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1.
Turk Kardiyol Dern Ars ; 52(1): 1-9, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38221835

RESUMO

OBJECTIVE: Earthquakes can significantly impact both the occurrence and the management of acute coronary syndromes (ACS). This study aimed to investigate the effects of an earthquake on patients with ACS by comparing their clinical and angiographic features before and after the event. METHODS: We utilized a retrospective observational cohort design, involving 260 ACS patients who underwent coronary angiography. Data on patient characteristics, clinical variables, and procedural details were extracted from medical records. Statistical analyses were conducted to compare the ACS groups pre- and post-earthquake and to assess outcomes, which included in-hospital mortality and complications. RESULTS: After the earthquake, the ACS patients were older and predominantly male. The distribution of ACS subtypes remained similar between the groups. The use of anticoagulation before the procedure decreased after the earthquake, while the usage of other medications remained stable. The incidence of non-critical coronary arteries decreased post-earthquake, and there was a higher frequency of non-intervention in this group. Intervention in the left anterior descending coronary artery was more common after the earthquake. In-hospital mortality was associated with post-earthquake ACS, certain ACS subtypes, shock at admission, bifurcation stenting, and the no-reflow phenomenon. Complete revascularization was found to reduce mortality. The duration of intensive care unit stays was longer before the earthquake, while in-hospital mortality was higher after the earthquake. Gender differences were observed in coronary ectasia, with females being more affected post-earthquake. CONCLUSION: Earthquakes significantly influence the clinical and angiographic features of ACS cases, thereby affecting mortality rates and revascularization outcomes.


Assuntos
Síndrome Coronariana Aguda , Terremotos , Intervenção Coronária Percutânea , Feminino , Humanos , Masculino , Síndrome Coronariana Aguda/epidemiologia , Angiografia Coronária , Vasos Coronários , Estudos Retrospectivos , Resultado do Tratamento
2.
Neurol India ; 71(5): 933-939, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37929430

RESUMO

Background: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. Neurogenic stress cardiomyopathy (NSC) is a condition of acute myocardial systolic dysfunction that can be observed after acute cerebrovascular events. Objective: In this study, we aimed to investigate the relationship between myocardial function assessed by two-dimensional speckle-tracking echocardiography and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: This cross-sectional study screened 97 patients (males, 42; females, 55; 65 ± 16 years) with acute ischemic stroke. Around 17 patients were excluded and 80 patients were studied. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score <16; Group 2, NIHSS score ≥16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by two-dimensional speckle tracking echocardiography within 48 h of admission to the neurology care unit. Results: There were no significant differences in the demographic parameters of patients. The absolute value of global longitudinal systolic strain (GLS) was significantly higher in Group 1 patients than in Group 2 patients (21.4 ± 2.2 vs 15.9 ± 2.7, P = 0.0281). We found that thirteen patients (22%) had normal LVEF and abnormal LV GLS in Group 1 (P = 0.036). Eight patients (36%) had normal LVEF and abnormal LV GLS in Group 2 (P = 0.042). E/e', QT on ECG, and serum troponin levels were significantly higher in Group 2 patients than in Group 1 patients (P < 0.05). Conclusions: Our results suggest that GLS is associated with stroke severity on admission in patients with acute ischemic stroke. GLS is an indicator of myocardial deformation with a different from LVEF. GLS can detect early myocardial dysfunction despite preserved LVEF.


