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Volume 57 (2019): Edition 3 (September 2019)

Volume 57 (2019): Edition 2 (June 2019)

Volume 57 (2019): Edition 1 (March 2019)

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Volume 56 (2018): Edition 2 (June 2018)

Volume 56 (2018): Edition 1 (March 2018)

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Volume 55 (2017): Edition 2 (June 2017)

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Détails du magazine
Format
Magazine
eISSN
2501-062X
Première publication
30 Mar 2015
Période de publication
4 fois par an
Langues
Anglais

Chercher

Volume 57 (2019): Edition 1 (March 2019)

Détails du magazine
Format
Magazine
eISSN
2501-062X
Première publication
30 Mar 2015
Période de publication
4 fois par an
Langues
Anglais

Chercher

12 Articles
access type Accès libre

Rheumatologic manifestations in celiac disease: what should we remember?

Publié en ligne: 28 Mar 2019
Pages: 3 - 5

Résumé

Mots clés

  • Celiac disease
  • arthritis
  • osteoporosis
  • bone disease
  • metabolic
  • myalgia
access type Accès libre

Cardiac sarcoidosis: Case presentation and Review of the literature

Publié en ligne: 28 Mar 2019
Pages: 7 - 13

Résumé

Abstract

Cardiac sarcoidosis usually occurs in the context of systemic disease; however, isolated cardiac involvement can occur in up to 25% of cases and tends to be clinically silent. When symptoms are present, they are often nonspecific and occasionally fatal, representing a diagnostic challenge. A high index of clinical suspicion and the integration of appropriate imaging, laboratory, and pathologic findings is always required. Treatment aims to control the systemic inflammatory condition while preventing further cardiac damage. However, even with adequate diagnosis and treatment strategies, prognosis remains poor. We describe the case of a patient who presented with cardiac symptoms, whose initial examination was unrevealing. Diagnosis was made retrospectively based on later systemic manifestations that revealed characteristic sarcoidosis findings.

Mots clés

  • AV block
  • cardiac sarcoidosis
  • heart failure
  • implantable cardioverter-defibrillator
  • ventricular tachycardia
access type Accès libre

Profiles of peptide YY and ghrelin, levels of hunger and satiety, and ad libitum intake in obese and non-obese Indonesian women

Publié en ligne: 28 Mar 2019
Pages: 15 - 22

Résumé

Abstract

Introduction. The current study aimed to assess profiles of peptide YY and ghrelin, visual analog scales (VAS) for hunger and satiety, and ad libitum intake in obese and non-obese women.

Methods. This open-label non-randomized interventional study involved obese (BMI ≥ 25–35 kg/m2) and non-obese (BMI 18.5–23.0 kg/m2) women subjects. Levels of peptide YY and ghrelin were determined by radioimmunoassay and enzyme-linked immunosorbent assay (ELISA), respectively, while the degrees of hunger and satiety were measured using visual analog scale (VAS) questionnaires. The results were compared in fasting condition and in 15, 60, 120, and 180 minutes after breakfast with balance composition formulation. This study also compared the ad libitum intake within 4 hours after breakfast.

Results. As compared to the non-obese group, the obese group have significantly lower levels of peptide YY in fasting, and in 15, 60, 120, and 180 minutes post-prandial, and smaller AUC (Area Under the Curve) of fasting peptide YY. Furthermore, the obese group showed significantly higher ad libitum intake. The obese group also have lower levels of ghrelin and lower VAS for hunger and higher in VAS for satiety as compared to the non-obese group.

Conclusions. There were significant differences in peptide YY level, 4 hours after breakfast ad libitum intake, ghrelin level, and VAS for hunger and satiety, between obese group and non-obese one.

Mots clés

  • peptide YY
  • ghrelin
  • hunger
  • satiation
  • food intake
access type Accès libre

Effect of reducing medication regimen complexity on glycaemic control in patients with diabetes

Publié en ligne: 28 Mar 2019
Pages: 23 - 29

Résumé

Abstract

Introduction. Medication Regimen complexity is an important issue of patients care that needs to be addressed. The aim of this study is the safe reduction of regimens complexities. The effect of this intervention on glycemic control was assessed in this study.

