scholarly journals Clinical and imaging variables associated to Microvascular Angina, a 13N-AMMONIA MPI Approach

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
JK Rojas-Senarque ◽  
H Gurrola-Luna ◽  
I Carvajal-Juarez ◽  
ME Soto-Lopez ◽  
B Belen-Rivera ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. On Behalf of MiniFellows Research Group CLINICAL AND IMAGING VARIABLES IN MICROVASCULAR ANGINA. A 13N-AMMONIA MPI APPROACH Background Patients with typical angina may have no obstructive artery disease1 and 2/3 may present microvascular dysfunction(MVD)2 which is associated with poor prognosis3,4,5. In 2017 the Coronary Vasomotion Disorders International Study Group (COVADIS) included it as a criteria of MVA6; later, included in MINOCA ESC 2020 guidelines.7 For diagnosis6,7: symptoms of ischemia; absence of relevant epicardial CAD (<50% diameter reduction or FFR >0.80); myocardial ischemia; impaired coronary microvascular function (CFR < 2 or <2.5 depending on methodology). Our aim was to identify clinical and imaging variables in patients with MVA due to 13N-ammonia Positron Emission Tomography/Cardiac Tomography(PET/CT) and Cardiac Computed Tomography Angiography(CCTA) in a cardiovascular imaging referral center. Methods.Retrospective, cross-sectional study of patients with suspected CAD. For inclusion: ischemia quantitation (summed stress score,SDS < 3) and obstruction <50% in all vessels. Exclusion criteria: previous infarction, intervention, or incomplete study. Clinical data was assessed. Both studies performed on the same day. Frequencies and percentages to report categorical variables; x2 and Fisher´s exact tests to compare them. Mean (+/-DE) or median (interquartile range) to report continuous variables according to their distribution, and T student or Wilcoxon test to compare them. Results 274 patients included: Group A (CFR <2) and group B (CFR 2)(108vs166). Difference for systemic hypertension(p <0.001), type 2 diabetes mellitus(p <0.001), dyslipidemia(p = 0.019), smoking(p <0.001). Group B presented higher incidence for mild ischemia(p = 0.004) while MVA for severe ischemia(p = 0.002). Difference between groups for EDV and ESV at rest (p = 0.002), EDV at stress(p = 0.03) and at rest(p < 0.001), LVEF at rest and stress(p < 0.001) and for a negative change of LVEF(p < 0.001). Also, reduced Calcium Score(SC)(p < 0.001) Discussion With a higher prevalence reported in women8,9, no difference for women in both groups. Presentation been reported as atypical 3,6,10, as in our study. Traditional risk factors may affect the microvascular circulation earlier in the disease. Regarding mild and severe ischemia, CFR´s may be lower in defect perfusion zones and presence of both ischemia and MVD has worse prognosis11 suggesting ischemia could had already developed in this group. LVEF drop supports the relation between CFR and ventricular function12. Finally, MVA group had a reduced CS, associated with CAD and worse prognosis, suggesting it also affects the microvasculature function. Conclusions 13N-ammonia PET/CT MPI with CCTA is a great combination to diagnose MVA, whose main component is microvascular dysfunction. Recognizing the risk factors associated with this pathology allows making opportune detections, implementing early treatment strategies, controlling symptoms and avoiding the disease"s evolution

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
H Gurrola-Luna ◽  
J K Rojas-Sernaque ◽  
A J Barajas Paulin ◽  
I Carvajal-Juarez ◽  
J L Bermudez-Gonzalez ◽  
...  

