Résumé
Introduction: No-reflow phenomenon in coronary vessels, manifested in some patients with reperfused acute myocardial infarction [MI], is associated with poor clinical and functional outcomes. Therefore, evaluation of predisposing risk factors can be helpful in risk assessment and identification of patients at higher risk. Herein, we aimed to study the predictive factors for the development of no-reflow phenomenon in patients with ST-elevation acute MI [STEMI], following primary percutaneous coronary intervention [PCI]
Materials and Methods: Overall, 141 patients with STEMI, treated with primary PCI, were enrolled in a cross sectional study. Angiographic data associated with no-reflow phenomenon including thrombolysis in MI [TIMI] were evaluated. Patients were divided into study and control [TIMI grade 3] groups. Demographic, clinical and laboratory [lab] data including cardiovascular risk factors [e.g., diabetes, hypertension, hyperlipidemia, smoking], door-to-balloon time, serum creatinine and glucose levels, white and red blood cell counts [WBC and RBC counts, respectively], mean platelet volume [MPV], and red cell distribution width [RDW] were evaluated in both groups
Results: The mean age of the patients was 60.3 +/- 11.9 years. No-reflow was observed in 35 [24.8%] cases. WBC count, MPV, serum creatinine, BS, and high-density lipoprotein [HDL] levels were significantly correlated with TIMI flow <3
Conclusion: Certain lab indices including MPV, WBC count, creatinine and HDL levels played significant independent roles in the no-reflow phenomenon. Thus, measuring such parameters might be helpful in predicting the risk of this condition in patients; however, further studies are required
Résumé
Peripheral neuropathy has been known as the main cause of diabetic foot ulcer and limb amputation. Early diagnosis of this complication can prevent more severe morbidity as well as enormous economic costs. Based on the duration of the disease, 110 diabetic patients were divided in two groups of less than 10 and more than 10-year history. After taking complete history about the symptoms of neuropathy, the patients were examined neurologically. Then, electrodiagnostic studies were performed on the patients. 96 patients [87/2%] had diabetic neuropathy. The prevalence of neuropathy had a significant relationship with the duration of the disease [P value= 0.004]. 61 patients [55/4%] complained of neuropathic symptoms. The results of the neurological exams were abnormal in 65 patients [59.09%]. The most common symptom was paresthesia [50% of patients] and the most frequent sign was abnormal Achilles' reflex. 77 patients [70%] had abnormal indices in nerve conduction studies the most common of which was decrease amplitude of peroneal and sural nerves. 16 patients [14/5%] showed alterations in NCS in the absence of clinical signs or symptoms and 19 patients [17/2%] had normal NCS indices despite the presence of signs or symptoms of neuropathy. High sensitivity of taking history and a careful neurological examination in the diagnosis of diabetic neuropathy necessitates physicians to pay more attention to clinical examinations and patient complaints, and avoid costly electrodiagnostic investigations. Thus, early diagnosis of sub-clinical neuropathy in these patients and providing them with necessary recommendations, irreversible complications such as amputation can be prevented