Methods. Seventy eight patients were recruited to the study. The entry criteria were non optimal glycemic, non-adherence (as demonstrated by indirect tools), and polypharmacy. The only intervention was the safe reduction of medication regimen complexity. This was done in view of the best practice guidelines; to ensure that all comorbidities are treated with the optimum number of medications for the optimum duration.

There was no change to hypoglycemic regimen. All patients, whose hypoglycemic regimen has changed after the recruitment, were excluded. The primary outcome measure was the change in HbA1c three months after the intervention.

Results. Reducing medications regimen complexities led to a significant improvement of HbA1c in the after phase compared to the before phase (mean HbA1c in the before phase was 7.7 ± 0.43% compared to 6.93 ± 0.4% in the after phase. Mean reduction in the HbA1c was 0.77 ± 0.23%, p values < 0.001).

Conclusion. Medications regimen complexity constitutes a burden for patients with diabetes. Reducing such regimens might improve glycemic control in those patients. Further studies are needed to confirm this favourable effect on the glycemic control.

Mots clés

  • Diabetes Mellitus
  • Medication Adherence
  • Glycemic
  • Glycosylated Hemoglobin A1c
  • Patient compliance
access type Accès libre

Thiol/Disulfide homeostasis in patients with rheumatoid arthritis

Publié en ligne: 28 Mar 2019
Pages: 30 - 36

Résumé

Abstract

Background. Oxidative stress may play an important role in rheumatoid arthritis (RA) etiopathogenesis. The thiol group is a very strong antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with RA by evaluating thiol/disulfide homeostasis.

Material and methods. A total of 50 female RA patients and 50 healthy female controls were included in this study. Thiol and disulfide values were calculated utilizing novel methods.

Results. Native thiol (p < 0.001) and total thiol (p < 0.001) levels of RA patients were significantly lower compared to values in the control group. However, the disulfide (p < 0.001) levels of RA patients were strongly higher than in healthy individuals. A negative correlation was found between thiol and disease activity score-28 among the patients, whereas a positive correlation was found between disulfide and disease activity score-28 among the patients.

Conclusion. We found that the thiol–disulfide rate deteriorated in RA patients, with the proportion of disulfide increasing. There is a strong correlation between the decrease in thiol levels, increase in disulfide levels and the disease activity scores.

Mots clés

  • Rheumatoid arthritis
  • thiol
  • disulfide
  • thiol/disulfide homeostasis
  • oxidative stress
access type Accès libre

Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies

Publié en ligne: 28 Mar 2019
Pages: 37 - 46

Résumé

Abstract

Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital.

Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation.

Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases.

Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

Mots clés

  • Hepatocellular carcinoma
  • Hepatitis viruses
  • Multiple infections
  • Cirrhosis
  • Liver cancer
  • Moldova
access type Accès libre

The relationship of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in peripheral blood with ST-segment resolution and the clinical outcomes of STEMI patients receiving thrombolytic therapy

Publié en ligne: 28 Mar 2019
Pages: 47 - 54

Résumé

Abstract

Introduction. One of the inflammatory factors affecting the prognosis of myocardial infarction is the high level of neutrophil count in the blood. In this study, we investigated the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in peripheral blood with ST-segment resolution and clinical outcomes of patients with ST-elevation myocardial infarction (STEMI) receiving thrombolytic therapy.

Methods. This cross-sectional study was conducted on the patients referring to the emergency department in Tabriz, Iran who were diagnosed with STEMI and began receiving treatment with reteplase. The patients were asked questions to gather information about their demographic characteristics as well as their risk factors, level of response to thrombolytic therapy, etc. For all of the patients, electrocardiogram (ECG) was recorded and different blood tests were performed upon their admission to the emergency department and the obtained data were fed into SPSS Version 19 to explore the possible relationships among different variables.

Results. The findings of this study revealed that there is no significant relationship between either NLR or PLR of patients suffering from myocardial infarction and their level of response to thrombolytic therapy. Moreover, no significant relationship was observed between NLR or PLR of these patients and their ejection fraction. However, the results indicated that NLR and PLR associated with an increase in the incidence rate of major adverse cardiac events (MACE) in STEMI patients.

Conclusion. The results of this study indicated that NLR and PLR are directly associated with the rate of in-hospital major adverse effects following STEMI irrespective of the ST resolution.