Assuntos
AVC Isquêmico , Acidente Vascular Cerebral , Disfunção Ventricular Esquerda , Estados Unidos , Masculino , Feminino , Humanos , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia , Volume Sistólico , Estudos Transversais , Ecocardiografia/efeitos adversos , Ecocardiografia/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/complicações
3.
Medicine (Baltimore) ; 102(37): e35075, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37713825

RESUMO

Neurodegeneration of the autonomic nervous systems due to Parkinson disease (PD) may lead to increase in the QT duration. In recent years, a new parameter index of cardio-electrophysiological balance (ICEB) was found. ICEB is a significant parameter of medicine related dysrhythmia. The purpose of this research is to assess ICEB in PD. Twenty-eight PD cases and 26 controls participated in our investigation. First diagnosed PD patients were registered in the research. The symptom progression of PD was assessed Modified Hoehn and Yahr Scale. Analyzed ECG variables are QRS, PR, QT, corrected QT (QTc) interval, ICEB and corrected index of cardio-electrophysiological balance (ICEBc). All cases had sinus rhythm. ICEB was analyzed by the ratio of QT/QRS. ICEBc was analyzed by the ratio of QTc/QRS. Twenty-eight PD cases participated in this research. Among PD cases, 15 patients were female (53.5%). The mean age of PD patients are 59.03 ± 9.94 years. There was no important difference between groups with respect to the clinical variables. The Modified Hoehn and Yahr Scale was appreciably higher in the PD group than the Control group. The heart rate of the PD group was significantly lower than that of the control group. PR intervals and QRS duration were similar in both groups. QT and QTc duration were significantly longer in PD patients. Also, the ICEB and ICEBc variables were appreciably higher in PD cases. The findings of our investigation suggest that ICEB is related to PD. ICEB can help to evaluate arrhythmia risk in patients with PD.


Assuntos
Doença de Parkinson , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Masculino , Coração , Sistema Nervoso Autônomo , Eletrofisiologia Cardíaca , Grupos Controle
4.
Brain Sci ; 13(8)2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37626536

RESUMO

Dyslipidemia is a major atherogenic risk factor for ischemic stroke. Stroke patients tend to have high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and low levels of high-density lipoprotein cholesterol (HDL-C). Therefore, it is noteworthy that there has been an increase in ischemic stroke cases in young and elderly individuals in recent years. This study investigated the TC/HDL-C ratio and the LDL-C/HDL-C ratio, which may be more specific and common lipid parameters in young patients with ischemic stroke. This study aimed to demonstrate the sensitivity and specificity of TC/HDL-C and LDL-C/HDL-C ratios as atherogenic markers for young adult ischemic strokes. This trial was conducted as a retrospective case-control study. A total of 123 patients (patient group) and 86 healthy individuals (control group) aged 18-50 years were randomly selected from four different hospitals. Lipid parameters and TC/HDL-C and LDL-C/HDL-C ratios were compared between these two groups. The mean age was 38.8 ± 7.3 years in patients and 37.7 ± 9 years in controls (p > 005). The HDL-C levels were 39.1 ± 10.8 mg/dL in patients and 48.4 ± 13.8 mg/dL in controls (p < 0.001). LDL-C/HDL-C ratios were 3.23 ± 1.74 and 2.38 ± 0.87, and TC/HDL-C ratios were 5.24 ± 2.31 and 4.10 ± 1.25 in the patient and control groups, respectively (p < 0.001). The LDL-C/HDL-C and TC/HDL-C cutoff values in ROC analyses were 2.61 and 4.40 respectively; the AUCs (95% CI) were determined to be 0.680 (0.608-0.753) and 0.683 (0.610-0.755) (p < 0.001), respectively. An increased risk of stroke was observed in those with a high LDL-C/HDL-C ratio (OR = 1.827; 95% CI = 1.341-2.488; p < 0.001). Our study obtained similar results when we compared the mean TC and LDL-C levels between the two groups. However, considering the TC/HDL-C and LDL-C/HDL-C ratios, it is noteworthy that there was a significant difference between the patient and control groups.

