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Venous Thromboembolic Diseases: Epidemiological, Clinical, Para clinical, Therapeutic and Evolutionary Aspects: Retrospective Study over a Period of 7.5 Years about 112 Cases collected in the Internal Medicine and Cardiology Department of Lnth 静脉血栓栓塞性疾病:流行病学、临床、准临床、治疗和进化方面:对伦敦大学内科和心内科112例患者7.5年的回顾性研究
Pub Date : 2021-02-27 DOI: 10.33425/2639-8486.1093
Toure Ai, S. K, Boncano A, Dodo B, H. M, Haggar S, Z. À, Djonyony S
Introduction: venous thromboembolism (VTE) is a real public health problem in the world due to its frequency and severity since the mortality from an untreated thromboembolic episode is around 30%. Because of its chronic and disabling complications (post-thrombotic disease and chronic thromboembolic pulmonary hypertension), it is responsible for a deterioration in the quality of life of patients. Objective: The aim of this work was to contribute to the study of the epidemiological , clinical, Para clinical, therapeutic and evolutive aspects of venous thromboembolism disease in the internal medicine and cardiology department of the Amirou Boubacar Diallo National Hospital. Patients and Methods: It's a prospective study from July 1st, 2019 to June 30th, 2020 and retrospective from January 1st, 2013 to June 30th, 2019 (7 years and 6 months) about 112 patients with whom the diagnostic of deep venous thrombosis (DVT ) and / or pulmonary embolism (PE) had been done. Results: In our study, the prevalence of venous thromboembolism has been estimated at 3.9% of hospitalized patients with cardiovascular diseases. There was a female predominance (sex ratio 1.38). The average age of patients was 52 years. Teabed-rest prolonged was the frequent risk factor (66%). The clinical symptomatology was dominated by oedema of the lower limb (83.3%) and pain in limb palpation (82.1%) in case of DVT, the dyspnea (23.02%) and thoracic pain (11.6%) in case of PE. The attack of the left lower limb prevailed (45.5%). The sinus tachycardia (25.9%) was the predominant electrical sign at the ECG. Through the Doppler of the lower limbs, the popliteal and femoral veins were the most involved with 22.3% and 17.8% respectively. According to the chest angio-CT, the left pulmonary artery was obstructed in 100% of case. The treatment was essentially made of low molecular weight heparins (90.1%) replaced quickly by vitamin k antagonist (began the first day of the heparin therapy) and / or of unfractionated heparin (9%). The most common complication was PE due to DVT and the overall mortality was 12.5%. Conclusion: VTE is pathology in young adults and elderly characterized by the formation of a clot in a vein responsible for the obstruction of the latter causing local inflammatory signs and / or its pulmonary migration which could be fatal. The prevention and treatment of VTE are based on anticoagulants.
引言:静脉血栓栓塞症(VTE)是世界上一个真正的公共卫生问题,因为其发生频率和严重程度,因为未经治疗的血栓栓塞事件的死亡率约为30%。由于其慢性和致残性并发症(血栓形成后疾病和慢性血栓栓塞性肺动脉高压),它是患者生活质量恶化的原因。目的:这项工作的目的是为阿米鲁·布巴卡尔·迪亚洛国立医院内科和心内科静脉血栓栓塞症的流行病学、临床、准临床、治疗和进化方面的研究做出贡献。患者和方法:这是一项从2019年7月1日至2020年6月30日的前瞻性研究,从2013年1月1日到2019年6月31日(7年零6个月)的回顾性研究,涉及112名诊断为深静脉血栓形成(DVT)和/或肺栓塞(PE)的患者。结果:在我们的研究中,静脉血栓栓塞症的患病率估计为心血管疾病住院患者的3.9%。患者以女性为主(性别比1.38),平均年龄52岁。长期卧床休息是常见的危险因素(66%)。临床症状主要是下肢水肿(83.3%)和肢体触诊疼痛(82.1%)(DVT),呼吸困难(23.02%)和胸痛(11.6%)(PE)。主要是左下肢发作(45.5%)。窦性心动过速(25.9%)是心电图的主要电征。下肢多普勒检查,腘静脉和股静脉受累最多,分别占22.3%和17.8%。根据胸部血管CT检查,100%的病例左肺动脉阻塞。该治疗基本上由低分子量肝素(90.1%)快速替换为维生素k拮抗剂(从肝素治疗的第一天开始)和/或普通肝素(9%)制成。最常见的并发症是DVT引起的PE,总死亡率为12.5%。结论:VTE是年轻人和老年人的病理学,其特征是在静脉中形成凝块,导致后者阻塞,导致局部炎症体征和/或其肺部迁移,这可能是致命的。VTE的预防和治疗是以抗凝血剂为基础的。
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引用次数: 0
Patients Living with HIV and Coronary Disease: Are we Using Appropriate Anti platelets as Part of Dual Antiplatelet Therapy? 艾滋病毒和冠心病患者:我们是否使用适当的抗血小板作为双重抗血小板治疗的一部分?
