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Inability to Ambulate in a Pediatric Patient Secondary to an Aneurysmal Bone Cyst With Associated Pathological Fracture. Cureus 2023; 15:e39310. [PMID: 37346204 PMCID: PMC10281798 DOI: 10.7759/cureus.39310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Bone pain in pediatric patients is exceedingly common, with etiologies ranging from benign lesions such as fibrous dysplasia and enchondromas to potentially devastating, life-threatening malignancies such as Ewing's sarcoma or osteosarcoma. Given the low yield of physical examination and routine laboratory workup, pediatric patients with bone pain or an inability to ambulate warrant further workup. The initial workup should consist of imaging with radiography. A large majority of patients will have a resolution of symptoms without intervention and will have normal imaging. When radiographic imaging has suspicious findings, expert consultation is warranted because differentiating between benign and malignant processes on imaging can be challenging. Here we present a case of a six-year-old male with progressive worsening leg pain who was found to have a rare aneurysmal bone cyst with an associated pathologic fracture requiring open reduction and internal fixation.
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Tracheomediastinal emphysema after tracheostomy in a post-COVID-19 patient: a case report. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2022; 26:3374-3376. [PMID: 35587091 DOI: 10.26355/eurrev_202205_28758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There are no reports of tracheomediastinal fistula development after tracheostomy. CASE REPORT A 72-year-old female patient with post acute COVID-19 was transferred to our intensive care unit. After two unsuccessful weaning attempts, a tracheostomy was performed at hospitalization on day 32. The patient's body mass index was 35 kg/m2 and she had a narrow neck anatomy. A percutaneous tracheostomy was performed using the Griggs method without any problems. Pneumothorax, pneumomediastinum, subcutaneous emphysema, and hemorrhage were not observed. Twenty-two days after the tracheostomy, the patient developed subcutaneous emphysema and experienced a sudden decrease in oxygen saturation. Bedside anterior-posterior chest X-ray did not detect pneumothorax and a tracheoesophageal fistula was found via esophageal endoscopy. A tracheomediastinal fistula was observed just below the cannula distal end via computed tomography. CONCLUSIONS There are multiple reasons why a tracheomediastinal fistula could develop after tracheostomy. Therefore, this condition should be considered in cases of sudden subcutaneous emphysema and oxygen deterioration following tracheostomy.
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Changes in serological bone turnover markers in bisphosphonate induced osteonecrosis of the jaws: A case control study. Niger J Clin Pract 2020; 23:154-158. [PMID: 32031088 DOI: 10.4103/njcp.njcp_374_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background There are a lot study confirmed the relationship of bone serum markers changes and skeletal irregularities. But there is no sufficient case control studies about the role of these markers on bisphosphonate induced osteonecrosis of jaws (BRONJ). Aims The aim of this study is to find out if there is any derangement of bone markers in bisphosphonate-treated patients with ONJ. Methods We obtained serum bone markers and other relevant endocrine assays on 20 patients with osteonecrosis of the jaw (ONJ) and 20 randomized healthy volunteers. All of the ONJ group treated with zoledronic acid and had been withdrawn from bisphosphonate for at least 6 months. Diagnostic criteria for ONJ were those formulated by the American Association of Oral and Maxillofacial Surgeons. Serum levels of several indices of bone remodeling were evaluated using commercial enzyme-linked immunosorbent assays. The biochemical assays were performed on N-Telopeptides of type I collagen (NTX), bone-specific alkaline phosphatase (ALP), calcitonin, osteocalcin, intact parathyroid hormone (PTH), T3, T4, TSH, and Vitamin D 25 hydroxy (Vit-D). Results In ONJ group, PTH level is statistically higher and TSH, Vit-D, osteocalcin and NTX levels statistically lower compared to control group. Conclusion We conclude that these changes in PTH, Vit-D, TSH, osteocalcin and NTX levels maybe have a role in the pathophysiology of BRONJ. But the data need to be confirmed by future studies.
