scholarly journals The Threshold of Admission Glycemia as a Predictor of Adverse Events in Diabetic and Non-Diabetic Patients with Acute Coronary Syndrome

2009 ◽  
Vol 3 ◽  
pp. CMC.S2289 ◽  
Author(s):  
Taysir S. Garadah ◽  
Salah Kassab ◽  
Qasim M. Al-Shboul ◽  
Abdulhai Alawadi
Keyword(s):  
Acute Coronary Syndrome ◽  
Adverse Events ◽  
Diabetic Patients ◽  
Stress Hyperglycemia ◽  
Coronary Syndrome ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
High Level ◽  
Group 1

Recent studies indicated a high prevalence of hyperglycemia in non-diabetic patients presenting with acute coronary syndrome (ACS). However, the threshold of admission glucose (AG) as a predictor of adverse events in ACS is unclear. Objective The aim of this study was to assess the threshold of admission glucose (AG) as a predictor of adverse events including Major Acute Cardiac Events (MACE) and mortality, during the first week of admitting patients presenting with ACS. Material and Methods The data of 551 patients with ACS were extracted and evaluated. Patients were stratified according to their blood glucose on admission into three groups: group 1: <7 mmol/L (n = 200, 36.3%) and group 2: >7 mmol/L and <15 mmol/L (n = 178, 32.3%) and group 3: ≥15 mmol/L (n = 173, 31.4%). Stress hyperglycemia was arbitrarily defined as AG levels > 7 mmol/L (group 2 and 3). Patients with ACS were sub-divided into two groups: patients with unstable angina (UA, n = 285) and those with ST segment elevation myocardial Infarction (STEMI, n = 266) and data were analyzed separately using multiple regression analysis. Results The mean age of patients was 59.7 ± 14.8 years and 63% were males. The overall mortality in the population was 8.5% (5.4% in STEMI and 3.1% in UA) patients. In STEMI patients, the odds ratio of stress hyperglycemia as predictor of mortality in group 3 compared with group 1 was 3.3 (CI 0.99-10.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.75-8.07, P = 0.065) after adjustment for age and sex. Similarly, in UA patients, the odds ratio of stress hyperglycemia in group 3 compared with group 1 was 2.7 (CI 0.37-18.98, P < 0.05), while in group 2 compared with group 1 was 2.4 (CI: 0.4-15.2, P = 0.344) after adjustment for age and sex. The incidence of more than 2 MACE in both STEMI and UA patients was higher in group 3 compared with the other two groups. Regression analysis showed that history of DM, high level of LDL cholesterol, high level of HbA1c, and anterior infarction were significant predictors of adverse events while other risk factors such as BMI, history of hypertension and smoking were of no significance. Conclusion This study indicates that the stress hyperglycemia on admission is a powerful predictor of increased major adverse events and hospital mortality in patients with acute coronary syndrome.

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 THE USING OF POLYPRENOL-CONTAINING DRUG IN PATIENTS WITH ACUTE CORONARY SYNDROME

2018 ◽  
Vol 33 (2) ◽  
pp. 21-25
Author(s):  
E. I. Tsoi ◽  
E. V. Vyshlov ◽  
V. B. Trusov
Keyword(s):  
Acute Coronary Syndrome ◽  
Standard Therapy ◽  
Control Group ◽  
Study Group ◽  
Double Blind ◽  
Coronary Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

The article shows the results of the study using drug Ropren in the patients with acute coronary syndrome. Ropren is  a plant drug containing polyprenols — dolichol precursors which take part in dolichol phosphate pathway. The pathology in this pathway leads to disbalance and glycoprotein deficiency. This is the reason of large group of diseases. This study is randomized double blind placebo controlled (No. NCT03122340 at ClinicalTrials.gov). Patients (n=68) with ACS taking standard therapy including atorvastatin 40 mg/day were randomized into to 2 groups: group 1 (n=34) took Ropren  8 drops 3 times per day for 3 week, then 5 drops 3 times per day for 5 weeks; group 2 (n=34) took placebo in the same dose regimen. After two — month therapy there was a positive dynamic (decreasing) in the level of interleukin-6 in the study group whereas in the control group there was no statistically significant change: 4.36 (2.61, 8.95) and 5.5 (3.3; 8.4) pg/ml, respectively (p<0.05). In the group of patients taking Ropren the reduction or cessation of statin was required significantly less than in the placebo group: 3 (8.8%) vs 9 (26.5%), respectively. One patient from the first group had a side effect in the form of gravity in the right hypochondrium. That is why the administration of Ropren in addition to standard therapy is reasonable in patients with ACS.

