scholarly journals Rizikos veiksnių įtaka ligonių išgyvenimui po kylančiosios aortos aneurizmos korekcijos konduitu

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Rasa Joana Čypienė ◽  
Palmyra Semėnienė ◽  
Arimantas Grebelis ◽  
Gintaras Turkevičius
Keyword(s):  
Risk Factors ◽  
Heart Surgery ◽  
Ascending Aorta ◽  
Functional Class ◽  
Aorta Aneurysm ◽  
Valve Insufficiency ◽  
Group 3 ◽  
Vilnius University ◽  
Group 2 ◽  
Surgery Center

Rasa Joana Čypienė1, Palmyra Semėnienė1, Arimantas Grebelis1, Gintaras Turkevičius21 Vilniaus universiteto Širdies chirurgijos centras,Santariškių g. 2, LT-08661 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Tikslas Analizuoti rizikos veiksniai 221 ligonio, kuriam atlikta kylančiosios aortos aneurizmos esant aortos vožtuvų nesandarumui, korekcija konduitu. Ligoniai ir metodai Darbas atliktas Vilniaus universiteto Širdies chirurgijos centre. Ligoniai stebėti nuo vieno mėn. iki 20 metų po operacijos. Pacientai tirti suskirstyti į šias tris grupes pagal klinikinę eigą:• 1 grupė – ūminė sluoksniuojančioji kylančiosios aortos aneurizma (ŪSA) – 48 (21,7%) ligoniai, vidutinė simptomų atsiradimo trukmė – 0,25 ± 0,11 mėn.• 2 grupė – lėtinė sluoksniuojančioji kylančiosios aortos aneurizma (LSA) – 44 (19,9%) ligoniai, vidutinė simptomų atsiradimo trukmė – 24,4 ± 5,26 mėn.• 3 grupė – lėtinė nesisluoksniuojančioji kylančiosios aortos aneurizma (LNA) – 129 (58,4%) ligoniai, vidutinė simptomų atsiradimo trukmė – 44,6 ± 5,06 mėn. Priešoperacinė vidutinė funkcinė klasė (f. kl.) (NYHA) klinikinėse grupėse atitinkamai buvo: 4,5 ± 0,08; 4,0 ± 0,12 ir 3,5 ± 0,05. Rezultatai Išskirta 14 (p < 0,01) reikšmingų rizikos veiksnių, turėjusių įtakos ligonių išgyvenimui – amžius, ligos trukmė, priešoperacinė funkcinė klasė, skausmas už krūtinkaulio, šokas, priešoperacinis miokardo infarktas Q+, KSdd, KSH, sistolinis arterinis kraujospūdis, DKA trukmė, galvos smegenų kraujotakos nepakankamumas, kairiojo skilvelio išmetimo frakcija, kylančiosios aortos skersmuo. Koreliacinė analizė parodė, kad yra glaudus tiesinis priešoperacinės f. kl. ir DKA trukmės – r = 0,374 (p = 0,01) ryšys. Išvados Analizė parodė, kad ligonių išgyvenimui tiek hospitaliniu, tiek atokiu periodais turėjo įtakos nustatyti reikšmingi rizikos veiksniai pagal klinikinę eigą. Pagrindiniai žodžiai: kylančiosios aortos aneurizma Effects of risk factors on patients’ survival after replacement of ascending aorta aneurysm with aortic valve insufficiency using conduit Rasa Joana Čypienė1, Palmyra Semėnienė1, Arimantas Grebelis1, Gintaras Turkevičius21 Vilnius University, Heart Surgery Center, Santariškių str. 2, LT-08661 Vilnius, Lithuania2 Vilnius University Hospital „Santariškių klinikos“, Heart Surgery Center,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Objective Risk factors were analyzed for 221 patients after replacement of ascending aorta aneurysm with aortic valve insufficiency using a conduit. Patients and methods Work was accomplished at Vilnius University Heart Surgery Center. Patients were followed up from 1 month to 20 years after operation. By the clinical course they were divided into three groups:group 1 – acute dissecting aortic aneurysm (ADA) – 48 (21.7%);group 2 – chronic dissecting aortic aneurysm (CHDA) – 44 (19.9%);group 3 – chronic aneurysm without dissection (CHAWD) – 129 (58.4%) patients. The mean period of anamnesis was in group 1 – 0.25 ± 0.11 months; group 2 – 24.4 ± 5.26 months; group 3 – 44.6 ± 5.06 months. The preoperational mean functional class in the groups was 4.5 ± 0.08; 4.0 ± 0.12 and 3.5 ± 0.05 respectively. Results There were 14 significant risks factors which have an impact on the survival of patients: age, period of anamnesis, preoperational functional classes, pain over the breastbone, preoperational myocardial infarction Q+, LVDD, LVH, systolic arterial hypertension, cardiopulmonary bypass (CPB) term, head cerebra failure, ejection fraction, ascending aorta diameters. Correlation analysis showed a close relation between preoperation functional class and CPB term r = 0.374 (p = 0.01). Conclusions Significant risk factors in different group of patients influenced their both in-hospital and follow-up survival. Key words: ascending aorta aneurysm