5.
Medicina (Kaunas) ; 59(4)2023 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-37109637

RESUMO

Objectives: Malnutrition is frequently seen in stroke patients. Malnutrition worsens the prognosis and increases the mortality rate in acute ischemic stroke patients. Malnutrition is a significant factor not only in the initiation of infection but also in its progression. The prognostic nutritional index (PNI) is a new index that evaluates the nutrition and inflammatory status. This study aims to investigate the relationship between PNI and stroke-related infection (SRI) development during hospitalization in patients with acute ischemic stroke. Materials and Methods: Acute ischemic stroke was the primary diagnosis for 158 patients who were admitted to the neurology intensive care unit. Patients' demographic, clinical, and laboratory parameters were recorded. PNI was calculated according to the formula given below. PNI: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (mm3). PNI > 380 normal, PNI: 350-380 moderate malnutrition risk, PNI < 350 severe malnutrition risk. Results: A total of 158 patients with acute ischemic stroke were included in the study. There were 70 male and 88 female patients, whereas the mean age of the patients was 67.79 ± 14.0 years. Nosocomial infection developed in 34 (21%) of the patients. Compared to high PNI scores, patients with low PNI scores were generally older, and the National Institutes of Health Stroke Scale (NIHSS) score, atrial fibrillation, infection, mortality rate, and hospitalization rates were all significantly higher. Conclusions: In this study, we discovered that patients with poor PNI had a considerably increased rate of infection development. It is vital to evaluate the nutritional status of patients with acute ischemic stroke during hospitalization.


Assuntos
AVC Isquêmico , Desnutrição , Acidente Vascular Cerebral , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Avaliação Nutricional , Prognóstico , Estudos Retrospectivos , Desnutrição/complicações , Desnutrição/diagnóstico , Acidente Vascular Cerebral/complicações , Fatores de Risco
6.
Eurasian J Med ; 54(1): 61-66, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35307631

RESUMO

OBJECTIVE: The clinical presentation of coronavirus disease 2019 may be more severe in individuals with diagnoses such as neurodegenerative diseases and cerebrovascular disease, which may occur at an advanced age, among the underlying chronic neurological disorders. In this study, we analyzed the incidence of underlying neurological disorders, the clinical process, the effects on prognosis, duration of hospitalization, and clinical parameters such as mortality and the incidence of neurological manifestations that occurred in the study group after being infected and their relationship with the prognosis in patients hospitalized due to coronavirus disease 2019. MATERIALS AND METHODS: This is a retrospective and single-centered study. Individuals aged 65 years and older whose diagnosis of coronavirus disease 2019 was confirmed and who were hospitalized for treatment were included in the study. RESULTS: A total of 282 individuals were included in the study. Neurological manifestaitons were observed in 217 (77.0%) patients, and 131 (46.5%) patients had a neurological disorders in their medical history. Of the 58 patients in intensive care, 36 (12.8%) had a positive history of neurological disorders (P=.006). The incidences of diseases common in advanced age were 22 (7.8%) for dementia, 37 (13.1%) for cerebrovascular disease, and 4 (1.4%) for movement disorders. The most common symptom were myalgia in 67 (23.8%) patients. CONCLUSION: The clinical presentation was more severe and the risk of being treated in the intensive care unit was higher in individuals with a history of neurological disorders and neurological manifestations. Furthermore, patients who developed neurological manifestations had a greater risk of mortality and longer periods of hospitalization.

7.
Rev Assoc Med Bras (1992) ; 67(1): 71-76, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34161491

RESUMO

OBJECTIVE: Myocardial speckle-tracking echocardiography can detect subtle abnormalities in the left atrial function. In this study, we aimed to investigate the relationship between left atrial myocardium and tissue function n assessed by two-dimensional speckle-tracking echocardiography and the National Institutes of Health Stroke Scale score in patients with acute ischemic stroke. METHOD: The study was composed of 80 patients (45 men, 35 women, mean age: 67±15 years) with acute ischemic stroke. The patients were divided into two groups based on the calculated National Institutes of Health Stroke Scale score (group 1, National Institutes of Health Stroke Scale score < 16; group 2, National Institutes of Health Stroke Scale score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac functions were evaluated using two-dimensional speckle-tracking echocardiography within 48 hours from admission to the neurology care unit. RESULTS: There were no significant differences between the patients' clinical parameters. Left ventricular ejection fraction was significantly higher in group 1 than in group 2 (59.2±5.6 to 51.4±6.3, p=0.024). Left atrial longitudinal strain was significantly higher in group 1 than in group 2 (34.48±9.73 to 26.27±7.41, p=0.019). There were no significant differences between other echocardiographic parameters. CONCLUSION: Our results suggest that left atrial longitudinal strain is associated with stroke severity during admission in patients with acute ischemic stroke. Left atrial longitudinal strain is an indicator of left atrial myocardial function.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Idoso de 80 Anos ou mais , Função do Átrio Esquerdo , Isquemia Encefálica/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/diagnóstico por imagem , Volume Sistólico , Função Ventricular Esquerda
8.
Br J Neurosurg ; : 1-4, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33629886

