Evaluation of Heart Function in Patients With Hemophilia

2015 ◽  
Vol 23 (4) ◽  
pp. 374-378 ◽  
Author(s):  
Hamid Amoozgar ◽  
Maedeh Fath ◽  
Parisa Jooya ◽  
Mehran Karimi
Keyword(s):  
Blood Pressure ◽  
Troponin I ◽  
Heart Function ◽  
Enzyme Level ◽  
Interventricular Septum ◽  
Tissue Doppler ◽  
Control Group ◽  
Cross Sectional ◽  
Diastolic Velocity ◽  
Significant Difference

There are conflicting reports about the protective effect of hemophilia on the occurrence of ischemic heart disease. This study focuses on evaluation of heart function in patients with hemophilia. Cross-sectional, case–control study was done on all patients with hemophilia A or B who came to hemophilia center, and data were compared to controls. The data were collected from their charts, and heart function was evaluated by 2-dimensional, Doppler and pulse tissue Doppler. The serum troponin I level was measured in all patients as a marker of myocardial damage. Fifty patients with hemophilia took part in this study. All of them were male with mean age 29.1 years. Systolic blood pressure (mean = 121.52 ± 11 vs 115.61 ± 9.81, P = .038) and diastolic (mean = 81.94 ± 4.51 vs 75.21 ± 3.95, P = .042) blood pressure were higher in the patients. Five (10%) patients had systolic hypertension and 7 (14%) patients had diastolic hypertension. The M-mode echocardiography results showed that interventricular septum in diastole in patients with hemophilia (mean 1.143 ± 0.29) was significantly thicker than the control group (mean 0.828 ± 0.22, P < .001). Tissue Doppler echocardiography showed that late diastolic velocity of septum (Aa; P = .030), systolic velocity (S) of lateral mitral valve ( P = .006), late diastolic velocity of lateral mitral (Aa) annulus ( P = .038), and late velocity of (Aa) tricuspid ( P = .004) had significant difference compared with the control group ( P < .05). Troponin enzyme level was < 0.1 in all patients. Patients with hemophilia had higher blood pressure and more hypertension. Echocardiographic study of patients with hemophilia showed some increase in septal thickness and changes in diastolic dysfunction

Effects of Confounding Factors on Blood Pressure in Hypertensive Patients: A Cross Sectional Study

2021 ◽  
Author(s):  
Emrah Ersoy ◽  
Cuneyt Ardic
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Control Group ◽  
Poor Sleep ◽  
Study Group ◽  
Confounding Factors ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Significant Difference

Abstract Background Blood pressure is influenced by biopsychosocial factors such as physical, environmental, emotional, cognitive and behavioral in hypertensive patients. ObjectiveThe aim of this study is to investigate confounding factors in hypertensive patients who have poor blood pressure control.DesignThis study was designed as a cross-sectional study.ParticipantsOur sample was 407 patients with hypertension in Rize, a Northern city in the Black Sea Region of Turkey. In study group, there were 207 hypertensive patients who had admission to emergency department due to high blood pressure. In control group, there were 200 hypertensive patients visiting family physician,who defined themselves as having regulated blood pressure over the past six months.Main MeasuresPatients completed the questionnaire including sociodemographic data, lifestyle behaviors, health risks and confounding factors via the face-to-face interview method. Key ResultsOf the hypertensive patients, 81.2% (n=168) of the study group and 34.0% (n=68) of the control group had confounding factors. There was a significant difference between the hypertensive patients of study and control group in terms of their confounding factors (p<0.001). When we asked the patients of study group questions to reveal their confounding factors, 21.3% (n=44) stated ‘anger’, 12.6% (n=26) ‘sadness’, 11.1% (n=23) ‘anxiety’, 10.6% (n=22) ‘depressed’, 9.2% (n=19) ‘unhealthy diet’, 7.2% (n=15) ‘fatigue and poor sleep quality’, and 3.9% (n=8) ‘irregular medication’. Mean systolic and diastolic blood pressure were significantly higher in hypertensive patients having confounding factors than those without confounding factors (p=0.001, p=0.001, respectively). Mean systolic blood pressure of hypertensives who stated their confounding factor as ‘anger’ was significantly higher than those the remaining groups (p<0.001).ConclusionsThis study has shown that confounding factors impair blood pressure control in patients with hypertension. Confounding factors should be kept in mind and revealed in case of poor blood pressure control in hypertensive patients.