scholarly journals Pirmosios aortos vožtuvą išsaugančios operacijos šalinant kylančios aortos aneurizmas Vilniaus universiteto Širdies chirurgijos centre

2007 ◽  
Vol 5 (4) ◽  
pp. 0-0
Author(s):  
Vytautas Sirvydis ◽  
Saulius Raugelė ◽  
Arimantas Grebelis ◽  
Gintaras Turkevičius ◽  
Rimantas Karalius ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Marfan Syndrome ◽  
Heart Surgery ◽  
Anticoagulation Therapy ◽  
Ascending Aorta ◽  
University Hospital ◽  
Aorta Aneurysm ◽  
Valve Sparing ◽  
Vilnius University ◽  
Surgery Center

Vytautas Sirvydis1,  Saulius Raugelė1, Arimantas Grebelis1,  Gintaras Turkevičius2, Rimantas Karalius1, Rasa Čypienė1, Palmyra Semėnienė11 Vilniaus universiteto Širdies chirurgijos centras2 Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Šiuolaikinė kardiochirurgija leidžia radikaliai chirurgiškai gydyti Marfano sindromu sergančius ligonius, kuriems diagnozuojama kylančios aortos aneurizma. Vienas iš pirmųjų metodų buvo sukurtas ir aprašytas Benthallio ir DeBono 1968 m., o 1992 m. Davidas aprašė operaciją, kurios metu išsaugomas natūralus aortos vožtuvas. Vėliau ši technika tobulinta, sukurta dar keletas panašių būdų. Nors ši metodika, atrodytų, leidžia išspręsti keletą problemų, tokių kaip antikoaguliantų vartojimas, tačiau diskusijų tebekelia jos naudojimas esant Marfano sindromui, kai aneurizma yra didesnė nei 50–55 mm. Supažindiname su pirmosiomis sėkmingomis aortos vožtuvą išsaugančiomis operacijomis šalinant kylančios aortos aneurizmas. Ligoniai ir metodai 2003–2006 m. Vilniaus universiteto ligoninės Santariškių klinikų Širdies chirurgijos centre atliktos keturios izoliuotos Davido I tipo operacijos Marfano sindromu sergantiems ligoniams, turintiems kylančios aortos lėtinę aneurizmą. Operuota dvi moterys ir du vyrai, amžiaus vidurkis 32,5 ± 5,7 m., visi buvo NYHA II funkcinės klasės. Retrospektyviai surinkti širdies echoskopijos duomenys iki ir po operacijos. Rezultatai Ritmo sutrikimų ar kitų grėsmingesnių komplikacijų, mirčių nebuvo. Aortos matmenys tiek ties sinotubuline jungtimi, tiek kylančios dalies skyrėsi statistiškai reikšmingai ir smarkiai, aortos vožtuvo nesandarumo nebuvo arba buvo menkas. Išvados Marfano sindromu sergantiems ligoniams, turintiems lėtinę kylančios aortos aneurizmą, aortos vožtuvą išsaugančios operacijos yra užtektinai saugus gydymo metodas. Literatūros ir mūsų duomenimis, šio tipo operacijos gali būti atliktos, kol aneurizmos dydis yra 50–55 mm ir nėra reikšmingo aortos vožtuvo nesandarumo. Pagrindiniai žodžiai: Marfano sindromas, aortos aneurizma, Davido operacija First experience of aortic valve sparing procedures in patients with aneurysm of ascending aorta at Vilnius University Hospital Santariškių Klinikos Heart Surgery Center Vytautas Sirvydis1,  Saulius Raugelė1, Arimantas Grebelis1,  Gintaras Turkevičius2, Rimantas Karalius1, Rasa Čypienė1, Palmyra Semėnienė11 Heart Surgery Center of Vilnius University2 Vilnius University Hospital Santariškių Klinikos Heart Surgery Center,Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objectives The methods of modern cardiac surgery allow to perform a thoroughgoing treatment of ascending aorta aneurysm. Benthall and DeBono in 1968 were the first to describe the basic surgical technique; in 1992 David reported a novel surgical procedure aimed to spare the native aortic valve. The latter technique is superior because of permanent anticoagulation therapy exclusion, but also it is controversial in cases when ascending aorta aneurysm exceeds 55 mm, especially in patients with Marfan syndrome. We would like to introduce our first experience in treating ascending aorta aneurysm and sparing the aortic valve in patients with Marfan syndrome. Patients and methods There were 4 successful cases of David I procedure during 1996–2006 at Vilnius University Hospital Santariškių Klinikos Heart Surgery Center. The patients were 2 male and 2 female, mean age 32.5 ± 5.7 years; all were of NYHA II functional class. Data were collected retrospectively from case histories. Results There were no deaths of any rhythm disturbances after surgery. The parameters of the ascending aorta and aortic root were significantly different as compared with preoperative data. Also, after surgery there were no aortic insufficiency or it was trivial. Conclusions The aortic valve sparing procedure in patients with Marfan syndrome and ascending aorta aneurysm appears to be a safe method of treatment. According to the literature and our data, these operations are safe and effective when the aneurysm does exceed 55 mm and there is no aortic valve insufficiency. Key words: aortic aneurysm, Marfan syndrome, David procedure