Abstract Introduction Microvascular Dysfunction defined as a Myocardial Flow Reserve (MFR) <2 or <2.5 depending on the center, may present in the absence of significant obstruction (1,2); it is included as a diagnosis criteria of Microvascular Angina (MVA) (3,4) and is an independent risk factor associated with poor prognosis (5–7). Traditional Coronary Artery Disease (CAD)risk factors have also been associated with MVA (8–10), however, there is reduced data in latin populations with high prevalence of comorbidities. The aim of this study was to identify the comorbidities that alter MFR with 13N-ammonia Positron Emission Tomography/Cardiac Tomography (PET/CT) and Cardiac Computed Tomography Angiography (CCTA) in a cardiovascular imaging referral center. Methods Retrospective cross-sectional study of patients with suspected CAD in which both PET/CT and CCTA were performed. Inclusion:CCTA with obstruction <50%. Exclusion: incomplete study, previous infarction or intervention. Clinical data was assessed. Mean (±DE) or median (interquartile range) to present continuous variables according to their distribution; T student or U Man Whitney to compare them. For each variable two groups were conformed depending on its presence or absence in order to compare MFR between them. Statistical analysis was performed with Statistical Package for Social Science (SPSs Inc, Chicago, IL; version 23.0) and GraphPad Prism version 9.0. p<0.05 was considered as significant. Results 335 patients included. MFR difference for each variable: female sex, hypertension (HT), Type 2 diabetes (T2D) and smoking – Appendix 1. Significant MFR difference for HT (p=0.024) and T2D (p=0.046). Severe ischemia had significant MFR reduction (p=0.006); patients with both HT and mild ischemia (p=0.018) – Appendix 2. Discussion Individuals with HT and T2D had a significantly lower MFR, consistent with previous studies (8,9). Absence of correlation with other risk factors, such as smoking (10) and female sex (11); latter may be caused by a significant lower number of women (108 vs 227). Further analysis in this subgroup ought to be done. When comparing MFR between level-of-ischemia groups, microvascular function was not reduced until severe ischemia. Remarkably, if we analyze the coexistence of HT with ischemia, MFR is reduced even in patients with mild ischemia. This finding highlights the importance of HT which alters function in early stages even in the absence of significant obstruction. This is one of the first studies correlating MFR with comorbidities in our population. Limitations the retrospective nature of the study. Conclusions MFR non-invasive assessment by PET/CT allows identifying very early stages of MVD, even in asymptomatic patients and when there's no evidence of ischemia or CAD. Therefore, timely recognition of this problem is mandatory to implement action strategies to stop the triggered events' cascade. FUNDunding Acknowledgement Type of funding sources: None.


Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2876
Author(s):  
Giovanni Manfredi Assanto ◽  
Giulia Ciotti ◽  
Mattia Brescini ◽  
Maria Lucia De Luca ◽  
Giorgia Annechini ◽  
...  

Background: Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. Patients and Methods: We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. Results: Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. Conclusion: A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications.


Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2715-2715
Author(s):  
Tomohiro Kadota ◽  
Sachiko Seo ◽  
Yoshihiro Nakagami ◽  
Hiroe Fuse ◽  
Yujiro Ueda ◽  
...  

Abstract Background: The standard therapy for primary gastric diffuse large B-cell lymphoma (DLBCL) is chemotherapy of R-CHOP with/without involved-field radiation therapy. Although some reports indicated that gastrointestinal complications after chemotherapy for DLBCL occur at a rate of 0-26%, little is known about riskfactors for the complications. In addition, to detect DLBCL in gastric lesion, both of positron emission tomography-computed tomography (PET-CT) and esophagogastroduodenoscopy (EGD) are useful tools. However, there have been few reports comparing them. The aim of this study is to show the outcomes including treatment-related complications in patients with gastric DLBCL and risk factors for the gastric complications. Moreover, we evaluated whether PET-CT is sufficient to detect DLBCL in gastric lesion by comparing with EGD. Patients and methods: This retrospective study included consecutive patients with newly diagnosed DLBCL between October 2003 and July 2014 who underwent EGD and were treated with R-CHOP in our hospital. We classified the patients into three groups. Group A-1: patients who had documented DLBCL in gastric lesion by EGD and underwent PET-CT; group A-2: patients who had documented DLBCL in gastric lesion by EGD and did not underwent PET-CT; group B: patients who had no documented DLBCL in gastric lesion by EGD and underwent PET-CT. Suspected lymphomatous lesions by EGD were biopsied and immunopathologically examined. Gastric DLBCL was defined only when pathologically confirmed. In PET-CT, gastric lesions with SUV max ≥ 5 were considered positive. Outcomes and risk factors for complications among group A were analyzed using the logistic regression model. We evaluated significance of PET-CT and EGD in group A-1 and B by the positive predictive value (PPV) and the negative predictive value (NPV). Results: Among 448 patients diagnosed with DLBCL, 178 patients were enrolled for our study: 55 in group A-1, 28 in group A-2 and 95 in group B. Among 83 patients with gastric DLBCL (group A), the median age was 69 years (range, 29-85). The numbers of patients with clinical stage (Ann Arbor classification) I, II, III, and IV were 27, 18, 5, and 33, respectively. The rate of complete remission was 87%, and the median 3- and 5-year over survival (OS) were 81% and 75%, respectively. The median 3-year OS of patients with very good, good, and poor grade of Revised International Prognostic Index (R-IPI) was 100%, 77%, and 63%, respectively (Figure, p=0.025). Ten patients had gastric complications: 6 with bleeding that needed blood transfusion and 3 with gastrointestinal stenosis defined as ordinary endoscopy could not pass, no patients had gastrointestinal perforation. Most of bleeding (66.7%) occurred during the first cycle of R-CHOP (median, 15 days; range, 1-206). A multivariate analysis showed that low serum albumin (ALB) at diagnosis was an independent risk factor for gastric complications (odds ratio 10.75, p <0.001). The numbers of patients with positive or negative results examined by PET-CT or EGD in group A-1 and B were shown in Table. PPV and NPV of PET-CT were 0.90 and 0.97, respectively. Conclusions: The present study showed that R-IPI was also predictive of survival in gastric DLBCL and low ALB at diagnosis as a significant risk factor for gastric complications following R-CHOP. In addition, our data suggested that PET-CT may be sufficient in the role of detecting gastric lesion of DLBCL because of high PPV and NPV. Disclosures No relevant conflicts of interest to declare.


