scholarly journals Clinical and angiographic characteristics of patients with STEMI and confirmed diagnosis of COVID-19: an experience of Tanta University Hospital

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Ahmed Alaarag ◽  
Timoor Hassan ◽  
Sameh Samir ◽  
Mohamed Naseem
Keyword(s):  
Poor Prognosis ◽  
Management Strategy ◽  
Clinical Presentation ◽  
Underlying Mechanism ◽  
Fibrinolytic Therapy ◽  
University Hospital ◽  
Total Occlusion ◽  
St Elevation ◽  
Primary Management ◽  
D Dimer

Abstract Background Patients with established cardiovascular diseases have a poor prognosis when affected by the coronavirus disease 2019 (COVID-19). Also, the cardiovascular system, especially the heart, is affected by COVID-19. So we aimed to evaluate the angiographic and clinical characteristics of COVID-19 patients presented by ST-elevation myocardial infarction (STEMI). Results Our retrospective study showed that STEMI patients with COVID-19 had elevated inflammatory markers with mean of their CRP (89.69 ± 30.42 mg/dl) and increased laboratory parameters of thrombosis with mean D-dimer (660.15 ± 360.11 ng/ml). In 69.2% of patients, STEMI was the first clinical presentation and symptoms suggestive of COVID-19 developed during the hospital stay; about one third of patients had a non-obstructive CAD, while patients with total occlusion had a high thrombus burden. Conclusion STEMI may be the initial presentation of COVID-19. A non-obstructive CAD was found in about one third of patients; on the other hand, in patients who had a total occlusion of their culprit artery, the thrombus burden was high. Identification of the underlying mechanism responsible for the high thrombus burden in these patients is important as it may result in changes in their primary management strategy, either primary PCI, fibrinolytic therapy, or a pharmaco-invasive strategy. Furthermore, adjunctive anticoagulation and antiplatelet therapy may need to be revised.

scholarly journals HEMOSTATIC ABNORMALITIES IN COVID-19: UNDERLYING MECHANISMS AND CLUES TO TREATMENT Do we Really See a “Storm” Never Seen Before?

2020 ◽  
pp. 001
Author(s):  
Jovan Antović
Keyword(s):  
Underlying Mechanism ◽  
University Hospital ◽  
Similar Extent ◽  
The World ◽  
Enormous Amount ◽  
Anticoagulant Prophylaxis ◽  
Underlying Mechanisms ◽  
Patients Experience ◽  
Short Time ◽  
D Dimer

Despite relatively short time since Covid-19 infection has appeared in the world, enormous amount of literature data (more than 20 000 articles currently (mid-June)) is available on PubMed. Those data, together with our own experience at Karolinska University Hospital point towards hemostatic abnormalities in significant number of severe patients. Majority of those patients experience persistent hypercoagulation with massively increased D-dimer and fibrinogen. As a consequence, clinical thrombotic events, including venous thromboembolism (VTE) are common in Covid-19 patients and it seems that increased anticoagulant prophylaxis may be beneficial for severe (ICU/mechanical ventilation) patients. The lungs are most severely injured by the virus and that the potential underlying mechanism is a crosstalk between inflammation/complement and hemostasis. It is important to emphasize that the importance of hemostatic abnormalities in Covid-19 patients should not be overestimated since thromboembolic phenomena are, to a similar extent, present in other influenza and severely ill patients.

Myocardial Infarction with and without ST-segment Elevation: a Contemporary Reappraisal of Similarities and Differences

2020 ◽  
Vol 16 ◽  
Author(s):  
Andreas Mitsis ◽  
Felice Gragnano
Keyword(s):  
Myocardial Infarction ◽  
Clinical Presentation ◽  
Standard Of Care ◽  
Epidemiologic Studies ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
P2y12 Inhibitors ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Similarities And Differences

Abstract:: Understanding the similarities and differences between myocardial infarction with or without ST-segment elevation is an essential step for a proper patients’ management in current practice. Both syndromes are caused by a critical stenosis or a total occlusion of coronary arteries (mostly due to thrombosis on atherosclerotic plaque), and manifest with a similar clinical presentation. Recent epidemiologic studies show that the relative incidence of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) moves in an opposite fashion (decreasing and increasing respectively), with a prognosis that is worse at short-term follow-up for STEMI but comparable at long-term. Current management differs, as for STEMIs an immediate reperfusion is recommended, while for NSTEMIs risk stratification is mandatory in order to stratify patients’ risk, and then decide the timing for coronary angiography. Periprocedural and technical aspects of the interventional management as well antithrombotic medications are for the most similarly implemented in the two types of MI, with routine radial access, DES implant, and novel P2Y12 inhibitors representing the standard of care in both cases. The following review article aims to compare the two types of MI, with and without persistent ST-segment elevation. The main purpose is to explore their similarities and differences and address areas of uncertainty with regards to clinical presentation, therapeutic management, and prognosis. The identification of high-risk NSTEMI patients is important as they may require an individualised approach that can substantially overlap with current STEMI recommendations and their mortality remains high if their management is delayed.