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Effect of Colchicine and Atorvastatin On Cell Death Mechanisms During Inflammatory Processes In Atheroschlerosis. J Biotechnol 2019. [DOI: 10.1016/j.jbiotec.2019.05.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Poster session 2THE IMAGING EXAMINATIONP536Appropriate use criteria of transthoracic echocardiography and its clinical impact: a continuous challengeP537Implementation of proprietary plug-ins in the DICOM-based computerized echo reporting system fuels the use of 3D echo and deformation imaging in the clinical routine of a multivendor laboratoryP538Exercise stress echocardiography appropriate use criteria: real-life cases classification ease and agreement among cardiologistsANATOMY AND PHYSIOLOGY OF THE HEART AND GREAT VESSELSP539Functional capacity in older people with normal ejection fraction correlates with left ventricular functional reserve and carotid-femoral pulse wave velocity but not with E/e and augmentation indexP540Survey of competency of practitioners for diagnosis of acute cardiopulmonary diseases manifest on chest x-rayASSESSMENT OF DIAMETERS, VOLUMES AND MASSP541Left atrium remodeling in dialysis patients with normal ejection fractionP542The prediction of postinfarction left ventricular remodeling and the role of of leptin and MCP-1 in regard to the presence of metabolic syndromeP543Ascending aorta and common carotid artery: diameters and stiffness in a group of 584 healthy subjectsAssessments of haemodynamicsP544Alternate echo parameters in patients without estimable RVSPAssessment of systolic functionP545Reduced contractile performance in heart failure with preserved ejection fraction: determination using novel preload-adjusted maximal left ventricular ejection forceP546Left ventricular dimensions and prognosis in acute coronary syndromesP547Time course of myocardial alterations in a murine model of high fat diet: A strain rate imaging studyP548Subclinical left ventricular systolic dysfunction in patients with premature ventricular contractionsP549Global myocardial strain by CMR-based feature tracking (FT) and tagging to predict development of severe left ventricular systolic dysfunction after acute st-elevation myocardial infarctionP550Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstructionP551The role of regional longitudinal strain assessment in predicting response to cardiac resynchronization therapy in patients with left ventricular systolic dysfunction and left bundle branch blockP552Speckle tracking automatic border detection improves echocardiographic evaluation of right ventricular systolic function in repaired tetralogy of fallot patients: comparison with MRI findingsP553Echocardiography: a reproducible and relevant tool in pah? intermediate results of the multicentric efort echogardiographic substudy (evaluation of prognostic factors and therapeutic targets in pah)Assessment of diastolic functionP554Relationship between left ventricular filling pressures and myocardial fibrosis in patients with uncomplicated arterial hypertensionP555Cardiac rehabilitation improves echocardiographic parameters of diastolic function in patients with ischemic heart diseaseP556Diastolic parameters in the calcified mitral annulusP557Biomarkers and echocardiography - combined weapon to diagnose and prognose heart failure with and without preserved ejection fractionP558Diastolic function changes of the maternal heart in twin and singleton pregnancyIschemic heart diseaseP559Syntax score as predictor for the correlation between epicardial adipose tissue and the severity of coronary lesions in patients with significant coronary diseaseP560Impact of strain analysis in ergonovine stress echocardiography for diagnosis vasospastic anginaP561Cardiac magnetic resonance tissue tracking: a novel method to predict infarct transmurality in acute myocardial infarctionP562Infarct size is correlated to global longitudinal strain but not left ventricular ejection fraction in the early stage of acute myocardial infarctionP563Magnetic resonance myocardial deformation assessment with tissue tracking and risk stratification in acute myocardial infarction patientsP564Increase in regional end-diastolic wall thickness by transthoracic echocardiography as a biomarker of successful reperfusion in anterior ST elevation acute myocardial infarctionP565Mitral regurgitation is associated with worse long-term prognosis in ST-segment elevation myocardial infarction treated with primary percutaneous coronary interventionP566Statistical significance of 3D motion and deformation indexes for the analysis of LAD infarctionHeart valve DiseasesP567Paradoxical low gradient aortic stenosis: echocardiographic progression from moderate to severe diseaseP568The beneficial effects of TAVI in mitral insufficiencyP569Impact of thoracic aortic calcification on the left ventricular hypertrophy and its regression after aortic valve replacement in patients with severe aortic stenosisP570Additional value of exercise-stress echocardiography in asymptomatic patients with aortic valve stenosisP571Valvulo-arterial impedance in severe aortic stenosis: a dual imaging modalities studyP572Left ventricular mechanics: novel tools to evaluate left ventricular performance in patients with aortic stenosisP573Comparison