scholarly journals CARDIOSYNCHRONOUS ELECTROMYOSTIMULATION IN PATIENTS WITH ACUTE HEART FAILURE

2013 ◽  
Vol 12 (6) ◽  
pp. 15-20
Author(s):  
G. G. Ivanov ◽  
M. Yu. Orkvasov ◽  
G. Khalabi
Keyword(s):  
Heart Failure ◽  
Conservative Treatment ◽  
Acute Heart Failure ◽  
Clinical Symptoms ◽  
Impedance Measurement ◽  
Pharmacological Therapy ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
The One

Aim. To study the effectiveness of the external cardiosynchronous electromyostimulation (ECSEMS) in patients with different variants of acute heart failure (AHF).Material and methods. The study included 62 AHF patients: Group I — those receiving only standard pharmacological therapy; and Group II — those in whom standard pharmacological therapy was ineffective after 12 hours, and who were also administered ECSEMS sessions for the next 7 days. The examination included multi-frequency bio-impedance measurement and dispersion mapping.Results. Clinical symptoms were less severe in Group I. In 64% of the Group II patients, the combination treatment was associated with a positive dynamics of the water balance parameters. The 7-day ECSEMS, as a part of the complex management of AHF patients, significantly reduced the one-month lethality, although did not change the one-year survival.Conclusion. The ECSEMS method could be used in order to increase the effectiveness of the conservative treatment of AHF patients. 

scholarly journals Prognostic Value of the Six-Minute Walk Test in Heart Failure

2020 ◽  
Author(s):  
Vinicius Astolpho ◽  
Roberto Barbosa ◽  
Gabriela Devens ◽  
Leticia Louzada ◽  
Pietro Lima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Primary Outcome ◽  
Average Distance ◽  
Adverse Outcomes ◽  
Walk Test ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
Minute Walk

Background: The 6-minute walk test (6MWT) is a simple and low-cost method that allows assessment of functional capacity in patients with heart failure (HF). However, the prognostic role of 6MWT in HF remains uncertain. Objectives: We aimed to evaluate the 6MWT as a predictor of mid-term adverse outcomes in patients with HF with mid-range and reduced ejection fraction. Methods: Prospective single-center cohort study that included patients with HF with an ejection fraction under 50% at a specialized outpatient HF service. Patients underwent the 6MWT on admission and were compared according to the distance walked: Group I walked ≥350 meters and group II <350 meters. The primary outcome was a composite of death from any cause or hospitalization for HF decompensation in one-year follow-up. Secondary outcomes were the components of the primary outcome in an isolated analysis. Results: Sixty patients were included, 43.3% male, with a mean age of 61.1 ± 12.9 years and ejection fraction 34.3 ± 10.1%. 52 patients (86.7%) were on guideline-directed triple therapy for HF. The average distance walked in the 6MWT was 395.1 ± 98.8 meters, with 40 patients (66.7%) in group I and 20 (33.3%) in group II. The primary outcome in groups I and II were, respectively, 15,0% and 35,0% (p=0.05). One-year mortality was 5.0% vs 15.0% (p=0.18) and the hospitalization rate was 10.0% vs 20.0% (p=0.28). Conclusions: There was no association of distance <350 meters in the 6MWT with the primary outcome in patients with HF. Despite the higher occurrence of outcomes in group II, the difference was not statistically significant in this analysis. On a selective basis, the 6MWT may be a useful tool for prognostic stratification in HF, if combined with other methods.

Evaluation of the Efficacy and Safety of Sublingual Immunotherapy (Traditional Coca’s extract) in Allergic Rhinoconjunctivitis

2021 ◽  
Vol 30 (1) ◽  
pp. 53-60
Author(s):  
Reham M. EL-Shabrawy ◽  
Atef El Bahrawi ◽  
Ahmad S. Khalil
Keyword(s):  
Quality Of Life ◽  
Sublingual Immunotherapy ◽  
Pharmacological Therapy ◽  
Allergic Rhinoconjunctivitis ◽  
Life Questionnaire ◽  
Group I ◽  
Medication Score ◽  
Group Ii ◽  
One Year

