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Therapy in the Prevention of Thromboembolic Complications in Patients with Atrial Fibrillation: Prospects for Higher Appointment of New Oral Anticoagulants in Сlinical Рractice
Oleg V. Gaisenok,
Anton S. Leonov
Issue:
Volume 1, Issue 2, April 2017
Pages:
29-31
Received:
25 February 2017
Accepted:
23 March 2017
Published:
14 April 2017
DOI:
10.11648/j.ccr.20170102.11
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Abstract: Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients treated in the department in 2013, accounted study group (n = 58). Analysis of prescribed therapy, the percentage of anticoagulant therapy (including the new oral anticoagulants), detection of SVT held on all enrolled patients. Results: use of anticoagulants in the study group was 46.5% (NOAC - 20.7%). The main reason fails to appoint anticoagulant therapy were follows: the inability of the patient to adhere or to monitor warfarin therapy and the presence of valvular AF, which does not allow to recommend NOAC (48.4%) and physician preference, based on the refusal or the patient's preference (41.9%). The presence of valvular AF significantly limited the possibility of appointing the NOAC. SVT has been registered by Holter ECG during hospitalization in 24 patients with AF. Moreover 12 patients without AF were previously identified SVT. Conclusions: The appointment of anticoagulants in patients with AF is insufficient. More active use of NOAC will allow to correct current situation. The correct interpretation of the concept of valvular AF can help it. Considering that under the mask of paroxysmal SVT described by Holter ECG may be hiding paroxysmal AF, open to debate is the question of the appointment of anticoagulant therapy in these patients. Answer this question will be able to conduct of specially-designed randomized clinical trials.
Abstract: Objective: To analyze the assignability of anticoagulation in patients with atrial fibrillation (including new oral anticoagulants (NOAC)) and detection of paroxysmal supraventricular tachycardia (SVT), according to a cohort study conducted on the rules of the local registry. Methods: Patients with atrial fibrillation, selected from 526 patients tr...
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The Association Between Systemic Hypertension and Chronic HCV-4 Infection
Hany Awadallah,
Ayman Mortada,
Reham Ezzat Al Swaff,
Ahmed Jomaa,
Fatma Ali-Eldin
Issue:
Volume 1, Issue 2, April 2017
Pages:
32-38
Received:
3 March 2017
Accepted:
27 March 2017
Published:
15 April 2017
DOI:
10.11648/j.ccr.20170102.12
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Abstract: Patients with chronic hepatitis C virus infection are more likely to have systemic hypertension, in addition to insulin resistance and diabetes. The present study aimed to evaluate the association between systemic hypertension and chronic HCV-4 infection among Egyptian patients. This cross-sectional study evaluated the existence of systemic hypertension among one thousand adult Egyptian subjects (500 patients with chronic HCV-4 infection versus 500 non infected subjects who served as a control group). Prevalence of systemic hypertension was significantly higher among patients with chronic HCV-4 infection (38.8%) than among the controls (21.8%) (P=0.001). 30.3% of all hypertensive patients were not aware of their illness; the rate of non-awareness among hypertensive patients with chronic HCV-4 infection was 22.68% while that of non infected subjects was 44.04% (p < 0.05). A statistically significant higher rate of systemic hypertension was found among diabetic patients. In conclusion, significant association exists between chronic HCV-4 infection and systemic hypertension especially among diabetic patients. Patients with chronic HCV infection are more aware of their systemic hypertension than non infected subjects.
Abstract: Patients with chronic hepatitis C virus infection are more likely to have systemic hypertension, in addition to insulin resistance and diabetes. The present study aimed to evaluate the association between systemic hypertension and chronic HCV-4 infection among Egyptian patients. This cross-sectional study evaluated the existence of systemic hyperte...
