scholarly journals Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

2014 ◽  
Vol 60 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Fernanda Carneiro Mussi ◽  
Andreia Santos Mendes ◽  
Tassia Lacerda de Queiroz ◽  
Ana Lúcia Siqueira Costa ◽  
Álvaro Pereira ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Robust Regression ◽  
Statistical Significance ◽  
Geometric Mean ◽  
University Hospital ◽  
Fisher Exact Test ◽  
Time Of Arrival ◽  
Exploratory Research ◽  
Exact Test

Objective To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times. Methods This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%. Results The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest. Conclusion The findings demonstrate the importance of health education aiming at the benefits of early treatment.

scholarly journals Association of comorbidities in atrial fibrillation in acute myocardial infarction

2017 ◽  
Vol 4 (1) ◽  
pp. 143
Author(s):  
Irfan Ahamed H.B. ◽  
Bilal Bin Abdullah ◽  
Mohammed Ismail ◽  
Syed Aman Jagirdar
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Structural Heart Disease ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Time Of Presentation

Background: Atrial fibrillation is a most common arrhythmia in patients with and without structural heart disease with an increasing incidence mainly due to the aging population. As the population ages, one can expect that AF will remain a frequent and troublesome complication of AMI with comorbidities. Therefore, the present study was undertaken to investigate the association of co-morbidities in atrial fibrillation in acute myocardial infarction.Methods: The study was performed after the institutional ethical clearance and consent from all the patients. Heart rate, atrial fibrillation, blood pressure, ventricular fibrillation and stroke after acute myocardial infarction were recorded. The blood sugar and serum lipid levels were also measured using commercially available kit as per the manufacturer’s guidelines. The data was analyzed for statistical significance using univariate analysis and comparison was performed by Fisher Exact test and by using SPSS Version 20.Results: In our study, all the patients who developed AF after AMI were more than 60 years of age. Higher heart rate was more than or equal to 100 in 62.5% of the patients. 25% of patients had diabetes mellitus 75% of 8 patients had atrial fibrillation after acute myocardial infarction, 77% of patients without atrial fibrillation were known hypertensive’s. Out of the patients who had atrial fibrillation, 50% had hyperlipidemia and developed ventricular fibrillation.Conclusions: Higher heart rate (>100 bpm) at time of presentation is a risk factor for AF following to AMI. Patients with new onset AF after AMI had more complication during hospital stay. 

scholarly journals Individuals with familial hypercholesterolemia have increased risk of re-hospitalization after acute myocardial infarction compared with controls

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Svendsen ◽  
H.W Krogh ◽  
J Igland ◽  
G.S Tell ◽  
L.J Mundal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Familial Hypercholesterolemia ◽  
Cox Regression ◽  
Public Institution ◽  
University Hospital ◽  
Funding Source ◽  
Hazard Ratios ◽  
Increased Risk ◽  
University Of Oslo

Abstract Background and aim We have previously reported that individuals with familial hypercholesterolemia (FH) have a two-fold increased risk of acute myocardial infarction (AMI) compared with the general population. The consequences of having an AMI on re-hospitalization and mortality are however less known. The aim of the present study was to compare the risk of re-hospitalization with AMI and CHD and risk of mortality after incident (first) AMI-hospitalization between persons with and without FH (controls). Methods The original study population comprised 5691 persons diagnosed with FH during 1992–2014 and 119511 age and sex matched controls randomly selected from the general Norwegian population. We identified 221 individuals with FH and 1947 controls with an incident AMI registered in the Norwegian Patient Registry (NPR) or the Cardiovascular Disease in Norway Project during 2001–2017. Persons with incident AMI were followed until December 31st 2017 for re-hospitalization with AMI or coronary heart disease (CHD) registered in the NPR, and for mortality through linkage to the Norwegian Cause of Death Registry. Risk of re-hospitalization was compared with sub-hazard ratios (SHR) from competing risk regression with death as competing event, and mortality was compared using hazard ratios (HR) from Cox regression. All models were adjusted for age. Results Risk of re-hospitalization was 2-fold increased both for AMI [SHR=2.53 (95% CI: 1.88–3.41)] and CHD [SHR=1.82 (95% CI: 1.44–2.28)]. However, persons with FH did not have increased 28-day mortality following an incident AMI (HR=1.05 (95% CI: 0.62–1.78), but the longer-term (>28 days) mortality after first AMI was increased in FH [HR=1.45 (95% CI: 1.07–1.95]. Conclusion This study yields the important finding that persons with FH have increased risk of re-hospitalization of both AMI and CHD after incident AMI. These findings call for more intensive follow-up of individuals with FH after an AMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): University of Oslo and Oslo University Hospital