Background: Allergic rhinoconjunctivitis is a common allergic disorder that significantly affects the patient’s Quality of life (QoL). In countries with low socioeconomic levels, traditional Coca’s extracts is an economical choice for Sublingual immunotherapy (SLIT).Objectives: This study aimed to evaluate the efficacy, safety, and effect on medication score of homemade Coca’s extracts SLIT in improving the QoL of patients with allergic rhinoconjunctivitis. Methodology: 120 allergic rhinoconjunctivitis patients were randomly classified into two similar groups of 60 patients each. Group I received pharmacological therapy regularly, while group II received SLIT and pharmacological treatment. Both groups were followed up for one year. Results: During the period of study, one patient dropped out from group I, while, 9 (15%) patients dropped out from group II. Initially, there were no statistically significant differences in the scores of mini rhinoconjunctivitis quality of life questionnaire (miniRQLQ) or medication scores between the two groups. After one year, both groups showed statistically highly significant improvement in QoL (p<0.001); however, improvement in group 2 was statistically significantly higher than group I (p<0.001). Medication score of group I showed a mild non-significant decrease from 2.97±0.18 to 2.70±0.723, while, Group II medication score significantly decrease from 3.00±0.000 to 0.38±0.495. There were no severe adverse effects in any of the two groups. No statistical difference was found in the incidence of mild adverse reaction between both groups. Conclusion: Home made Coca’s extracts used in SLIT are a safe treatment that improve both qualities of life and medication score in patients suffering from severe allergic rhinoconjunctivitis.

CURRENT ASPECTS OF DRUG THERAPY OF CHRONIC HEART FAILURE SYNDROME

2020 ◽  
Vol 4 (2) ◽  
pp. 1085-1096
Author(s):  
T.V. Statkevich ◽  
◽  
N.P. Mitkovskaya ◽  
◽  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Drug Therapy ◽  
Chronic Heart Failure ◽  
Clinical Symptoms ◽  
Nyha Class ◽  
Treatment And Prevention ◽  
One Year ◽  
The One

Chronic heart failure (CHF) is an important problem for the country, which has both medical and socio-economic aspects. The presence of the syndrome not only significantly increases the risks of an unfavorable course of diseases underlying its etiological basis, but in itself, through the development of decompensation, causes a high frequency of deaths. Despite all the advances in pharmacotherapy, the prognosis of heart failure remains poor. More than 40% of patients die within 4 years after the diagnosis of heart failure, and the one-year mortality rate for patients with severe CHF (NYHA class IV) exceeds 50%. The foregoing determines the need and importance of using all possible drug and non-drug therapy technologies aimed at reducing mortality, increasing the duration and quality of life of patients with CHF, as well as reducing the number and likelihood of decompensation and related hospitalizations, and makes this direction one of the priorities in medicine. The article describes current approaches to the treatment of patients with CHF syndrome from the perspective of evidence-based medicine and taking into account the recommendations of leading international organizations for the treatment and prevention of cardiovascular diseases. The drugs used were analyzed in terms of their influence on clinical symptoms, quality of life of patients, the risk of hospitalization due to decompensation of CHF, and mortality rates. The emphasis is made on the possibilities, mechanism of action and further prospects for the use of a new class of drugs in the treatment of CHF, acting at the level of the renin-angiotensin-aldosterone system and the system of neutral endopeptidases - inhibitors of angiotensin-neprilisin receptors.

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals Prognostic value of biomarkers and co-morbidities in patients with acute heart failure: One-year follow-up study

2017 ◽  
Vol 145 (3-4) ◽  
pp. 118-123
Author(s):  
Dejan Petrovic ◽  
Marina Deljanin-Ilic ◽  
Sanja Stojanovic
Keyword(s):  
Heart Failure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Acute Heart Failure ◽  
Troponin I ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
High Sensitivity ◽  
Clinical Group ◽  
One Year