scholarly journals Leukapheresis Reduces 4-Week Mortality in Leukemia Patient with Hyperleukocytosis-a Retrospective Study from a Tertiary Center

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 3782-3782
Author(s):  
Nan Xinyu ◽  
Srivastava Pallavi ◽  
Mamta Puppala ◽  
Sai Ravi Pingali ◽  
Ibrahim Ibrahim ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Coronary Syndrome ◽  
Respiratory Failure ◽  
Data Warehouse ◽  
Kidney Injury ◽  
Average Decrease ◽  
Coronary Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background: Hyperleukocytosis is complication of leukemia and is defined as peripheral white blood cell (WBC) count greater than 100, 000/mm^3. The high WBC count can increase blood viscosity and lead to leukostatsis, which is a medical emergency most commonly seen in acute leukemias. The use of Leukapheresis, is controversial and there are few guidelines. We performed a retrospective review of outcomes in patients with hyperleukocytosis who received leukapheresis in Houston Methodist Hospital between 2006 and 2015. Methods: The patient data was queried from METEOR (Methodist Environment for Translational Enhancement and Outcomes Research), a clinical data warehouse and analytics environment that integrates existing business data warehouse with internal and external research databases and national registries to support clinical research and outcome studies for improving patient care cost-effectively. METEOR data warehouse contains records dating back to January 1, 2006 with over 1 million unique patients and over 4 million unique patient encounters. We queried for the diagnosis of leukemia and those that received at least one course of leukapheresis and also obtained baseline demographics, and overall outcomes. Results: We reviewed 5585 of whom 42 patients who meet the criteria-patients, 29 of them have diagnosis of AML, 6 with CLL, 4 with ALL, and 3 with CML. The baseline demographics included 29 males and 13 females, whose median age was 52.5; 19 were Caucasians while 10 were African Americans, 5 Hispanic, 5 Asian and 3 reportedly as others. As shown in Table 1, the population is divided into 3 groups according to WBC before leukapheresis. Group 1 has 7 patients with WBC <100,000, median of 80.460. Group 2 has 17 patients with WBC range from 100,000 to 200,000, median of 150,740. Group 3 has 18 patients with WBC above 200,000, median of 252,200. In group 1, the average leukostatsis symptom grade is 1.43, average % decrease of WBC is 34.54%, ( blast-84%). In group 2, the average leukostatsis symptom grade is 1.88, average % decrease of WBC is 48.25%, ( blast- 69%). In group 3, the average leukostatsis symptom grade is 1.06, average % decrease of WBC is 42.81%, (blast-59.5%). In terms of complications, in group 1, 42.86% presented with acute kidney injury (AKI), 28.57% with tumor lysis syndrome, 28.57% with disseminated intravascular coagulation (DIC), 28.57% with sepsis, 14.29% with pneumonia, 42.86% with respiratory failure, 14.29% and with acute coronary syndrome (ACS). In group 2, 17.65% presented with AKI, 47.06% with TLS, 47.06 % with DIC, 23.53% with sepsis, 11.76% with pneumonia, 41.18% with respiratory failure, and 5.88% with acute coronary syndrome. In group 3 11.10 % presented with acute kidney injury, 44.44% with TLS, 38.89 % with DIC, 22.22% with sepsis, 11.11% with pneumonia, 27.78 % with respiratory failure, and 5.56 % with ACS. The 4 weeks mortality rate are 42.86% for group 1, 29.41% for group 2, and 22.22% for group 3. Conclusions: We have validated the Hyperleukocytosis grading schema and usefulness of leukapheresis. Our data indicates comparable mortality in pts with WBC between 100 -200,000 and > 200,000. Further statistical review of this data set will be presented at the ASH Meeting, Orlando 2015 Table 1. Group 1 Group 2 Group 3 WBC range <100,000 100,000 to 200,000 >200,000 Number of patients 7 17 18 Average leukostasis symptom grade 1.43 1.88 1.06 % Lymphoid leukemia 14.29% 17.65% 33.33% Median WBC before leukapheresis 80,460 150,740 252,200 Average % decrease of WBC 34.54% 48.25% 42.81% Median % of blast before leukapheresis 84% 69% 59.5% Average % change in %blast 5.35% 11.23% -6.55% Average Creatinine after Leukapheresis 2.39 1.47 1.38 Average uric acid after leukapheresis 8.77 6.52 6.75 Average Fibrinogen after leukapheresis 424.25 336.78 300.56 % Acute kidney injury 42.86% 17.65% 11.10% % Tumor lysis syndrome 28.57% 47.06% 44.44% % DIC 28.57% 47.06% 38.89% % Sepsis 28.57% 23.53% 22.22% % Pneumonia 14.29% 11.76% 11.11% % Respiratory failure 42.86% 41.18% 27.78% % Acute Coronary Syndrome 14.29% 5.88% 5.56% % 4 weeks Mortality 42.86% 29.41% 22.22% References: 1. Novotny JR, Müller-Beissenhirtz H, Herget-Rosenthal S, Kribben A, Dührsen U. Grading of symptoms in hyperleukocytic leukaemia: a clinical model for the role of different blast types and promyelocytes in the development of leukostatsis syndrome. Eur J Haematol 2005:74:501-510 Disclosures No relevant conflicts of interest to declare.