Mots clés

  • neutrophil
  • lymphocyte
  • platelet
  • myocardial infarction
access type Accès libre

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Publié en ligne: 28 Mar 2019
Pages: 55 - 60

Résumé

Abstract

Background and Objective. Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU).

Methods. Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan. The patients were examined for serum 25-hydroxyvitamin D (vitD3) level and VAP severity and prognosis. Clinical pulmonary infection score was used for the diagnosis, and Sequential Organ Failure Assessment (SOFA) Score was used to determine the severity of VAP.

Results. Low level serum vitD3 (under 30 ng/mL) was found in 66 (78.6%) patients. In this series of VAP patients, there were no significant differences in blood culture results, 14 and 28-day sepsis-associated mortality, mechanical ventilation duration, or SOFA Score on days 3, 7, and 14 between the low level and normal level vitD3 patients (p > 0.05).

Conclusion. Serum vitD3 level was not associated with mortality from VAP or complications due to sepsis in the inpatients in the ICU.

Mots clés

  • Vitamin D
  • Pneumonia
  • Ventilator-Associated
access type Accès libre

Metabolic and bone profile in postmenopausal women with and without type 2 diabetes: a cross-sectional study

Publié en ligne: 28 Mar 2019
Pages: 61 - 67

Résumé

Abstract

Introduction. Current studies support the implication of metabolic changes associated with type 2 diabetes in altering bone metabolism, structure and resistance.

Objective. We conducted a cross-sectional study on postmenopausal women aimed to analyze the differences in metabolic and bone profile in patients with and without type 2 diabetes

Methods. We analyzed the metabolic and bone profile in postmenopausal women with and without type 2 diabetes (T2DM). Clinical, metabolic, hormonal parameters, along with lumbar, hip and femoral bone mineral density (BMD) and trabecular bone score (TBS) were evaluated.

Results. 56 women with T2DM(63.57±8.97 years) and 83 non-T2DM (60.21±8.77 years) were included. T2DM patients presented a higher value of body mass index (BMI) and BMD vs. control group (p = 0.001; p = 0.03-lumbar level, p = 0.07-femoral neck and p = 0.001-total hip). Also, BMI correlated positively with lumbar-BMD and glycated hemoglobin (HbA1c) (r = 0.348, p = 0.01; r = 0.269, p = 0.04), correlation maintained even after age and estimated glomerular filtration rate (eGFR) adjustment (r = 0.383, p = 0.005; r = 0.237, p = 0.08). Diabetic patients recorded lower levels of 25(OH)D(p = 0.05), bone markers (p ≤ 0.05) and TBS(p = 0.07).

For the entire patient group we found a negative correlation between HbA1c level and bone markers: r = -0.358, p = 0.0005-osteocalcin, r = -0.40, p = 0.0005-P1NP, r = -0.258, p = 0.005-crosslaps.

Conclusions. Our results indicate the presence of altered bone microarchitecture in T2DZ patients according to the TBS score, combined with lower levels of bone markers, with a statistically significant negative correlation between HbA1c level and bone markers.

Mots clés

  • type 2 diabetes mellitus
  • diabetic bone disease
  • trabecular bone score
  • osteocalcin
  • bone density
access type Accès libre

Acute coronary syndrome with elevation of ST associated with ergotamine abuse

Publié en ligne: 28 Mar 2019
Pages: 69 - 71

Résumé

Abstract

There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal.

Mots clés

  • ergotamine
  • acute coronary syndrome
  • myocardial infarction
  • dissection
access type Accès libre

Is recurrent Kikuchi-Fujimoto disease a precursor to systemic lupus erythematosus?

Publié en ligne: 28 Mar 2019
Pages: 72 - 77

Résumé

Abstract

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, self-limiting disease characterized by cervical lymphadenopathy and fever. Since KFD was first reported in 1972, the validity of this clinical entity has been controversial and its aetiology remains unknown. Herein, we report a case of a patient with KFD, which was believed to be associated with systemic lupus erythematosus.