scholarly journals AVIATOR: An open international registry to evaluate medical and surgical outcomes of aortic valve insufficiency and ascending aorta aneurysm

2019 ◽  
Vol 157 (6) ◽  
pp. 2202-2211.e7 ◽  
Author(s):  
Frederiek de Heer ◽  
Jolanda Kluin ◽  
Gebrine Elkhoury ◽  
Guillaume Jondeau ◽  
Maurice Enriquez-Sarano ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Surgical Outcomes ◽  
Ascending Aorta ◽  
Aortic Valve Insufficiency ◽  
Aorta Aneurysm ◽  
International Registry ◽  
Valve Insufficiency

scholarly journals Oxidative Stress Inside the Pathogenesis of Ascending Aorta Aneurysms: A Clearer Vision for Identifying Promising Biomarkers and Therapeutic Targets

2021 ◽  
Author(s):  
Carmela Balistreri ◽  
Calogera Pisano ◽  
Giovanni Ruvolo
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Genetic Variants ◽  
Complex Disease ◽  
Ascending Aorta ◽  
Oxygen Species ◽  
Aorta Aneurysm ◽  
Independent Risk Factors ◽  
The Impact ◽  
And Oxidative Stress

Ascending aorta aneurysm (AsAA) is a complex disease, currently defined an inflammatory disease. In the sporadic form, AsAA has, indeed, a complex physiopathology with a strong inflammatory basis, significantly modulated by genetic variants in innate/inflammatory genes, acting as independent risk factors and as largely evidenced in our recent studies performed during the last 10 years. Based on these premises, here, we want to revise the impact of reactive oxygen species (ROS) and oxidative stress on AsAA pathophysiology and consequently on the onset and progression of sporadic AsAA. This might consent to add other important pieces in the intricate puzzle of the pathophysiology of this disease with the translational aim to identify biomarkers and targets to apply in the complex management of AsAA, by facilitating the AsAA diagnosis currently based only on imaging evaluations, and the treatment exclusively founded on surgery approaches.

VENTRICULOPERITONEAL SHUNTING AFTER ANEURYSMAL SUBARACHNOID HEMORRHAGE

Neurosurgery ◽  
2008 ◽  
Vol 62 (3) ◽  
pp. 618-627 ◽  
Author(s):  
Andrew S. Little ◽  
Joseph M. Zabramski ◽  
Madelon Peterson ◽  
Pamela W. Goslar ◽  
Scott D. Wait ◽  
...  
Keyword(s):  
Risk Factors ◽  
Subarachnoid Hemorrhage ◽  
Functional Status ◽  
Posthemorrhagic Hydrocephalus ◽  
Ventriculoperitoneal Shunting ◽  
Group 3 ◽  
Group 2 ◽  
Ventricle Size ◽  
Group 1