scholarly journals Structural and Functional Changes in Maternal Heart during Pregnancy: An Echocardiographic Study

2017 ◽  
Vol 02 (04) ◽  
pp. 072-076
Author(s):  
Sunanda Kasula ◽  
Sumalatha Beeram ◽  
Ramakrishna Janapati ◽  
Indrani Garre
Keyword(s):  
Blood Pressure ◽  
Gestational Age ◽  
Systolic Function ◽  
Interventricular Septum ◽  
Clinical History ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Cross Sectional ◽  
Functional Changes ◽  
Significant Difference

Abstract Background Pregnancy is associated with profound physiologic alterations in the maternal cardiovascular system. This study aimed to investigate maternal cardiac performance during normal pregnancy by two-dimensional echocardiography parameters and various functional and structural alterations. Methods This was a cross-sectional study of 100 normal pregnant women who attended the antenatal clinic, and all participants had clinical history, physical examination, and 12-lead electrocardiogram. Two-dimensional, M-mode, and Doppler echocardiography was done. Echocardiographic parameters were compared with normal age-matched controls from previously published studies. Results The mean age of the study group was 23.35 ± 3.05 years, mean systolic blood pressure was 110.5 ± 8.69 mm Hg, and mean diastolic blood pressure was 71.6 ± 6.77 mm Hg. There was an increase in left atrial (LA) diameter, left ventricular end diastolic diameter, and interventricular septum (IVS) thickness as gestational age advanced. There was a gradual decrease in E-wave velocity, and E/A ratio increased during the second trimester and decreased during the third trimester. The E-wave deceleration time increased with gestational age There was no statistically significant difference between IVS thickness and E/A ratio (p = 1.000). Conclusion Cardiac chamber dimensions, LV wall thickness, and LA size, most indices of systolic function although within normal range, were significantly higher in pregnant Asian Indian women than in the controls. This study shows that the subtle reduction in myocardial compliance appears as an adaptive response to changes of preload, afterload, and LV geometry.

Comparison of liver hemodynamics according to doppler ultrasonography in alcoholic patients subtyped by Cloninger classification and non-alcoholic healthy subjects

2006 ◽  
Vol 18 (1) ◽  
pp. 7-14
Author(s):  
Z. Sumru Cosar ◽  
Behcet Cosar ◽  
Suna Oktar ◽  
Zehra Arikan ◽  
Hakan Özdemir ◽  
...  
Keyword(s):  
Portal Vein ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Healthy Subjects ◽  
Peak Systolic Velocity ◽  
Control Group ◽  
Cross Sectional ◽  
Diastolic Velocity ◽  
Significant Difference

Background:The aim of this study was to search for morphological and hemodynamic changes in hepatic and splanchnic vasculature in alcoholic patients without the signs of hepatic damage and subtyped by Cloninger classification by means of sonography, and compare the subtypes among themselves and with nonalcoholic healthy subjects.Methods:Thirty alcohol dependent patients and 30 healthy subjects with no alcohol problem or hepatic impairment were included in the study. Patients were subtyped by Cloninger classification and all patients were evaluated by gray-scale and spectral Doppler ultrasound. The diameter of the portal vein, portal venous velocity, peak systolic and end diastolic velocities of hepatic and superior mesenteric arteries were assessed. RI, PI and systolic/diastolic velocity ratios were also calculated.Results:Portal vein diameter (PV diameter), portal vein cross sectional area (PV area), portal vein velocity (PV PSV), hepatic artery peak systolic velocity (HA PSV), hepatic artery end diastolic velocity (HA EDV), hepatic artery resistive index (HA RI), hepatic artery pulsatility index (HA PI), and systolic/diastolic velocity ratios (HA S/D), superior mesenteric artery peak systolic velocity (SMA PSV), superior mesenteric artery end diastolic velocity (SMA EDV), superior mesenteric artery resistive indices (SMA RI), pulsatility index (SMA PI), and systolic/diastolic velocity rates (SMA S/D) showed no significant difference among the groups (P > 0.01). Although there is no significant difference in PV PSV, HA PSV, SMA PSV, SMA EDV values between the groups, mean values of Type II alcoholics is greater than other groups. Portal vein cross-sectional area was greater in alcoholic patients (Type I, II and III) compared to the control group (P = 0.000). Portal vein velocity, hepatic artery peak systolic and end diastolic velocity, superior mesenteric artery peak systolic and end diastolic velocity were significantly greater in alcoholic patients than in the control group (P < 0.001). No statistical difference was detected between other parameters evaluated.Conclusion:In alcohol dependent patients, some hemodynamic and morphologic changes occur in hepatic and splanchnic circulation, even before the signs of hepatic damage develop, which can be detected by means of Doppler and gray-scale sonography. But as there is no significant difference between the Doppler ultrasonographic findings among alcoholics subtyped by a Cloninger classification, which is a clinical classification, it suggests that psychiatric classification doesn't show any correlation with biological parameters, and because of this Cloninger classification a psychiatric classification cannot be considered as a characteristic determinative factor in the prognosis of hepatic disorder due to alcohol use. However, higher values of Type II alcoholics can be attributed to the longer alcohol intake of this subtype.