Mots clés

  • Kikuchi-Fujimoto disease
  • systemic lupus erythematosus
  • FDG-PET/CT
  • enhanced CT
access type Accès libre

Left Ventricular noncompaction in a patient with systemic lupus erythematosus

Publié en ligne: 28 Mar 2019
Pages: 78 - 82

Résumé

Abstract

Left ventricular noncompaction is a rare structural cardiomyopathy that can occur isolated or in relationship with other conditions, mainly with musculoskeletal diseases or congenital heart defects. The association of left ventricular noncompaction and connective tissue disorders, including systemic lupus erythematosus, was scarcely described in the literature. Reported cases are, more likely, cardiomyopathies mimicking left ventricular noncompaction or transient left ventricular noncompaction with ventricular function improving after appropriate treatment.

We present the case of a 23-year-old woman admitted for cardiac evaluation because of ECG abnormalities observed during a routine check-up. Echocardiography showed severe systolic and diastolic dysfunction, diffuse hypokinesis and hypertrabeculation, suggestive of left ventricular non-compaction. Cardiac magnetic resonance imaging confirmed the diagnosis. She later presented with specific clinical and biological parameters and was diagnosed with systemic lupus erythematosus. Corticosteroid and hydroxychloroquine treatment induced general improvement of signs and symptoms, but no recovery of cardiac function.

Mots clés

  • left ventricular noncompaction
  • LVNC
  • cardiomyopathy
  • systemic lupus erythematosus
12 Articles
access type Accès libre

Rheumatologic manifestations in celiac disease: what should we remember?

Publié en ligne: 28 Mar 2019
Pages: 3 - 5

Résumé

Mots clés

  • Celiac disease
  • arthritis
  • osteoporosis
  • bone disease
  • metabolic
  • myalgia
access type Accès libre

Cardiac sarcoidosis: Case presentation and Review of the literature

Publié en ligne: 28 Mar 2019
Pages: 7 - 13

Résumé

Abstract

Cardiac sarcoidosis usually occurs in the context of systemic disease; however, isolated cardiac involvement can occur in up to 25% of cases and tends to be clinically silent. When symptoms are present, they are often nonspecific and occasionally fatal, representing a diagnostic challenge. A high index of clinical suspicion and the integration of appropriate imaging, laboratory, and pathologic findings is always required. Treatment aims to control the systemic inflammatory condition while preventing further cardiac damage. However, even with adequate diagnosis and treatment strategies, prognosis remains poor. We describe the case of a patient who presented with cardiac symptoms, whose initial examination was unrevealing. Diagnosis was made retrospectively based on later systemic manifestations that revealed characteristic sarcoidosis findings.

Mots clés

  • AV block
  • cardiac sarcoidosis
  • heart failure
  • implantable cardioverter-defibrillator
  • ventricular tachycardia
access type Accès libre

Profiles of peptide YY and ghrelin, levels of hunger and satiety, and ad libitum intake in obese and non-obese Indonesian women

Publié en ligne: 28 Mar 2019
Pages: 15 - 22

Résumé

Abstract

Introduction. The current study aimed to assess profiles of peptide YY and ghrelin, visual analog scales (VAS) for hunger and satiety, and ad libitum intake in obese and non-obese women.

Methods. This open-label non-randomized interventional study involved obese (BMI ≥ 25–35 kg/m2) and non-obese (BMI 18.5–23.0 kg/m2) women subjects. Levels of peptide YY and ghrelin were determined by radioimmunoassay and enzyme-linked immunosorbent assay (ELISA), respectively, while the degrees of hunger and satiety were measured using visual analog scale (VAS) questionnaires. The results were compared in fasting condition and in 15, 60, 120, and 180 minutes after breakfast with balance composition formulation. This study also compared the ad libitum intake within 4 hours after breakfast.

Results. As compared to the non-obese group, the obese group have significantly lower levels of peptide YY in fasting, and in 15, 60, 120, and 180 minutes post-prandial, and smaller AUC (Area Under the Curve) of fasting peptide YY. Furthermore, the obese group showed significantly higher ad libitum intake. The obese group also have lower levels of ghrelin and lower VAS for hunger and higher in VAS for satiety as compared to the non-obese group.

Conclusions. There were significant differences in peptide YY level, 4 hours after breakfast ad libitum intake, ghrelin level, and VAS for hunger and satiety, between obese group and non-obese one.