Pub Date : 2021-02-27 DOI: 10.33425/2639-8486.1094
O. Archer, J. Perram, J. Nadel, S. Emmanuel, G. Matthews, R. Beresford, C. Holloway
Background: People living with HIV (PLHIV) have a higher incidence of cardiovascular disease and complications after intervention, including in-stent thrombosis. The frequency of potential drug-drug interactions in the setting of acute coronary syndrome (ACS) with antiretroviral therapy (ART) and dual-antiplatelet therapy (DAPT) regimens remains unclear. We sought to determine the frequency of potential drug-drug interactions in a cohort of people living with HIV who were investigated for coronary disease and initiated on DAPT as per Australian ACS Guidelines. Methods: A retrospective audit was performed in a single tertiary hospital in PLHIV presenting with symptomatic coronary artery disease (CAD) receiving DAPT. Patients were grouped based on exposure to a protease inhibitor or efavirenz and etravirine, given that these were found to have the greatest potential interactions with DAPT. Results: Fifty-three patients received DAPT, of which 31 (58%) had a potential drug-drug interaction. Clopidogrel was the most frequent P2Y12 inhibitor prescribed, accounting for 47 (87%) of the interactions. Twenty-six patients were on a protease inhibitor, of which 21 (81%) had a potential drug-drug interaction. There were 11 instances of efavirenz and 3 of etravirine use, of which all resulted in potential drug-drug interactions (100%, respectively). Conclusion: Potential drug-drug interactions were very common in PLHIV needing DAPT. The widespread use of clopidogrel in DAPT regimens resulted in a high rate of drug-drug interactions. An awareness of interactions and guidelines around P2Y12 inhibitor selection may help reduce the rate of in-stent thrombosis for PLHIV and improve clinical outcomes.
背景:艾滋病毒感染者(PLHIV)在干预后心血管疾病和并发症的发生率更高,包括支架内血栓形成。急性冠脉综合征(ACS)与抗逆转录病毒治疗(ART)和双重抗血小板治疗(DAPT)方案的潜在药物-药物相互作用的频率尚不清楚。我们试图确定一组艾滋病毒感染者中潜在药物-药物相互作用的频率,这些人接受了冠状动脉疾病调查,并根据澳大利亚ACS指南开始使用DAPT。方法:回顾性分析某三甲医院出现症状性冠状动脉疾病(CAD)并接受DAPT治疗的PLHIV患者。根据蛋白酶抑制剂或依非韦伦和依曲维林的暴露程度对患者进行分组,因为发现这些药物与DAPT有最大的潜在相互作用。结果:53例患者接受DAPT治疗,其中31例(58%)存在潜在的药物相互作用。氯吡格雷是处方中最常见的P2Y12抑制剂,占相互作用的47(87%)。26例患者使用蛋白酶抑制剂,其中21例(81%)存在潜在的药物相互作用。使用依非韦伦11例,使用依曲维林3例,均导致潜在的药物-药物相互作用(分别为100%)。结论:需要DAPT治疗的PLHIV患者存在潜在的药物相互作用。氯吡格雷在DAPT方案中的广泛使用导致了药物-药物相互作用的高发生率。了解相互作用和P2Y12抑制剂选择指南可能有助于降低PLHIV支架内血栓形成率并改善临床结果。
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引用次数: 1
Epidemiology of Sudden Cardiac Death: Necropsic Studies at Aristide Le Dantec Hospital 心脏性猝死的流行病学:Aristide Le Dantec医院的尸检研究
Pub Date : 2021-02-27 DOI: 10.33425/2639-8486.1095
Bodian M, Akanni Scg, Beye Sm, Mingou Js, Diouf Y, Niass Ad, A. F., Sarr Sa, Diop Cmbm, Ndiaye Pg, Ngaide Aa, D. M, Lèye M, Ralaizandry U, Ndiaye Mb, M. A, Kane Ad, K. A, D. M