of long-term outcome after percutaneous mitral valvuloplasty versus mitral valve replacement in moderate to severe mitral stenosis with left ventricular dysfunctionP574Incidence of de novo left ventricular dysfunction in patient treated with aortic valve replacement for severe aortic regurgitationP575Transforming growth factor-beta dependant progression of the mitral valve prolapseP576Quantification of mitral regurgitation with multiple jets: in vitro validation of three-dimensional PISA techniqueP577Impaired pre-systolic contraction and saddle-shape deepening of mitral annulus contributes to atrial functional regurgitation: a three-dimensional echocardiographic studyP578Incidence and determinants of left ventricular (lv) reverse remodeling after MitraClip implantation in patients with moderate-to severe or severe mitral regurgitation and reduced lv ejection fractionP579Severe functional tricuspid regurgitation in rheumatic heart valve disease. New insights from 3D transthoracic echocardiographyP58015 years of evolution of the etiologic profile for prosthetic heart valve replacement through an echocardiography laboratoryP581The role of echocardiography in the differential diagnosis of prolonged fever of unknown originP582Predictive value for paravalvular regurgitation of 3-dimensional anatomic aortic annulus shape assessed by multidetector computed tomography post-transcatheter aortic valve replacementP583The significance and advantages of echo and CT imaging & measurement at transcatherter aortic valve implantation through the left common carotid accessP584Comparison of the self-expandable Medtronic CoreValve versus the balloon-expandable Edwards SAPIEN bioprostheses in high-risk patients undergoing transfemoral aortic valve implantationP585The impact of transcatheter aortic valve implantation on mitral regurgitation severityP586Echocardiographic follow up of children with valvular lesions secondary to rheumatic heart disease: Data from a prospective registryP587Valvular heart disease and different circadian blood pressure profilesCardiomyopathiesP588Comparison of transthoracic echocardiography versus cardiac magnetic for implantable cardioverter defibrillator therapy in primary prevention strategy dilated cardiomyopathy patientsP589Incidence and prognostic significance of left ventricle reverse remodeling in a cohort of patients with idiopathic dilated cardiomyopathyP590Early evaluation of diastolic function in fabry diseaseP591Echocardiographic predictors of atrial fibrillation development in hypertrophic cardiomyopathyP592Altered Torsion mechanics in patients with hypertrophic cardiomyopathy: LVOT-obstruction is the topdog?P593Prevention of sudden cardiac death in hypertrophic cardiomyopathy: what has changed in the guidelines?P594Coronary microcirculatory function as determinator of longitudinal systolic left ventricular function in hypertrophic cardiomyopathyP595Detection of subclinical myocardial dysfunction by tissue Doppler ehocardiography in patients with muscular dystrophiesP596Speckle tracking myocardial deformation analysis and three dimensional echocardiography for early detection of chemotherapy induced cardiac dysfunction in bone marrow transplantation patientsP597Left ventricular non compaction or hypertrabeculation: distinguishing between physiology and pathology in top-level athletesP598Role of multi modality imaging in familiar screening of Danon diseaseP599Early impairment of global longitudinal left ventricular systolic function independently predicts incident atrial fibrillation in type 2 diabetes mellitusP600Fetal cardiovascular programming in maternal diabetes mellitus and obesity: insights from deformation imagingP601Longitudinal strain stress echo evaluation of aged marginal donor hearts: feasibility in the Adonhers project.P602Echocardiographic evaluation of left ventricular size and function following heart transplantation - Gender mattersSystemic diseases and other conditionsP603The impact of septal kinetics on adverse ventricular-ventricular interactions in pulmonary stenosis and pulmonary arterial hypertensionP604Improvement in right ventricular mechanics after inhalation of iloprost in pulmonary hypertensionP605Does the treatment of patients with metabolic syndrome correct the right ventricular diastolic dysfunction?P606Predictors of altered cardiac function in breast cancer survivors who were treated with anthracycline-based therapyP607Prevalence and factors related to left ventricular systolic dysfunction in asymptomatic patients with rheumatoid arthritis: a prospective tissue-doppler echocardiography studyP608Diastolic and systolic left ventricle dysfunction presenting different prognostic implications in cardiac amyloidosisP609Diagnostic accuracy of Bedside Lung Ultrasonography in Emergency (BLUE) protocol for the diagnosis of pulmonary embolismP610Right ventricular systolic dysfunction and its incidence in breast cancer patients submitted to anthracycline therapyP611Right ventricular dysfunction is an independent predictor of survival among cirrhotic patients undergoing liver transplantCongenital heart diseaseP612Hypoplasia or absence of posterior leaflet: a rare congenital anomaly of the mitral valveP613ECHO screening for Barlow disease in proband's relativesDiseases of the