Mots clés

  • peptide YY
  • ghrelin
  • hunger
  • satiation
  • food intake
access type Accès libre

Effect of reducing medication regimen complexity on glycaemic control in patients with diabetes

Publié en ligne: 28 Mar 2019
Pages: 23 - 29

Résumé

Abstract

Introduction. Medication Regimen complexity is an important issue of patients care that needs to be addressed. The aim of this study is the safe reduction of regimens complexities. The effect of this intervention on glycemic control was assessed in this study.

Methods. Seventy eight patients were recruited to the study. The entry criteria were non optimal glycemic, non-adherence (as demonstrated by indirect tools), and polypharmacy. The only intervention was the safe reduction of medication regimen complexity. This was done in view of the best practice guidelines; to ensure that all comorbidities are treated with the optimum number of medications for the optimum duration.

There was no change to hypoglycemic regimen. All patients, whose hypoglycemic regimen has changed after the recruitment, were excluded. The primary outcome measure was the change in HbA1c three months after the intervention.

Results. Reducing medications regimen complexities led to a significant improvement of HbA1c in the after phase compared to the before phase (mean HbA1c in the before phase was 7.7 ± 0.43% compared to 6.93 ± 0.4% in the after phase. Mean reduction in the HbA1c was 0.77 ± 0.23%, p values < 0.001).

Conclusion. Medications regimen complexity constitutes a burden for patients with diabetes. Reducing such regimens might improve glycemic control in those patients. Further studies are needed to confirm this favourable effect on the glycemic control.

Mots clés

  • Diabetes Mellitus
  • Medication Adherence
  • Glycemic
  • Glycosylated Hemoglobin A1c
  • Patient compliance
access type Accès libre

Thiol/Disulfide homeostasis in patients with rheumatoid arthritis

Publié en ligne: 28 Mar 2019
Pages: 30 - 36

Résumé

Abstract

Background. Oxidative stress may play an important role in rheumatoid arthritis (RA) etiopathogenesis. The thiol group is a very strong antioxidant. In this study, we aimed to investigate the presence of oxidative stress in patients with RA by evaluating thiol/disulfide homeostasis.

Material and methods. A total of 50 female RA patients and 50 healthy female controls were included in this study. Thiol and disulfide values were calculated utilizing novel methods.

Results. Native thiol (p < 0.001) and total thiol (p < 0.001) levels of RA patients were significantly lower compared to values in the control group. However, the disulfide (p < 0.001) levels of RA patients were strongly higher than in healthy individuals. A negative correlation was found between thiol and disease activity score-28 among the patients, whereas a positive correlation was found between disulfide and disease activity score-28 among the patients.

Conclusion. We found that the thiol–disulfide rate deteriorated in RA patients, with the proportion of disulfide increasing. There is a strong correlation between the decrease in thiol levels, increase in disulfide levels and the disease activity scores.

Mots clés

  • Rheumatoid arthritis
  • thiol
  • disulfide
  • thiol/disulfide homeostasis
  • oxidative stress
access type Accès libre

Profile of hepatocellular carcinoma in the Republic of Moldova: first-hand information on the presentation, distribution and etiologies

Publié en ligne: 28 Mar 2019
Pages: 37 - 46

Résumé

Abstract

Introduction. Moldova is the European country with the highest incidence of hepatocellular carcinoma (HCC) in both sexes. There is, however, no data comprehensively describing the presentation and the risk factors of HCC in the country. We decided to analyze cases of HCC recently received in a tertiary healthcare Institution from Chisinau, the Moldovian capital.

Methods. A series of 148 primary liver tumors including 139 cases of HCC were retrospectively analyzed for demographic features, serological and biochemical data, and clinical presentation.

Results. The mean age of patients was 59 ± 10 years (range: 19-66) with a M:F sex ratio of 1.9. Tumors appeared on full-blown liver cirrhosis in 83% of cases and were composed of multiple nodules at diagnosis in 36% of patients. Serum Alpha-fetoprotein was exceeding 10ng/mL in 76% of cases. Liver tumor and hepatitis were co-discovered in 34% of cases. More than 81% of hepatocellular carcinomas were associated with at least one hepatitis virus. Carriers of anti-hepatitis C virus were predominating (55% of cases) over patients seropositive for hepatitis B virus surface antigen (36%). Half of the latter were also infected with hepatitis Delta virus. In total, dual or triple infections were present in 24% and 7% of cases.