Introduction: Sudden cardiac death (SCD) remains a major public health issue. In Senegal, there is a lack of data on this phenomenon; this underlies the relevance of this study whose objective is to study the epidemiological profile of victims experiencing unrecovered sudden cardiac arrest at Aristide LE DANTEC Hospital. Patients and Methods: This is a transverse study with retrospective data collection from January 1, 2016 to January 31, 2017. Included, in the study were all victims of sudden cardiac death in Dakar who had a necropsy in the morgues of Aristide Le Dantec Hospital. Results: We recorded 69 cases of sudden death of cardiovascular origin from 169 forensic autopsy reports, or 40.8% of autopsies. The average age was 44 years with a male predominance in 76.81%. The large majority of death occurred at home (26%), without witnesses (48%) and at rest (36%). Two cases of sudden death, or 3%, occurred at exertion. These deaths were recorded in 16% of cases in the middle of the day. The highest death rate was recorded during the month of December (15.9%). Malaise was the predominant symptom (13%) followed by emotional stress (6%). The existence of a history could only be clarified in 4% of cases. The electrocardiogram was only performed in 1 case. At necropsy, ischemic heart disease was the leading disease (46%), 26% of which was due to myocardial infarction, followed by hypertrophic cardiomyopathy (16%) and mixed cardiomyopathy (13%). Tamponade, dilated cardiomyopathy and aortic dissection were found in 9%, 6% and 4% of cases, respectively. Conclusion: Sudden cardiac death is a major public health problem. In the Senegalese population, victims of unrecovered SCD are relatively young with a predominance of men. Coronary artery disease is the most frequently implicated pathology. Faced with this observation, a national program for the integrated control of cardiovascular risk factors is necessary.
心源性猝死(SCD)仍然是一个主要的公共卫生问题。在塞内加尔,缺乏这一现象的数据;这项研究的目的是研究在阿里斯蒂德LE DANTEC医院经历未恢复的心脏骤停的受害者的流行病学概况。患者和方法:这是一项横向研究,回顾性收集2016年1月1日至2017年1月31日的数据。在这项研究中包括了所有在达喀尔心脏性猝死的受害者,他们在阿里斯蒂德勒丹特克医院的停尸房进行了尸检。结果:我们从169份法医尸检报告中记录了69例心血管原因的猝死,占尸检的40.8%。平均年龄44岁,男性占76.81%。绝大多数死亡发生在家中(26%)、无证人(48%)和休息时(36%)。2例猝死(3%)发生在用力过程中。16%的病例在白天死亡。死亡率最高的是12月份(15.9%)。不适是主要症状(13%),其次是情绪紧张(6%)。只有4%的病例可以明确病史的存在。仅1例进行了心电图检查。在尸检中,缺血性心脏病是主要疾病(46%),其中26%是由于心肌梗死,其次是肥厚性心肌病(16%)和混合性心肌病(13%)。心包填塞、扩张性心肌病和主动脉夹层分别占9%、6%和4%。结论:心源性猝死是一个重大的公共卫生问题。在塞内加尔人口中,未治愈的SCD的受害者相对年轻,以男性为主。冠状动脉疾病是最常见的病理。面对这一观察结果,一个综合控制心血管危险因素的国家计划是必要的。
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引用次数: 0
Effects of Selective Endothelin Receptor Antagonist on Vegf Signaling System in Diabetic Penis: A Possible Clinical Implication for Diabetes Induced Erectile Dysfunction 选择性内皮素受体拮抗剂对糖尿病阴茎血管内皮生长因子信号系统的影响:糖尿病性勃起功能障碍的可能临床意义
Pub Date : 2021-02-27 DOI: 10.33425/2639-8486.1096
A. Maqbool, S. Jesmin, Chishimba N Mowa, S. N. Sultana, N. Shimojo, Y. Matsuishi, Takeru Shima, N. Yamaguchi, T. Miyauchi, S. Kawano, M. Moroi
Erectile dysfunction (ED) affects around 50 percent of male diabetic patients due to vascular and neuropathic complications arising from diabetes. Vascular endothelial growth factor (VEGF) has been extensively investigated for its pathogenic relevance in various diabetes complications, and we have already noted that VEGF signaling is significantly reduced at the insulin-resistant stage in the penis of type II diabetic rat model. The present research used a three-week streptozotocin (STZ)-induced diabetic (DM) rat model to determine the expression of VEGF with