scholarly journals Interventional Treatment of Bronchiectasis Macrosomia Based on Multirow CT Tomography Monitoring

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
DongDong Lu ◽  
Wenshu Chai ◽  
Xue Gao ◽  
Xue Yan
Keyword(s):  
Interventional Treatment ◽  
X Rays ◽  
Clinical Value ◽  
Potential Health ◽  
Coronary Ct ◽  
Significant Difference ◽  
Small Doses ◽  
Depth Study ◽  
Strict Compliance ◽  
Artery Disease

We present in this paper an in-depth study and analysis of bronchiectasis haemoptysis by multirow CT tomography and a multifaceted treatment and analysis of the interventions monitored by the scan. Although coronary CT is of great clinical value in the diagnosis and monitoring of coronary artery disease, the potential radiation damage caused by coronary CT should not be underestimated because CT imaging is based on X-rays and the actual effective dose is 5–30 mSv, which is reported in the literature to be high when using conventional imaging modalities for coronary CT. Although there is no direct evidence of a definite causal relationship between X-ray exposure during CT examinations and tumorigenesis, theoretically, even small doses of radiation exposure may pose some potential health risk. Therefore, in clinical practice, coronary CT examinations should be performed in strict compliance with the radiation protection rule “as low as reasonably achievable” (ALARA) recognized by the radiation industry. For longitudinal openings in the range of 0° to 59° and transverse openings in the range of 0° to 44°, the CB2 catheter is significantly more stable than the MIK catheter, and for longitudinal openings in the range of 60° to 119° and transverse openings in the range of 0° to 44°, the CB2 catheter is more stable than the MIK catheter. For longitudinal openings from 0° to 120° and lateral openings from 45° to 90°, there was no significant difference in cannulation stability between the CB2 and MIK catheters. There was a potential tendency for MIK cannulation stability to be higher than CB2 for longitudinal openings in the range of 120° to 180° and lateral openings in the range of 45° to 90°, but there was no significant difference.

Abstract 13551: Identifying Left Main Coronary Artery Disease Using Coronary Artery Calcium Scans

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Joel E Money ◽  
Joseph B Muhlestein ◽  
Steve M Mason ◽  
Tami L Bair ◽  
Kirk U Knowlton ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Data Sets ◽  
Left Main ◽  
Coronary Ct ◽  
Therapy Strategy ◽  
Significant Difference ◽  
Routine Medical Practice ◽  
Heavy Burden ◽  
Artery Disease

Introduction: The ISCHEMIA trial tested an invasive vs. an initial medical strategy in patients (pts) with stable coronary disease and evidence of ischemia. No significant difference between strategies in cardiovascular events was found at 3.2 years. However, pts were screened before randomization by coronary CT angiography (CCTA) to exclude ≥50% left main coronary stenosis (LMCS). CCTA adds complexity to routine medical practice, including time delays, expense, and safety concerns. We tested whether a coronary artery calcium scan (CACS), a simpler, less expensive test, could replace CCTA to exclude significant LMCS. Methods: We hypothesized that pts with ≥50% LMCS would have a LM CACS score>0. As a corollary, we postulated that a LM CACS=0 would exclude pts with LMCS. To test this, we searched Intermountain Healthcare’s electronic medical records database for all adult pts who had undergone non-contrast cardiac CT for quantitative CACS scoring prior to selective coronary angiography (SCA) and were found to have a LMCS ≥50%. Pts aged <50 and those with a heart transplant were excluded. Cases with incomplete (qualitative) angiographic reports for LMCS and those with incomplete or discrepant LM CACS results were reviewed and reassessed blinded to CACS or SCA findings, respectively. Results: Among 674 candidate pts with CACS followed by SCA, 24 qualifying pts were identified who had a quantitative CACS score and LMCS ≥50%. Their age averaged 71 ± 11 years, and 83% were men. Angiographic LMCS averaged 77% (range 50%-99%). A heavy burden of both total CAC and LM CAC was typically present. Total CACS score averaged 2,545 Agatston Units (AU), range 571-6,636. LM CACS score averaged 214 AU, range 47-610. Importantly, no LMCS pt had a LM CACS score of 0 vs. 57% (368/650) of non-LMCS controls (p<0.00001). Conclusions: Our results support the hypothesis that an easily administered, inexpensive, low radiation CACS can identify a large subset of pts with a very low risk of LMCS without the need for routine CCTA. Using CACS to exclude LMCS may efficiently allow for safe implementation of an initial medical therapy strategy in clinical practice for ISCHEMIA trial-like pts with at least moderate ischemia on stress testing. These promising results deserve validation in larger data sets.