Conclusions. The burden of infections with hepatitis viruses is particularly important in Moldova and corresponds to a situation commonly observed in countries of the Southern hemisphere. A pro-active policy of screening for persistent liver infection targeting population at risk of HCC (> 50 years) and coupled with the distribution of antivirals in positive cases should be rapidly implemented in Moldova to reduce incidence or primary liver cancer.

Mots clés

  • Hepatocellular carcinoma
  • Hepatitis viruses
  • Multiple infections
  • Cirrhosis
  • Liver cancer
  • Moldova
access type Accès libre

The relationship of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in peripheral blood with ST-segment resolution and the clinical outcomes of STEMI patients receiving thrombolytic therapy

Publié en ligne: 28 Mar 2019
Pages: 47 - 54

Résumé

Abstract

Introduction. One of the inflammatory factors affecting the prognosis of myocardial infarction is the high level of neutrophil count in the blood. In this study, we investigated the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in peripheral blood with ST-segment resolution and clinical outcomes of patients with ST-elevation myocardial infarction (STEMI) receiving thrombolytic therapy.

Methods. This cross-sectional study was conducted on the patients referring to the emergency department in Tabriz, Iran who were diagnosed with STEMI and began receiving treatment with reteplase. The patients were asked questions to gather information about their demographic characteristics as well as their risk factors, level of response to thrombolytic therapy, etc. For all of the patients, electrocardiogram (ECG) was recorded and different blood tests were performed upon their admission to the emergency department and the obtained data were fed into SPSS Version 19 to explore the possible relationships among different variables.

Results. The findings of this study revealed that there is no significant relationship between either NLR or PLR of patients suffering from myocardial infarction and their level of response to thrombolytic therapy. Moreover, no significant relationship was observed between NLR or PLR of these patients and their ejection fraction. However, the results indicated that NLR and PLR associated with an increase in the incidence rate of major adverse cardiac events (MACE) in STEMI patients.

Conclusion. The results of this study indicated that NLR and PLR are directly associated with the rate of in-hospital major adverse effects following STEMI irrespective of the ST resolution.

Mots clés

  • neutrophil
  • lymphocyte
  • platelet
  • myocardial infarction
access type Accès libre

Serum vitamin D level was not associated with severity of ventilator associated pneumonia

Publié en ligne: 28 Mar 2019
Pages: 55 - 60

Résumé

Abstract

Background and Objective. Vitamin D deficiency is considered one of the most common nutritional deficiencies associated with weakened immune system and increased likelihood of sepsis. The current study was conducted to investigate the association between serum vitamin D level and the severity and prognosis of ventilator associated pneumonia (VAP) in inpatients in intensive care unit (ICU).

Methods. Eighty-four consecutive patients with VAP were enrolled in this observational, prospective study conducted in the ICU of Besat Hospital, Hamadan. The patients were examined for serum 25-hydroxyvitamin D (vitD3) level and VAP severity and prognosis. Clinical pulmonary infection score was used for the diagnosis, and Sequential Organ Failure Assessment (SOFA) Score was used to determine the severity of VAP.

Results. Low level serum vitD3 (under 30 ng/mL) was found in 66 (78.6%) patients. In this series of VAP patients, there were no significant differences in blood culture results, 14 and 28-day sepsis-associated mortality, mechanical ventilation duration, or SOFA Score on days 3, 7, and 14 between the low level and normal level vitD3 patients (p > 0.05).

Conclusion. Serum vitD3 level was not associated with mortality from VAP or complications due to sepsis in the inpatients in the ICU.

Mots clés

  • Vitamin D
  • Pneumonia
  • Ventilator-Associated
access type Accès libre

Metabolic and bone profile in postmenopausal women with and without type 2 diabetes: a cross-sectional study

Publié en ligne: 28 Mar 2019
Pages: 61 - 67

Résumé

Abstract

Introduction. Current studies support the implication of metabolic changes associated with type 2 diabetes in altering bone metabolism, structure and resistance.