Abstract OBJECTIVE The goals of this study were to investigate the risk factors, indications, complications, and outcome for patients with ventriculoperitoneal shunts (VPSs) after subarachnoid hemorrhage and to define a subgroup eligible for future prospective studies designed to clarify indications for placement of a VPS. METHODS Clinical characteristics of 236 prospectively evaluated patients with subarachnoid hemorrhage and 6 months of follow-up were analyzed. Hydrocephalus was estimated by the relative bicaudate index (RBCI) measured on computed tomographic scans at the time of shunting. Patients were divided into three groups by ventricle size: Group 1 included 121 patients with small ventricles (RBCI &lt;1.0), Group 2 included 88 patients with borderline ventricle size (RBCI 1.0–1.4), and Group 3 included 27 patients with markedly enlarged ventricles (RBCI &gt;1.4). RESULTS Initially, 86 patients (36%) underwent ventriculoperitoneal shunting: 19 in Group 1 (16%), 43 in Group 2 (49%), and 24 in Group 3 (90%). Indications for placement of a VPS, risk factors, and outcome differed markedly by group. Four patients (3% of those not initially shunted) developed delayed hydrocephalus requiring a VPS, including one in Group 2 (2%). The 6-month shunt complication rate was 13%. Evaluation of patients in Group 2 indicated that functional status was an important factor in selecting candidates for shunting, and that patients receiving shunts and shunt-free patients demonstrated improvement in functional status during follow-up. CONCLUSION Although we currently use a proactive shunting paradigm for posthemorrhagic hydrocephalus, this report demonstrates that a conservative approach to patients with borderline ventricle size (i.e., RBCI of 1.0–1.4) and normal intracranial pressure should be evaluated in a prospective randomized trial.

scholarly journals The Effects of Norepinephrine Infusion on the Circulating Lymphocyte Counts of Post–Open Heart Surgery Patients

2000 ◽  
Vol 1 (3) ◽  
pp. 199-209
Author(s):  
Wanda Zziwambazza ◽  
Carrie J. Merkle ◽  
Ida M. Moore ◽  
Jean Davis
Keyword(s):  
Heart Surgery ◽  
Open Heart Surgery ◽  
The Other ◽  
Open Heart ◽  
Postoperative Infections ◽  
Norepinephrine Infusion ◽  
Beta Blocking ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

In this retrospective study employing chart reviews, 75 open heart surgery patients (OHSPs) were divided into 3 groups of 25 patients. Group 1 received no intravenous (IV) norepinephrine (NE) after surgery. Group 2 and group 3 received a minimum of 0.028 mcg/kg/min of IV NE for 6-24 h and greater than 24 h, respectively. In the 3 groups, preoperative lymphocyte counts were compared to counts obtained on postoperative days 1 and 2. The results showed lower lymphocyte counts on postoperative day 2 in group 3 subjects, who received NE for 24 h or more, compared to subjects of the other groups who received no NE or 6-24 h of NE (p < 0.05). There was also evidence that preoperative use of beta-blocking agents significantly affected the change in lymphocyte counts from day 1 to day 2 in both groups receiving NE. Furthermore, postoperative infections were more prevalent in group 3 than the other 2 groups (p < 0.05). The lower lymphocyte counts and higher infection rate, however, may be linked to lower postoperative blood pressure and increased number of intensive care unit days in group 3. Further investigation is warranted to elucidate the effects of IV NE administration on the lymphocyte counts of OHSPs and to reduce infections in those receiving NE.

Prophylactic Use of a Combination of an Anticoagulant and Ursodeoxycholic Acid for Sinusoidal Obstruction Syndrome after Allogeneic Myeloablative Hematopoietic Stem Cell Transplantation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5755-5755
Author(s):  
Hiroshi Okamura ◽  
Mitsutaka Nishimoto ◽  
Takahiko Nakane ◽  
Hideo Koh ◽  
Yasuhiro Nakashima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Research Funding ◽  
Gemtuzumab Ozogamicin ◽  
Adult Patients ◽  
Allogeneic Hsct ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
Prophylactic Use ◽  
Group 1