scholarly journals Pharmacokinetics and safety of XAV-19, a swine glyco-humanized polyclonal anti-SARS-CoV-2 antibody, for COVID-19-related moderate pneumonia: a randomized, double-blind, placebo-controlled, phase IIa study

2021 ◽  
Author(s):  
Benjamin Gaborit ◽  
Eric Dailly ◽  
Bernard Vanhove ◽  
Régis Josien ◽  
Karine Lacombe ◽  
...  
Keyword(s):  
Adverse Events ◽  
High Serum ◽  
Serum Concentrations ◽  
Serious Adverse Events ◽  
Double Blind ◽  
Good Tolerability ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objective: We assessed the pharmacokinetics and safety of XAV-19, a swine glyco-humanized polyclonal antibody against SARS-CoV-2, in COVID-19-related moderate pneumonia. To evaluate the optimal dose and safety of XAV-19 during this first administration to patients with COVID-19-related moderate pneumonia. Methods : In this phase 2a trial, adults with COVID-19-related moderate pneumonia of ≤10 days duration were randomized to infusion of XAV-19 0.5mg/kg at day 1 and day 5 (group 1), 2mg/kg at day 1 and day 5 (group 2), 2mg/kg at day 1 (group 3) or placebo. Results : Eighteen patients (n=7 for group 1, n=1 for group 2, n=5 for group 3, and n=5 for placebo) were enrolled. Baseline characteristics were similar across groups, XAV-19 serum concentrations (μg/mL, median, range) at C max and at day 8 were 9.1 (5.2-18.1) and 6.4 (2.8-11.9), 71.5 and 47.2, and 50.4 (29.1-55.0) and 20.3 (12.0-22.7) for groups 1, 2 and 3, respectively (p=0.012). Terminal half-life (median, range) was estimated at 11.4 (5.5-13.9) days for 2 mg/kg of XAV-19 at day 1. Serum XAV-19 concentrations were above the target concentration of 10 μg/mL (tow fold the in vitro 100% inhibitory concentration [IC 100 ]) from the end of perfusion to more than 8 days for XAV-19 2 mg/kg at day 1. No hypersensitivity or infusion-related reactions were reported during treatment, there was no discontinuation for adverse events and no serious adverse events related to study drug. Conclusions : Single intravenous dose of 2mg/kg of XAV-19 demonstrated high serum concentrations, predictive of potent durable neutralizing activity with good tolerability. Trial registration: ClinicalTrials.gov Identifier: NCT04453384

Abstract 3147: Uric Acid Independently Predicted Acute Coronary Syndrome in a Large Cohort of Ethnic Chinese

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Shao-Yuan Chuang ◽  
Jonathan Jiunn-Horng Chen ◽  
Chih-Cheng Wu ◽  
Wen-Harn Pan
Keyword(s):  
Body Mass Index ◽  
Acute Coronary Syndrome ◽  
Uric Acid ◽  
Total Cholesterol ◽  
Body Mass ◽  
Ethnic Chinese ◽  
Coronary Syndrome ◽  
Group 4 ◽  
Group 3 ◽  
Group 2