scholarly journals Gender-Related Differences of Cardiac Troponin-I Levels in Patients with Acute Myocardial Infarction at Time of Acute Chest Pain

2021 ◽  
pp. 199-205
Author(s):  
Mahir Abdulkadhum Khudhair Alzughaibi ◽  
Ammar Waheeb Obeiad ◽  
Nassar Abdalaema Abdalhadi Mera ◽  
Mohammed Sadeq Hamzah Al-Ruwaiee
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Troponin I ◽  
Statistical Significance ◽  
Acute Chest Pain ◽  
Blood Analysis ◽  
P Value ◽  
Cross Sectional ◽  
Time Of Admission

Background: Cardiac Troponins-I (CTNI) are myoregulatory polypeptides that control the actin-myosin interface, considered specific to cardiomyocytes. Age and sex variances in the extent of CTNI levels have arisen a recent debatable emphasis. Existing revisions do not display a reliable clinical power of sex-specific CTNI 99th centiles, which actually might mirror procedural aspects. Nevertheless, from a biochemical viewpoint, the trends of sex-specific CTNI 99th centiles seem sensible for the ruling-in of acute myocardial infarction AMI. Vulnerable females may be missed when applying the male sex-specific threshold. This study aimed to determine whether gender differences in CTNI exist in patients with AMI presented with chest pain. Methodology: The study was a cross-sectional, single-center, included 236-patients with AMI diagnosis by cardiologists at Merjan teaching hospital during the period from April to July 2020 from patients attending the hospital for cardiac consultation complaining of acute chest pain suggestive of AMI. Blood analysis had initiated at the time of admission included serum creatinine, blood urea, R/FBS, WBCs, PCV, and serum CTNI. A p-value below 0.05 specifies statistical significance. All statistical bioanalyses had performed by IBM-SPSS, version-25 for Windows. Results: The mean age of participants was 67.5 years, the men were dominant 76.2%. The incidence of DM and hypertension were significantly high and 24.5% of the patients were current smokers. Biochemical serum analysis revealed mean creatinine, urea, sugar, and STI values were 79.8±4.2 mmol/l, 15.9±1.7 mmol/l, 10.9±0.9 mmol/l, and 7.9±0.6 ng/ml separately. Both hypertension and smoking were significantly (p-0.001) more among males compared to the females, which is not the case for the prevalence of DM. The males were heavier significantly than females (p-0.001). Almost, there was no impact of gender on most of the other study variables other than serum TNI levels, which were significantly higher among the males (p-0.001). Conclusion: In patients with AMI presented with acute chest pain, the routine of CTNI in the diagnosis of AMI is based on the patient's gender. The application of gender-dependent cutoff levels for CTNI analyses appears to be highly suggested.

Delays in Presentation by Patients with ST Elevation Myocardial Infarction

2021 ◽  
Author(s):  
Suhaib Almashari ◽  
Yasir Al-Malki ◽  
Adil Al-Riyami ◽  
Sunil K Nadar
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Public Education ◽  
Primary Angioplasty ◽  
St Elevation Myocardial Infarction ◽  
University Hospital ◽  
Sultan Qaboos University ◽  
Early Evaluation ◽  
St Elevation ◽  
Patient Factor

Objectives: To assess causes of delay for presentation with ST elevation myocardial infarction (STEMI) at our institution. Methods: We included patients with a STEMI that were taken up for primary angioplasty, who had presented from Jan 2017 to December 2019 to the emergency department at Sultan Qaboos university hospital, Muscat. Results: 101 patients (Mean age 54.8+10.8 years; 80 (79.2%) male) were included. The median (IQR) pain to door time was 60 (30-120) minutes.  66 (66%) patients arrived within 90 minutes. All except one arrived by privately arranged transport. Feeling that the pain was not important (60%) or not cardiac (22%) were the main reasons for delay. Being diabetic was the only patient factor that predicted delay. Conclusion: A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. However more public education is required to improve awareness about the importance of early evaluation of chest pain. Keywords: Acute myocardial infarction; prehospital delay

