scholarly journals Value of Delta Fractional Flow Reserve (ΔFFR) For Predicting Coronary Ischemic Lesions

2020 ◽  
Vol 9 ◽  
pp. 1528
Author(s):  
Vahid Eslami ◽  
Morteza Safi ◽  
Mohammad hasan Namazi ◽  
Mehdi Pishgahi ◽  
Amir Eftekharzade ◽  
...  
Keyword(s):  
Fractional Flow Reserve ◽  
Characteristic Curve ◽  
Coronary Vessels ◽  
Cross Sectional Study ◽  
Fractional Flow ◽  
Cross Sectional ◽  
Ischemic Lesion ◽  
Flow Reserve ◽  
The Mean ◽  
The Difference

Background: The decrease in fractional flow reserve (FFR) after adenosine administration from baseline FFR value (termed as ΔFFR) may reflect the compensatory capacity of the microvascular circulation and thus may predict significant coronary stenotic lesions. We aimed to investigate whether baseline FFR and ΔFFR can help identify the coronary ischemic lesion and its severity. Materials and Methods: This cross-sectional study was performed on 154 consecutive patients (Mean age 62.42 ± 9.36 years) that underwent coronary angiography and with definitive intermediate coronary lesions at any of the coronary vessels. FFR was calculated by dividing the mean distal intracoronary pressure by the mean arterial pressure. ΔFFR was also defined as the difference between baseline FFR and hyperemic FFR (considering FFR<0.75 as the criteria for ischemia). Results: The area under receiver-operating characteristic curve for baseline FFR was found as 0.933, and for ΔFFR was 0.946 indicated high values of both indices for predicting ischemic lesions. The best cut-off point for baseline FFR and ΔFFR for discriminating ischemic lesions from the normal condition was 89.5 (yielding a sensitivity of 92.2% and a specificity of 68.0%) and 9.5 (yielding a sensitivity of 96.0% and a specificity of 85.3%), respectively. Conclusion: Our study could successfully demonstrate the high value of both baseline FFR and ΔFFR for predicting coronary ischemic lesions with the cut-off values of <89.5 and >9.5, respectively. [GMJ.2020;9:e1528]

scholarly journals Cross-sectional study to compare the biochemical parameters in low normal versus high normal plasma glucose levels in euglycemic individuals

2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma
Keyword(s):  
Uric Acid ◽  
Total Cholesterol ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Normal Group ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.

scholarly journals Prognostic value of per-vessel treatment adherence in stable coronary artery disease based on novel computational pressure-flow dynamics derived fractional flow reserve

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C K L Leung ◽  
L Y Lam ◽  
K Y Li ◽  
A S Y Yu ◽  
M Z Wu ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Fractional Flow Reserve ◽  
Coronary Vessels ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Adherence Group ◽  
Group 1

Abstract Background Computational pressure-flow dynamics derived fractional flow reserve (caFFR) is a novel index developed to evaluate the extent of myocardial ischemia in patients with coronary artery disease (CAD), which eliminates the need of invasive pressure guidewire and hyperaemic stimulus in conventional fractional flow reserve (FFR) measurement. Studies have shown improved clinical outcomes associated with adherence to functional myocardial ischemia assessment when deciding to perform percutaneous coronary intervention (PCI) at a per-patient level. However, the clinical significance of such treatment adherence at a per-vessel level remains uncertain. Methods A total of 928 patients (mean age 66.2±10.5, male 72.7%) with stable CAD were included in this study. The caFFR of all three major coronary vessels were obtained for every patient, and the FFR threshold of 0.8 was adopted as the threshold for caFFR to indicate functionally significant artery stenosis which warrants PCI, and vice versa. Based on the caFFR of each major coronary vessel and whether PCI was performed to the respective vessel, patients were stratified into 0–1 vessel with treatment adherence group (group 1) (n=105), 2 vessels with treatment adherence group (group 2) (n=338), and 3 vessels with treatment adherence group (group 3) (n=485). The primary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause mortality, non-fatal myocardial infarction and any subsequent revascularization. Results The severity of CAD based on SYNTAX score assessment was 18.6±10.2 in group 1, 14.6±8.9 in group 2, and 11.5±9.9 in group 3 (P&lt;0.001). The rates of MACE at 3 years were significantly different across groups 1, 2 and 3 (17.1% vs. 12.1% vs. 7.4%; P=0.004). With reference to group 3, the risk of MACE at 3 years was increased in group 2 (adjusted hazard ratio [HR]=1.597; 95% confidence interval [CI]=1.020–2.501; P=0.041), and further increased in group 1 (adjusted HR=1.933; 95% CI=1.081–3.457; P=0.026). Conclusion In stable CAD patients, the risk of MACE is incremental when fewer major coronary vessels are treated with adherence to caFFR threshold of 0.8. Per-vessel treatment adherence significantly affects clinical outcomes in terms of MACE. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Association of 12-Month Contraceptive Supply Policy and Months of Oral Contraception Prescribed by Obstetrics and Gynecology Physicians: An Exploratory Cross-Sectional Study

