Outcome of Saddle Pulmonary Embolism: A Nested Case-Control Study.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1102-1102
Author(s):  
Gauruv Bose ◽  
Esteban Gandara ◽  
Marc Carrier ◽  
Petra MG Erkens ◽  
Marc Rodger ◽  
...  

Abstract Abstract 1102 Introduction: The management of saddle pulmonary embolism (PE) is controversial. Evidence about outcomes and management strategies is scarce in the literature due to the small prevalence of saddle PE. Historically it has been recommended that this group of patients should be treated aggressively. Purpose: To determine the prevalence and outcomes of patients diagnosed with saddle PE. Methods: Retrospective cohort study of consecutive patients with saddle PE diagnosed at the Ottawa Hospital between January 2007 and December 2008. Patients were included if a thrombus was present on computed tomographic pulmonary angiography (CTPA) in the main pulmonary arteries spanning the bifurcation of the main pulmonary trunk. These cases were each matched with two non-saddle controls with proximal PE (thromboemboli in the main pulmonary arteries) based on age, sex, systolic blood pressure greater than or less than 90 mmHg, and the presence or absence of cancer. Demographics, prognostic factors, treatment, and outcomes were collected. Patients were followed over a 30 day period following the diagnosis. RESULTS: A total of 32 (5%) of 724 patients with PE had a saddle event. Baseline characteristics are depicted in Table 1. Differences between the saddle case group and non-saddle control group include the presence of right ventricular dilation (59% of saddle cases vs. 22% of controls, p-value: 0.0007) and in the proportion of patients managed as outpatients (7% of saddle cases vs. 33% of controls, p-value: 0.02). At 30 days no differences were found in patients with saddle PE or proximal PE for all cause mortality (6% vs. 10%; OR: 0.64; 95% CI: 0.08–3.2), PE related mortality (0% vs. 6%; OR: 0.52; 95% CI: 0.01–6.1), major bleeding (3% vs. 5%; OR: 0.65; 95% CI: 0.02–6.4), or recurrent venous thromboembolism (6% vs. 10%; OR: 0.64; 95% CI: 0.08–3.2). Conclusions: Patients with saddle PE do not have a worse 30-day prognosis than patients with proximal PE matched by age, sex, systolic blood pressure, and presence of cancer. Disclosures: No relevant conflicts of interest to declare.

2017 ◽  
Vol 3 (6) ◽  
pp. 750-756
Author(s):  
Sri Maisi ◽  
Suryono Suryono ◽  
Melyana Nurul Widyawati ◽  
Ari Suwondo ◽  
Suryati Kusworowulan

Background: Hypertension during pregnancy remains high in Indonesia. It is a major cause of maternal death. Aromatherapy lavender and classical music therapy are considered effective in lowering blood pressure in hypertension.Objective: To examine the effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension.Methods: A quasy experimental study with pretest-posttest control group design. There were 52 pregnant women with the inclusion criteria selected as samples using simple random sampling, divided into lavender aromatherapy group, classical music group, combination of aromatherapy and music group, and control group. Sphygmomanometer was used to measure blood pressure. Mann Whitney and Post Hoc test were used for data analysis.Results: Results showed that four groups have a significant decrease in systolic blood pressure after given intervention with p-value <0.05. The mean decrease of systolic blood pressure among four groups was: lavender group (5.77 mmHg), music group (7.23 mmHg), combination group (9.54 mmHg), and control group (3.67 mmHg); and the mean decrease of diastolic blood pressure was: the lavender group (2.77 mmHg), music group (0.61 mmHg), combination group (8.23 mmHg), and control group (3.42 mmHg).Conclusion: there was a significant effect of lavender aromatherapy and classical music therapy in lowering blood pressure in pregnant women with hypertension. However, the combination of both interventions was more effective than lavender aromatherapy or music therapy alone.


