P3358Cardiovascular risk, aortic valve microcalcification and vascular microcalcification: is there a link?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Domingues ◽  
M Oliveira-Santos ◽  
M Castelo-Branco ◽  
R Silva ◽  
A Gomes ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Blood Pool ◽  
Pet Ct ◽  
Risk Distribution ◽  
Group A ◽  
Ascvd Risk ◽  
The Mean ◽  
Group B

Abstract 18F-sodium fluoride (18F-NaF) has been used to evaluate aortic stenosis. It is know that its uptake is related with microcalcification. The purpose of this study is to assess the relationship between 18F-NaF uptake by the aortic valve and by the main arterial vessels and cardiovascular risk. Twenty-five hypertensive patients without known cardiovascular disease or aortic stenosis underwent PET-CT with 18F-NaF. Cardiovascular risk was assessed through the ASCVD risk calculator. The patients had a mean age of 64.0±8.6 years and 56% were males. The mean ASCVD risk was of 28.8±19.0 (IQR: 10–48.5). The uptake of 18F-NaF assessed through the corrected uptake per lesion (CUL = max SUV – mean blood-pool SUV) was of 0.49±0.14 (IQR: 0.44–0.57) and the mean uptake in the aortic, coronary and carotid territories was of 0.66±0.21 (IQR: 0.53 - 0.76).The patients were classified according to the ASCVD: Group A: patients with a risk above the 50thpercentile of the ASCVD risk distribution (50thpercentile=25), 12 patients) and Group B: patients with a risk under or equal to the 50thpercentile of the ASCVD risk distribution, 13 patients. The uptake of 18F-NaF in the aortic valve (AoV)and in the main vascular territories (VT) were evaluated in both groups: A vs B: AoV CUL = 0.57±0.09 vs 0. 42±0.14, p=0.005; VT= 0.78±0.16 vs 0.54±0.20, p=0.003. We also evaluate the relation between AoV uptake and VT uptake and they were significantly related (r=0.69, p=0.0001). In conclusion on this study microcalcification of the aortic valve and in the main vessels, evaluated through 18F-NaF uptake, were related between them and with cardiovascular risk reinforcing the importance of cardiovascular risk prevention in aortic valve degeneration and vascular atherosclerosis.

5965Perimatrial inflammation measured by fluoine-18-fluorodeoxyglucose-positron emission tomography/computed tomography to predict new-onset atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Hada ◽  
S Iwamiya ◽  
S Hijikata ◽  
T Yoshitake ◽  
H Sato ◽  
...  
Keyword(s):  
Blood Pool ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Significant Difference ◽  
Group A ◽  
Arterial Inflammation ◽  
Group B ◽  
Fdg Pet Ct ◽  
New Onset

Abstract Background Fluoine-18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is a useful modality of inflammatory disease. Epicardial adipose tissue (EAT) contains abundant ganglionated plexi, therefore EAT inflammation may cause atrial arrhythmia, such as atrial premature contraction (APC) and atrial fibrillation (AF). Previous studies have shown that inflammatory activity of EAT has relation to the presence of AF. However, it is unknown whether EAT inflammation contributes to the occurrence of AF. Methods Out of 20720 examinees who underwent FDG-PET/CT for screening of cancer in the years 2012–2018, 151 (aged 65.6±12.0 years old, 62 females) had ambulatory electrocardiographic monitoring (Holter ECG) within a year and non-detection of AF. Standardized uptake value (SUV) was measured in fat adjacent to roof of left atrium (ROOF), atrioventricular groove (AV), left main coronary artery (LMT), and right ventricular blood pool (RV). In order to correct for blood pool activity, SUV of ROOF, AV, and LMT were divided by SUV of RV respectively, yielding target-to-background ratio (TBR). As regards to arterial inflammation, measurements were performed with SUV in ascending aorta (A-Ao) and in superior vena cava (SVC) as blood pool. In the same way, SUV of A-Ao was divided by SUV of SVC, yielding TBR. Results According to Holter ECG, APC≥100 beats per day was seen in 60 patients (Group A), but not in the other 91 (Group B). In Group A, TBR of ROOF, AV, and LMT were all significantly higher than Group B (p<0.001, p=0.004, and p=0.008, respectively). During a median follow-up of 179 days, new-onset AF was diagnosed in 7 patients (4 in Group A (6.7%), 3 in Group B (3.3%), p=0.046). There was significant difference in TBR of ROOF between patients with and without new-onset AF (p<0.001), but not in TBR of AV and LMT. In addition, no significant difference was observed in TBR of A-Ao between these two groups. In the Cox proportional hazard analysis, TBR of ROOF was found to be an independent predictor of new-onset AF (odds ratio 40.1, 95% confidence interval 6.05 to 265.9, p<0.001). Conclusions Although EAT inflammation evaluated by SUV is related to frequent APCs, only in fat adjacent to roof of left atrium is associated with and predicts future occurrence of AF. Arterial inflammation measured by SUV has no relation to atrial arrhythmia.

