Cardiovascular and Hematological Disorders - Drug Targets最新文献

Stroke following percutaneous trans-septal mitral commissurotomy (PTMC) is an unusual complication that could significantly affect the quality of life of the patients, particularly the young and active ones. We present a middle-aged woman who experienced stroke following PTMC and successfully treated with thrombolytic therapy regarding the potential adverse effects of this type of therapy. Also, we present a simple novel stepwise clinical approach for PTMC-related stroke.

Background & objective: Acute renal failure (AKI) is one of the most important complications of PCI. Due to delay in creatinine increase, we need specific factors to detect AKI earlier. The aim of this study is to evaluate the valuable factors by focusing on HFAB-P that can be predictive for AKI after Percutaneous Coronary Intervention (PCI).

Methods: This prospective study was performed on 95 patients (55 males and 44 females aged between 49-78 years) under PCI in Golestan and Imam Khomeini hospitals in Ahvaz. Patients were divided into three groups based on the development of AKI after the procedure: no AKI, severe AKI (doubling of serum creatinine or needing dialysis) and any type of AKI (increased creatinine ≥ 0/3 mg/dl or a 50% increase in the means of 1/5 times serum creatinine). The demographic and clinical characteristics of the patients, the medical history and the results of the HFABP marker, GFR, and creatinine before and after PCI were evaluated for all patients.

Results: The progenies showed 6 patients with severe AKI, 17 patients with any type of AKI, and 72 patients without AKI. Diabetes (P = 0.003), hypertension (P = 0.027), gender of patients (P = 0.025) and hospital admission days (P <0.001) were significantly different among the groups. Patients' age and positive troponin were significantly higher in patients with AKI. HFABP was the only factor that had significant changes before and after PCI (P <0.001). The cut-off value of HFABP was 4.69 with 95.6% sensitivity and 84.7% specificity. It has a good negative predictive value of 98.39% which suggests it to be a good test for the AKI prediction. Glomerular Filtration Rate (GFR) and creatinine (Cr) were significantly different after PCI (P <0.001).

Conclusion: HFABP can be considered as a predictor for AKI after PCI. Moreover, our study suggests that evaluating several parameters such as Cr and GFR before and after PCI can predict the AKI development after PCI.

Background: A mathematical model of blood flow is a way to study the blood flow behavior. In this research work, a mathematical model of non-Newtonian blood flow through different stenosis, namely bell shape and cosine shape, is considered. The physiologically important flow quantities of blood flow behavior to describe the blood flow phenomena are obtained such as resistance to flow, skin friction and blood flow rate.

Methods: Mathematical methods are used to analyze a mathematical model of blood flow through stenosed artery. The resistance to flow, skin friction and blood flow rate were obtained to describe the blood flow in stenosis. The resistance to flow is a relation between pressure and blood flow rate while the skin friction is the friction at the artery membrane. Resutls: The blood flow in cosine geometry exhibits higher resistance to flow and flow rate than in the bell geometry, while the blood flow in bell geometry gives a higher skin friction than in cosine geometry. Not only the effect of stenotic geometry was studied but also the effect of stenosis depth and stenosis height on the flow quantities Moreover, the power law index was adjusted to explore the non-Newtonian behavior. When blood exhibits Newtonian behavior, the resistance to flow and skin friction decrease but the blood flow rate increases.

Conclusion: The stenosed artery geometry, the stenosis length, stenosis depth and the power law index (non-Newtonian behavior) are important factors affecting the blood flow through the stenosed artery. This work provides some potential aspects to further study the causes and development of cardiovascular diseases.

Background: Chrysin (CH) is one of the main flavonoids of vegetables, fruits, and plants, the neuroprotective effect of which has been demonstrated in this study.

Objective: The aim of the current investigation is the evaluation of the impact of chrysin (CH) on serum corticosterone level. Additionally, depression due to chronic stress was studied in animal models.

Methods: The rats were restrained for 1 hour daily for 3 weeks. During these weeks, all animals were daily injected with either vehicle or CH (10, 20, 30 µg/kg).