Author(s):  
Muhammad Mumtaz ◽  
Almuhanad Abdullah Alsuwaiket ◽  
Shammas Raza ◽  
Farhat Kazmi ◽  
Quratulain Shaikh ◽  
...  

Purpose: Xerostomia is a feeling of dry mouth and may result in poor oral hygiene, dental caries, mucosal lesions and burning mouth syndrome. Medication, systemic diseases and stress are common etiological factors of xerostomia. The present study investigated the prevalence of xerostomia and explored the possible risk factors associa­ted with this condition among Saudi population. Methods: The present cross-sectional study was conducted on 418 participants visiting at Maxillofacial clinic, at secondary care hospital, Riyadh.  Demographic data and complete medical history were obtained from participants. All participants were requested to fill the Xerostomia-Inventory (XI) questionnaire. Comparisons between mean scores of XI-inventory and categorical variables like gender, comorbid conditions were made with students t-test or Wilcoxon test. Chi-square or Fischer’s Exact test were used for comparison between categorical variables like gender and responses to XI-items (No/Yes). P value of <0.05 was considered significant. All analysis was done on JMP-version-12. Results: Total 418-participants with mean age (41.1 ± 12.8 years) were included in the study in which 302-participants (72.2%) were female and 116-participants (27.8%) were male. Xerostomia’s prevalence was 24.7% and it was higher in males (34%) as compared to females (21%). A statistically-significant association was found between xerostomia and participant’s age (P < 0.0001). The participants with systemic illness showed a significantly higher mean Xerostomia Inventory (XI) score as compared to the healthy patients. In our study population common comorbid conditions were hypertension and diabetes. Conclusion: The prevalence of xerostomia increases with increasing age and it has strong positive co-relation with chronic systemic diseases.


2018 ◽  
Vol 99 (5) ◽  
pp. 766-774
Author(s):  
O V Slesarev ◽  
I M Bayrikov ◽  
O S Kovshova ◽  
M V Komarova

Aim. To analyze the influence of psychosocial risk factors on the dynamics of indicators characterizing temporomandibular disorders. Methods. 61 clinical cases of temporomandibular disorders with chronic pain were investigated (18 % of the total number of observations of temporomandibular disorders). Diagnostic criteria of temporomandibular disorders were used: axis II, computed tomography and magnetic resonance imaging of temporomandibular joint. Interviewing method was used for clinical diagnosis of psychological phenomena and testing attitude to the disease, identifying communicative deviations according to R.C. Rogers (2002). Patients were divided into 2 groups: group A - patients with nociceptive pain, social adaptation is not disturbed; group B - patients with neuropathic pain, psychosomatization on the background of mental rigidity. In both groups, an identical treatment regimen was implemented for two years. Statistical processing of the obtained data was carried out using IBM SPSS 21 and included comparison of related groups by Friedman analysis and paired Wilcoxon test, comparison of independent groups by Mann-Whitney-Wilcoxon criterion, and comparison of the qualitative features by contingency tables by Chi-square Pearson. Results. The radiological semiotics of temporomandibular joint in both groups is similar in the structure of nosology. At the beginning of the treatment cycle, the pain intensity and the temporomandibular index are similar. After 2 years of follow-up, patients in group A showed a significantly higher positive response to the therapy compared to patients in group B: pain intensity in group A was 15.36±2.53 and in group B - 37.32±3.45 (p<0.001); depression on the SCL-90-R scale - 0.29±0.04 and 1.12±0.12 (p<0.001), the degree of disability on the GCPS scale - 0.68±0.08 and 1.17±0.10 (p=0.001), temporomandibular index - 0.15±0.01 and 0.23±0.02 (p<0.001), respectively. Conclusion. In patients of group B, affective disorders form the psychosomatic structure of personality and affect the outcome of therapy. When formulating the final diagnosis and planning the treatment in patients with temporomandibular disorders, it is necessary to take into account the psychosocial characteristics of the patient.