Revival of Continuous Suture Technique in Aortic Valve Replacement in Patient with Aortic Valve Stenosis a Novel Modified Technique

2011 ◽  
Vol 6 (5) ◽  
pp. 311-315 ◽  
Author(s):  
Go Watanabe ◽  
Teruaki Ushijima ◽  
Shigeyuki Tomita ◽  
Shojiro Yamaguchi ◽  
Yoshinao Koshida ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Suture Technique ◽  
Continuous Suture ◽  
Cardiac Procedures ◽  
Group A ◽  
Group B

Objective The continuous suture technique has numerous advantages as simple, quick, and effective for aortic valve replacement; however, it is technically difficult. We have modified the continuous suture technique and evaluated our new technique in patients with aortic stenosis. Methods Between July 2007 and May 2010, 86 patients with aortic valve stenosis underwent aortic valve replacement alone or with other concomitant cardiac procedures including mitral valve surgery in our hospital. The patients were randomly divided into two groups: group A (n = 43) in which the continuous suture technique with some modifications was used and group B (n = 43) in which the conventional interrupted suture technique was used. There were no statistical differences between two groups in age, sex, body surface area, concomitant cardiac procedures, blood loss, and postoperative extubation time. Results The aortic cross-clamp time, cardiopulmonary bypass time, operation time, and hospital stay were significantly shorter in group A than that in group B, and the valve size was significantly larger in group A. No perivalvular leak was detected in postoperative echocardiograms. All patients recovered satisfactorily without complications associated with suture technique or prosthesis. During follow-up of 4 to 38 months, there were no clinically significant complications in group A, while one patient in group B developed perivalvular leakage requiring reoperation 3 months after surgery. Conclusions Our modified continuous suture method is useful for aortic valve replacement in patients with aortic stenosis and beneficial for the patients because the procedure is less invasive and a larger valve can be implanted.

Difference in Outcome Following Surgery for Native Aortic and Mitral Valve Infective Endocarditis

2018 ◽  
Vol 67 (08) ◽  
pp. 652-658 ◽  
Author(s):  
Tuukka Kaartama ◽  
Shahab Nozohoor ◽  
Malin Johansson ◽  
Johan Sjögren ◽  
Pedro Timane ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Long Term Results ◽  
Native Valve ◽  
Group A ◽  
Short And Long Term ◽  
The Mean ◽  
Group B

Background We investigated differences in clinical presentation, microbiology, and short- and long-term results according to the affected valve in patients who underwent surgery for left-sided native valve infective endocarditis (IE). Methods This was a single-center retrospective study of 117 patients with isolated mitral valve IE (group M) and 140 patients with isolated aortic valve IE (group A) who underwent surgery between 1998 and 2015. Results The mean age of patients in group M was 62 ± 14 years, whereas in group A the patients were 56 ± 14 years old (p = 0.001). There were 61 females (52% of patients) in group M and 31 females (22% of patients) in group A (p < 0.001). Abscesses were more common in group A than in group B. Staphylococcus aureus was more frequent in group M (47%, n = 55) than in group A (21%, n = 30; p < 0.001). The length of time from symptom onset to surgery was longer in group A than in group M, but the time from diagnosis to surgery was shorter in group A than in group M. Ninety-day mortality was similar in group M and group A in patients operated within 48 hours after diagnosis, but in patients who were operated more than 48 hours after diagnosis the 90-day mortality was 15% in group M and 3% in group A (p = 0.006). Conclusion There were considerable differences in preoperative characteristics, microbiology, timing of surgery, and outcomes between patients who underwent surgery for isolated aortic valve IE and those who were operated for isolated mitral valve IE.