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Shape Optimization of a NURBS Modelled Coronary Stent Using Kriging and Genetic Algorithm
Issue:
Volume 1, Issue 2, April 2017
Pages:
39-47
Received:
23 January 2017
Accepted:
9 February 2017
Published:
17 April 2017
DOI:
10.11648/j.ccr.20170102.13
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Abstract: In this paper, structural shape of stent has been optimized using NURBS for parameterization of stent structure and target those objectives which are critical for vascular injury. NURBS modeling is done using python coding in RHINO 3D software. For later part of the design, Solidworks is used. The objectives considered in our study are dogboning, foreshortening and arterial wall stresses, all of which are strongly linked to vascular injury leading to restenosis. We use control point weights, strut thickness and strut width as design variables for Latin Hypercube sampling (LHS) in order to generate dataset for Stent deployment simulations. In our study, we generate 80 design data points using LHS in Matlab R2014a. Finite element analysis of stent deployment process is then carried out using ANSYS for all 80 designs of stent generated using LHS. Thereafter, we use Kriging for surrogate modeling and non-dominated sorting genetic algorithm (NSGA-II) in MATLAB for multi-objective design optimization so as to minimize dogboning, foreshortening and arterial wall stresses. As a result, we obtain a range of pareto optimal design parameter values which can be used in clinical design guides so as to accommodate variations observed across different patients.
Abstract: In this paper, structural shape of stent has been optimized using NURBS for parameterization of stent structure and target those objectives which are critical for vascular injury. NURBS modeling is done using python coding in RHINO 3D software. For later part of the design, Solidworks is used. The objectives considered in our study are dogboning, f...
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Tacrolimus Versus Ciclosporin for Immunosuppression in Cardiac Transplantation – Short to Mid-Term Renal Effects
Joel Korkala,
Sanjeet Avtaar Singh,
Sudeep Das De,
Alan Kirk
Issue:
Volume 1, Issue 2, April 2017
Pages:
48-56
Received:
26 February 2017
Accepted:
28 March 2017
Published:
17 April 2017
DOI:
10.11648/j.ccr.20170102.14
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Abstract: Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxicity. The results were reviewed at the Scottish National Advanced Heart Failure Service. A retrospective analysis of data from 50 patients was conducted. All patients had undergone orthotopic heart transplantation between September 2010 and June 2016. In addition to tacrolimus or ciclosporin all patients also received mycophenolate mofetil and corticosteroids. Serum creatinine levels and estimated glomerular filtration rates (eGFR) were compared at 3 monthly intervals during follow-up post-transplant. Statistical analysis was performed using Student’s t-test for continuous variables and Chi-squared test for categorical variables. The drug regimens remained unchanged in all patients through the study period. The eGFR was significantly higher in the ciclosporin group compared to the tacrolimus group at 9 months (p=0.045) and 1 year (p=0.025). There was also a trend towards higher serum creatinine in the tacrolimus group (p=0.125 at 12 months). This study indicates there is a significant impairment of renal function in patients on tacrolimus compared to ciclosporin. Larger studies and longer follow-up is needed to denote if this impairment is sustained and irreversible.
Abstract: Approximately 100 cardiac transplants are performed yearly in the UK. The choice of maintenance immunosuppression regimes, however, varies due to the dearth of evidence. Tacrolimus and ciclosporin are used most commonly. An added benefit of tacrolimus has been suggested due to reduced rejection rates and side effect profile, particularly nephrotoxi...