aortaP614Aortic size distribution and prognosis in an unselected population of patients referred for standard transthoracic echocardiographyP615Abdominal aorta aneurysm ultrasonographic screening in a large cohort of asympromatic volounteers in an Italian urban settingP616Thoracic aortic aneurysm and left ventricular systolic functionStress echocardiographyP617Wall motion score index, systolic mitral annulus velocity and left ventricular mass predicted global longitudinal systolic strain in 238 patients examined by stress echocardiographyP618Prognostic parameters of exercise-induced severe mitral valve regurgitation and exercise-induced systolic pulmonary hypertensionP619Risk stratification after myocardial infarction: prognostic value of dobutamine stress echocardiographyP620relationship between LV and RV myocardial contractile reserve and metabolic parameters during incremental exercise and recovery in healthy children using 2-D strain analysisP621Increased peripheral extraction as a mechanism compensatory to reduced cardiac output in high risk heart failure patients with group 2 pulmonary hypertension and exercise oscillatory ventilationP622Can exercise induced changes in cardiac synchrony predict response to CRT?Transesophageal echocardiographyP623Fully-automated software for mitral valve assessment in chronic mitral regurgitation by three-dimensional transesophageal echocardiographyP624Real-time 3D transesophageal echocardiography provides more accurate orifice measurement in percutaneous transcatheter left atrial appendage closureP625Percutaneous closure of left atrial appendage: experience of 36 casesReal-time three-dimensional TEEP626Real-time three-dimensional transesophageal echocardiography during pulmonary vein cryoballoon ablation for atrial fibrilationP627Three dimensional ultrasound anatomy of intact mitral valve and in the case of type 2 disfunctionTissue Doppler and speckle trackingP629Left ventricle wall motion tracking from echocardiographic images by a non-rigid image registrationP630The first experience with the new prototype of a robotic system for remote echocardiographyP631Non-invasive PCWP influence on a loop diuretics regimen monitoring model in ADHF patients.P632Normal range of left ventricular strain, dimensions and ejection fraction using three-dimensional speckle-tracking echocardiography in neonatesP633Circumferential ascending aortic strain: new parameter in the assessment of arterial stiffness in systemic hypertensionP634Aortic vascular properties in pediatric osteogenesis imperfecta: a two-dimensional echocardiography derived aortic strain studyP635Assessment of cardiac functions in children with sickle cell anemia: doppler tissue imaging studyP636Assessment of left ventricular function in type 1 diabetes mellitus patients by two-dimensional speckle tracking echocardiography: relation to duration and control of diabetesP637A study of left ventricular torsion in l-loop ventricles using speckle-tracking echocardiographyP638Despite No-Reflow, global and regional longitudinal strains assessed by two-dimensional speckle tracking echocardiography are predictive indexes of left ventricular remodeling in patients with STEMIP639The function of reservoir of the left atrium in patients with medicaly treated arterial hypertensionP640The usefulness of speckle tracking analysis for predicting the recovery of regional systolic function after myocardial infarctionP641Two dimensional speckle tracking echocardiography in assessment of left ventricular systolic function in patients with rheumatic severe mitral regurgitation and normal ejection fractionP642The prediction of left-main and tripple vessel coronary artery disease by tissue doppler based longitudinal strain and strain rate imagingP643Role of speckle tracking in predicting arrhythmic risk and occurrence of appropriate implantable defibrillator Intervention in patients with ischemic and non-ischemic cardiomyopathyComputed Tomography & Nuclear CardiologyP644Cardiac adrenergic activity in patients with nonischemic dilated cardiomyopathy. Correlation with echocardiographyP645Different vascular territories and myocardial ischemia, there is a gradient of association? Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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The improvement of cardiac synchronization parameters by ivabradine treatment in patients with systolic heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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PP-204 PROPERTIES OF BLOOD RHEOLOGY IN PATIENTS WITH CORONARY SLOW FLOW PHENOMENON. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70408-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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PP-311 THE USE OF ORAL ANTICOAGULANT THERAPY IN HOSPITALIZED PATIENTS WITH ATRIAL FIBRILLATION IN THE LAST YEAR AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70515-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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PP-195 RELATIONSHIP OF CORONARY FLOW TO NEUTROPHIL/LYMPHOCYTE RATIO IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70399-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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OP-071 THE ASSESSMENT OF THE RELATIONSHIP BETWEEN ARTERIAL BLOOD PRESSURE, AORTIC STIFFNESS AND SERUM ENDOTHELIN-1 LEVELS IN PATIENTS WITH ESSENTIAL HYPERTENSION. