectional study was set up to compare T1 intensity in basal ganglia at MRI and Mn blood levels in subjects with or without pneumoconiosis. Clinical, radiological, pulmonary function and laboratory parameters were assessed among 154 welders referred to our hospital for suspected pulmonary pathology.Results:The study group included 123 male welders with pneumoconiosis (79.9%) and 31 welders without pulmonary damage (20.1%). The cases without pneumoconiosis were younger (38.5±6.6 vs 42.1±7.1, p=0.012). Cases with pneumoconiosis had blood lower Mn levels [13.5 (10-21)] as compared to those without pneumoconiosis [18.5 (7.8-34)], p=0.035. In the same groups, the cases with high blood Mn levels were 49 (39.8%) and 18 (58.1%) p=0.052, respectively. Brain MRI hyperintensity was found in 86 (55.8%) subjects with welder’s lung 63 (51.2%) but also in 23 (74.2%) individuals without welder’s lung. MRI hyperintensity in basal ganglia was significantly related to high blood Mn (p<0.005).Conclusion:This is the first study evaluating blood Mn levels of welders and their correlation with pulmonary and neurological effects. In Mn-exposed welders, poor working conditions may be associated with exposure fibrogenic fumes leading to chronic lung diseases and hyperintensity in brain MRI suggesting Mn accumulation. 相似文献
903.
Panagiotis Savvoulidis MD PhD Adnan M. Nadir MD MRCP Anthony Mechery MBBS DM MRCP Sagar N. Doshi MD BSc Hons MBChB FRCP 《Catheterization and cardiovascular interventions》2023,101(3):660-667
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe symptomatic aortic valve stenosis. TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased in frequency over time, with the introduction of lower profile delivery systems and sheaths, they remain one of the most frequently encountered and serious complications of TAVR. Patient-specific predisposing factors have been well characterized. However, much less is known about device-specific complications. Awareness of the possible device-related complications may lead to earlier identification, prompt management, and better outcomes. We report a previously unreported complication of the Edwards expandable eSheath that lead to avulsion of the external iliac artery following successful TAVR with a 29-mm Edwards Sapien 3 transcatheter heart valve. Bleeding was promptly controlled with an occlusion balloon and emergency surgical repair was required with a favorable outcome. 相似文献
904.
Benjamin Bouyer MD Zakaria Jalal MD PhD F. Daniel Ramirez MD Nicolas Derval MD Xavier Iriart MD Josselin Duchateau MD PhD François Roubertie MD PhD Nadir Tafer MD Romain Tixier MD Thomas Pambrun MD Ghassen Cheniti MD Ciro Ascione MD Masaaki Yokoyama MD Christopher Kowalewski MD Samuel Buliard MD Rémi Chauvel MD Marine Arnaud MD Mélèze Hocini MD Michel Haïssaguerre MD Pierre Jaïs MD PhD Hubert Cochet MD PhD Jean-Benoit Thambo MD PhD Frederic Sacher MD PhD 《Journal of cardiovascular electrophysiology》2023,34(6):1395-1404
Aim
Ventricular arrhythmias (VAs) are the most common cause of death in patients with repaired Tetralogy of Fallot (rTOF). However, risk stratifying remains challenging. We examined outcomes following programmed ventricular stimulation (PVS) with or without subsequent ablation in patients with rTOF planned for pulmonary valve replacement (PVR).Methods
We included all consecutive patients with rTOF referred to our institution from 2010 to 2018 aged ≥18 years for PVR. Right ventricular (RV) voltage maps were acquired and PVS was performed from two different sites at baseline, and if non-inducible under isoproterenol. Catheter and/or surgical ablation was performed when patients were inducible or when slow conduction was present in anatomical isthmuses (AIs). Postablation PVS was undertaken to guide implantable cardioverter-defibrillator (ICD) implantation.Results
Seventy-seven patients (36.2 ± 14.3 years old, 71% male) were included. Eighteen were inducible. In 28 patients (17 inducible, 11 non-inducible but with slow conduction) ablation was performed. Five had catheter ablation, surgical cryoablation in 9, both techniques in 14. ICDs were implanted in five patients. During a follow-up of 74 ± 40 months, no sudden cardiac death occurred. Three patients experienced sustained VAs, all were inducible during the initial EP study. Two of them had an ICD (low ejection fraction for one and important risk factor for arrhythmia for the second). No VAs were reported in the non-inducible group (p < .001).Conclusion
Preoperative EPS can help identifying patients with rTOF at risk for VAs, providing an opportunity for targeted ablation and may improve decision-making regarding ICD implantation. 相似文献905.
Muhammad Abd Ur Rehman Abdulrahman Fadhl Abdulrahman Aariz Zainab Yahya Paksoy Nadir Kharma 《Clinical Case Reports》2021,9(7)
Until we have strong evidence to the contrary, symptomatic hyponatremia should be treated with extra caution in COVID‐19 co‐infection patients as the latter could be another risk factor for the development of extrapontine myelinolysis. 相似文献
906.
Fathia Aidid Narjisse Aichouni Ihssane Afilal Widad Abbou Rachid Jabi Nadir Miry Amal Bennani Imane Kamaoui Siham Nasri Imane Skiker 《Radiology Case Reports》2022,17(9):2910
Desmoid tumors are benign fibroblastic neoplasms, with locally invasive features and a tendency of recurrence. They are considered an aggressive non-metastatic fibromatosis. The retroperitoneal location is extremely rare. Their exact mechanism of occurrence is still controversial, but could be related to a genetic predisposition, hormonal factors or traumatic factors, including surgery. This entity faces management difficulties due to its rarity, the variable circumstances of its discovery, and the non-specific clinical manifestations. Their sensitivity to chemotherapy and radiotherapy is limited and surgery remains the only curative treatment in symptomatic cases, however observational waiting could consist the most appropriate management in selected asymptomatic patients, moreover it could avoid unnecessary morbidity from surgery or radiotherapy, which makes the management of this condition a multidisciplinary decision and should be adapted to fit the patients individually. We report a case of a retroperitoneal desmoid tumor in a 31-year-old woman with a history of familial adenomatous polyposis, through which we will discuss this extremely rare neoplastic entity. 相似文献
907.
908.
Ahmed M Adlan Ven G Lim Gurpreet Dhillon Hibba Kurdi Gemina Doolub Nadir Elamin Amir Aziz Sanjay Sastry Gershan Davis 《The British Journal of Cardiology》2020,27(2)
During the coronavirus disease (COVID-19) pandemic, the British Cardiovascular Society/British Cardiovascular Intervention Society and the British Heart Rhythm Society recommended to postpone non-urgent elective work and that primary percutaneous coronary intervention (PCI) should remain the treatment of choice for patients with ST-segment elevation myocardial infarction (STEMI). We sought to determine the impact of COVID-19 on the primary PCI service within the United Kingdom (UK).A survey of 43 UK primary PCI centres was performed and a significant reduction in the number of cath labs open was found (pre-COVID 3.6±1.8 vs. post-COVID 2.1±0.8; p<0.001) with only 64% of cath labs remained open during the COVID-19 pandemic. Primary PCI remained first-line treatment for STEMI in all centres surveyed.Key words: acute myocardial infarction, healthcare delivery, medical education, percutaneous coronary intervention 相似文献