scholarly journals Prognostic significance of bone marrow FDG uptake in patients with gynecological cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kotaro Shimura ◽  
Seiji Mabuchi ◽  
Naoko Komura ◽  
Eriko Yokoi ◽  
Katsumi Kozasa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Bone Marrow ◽  
Poor Prognosis ◽  
Gynecological Cancer ◽  
Prognostic Significance ◽  
Standardized Uptake Value ◽  
Suppressor Cells ◽  
Underlying Mechanism ◽  
Fdg Uptake

AbstractWe investigated the prognostic significance and the underlying mechanism of increased bone marrow (BM) 2-(18F) fluoro-2-deoxy-D-glucose as a tracer (FDG)-uptake in patients with gynecological cancer. A list of patients diagnosed with cervical, endometrial, and ovarian cancer from January 2008 to December 2014 were identified. Then, through chart reviews, 559 patients who underwent staging by FDG-positron emission tomography (PET)/computed tomography (CT) and subsequent surgical resection were identified, and their clinical data were reviewed retrospectively. BM FDG-uptake was evaluated using maximum standardized uptake value (SUVmax) and BM-to-aorta uptake ratio (BAR). As a result, we have found that increased BAR was observed in 20 (8.7%), 21 (13.0%), 21 (12.6%) of cervical, endometrial, and ovarian cancer, respectively, and was associated with significantly shorter survival. Increased BAR was also closely associated with increased granulopoiesis. In vitro and in vivo experiments revealed that tumor-derived granulocyte colony-stimulating factor (G-CSF) was involved in the underlying causative mechanism of increased BM FDG-uptake, and that immune suppression mediated by G-CSF-induced myeloid-derived suppressor cells (MDSCs) is responsible for the poor prognosis of this type of cancer. In conclusion, increased BM FDG-uptake, as represented by increased BAR, is an indicator of poor prognosis in patients with gynecological cancer.

scholarly journals Tumor-Associated Trypsin Inhibitor (TATI) as a Biomarker of Poor Prognosis in Oropharyngeal Squamous Cell Carcinoma Irrespective of HPV Status

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2811
Author(s):  
Anni Sjöblom ◽  
Ulf-Håkan Stenman ◽  
Jaana Hagström ◽  
Lauri Jouhi ◽  
Caj Haglund ◽  
...  
Keyword(s):  
Trypsin Inhibitor ◽  
Poor Prognosis ◽  
Tissue Expression ◽  
University Hospital ◽  
Study Cohort ◽  
Hpv Dna ◽  
P16 Immunohistochemistry ◽  
Tumor Tissues ◽  
Hpv Status ◽  
Survival Endpoints

Background: We studied the role of tumor-associated trypsin inhibitor (TATI) in serum and in tumor tissues among human papillomavirus (HPV)-positive and HPV-negative OPSCC patients. Materials and methods: The study cohort included 90 OPSCC patients treated at the Helsinki University Hospital (HUS), Helsinki, Finland, in 2012–2016. TATI serum concentrations (S-TATIs) were determined by an immunofluorometric assay. Immunostaining was used to assess tissue expression. HPV status was determined with a combination of p16 immunohistochemistry and HPV DNA PCR genotyping. The survival endpoints were overall survival (OS) and disease-specific survival (DSS). Results: A significant correlation was found between S-TATI positivity and poor OS (p < 0.001) and DSS (p = 0.04) in all patients. In HPV-negative cases, S-TATI positivity was linked to poor OS (p = 0.01) and DSS (p = 0.05). In HPV-positive disease, S-TATI positivity correlated with poor DSS (p = 0.01). S-TATI positivity was strongly associated with HPV negativity. TATI serum was negatively linked to a lower cancer stage. TATI expression in peritumoral lymphocytes was associated with favorable OS (p < 0.025) and HPV positivity. TATI expression in tumor and in peritumoral lymphocytes correlated with lower cancer stages. Conclusion: Our results suggest that S-TATI positivity may be a biomarker of poor prognosis in both HPV-positive and HPV-negative OPSCC.

COMPARISON OF MORTALITY RELATED RISK FACTORS OF COVID-19 AND SARI DEATH DURING THE PEAK OF PANDEMIC IN A TERTIARY CARE CENTRE.

