Development of a fully implantable wireless pressure monitoring system

A fully implantable wireless pressure sensor system was developed to monitor bladder pressures in vivo. The system comprises a small commercial pressure die connected via catheter to amplifying electronics, a microcontroller, wireless transmitter, battery, and a personal digital assistant (PDA) or computer to receive the wireless data. The sensor is fully implantable and transmits pressure data once every second with a pressure detection range of 1.5 psi gauge and a resolution of 0.02 psi. In vitro calibration measurements of the device showed a high degree of linearity and excellent temporal response. The implanted device performed continuously in vivo in several porcine studies lasting over 3 days. This system can be adapted for other pressure readings, as well as other vital sign measurements; it represents the first step in developing a ubiquitous sensing platform for telemedicine and remote patient monitoring.     

Apical hypertrophic cardiomyopathy might lead to misdiagnosis of ischaemic heart disease

Purpose In this study, demographic, clinic, electrocardiographic and angiographic properties of patients, on whom coronary angiography was performed with the pre-diagnosis of coronary artery disease (CAD) and whose ventriculography demonstrated typical apical hypertrophic cardiomyopathy (AHCM), were investigated. Methods Seventeen patients (mean age 58 +/- 10 years, 10 male) with CAD pre-diagnosis, on whom coronary angiography was performed and had typical spade-like appearance on left ventriculography, were included in the study between January 2000 and May 2005. Results As risk factor for CAD, 8 (47%) patients had hypertension, 8 (47%) patients had dyslipidaemia, 2 (11%) patients had type 2 diabetes mellitus, 13 (77%) patients had a history of smoking, and 2 (11%) patients had family history. Seven (42%) patients presented unstable angina pectoris, 8 (47%) patients presented stable angina pectoris and 2 (11%) patients were asymptomatic. On coronary angiography, it was determined that 10 (58%) patients had normal coronary arteries, 3 (17%) patients had non-significant stenosis and 4 (25%) patients had myocardial bridging. Five (30%) patients revealed mid-ventricular obstruction and intraventricular gradient was 25 +/- 5 mmHg by the catheterization. All patients showed 'giant' negative (>/= 10 mm) T waves in the precordial leads, whereas 2 patients had atrial fibrillation. Maximum wall thickness was measured as 18 +/- 4 mm in the apical region by transthoracic echocardiography. One patient (5%) who had mid-ventricular obstruction developed atrial fibrillation during 2 years follow-up, though any other events did not occur during hospitalization or follow-up period. Conclusions Physicians caring for patients with chest pain should consider AHCM in their differential diagnosis in case of a patient with chest pain and electrocardiographic changes suggestive of CAD.     

Plasma fibrinogen level as possible prognostic biomarker in diffuse large B-cell lymphoma

Objectives: Although many studies have assessed numerous molecular and immunohistochemical prognostic markers for diffuse large Bcell lymphoma (DLBCL), there is always a need for simple widely available markers. This study was planned to illustrate the clinical significance of baseline plasma fibrinogen levels in DLBCL patients.

Methods: We prospectively investigated 76 DLBCL patients treated with rituximab plus cyclophosphamide, vincristine, doxorubicin and hostacortine between August 2015 and February 2018. Baseline plasma fibrinogen level was measured and correlated with patients’ clinical features, laboratory parameters, response to therapy, progression-free survival and overall survival.

Results: Significant association between fibrinogen level and clinical features such as the presence of B symptoms (P?<?.001) and clinical stage (P?<?.001) was observed while no association with age, gender, number of involved extranodal sites, performance status and international prognostic index (IPI) was found. Baseline fibrinogen level was significantly related to laboratory parameters including red cell distribution width (RDW) (P?<?.001), platelet count (P?=?.02), serum lactate dehydrogenase (LDH) (P?=?.009) and B2-microglobulin (P?=?.008). No statistically significant correlations were detected between baseline fibrinogen levels; and response to therapy, progression-free survival and overall survival.

Conclusion: Baseline plasma fibrinogen level did not show prognostic significance for DLBCL patients, although it was associated with patients’ clinical features and laboratory parameters. Being simple, cheap and widely available laboratory test, its use should be encouraged routinely in clinical practice to precisely clarify its predictive merit.     

Effect of trimetazidine on myocardial salvage index in patients with acute ST segment elevation myocardial infarction undergoing primary PCI

IntroductionAcute STEMI is the most serious presentation of CAD. Restoration of the coronary flow facilitates cardiomyocyte salvage and decreases cardiac morbidity and mortality. However, reperfusion may result in paradoxical cardiomyocyte dysfunction, a phenomenon termed reperfusion injury. Trimetazidine is a metabolic anti-ischemic drug which is beneficial in reducing periprocedural myocardial reperfusion injury.The aim of the work is to study the effect of trimetazidine on myocardial salvage index in patients with acute STEMI who underwent primary PCI.MethodsForty patients presented with acute STEMI, underwent primary PCI with injection of an intravenous dose of Tc-99m labeled Sestamibi before primary PCI then first set of SPECT images were taken within 6 h from injection time to assess the initial size of the perfusion defect. Prior to discharge the patients received another dose of Tc-99m labeled Sestamibi and follow up SPECT images were taken to assess the final perfusion defect and to calculate myocardial salvage and myocardial salvage index.Twenty patients of them received trimetazidine before primary PCI (study group) and the other twenty patients did not receive trimetazidine (control group).Results(1) Patients with acute STEMI undergoing primary PCI who received trimetazidine before primary PCI had better myocardial salvage index, however it was statistically non significant. (2) Statistically significant better myocardial salvage index with post procedural TIMI 3 flow than with post procedural TIMI 2 flow among patients who received trimetazidine before primary PCI.ConclusionIn the presence of post procedural TIMI3 flow trimetazidine is beneficial in improving myocardial salvage index in patients presented with acute STEMI who underwent primary PCI.