Results: Present data indicated that the serum corticosterone levels markedly elevated in the stressed group versus the non-stressed group (p<0.001). The serum corticosterone levels were significantly lower in the stress-exposed rats administered with CH versus the stress-exposed non- CH-treated rats (p<0.05). In addition, immobility time significantly increased in the rats submitted to restraint stress versus the non-stressed group (p<0.001). Also, the number of crossing significantly decreased in the rats submitted to restraint stress versus non-stressed rats (p<0.001). The immobility time and the number of crossing were also reduced in the CH-administrated stressed rats (30 mg/kg) versus non-treated stressed group (p<0.001, p<0.05, respectively). CH also ameliorated the MDA and GSH content as well as antioxidant enzymes activities in stressed rats (p<0.05).

Conclusion: The present study suggested that CH might be useful for the management of depressant-like effects induced by chronic stress via decreasing oxidative damage in the brain.

HIV-positive patients have a 60- to 200-fold increased incidence of Non-Hodgkin Lymphomas (NHL) because of their impaired cellular immunity. Some NHL are considered Acquired Immunodeficiency Syndrome (AIDS) defining conditions. Diffuse large B-cell Lymphoma (DLBC) and Burkitt Lymphoma (BL) are the most commonly observed, whereas Primary Effusion Lymphoma (PEL), Central Nervous System Lymphomas (PCNSL), Plasmablastic Lymphoma (PBL) and classic Hodgkin Lymphoma (HL) are far less frequent. Multicentric Castleman disease (MCD) is an aggressive lymphoproliferative disorder highly prevalent in HIV-positive patients and strongly associated with HHV-8 virus infection. In the pre-Combination Antiretroviral Therapy (CART) era, patients with HIV-associated lymphoma had poor outcomes with median survival of 5 to 6 months. By improving the immunological status, CART extended the therapeutic options for HIV positive patients with lymphomas, allowing them to tolerate standard chemotherapies regimen with similar outcomes to those of the general population. The combination of CART and chemotherapy/ immuno-chemotherapy treatment has resulted in a remarkable prolongation of survival among HIVinfected patients with lymphomas. In this short communication, we briefly review the problems linked with the treatment of lymphoproliferative diseases in HIV patients. Combination Antiretroviral Therapy (CART) not only reduces HIV replication and restores the immunological status improving immune function of the HIV-related lymphomas patients but allows patients to deal with standard doses of chemotherapies. The association of CART and chemotherapy allowed to obtain better results in terms of overall survival and complete responses. In the setting of HIVassociated lymphomas, many issues remain open and their treatment is complicated by the patient's immunocompromised status and the need to treat HIV concurrently.

Background: Pure Red Cell Aplasia (PRCA) is a clinical entity comprising severe normochromic normocytic anemia, reticulocytopenia, erythroblastopenia in the bone marrow, with normal leukocyte and platelets count. PRCA can be classified into congenital and acquired, with the latter characterized as idiopathic or secondary to various infections, hematological malignancies, collagen vascular diseases, thymoma, and exposure to a variety of drugs and other chemical substances.

Methods: Herein, we present a female patient, who presented with PRCA due to azathioprine treatment.

Results: Prompt discontinuation of the drug together with red blood cells transfusions led to complete recovery in this young patient, without any addition of immunosuppressive regimen.

Conclusion: We followed 'the wait and see practice' instead of administering immunosuppression to our patient, after careful consideration and extensive consultation with our hematologists. This 'wait and see practice' proved to be effective in the long run.

Introduction: Severe ankle hemophilic arthropathy can be a calamitous sign of severe hemophilia with important inferences for activities of daily living.

Aims: To summarize the contemporary, accessible information on Total Ankle Replacement (TAR) for ankle hemophilic arthropathy.

Methods: A search of Cochrane Library and PubMed (MEDLINE) regarding the role of TAR in ankle hemophilic arthropathy.

Results: The insufficient information regarding the results of TAR for hemophilic arthropathy is confined to scanty case series and case reports. An evaluation of the accessible literature reveals encouraging but inconstant outcomes. The reported rate of adverse events is 33%. The reported anticipated survival of TAR is 94% at 5 years, 85% at 10 years and 70% at 15 years.

Conclusion: Whereas people with advanced hemophilic arthropathy of the ankle are prone to ameliorate pain and range of motion following TAR, there is deficient knowledge to regularly recommend its use. Adverse events and infection percentages are disturbing. Moreover, the lack of survival analysis knowledge makes it difficult to assess the benefit to people with hemophilia. TAR is a demanding surgical procedure and its survival is not comparable to that after hip or knee replacement.

Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS.

Methods: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software.

Results: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission.

Conclusion: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.