RESUMO

OBJECTIVE: Although dual-energy x-ray absorptiometry (DXA) remains the gold standard for the measurement of bone mineral density (BMD), degenerative spine and spinal instrumentation yields inaccurate results, warranting the need for optional methods. METHODS: Surgical options depend on the BMD of the patients, and to accommodate this need, we compared Hounsfield unit (HU) measurements obtained from computed tomography (CT) scans with the T-scores obtained from DXA scans to inquire whether HU measurements can screen for BMD. In this study, we also evaluated the relationship between body mass index and spontaneous fractures. RESULTS: Based on the findings described in this study, we provide evidence that HU measurements obtained from CT scans can predict BMD. CONCLUSIONS: This, therefore, allows HU measurements to be used as an effective diagnostic method in lieu of DXA scans when deciding on appropriate management of therapy for patients with spinal instrumentation or degenerative spines.

9.
Rev. Assoc. Med. Bras. (1992, Impr.) ; 67(1): 71-76, Jan. 2021. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1287788

RESUMO

SUMMARY OBJECTIVE: Myocardial speckle-tracking echocardiography can detect subtle abnormalities in the left atrial function. In this study, we aimed to investigate the relationship between left atrial myocardium and tissue function n assessed by two-dimensional speckle-tracking echocardiography and the National Institutes of Health Stroke Scale score in patients with acute ischemic stroke. METHOD: The study was composed of 80 patients (45 men, 35 women, mean age: 67±15 years) with acute ischemic stroke. The patients were divided into two groups based on the calculated National Institutes of Health Stroke Scale score (group 1, National Institutes of Health Stroke Scale score < 16; group 2, National Institutes of Health Stroke Scale score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac functions were evaluated using two-dimensional speckle-tracking echocardiography within 48 hours from admission to the neurology care unit. RESULTS: There were no significant differences between the patients' clinical parameters. Left ventricular ejection fraction was significantly higher in group 1 than in group 2 (59.2±5.6 to 51.4±6.3, p=0.024). Left atrial longitudinal strain was significantly higher in group 1 than in group 2 (34.48±9.73 to 26.27±7.41, p=0.019). There were no significant differences between other echocardiographic parameters. CONCLUSION: Our results suggest that left atrial longitudinal strain is associated with stroke severity during admission in patients with acute ischemic stroke. Left atrial longitudinal strain is an indicator of left atrial myocardial function.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , AVC Isquêmico , Volume Sistólico , Função do Átrio Esquerdo , Função Ventricular Esquerda , Pessoa de Meia-Idade
10.
Pediatr Neurosurg ; 55(5): 309-312, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33207345