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70034-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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VP-006 LEFT VENTRICULAR PERFORATION BY A GUIDEWIRE CROSSING A STENOTIC CALCIFIC AORTIC VALVE. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70227-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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PP-069 THE FACTORS AFFECTING RADIAL ACCESS IN TRANSRADIAL CORONARY ANGIOGRAPHY AND ANGIOPLASTY PROCEDURES. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70294-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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PP-143: SUCCESSFUL IMPLANTATION OF CARDIAC RESYNCHRONIZATION THERAPY-DEFIBRILLATOR DEVICE IN PATIENT WITH CENTRAL VEIN OCCLUSION. Int J Cardiol 2011. [DOI: 10.1016/s0167-5273(11)70375-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Extraction socket healing in rats treated with bisphosphonate: Animal model for bisphosphonate related osteonecrosis of jaws in multiple myeloma patients. Med Oral Patol Oral Cir Bucal 2011; 16:e879-83. [PMID: 21743422 DOI: 10.4317/medoral.17150] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Accepted: 12/12/2010] [Indexed: 11/05/2022] Open
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ATHEROSCLEROTIC RISK FACTORS IN PATIENTS HAVING ACUTE ST ELEVATION MYOCARDIAL INFARCTION UNDER 35 YEARS OF AGE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Effect of sedation on soluble P-selectin levels, coagulation and myocardial damage following a coronary intervention. Int J Clin Pract 2006; 60:526-32. [PMID: 16700848 DOI: 10.1111/j.1368-5031.2006.00834.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This study was aimed to investigate the effect of sedation on plasma soluble P-selectin (sP-selectin) levels and initiation phase of coagulation following coronary intervention. A total of 58 patients with unstable angina were randomised into two groups of sedated (n = 29) and nonsedated (n = 29) patients. sP-Selectin, adrenaline, noradrenaline, von Willebrand factor (vWF), fibrinogen, platelet and troponin-I levels were measured before the intervention and at 30 min and 24 h after the intervention. In the sedated group, adrenaline, noradrenaline, sP-selectin and fibrinogen levels remained stable 30 min after the intervention (p > 0.05), whereas vWF level increased (p < 0.05). In the nonsedated group, 30-min sP-selectin (p < 0.001), adrenaline (p < 0.05), noradrenaline (p = 0.012), vWF (p < 0.001) and fibrinogen (p < 0.001) levels were found to be increased. Also, 24-h sP-selectin, vWF and fibrinogen levels for both groups showed significant increases when compared with the values both 30 h before (p < 0.001) and 30 min after the intervention (p < 0.001). Sedation before interventions reduces sP-selectin levels, initial phase of coagulation and, consequently, myocardial damage.
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Early onset of subclinical atherosclerosis in women with gestational diabetes mellitus. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2006; 27:177-82. [PMID: 16435313 DOI: 10.1002/uog.2687] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Common carotid artery intima-media thickness (CIMT) is a non-invasively assessed marker of subclinical atherosclerosis. Our aim in this study was to investigate CIMT in women with gestational diabetes mellitus (GDM). METHODS Thirty women with GDM and 40 unaffected women (as a control group) were included in the study. Blood samples were drawn from each woman in the morning after they had fasted for at least 8 h, and levels of fasting glucose, insulin, homocysteine, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein (VLDL) cholesterol were measured, along with the CIMT in the two groups. RESULTS The mean triglyceride (P = 0.016) and VLDL cholesterol (P = 0.011) levels in the GDM group were significantly higher than those in the unaffected women. There were no significant differences between the groups with respect to plasma levels of total cholesterol, HDL cholesterol, LDL cholesterol and insulin. The mean homocysteine (P = 0.027) and fasting glucose (P = 0.019) levels in women with GDM were significantly higher than those in the control group. Patients with GDM had significantly higher CIMT than did the unaffected women (0.582 +/- 0.066 mm vs. 0.543 +/- 0.049 mm, P = 0.006). CIMT correlated positively with maternal age (r = 0.316, P = 0.008), body mass index (BMI) at the time of a 50-g oral glucose load test (r = 0.414, P = 0.001) and homocysteine levels (r = 0.332, P = 0.008), and fasting glucose (r = 0.265, P = 0.031) and 1-h glucose value (r = 0.410, P = 0.001) at the time of the oral glucose tolerance test. There was a positive correlation between the presence of GDM and CIMT (r = 0.372, P = 0.001). However, stepwise multiple regression analysis showed that GDM/no GDM (95% CI +0.012 to +0.076, P = 0.008) and BMI at the time of the 50-g test (95% CI +0.001 to +0.009, P = 0.011) were independent parameters related to CIMT. CONCLUSION Women with GDM have increased CIMT compared with unaffected women.