Few studies examine the association between serum uric acid (SUA) and acute coronary syndrome (ACS). We aimed to investigate the association between SUA and ACS in a prospective study of ethnic Chinese. Enrolled were 128569 adults ≥ 20 yrs from 4 MJ Health Checkup Clinics in Taiwan during 1994 –1996, excluding those with heart disease, stroke, renal disease and cancer disease. All physical examination, biochemical test and structured questionnaire were executed in standardized central labs. ACS was defined by main ICD-9 of 410 – 414 from claim data of National Health Insurance for hospitalization and from Death certification registry. Cox proportional hazard model was used to estimate the hazard ratios (HRs) between levels of SUA and ACS events. A total of 2049 subjects (Men: 1239/Women: 810) developed ACS during the period from baseline to Dec.31.2002. Men had higher ACS incidence than women (2.84 vs. 1.61 per 1000 person-years [PY]; p < .0001). Independent risk factors of ACS unfolded from this study included age, male sex, waist circumference, body mass index, triglycerides, total-cholesterol, hypertension, diabetes, uric acid, and current smoking. The crude incidences of ACS were 1.27, 2.06, 3.27 and 4.61 per 1000 PY in that order for four consecutive SUA groups (group1: <5.0 mg/dl; group 2: 5.0 – 6.9 mg/dl; group 3: 7.0 – 8.9 mg/dl; group 4: ≥9.0 mg/dl) (p-value for trend <.0001). Compared to group1, the multi-variate adjusted HRs (95% Confidence intervals) were 1.14 (0.92, 1.42) for group 2, 1.38 (1.10, 1.72) for group 3 and 1.38 (1.10, 1.72) for group 4 among men, and 1.03 (0.87, 1.22), 1.30 (1.05, 1.62) and 1.43 (0.99, 2.05) among women after adjusting for age, systolic/diastolic BP, body mass index, triglycerides, total cholesterol, diabetes, smoking, alcohol drinking, physical activity, and occupation. One standard deviation increase in SUA corresponded to around 30% ACS risk increase in women (HR=1.33; 1.04 –1.70) and 60% in men (HR=1.59; 1.25–2.03). Baseline SUA level independently predicts the development of ACS and should be considered as a potential risk factor of ACS.

Abstract WP380: Thyrotoxicosis is Associated With Worse In-Hospital Mortality in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sakiru O Isa ◽  
Olajide Buhari ◽  
Hameem Changezi
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
The Body ◽  
Significant Difference ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
Time Of Presentation ◽  
Group 1

Introduction: Hyperthyroidism increases the basal metabolic rate and affects most systems in the body. Patients with hyperthyroidism have been shown to have a higher incidence of ischemic stroke. There is a paucity of information regarding its effects on the short-term outcomes of patients admitted with ischemic stroke. Hypothesis: Hyperthyroidism is associated with worse in-hospital outcomes in patients admitted for ischemic stroke. Methods: We queried the National Inpatient Sample to identify adult patients(aged 18 and above) admitted for ischemic stroke between January 2011 and December 2014. We compared those with a history of hyperthyroidism (group 1) and thyrotoxicosis on admission (group 2) with the rest of the patients (group 3). The main outcome was in-hospital mortality. Secondary outcomes included the length of hospital stay and cost of hospitalization. We used the logistic regression model and adjusted for baseline characteristics and co-morbidities. Results: There were 643,786 patients in the study, 0.44% had a history of hyperthyroidism, and 0.01% had thyrotoxicosis at the time of presentation. The odd of mortality in group 1 compared to group 3 was 0.89, 95% CI 0.75-1.05, p=0.16 while in group 2 compared to group 3, it was 2.42, 95% CI 1.29-4.52, p<0.006. The mean length of stay was also longer in group 2 with a mean difference of 8.06, 95% CI 4.74 - 11.39, p<0.0001. Conclusion: From the study, there was no significant difference in in-hospital mortality between patients with previously diagnosed hyperthyroidism and those without diagnosed hyperthyroidism. Patients who had thyrotoxicosis on admission, on the other hand, had worse outcomes compared to patients without thyrotoxicosis.