Association between 10 Microsatellite Markers and Nonsyndromic Cleft Lip Palate in the Chilean Population

2004 ◽  
Vol 41 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Rafael Blanco ◽  
José Suazo ◽  
JoséLuis Santos ◽  
Mónica Paredes ◽  
Hsiao Sung ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Statistical Significance ◽  
Positive Family History ◽  
Case Control ◽  
University Hospital ◽  
Control Group ◽  
Exact Test ◽  
Rehabilitation Centers ◽  
Cleft Lip Palate ◽  
Chilean Population

Objective The objective of this case-control study was to evaluate the possible association between nonsyndromic cleft lip/palate (NSCLP) and 10 genetic markers in four chromosomal regions in the admixed Spanish-Amerindian Chilean population. Setting Study participants included 56 patients with NSCLP identified and interviewed for positive family history during the course of clinical examinations at different rehabilitation centers in the cities of Santiago and Talca, Chile. A control group of 59 normal individuals without known familial antecedents of clefting was obtained from blood bank donors of the University Hospital, University of Chile. Cases and controls belonged to low- to low-middle socioeconomic strata. Results Ten markers from chromosome 4p, 4q, 6p, 17q, and 19q were assessed (MSX1, D4S175, D4S192, F13A1, EDN1, D6S89, D6S105, D6S109, D17S579, BCL3). Four of them showed significant deviations from Hardy-Weinberg expectations in controls, according to the exact test (D4S192, BCL3, F13A1, and D6S89). The case-control comparison by means of the CLUMP program showed significant differences only in BCL3, and D6S109 almost reached statistical significance. Conclusions Most of the genetic regions with positive results in Caucasian populations may not be involved in NSCLP in Chile, regardless of the positive evidence for the candidate region on chromosome 19. Similar findings have been reported recently in the Chinese population.

scholarly journals Outcome of Patients Having Acute Myocardial Infarction with and without Streptokinase

2019 ◽  
Vol 31 (2) ◽  
pp. 68-71
Author(s):  
Faruque Uddin ◽  
AK Fazlul Hoque
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Time Of Arrival ◽  
College Hospital ◽  
Medical College ◽  
North East ◽  
Acute Mi ◽  
Medicine Today ◽  
Mean Time

Introduction: Acute myocardial infarction is the leading cause of death. Streptokinase is the most commonly used thrombolytic agent. This study was conducted to compare in-hospital outcome of patients with acute myocardial infarction receiving streptokinase with those not receiving it. Materials & Methods: This descriptive observational study was conducted at Coronary Care Unit, North East Medical College Hospital from 1st July August 2016 to 30th June 2018. 340 patients having acute MI were in- cluded in the study. Two groups were formed: sk group receiving streptokinase and non-sk group not receiving. In-hospital mortality was the primary end point while mechanical and electrical complications were the secondary end points. Results: Among 340 patients, 255(75%) were males and 85(25%) females. Out of those 218 received strep-tokinase, while 122 did not. Mean age of sk group was 53.15±10.30 years and non-sk group 60.5±16 ears. Mean time of arrival to the hospital after symptom onset was 10.41±9.97 hours. SK group patients reached in 5.9±4.76 hours while non-sk group in 19.4±10.5 hours. In-hospital mortality in sk and non-sk group was 19(8.7%) and 25(20.5%) respectively, p=0.002. Complication rate was significantly higher in the non-sk group, 54.09% vs 34.86%, p=0.04. Conclusion: Patients of acute myocardial infarction receiving streptokinase have significantly lesser in-hospital mortality and complications as compared to patients not receiving it. Medicine Today 2019 Vol.31(2): 68-71

scholarly journals Comparison of the Level of Awareness about the Transmission of Echinococcosis and Toxocariasis between Pet Owners and Non-Pet Owners in Greece