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Determination of lornoxicam in pharmaceutical preparations by zero and first order derivative UV spectrophotometric methods. DIE PHARMAZIE 2005; 60:421-5. [PMID: 15997830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Zero and first order derivative UV spectrophotometric methods were developed for the analysis of lornoxicam (LOR). The solutions of the standards and pharmaceutical samples were prepared in 0.05 N NaOH. Absorbances of LOR were measured at 376 nm for the zero order by measuring height of peak from zero and at 281 and 302 nm for the first order derivative spectrophotometric method by measuring peak to peak height. The linearity ranges were found to be 0.5-35 microg/mL for the zero order and 0.2-75 microg/mL for the first order derivative UV spectrophotometric method. The methods were validated and applied to the determination of LOR in pharmaceutical preparations (tablet and injectable, both containing 8 mg LOR). It was concluded that the methods developed were accurate, sensitive, precise, robust, rugged and useful for the quality control of LOR in pharmaceutical preparations.
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Lipoprotein(a) levels in patients with unstable angina and their relationship with atherothrombosis and myocardial damage. Int J Clin Pract 2005; 59:150-5. [PMID: 15854189 DOI: 10.1111/j.1742-1241.2005.00442.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The aim of the study was to compare lipoprotein(a) [Lp(a)] levels in patients with cTroponin-I (cTn-I)-positive or -negative unstable angina and to investigate their relationship with atherothrombosis. A total of 202 consecutive patients were enrolled in the study. Lp(a), fibrinogen, plasminogen, PAI-1 and t-PA levels were measured and C-reactive protein (CRP) assays were performed on admission for all patients, and venous blood samples were drawn 12 and 24 h later for cTn-I measurements. The patients were divided into cTn-I-negative (cTn-I < 1 ng/ml) and -positive (cTn-I > or = 1 ng/ml) unstable angina groups. Lp(a) levels of the cTn-I-positive patients were higher than those of the cTn-I-negative patients (52.9 +/- 6.0 and 15.7 +/- 2.5 mg/dl, p < 0.0001). There was a positive correlation between Lp(a) and cTn-I levels (r = 0.692; p = 0.0001). Increase in coagulation activity and impairment in fibrinolytic activity were significant in the cTn-I-positive patients. Elevated Lp(a) levels may have a role in the development of myocardial damage in patients with unstable angina.
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Saccular dilatations originating from the conus artery. Heart 2004; 90:915. [PMID: 15253967 PMCID: PMC1768385 DOI: 10.1136/hrt.2003.030858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Association between the metabolic syndrome and newly diagnosed coronary artery disease. DIABETES, NUTRITION & METABOLISM 2003; 16:169-75. [PMID: 14635734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
This case-control study was designed to outline age- and gender-related differences of metabolic risk factors in a group of patients with coronary artery disease (CAD). Accordingly, a total of 366 consecutive patients with a recent diagnosis of CAD (139 women, 41-79 yr; 227 men, 39-78 yr) were screened between October 1999 and April 2001 at Baskent University Adana Medical Center, and 366 age- and gender-matched individuals were selected as a control group. We compared demographics, blood pressure, body mass index, waist circumference, lipid profile, fasting and post-prandial glucose-insulin levels between CAD patients and the control group. Prevalence of metabolic syndrome was 72.6% in females, and 39.0% in males with CAD. Hypertension, obesity and diabetes were more common in female patients; 64.5% of female patients had premature CAD and 83.5% of those had metabolic syndrome. In logistic (OR: 3.57 for women and OR: 1.59 for men) regression analysis, metabolic syndrome was independently associated with CAD in both genders. As a conclusion, prevalence of metabolic syndrome was significantly higher in patients with CAD than the control group, especially in female patients. The metabolic syndrome was independently associated with CAD in both genders.
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p53, p21 and metallothionein immunoreactivities in patients with malignant pleural mesothelioma: correlations with the epidemiological features and prognosis of mesotheliomas with environmental asbestos exposure. Respir Med 2001; 95:588-93. [PMID: 11453316 DOI: 10.1053/rmed.2001.1108] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The aim of this study is to investigate immunoreactivity for p53, p21 and metallothionein in diffuse malignant pleural mesothelioma (DMPM) and to determine the relationships between the age, sex, asbestos exposure time, survival of DMPM patients with environmental asbestos exposure and immunoreactivity to p53, p21 and metallothionein. Sixty-seven histopathologically-confirmed DMPMs, 38 of whom had environmental and 29 had occupational asbestos exposure, were included. The tumour tissue samples were immunostained with antibodies against p53, p21 and metallothionein. Epidemiological data and the survival times for the DMPM patients with environmental asbestos exposures were obtained from hospital records. Thirty-three per cent of the DMPMs were positive for p53, 35% for p21 and 52% for metallothionein. There was no statistical difference between the histological subtypes of DMPM in terms of immunoreactivity for p53, p21 and metallothionein. For p21 and metallothionein there was a statistically significant difference between the exposure characteristics: patients with environmental asbestos exposure had shown more immunopositivity. There were statistically significant differences between age groups and between asbestos exposure times for metallothionein, and between asbestos exposure times and p21. The patients with positive immunostaining had longer exposure times and were older than those having negative immunostaining. The differences between survival of the patients were not statistically significant in terms of the immunohistochemical results for p53, p21 and metallothionein.