2021 ◽  
Author(s):  
Megan Fuerst ◽  
Kaitlin Schrote ◽  
Bharti Garg ◽  
Maria Rodriguez
Keyword(s):  
The United States ◽  
Cross Sectional Study ◽  
Oral Contraception ◽  
Physician Education ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Supply Policy ◽  
The Mean ◽  
The Difference ◽  
United States Standard

Abstract Objective This study sought to determine if there was a difference in the months of oral contraception prescribed by physicians living in U.S. states with a 12-month supply policy compared to physicians in states without a policy. Methods We conducted an exploratory descriptive study using a convenience sample of Obstetrics & Gynecology resident physicians (n=275) in the United States. Standard bivariate analyses were used to compare the difference between groups. Results Few physicians in both groups (3.8% with a policy and 1.4% without a policy) routinely prescribed a 12-month supply of contraception. The mean coverage prescribed by providers in states with and without a policy was 2.81 and 2.07 months (p<0.05). Conclusions The majority of physicians were unaware of 12-month contraceptive supply policies and unable to correctly write a prescription for 12-months of contraception, regardless of whether they lived in a state with a 12-month contraceptive supply policy. Physician education may be needed to effectively implement 12-month contraceptive supply policies.

scholarly journals Accuracy of computational pressure-fluid dynamics applied to coronary angiography to derive fractional flow reserve: FLASH FFR

2019 ◽  
Vol 116 (7) ◽  
pp. 1349-1356 ◽  
Author(s):  
Jianping Li ◽  
Yanjun Gong ◽  
Weimin Wang ◽  
Qing Yang ◽  
Bin Liu ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Fractional Flow Reserve ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Characteristic Curve ◽  
Fractional Flow ◽  
Performance Goal ◽  
Flow Reserve

Abstract Aims Conventional fractional flow reserve (FFR) is measured invasively using a coronary guidewire equipped with a pressure sensor. A non-invasive derived FFR would eliminate risk of coronary injury, minimize technical limitations, and potentially increase adoption. We aimed to evaluate the diagnostic performance of a computational pressure-flow dynamics derived FFR (caFFR), applied to coronary angiography, compared to invasive FFR. Methods and results The FLASH FFR study was a prospective, multicentre, single-arm study conducted at six centres in China. Eligible patients had native coronary artery target lesions with visually estimated diameter stenosis of 30–90% and diagnosis of stable or unstable angina pectoris. Using computational pressure-fluid dynamics, in conjunction with thrombolysis in myocardial infarction (TIMI) frame count, applied to coronary angiography, caFFR was measured online in real-time and compared blind to conventional invasive FFR by an independent core laboratory. The primary endpoint was the agreement between caFFR and FFR, with a pre-specified performance goal of 84%. Between June and December 2018, matched caFFR and FFR measurements were performed in 328 coronary arteries. Total operational time for caFFR was 4.54 ± 1.48 min. caFFR was highly correlated to FFR (R = 0.89, P = 0.76) with a mean bias of −0.002 ± 0.049 (95% limits of agreement −0.098 to 0.093). The diagnostic performance of caFFR vs. FFR was diagnostic accuracy 95.7%, sensitivity 90.4%, specificity 98.6%, positive predictive value 97.2%, negative predictive value 95.0%, and area under the receiver operating characteristic curve of 0.979. Conclusions Using wire-based FFR as the reference, caFFR has high accuracy, sensitivity, and specificity. caFFR could eliminate the need of a pressure wire, technical error and potentially increase adoption of physiological assessment of coronary artery stenosis severity. Clinical Trial Registration URL: http://www.chictr.org.cn Unique Identifier: ChiCTR1800019522.