scholarly journals Cardio specific Troponin I in patients with Aortic stenosis

1970 ◽  
Vol 24 (1) ◽  
pp. 9-11
Author(s):  
Nazmun Nahar ◽  
Bilquis Ara Begum ◽  
Dr Khaleque-uzzaman ◽  
SM Mashud ◽  
Sultana Parveen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Aortic Stenosis ◽  
Troponin I ◽  
Left Ventricular ◽  
Definitive Treatment ◽  
Control Group ◽  
Cross Sectional ◽  
Control Subjects ◽  
Significant Difference ◽  
The Mean

To evaluate the association of Cardio specific Troponin I (CTnI) and aortic stenosis. Cross sectional study was conducted among 20 aortic stenosis patients and 20 control groups. A structured questioner and checklist was used to collect data through face to face interview, Echocardiography findings, and laboratory estimation of cTnl. A total 20 patients and 20 healthy control subjects were investigated for cTnl. cTnl level was within normal physiological limits in all the control subjects. The mean value was 0.02±00. The mean cTnl level in Aortic stenosis patients were 0.67±0.81. EJection fraction of Aortic stenosis patients were normal, indicating that cases yet not develops complication (eg; Heart failure). The cTnl in control group and Aortic stenosis patients shows significant difference of mean (p < 0.001). cTnl level in Aortic stenosis patients increases in absence of heart failure indicating that it can expose cardiomyocyte injury prior to the development of over Left ventricular dysfunction. So that, serial monitoring of cTnl could help clinician to give definitive treatment before development of complications. Keywords: Cardiospecific Troporin I. Aortic Stenosis.   doi: 10.3329/bjpath.v24i1.2875 Bangladesh J Pathol 24 (1) : 9-11

Clinical-Reported Outcomes Of Deferoxamine Versus Deferasirox In The Treatment Of Homozygous BetaThalassemia

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Zeina A Munim Al-Thanoon ◽  
Zeina A Munim Al-Thanoon ◽  
Mustafa Basil ◽  
Nasih A Al-Kazzaz
Keyword(s):  
Serum Ferritin ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Beta Thalassemia ◽  
Control Group ◽  
Current Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Multiple Blood ◽  
Group 2

Iron chelation therapy with deferoxamine (DFO),the current standard for the treatment of iron overload in patients with betathalassemia,requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence,resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox (DFX) is an orally administered iron chelator that has been approved for use in many countries. The requirement of an effective,well tolerated iron chelator with a less demanding mode of administration has led to the development of deferasirox. The present study was aimed to compare the satisfaction and compliance with deferoxamine versus deferasirox (Exjade®),a novel oral iron chelator in patients with transfusion - dependent beta- thalassemia. A cross-sectional,single-center investigation study was carried out in the Thalassemia Center of Ibn-Atheer Teaching Hospital in Nineveh province,Iraq. One hundred and eight thalassemic patients aged between 2- 20 years old having received multiple blood transfusions and a serum ferritin greater than 1500 ng/ml. Patients were randomised into two groups. Group 1 received deferoxamine at a dose of 20-50mg/kg/day and group 2 received deferasirox at the dose of 10-30 mg/kg/day. Another 56 apparently healthy volunteers were used as a control group. The assessment of chelation was done during the period between November 2013 and February 2014 by measurement of serum ferritin. Satisfaction and compliance was assessed by using a special questionnaire prepared by the researcher. Out of the 108 thalassemic patients enrolled there was no discontinuation in treatment with the two drugs under study. The serum ferritin did not change significantly in any of the chelation groups. In comparison with the patients who were treated with DFO,those receiving DFX reported a significantly higher rate of compliance and satisfaction (P < 0.05). However,no significant difference was observed between the two groups regarding their satisfaction (P > 0.05).Compliance with deferasirox (50 %) was more than that with deferoxamine (20 %). Satisfaction with deferoxamine was significantly lower than deferasirox (p= 0.00).

scholarly journals Blastocystis sp. Carriage and Irritable Bowel Syndrome: Is the Association Already Established?