Abstract Introduction: Sinusoidal obstruction syndrome (SOS) is one of the potentially fatal complications of hematopoietic stem cell transplantation (HSCT). In particular, severe SOS frequently leads to multiple organ failure, and a worse prognosis. Thus, prophylaxis against development of SOS could contribute improved survival after HSCT. Previous reports demonstrated the effectiveness of the prophylactic use of ursodeoxycholic acid (UDCA) or certain anticoagulants, including unfractionated and low-molecular-weight heparin, for SOS. In two randomized controlled trials and two meta-analyses it was reported that UDCA, a hydrophilic bile acid, was an effective and safe drug for prophylaxis against SOS. The usefulness and feasibility of prophylactic use of anticoagulants after allogeneic HSCT are however still controversial. In addition, to our knowledge no study has evaluated the feasibility of usage of UDCA combined with an anticoagulant for SOS prevention after allogeneic HSCT in adult patients. To assess the efficacy and safety of use of UDCA combined with an anticoagulant as SOS prophylaxis, we performed a retrospective cohort study to examine the occurrences of SOS and hemorrhagic events in patients who underwent myeloablative allogeneic HSCT at our institution. We examined use of any anticoagulant together with simultaneous administration of UDCA, in comparison with UDCA alone for the prevention of SOS. Patients and methods: We reviewed the charts of consecutive adult patients in whom myeloablative allogeneic HSCT was performed at our hospital from November 1994 to May 2014, and who received either unfractionated heparin or dalteparin (low-molecular-weight heparin) with UDCA (group 1), danaparoid with UDCA (group 2), or UDCA only (group 3), used for prophylaxis against SOS. Results: A total of 280 patients (group 1: n=52; group 2: n=33; and group 3: n=195) were investigated. The proportions of patients with risk factors for SOS-including non-remission at the time of HSCT, a second or subsequent HSCT, high aspartate aminotransferase (AST) levels before HSCT, high ferritin levels before HSCT, a history of receiving gemtuzumab ozogamicin, and HLA disparity-were similar across the three groups. In group 1, a conditioning regimen containing busulfan was used less frequently (P = 0.002). SOS occurred in seven patients (13.7%) in group 1, five patients (15.2%) in group 2, and 28 patients (14.4%) in group 3, all meeting the Seattle criteria. None of the patients in group 1, two (6.1%) in group 2, and nine (4.6%) in group 3 had SOS diagnosed according to the Baltimore criteria. There was no significant difference in the incidence of SOS among the three groups. In addition, with regard to the cumulative incidence of severe SOS, no statistically significant difference was present among the three groups. The incidence of hemorrhagic events within 30 and 100 days following allogeneic HSCT was not significantly different across the three groups (30 days; 5.8%, 3.0%, 5.1%, P = 0.843, 100 days; 17.6%, 15.2%, 14.4%, P=0.843, respectively). Furthermore, the probabilities of OS and NRM until day 100 after allogeneic HSCT were similar among the three groups (P = 0.733 and P = 0.637, respectively). In a univariate model, a history of gemtuzumab ozogamicin treatment, high serum ferritin levels before HSCT, an HLA mismatched donor, and non-complete remission of disease at the time of allogeneic HSCT were found to be significant risk factors for SOS. Multivariate analysis revealed that a history of gemtuzumab ozogamicin therapy, a mismatched HLA donor, and non-complete remission of disease at the time of allogeneic HSCT were significant and independent risk factors for SOS. In the multivariate as well as univariate analyses, combined administration of UDCA and any anticoagulant for SOS prophylaxis did not have a significant effect on the incidence SOS, when compared to prophylaxis with UDCA alone. Conclusion: Our study results suggest that the combined use of UDCA and an anticoagulant for SOS prophylaxis after myeloablative allogeneic HSCT in adult patients was not beneficial. Establishment of an optimal strategy for prophylaxis against SOS after HSCT is still needed. Disclosures Nakane: Mundipharma KK: Research Funding. Koh:Pfizer: Consultancy, Honoraria. Hino:Pfizer: Honoraria, Research Funding; Nippon Shinyaku: Honoraria, Speakers Bureau; Alexion: Honoraria, Research Funding. Nakamae:Mochida Pharmaceutical Co., Ltd.: Honoraria, Research Funding; Pfizer: Consultancy, Honoraria; Novartis Pharma KK: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel/accommodation/meeting expenses, Research Funding.

Chorangiosis of Chorionic Villi: What Does It Really Mean?