NO mechanism in penile tissue and subsequently investigated its impact endothelin antagonism on these shifts. Citrate saline vehicle or STZ (65 mg/kg IP) was administered to male Sprague-Dawley rats (weight 453 ± 23 g). Hyperglycemia confirmed diabetes, and then after 1 week of diabetes, animals were divided into receiving endothelin-A (ET-A) receptor antagonists (TA-0201, 1 mg/kg) or saline by osmotic minipump for 2 weeks and then sacrificed. Significantly improved glucose levels in DM rats (405 ± 103 mg/dL) relative to non-DM rats (120 ± 8 mg/dL) and higher local ET-1 levels in DM penis by 20% are observed. A 30 percent decline in penile tissue expression of VEGF was observed in DM rats and improved by an antagonist with ET. Penile NO and eNOS levels in DM rats decreased, while ET-A receptor antagonist significantly increased. Therefore, we infer that ET antagonism seemed able to restore the down-regulated VEGF and was possibly efficient in restoring the decreased levels of NO and eNOS in DM.
由于糖尿病引起的血管和神经病变并发症,大约50%的男性糖尿病患者受到勃起功能障碍(ED)的影响。血管内皮生长因子(Vascular endothelial growth factor, VEGF)在各种糖尿病并发症中的致病相关性已被广泛研究,我们已经注意到,在II型糖尿病大鼠模型的阴茎胰岛素抵抗阶段,VEGF信号明显减少。本研究采用三周链脲佐菌素(STZ)诱导的糖尿病(DM)大鼠模型,通过NO机制测定VEGF在阴茎组织中的表达,并随后研究其内皮素拮抗剂对这些变化的影响。雄性Sprague-Dawley大鼠(体重453±23 g)经高血糖确诊为糖尿病后,给予柠檬酸盐溶液或STZ (65 mg/kg IP),在糖尿病1周后,将动物分为内皮素- a (ET-A)受体拮抗剂(TA-0201, 1 mg/kg)或生理盐水,经渗透小泵灌注2周后处死。糖尿病大鼠的血糖水平(405±103 mg/dL)明显高于非糖尿病大鼠(120±8 mg/dL),糖尿病大鼠阴茎局部ET-1水平升高20%。DM大鼠阴茎组织中VEGF表达下降30%,ET拮抗剂改善了这一现象。DM大鼠阴茎NO和eNOS水平下降,而ET-A受体拮抗剂显著增加。因此,我们推断ET拮抗似乎能够恢复下调的VEGF,并可能有效地恢复DM中下降的NO和eNOS水平。
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引用次数: 0
Elevated Cardiopulmonary Complications after Revascularization in Patients with Severe Mental Health Disorders. 严重精神疾病患者血运重建术后心肺并发症升高。
Pub Date : 2021-01-01 DOI: 10.33425/2639-8486.1122
Leah Gober, Adam Brown, Avianne P Bunnell, Brian E Bunnell, Jean Marie Ruddy

Introduction: Mental health disorders (MHD) are prevalent within surgical patient populations and can be associated with poorer postoperative outcomes, particularly in those with more severe MHD (schizophrenia and bipolar disorder). However, these associations have not been examined in vascular surgery patients. This study investigated patients undergoing lower extremity revascularization, hypothesizing that those with severe MHD would experience worse health and postoperative outcomes.

Methods: A retrospective chart review of patients from 2010-2015 with peripheral arterial disease (PAD) requiring revascularization was conducted, with subsequent narrowing to those with concurrent MHD diagnoses, including severe MHD (sMHD) defined as bipolar disorder or schizophrenia and non-severe MHD (nsMHD), defined as anxiety or depression. The primary endpoints were 30-day mortality; Major Adverse Limb Events (MALE) including amputation at the above or below knee level; and Major Adverse Cardiac Events (MACE) including myocardial infarction (MI), congestive heart failure (CHF) exacerbation, and arrhythmia. Secondary endpoints were readmission within 30 days, pulmonary complications, and wound infection. Statistical analyses included Fisher Exact Test and Student's T-test.