Introduction/Objective. Clinical risk stratification of patients hospitalized due to acute heart failure (AHF) applying B-type natriuretic peptide (BNP), troponin I (TnI), and high-sensitivity C-reactive protein (hsCRP) biochemical markers can contribute to early diagnosis of AHF and lower mortality rates. The aim of this study was to investigate the prognostic significance of biomarkers (BNP, TnI, and hsCRP) and co-morbidities concerning one-year mortality in patients with AHF. Methods. Clinical group comprised 124 consecutive unselected patients, age 60?80 years, treated at the Coronary Care Unit of the Niska Banja Institute, Nis. The patients were monitored for one year after the discharge. During the first 24 hours after admission, BNP, TnI, and hsCRP were measured in fasting serum. Results. Total one-year mortality was 29.8%. The levels of serum BNP were significantly higher in the group of non-survivors compared to the group of survivors (1353.8 ?} 507.8 vs. 718.4 ?} 387.6 pg/mL, p < 0.001). We identified several clinical and biochemical prognostic risk factors by univariate and multivariate analysis. Independent predictors of one-year mortality were the following: BNP, TnI, depression, hypotension, chronic renal failure, ejection fraction, and right-ventricle systolic pressure. Conclusion. The presence of BNP and TnI biomarkers and several co-morbidities such as depression or chronic renal failure have significant influence on one-year mortality in patients with AHF.

Abstract 4510: Pulmonary Hypertension before Transcatheter Aortic Valve Implantation Is Reversible and Lacks Prognostic Significance

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Abdullah M Al Ali ◽  
Brad Munt ◽  
Lukas Altwegg ◽  
Karin Humphries ◽  
Ronald Carere ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Prognostic Significance ◽  
Left Ventricular ◽  
Group Iii ◽  
Transcatheter Aortic Valve ◽  
Group I ◽  
Group Ii ◽  
One Year ◽  
Valve Implantation

The prognostic significance of pulmonary hypertension (PH) and the potential for reversibility in the setting of aortic stenosis (AS) have been debated. We examined the clinical correlates and prognostic significance of PH in high risk elderly patients with symptomatic severe AS undergoing transcatheter aortic valve implantation (AVI). AVI was performed in 143 patients. Adequate echocardiographic estimation of baseline pulmonary artery systolic pressure was available in 115 (80%). Patients were divided into 3 groups according to baseline pulmonary artery pressure estimated by transthoracic echocardiogram: I: <30 mmHg, II: 30 –50 mmHg and III: >50 mmHg. Clinical and echocardiographic follow-up was obtained at 1, 6 and 12 months after AVI. Group I consisted of 17 patients (15%), group II 58 patients (50%) and group III 40 patients (35%). At baseline the three groups were similar in terms of age, functional status, presence of severe pulmonary disease, aortic valve area and mean gradient. Patients with severe PH (group III) were more likely to have left ventricular dysfunction (LVEF <50%) than patients with mild to moderate PH (groups I and II) (52% vs. 21%, p=0.002) and had more severe mitral regurgitation (grade ≥ 3 in 68% vs. 41%, p =0.0002). At one month, systolic pulmonary artery pressure fell significantly in group III (11.0 ± 14.3 mmHg, p=0.0008) and this reduction was maintained at 6 months. However, the changes in group I (increase of 7.1 ± 8.7 mmHg, p=0.07) and group II (decrease of 0.9 ± 9.3 mmHg, p=0.53) were not significant. Mortality at one year following AVI was 21%, but was not related to severity of PH. Using group III as a reference, hazard ratios were 0.83 (95% CI: 0.24 –2.9) for group I and 0.88 (95% CI: 0.4 –1.9) for group II. In elderly patients with severe AS treated with transcatheter AVI, severe PH is associated with more depressed left ventricular function and more severe mitral regurgitation. Severe PH is associated with a significant and greater fall in pulmonary pressure following AVI and does not influence one year survival.

Abstract 17352: Differences in Clinical Characteristics, Risk Factors, Rate of Recurrence and 1-year Outcome Between Acute Heart Failure Patients With Stroke or TIA and Those Without This Co-morbidity. Results From the Gulf aCute heArt failuRe rEgistry (gulf Care)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mohammed A Al Hashemi ◽  
Kadhim Sulaiman ◽  
Jassim Al-Suwaidi ◽  
Khalid F AlHabib ◽  
Husam AlFaleh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Characteristics ◽  
De Novo ◽  
Stroke Patients ◽  
Lv Dysfunction ◽  
Co Morbidity ◽  
History Of ◽  
One Year ◽  
Ischemic Attack