P927Long-term mortality in patients with paradoxical low-flow low-gradient versus normal-flow high-gradient aortic stenosis undergoing transcatheter aortic valve implantation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Fusini ◽  
M Muratori ◽  
G Tamborini ◽  
S Ghulam Ali ◽  
P Gripari ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Low Flow ◽  
Normal Flow ◽  
Transcatheter Aortic Valve ◽  
Group A ◽  
Aortic Valve Implantation ◽  
Group B ◽  
Valve Implantation

Abstract Background Controversial data exist on clinical outcomes of patients with paradoxical low-flow, low-gradient aortic stenosis (PLF-LG) undergoing valve replacement. This entity is a combination of a small aortic valve area (AVA<1cm2), a preserved left ventricular ejection fraction (LVEF≥50%), and a “paradoxical” low mean gradient due to the presence of low LV stroke volume (≤35 mL/m2). The low flow state is explained by the presence of a high afterload and pronounced LV concentric remodeling, with impaired LV filling. Currently, poorer outcomes have been reported after surgical aortic valve replacement in patients with PLF-LG AS compared with the normal-flow high-gradient (NF-HG) AS. Purpose The aim of this study was to determine the clinical outcomes in patients with PLF-LG AS undergoing transcatheter aortic valve implantation (TAVI) compare to NF-HG patients. Methods A total of 609 patients (age 81±6 years) with symptomatic severe AS and preserved LVEF who underwent TAVI, was enrolled and divided in two groups: group A included patients with NF-HG (542 patients) and group B including those with PLF-LG (66 patients). At 1-year follow-up, death and clinical events were reported. Results TAVI was feasible in all patients. A significant reduction in mean aortic pressure gradient was observed after TAVI both in PLF-LG (baseline, 30±5 mmHg; 1-year, 11±4 mmHg; p<0.001) and in NF-HG (baseline, 53±11 mmHg; 1-year, 12±4 mmHg; p<0.001) together with an increase in AVA (PLF-LG: baseline, 0.74±0.16 cm2, 1-year: 1.83±0.41 cm2, p<0.001; NF-HG: baseline, 0.65±0.16 cm2, 1-year: 1.84±0.35cm2, p<0.001). Perioperative mortality at 30-days was similar in group A (17/542, 3%) and in group B (2/66, 3%). Figure shows the survival curves up to 5 years follow-up according to the two groups. PLF-LG and HG-AS had similar survival rate throughout the long-term follow-up. Similarly, rehospitalization rate was not different in the two groups (PLF-LG: 12% vs NF-HG: 7%, p=0.121). Kaplan-Meier analysis Conclusions Differently from surgical series, TAVI patients with PLF-LG AS had showed similar mortality and rehospitalization rates compared to NF-HG.

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

2020 ◽  
Vol 33 (1) ◽  
pp. 41-47
Author(s):  
Mohsena Akhter ◽  
Ishrat Bhuiyan ◽  
Zulfiqer Hossain Khan ◽  
Mahfuza Akhter ◽  
Gulam Kazem Ali Ahmad ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Close Contact ◽  
Randomized Study ◽  
Sarcoptes Scabiei ◽  
Efficacy And Safety ◽  
Common Skin ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

Evaluating of oral and salivary conditions of two specific groups of workers

RSBO ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 50
Author(s):  
Eduardo Pizzatto ◽  
Nicolae Carvalho de Paula ◽  
Carolina Dea Bruzamolin ◽  
Paulo H. Tomazinho ◽  
Luciane Variani Pizzatto ◽  
...  
Keyword(s):  
Oral Microbiota ◽  
Tooth Decay ◽  
Oral Diseases ◽  
Industrial Countries ◽  
Group A ◽  
Dmft Index ◽  
Saliva Collection ◽  
The Mean ◽  
Group B ◽  
Lactobacillus Spp