Results: Eighteen patients with MHD (sMHD, n=10; nsMHD, n=8) were identified and stratified. Twenty-four limbs were revascularized (sMHD, n=13; nsMHD, n=11). Overall incidence of 30-day mortality, MALE, and MACE were 4.2%, 33.3%, and 50.0%, respectively. Readmission rate, pneumonia, and wound infection occurred in 41.7%, 20.8%, and 16.7% of the population. Stratifying by MHD severity, no significant differences were observed for medical comorbidities, MALE, intervention type (open vs. endovascular), or treatment indication (claudication vs. critical limb ischemia). Patients with sMHD had significantly higher rates of MACE compared to patients with nsMHD (30.8% vs. 18.2%, p<.05). Pneumonia was also more prevalent in this group (38.5% vs. 0.0%, p<.05).

Conclusion: While patients with concurrent diagnoses of MHD and PAD presented with similar comorbidities, comparable disease severity, and were equally treated by open versus endovascular techniques, those with severe MHD suffered significantly elevated rates of cardiopulmonary complications, specifically MACE and pneumonia. Further investigation is warranted to identify opportunities to optimize post-operative care for these complex patients.

心理健康障碍(MHD)在外科患者人群中很普遍,并且可能与较差的术后结果相关,特别是在那些更严重的MHD(精神分裂症和双相情感障碍)患者中。然而,这些关联尚未在血管手术患者中得到检验。本研究调查了接受下肢血运重建术的患者,假设严重MHD患者的健康状况和术后结果更差。方法:对2010-2015年需要血运重建术的外周动脉疾病(PAD)患者进行回顾性图表回顾,随后将范围缩小到并发MHD诊断的患者,包括定义为双相情感障碍或精神分裂症的重度MHD (sMHD)和定义为焦虑或抑郁的非重度MHD (nsMHD)。主要终点为30天死亡率;主要肢体不良事件(MALE)包括膝关节以上或以下截肢;以及主要心脏不良事件(MACE),包括心肌梗死(MI)、充血性心力衰竭(CHF)加重和心律失常。次要终点为30天内再入院、肺部并发症和伤口感染。统计分析包括Fisher精确检验和学生t检验。结果:18例MHD患者(sMHD, n=10;nsMHD, n=8)进行鉴定和分层。24条肢体血运重建(sMHD, n=13;nsMHD, n = 11)。30天死亡率、男性死亡率和MACE的总发生率分别为4.2%、33.3%和50.0%。再入院率、肺炎和伤口感染发生率分别为41.7%、20.8%和16.7%。按MHD严重程度分层,在医学合并症、男性、干预类型(开放与血管内)或治疗指征(跛行与严重肢体缺血)方面没有观察到显著差异。结论:虽然同时诊断为MHD和PAD的患者表现出相似的合并症、相似的疾病严重程度,并且接受开放和血管内技术的治疗相同,但严重MHD患者的心肺并发症发生率显著升高,特别是MACE和肺炎。进一步的研究是必要的,以确定机会,以优化这些复杂的病人的术后护理。
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引用次数: 1
Left Atrial Mass: Thrombus? Myxoma? Or Both? Myxoma surrounded by thrombus 左心房肿块:血栓?粘液瘤?还是两者都有?血栓包围的粘液瘤
Pub Date : 2020-12-30 DOI: 10.33425/2639-8486.1089
M. Taşar, Fatih Ada
Left atrial masses are generally myxomas or thrombus formations. When the operation of the mass is inevitable, preoperative radiological techniques are used for understanding the properties. When a mass in left atrium is seen, it thought to be solely myxoma or thrombus. In this case, we aimed to present a patient that underwent open cardiac surgery for a left atrial mass and it was a myxoma which was surrounded by thrombus formation. *Correspondence: Dr. Mehmet Taşar, Dr.Sami Ulus Maternity, Child Health Education and Research Hospital, Cardiovascular Surgery Department, Ankara, Turkey, Tel: +90 505 442 47 80. Received: 02 December 2020; Accepted: 22 December 2020
左心房肿块通常是粘液瘤或血栓形成。当肿块的手术不可避免时,使用术前放射学技术来了解其性质。当看到左心房的肿块时,它被认为是单纯的粘液瘤或血栓。在这种情况下,我们的目的是介绍一名因左心房肿块接受心脏直视手术的患者,这是一种被血栓形成包围的粘液瘤*通讯:Mehmet Taşar医生,Sami Ulus妇产医生,儿童健康教育和研究医院,心血管外科,土耳其安卡拉,电话:+90 505 442 47 80。接收日期:2020年12月2日;接受日期:2020年12月22日
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引用次数: 1
