RESUMO
Graft verus host disease (GVHD) following Liver transplantation is rare life threatening complication with very high mortality rate around 85%. Due to increased recognition of this condition management approach is rapidly evolving due to newer diagnostic methods and drugs. Etiology, risk factors, pathogenesis, preventive strategies, management approach and newer drugs are discussed. We present our experience of 2 cases from a large cohort of 1052 Liver transplant operations over a decade.
RESUMO
BACKGROUND: Calcific aortic stenosis and coronary artery disease share common risk factors. In some of the previous studies statins have been used to retard the progression of aortic stenosis, but the results were inconsistent. METHODS: One hundred and ten patients of CAS above the age of 40 years have undergone clinical, biochemical and echocardiographic evaluation. Coronary angiograms were done in 66% of them. RESULTS: Male to female ratio was 2:1. Patients of CAS with CAD showed higher prevalence of diabetes, hypertension, dyslipidemia, smoking and family history of CAD. Prevalence of obesity and bicuspid aortic valve by echocardiogram was high in those without CAD. CONCLUSIONS: On comparison of prevalence of risk factor in those with and without associated CAD, there was higher prevalence of diabetes (65% vs 30%), hypertension (52% vs 43%), dyslipidemia (69% vs 52%), smoking (24% vs 18%) and family history of CAD (34% vs 16%) in those with associated CAD. The incidence of obesity was higher in those without CAD (20% vs 30%). The difference observed in diabetes alone was found to be statistically significant.