2020 ◽  
Vol 9 (2) ◽  
pp. 1771-1778
Author(s):  
Reni Hariyanti ◽  
Suharyo Hadisaputro ◽  
Sri Sumarni ◽  
Erna Widyastuti

This study was conducted to examine the effectiveness of cucumber suri juice (Cucumis Sativus) on blood pressure in hypertensive menopausal women. The study was a quasi-experimental pretest-posttest with control group design. It was 20 respondents selected by purposive sampling, divided into two groups there were intervention group (10 respondent) and control group (10 respondent). Data were analyzed used paired T test. The results showed that the decrease systolic blood pressure in the intervention group was 31,30 mmHg and diastolic blood pressure 16,60 mmHg (p value 0,000) and in the control group decreased systolic blood pressure by 2,0 mmHg and diastolic blood pressure 1.3 mmHg (p value> 0.05). There was a significant effect of cucumber suri juice on blood pressure in the intervention group. Therefore that the cucumber suri juice can be an alternative treatment among menopausal women with hypertension


2022 ◽  
Vol 10 (G) ◽  
pp. 1-5
Author(s):  
Wahyu Rima Agustin ◽  
Wahyuningsih Safitri ◽  
Dyan Kurniasari ◽  
Setiyawan Setiyawan ◽  
Atiek Murharyati ◽  
...  

Abstract BACKGROUND: Chronic renal failure (CRF) is a reduction in chronic renal function that leads to non-reversible and progressive kidney tissue damage. Blood pressure is a major risk factor that can increase the mortality rate by up to 20 times in patients with chronic renal failure who are undergoing hemodialysis therapy. Intradialytic exercise is an intervention that can be used to control systolic blood pressure. AIM: This study was to analyze the effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital. METHODS: The research method is quasi-experimental design pre-post with control group design. The study population was 97 dialysis patients. The sampling technique used a purposive sampling of 30 people. Data analysis using Paired t-Test. RESULTS: The research results showed  that the sex characteristics of most respondents were male as many as 17 people (56.7%), the average age of the respondents was 51.03 years, the pre-intervention in the control group obtained an average systolic blood pressure of 168.93 mmHg and 106 diastole, 120 mmHg, while the blood pressure in the control group post was 173.13 mmHg systole and 107 mmHg diastoles. In the treatment group, the average blood pressure in the pre-intradialytic exercise showed 162.20 mmHg systole and 104.27 mmHg diastole, while the post-intradialytic exercise system blood pressure was 153.13 mmHg and diastole 94.33 mmHg. CONCLUSION: There is an effect of intradialytic exercise on changes in blood pressure in chronic renal failure patients undergoing hemodialysis therapy at Indriati Solo Baru Hospital with a p-value of 0.025. Intradialytic exercise can be recommended as structured physical exercise therapy for hemodialysis therapy patients.   KEYWORDS: intradialytic exercise, chronic renal failure, patients, changes in blood pressure, hemodialysis


2021 ◽  
Author(s):  
Amirhossein Akbarzadeh ◽  
Fariborz Akbarzadeh ◽  
Babak Kazemi

Abstract Background: Autonomic changes play an essential role in the genesis of neurally mediated syncope (NMS). The aim of this study was to compare the changes of the autonomic nervous system (ANS) by measuring spectral indices of beat-to-beat systolic blood pressure and heart rate variability (SBPV and HRV) in ranges of low frequency (LF), high frequency (HF), and the LF/HF ratio during head-up tilt test (HUTT) in patients with and without a syncope response. Methods: In this case-control study of 46 patients with a suspected history of unexplained syncope, data were recorded separately during the typical three phases of HUTT. Patients who developed syncope were designated as the case group and the rest as the control group. Results: Thirty one patients experienced syncope during HUTT. Resting HRV and SBPV indices were significantly lower in cases than controls. After tilting in the syncope group, both HF and LF powers of SBPV showed a significant and gradual decrease. LF/HF in HRV increased in both groups similarly during the test but in SBPV, mainly driven by oscilations in its LF power, it increased significantly more during the first two phases of the test in syncope patients only to paradoxically decrease during active tilt (p< 0.001). Conclusion: Our findings show an abnormal autonomic function in patients with syncope, both at rest and tilting. Fluctuations of spectral indices of beat-to-beat SBPV, a potential noval index of pure sympathetic activity, show an exaggerated response during tilt and its withdrawal before syncope.