Cocaine Induced Peripheral Artery Occlusion Resulting in Critical Limb Ischemia 可卡因诱导的外周动脉闭塞导致严重肢体缺血
Pub Date : 2020-12-30 DOI: 10.33425/2639-8486.1090
K. Collins, R. Senese, A. Ramanathan
Introduction: Cocaine addiction is a common health problem. While Cocaine’s effects on the heart and the cerebrovascular system are well documented and studied, cases of peripheral arterial occlusion from Cocaine use are uncommon in the literature. Case: A case of a forty six year old man with cocaine induced common iliac artery thrombosis which was successfully treated by stenting is presented. Discussion: Cocaine induced peripheral arterial disease is discussed along with possible mechanisms. Conclusion: Physicians should be aware of Cocaine use as one of the possible risk factors for peripheral arterial occlusion. *Correspondence: Anantha Ramanathan, Dept of Surgery, Nassau University Medical Center, Hempstead Tpke, East Meadow, NY, Tel: +1929 365 7501. Received: 04 December 2020; Accepted: 29 December 2020
简介:可卡因成瘾是一个常见的健康问题。虽然可卡因对心脏和脑血管系统的影响已被充分记录和研究,但因使用可卡因而导致外周动脉闭塞的病例在文献中并不常见。病例:一位四十六岁男性因可卡因诱发髂总动脉血栓形成,经支架置入术成功治疗。讨论:讨论了可卡因引起的外周动脉疾病及其可能的机制。结论:医生应意识到可卡因的使用是外周动脉闭塞的可能危险因素之一*通讯:Anantha Ramanathan,拿骚大学医学中心外科,纽约州东草甸亨普斯特德Tpke,电话:+1929 365 7501。接收日期:2020年12月4日;接受日期:2020年12月29日
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引用次数: 0
The Value of Assessing Myocardial Deformation at Recovery after Dobutamine Stress Echocardiography in Predicting Coronary Artery Disease 多巴酚丁胺应力超声心动图评估恢复期心肌变形对预测冠心病的价值
Pub Date : 2020-12-30 DOI: 10.33425/2639-8486.1086
Abdulaziz Aboshahba, H. Khalaf, Ali Alamin, S. Nouh, Abdulaziz Rezq, Ahmed H Dawood, Ibrahim Altaj, G. Abdelhady, Mohamed Elbordy, R. Solomon, Abdelmohsen Mostafa
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引用次数: 0
Underuse of Injectable Penicillin in Secondary Prophylaxis of Rheumatic Heart Disease in Nepal 注射用青霉素在尼泊尔风湿性心脏病二级预防中的使用不足
Pub Date : 2020-12-30 DOI: 10.33425/2639-8486.1087
S. Laudari, Tiwari K. Kaushal, A. Subedi, Sanjib K Sharma
Background and Aims: Secondary prophylaxis has remained the mainstay of rheumatic fever and rheumatic heart disease management. Despite the proven efficacy and superiority of injectable penicillin in rheumatic heart disease patients, it has been underused in Nepal. Materials and Methods: This is a hospital based cross-sectional study during June 2014 to October 2018 over a period of 52 months at College of Medical Sciences-Bharatpur including 350 patients with clinical and/or echocardiographic evidence of definite rheumatic heart disease. Data was collected from both cardiology outpatients and inpatients (admitted in cardio ward/coronary care unit). Relevant data and information were entered into the pre-structured proforma and then analyzed by SPSS-16 software. Results: The age of the patients ranged from 6 to 80 years with mean age 36.76±4.6years with female preponderance (F:M=1.26:1). The predominantly involved isolated valve was mitral in 152 patients (44.43 %) followed by aortic valve in 70 patients (20.00 %) and rest 90 (25.71 %) had dual valvular involvement. The common complications encountered were heart failure in 200(57.14 %) and arrhythmias in 