2021 ◽  
pp. 136-139
Author(s):  
K. Anbananthan ◽  
A. Manimaran ◽  
A. Ramasamy ◽  
S. A. Natesh ◽  
AnuSree. S. C
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Cerebrovascular Disease ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Poor Prognosis ◽  
Severe Acute Respiratory Infection ◽  
Viral Infectious Disease ◽  
Study Population ◽  
D Dimer

Background: COVID-19 is a viral infectious disease caused by the SARS CoV-2 virus which causes severe respiratory distress in a certain number of patients with specic risk factors. This study compares the mortality risk factors of COVID 19 and Severe Acute Respiratory Infection (SARI) deaths and also determines the most likely causes that lead to such a poor prognosis Objectives: To evaluate the risk factors of COVID 19 and SARI causing mortality. To compare the most likely risk factors that lead to such a poor prognosis Materials And Methods: This was a Cross sectional study done on 190 patients which includes all cases of covid 19 and SARI deaths within the peak of pandemic period (August 2020). Patient datas were collected from MRD registry at Thanjavur Medical College. Results: Among the study population of 190, age distribution of the patients died due to covid-19 was minimum 26 years to maximum 89 years and mean age of 61years. Most commonly affected were in the age around 60years. Distribution of male is around 72.1%.This study showed 47.9% were covid positive and 42.1% were suspected based on CT chest nding and clinical features. Around 84.7% were diabetic and 56.3% were hypertensive. There is no signicant difference between the exposure rate of diabetes, hypertension, CKD, chronic lung disease, cerebrovascular disease, liver disease, malignancy among covid and SARI group. Among these study population 94.7% had elevated d-dimer level. Conclusion: This study showed various comorbidities, complications, and demographic variables including diabetes, hypertension, chronic kidney disease,, chronic lung disease,liver disease, Cerebrovascular disease, cancer, increased D-dimer, male gender, older age(>50), smoking, and obesity are clinical risk factors for a fatal outcome associated with COVID 19.

The Effect of the Change in Lymph Flow Following Gastrectomy for Initial Disease on the Prognosis of Remnant Gastric Cancer

2021 ◽  
Author(s):  
Yoshihiko Kakiuchi ◽  
Satoru Kikuchi ◽  
Shinji Kuroda ◽  
Masahiko Nishizaki ◽  
Shunsuke Kagawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Poor Prognosis ◽  
Malignant Disease ◽  
Univariate Analysis ◽  
Lymph Flow ◽  
University Hospital ◽  
Gastric Disease ◽  
Remnant Gastric Cancer ◽  
Initial Surgery

Abstract Background: Remnant gastric cancer (RGC) has been increasing for various reasons such as longer life span, medical progress, and others. It generally has a poor prognosis, and its mechanism of occurrence is unknown. The purpose of this study was to evaluate the clinicopathological features of and clarify the prognostic factors of RGC.Methods: Between January 2002 and January 2017, 39 patients with RGC following distal gastrectomy underwent curative surgical resection at the Okayama University Hospital; their medical records and immunohistochemically stained extracted specimens were used for retrospective analysis. Results: On univariate analysis, initial gastric disease, pathological lymph node metastasis, and pathological stage were the significant factors associated with a poor overall survival (OS) (p=0.0139, 0.0061, and 0.0158, respectively). Multivariate analysis of these 3 factors showed that only initial gastric disease caused by malignant disease was an independent factor associated with a poor prognosis (p=0.0141, odds ratio [OR]:4.151, 95% confidence interval [CI]:1.333-12.93). In addition, the presence of a left gastric artery (LGA), and tumor-infiltrating CD8+ T cell expression were higher in the benign disease group than in the malignant group (p<0.0001 and p=0.0485, respectively).Conclusion: The lymph flow change caused by lymph node dissection for malignant disease in initial surgery might have an effect on the suppression of tumor immunity and the poor prognosis of RGC.

scholarly journals Performance of the Quantitative Latex Immunoturbidimetric D-dimer Assay for the Diagnosis of Acute Pulmonary Embolism at Rafik Hariri University Hospital

2020 ◽  
Vol 7 (3) ◽  
pp. 125-128
Author(s):  
Rida Salman ◽  
Mira Alsheikh ◽  
Rim Ismail
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Ct Angiography ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Retrospective Chart Review ◽  
Latex Agglutination ◽  
University Hospital ◽  
Acute Pe ◽  
D Dimer

Background and aims: The diagnostic workup for pulmonary embolism (PE) includes D-dimer assay and computed tomographic angiography. Several D-dimer assays have been approved for PE diagnosis with different sensitivity and specificity. We aimed to study the sensitivity and specificity of the quantitative latex agglutination D-dimer assay used in a referral teaching hospital in Lebanon for the diagnosis of acute PE. Methods: Using a retrospective chart review, we studied 300 patients who had D-dimer test at Rafik Hariri University Hospital in the period between January 1, 2012 and December 31, 2013. Accordingly, 93 patients had a CT angiography after being suspected to have acute PE. A statistical table 2*2 was used to compare the results of CT angiography and D-dimer test. Results: Thirteen patients (13.97%) had PE and 60 patients (64.51%) had positive D-dimer test. Quantitative latex agglutination D-dimer assay had a sensitivity of 69%, specificity of 36%, and negative predictive value of 88%. False positive ratio was also 64%. Moreover, the receiver operating characteristic (ROC) curve was obtained with an area under the curve measuring 0.527. Conclusion: Quantitative latex agglutination D-dimer assay has a high negative predictive value; thus, it can exclude a PE diagnosis if it is associated with low clinical pretest probability.

Sign in / Sign up

Export Citation Format

Share Document