The Correlation Between Arterial Lactate and Venous Lactate in Patients With Sepsis and Septic Shock

2016 ◽  
Vol 33 (2) ◽  
pp. 116-120 ◽  
Author(s):  
Pongdhep Theerawit ◽  
Chalermpon Na Petvicharn ◽  
Viratch Tangsujaritvijit ◽  
Yuda Sutherasan
Keyword(s):  
Characteristic Curve ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
Arterial Lactate ◽  
Paired Samples ◽  
The Mean ◽  
Sepsis And Septic Shock ◽  
The Relationship

Background: Applying peripheral venous lactate instead of arterial lactate in clinical practice is questionable because of deviation between both values. We aimed to find the relationship between the arterial lactate and the peripheral venous lactate before reasoned that the venous lactate could be used in substitution to the arterial lactate in sepsis. Methods: We conducted a prospective, cross-sectional study at a university hospital. The patients with sepsis in ICU who required lactate level monitoring were enrolled in this research. The correlation and agreement between arterial lactate (A-LACT) and peripheral venous lactate (V-LACT) were the primary outcomes. Results: A total of 63 paired samples were collected. The A-LACT and V-LACT were strongly correlated ( r = .934, P < .0001, r2 = .873). The regression equation was A-LACT = (0.934 × V-LACT) − 0.236. The mean difference between V-LACT and A-LACT was 0.66 ± 1.53 mmol/L. The 95% limits of agreement were between −3.66 and 2.33 mmol/L. The V-LACT ≥ 4 mmol/L can predict A-LACT level ≥ 4 mmol/L with 87.5% sensitivity and 91.5% specificity, and the area under receiver operating characteristic curve was 0.948. Conclusion: The present study demonstrated a strong correlation between A-LACT and V-LACT, but an agreement between both parameters was poor. We suggest not to use the V-LACT in substitution to the A-LACT in sepsis regarding the absolute value and clearance rate, but the V-LACT ≥ 4.5 mmol/L may be used for predicting the A-LACT ≥ 4 mmol/L.

scholarly journals Difference of Maternal Serum Interleukin-8 in Preterm Labor and Full Term Labor

2016 ◽  
Author(s):  
Komang W Budiartha
Keyword(s):  
Preterm Labor ◽  
Cross Sectional Study ◽  
Maternal Serum ◽  
T Test ◽  
Full Term ◽  
Interleukin 8 ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference ◽  
Term Labor

Objective: To determine the difference of maternal interleukin-8 (IL-8) in preterm labor and full term labor. Method: This is a cross sectional study with 68 samples, 29 subjects with preterm labor and 39 subjects with full term labor. IL-8 concentration was obtained from blood samples of the subjects, which were examined at Prodia Laboratory Denpasar. Data was analyzed using t-test for independent samples with =0.05. Result: The mean IL-8 level for the preterm labor group was 23.56 10.69 pg/ml and 12.19 5.79 pg/ml for the full term labor group. Statistical analysis using independent samples t-test showed that the average IL-8 level of both groups were significantly different (p=0.001). Conclusion: We concluded from this study that serum IL-8 concentration in women who had preterm labor is significantly higher in comparison to women who had full term labor. [Indones J Obstet Gynecol 2014; 4: 185-187] Keywords: full term labor, interleukin-8, preterm labor

scholarly journals Correlation Between Stigma and Quality of Life in Leprosy Patients in Mehrab Khan Region of Mashhad

2021 ◽  
Author(s):  
Zahra Safavi Bayat ◽  
Wim Van Brakel ◽  
Hamideh Ebrahimi ◽  
Nadere Naderi Ravesh ◽  
Nezhat Shakeri ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pearson Correlation ◽  
Inverse Correlation ◽  
Cross Sectional Study ◽  
Social Dimension ◽  
Cross Sectional ◽  
Psychological Dimension ◽  
The Mean ◽  
The Difference

Leprosy is one of the oldest chronic diseases, and similar to other infectious diseases, it causes long-term physical and social effects on the lives of patients and their families. This was a cross-sectional study conducted with 103 patients with leprosy in Mashhad in the Mehrab Khan region in March 2016. The sampling method was convenience sampling. The data was analyzed using SPSS version 19. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential tests (ANOVA, Pearson correlation, and independent t-test) were used. The results showed that the mean age of patients was 65.2±8.1 years and the mean age of developing leprosy was 15.3±7.03. There was an inverse correlation between the score of overall stigma, internal stigma, and all dimensions of quality of life that was statistically significant, except for the social dimension (r= -0.181…; P=0.067). There was an inverse correlation between the psychological dimension of quality of life and experienced stigma. The highest score of the overall quality of life was related to divorced patients with a mean score of 79.7, which was statistically significant (P=0.016) from those who were not divorced. In post-hoc test, just the difference between widow and divorced were significant regarding quality of life. According to results, there was a negative correlation between the quality of life and all aspects of stigma using the SARI tool.

scholarly journals Social Media and Academic Impact: Do Early Tweets Correlate With Future Citations?