155(44.29 %) patients. Two hundred ten (60.00 %) of the patients received penicillin (oral and injectable) and erythromycin. Majority (180/210=85.71 %) were prescribed on oral penicillin whereas only 46/210=21.90 % received injectable penicillin; the ratio being 3.35:1. Conclusion: RHD is a leading cause of heart failure and death among young population. There is underuse of penicillin with very minimal focus on use of injectable penicillins currently. Hence, Nepal government and other non-governmental organizations should consider implementation of use of penicillin broadly and moreover focus on use and adherence of injectable penicillin. *Correspondence: Dr. Shankar Laudari, MD, DM, FESC, FACC Cardiology, Consultant Cardiologist, Department of Cardiology, College of Medical Sciences-TH, Bharatpur, Nepal, Tel: 977-9845112909. Received: 20 November 2020; Accepted: 02 December 2020
背景和目的:二级预防仍然是风湿热和风湿性心脏病治疗的主要内容。尽管注射用青霉素已被证明对风湿性心脏病患者有疗效和优越性,但在尼泊尔却没有得到充分利用。材料和方法:这是一项2014年6月至2018年10月在巴拉特布尔医学院进行的为期52个月的医院横断面研究,包括350名有明确风湿性心脏病临床和/或超声心动图证据的患者。数据收集自心脏病门诊患者和住院患者(入住心脏病房/冠状动脉护理室)。将相关数据和信息输入到预先构建的形式表中,然后用SPSS-16软件进行分析。结果:患者年龄6~80岁,平均年龄36.76±4.6岁,女性占优势(F:M=1.26:1),主要累及二尖瓣152例(44.43%),主动脉瓣70例(20.00%),其余90例(25.71%)累及双瓣。常见并发症为200例(57.14%)心力衰竭和155例(44.29%)心律失常。210名(60.00%)患者接受青霉素(口服和注射)和红霉素治疗。大多数(180/210=85.71%)服用口服青霉素,而只有46/210=21.90%服用注射青霉素;比值为3.35:1。结论:RHD是年轻人群心力衰竭和死亡的主要原因。青霉素的使用不足,目前很少关注注射青霉素的使用。因此,尼泊尔政府和其他非政府组织应考虑广泛使用青霉素,并将重点放在注射青霉素的使用和坚持上*通讯:Shankar Laudari博士,医学博士,DM,FESC,FACC心脏病学,顾问心脏病学家,TH医学院,Bharatpur,尼泊尔,电话:977-9845112909。接收日期:2020年11月20日;接受日期:2020年12月2日
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引用次数: 1
Smoker’s Polycythemia: Is It a Cardiovascular Risk? 吸烟者红细胞增多症:有心血管风险吗?
Pub Date : 2020-10-31 DOI: 10.33425/2639-8486.1085
Abeer M. Shawky
Increase red blood cell mass and decrease plasma volume can elevate blood viscosity, which can impair blood flow, making individuals susceptible to vaso-occlusive events. Smoking that results in secondary polycythemia and erythrocytosis can cause additional harms in smokers. It can be defined by an expansion of red cell mass with elevated haemoglobin and hematocrit as a physiologic response to increased erythropoietin production secondary to generalized tissue hypoxia. Hypoxia in smoker’s polycythemia is present with normal or falsely elevated oxygen saturation value. This article stressing the importance of being aware of cardiovascular risk in patients with polycythemia as a result of chronic smoking exposure. *Correspondence: Abeer Mohamed Shawky, Cardiology Department, Faculty of medicine, Al-Azhar university, Cairo, Egypt, E-mail: abeer_ shawky@hotmail.com. Received: 02 October 2020; Accepted: 30 October 2020
增加红细胞质量和减少血浆容量会提高血液粘度,从而损害血液流动,使个体容易发生血管闭塞事件。导致继发性红细胞增多症和红细胞增多的吸烟会对吸烟者造成额外的伤害。它可以定义为红细胞质量的扩张,血红蛋白和红细胞压积升高,这是对全身组织缺氧引起的红细胞生成素增加的生理反应。吸烟者红细胞增多症的低氧表现为血氧饱和度正常或异常升高。这篇文章强调了意识到慢性吸烟导致红细胞增多症患者心血管风险的重要性*通讯:埃及开罗爱资哈尔大学医学院心脏病学系Abeer Mohamed Shawky,电子邮件:Abeer_shawky@hotmail.com.接收日期:2020年10月2日;接受时间:2020年10月30日
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引用次数: 1
期刊
Cardiology & vascular research (Wilmington, Del.)
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