2021 ◽  
Vol 9 (1) ◽  
pp. 28-32
Author(s):  
Eliza Eliza ◽  
Ayu Lestari ◽  
Sumarman Sumarman ◽  
Andi Eka Yunianto

Background : Hypertension is a condition when systolic blood pressure ≥ 140 mmHg and diastolic blood pressure  ≥ 90 mmHg blood. One of herbal therapies to help lowering blood pressure is by utilizing foods which contain high potassium, such as bananas, melons, and young coconut water.Objective : To analyze the effect of banana melon and young coconut water pudding on lowering blood pressure levels of hypertensive patients at the Palembang Public Health Center.Method : A quasi-experimental study with pre and pos test control group design. The subjects were 60 hypertensive patients at Palembah PHC who were eagerly fulfilled inclusion and exclusion criteria. Data analysis were used t-dependent and t-independent tests to analyze the effect of melon banana pudding and young coconut water with blood pressure.Results : The results showed there was an average decrease in systolic and diastolic blood pressure in the treatment group of 13.07 mmHg (p= 0.000) and 6.93 mmHg (p= 0,000). Consumption of banana melon pudding and young coconut water showed a significant effect on reducing 6.1 mmHg systolic blood pressure (p=0.003) and 4.56 mmHg diastolic blood pressure (p=0,000). T-independent test showed that systolic blood pressure in the treatment and control groups obtained p-0.005 and diastolic blood pressure obtained p-value 0.048.Conclusion : Consumption of banana melon pudding and young coconut water could lower blood pressure levels f hypertensive patients


2019 ◽  
Author(s):  
Mulastin Mulastin ◽  
Sugiharto .

Preeclampsia is one of the causes of the Maternal Mortality Rate (MMR). In Central Java Province in 2016 reached 109.65 from 100,000 live births. Data obtained from pregnant women with preeclampsia at the Kaliwungu holy health center were 64 pregnant women. One of the symptoms of preeclampsia is high blood, there are several ways to improve body condition with music therapy, and listen to murottal. The goal is to know the influence of murottal Al-Qur’an letter Ar-Rahman to blood presure of pregnant women who have preeclampsia. This type of research is an experimental study using the Quasy design experiment pretest-posttest control group design.Thepopulationofthisstudywereallpregnantwomenwhohadpreeclampsiaat Puskesmas Kaliwungu Kudus which were 64 pregnant women in September-October 2017, and the sample was pregnant women who had preeclampsia, 32 as intervention group and 32 as control group. Sampling techniques with quota sampling (non probability). Data analysis of the research with using the Independent T Test. The results of the research showed that the blood pressure were significantly higher in intervension than the case of control groups. average systolic blood pressure in the intervention group was 122.78 mmHg and the control group was 126.75 mmHg with the results of the statistical test 0.001<P value so that there was an effect. There was a decrease in systolic blood pressure of 3.97 mmHg. While the average value of diastole blood pressure in the intervention group was 82.22 mmHg and the control group was 81.92 and the results of the statistical test were 0.015<P value. There is a decrease in diastolic blood pressure of 0.3 mmHg. Which means there is an Ar-Rahman letter’s morattal influence on blood pressure decrease in pregnant women who have preeclampsia. Expected at the time of ANC or at the time of pregnant mother class to be given listening murottal technique of Ar-Rahman letter by improvingservicesforpregnantmotherforpregnantmotherwhospendspreeclampsia.


2017 ◽  
Vol 3 (3) ◽  
pp. 246-254 ◽  
Author(s):  
Hamdiah Hamdiah ◽  
Ari Suwondo ◽  
Triana Sri Hardjanti ◽  
Ariawan Soejoenoes ◽  
M Choiroel Anwar