Background: Chronic heart failure (CHF) is a known risk for stroke and morbidities and mortalities are known to be higher in CHF patients compared to stroke patients without CHF we here study the prevalence and the clinical significance in a group of patient with stroke or transient ischemic attack (TIA) who were admitted to hospital with acute heart failure (AHF) compared to those without stroke and are admitted with acute heart failure Methods: Data were derived from a prospective, multicenter, multinational study of 5005 patients hospitalized with AHF from February 2013 to November 2012. Data were analyzed according to the presence or absence of Stroke or bronchial TIA. Demographic, management, in-hospital and 1-year outcomes were compared Results: Stroke patients were likely to have a decompensation of chronic failure rather than De-Novo AHF when compared to those without Stroke/TIA (see table). Stroke patients were older; more likely to be female, have history of DM, HTN, dyslipidemia and CKD. Stroke patients were likely to have Atrial fibrillation, PVD, systolic LV dysfunction as well as CAD when compared to those without Stroke, they were also more likely receive NIV, IV inotropes and likely to have had cardiac PCI prior to this admission with AHF. Stroke patients had higher recurrence of stroke and one-year mortality rates. Conclusion: Patients who presented with AHF and history of stroke/TIA were having different clinical characteristics as well as comorbidities as compared to those without Stroke, with worse in-hospital and one-year outcome. The current study underlies the need to aggressively manage these high-risk patients.

NORMALAND ABNORMAL LIQUOR VOLUME AND ITS CORRELATION WITH PERINATAL OUTCOME

2021 ◽  
pp. 4-6
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Intensive Care ◽  
Fetal Distress ◽  
Special Unit ◽  
Group I ◽  
Group Ii ◽  
The Difference ◽  
One Year ◽  
Four Quadrant

Aim:To assess and compare the perinatal outcome among mothers with normal and abnormal amniotic uid volume. Method: A prospective comparative study was conducted for a period of one year from January 2020 to December 2020. Group I consist of 50 patients with normal amniotic uid and group II consists of 50 patients with either oligohydramnios or polyhydramnios. Amniotic uid index (AFI) was calculated using Phalen's four quadrant technique using ultrasound. The perinatal outcome was judged by assessing the fetal distress predicted by abnormal fetal heart rate (FHR) or meconium stained liquor, one minute and 5 minute Apgar score, frequency of admission to neonatal intensive care unit (NICU), baby weight of less than 10th percentile for gestation age and perinatal mortality. Results: Induction of labour, caesarean section and meconium stained liquor was found to be most common among the patients in group II (abnormal AFI) in comparison with normal AFI subjects and similarly the perinatal outcome measures like low birth weight, increased frequency of admission to NICU due to respiratory distress and a low APGAR score was more commonly found in abnormal AFI group and the difference was found to be statistically signicant. Conclusion: AFI measurement in antepartum or intrapartum period can help to identify women who need increased antepartum surveillance for pregnancy complications and such women should be managed in a special unit to combat the complications effectively.

Non-pharmacological therapy of acute heart failure: when drugs alone are not enough

2021 ◽  
pp. 651-663
Author(s):  
Jeroen Dauw ◽  
Wilfried Mullens ◽  
Johan Vijgen ◽  
Pascal Vranckx
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Signs And Symptoms ◽  
Coronary Intervention ◽  
Pharmacological Therapy ◽  
Circulatory Support ◽  
Pharmacologic Therapy ◽  
Pharmacological Agents ◽  
Acute Heart Failure Syndrome ◽  
Percutaneous Coronary

Acute heart failure syndrome has been defined as new-onset or a recurrence of worsening signs and symptoms of heart failure, necessitating urgent or emergency management. The management of acute heart failure syndrome is challenging, given the heterogeneity of the patient population, in terms of the clinical presentation, pathophysiology, prognosis, and therapeutic options. The management of acute heart failure syndrome is a dynamic process, requiring ongoing simultaneous diagnosis (monitoring) and treatment. Pharmacological agents remain the mainstay of therapy for acute heart failure syndrome. However, at all time, during the early diagnostic, etiologic, and therapeutic work-up, non-pharmacologic therapy may be indicated and should be considered. The management of the complex cardiac patient with acute heart failure syndrome and/or (potential) haemodynamic compromise has become a special dimension for specialized myocardial intervention centres, providing 24 hours per day and 7 days per week state-of-the-art facilities for (primary) percutaneous coronary intervention and cardiac intensive care, including mechanical ventilation, ultrafiltration, with or without dialysis, and short-term percutaneous mechanical circulatory support. Through the understanding of the underlying pathophysiology and approaches into the problems of acute heart failure syndrome, one should be better prepared to understand and treat its many facets.

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