2021 ◽  
pp. 014556132110421
Author(s):  
Nilan G. Vaghjiani ◽  
Vatsal Lal ◽  
Nima Vahidi ◽  
Ali Ebadi ◽  
Matthew Carli ◽  
...  
Keyword(s):  
Social Media ◽  
Citation Rate ◽  
Cross Sectional Study ◽  
Academic Impact ◽  
Cross Sectional ◽  
Significant Difference ◽  
Social Media Platforms ◽  
The Mean ◽  
The Difference ◽  
Number Of Citations

Objective: Determine whether social media platforms can influence article impact as measured by citations. Methods: Cross-sectional study that analyzed articles published in the top 10 otolaryngology journals by Eigenfactor score in January 2015. Total accumulated Twitter mentions and citations were recorded in 2021. The main outcomes examined the difference in citations, tweets, article types, and author counts accumulated over a 5-year period for all articles that were either tweeted or nontweeted. Results: A total of 3094 articles were included for analysis. The average article was cited 11.2 ± 13.2 times and tweeted 2.10 ± 4.0 times. Sixty-four percent of the articles had at least one tweet. Over the study period, there was a statistically significant difference in mean number of citations between tweeted articles (12.1 ± 15.0) versus nontweeted articles (9.6 ± 10.5) citations, representing a 26% difference ( P < .001). Review articles had the highest mean citations (19.4 ± 23.4) while editorials had the lowest mean citations (2.8 ± 6.9). Tweets peaked in the year of publication, but citations continued to rise in the subsequent years. Tweeted articles’ peak citation rate change was +1.27 mean citations per year, compared to +0.99 mean citations per year in nontweeted articles. The mean author count in tweeted articles (5.40 ± 3.1) was not significantly different than the mean author count in nontweeted articles (5.19 ± 2.65, P = .0794). Conclusion: These data suggest a moderate correlation between tweets and article citations, but a clear difference in the number of citations in articles tweeted versus those with no tweets. Thus, dissemination of knowledge may be impacted by social medial platforms such as Twitter.

scholarly journals A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion

2020 ◽  
Vol 8 (4) ◽  
pp. 1231
Author(s):  
Avdhesh Kumar ◽  
Brijesh Kumar ◽  
Sanjay Kumar Verma ◽  
Anand Kumar ◽  
R. K. Mathur ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Common Cause ◽  
Tuberculous Pleural Effusion ◽  
Mdr Tb ◽  
The Mean ◽  
The Difference

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females.  The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.

scholarly journals Contraceptive User’s Profile

2016 ◽  
Author(s):  
Eka R Gunardi
Keyword(s):  
Obstet Gynecol ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Contraceptive Methods ◽  
Cross Sectional ◽  
Study Population ◽  
The Mean ◽  
The Difference ◽  
Almost All ◽  
The Cost

Objective: To obtain informations regarding the profile of contraceptive users in Raden Saleh Clinic, Jakarta. Method: A cross-sectional study was conducted in June 2012, at Raden Saleh Clinic, Jakarta. The study population was the patient who came to Raden Saleh Clinic from 2008 until 2011. Results: The mean age of the contraception users was 34.06 and the mean of their husband’s age was 38.91 years old. Most of the patients were graduated from senior high school (43.2%) and university (37.9%). More than half of the patients (55.2%) were not working and more than a half of their husband (53.2%) were private employee. Almost all (92.6%) of the patient were married. Most of the patient (38.8%) came with no prior contraception. After consultation, all patients had chosen their preferred contraceptive methods, namely IUD (61.4%), injectable contraception (20.9%), pill (13.7%), sterilization (3.4%), and implant (0.6%). Conclusion: Family planning reduces maternal mortality and the best method is different for each patient because of the difference in their own condition and the consideration of the cost and benefit. [Indones J Obstet Gynecol 2013; 1-4:179-82] Keywords: contraception, contraceptive users profile

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