2020 ◽  
Author(s):  
Mayda Rahi ◽  
Diane Le Pluart ◽  
Alexandra Beaudet ◽  
Sophie Ismael ◽  
Marion Parisey ◽  
...  

Abstract Background: The efficacy of lockdown in containing the COVID-19 pandemic has been reported in different studies. However, the impact on sociodemographic characteristics of individuals infected with SARS-CoV-2 has not been evaluated. The aim of this study was to describe the changes in sociodemographic characteristics of patients hospitalized for COVID-19 and to compare the transmission risk factors of COVID-19 before and during lockdown in France. Methods: An observational retrospective study was conducted in a University Hospital in Paris, France. Data from patients hospitalized for COVID-19 in the Infectious Diseases Department between February 26 and May 11, 2020 were collected. The study population was divided into 2 groups: group A of patients infected before lockdown, and group B of patients infected during lockdown, considering a maximum incubation period of 14 days. Sociodemographic characteristics and transmission risk factors were compared between the 2 groups using Student's t-test for continuous variables and Chi-2 test or Fisher exact test for categorical variables.Results: Three hundred eighty-three patients were included in the study, 305 (79.6%) in group A and 78 (20.4%) in group B. Patients in group A were significantly younger (60.0 versus (vs) 66.5 years (p=0.03)). The professionally active population was larger in group A (44.3% vs 24.4%). There were significantly more non-French-speaking people in group B (16.7% vs 6.6%, p<0.01). Most patients from group A had individual accommodation (92.8% vs 74.4%, p<0.01). Contact with a relative was the main transmission risk factor in both groups (24.6% vs 33.3%, p=0.16). Recent travel and large gathering were found only in group A. The proportion of people living in disadvantaged conditions, such as homeless people or people living in social housing, was significantly higher in group B (11.5% vs 4.3%, p=0.03) as was the proportion of institutionalized individuals (14.1% vs 3.0%, p<0.01).Conclusions: In this study conducted in patients hospitalized for COVID-19 in Paris, France, the likelihood of being infected despite the lockdown was higher for people who do not speak French, live in social housing, are homeless or institutionalized. Targeted measures have to be implemented to protect these populations.


2021 ◽  
Author(s):  
Akinao Kaneta ◽  
Takahiro Sato ◽  
Hiroshi Nakano ◽  
Takuro Matsumoto ◽  
Takeshi Tada ◽  
...  

Abstract Background Postoperative pneumonia is one of the major complications after esophagectomy. The aim of this study was to determine whether bacterial cultures before esophagectomy could predict occurrence of postoperative pneumonia and help treatment strategies for postoperative pneumonia. Methods Sixty-nine patients who underwent subtotal esophagectomy at Fukushima Medical University hospital between January 2017 and May 2021 were included in this study. We collected sputum, oral and/or nasopharyngeal swabs for bacterial culture preoperatively from all patients and from those who were suspected of postoperative pulmonary infections. We compared cultured pathogenic bacteria obtained preoperatively and postoperatively from patients who developed postoperative pneumonia, and investigated their association with incidence of postoperative pneumonia. Fisher’s exact test was used to compare categorical variables between groups, and Wilcoxon test was used to compare continuous variables. Risk factors for postoperative pneumonia and severe pneumonia were analyzed using multivariate logistic regression models. Results Postoperative pneumonia occurred in 22 (31%) of the 69 patients, and 13 of the 22 patients were classified as with severe pneumonia. Multivariate analysis revealed that longer operative duration (for 30 minutes increase; odds ratio 1.27, 95% confidence interval 1.01–1.51, p=0.039) and positivity for preoperative bacterial culture (odds ratio 5.03, 95% confidence interval 1.31–19.2, p=0.018) were independent risk factors for severe postoperative pneumonia, but not for all incidence of postoperative pneumonia. Of note, in only 5 out of the 22 patients with pneumonia, the same pathogen species were detected preoperatively and after the onset of pneumonia. Conclusions In conclusion, our results implied that preoperative bacterial culture may be useful to predict severe postoperative pneumonia. However, it may not be useful in determining pathogenic bacteria responsible for postoperative pneumonia.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mayda Rahi ◽  
Diane Le Pluart ◽  
Alexandra Beaudet ◽  
Sophie Ismaël ◽  
Marion Parisey ◽  
...  