Introduction and Objective: Tooth decay is one of the most common chronic oral diseases found in industrial countries and is a multifactorial disease which has sugar as a key dietary factor. The amount of saliva concentration and presence of cariogenic bacteria will favor the development of caries. Because of this, the aim of this study was to collect and analyze data on oral alterations referred to tooth decay, oral pH changes, and changes of the oral microbiota in two distinct groups of workers. Material and methods: 30 individuals belonging to two different groups of workers: group A (GA) – workers who maintain daily contact with the confectionery; group B (GB) – workers who do not have such contact. Saliva collection was done by analysis of the salivary pH in both groups, as well as cultivation of Lactobacillus spp and S. mutans. We also evaluate the dental status of individuals belonging to the two groups through the DMFT index. Results: After the examinations of 30 workers (17 from the GA [9 men and 8 women] and 13 in the GB [7 men and 6 women]), the mean DMFT of the individuals in the group A and group B, was 7.41 (SD 5.14) 7.08 (SD 5.56), respectively, without statistically significant differences (p < 0.05). The count of S. mutans and Lactobacillus spp, was not statistically significant. Conclusion: There was no statistically significant relationship between presence of dental caries and the fact that workers are in contact with sugar because they work on candy food industry, but new studies are needed for more precise research.

scholarly journals Comparative study between fascia lata and temporalis fascia in myringoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez
Keyword(s):  
Tympanic Membrane ◽  
Good Alternative ◽  
Fascia Lata ◽  
The Body ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Fascia Lata Graft ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.

scholarly journals Home physiotherapy with vs. without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sanjay Bhalchandra Londhe ◽  
Ravi Vinod Shah ◽  
Amit Pankaj Doshi ◽  
Shubhankar Sanjay Londhe ◽  
Kavita Subhedar ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Forgotten Joint Score ◽  
Group A ◽  
Manipulation Under Anaesthesia ◽  
Total Knee ◽  
The Mean ◽  
Group B ◽  
Discharge From Hospital

Abstract The aim of this retrospective cohort study was to compare home physiotherapy with or without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty. Methods A total of 900 patients (including 810 females and 90 males) who had undergone total knee arthroplasty were divided into group A (n = 300) and group B (n = 600). Patients in group A had home physiotherapy on their own after discharge from hospital. The physiotherapist did not visit them at home. Patients in group B received home physiotherapy under supervision of physiotherapist for 6 weeks after discharge from hospital. Patients’ age, range of motion of the knee, and forgotten joint score-12 were assessed. A p < 0.05 was considered statistically significant. Results In group A, the mean age was 69.1 ± 14.3 years (range: 58 to 82 years); in group B, the mean age was 66.5 ± 15.7 years (range: 56 to 83 years) (p > 0.05). Preoperatively, the mean range of motion of the knee in group A and B was 95.8° ± 18.1° and 95.4° ± 17.8°, respectively (p > 0.05). The mean forgotten joint score-12 of group A and B were 11.90 ± 11.3 and 11.72 ± 12.1 (p > 0.05), respectively. Six weeks after total knee arthroplasty, the mean ROM of the knee in group A and B was 109.7° ± 22.3° and 121° ± 21.5°, respectively (p < 0.05). The mean postoperative forgotten joint score-12 of the group A and B was 24.5 ± 16.4 and 25.6 ± 17.4, respectively (p > 0.05). The rate of manipulation under anaesthesia was 3% in group A and 0.2% in group B (p < 0.05). Conclusion After total knee arthroplasty, frequent physiotherapist’s instruction helps the patients improve knee exercises and therefore decrease the risk of revision surgery. The home physiotherapy under supervision of physiotherapist lowers the rate of manipulation under anaesthesia. Level of evidence Therapeutic study, Level IIa.

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