2020 ◽  
Vol 17 (15) ◽  
pp. 5292 ◽  
Author(s):  
Christina Kantarakia ◽  
Maria E. Tsoumani ◽  
Antonis Galanos ◽  
Alexander G. Mathioudakis ◽  
Eleni Giannoulaki ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Linear Regression Analysis ◽  
Signs And Symptoms ◽  
Knowledge Score ◽  
Fisher Exact Test ◽  
Pet Ownership ◽  
Cross Sectional ◽  
Exact Test ◽  
Pet Owners ◽  
Chi Squared

Ζoonotic parasitic diseases that can occur through animal contact pose risks to pets, their owners and to their bond. This study aims to assess the level of knowledge about zoonoses, specifically echinococcosis and toxocariasis, among cat/dog owners and non-pet owners in Greece. Multiple-choice questionnaires were designed to obtain data regarding the knowledge of pet and non-pet owners on echinococcosis and toxocariasis, including signs and symptoms of these zoonoses, ways of transmission and precautions that need to be taken into account in order to avoid it. A total of 185 questionnaires were retrieved and data was expressed as absolute (Ν) and relative frequencies (%). Associations between pet ownership, residence and outcome variables were evaluated using the Fisher exact test and Chi-squared test, respectively. Multifactorial linear regression analysis was used to investigate the cross-sectional association between demographic characteristics and the awareness of helminthic zoonoses. All tests were two-sided and statistical significance was set at p < 0.05. Our study revealed a disturbing lack of awareness of echinococcosis and toxocariasis (mean zoonotic knowledge score 8.11 ± 3.18) independently of pet ownership. Surprisingly, in some cases the ignorance of pet owners exceeded that of non-pet owners. Given the progressive impact of toxocariasis in public health and the high prevalence of echinococcosis in the Mediterranean region, measures should be taken to inform people about zoonoses and eliminate their putative transmission.

OP106 The Xpert™ Clostridium difficile Kit Incorporation: Conducting a Local Clinical Study as Part of Hospital Health Technology Assessment

2019 ◽  
Vol 35 (S1) ◽  
pp. 26-26
Author(s):  
Eliane Würdig Roesch ◽  
Victorya Raabe ◽  
Alexandre da Silva ◽  
Maria Angélica Pires Ferreira
Keyword(s):  
Clostridium Difficile ◽  
Teaching Hospital ◽  
Statistical Significance ◽  
Health Technology ◽  
Nucleic Acid Amplification ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Group I ◽  
Tertiary Teaching ◽  
Enzymatic Test

IntroductionThe Xpert™ Clostridium difficile kit is a nucleic acid amplification test indicated after discrepant results from an enzymatic test; was submitted for incorporation in a teaching hospital in Brazil. In order to evaluate the potential for improvement with Xpert™ incorporation, the performance of the available technology (enzymatic test) was assessed using a real word evidence approach. Additionally, the association between enzymatic test results and the agreement to the Infectious Diseases Society of America (IDSA) recommendations for stool test submission (≥ 3 unformed stools in 24 hours without laxatives) for Clostridium difficile were evaluated.MethodsThis is a retrospective cohort study conducted at a tertiary teaching hospital. We included all consecutive tested patients that were submitted for enzyme immunoassay – glutamate dehydrogenase (GDH) plus toxin detection from 15 March to 8 May 2018. Data referent to episodes of unformed stools in 24 hours and use of laxatives were recorded. Statistical significance was tested by Fisher Exact test (α = 0.05).ResultsOne hundred and thirty-eight consecutive patients were tested: 4 (2.9 percent) were positive for GDH and toxin (group III); 114 (82.6 percent) were negative for both (group I). Twenty (14.5 percent) cases were discrepant, all being positive to GDH and negative for toxin (group II). There were not negative GDH and positive toxin cases. The IDSA guidelines were followed in 33 (28.9%), 3 (15%) and 3(75%) test orders in groups I, II and III, respectively (p = 0.03).ConclusionsOnly a minority of patients had discrepant results in enzymatic tests and would be candidates for the Xpert™ test. The low adherence to IDSA guidelines could explain the low positivity rate of enzymatic tests at the hospital. Considering the uncertainty about the potential of the new test for changing infection control practices, Xpert™ was not recommended for incorporation. Using real world evidence data is important for contextualized health technology studies in hospitals.