P4624Predictive performance of CRUSADE bleeding score in non ST elevation acute coronary syndrome patients treated with ticagrelor versus clopidogrel

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Graca Santos ◽  
F Montenegro Sa ◽  
C Ruivo ◽  
R Ribeiro Carvalho ◽  
J Correia ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Predictive Performance ◽  
Roc Curves ◽  
National Registry ◽  
Red Blood Cell Transfusion ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Group 2 ◽  
Risk Categories ◽  
Group 1

Abstract Introduction CRUSADE score is commonly used for bleeding risk stratification in the context of acute coronary syndrome (ACS). However, the study validating it was performed before ticagrelor was available. Purpose To compare the predictive performance of CRUSADE score in two groups of non-ST elevation ACS (NSTEACS) patients, one treated with ticagrelor and another with clopidogrel. Methods Retrospective study of 2077 NSTEACS patients admitted between January 2014 and September 2017 and included in a multicentre national registry. Group 1 was composed by patients medicated with ticagrelor, and Group 2 with clopidogrel. Patients with bleeding history were excluded. The primary endpoint (PE) results from a composite which includes: in-hospital major bleeding (MB) according to the Registry criteria, need for red blood cell transfusion (RBCT), or haemoglobin drop ≥2g/dL (HbD). The groups were compared according to their demographic, clinical and laboratory characteristics. The occurrence of the PE (and its components) across CRUSADE risk categories was assessed by Chi-square for linear trend. The performance of CRUSADE score for PE prediction in each cohort was assessed by Receiver Operator Characteristics (ROC) curves. Results Group 1 included 662 (31.9%) and Group 2 1415 (68.1%) patients. Mean CRUSADE score was higher in Group 2 (23.1±14.7 versus (vs) 26.7±16.3, p=0.001). No difference was observed regarding the PE (14.8% vs 17.0%, p=0.200) and its components. With the exception of MB in Group 1 (p-trend=0.425), the relative occurrence of the PE and its components increased across CRUSADE risk categories [Figure 1. panel A]. In-hospital mortality was numerically superior in Group 2, but did not reach statistical significance (1.1% vs 1.6%, p=0.368). In both groups, the performance of CRUSADE score in predicting the PE was modest (Group 1 AUC=0.59 and p=0.006, Group 2 AUC=0.62 and p<0.001), and no difference was observed when comparing the two groups (P value for ROC curves comparison = 0.899) [Figure 1. panel B and C respectively]. Figure 1 Conclusion In this study based on a national registry of NSTEACS patients, the use of ticagrelor did not influence the occurrence of bleeding related events and it did not change the predictive performance of the CRUSADE score. According to this analysis, CRUSADE score may be applied without limitation to NSTEACS patients managed with ticagrelor.

334 DNA SYNTHESIS DURING THE FIRST CELL CYCLE OF PORCINE OOCYTES FOLLOWING DIFFERENT ACTIVATION TREATMENTS

2007 ◽  
Vol 19 (1) ◽  
pp. 282
Author(s):  
S.-A. Ock ◽  
D. Kang ◽  
J. Han
Keyword(s):  
Cell Cycle ◽  
Dna Synthesis ◽  
Molecular Signaling ◽  
Oocyte Activation ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Nuclear Ploidy ◽  
High Level ◽  
Group 1