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Abstract
Hemangiopericytoma is an uncommon mesenchymal tumor originating from pericytes. We describe the clinical and morphologic features in a case of intrathoracic extrapulmonary giant hemangiopericytoma. The tumor was radically removed, and the microscopy report was benign hemangiopericytoma. Because of the high risk of local recurrence, long-term follow-up is important in such patients.
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Extracapsular cataract extraction with posterior chamber lens implantation in capsular glaucoma. Ophthalmologica 2000; 214:260-3. [PMID: 10859508 DOI: 10.1159/000027501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate intraocular pressure (IOP) control after extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens (PCIOL) implantation in patients with capsular glaucoma (CG) and coexisting cataract. METHODS This prospective study included 20 patients (20 eyes) having CG and cataract whose IOPs were under 22 mm Hg and controlled with antiglaucoma medication. All patients had ECCE with PCIOL implantation and the follow-up period was at least 18 months. IOP was measured postoperatively at 3, 6, 9, 12 and 18 months and compared with preoperative IOP. RESULTS Following the cataract extraction, PCIOL implantation produced a statistically significant reduction in IOP at all time points compared with the preoperative IOP during the study period (p < 0. 001). The mean preoperative IOP was 18.25 +/- 1.83 mm Hg; postoperatively at 1 month, it was 13.45 +/- 2.06 mm Hg; at 3 months 14.80 +/- 2.50 mm Hg; at 6 months 15.35 +/- 1.27 mm Hg, at 12 months 14.85 +/- 1.87 mm Hg and at 18 months 15.15 +/- 1.42 mm Hg (p < 0. 0008). The mean reduction in IOP was 16.98% from baseline at 18 months postoperatively. The mean number of antiglaucoma medication was reduced from 1.35/eye preoperatively to 0.60/eye postoperatively at 18 months (p < 0.0007). CONCLUSION The result of our study revealed that ECCE with PCIOL implantation may be a reliable choice in controlling IOP in patients with CG.
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Effect of conjunctival structure and inflammatory cell counts on intraocular pressure after trabeculectomy. Ophthalmologica 1999; 213:371-5. [PMID: 10567869 DOI: 10.1159/000027457] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the conjunctival structure and inflammatory cell counts and to determine the predictive value of these histological parameters for postoperative intraocular pressure (IOP) levels after trabeculectomy. METHODS A clinical and histological study was performed on consecutive patients. Postoperative (mean 32. 8 +/- 18.4 months; range 6-60 months) conjunctival biopsies of 36 eyes of 28 primary open-angle glaucoma patients who had trabeculectomy between 1992 and 1995 were included in the study. According to postoperative pressure control, patients with < or = 16 mm Hg and those with >16 mm Hg were taken as groups 1 and 2, respectively. The control group (group 3) consisted of 15 age-matched patients without glaucoma, who had received no topical therapy. We compared the conjunctival structure and cell counts within these groups. Goblet cells, acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharides and collagen compositions were determined in groups 1, 2 and 3. RESULTS The number of goblet cells was significantly higher in group 1 (6.74 +/- 7.23) than group 2 (3. 09 +/- 2.77; p = 0.017). No statistical difference was observed in the number of acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness, vascular density, mucopolysaccharide or collagen compositions between groups 1 and 2 (p > 0.05). In addition, when groups 1 and 2 were compared with the control group, there was a significant decrease in goblet cells (p < 0.001), an increase in acute inflammatory cells, chronic inflammatory cells, fibroblasts, epithelial thickness and vascular density (p < 0.001), but there was no significant difference in mucopolysaccharide and collagen compositions (p > 0.05). CONCLUSIONS This study suggests that at the time of surgery a high number of goblet cells may be a predictor of lowered IOP (< or = 16 mm Hg) following trabeculectomy without antimetabolite.