RESUMO

INTRODUCTION: Primary intradiploic meningiomas account for <1% of all osseous calvarial lesions and are categorized as bone tumors. They are frequently observed in the frontotemporal region of the calvarium, anterior cranial fossa, and orbit. We present a case of intradiploic meningioma of the orbital roof, which is rarely observed in the pediatric age-group; it was surgically treated with a unique minimally invasive approach. CASE PRESENTATION: A 16-year-old male with chief complaints of headache on the right side for approximately 1 year was presented to our clinic. Cranial MRI revealed an intradiploic mass with homogeneous, hypointense contrast patterns on the T1W and T2W images of the right orbital roof. A skin incision was made through the right eyebrow, and the frontal sinus anterior wall was opened by craniotomy. Gross total resection was achieved by reaching the tumor present in the orbital roof. The mass was characterized as psammomatous meningioma by a pathological examination. DISCUSSION/CONCLUSION: In cranial oncologic surgery, lesion localization and possible pathological diagnosis are essential for the determination of the correct surgical technique. In particular, in pediatric cases, selecting a method that will reduce the need for transfusion, shorten the surgical time, minimize the chances of facial deformity, and facilitate postoperative care will ensure compliance with the correct and appropriate treatment process.


Assuntos
Sobrancelhas , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Neoplasias Orbitárias/cirurgia , Adolescente , Humanos , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Órbita/diagnóstico por imagem , Órbita/cirurgia , Neoplasias Orbitárias/diagnóstico por imagem
11.
J Stroke Cerebrovasc Dis ; 29(7): 104847, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32389558

RESUMO

BACKGROUND: In patients with normal pressure hydrocephalus (NPH), lumbar puncture (LP) is an effective method for assessing both the diagnosis as well as the possible efficacy of ventriculoperitoneal shunting based on symptom improvement. However, it should be considered that there exists a low risk of complications and that these risks may result in morbidity and mortality. We present a patient who developed hematoma in the basal ganglia following LP. CASE DESCRIPTION: A 56-year-old man presented with progressive dementia, ataxia, and urinary incontinence for 8 months. The patient received LP. He had no history of coagulopathy and had NPH findings on cranial magnetic resonance imaging. On the second day after LP, he complained of headache and had left hemiparesis, and intracerebral hematoma was observed at the basal ganglia, posterior to the lentiform nucleus. CONCLUSIONS: Although intracerebral hematoma after LP is one of the rare complications to be more cautious about, particularly in patients with a history of chronic disease or chronic changes in imaging, a history of previous cerebrovascular events and recurrent LPs with probably less cerebrospinal fluid drainage should be planned. Moreover, it should be considered that intracerebral hematoma may develop in patients with clinical deterioration, and good clinical follow-up is required.


Assuntos
Hemorragia dos Gânglios da Base/etiologia , Gânglios da Base , Hematoma/etiologia , Hidrocefalia de Pressão Normal/diagnóstico , Hidrocefalia de Pressão Normal/terapia , Punção Espinal/efeitos adversos , Gânglios da Base/diagnóstico por imagem , Hemorragia dos Gânglios da Base/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Humanos , Hidrocefalia de Pressão Normal/fisiopatologia , Masculino , Pessoa de Meia-Idade
12.
Int Wound J ; 17(1): 132-136, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31680429

RESUMO

Paediatric burn wounds are challenging conditions to manage for both the doctors and patients and can cause several complications entailing a complicated treatment and recovery process. This study aims to evaluate sociodemographic conditions and antibiogram culture results of paediatric burn wounds. Our study retrospectively evaluated 419 paediatric patients with burns regarding age, gender, burn area and degree, total days spent in hospital, surgical history, final condition, additional disease history, previous attempts, and culture results with their antibiotic resistances, haemogram results, C-reactive protein results, sociocultural conditions, burned region of the body, and structure of the burn. The prominent observations were an increased rate of incidence in male patients and patients with low socioeconomic conditions, the highest incidence of burns from scalding and domestic accidents, and the highest incidence of third-degree burns. Furthermore, even though the most encountered burn types were extremity burns, the burn types with the highest culture growth ratio were the perineum burns. The dominant culture growth bacterial group was coagulase-negative staphylococcus, and the ratio of medication resistance was 67.8%. It is imperative to raise awareness regarding domestic accidents to prevent paediatric burn wounds. The mortality risk can be reduced by carefully monitoring multiple organ involvement and providing timely treatment. Moreover, appropriate wound care is warranted to avoid infection from skin flora.