2016 ◽  
Vol 140 (6) ◽  
pp. 588-593 ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Risk Factors ◽  
Low Grade ◽  
Minimal Risk ◽  
Pregnancy Risk ◽  
Chorionic Villi ◽  
Injury Group ◽  
Increased Risk ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Chorangiosis has been regarded as a result of low-grade placental hypoxia associated with pregnancy risk factors and abnormal outcomes. It is unknown whether these are a consequence of chorangiosis itself or of associated other placental pathology.Context.— To prove that chorangiosis itself does not portend an increased risk for pregnancy unless associated with other placental pathology.Objective.— This retrospective statistical study analyzes 1231 consecutive placentas with diffuse or focal hypervascularity of chorionic villi: 328 with preuterine pattern of chronic hypoxic placental injury (group 1), 297 with uterine type of chronic hypoxic placental injury (group 2), and 606 cases with chorangiosis (group 3) not fulfilling the inclusion criteria for groups 1 or 2.Design.— Group 2, with 33 cases of chorangiosis (11.1%), featured 10 and 11 statistically significant highest percentages of abnormal clinical and placental variables, respectively; group 3 featured the highest percentages of multiple pregnancy, the heaviest placentas, and the most common acute chorioamnionitis, fetal inflammatory response; and group 1 had the highest proportion of mild erythroblastosis of fetal blood. When comparing groups 1 and 3, 21 of 29 clinical risk factors/outcomes (72.4%) and 30 of 41 placental variables (73.2%) were more common in group 1.Results.— Presence of diffuse hypoxic patterns of placental injury adds prognostically negative significance to increased vascularity of chorionic villi. Chorangiosis without those patterns portends minimal risk for the pregnancy, and is associated with significantly fewer pregnancy risk factors, abnormal outcomes, and other placental abnormalities.Conclusions.—

scholarly journals Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

2019 ◽  
Vol 5 (2) ◽  
pp. 156-160
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
ATM Ashadullah ◽  
Khondker Shaheed Hussain ◽  
Mohammad Ahtashamul Haque
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Group 4 ◽  
History Of ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

scholarly journals Risk factors for diastolic left ventricular myocardial dysfunction in patients with chronic kidney disease

2018 ◽  
Vol 90 (9) ◽  
pp. 60-67 ◽  
Author(s):  
T E Rudenko ◽  
E S Kamyshova ◽  
M P Vasilyeva ◽  
I N Bobkova ◽  
N I Solomakhina ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Filtration Rate ◽  
Myocardial Dysfunction ◽  
Left Ventricular ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Purpose of the study. To examine the frequency and risk factors for the development of diastolic dysfunction (DD) of the left ventricle (LV) of the heart in patients with chronic kidney disease (CKD). Materials and methods. The study included 225 patients with stage I-CKD of non-diabetic etiology (median age 47.0 years, 50.2% of women). Depending on the degree of decrease in the glomerular filtration rate (GFR), all patients were divided into 3 groups. Group 1 (n=70) consisted of patients with GFR 89-45 ml / min / 1.73 m2, group 2 (n=120) - patients with GFR 44-15 ml / min / 1.73 m2, group 3 (n=35) - patients with GFR

scholarly journals The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness

2021 ◽  
Vol 7 (11) ◽  
pp. 922
Author(s):  
Chien-Ming Chao ◽  
Chih-Cheng Lai ◽  
Hsuan-Fu Ou ◽  
Chung-Han Ho ◽  
Khee-Siang Chan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Economic Burden ◽  
Invasive Pulmonary Aspergillosis ◽  
Medical Expenditure ◽  
Apache Ii Score ◽  
Solid Cancer ◽  
Severe Influenza ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill influenza patients remains undefined. The study was retrospectively conducted in three institutes. From 2016 through 2018, all adult patients with severe influenza admitted to an intensive care unit (ICU) were identified. All patients were classified as group 1, patients with concomitant severe influenza and IPA; group 2, severe influenza patients without IPA; and group 3, severe influenza patients without testing for IPA. Overall, there were 201 patients enrolled, including group 1 (n = 40), group 2 (n = 50), and group 3 (n = 111). Group 1 patients had a significantly higher mortality rate (20/40, 50%) than that of group 2 (6/50, 12%) and group 3 (18/11, 16.2%), p < 0.001. The risk factors for IPA occurrence were solid cancer and prolonged corticosteroid use in ICU of >5 days. Group 1 patients had significantly longer hospital stay and higher medical expenditure than the other two groups. The risk factors for mortality in group 1 patients included patients’ Charlson comorbidity index, presenting APACHE II score, and complication of severe acute respiratory distress syndrome. Overall, IPA has a significant adverse impact on the outcome and economic burden of severe influenza patients, who should be promptly managed based on risk host factors for IPA occurrence and mortality risk factors for coinfection with both diseases.

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