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Abstract
OBJECTIVE Typical bronchial carcinoids are very low grade neuroendocrine neoplasm of the tracheobronchial tree and have very good results in surgical treatment. Surgical treatment varies from bronchotomy-excision to major resective procedures. We presented our results of bronchotomy, simple excision and long-term follow-up. METHODS In Atatürk Centre for Chest Disease and Chest Surgery, 16 patients with bronchial carcinoid tumour underwent bronchotomy-excision over a 23-year-period. In all of the cases tumours were in polypoid type. Except these 16 cases 51 patients with bronchial carcinoids underwent operations in the same period. Presenting symptoms were haemoptysis, cough, recurrent pulmonary infection, dyspnea and chest pain. Rigid bronchoscopies were performed on all of the patients preoperatively for diagnosis of the tumour and to determine the surgical procedure and we performed control bronchoscopies on all of the patients in their follow-up period. RESULTS Patients were checked for periods ranging from 2 to 23 years both radiologically and bronchoscopically. We did not find any recurrences and death related to surgery and morbidity rate were minimal. CONCLUSION We think that bronchotomy and simple excision are effective and safe procedures for the treatment of bronchial carcinoid tumours with low morbidity in selected cases like polypoid type lesions and have as good a long-term survival rate as the other surgical treatment methods have.
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Abstract
OBJECTIVE Thoracic actinomycosis is a disease that is difficult to diagnose because its appearance varies from similarities with bronchogenic carcinoma to pneumonitis-like tuberculosis infections. Therefore the majority of patients undergo operations for diagnosis. We had seven patients with thoracic actinomycosis which were not diagnosed before operation. METHODS Between July 1990 and November 1997, seven patients with thoracic actinomycosis were diagnosed after thoracotomy in our centre. They all had non-specific symptoms and radiographic findings, so we failed to diagnose the disease during preoperative examinations. Therefore they all underwent thoracotomy for diagnosis. Four patients were operated because of suspicion of malignancy, two patients were operated because of pulmonary infiltration and abscess formation and one patient because of undiagnosed pulmonary infiltration. Lobectomy was performed in five of them because of destroyed lobes, and wedge resection was performed in two patients. In two patients the disease was diagnosed by fresh smears obtained from specimens in the course of operation and confirmed histopathologically and in the others histopathologically in the postoperative period. RESULTS Three major complications, acute renal failure, empyema and persistent air leakage developed in three cases after the operations. Bronchopleural fistula was found in only one of them and the patient died because of uncontrolled infection and sepsis on the 26th postoperative day. All of the other six cases are still alive. We did not observe any other problem in their long-term follow-up. All patients regularly took 20 million units/day of intravenous crystalline penicillin G when they were in the hospital. After that, antibiotic treatment was completed up to 2 months with procaine penicillin. CONCLUSIONS Sometimes diagnosis of the actinomycosis of the lung is very difficult although it is an infection. In that case thoracotomy is needed for the diagnosis and sometimes for the treatment. In some cases because of the irreversible parenchymal change resective surgery may be needed. Actinomyces israelii infections should be suspected of in chronic infiltrative, nodular, cavitary process and tumour-like mass lesions besides other most probable causes. After diagnosed, it is treated using penicillin chemotherapy at least for 2 months.
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Abstract
Tracheal hamartoma is a rare tumor and difficult to diagnose. A case is presented in which tracheal hamartoma was misdiagnosed and treated for four years as asthma. The tumor was curatively excised via posterolateral thoracotomy.
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Abstract
Cystic lymphangioma is an extremely rare mediastinal benign tumor characterized by congenitally enlarged lymphatic vessels. It is often diagnosed incidentally because it is only symptomatic when it grows to be very large. We present two cases of mediastinal cystic lymphangioma and review the literature.
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The determination of additive effect and intraocular pressure lowering effects of 0.05% bromocriptine and 0.25% timolol. Int Ophthalmol 1996; 20:53-5. [PMID: 9112164 DOI: 10.1007/bf00212946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
It has been confirmed that topically applied bromocriptine has a satisfactory intraocular pressure (IOP) lowering effect without serious ocular or systemic side effects. We compared the IOP lowering effects of 0.05% bromocriptine and 0.25% timolol and determined whether they have an additive effect in lowering IOP in normal volunteers. In a double-blind, randomised, prospective, single-dose study, we measured IOP in 24 ocular normotensive subjects before (baseline) and 2, 4 and 6 hours after topical instillation of the following drugs: timolol and bromocriptine alone (n: 14), timolol+bromocriptine, timolol+placebo, bromocriptine+placebo (n: 10). Both bromocriptine and timolol have a significant IOP lowering effect (p < 0.01) compared with the baseline value during the study period. There were no significant differences in IOP lowering effect between timolol and bromocriptine at 2 and 4 hours (p > 0.05), but timolol was more efficacious than bromocriptine at 6 hours (p < 0.05). An additive effect in lowering IOP was not found. Although timolol and bromocriptine have no additive effect in lowering IOP, topically applied bromocriptine may be used in the treatment of glaucoma.
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