Assuntos
Antibacterianos/uso terapêutico , Queimaduras por Corrente Elétrica/diagnóstico , Queimaduras por Corrente Elétrica/tratamento farmacológico , Queimaduras por Corrente Elétrica/epidemiologia , Queimaduras por Corrente Elétrica/microbiologia , Tempo de Internação/estatística & dados numéricos , Infecção dos Ferimentos/terapia , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos , Turquia/epidemiologia
13.
Pediatr Neurosurg ; 54(4): 277-280, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261150

RESUMO

The Meckel-Gruber syndrome is a rare, congenital, and lethal malformation characterized by typical manifestations such as encephalocele, polycystic kidneys, and polydactyly. Herein, we present a case of a patient with the typical triad as well as facial, ocular, liver, and genital abnormalities who lived for almost 5 months.


Assuntos
Transtornos da Motilidade Ciliar/diagnóstico por imagem , Encefalocele/diagnóstico por imagem , Doenças Renais Policísticas/diagnóstico por imagem , Polidactilia , Retinose Pigmentar/diagnóstico por imagem , Transtornos da Motilidade Ciliar/congênito , Encefalocele/congênito , Evolução Fatal , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Doenças Raras , Retinose Pigmentar/congênito , Ultrassonografia Pré-Natal
14.
World Neurosurg ; 126: e731-e735, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30851469

RESUMO

BACKGROUND: Revascularization before infarct development after cerebral ischemia may affect morbidity. The success of revascularization can be less than expected because of spontaneous thrombosis or restenosis with intimal hyperplasia. The aim of this study was to compare dabigatran etexilate, a direct thrombin inhibitor, with bemiparin sodium, a second-generation low-molecular-weight heparin, after carotid artery anastomosis. METHODS: This study used 24 randomly selected Sprague-Dawley rats. The rats were separated into 3 equal groups: group 1 (control group); group 2 (dabigatran group), in which dabigatran 10 mg/kg was orally administered for 7 days; and group 3 (bemiparin group), in which bemiparin 250 IU/kg was subcutaneously administered for 7 days. The right-side carotid artery of rats was used for anastomosis and the left-side carotid artery was used for the control. The carotid artery was explored and transected. Anastomosis was applied using 10/0 polypropylene sutures. After 7 days of treatment, the right and left carotid arteries were removed. Lumen diameter, lumen area, tunica media thickness, edema, vessel wall injury, intimal hyperplasia, thrombus, and inflammation were evaluated in tissue biopsy specimens. RESULTS: Bemiparin used after anastomosis caused less thickening of tunica media and reduced intimal hyperplasia but did not decrease lumen diameter and area. Dabigatran increased edema and inflammation but did not prevent intimal hyperplasia. CONCLUSIONS: Bemiparin reduced intimal hyperplasia and prevented thrombosis angiogenesis, but dabigatran did not prevent intimal hyperplasia, and its anticoagulation effect was more than the antithrombotic effect.


Assuntos
Anticoagulantes/farmacologia , Antitrombinas/farmacologia , Artérias Carótidas/efeitos dos fármacos , Revascularização Cerebral/métodos , Dabigatrana/farmacologia , Heparina de Baixo Peso Molecular/farmacologia , Neointima/prevenção & controle , Trombose/prevenção & controle , Animais , Anticoagulantes/uso terapêutico , Antitrombinas/uso terapêutico , Dabigatrana/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Ratos , Ratos Sprague-Dawley
15.
Pediatr Neurosurg ; 53(6): 413-415, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30176663

RESUMO

Factor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity. We present an 8-month-old female patient who developed subdural hematoma after ventriculoperitoneal shunt surgery but not bleeding after choroid plexus papilloma due to FXIII deficiency.