scholarly journals Study of the correlation between platelet parameters in the patients with coronary heart disease

2017 ◽  
Vol 5 (6) ◽  
pp. 2319
Author(s):  
Mohamed Abdirahman Abdinur ◽  
Xie Yong ◽  
Kong Lingcai ◽  
Farah Abdidahir Mohamud ◽  
Jamac Abdidahir Mohamud ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Angiography ◽  
Control Group ◽  
Interventional Treatment ◽  
Clinical Value ◽  
Distribution Width ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Group 2

Background: The incidence and development of coronary heart disease are ultimately associated with the size and function of platelet. Present study aimed to determine the clinical value of platelet distribution width as an indicator for prediction or risk stratification of coronary heart disease by retrospective analysis of particular population.Methods: This retrospective study covered a total of 150 patients that were included due to a variety of indications for coronary angiography. The control group N-CHD was the patients without coronary heart disease confirmed by coronary angiography examination. The S-CHD group was patients with Stable type coronary heart disease confirmed diagnosis by coronary angiography examination. Study group 2 defined as group ACS were the patients who suffering acute coronary syndrome episode at admission and received coronary angiography and interventional treatment thereafter.Results: The PDW of S-CHD and ACS were 13.85±2.68 and 13.89±1.16, respectively, and there was no significant difference, while the PDW of the N-CHD group was 12.58±2.11, and the values of the first two groups were significantly higher than those of the N-CHD group. In addition, the MPV and P-LCR of S-CHD were significantly higher than those of N-CHD group (11.14±1.17 versus 10.51±0.91 and 32.71±9.99 versus 28.41±7.69), respectively P<0.01; but there was no significant difference between S-CHD and ACS.Conclusions: PDW, MPV, and P-LCR are the platelet volume indicators that can reflex the variability of circulation platelets; their increase was highly and positively associated with Coronary heart disease.

scholarly journals Clinical value of digital tomographic fusion imaging in the diagnosis of avascular necrosis of the femoral head in adults

2021 ◽  
Author(s):  
Jiangang Zhang ◽  
Zhuhai Wang ◽  
Ge Hong
Keyword(s):  
Femoral Head ◽  
Avascular Necrosis ◽  
Predictive Value ◽  
Detection Rate ◽  
Fusion Imaging ◽  
X Rays ◽  
Clinical Value ◽  
High Detection Rate ◽  
Detection Rates ◽  
Significant Difference

Abstract Background To explore the clinical significance of digital tomographic fusion imaging in the diagnosis of avascular disease of the femoral head in adults. Methods Eighty-two adult patients with avascular necrosis of the femoral head confirmed by MRI in the department of orthopedics of our hospital were studied retrospectively. The related signs of adult avascular necrosis of the femoral head were diagnosed by digital tomographic fusion imaging, and the detection rates of digital X-ray (DR) and digital tomosynthesis (DTS) were compared to clarify the clinical value of digital tomographic fusion imaging in the diagnosis of adult avascular necrosis of the femoral head. Results DTS detected DR and 78 cases identified 55 cases. Taking the results of CT/MRI as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of DR and DTS in the diagnosis of ANFH were calculated. There was a significant difference in the detection rate between the two methods (P < 0.05). Conclusion The digital tomographic fusion imaging technique has the advantages of high detection rate and excellent image quality, is economical, and is worth popularizing. For those with negative X-rays, DTS diagnosis and CT or/and MRI can avoid unnecessary CT and MRI examinations, which is helpful to reduce the waste of medical resources.

Markers of Hemostatic Activation in Affected Coronary Arteries during Angioplasty

1994 ◽  
Vol 72 (05) ◽  
pp. 672-675 ◽  
Author(s):  
Nicolas W Shammas ◽  
Michael J Cunningham ◽  
Richard M Pomearntz ◽  
Charles W Francis
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Venous Blood ◽  
Balloon Inflation ◽  
Blood Samples ◽  
Hemostatic System ◽  
Significant Difference ◽  
Hemostatic Markers ◽  
Artery Disease ◽  
High Doses

SummaryTo characterize the extent of early activation of the hemostatic system following angioplasty, we obtained blood samples from the involved coronary artery of 11 stable angina patients during the procedure and measured sensitive markers of thrombin formation (fibrino-peptide A, prothrombin fragment 1.2, and soluble fibrin) and of platelet activation ((3-thromboglobulin). Levels of hemostatic markers in venous blood obtained from 14 young individuals with low pretest probability for coronary artery disease were not significantly different from levels in venous blood or intracoronary samples obtained prior to angioplasty. Also, there was no translesional (proximal and distal to the lesion) gradient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first balloon inflation. Furthermore, no significant difference was noted between angioplasty and postangioplasty intracoronary concentrations. We conclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angioplasty when high doses of heparin and aspirin are administered.