Background: Pregnancy increases the risk of developing anxiety that may affect the fetus. Yoga is considered as an alternative therapy to reduce anxiety, blood pressure, and fetal heart rate.Objective: This study aimed to examine the effect of prenatal yoga on anxiety, blood pressure, and fetal heart rate in primigravida mothers.Methods: There were 39 primigravida mothers selected using purposive sampling, which divided to be an experiment group with four-times prenatal yoga and eight-times prenatal yoga, and a control group. The Hamilton Rating Scale For Anxiety (HRSA) was used. Data were analyzed using One way ANOVA and MANOVA.Results: There was a statistically significant difference of prenatal yoga on anxiety (P=0.005), systolic blood pressure (P=0.045), and fetal heart rate (P=0.010). However, there was no significant difference of prenatal yoga on diastolic blood pressure with p-value 0.586 (>0.05)Conclusion: There were significant effects of prenatal yoga on anxiety level, systolic blood pressure, and the fetal heart rates in primigravida mothers. The findings of this study can be an alternative treatment for midwife to deal with anxiety during pregnancy, and an input on the class program of pregnant women to improve the quality of maternal and fetal health.


2021 ◽  
Vol 13 (02) ◽  
pp. 128
Author(s):  
Roikatul Miskiyah ◽  
Friska Realita

ABSTRAKLatar Belakang : Hipertensi adalah The Silent Disease sehingga seseorang tidak akan mengetahui jika dirinya menderita hipertensi atau tekanan darah tinggi. Meningkatnya tekanan darah sistolik lebih besar dari 120 mmHg dan diastolik lebih besar dari 80 mmHg pada dua kali pengukuran dengan selang waktu 5 menit dalam keadaan cukup istirahat disebut dengan Hipertensi, Hal tersebut timbul karena adanya banyak faktor interaksi resiko yang dimiliki seseorang. Tujuan : Penelitian ini bertujuan untuk menganalisis efektivitas buah mengkudu dalam menurunkan hipertensi. Metode : Pencarian artikel nasional ini dilakukan dengan basis data seperti google scohlar. Dengan kata kunci: “hipertensi”.”ekstrak buah mengkudu”. Dan penulis menemukan 7 artikel yang relevan 2014-2018. masing-masing mewakili efektivitas buah mengkudu terhadap penurunan hipertensi terhadap semua sampel.  Hasil  : Tujuh artikel yang di dapat, Menunjukkan hasil uji statistik  p Value 0,015 (p<0,05). berarti ada pengaruh antara tekanan darah siastolik maupun diastolik penderita hipertensi sebelum dan sesudah diberikan air perasan buah mengkudu. Kesimpulan : tekanan darah pada kelompok perlakuan sesudah intervensi buah mengkudu mengalami penurunan tekanan darah dibandingkan dengan kelompok control, efektivitas buah mengkudu ialah salah satu pengobatan non farmakologis.Kata kunci: Hipertensi, Ekstrak Buah MengkuduTHE EFFECTIVENESS OF NONI FRUIT (MORINDA CITRIFOLIA L.)    TO REDUCE HYPERTENSIONABSTRACTBackground : Hypertension is The Silent Disease so that a person will not know if he has hypertension or high blood pressure. Increased systolic blood pressure greater than 120 mmHg and diastolic greater than 80 mmHg in two measurements with an interval of 5 minutes in a state of sufficient rest is called Hypertension. This arises because there are many risk interaction factors that a person has. Objective : This study aims to analyze the effectiveness of noni fruit in reducing hypertension. Methods : This national article search was carried out using databases such as Google Scohlar. With keywords: "hypertension", "noni fruit extract". And the author found 7 relevant articles 2014-2018. each represents the effectiveness of noni fruit in reducing hypertension in all samples. Results : Seven articles were obtained, showing the results of the statistical test p Value of 0.015 (p <0.05). This means that there is an influence between systolic and diastolic blood pressure in patients with hypertension before and after being given noni juice. Conclusion : blood pressure in the treatment group after the noni fruit intervention decreased blood pressure compared to the control group, the effectiveness of noni fruit is one of the non-pharmacological treatments.Keywords: Hypertension, Mengkudu Fruit Extract.