Assuntos
Deficiência do Fator XIII/complicações , Hematoma Subdural/diagnóstico por imagem , Papiloma do Plexo Corióideo/cirurgia , Deficiência do Fator XIII/sangue , Feminino , Hematoma Subdural/etiologia , Hemorragia , Humanos , Lactente , Hemorragias Intracranianas/etiologia , Papiloma do Plexo Corióideo/patologia , Derivação Ventriculoperitoneal/efeitos adversos
16.
Rev Port Cardiol ; 36(12): 895-900, 2017 Dec.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29191713

RESUMO

INTRODUCTION: Speckle tracking echocardiography (STE) for two-dimensional (2D) strain analysis is a new tool to assess myocardial function. The aim of this study was to assess right atrial (RA) function using STE in patients with an atrial septal defect (ASD) before and one month after percutaneous closure. METHODS: We prospectively examined 32 consecutive patients (nine male, 23 female) who underwent percutaneous transcatheter closure of a secundum ASD between June 2013 and December 2015. Echocardiography was performed on admission, prior to cardiac catheterization and then one month after ASD closure. Peak global RA longitudinal strain was analyzed by 2D-STE. RESULTS: Patients' mean age was 34.6±8.2 years. The mean diameter of the occlusive devices was 18.5±7.5 mm. Right ventricular (RV) end-diastolic diameters were significantly increased but decreased significantly after ASD closure (43±5 vs. 38±4 mm, p<0.05). Left atrial (LA) diameters (40±8 vs. 37±6 mm, p<0.05) decreased significantly after the intervention, whereas left ventricular (LV) end-diastolic diameters (45±5 vs. 46±4 mm, NS) remained unchanged. Tricuspid annular plane systolic excursion increased significantly (17.6±5.4 vs. 22.3±8.1 mm, p<0.05). After closure of the defect, a significant increase was observed in longitudinal RA strain (26.5±9.6% vs. 35.3±10.5%, p<0.001). CONCLUSIONS: After percutaneous transcatheter closure of a secundum ASD, there was an increase in RA longitudinal strain. 2D-STE strain analysis appears to be helpful for the assessment of RA function and of response to correction of volume overload after percutaneous transcatheter closure of a secundum ASD.


Assuntos
Função do Átrio Direito , Ecocardiografia/métodos , Comunicação Interatrial/fisiopatologia , Comunicação Interatrial/cirurgia , Adulto , Procedimentos Cirúrgicos Cardíacos/métodos , Feminino , Testes de Função Cardíaca/métodos , Humanos , Masculino , Estudos Prospectivos
17.
Acta Cardiol Sin ; 33(5): 523-529, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28959106

RESUMO

BACKGROUND: Transthoracic echocardiography is used for assessment of right ventricular (RV) function. Speckle tracking echocardiography (STE) is a new tool to assess myocardial function. The aim of this study was to evaluate RV function using STE in patients with atrial septal defect (ASD) before and the first month after percutaneous closure. METHODS: We prospectively examined 32 consecutive patients (9 male, 23 female) who underwent percutaneous transcatheter closure (PTC) of secundum ASD from June 2013 to December 2015. Echocardiography was initially performed upon admission, prior to cardiac catheterization and then the first month after PTC of secundum ASD. Thereafter, the peak global RV longitudinal strain (RVLSR) was analyzed by two-dimensional STE. RESULTS: The mean age of the patients was 34.6 ± 8.2 years, and the mean diameter of the occlusive devices was 18.5 ± 7.5 mm. RV end diastolic diameters were significantly larger and decreased significantly after ASD closure (43 ± 5 vs. 38 ± 4 mm, p < 0.05). Left atrium diameters (40 ± 8 vs. 37 ± 6 mm, p < 0.05) decreased significantly after the intervention, whereas left ventricle end-diastolic diameters (45 ± 5 vs. 46 ± 4 mm, nonspecific) remain unchanged. Tricuspid annular plane systolic excursion increased significantly (17.6 ± 5.4 vs. 22.3 ± 8.1 mm, p < 0.05). RV myocardial performance index significantly improved (0.38 ± 0.15 vs. 0.29 ± 0.08, p < 0.05). After interventional closure of the defect, we observed a significant increase of the longitudinal RV strain (28.3 ± 5.6% vs. 22.4 ± 4.3%, p < 0.001). CONCLUSIONS: Two-dimensional strain appears to facilitate the assessment of RV function and its response to correction of volume overload after PTC of secundum ASD.