Functional Fractionation of Platelets: Aggregation Kinetics and Glycoprotein Labeling of Differing Platelet Populations

1982 ◽  
Vol 48 (02) ◽  
pp. 211-216 ◽  
Author(s):  
V M Haver ◽  
A R L Gear
Keyword(s):  
Galactose Oxidase ◽  
Aggregation Kinetics ◽  
Maximal Rate ◽  
Membrane Glycoproteins ◽  
Whole Cells ◽  
Reversible Aggregation ◽  
Significant Difference ◽  
Small Doses ◽  
Major Loss ◽  
Kinetics Of

SummaryPlatelet heterogeneity has been studied with a technique called functional fractionation which employs gentle centrifugation to yield subpopulations (“reactive” and “less-reactive” platelets) after exposure to small doses of aggregating agent. Aggregation kinetics of the different platelet populations were investigated by quenched-flow aggregometry. The large, “reactive” platelets were more sensitive to ADP (Ka = 1.74 μM) than the smaller “less-reactive” platelets (Ka = 4.08 μM). However, their maximal rate of aggregation (Vmax, % of platelets aggregating per sec) of 23.3 was significantly lower than the “less-reactive” platelets (Vmax = 34.7). The “reactive” platelets had a 2.2 fold higher level of cyclic AMP.Platelet glycoproteins were labeled using the neuraminidase-galactose oxidase – [H3]-NaBH4 technique. When platelets were labeled after reversible aggregation, the “reactive” platelets showed a two-fold decrease in labeling efficiency (versus control platelets). However, examination of whole cells or membrane preparations from reversibly aggregated platelets revealed no significant difference in Coomassie or PAS (Schiff) staining.These results suggest that the large, “reactive” platelets are more sensitive to ADP but are not hyperaggregable in a kinetic sense. Reversible aggregation may cause a re-orientation of membrane glycoproteins that is apparently not characterized by a major loss of glycoprotein material.

The Effect of Antiplatelet Drugs on Plasma Betathromboglobulin in Coronary Artery Disease

1979 ◽  
Author(s):  
P Han ◽  
A Turpie ◽  
E Genton ◽  
M Gent
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Crossover Trial ◽  
Specific Protein ◽  
Antiplatelet Drugs ◽  
Significant Difference ◽  
Pre Treatment ◽  
Artery Disease ◽  
Therapeutic Doses ◽  
Granule Release

Platelets play a role in the development and complications of coronary artery disease (CAD) and a number of abnormalities of platelet function which can be corrected by antiplatelet drugs have been described. Betathromboglobulin (BTG), a platelet-specific protein which is released from α-granules during platelet activation is significantly elevated in patients with angiographically demonstrated CAD (51.0 ± 31.0 ng/ml., n = 50) compared to normal (28.0 ± 8.0 ng/ml., n = 70) p < 0.001. The effect of sulphinpyrazone (800 mg.) or aspirin (1200 mg.)/dipyridamole (200 mg.) on plasma BTG in CAD was studied in a blind prospective crossover trial in 25 patients. Mean BTG concentration pre-treatment was 52.3 ng/ml. and after 1 month’s treatment with placebo, sulphinpyrazone or aspirin/dipyridamole mean plasma BTG concentrations were 53.5, 49.6 and 56.7 ng/ml. respectively. Analysis of variance showed no significant difference between the means (p > 0.1) . This study confirms increased plasma BTG concentrations in patients with CAD and indicates that therapeutic doses of these antiplatelet drugs do not significantly effect the BTG level and thus appear not to prevent α-granule release in CAD.