INADVERTANT PENETRATION OF BLOOD VESSELS DURING INFERIOR ALVEOLAR NERVE BLOCK TECHNIQUES

2013 ◽  
Vol 5 (2) ◽  
pp. 21-25
Author(s):  
Manjunath. Shankariah ◽  
Malapati Sudhakar Rao ◽  
Kalappa T Muthanna
Keyword(s):  
Nerve Block ◽  
Statistical Significance ◽  
Inferior Alveolar Nerve ◽  
The Other ◽  
Fisher Exact Test ◽  
Inferior Alveolar Nerve Block ◽  
Systemic Complications ◽  
Exact Test ◽  
Group I ◽  
Significant Difference

ABSTRACT Background The blood aspiration technique before the injection of local anesthetic solution is an essential procedure, because it prevents possible systemic’ complications. The purpose of this study is to evaluate the incidence of intravascular injection in different techniques of inferior alveolar nerve block and to know the technique which has very low incidence of vascular penetration. Methods Fifty patients in the ages of 17-70 years irrespective of sex, who were indicated for bilateral extractions of mandibular teeth were selected for this study. Patients were randomly divided into two divisions consisting of 25 patients requiring bilateral extraction procedures. In first division classical technique of inferior alveolar nerve block was administered on one side and on 2nd appointment Angelo Sargenti technique was administered on the other side. In the second division of 25 patients, indirect technique was administered on one side in 1st appointment and Clark and Holmes technique was administered on the other side in next appointment. Incidence of positive aspiration due to inadvertent penetration of inferior alveolar vessels was recorded. Results In group I positive aspiration rate was 8%, group II it was 4%, group III it was 4% and group IV it was 8%. Chi-square and fisher exact test was used and statistically there was no significant difference in the incidence of positive aspiration in all four groups. We found an overall aspiration rate of 6% in all four groups. Conclusion The incidence of positive aspiration was evaluated in all the 4 groups. There was no statistical significance in the rate of positive aspiration in all the groups included in our study.

scholarly journals Does the Intake of Selective Serotonin Reuptake Inhibitors Negatively Affect Dental Implant Osseointegration? A Retrospective Study

2018 ◽  
Vol 44 (4) ◽  
pp. 260-265 ◽  
Author(s):  
Mehmet Ali Altay ◽  
Alper Sindel ◽  
Öznur Özalp ◽  
Nelli Yildirimyan ◽  
Dinçer Kader ◽  
...  
Keyword(s):  
Dental Implants ◽  
Failure Rate ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Statistical Significance ◽  
Serotonin Reuptake Inhibitors ◽  
Implant Failure ◽  
Selective Serotonin ◽  
Fisher Exact Test ◽  
Exact Test

The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors (SSRIs) have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in patients rehabilitated with dental implants. A retrospective cohort study was conducted, including a total of 2055 osseointegrated dental implants in 631 patients (109 implants in 36 SSRI \users and 1946 in 595 nonusers). Predictor and outcome variables were SSRI intake and osseointegration failure, respectively. The data were analyzed with Mann–Whitney test or Fisher exact test accordingly. Both patient-level and implant-level models were implemented to evaluate the effect of SSRI exposure on the success of osseointegration of dental implants. Median duration of follow-up was 21.5 months (range = 4–56 months) for SSRI users and 23 months (range –60 months) for nonusers (P = .158). Two of 36 SSRI users had 1 failed implant each; thus, the failure rate was 5.6%. Eleven nonusers also had 1 failed implant each; thus, the failure rate was 1.85%. The difference between the 2 groups failed to reach statistical significance at patient and implant levels (P = .166, P = .149, respectively). The odds of implant failure were 3.123 times greater for SSRI users compared with nonusers. Patients using SSRIs were found to be 3.005 times more likely to experience early implant failure than nonusers. The results of this study suggest that SSRIs may lead to increase in the rate of osseointegration failure, although not reaching statistical significance.

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