Abstract Background The efficacy of lockdown in containing the COVID-19 pandemic has been reported in different studies. However, the impact on sociodemographic characteristics of individuals infected with SARS-CoV-2 has not been evaluated. The aim of this study was to describe the changes in sociodemographic characteristics of patients hospitalized for COVID-19 and to compare the transmission risk factors of COVID-19 before and during lockdown in France. Methods An observational retrospective study was conducted in a University Hospital in Paris, France. Data from patients hospitalized for COVID-19 in the Infectious Diseases Department between February 26 and May 11, 2020 were collected. The study population was divided into 2 groups: group A of patients infected before lockdown, and group B of patients infected during lockdown, considering a maximum incubation period of 14 days. Sociodemographic characteristics and transmission risk factors were compared between the 2 groups using Student’s t-test for continuous variables and Chi-2 test or Fisher exact test for categorical variables. Results Three hundred eighty-three patients were included in the study, 305 (79.6%) in group A and 78 (20.4%) in group B. Patients in group A were significantly younger (60.0 versus (vs) 66.5 years (p = 0.03)). The professionally active population was larger in group A (44.3% vs 24.4%). There were significantly more non-French-speaking people in group B (16.7% vs 6.6%, p <  0.01). Most patients from group A had individual accommodation (92.8% vs 74.4%, p <  0.01). Contact with a relative was the main transmission risk factor in both groups (24.6% vs 33.3%, p = 0.16). Recent travel and large gathering were found only in group A. The proportion of people living in disadvantaged conditions, such as homeless people or people living in social housing, was significantly higher in group B (11.5% vs 4.3%, p = 0.03) as was the proportion of institutionalized individuals (14.1% vs 3.0%, p <  0.01). Conclusions In this study conducted in patients hospitalized for COVID-19 in Paris, France, the likelihood of being infected despite the lockdown was higher for people who do not speak French, live in social housing, are homeless or institutionalized. Targeted measures have to be implemented to protect these populations.


Author(s):  
Natalia I. Latyshevskaya ◽  
Tatyana L. Yatsyshena ◽  
Elena L. Shestopalova ◽  
Irina Yu. Krainova

Modern trends in the deterioration of health and the growth of non-communicable diseases among the adult working-age population, including medical workers, actualize the importance of a healthy lifestyle for maintaining health and professional longevity. There were almost no studies related to cosmetologists' experienced group as representatives of aesthetic medicine. There is no scientific evidence on behavioral risks of this group. It justifies the relevance of this study. The study aims to analyze the essential components of the cosmetologists' lifestyle depending on age and the argumentation of priority behavioral health risk factors for preventive and recreational work justification. Sixty women (practicing cosmetologists in Volgograd at the age of 28-39 years (group A) and 40-53 (group B)) took part in the study. Lifestyle assessment included a modified questionnaire. The questionnaire consists of 5 blocks (block 1 - nutrition; 2 - physical activity, including hardening and active rest; 3 - daily regimen; 4 - personal hygiene; 5 - bad habits). It allows the analysis of the adherence to a healthy lifestyle based on the provision of quantitative data. Statistical data processing was carried out using the Excel package. The authors identified the essential and statistically significant differences in the cosmetologists' lifestyle depending on age. The respondents of group B demonstrated hygienically rational indicators in all blocks of the lifestyle more often. They had a more formed adherence to a healthy lifestyle: 504 answers in the category "insignificant risk" of respondents in group B versus 354 in group A. Distribution of answers in the "high risk" category: 119 responses in group B and 185 in group A. The lifestyle of 46.7% of the respondents in group B refers to a healthy lifestyle. 3.3% of the group B respondents have an anxious lifestyle, 50% have health risks. 10% of Group A respondents' lifestyle refers to a healthy lifestyle. 13.3% of Group A respondents' lifestyle refers to an anxious lifestyle; 76.7% of this group have health risks. There was almost no complex hygienic research profession of medical cosmetologists. Cosmetologists of the older age group (40-53 years old) are more conscious of maintaining a hygienically rational lifestyle. The most significant defects among cosmetologists aged 28-39 years are low physical activity, nutritional defects, insufficient duration of night rest, and excessive use of information and communication technologies for rest, accompanied by manifestations of neurotization and signs of pronounced fatigue. The obtained results argue the need to develop and implement informational and educational measures to prevent risk behavior patterns, taking into account the age of cosmetologists and the priority of the identified behavioral risk factors.


1999 ◽  
Vol 99 (11) ◽  
pp. 571 ◽  
Author(s):  
Richard R Terry ◽  
Francis W Kelly ◽  
Cheryl Gauzer ◽  
Melissa Jeitler
Keyword(s):  

Sign in / Sign up

Export Citation Format

Share Document