Author(s):  
Sampada Thakare ◽  
Adarshlata Singh

Abstract Aims and objectives: To study the pattern of early-onset male androgenetic alopecia (AGA) and its association with metabolic syndrome (MetS). Study design: A case–control study was conducted in the tertiary care center, Department of Dermatology, from year 2012 to 2014. Materials and methods: A total number of 100 patients, 50 male patients with early-onset AGA cases and 50 age-matched controls, were enrolled. The Norwood–Hamilton classification was used to assess the grade of AGA. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Blood pressure, blood glucose, and lipid parameters along with waist circumference were assessed in all the study participants. Statistical analysis was done by using descriptive and inferential statistics using chi-square test and Z test for difference between two means. The statistical software used in the analysis was Statistical Package for the Social Sciences 17.0 and Graph Pad Prism 5.0, and the results with (p < 0.05) were considered significant. Results: Most common grades of early-onset male AGA were 38% with grade IV, 26% with grade IIIv (vertex), and 16% with grade III. 50% of the case group with early-onset male AGA and 10% of control group patients had MetS (p < 0.05). As compared with controls, patients with early-onset AGA had a statistically significant mean value for fasting blood sugar level (p-value 0.001), triglyceride level (p-value 0.013), waist circumference (p-value 0.004), systolic blood pressure (p-value 0.006), and diastolic blood pressure (p-value 0.010) respectively. There was no significant association between early-onset male AGA and serum levels of HDL, LDL, VLDL, and cholesterol (p > 0.05). Conclusion: It is inferred from this study that the most common grade of early-onset male AGA was grades IV and III vertex. There also was association of early-onset male AGA with MetS. More prospective studies are required with a large sample size to justify the association between early-onset male AGA and MetS.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.G Kamotho ◽  
F Bukachi

Abstract Background Africa faces a growing burden of communicable and non-communicable diseases (NCDs). Innovative health tech companies are on the rise in Africa, but to be truly effective they need to cover the patient journey and to involve key stakeholders in the health ecosystem. Purpose To prove that Digital Health could enable rural folk to consult a doctor conveniently, to control NCDs and to access affordable, quality drugs, all part of Universal Healthcare. Methods This was a longitudinal, interventional, comparative study based at a community hospital in Murang'a County. The centre lacks doctors but the local paramedics and nurses carried out initial assessments. Doctors and specialists in Kiambu County were consulted online using the Daktari Africa telemedicine platform, which has regulatory approval and received various awards. Blood pressure and sugar levels were recorded on individual patient profiles. Results 121 consultations were made between January and October 2019: 81 were online (the “Cases”), and 40 were interviewed there who had been seen in the usual way by the local staff (the “Controls”). Of the 81 case consultations, 72 were unique patients, seven were seen twice online, and two were seen three times. Of the Cases 60 (83.3%) were female and 12 (16.6%) were male. The average age was 63 years. 44 (61.1%) were hypertensive and 8 (11.1%) were diabetic. Among the Controls, 27 (67.5%) were female and 13 (32.5%)male. Average age was 54 years. 15 (37.5%) were hypertensive and 10 (25%) diabetic. Between the Cases and the Controls, the p-values of the differences in gender and age were 0.125 and 0.054 respectively, meaning that they were essentially homogeneous. For hypertension, among the Cases the average initial BP was 145/85 mmHg, the average final BP (in a subsequent check) was 143/89 mmHg. The average drop in BP in the Case group was 15.17/8.83 mmHg. In the Control group the average initial BP was 150/91 mmHg, the average final was 147/92 mmHg. The average drop in BP was 3.4/-0.4 mmHg. The difference in drop in BP between the two groups of patients was significant for the systolic BP (p-value = 0.048), but not for the diastolic (p-value = 0.534). While all diabetic Cases were recommended to have HbA1c tests, only 2 (2.5%) managed to. None (0%) of the Controls had HbA1c. (The local laboratories are limited.) The consulting doctors held two live, educative webinars on diabetes for the local paramedics using the same telemedicine platform. And a partnership was entered into with a Kenyan drug manufacturer to ensure access to quality but affordable medication. Conclusions Telemedicine is acceptable in rural African populations. Daktari Africa was effective in improving systolic blood pressure control, and was able to organize educative sessions for the local staff. Quality, affordable medication was made available to patients. These are steps towards universal healthcare. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Pfizer Global Medical Grants


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