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Biological Investigation of the Benefits and Risk of Plants Consumed by Diabetics in Ngaoundere
Mbarawa Kofia Ibrahim,
Ngah Esther,
Ndoe Guiaro Marcellin,
Gilles Mache,
Tamanji Marcel Nanji,
Sitty Eguessa,
Nwabo Kamdje Armel,
Zofou Denis,
Assob Nguedia
Issue:
Volume 1, Issue 2, April 2017
Pages:
57-61
Received:
25 February 2017
Accepted:
28 March 2017
Published:
18 May 2017
DOI:
10.11648/j.ccr.20170102.15
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Abstract: Medicinal plants have been reported as high risk of kidney failure among consumers. Around 80% in sub-Saharan population consume medicinal plants. This present study aimed to evaluate the influence of everyday life consumption of anti-diabetic plants among diabetic patients. We performed an analytical study in 54 participants. In diabetic population, we included 27 consumers of anti-diabetic plants and 27 non-consumers. We made the kidney screening with the measurement of the serum creatinine, urine creatinine, serum urea and fasting blood glucose. We estimated the GFR with the creatinine clearance of 24h. We used questionnaire to collect socio-demographic and personal history data. We identified 4 anti-diabetic plants used by our participants which are Leptadenie hastata, Detarium microcarpum, Boswellia dalzielii and Moringa oleifera. The average value of fasting blood glucose was low in patient consumers of plants (166 ± 43 mg/dl) than in non-consumers (229±53 mg/dl). We noted that consumers of Moringa oleifera (148.14±42 mg/dl) and Leptadenia hastata (148.25±46 mg/dl) presented best values of fasting blood glucose. We noted high prevalence of stage 3 and 4 of CKD in consumers of plant extracts (15%) than non-consumers (7%). Patient consumers of Detarium microcarpum and Boswellia dalzielii presented average value of eGFR in stage 2 of CKD. Though, consumers of Moringa oleifera and Leptadenia hastata presented healthy status of kidney function (116 ml/min/1.73m2 and 115 ml/min/1.73m2) followed by non-consumers group (102 ml/min/1.73m2). These results showed that Moringa oleifera and Leptadenia hastate are better anti-diabetic plants for management of diabetes and they could have nephron-protection effect among diabetics.
Abstract: Medicinal plants have been reported as high risk of kidney failure among consumers. Around 80% in sub-Saharan population consume medicinal plants. This present study aimed to evaluate the influence of everyday life consumption of anti-diabetic plants among diabetic patients. We performed an analytical study in 54 participants. In diabetic populatio...
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Role of Polymorphism in PLA2G7 Gene in Pathogenesis of Atherosclerosis in Patients of Kashmir Valley India
Nazia,
Tehseen Hassan,
Showkat Ahmad Bhat,
Ishraq Hussain,
Muneeb U Rehman,
Sabhiya Majid,
Roohi Ashraf,
Sheikh Bilal Ahmad
Issue:
Volume 1, Issue 2, April 2017
Pages:
62-66
Received:
29 April 2017
Accepted:
6 May 2017
Published:
15 June 2017
DOI:
10.11648/j.ccr.20170102.16
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Abstract: Background: Coronary artery disease (CAD) also known as atherosclerotic heart disease. Atherosclerosis is a multifactorial progressive disease manifested by the focal development within the arterial wall of lesions the atherosclerotic plaques. The PLA2G7 gene polymorphism is related to enzyme activity which is related to the pro atherosclerotic abilities. This study was designed to investigate an association of this polymorphism with coronary artery disease (CAD) and healthy subjects. Material and method: In this study, the PLA2G7 genotype of 30 patients with coronary artery disease, and 20 healthy subjects were assessed by Polymerase chain reaction polymorphism (PCR-RFLP) method. On genetic level the role of polymorphism of PLA2G7 gene has been widely studied across the world in different ethnic populations. Results: Our study shown 66% (20/30) of the Coronary Heart Disease cases showed homozygous and 26% (8/30) of the cases however showed heterozygous condition. Almost all 80% (16/20) of the normal samples showed heterozygous condition except in four cases where PLA2G7 gene was found to be Homozygous Mutant two & Homozygous normal two. The allelic association of this polymorphism with Coronary Heart Disease was evaluated by χ2 (Chi square) test and was found to be significant (P=0.006).Homozygous mutant condition of PLA2G7 gene was found to be certainly higher in Coronary Heart Disease Cases of above 60 years of age (80%), than ages below 60 years and in controls (16.6%) and was significant as p=0.005, compared to below 60 years of age (33.3%) and in controls (0%) and association was insignificant as p=0.4667. Conclusion: Our study suggests that the polymorphisms of PLA2G7 gene act synergistically to increase the risk of Coronary Heart Disease. Furthermore, it should be noted that the sample size was relatively small in the studied population and so large-scale prospective studies are needed to confirm these findings.
Abstract: Background: Coronary artery disease (CAD) also known as atherosclerotic heart disease. Atherosclerosis is a multifactorial progressive disease manifested by the focal development within the arterial wall of lesions the atherosclerotic plaques. The PLA2G7 gene polymorphism is related to enzyme activity which is related to the pro atherosclerotic abi...
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