Osteoprotegerin and Osteopontin Serum Levels are Associated with Vascular Function and Inflammation in Coronary Artery Disease Patients

2020 ◽  
Vol 18 (5) ◽  
pp. 523-530 ◽  
Author(s):  
Konstantinos Maniatis ◽  
Gerasimos Siasos ◽  
Evangelos Oikonomou ◽  
Manolis Vavuranakis ◽  
Marina Zaromytidou ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Function ◽  
Vascular Function ◽  
Serum Levels ◽  
Atherosclerosis Progression ◽  
Control Subjects ◽  
Significant Difference ◽  
Artery Disease ◽  
Stable Cad

Background: Osteoprotegerin and osteopontin have recently emerged as key factors in both vascular remodelling and atherosclerosis progression. Interleukin-6 (IL-6) is an inflammatory cytokine with a key role in atherosclerosis. The relationship of osteoprotegerin, osteopontin, and IL-6 serum levels with endothelial function and arterial stiffness was evaluated in patients with coronary artery disease (CAD). Methods: We enrolled 219 patients with stable CAD and 112 control subjects. Osteoprotegerin, osteopontin and IL-6 serum levels were measured using an ELISA assay. Endothelial function was evaluated by flow-mediated dilation (FMD) in the brachial artery and carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness. Results: There was no significant difference between control subjects and CAD patients according to age and sex. Compared with control subjects, CAD patients had significantly impaired FMD (p<0.001) and increased PWV (p=0.009). CAD patients also had significantly higher levels of osteoprotegerin (p<0.001), osteopontin (p<0.001) and IL-6 (p=0.03), compared with control subjects. Moreover, IL-6 levels were correlated with osteoprotegerin (r=0.17, p=0.01) and osteopontin (r=0.30, p<0.001) levels. FMD was correlated with osteoprotegerin levels independent of possible confounders [b coefficient= - 0.79, 95% CI (-1.54, -0.05), p=0.04]. Conclusion: CAD patients have increased osteoprotegerin, osteopontin and IL-6 levels. Moreover, there is a consistent association between osteoprotegerin and osteopontin serum levels, vascular function and inflammation in CAD patients. These findings suggest another possible mechanism linking osteoprotegerin and osteopontin serum levels with CAD progression through arterial wall stiffening and inflammation.

scholarly journals POS1280 SPINAL LOCATION OF TUBERCULOSIS: WHAT HAS CHANGED OVER THE LAST YEARS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 923.3-923
Author(s):  
S. Boussaid ◽  
M. Mrabet ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Developing Nations ◽  
Lumbar Pain ◽  
X Rays ◽  
Resonance Imaging ◽  
Vertebral Collapse ◽  
The Past ◽  
Significant Difference ◽  
Tuberculous Spondylodiscitis ◽  
Different Parts

Background:Tuberculosis (TB) is no longer a disease limited to developing nations and is still a major cause of significant morbidity and mortality worldwide. It can affect the different parts of the spine.Objectives:The aim of this study was to determine the preferred spinal location of TB.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from observations of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with tuberculous spondylodiscitis (TS).Results:Fifty-two patients were included (37F/15M). Their mean age was 55.21 years ± 17.79 [19-91]. TS was more frequently unifocal (75%) than multifocal (25%). Lumbar spine involvement was the most common (57.7%) and more frequent in women (63.3%) but with no statistically significant difference (p = 0.2). Other localizations were described such as: dorso-lumbar (21.2%), dorsal (15.4%), lumbosacral (3.8%) and cervical (1.9%). Lumbar pain was present in 34 patients (65.4%) and 29 patients (55.8%) suffered from segmental lumbar stiffness. Imaging was contributive by showing the vertebral location using standard X-rays, computed tomography and magnetic resonance imaging. Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively).Conclusion:TS is a rare but serious clinical condition which may lead to severe deformity and early or late neurological complications. Spinal involvement is often unifocal and mostly diagnosed with lumbar pain or stiffness. Multifocal forms, touching several parts of the spine, however remain rare. Our findings remain consistent with those of the literature.Disclosure of Interests:None declared

scholarly journals Impact of Coronary CT angiography in combination with CAD-RADS on the management of coronary artery disease patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
F Andre ◽  
S Seitz ◽  
P Fortner ◽  
R Sokiranski ◽  
F Gueckel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Ct Angiography ◽  
Patient Management ◽  
Male Gender ◽  
Coronary Ct ◽  
History Of ◽  
Artery Disease ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Siemens Healthineers Introduction Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management. Purpose Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity. Methods CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis. Results The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p &lt; 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF. Conclusions CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models. CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)

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