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 340
Author(s):  
Fernando Salvador ◽  
Beatriz Lobo ◽  
Lidia Goterris ◽  
Carmen Alonso-Cotoner ◽  
Javier Santos ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Microscopic Examination ◽  
Parasitic Infection ◽  
Diagnostic Technique ◽  
Control Group ◽  
Cross Sectional ◽  
Significant Difference ◽  
Blastocystis Sp ◽  
Irritable Bowel ◽  
Asymptomatic Subjects

Background: The aim of the present study is to describe the occurrence of Blastocystis sp. detection among asymptomatic subjects and patients with irritable bowel syndrome in order to evaluate the potential association between irritable bowel syndrome and the parasitic infection. Methods: Cross-sectional study where adult patients with irritable bowel syndrome diagnosed according to Rome IV criteria were included. A control group was formed by asymptomatic subjects older than 18 years. Exclusion criteria were: immunosuppressive condition or having received any drug with demonstrated activity against Blastocystis sp. within the last 6 months before study inclusion. Epidemiological and clinical information was collected from all included participants. Two stool samples were obtained from all participants: one sample for microscopic examination and one sample for Blastocystis sp. PCR detection. Blastocystis sp. infection was defined by the positivity of any of the diagnostic techniques. Results: Seventy-two participants were included (36 asymptomatic subjects and 36 patients with irritable bowel syndrome). Thirty-five (48.6%) were men, and median age of participants was 34 (IQR 29–49) years. The overall rate of Blastocystis sp. carriage was 27.8% (20/72). The prevalence assessed through microscopic examination was 22.2% (16/72), while the prevalence measured by PCR was 15.3% (11/72). When comparing the presence of Blastocystis sp. between asymptomatic subjects and IBS patients, we did not find any statistically significant difference (36.1% vs. 19.4% respectively, p = 0.114). Conclusions: regarding the occurrence of Blastocystis sp., no differences were found between asymptomatic participants and patients with irritable bowel disease irrespective of the diagnostic technique performed.

scholarly journals Effects of Aroma Massage on Home Blood Pressure, Ambulatory Blood Pressure, and Sleep Quality in Middle-Aged Women with Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Myeong-Sook Ju ◽  
Sahng Lee ◽  
Ikyul Bae ◽  
Myung-Haeng Hur ◽  
Kayeon Seong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Placebo Group ◽  
Sleep Quality ◽  
Nursing Intervention ◽  
Home Blood Pressure ◽  
Control Group ◽  
Middle Aged ◽  
Significant Difference ◽  
Before And After ◽  
Massage Group

The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n=28), the placebo group (n=28), and the no-treatment control group (n=27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F=6.71,P=0.002) between groups after intervention. There was also a significant difference in SBP (F=13.34,P=0.001) and diastolic blood pressure (DBP) (F=8.46,P=0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F=6.75,P=0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life.