18.
Korean Circ J ; 46(6): 791-797, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27826337

RESUMO

BACKGROUND AND OBJECTIVES: Genetic influence on T-wave peak to End (Tpe) time in patients with a first anterior acute myocardial infarction (AMI) is uncertain. A polymorphism in the angiotensin-II type 1 receptor (AT1R) gene was discovered recently. The polymorphism consists of an A or C variant, given three different possible genotypes: AA, AC, CC. The purpose of this study was to determine the effects of polymorphism of the AT1R gene polymorphism on Tpe after a first anterior AMI. SUBJECTS AND METHODS: The subjects were 142 patients (110 men, 32 women, 58±13 years) with a first anterior AMI; ten patients were excluded from this study. Based on the polymorphism of the AT1R gene, they were classified into two groups: Group 1 (AA genotype) of 91 patients and group 2 (AC and CC genotype) of 41 patients. A 12-lead resting ECG was recorded at admission to the coronary care unit in patients with anterior AMI and were manually measured with a ruler. QTc, QTd, QTcd, Tpe, Tpe/QT parameters were measured. RESULTS: There was no significant difference in the baseline characteristics of patients (p>0.05). We found significant reduction in QTc, QTd, QTcd, Tpe, Tpe/QT indices Group 1 (AA genotype) (mean 66±28 ms) than group 2 (AC and CC genotype) (mean 95±34 ms) (p<0.05). CONCLUSION: In patients with a first anterior AMI, AT1R gene polymorphisms may influence on repolarization parameters. Although further studies are required.

19.
Cutan Ocul Toxicol ; 34(4): 344-6, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25363067

RESUMO

Acute generalized exanthematous pustulosis (AGEP) is an acute sterile pustular eruption most commonly induced by medications. Although antibiotics are the most commonly accused drugs in AGEP, non-antibiotic agents may also cause this disease. We present a case of AGEP following use of iodixanol for coronary angiography in a 61-year-old woman. Given the wide use of this substance in cardiology, clinicians should be aware of this potential complication.


Assuntos
Pustulose Exantematosa Aguda Generalizada/etiologia , Meios de Contraste/efeitos adversos , Ácidos Tri-Iodobenzoicos/efeitos adversos , Pustulose Exantematosa Aguda Generalizada/diagnóstico , Pustulose Exantematosa Aguda Generalizada/tratamento farmacológico , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Biópsia , Meios de Contraste/administração & dosagem , Angiografia Coronária/métodos , Feminino , Humanos , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Resultado do Tratamento , Ácidos Tri-Iodobenzoicos/administração & dosagem
20.
BMJ Case Rep ; 20142014 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-24448432

RESUMO

Behcet's disease (BD) is a multisystemic inflammatory disorder of unknown origin, presenting with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. Coronary involvement is very rare in patients with BD. Sildenafil, an oral drug used to treat erectile dysfunction, was shown to cause significant cardiovascular problems including acute myocardial infarction (MI) and sudden cardiac death. Acute MI associated with BD and sildenafil has not been reported previously. We present a case of a 23-year-old male patient with an acute inferior MI associated with BD diagnosed after admission of sildenafil, who was successfully treated with thrombus aspiration and tirofiban administration.


Assuntos
Síndrome de Behçet/complicações , Eletrocardiografia , Infarto do Miocárdio/etiologia , Piperazinas/uso terapêutico , Sulfonas/uso terapêutico , Síndrome de Behçet/tratamento farmacológico , Angiografia Coronária , Seguimentos , Humanos , Masculino , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/tratamento farmacológico , Purinas/uso terapêutico , Citrato de Sildenafila , Vasodilatadores/uso terapêutico , Adulto Jovem
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