Inhibitors of protein synthesis and phosphorylation have been widely used for oocyte activation and have been reported to induce abnormalities in nuclear ploidy due to aberrant DNA synthesis (DNAS). The present experiment was designed to compare the DNAS during the first cell cycle of porcine parthenotes following different activation treatments. Cumulus–oocyte complexes were cultured in TCM-199 supplemented with 0.5 �g mL-1 LH and FSH, 10 ng mL-1 EGF, and 0.1% PVA for 22 h, and additionally cultured in media without LH and FSH for 22 h. MII oocytes were then electrically pulsed twice in 0.28 M mannitol containing 0.05 mM CaCl2 and 0.1 mM MgSO4 at 1.8 kV cm-1 for 30 �s (group 1), followed by 7.5 �g mL-1 cytochalasin B (CCB, group 2), 10 �g mL-1 cycloheximide (CHX, group 3), or 1.9 mM 6-dimethylaminopurine (6-DMAP, group 4) for 3 h. Eggs were incubated with 100 �M 5-bromo-222-deoxyuridine (BrdU) for 1 h at 0, 2, 4, 6, 8, 10, and 12 h after activation to evaluate DNAS (Adenot et al. 1997 Development 124, 4615–4625) by determining the BrdU signal under a fluorescence microscope. Experiments were replicated 4 times; results were expressed as mean � SD and analyzed using one-way ANOVA by SPSS 10.0. The percentage of DNAS was calculated by dividing the number of BrdU-positive eggs by the total number of eggs used. DNAS in groups 1, 3, and 4 initiated at 2–3 h post-activation (hpa) but at 4–5 hpa in group 2. In group 1, DNAS was faint until 3 hpa, gradually increasing thereafter until 11 hpa (20.7 � 19.6, 29.4 � 17.0, 41.3 � 16.7, and 64.4 � 6.2, at 4–5, 6–7, 8–9, and 10–11 hpa, respectively). There was a significant (P &lt; 0.05) increase in DNAS at 10–11 h, but a significant (P &lt; 0.05) decrease (34.3 � 6.4) at 12–13 hpa. In groups 2 and 3, after 4–5 hpa, DNAS gradually increased until 7 h (6.2 � 1.4 and 29.8 � 16.6 at 4–5 hpa, and 21.1 � 13.7 and 40.0 � 18.7 at 6–7 hpa, respectively), but a DNAS peak was observed at 8–9 h (44.6 � 9.0) in group 2 and at 10–11 h (40.5 � 22.1) in group 3. Interestingly, group 4 parthenotes showed a different DNAS pattern compared with other groups, as it started at 2–3 hpa (24.8 � 11.7), reached a significantly (P &lt; 0.05) high level at 4–5 hpa (56.3 � 9.0), and gradually decreased at 6–7 hpa (42.7 � 10.3) until 12–13 hpa (29.5 � 14.9). In conclusion, CCB, CHX, and 6-DMAP used for oocyte activation exhibited different patterns of DNA synthesis during the first cell cycle of porcine parthenotes. Therefore, further experiments are required to evaluate the molecular signaling that regulates DNAS, embryonic developmental velocity, and ploidy of 2-cell parthenotes.

scholarly journals P1033VALUE OF ADDING PENTOXIFYLLINE IN COMPARISON TO ANGIOTENSIN CONVERTING ENZYME INHIBITORS IN TYPE 2 DIABETIC PATIENTS AMONG EGYPTIAN POPULATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Magdy ElSharkawy ◽  
Mohamed Mostafa ◽  
Mohamed Ezzat
Keyword(s):  
Kidney Disease ◽  
Serum Creatinine ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Trial Duration ◽  
Diabetic Kidney ◽  
History Of ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims Microalbuminuria is one of the early presentations of diabetic kidney disease that may progress to macroalbuminuria, progressive loss of glomerular filtration rate and eventually end stage renal disease. Early recognition and management of microalbuminuria can avert irreversible complications. Antihypertensive medications and antihyperlipidemic medications are medications that have been used to control diabetic nephropathy, but the reports of some side effects limited the usage of some of these drugs in diabetic patients. Pentoxifylline is an anti-inflammatory medication that have been experienced for clinical trials in diabetic patients with diabetic kidney disease. Effect of Pentoxifylline on albuminuria has been evaluated in several studies with different outcomes where a significant decrease in albuminuria in the Pentoxifylline group compared with placebo was the final conclusion. The aim of our study is the assessment of the value of Pentoxifylline addition in diabetic patients. Method Of 90 patients aged between 20 and 55 years old with a history of diabetes mellites type II for more than 5 years with normal serum creatinine and had a spot urinary albumin/creatinine ratio of &gt; 300 mg/g on two consecutive measurements with HBA1C &lt; 7% and lacking any history of glomerular disease, immunological, malignant nor cardiovascular disease in the previous 6 months nor using pentoxifylline for the past 3 month attending Ain Shams University clinics in Egypt from October 2017 to September 2018, 61 patients were eligible and randomly assigned in prospective, randomized, parallel-group, non-blind study after obtaining written informed consent from studied patients into 2 groups either the Pentoxifylline group (n = 30) receiving 400 mg thrice daily for 6 months or Ramipril group (n = 31) receiving 2.5 mg once daily on the same schedule. Blood samples and single first morning void urine samples were collected before breakfast after an 8–12 hours overnight fast. Plasma glucose, HbA1c, serum Creatinine, AST, ALT, and urinary protein / Creatinine levels were measured. All biochemical analyses were performed. Participants were followed up after 1, 3 and 6 months during the treatment period to evaluate the outcome Results Highly Statistically significant differences were noted as regard the reduction of the proteinuria levels at the same measurement points in both groups where the mean ranges of proteinuria in group 1 were found to be 2.2±1, 1.8±0.7, 1.4±0.6 mg\g at the start of the study, 3 and 6 month later respectively while in group 2 the mean range was found to be 2.6±1.2, 2±0.8, 1.6±0.7 mg\g with marked reduction of 20.6% after 3 month and 37.6% after 6 month from the start of the trial in group 1 in contrast to 20.7% and 40.2% respectively in group 2, also the effect of both drugs on the level of HbA1c has been studied in both group, in group 1 there was no reduction in the level of HbA1c after 6 month of drug administration in contrary to group 2 which showed a reduction of 4% where these results were found to be statistically significant in group 2 only. we also found statistically significant differences in both groups as regard the decline in eGFR throughout the trial duration which was 4% in group 1 and 6% in group 2. Conclusion We concluded that Pentoxifylline has a promising role as an antiproteinuric agent in comparison with ACEI from our statistical analysis of the study data with a more decline in eGFR throughout the trial duration in the study population using ACEI in comparison to Pentoxifylline. Due to restrictions of the study design these observations need further confirmation by prospective studies. Figure (1) showing comparison between both groups as regard the level of proteinuria and its reduction rate over 6 months Figure (2) showing eGFR levels at 0, 6 months in both groups Figure (3) showing comparison between both groups as regard HbA1C at baseline and after 6 months.