scholarly journals Impaired atrial electromechanical coupling in lichen planus patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Jafaripour ◽  
Z Aryanian ◽  
S Hosseinzadeh ◽  
R Pourkia ◽  
MM Ansari Ramandi ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Electromechanical Coupling ◽  
Wave Dispersion ◽  
Tissue Doppler ◽  
P Wave ◽  
Control Group ◽  
P Value ◽  
P Wave Dispersion ◽  
Increased Risk ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Lichen planus (LP) which is a chronic inflammatory disease can cause impaired atrial electromechanical coupling, leading to increased risk of atrial fibrillation. Purpose The present study aimed to evaluate atrial electromechanical coupling in LP patients by using electrocardiography (ECG) and echocardiography. Methods Forty-six LP patients were investigated in this cross-sectional case-control study. The control group comprised healthy individuals selected in age and gender-matched manner. Echocardiography and ECG were done for all patients to show inter and intra-atrial electromechanical delays and P wave dispersion respectively. The electromechanical delays were calculated by using the difference between the delays from the onset of the P wave on ECG to the onset of A wave on tissue Doppler recordings of the different areas. Results The baseline characteristics of the case and control group were similar and did not differ significantly. The P wave dispersion was 45.63 ± 3.48 milliseconds in the LP group in comparison to 36.56 ± 2.87 milliseconds in the control group (p &lt; 0.001). As shown in the table, the intra and inter-atrial electromechanical delays were also significantly prolonged in LP patients when compared to the control group (p &lt; 0.001). There was no significant difference between the left and right ventricular systolic function and diastolic function of the two groups. Conclusion The results of the study indicate the presence of significant impaired atrial electromechanical coupling in patients with LP confirmed by both electrocardiographic and echocardiographic tools. Electromechanical delays Case N = 46 (mean ± SD) Control N = 46 (mean ± SD) P value Septal - PA (msec) 59.71 ± 13.24 44.39 ± 11.07 0.002 Lateral - PA (msec) 55.71 ± 13.26 48.89 ± 11.21 0.009 Tricuspid - PA (msec) 52.37 ± 13.12 43.28 ± 10.58 0.002 Inter-atrial delay (msec) (lateral PA−RV PA) 8.47 ± 1.62 6.37 ± 1.36 &lt;0.001 Intra-atrial delay (msec) (LA) [lateral PA−septal PA] 4.80 ± 1.48 3.83 ± 0.82 &lt;0.001 Intra-atrial delay (msec) (RA) [septal PA−RV PA] 3.91 ± 0.96 2.02 ± 0.71 &lt;0.001 PA Delay from the onset of the P wave on ECG to the onset of A wave on tissue Doppler, N: number, SD: Standard Deviation, LA: Left Atrium, RA: Right Atrium, RV: Right Ventricle

scholarly journals Anolunula in Fingernails among Patients Infected with HIV

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Pratik Gahalaut ◽  
Nitin Mishra ◽  
Sandhya Chauhan ◽  
Mir Mubashir Ali ◽  
Madhur Kant Rastogi ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Cross Sectional Study ◽  
Negative Control ◽  
Hiv Positive ◽  
Control Group ◽  
Cross Sectional ◽  
Significant Difference ◽  
Stage 1 ◽  
And Control ◽  
Hiv Negative

Lunula is the white, half-moon shaped area seen in proximal ends of some nails. Though a few studies have described the nail changes that can occur in association with HIV infection, none of these paid much attention to lunula. Aims and Objectives. To study the lunula in fingernails among HIV infected patients. Materials and Methods. An observational, cross-sectional study to record presence of lunula in 168 HIV-positive patients and compare it with age and sex matched 168 healthy HIV-negative control. Anolunula (absence of lunula) in HIV-positive patients was correlated with CD4 counts, stages of HIV infection, time since patient was diagnosed as HIV-positive, and status of antiretroviral therapy. Results. Anolunula was present in significantly more fingernails in HIV-positive patients compared to HIV-negative controls. There was a highly significant difference for total anolunula (anolunula in all fingernails) in study and control group. Incidence of total anolunula was directly proportional to the stage of HIV infection, increasing progressively as the HIV infection advances from stage 1 to stage 4. Conclusion. Absence of lunula is related to not only HIV infection per se but also the stages of HIV infection.

scholarly journals Variables associated with family breakdown in healthy and obese/ overweigh adolescents

2014 ◽  
Vol 32 (1) ◽  
pp. 70-77
Author(s):  
Carla Cristina J. N. de Almeida ◽  
Paula de Oliveira Mora ◽  
Valmir Aparecido de Oliveira ◽  
Camila Aparecida Joao ◽  
Carolina Regina Joao ◽  
...  
Keyword(s):  
Public School ◽  
Cross Sectional Study ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obese Adolescents ◽  
Significant Difference ◽  
Family Breakdown

Objective: To evaluate the presence of family breakdown factors among eutrophic and overweight/obese adolescents. Methods: Cross-sectional study of 242 students aged between 14 and 19 years old, from a public school. Each student was weighed, measured and answered a questionnaire with closed questions addressing the presence of family breakdown factors. The adolescents were divided in two groups: euthophic and overweight/obese. The answers of both groups were compared by Fisher's exact and Mann-Whitney tests. Results: There was no statistically significant difference in the prevalence of the studied factors between the two groups. Comparing the number of positive answers (presence of family breakdown factors) and negative ones (absence of family breakdown factors), no difference was observed between the groups. Conclusions: The inclusion of a control group showed that factors of family breakdown, usually identified as associated with obesity in adolescents, may also be present in eutrophic adolescents.

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