scholarly journals P977 CT phenotype of high-risk atherosclerotic plaques causing an acute coronary syndrome compared to silent vulnerable plaques

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
R I Hodas ◽  
D Opincariu ◽  
N Rat ◽  
I Rodean ◽  
M Chitu ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
High Risk ◽  
Morphological Characteristics ◽  
Plaque Morphology ◽  
Atherosclerotic Plaques ◽  
Plaque Instability ◽  
Coronary Syndrome ◽  
Atheromatous Plaques ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements PlaqueImage.- research grant no. 103544/2016, contract number 26/01.09.2016 - Background Previous studies demonstrated that plaque morphology has a crucial role in the development of an acute coronary syndrome (ACS). However, not all vulnerable coronary plaques produce an ACS and the prediction power of various vulnerability features to predict an acute coronary event in a close future, has not been elucidated so far. Objective We aimed to use multi-slice computed tomography angiography (CTA) for assessment of morphological characteristics of culprit lesions producing an ACS in the next several months after CT assessment, in comparison with morphological characteristics of unstable coronary atherosclerotic plaques which did not trigger an ACS. Material and methods We analyzed 40 patients in whom CTA revealed presence of unstable coronary lesions, exhibiting at least one marker of vulnerability: napkin ring sign (NRS), spotty calcium (SC), positive remodeling (PR) or presence of low attenuation plaque (LAP), divided in 2 groups: group 1 - 20 patients who developed an ACS in the next 6 months following CTA examination, and group 2 – 20 patients matched for age, gender and risk factors, who did not present any cardiovascular event 6 month after CTA assessment. Post-processing of multi-slice CTA images was performed in order to assess morphological characteristics and CT-derived markers of atherosclerotic plaque instability. Results Similar mean values of plaque length (17.1 +/- 5.9 mm vs 16.9 +/- 3.4 mm; p = 0.6) and total atheroma volume (188.1 +/- 104.7 mm3vs 186.4 +/- 90.7 mm3; p = 0.8) were obtained for both groups. The mean number of vulnerability markers was 1.6 in group 1 vs 1.2 in group 2 (p = 0.07). However, atherosclerotic lesions in patients from group 1 presented significantly higher values of lipid-rich atheroma (9.8 +/- 10.8 mm3vs 2.6 +/- 1.0 mm3; p = 0.01) and remodeling index (1.14 +/- 0.3 in group 1 vs 0.89 +/- 0.19 in group 2, p = 0.04). At the same time, atheromatous plaques in patients who developed an ACS during the 6-months follow-up showed in a significantly higher proportion LAP (45% in group vs 10% in group 2, p = 0.03) and PR (15%in group 1 versus 5% in group 2, p = 0.04), but not NRS (30% vs 25%, p = ns) or SC (65% vs 40%, p = 0.2). Conclusions Atherosclerotic plaques producing an ACS exhibit a different phenotype than unstable plaques that remain silent. The CTA profile of atheromatous plaques producing an ACS includes the presence of low attenuation, positive remodeling, higher RI and lipid-rich atheroma. Presence of these features in high-risk coronary plaques identifies very high risk patients, who can benefit from adapted therapeutic strategy in order to prevent the development of an ACS.

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