Objective. We conducted a cross-sectional study on postmenopausal women aimed to analyze the differences in metabolic and bone profile in patients with and without type 2 diabetes

Methods. We analyzed the metabolic and bone profile in postmenopausal women with and without type 2 diabetes (T2DM). Clinical, metabolic, hormonal parameters, along with lumbar, hip and femoral bone mineral density (BMD) and trabecular bone score (TBS) were evaluated.

Results. 56 women with T2DM(63.57±8.97 years) and 83 non-T2DM (60.21±8.77 years) were included. T2DM patients presented a higher value of body mass index (BMI) and BMD vs. control group (p = 0.001; p = 0.03-lumbar level, p = 0.07-femoral neck and p = 0.001-total hip). Also, BMI correlated positively with lumbar-BMD and glycated hemoglobin (HbA1c) (r = 0.348, p = 0.01; r = 0.269, p = 0.04), correlation maintained even after age and estimated glomerular filtration rate (eGFR) adjustment (r = 0.383, p = 0.005; r = 0.237, p = 0.08). Diabetic patients recorded lower levels of 25(OH)D(p = 0.05), bone markers (p ≤ 0.05) and TBS(p = 0.07).

For the entire patient group we found a negative correlation between HbA1c level and bone markers: r = -0.358, p = 0.0005-osteocalcin, r = -0.40, p = 0.0005-P1NP, r = -0.258, p = 0.005-crosslaps.

Conclusions. Our results indicate the presence of altered bone microarchitecture in T2DZ patients according to the TBS score, combined with lower levels of bone markers, with a statistically significant negative correlation between HbA1c level and bone markers.

Mots clés

  • type 2 diabetes mellitus
  • diabetic bone disease
  • trabecular bone score
  • osteocalcin
  • bone density
access type Accès libre

Acute coronary syndrome with elevation of ST associated with ergotamine abuse

Publié en ligne: 28 Mar 2019
Pages: 69 - 71

Résumé

Abstract

There are few case reports of cases of carotid and aortic dissection related to the ergotamine abuse, but the cases that affect the coronary arteries is a very rare coronary. We present a patient of a 48-year-old female with an ST-segment elevation myocardial infarction attributable to chronic ergotamine use. The coronary angiography showed dissection of right coronary artery proximal.

Mots clés

  • ergotamine
  • acute coronary syndrome
  • myocardial infarction
  • dissection
access type Accès libre

Is recurrent Kikuchi-Fujimoto disease a precursor to systemic lupus erythematosus?

Publié en ligne: 28 Mar 2019
Pages: 72 - 77

Résumé

Abstract

Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign, self-limiting disease characterized by cervical lymphadenopathy and fever. Since KFD was first reported in 1972, the validity of this clinical entity has been controversial and its aetiology remains unknown. Herein, we report a case of a patient with KFD, which was believed to be associated with systemic lupus erythematosus.

Mots clés

  • Kikuchi-Fujimoto disease
  • systemic lupus erythematosus
  • FDG-PET/CT
  • enhanced CT
access type Accès libre

Left Ventricular noncompaction in a patient with systemic lupus erythematosus

Publié en ligne: 28 Mar 2019
Pages: 78 - 82

Résumé

Abstract

Left ventricular noncompaction is a rare structural cardiomyopathy that can occur isolated or in relationship with other conditions, mainly with musculoskeletal diseases or congenital heart defects. The association of left ventricular noncompaction and connective tissue disorders, including systemic lupus erythematosus, was scarcely described in the literature. Reported cases are, more likely, cardiomyopathies mimicking left ventricular noncompaction or transient left ventricular noncompaction with ventricular function improving after appropriate treatment.

We present the case of a 23-year-old woman admitted for cardiac evaluation because of ECG abnormalities observed during a routine check-up. Echocardiography showed severe systolic and diastolic dysfunction, diffuse hypokinesis and hypertrabeculation, suggestive of left ventricular non-compaction. Cardiac magnetic resonance imaging confirmed the diagnosis. She later presented with specific clinical and biological parameters and was diagnosed with systemic lupus erythematosus. Corticosteroid and hydroxychloroquine treatment induced general improvement of signs and symptoms, but no recovery of cardiac function.

Mots clés

  • left ventricular noncompaction
  • LVNC
  • cardiomyopathy
  • systemic lupus erythematosus

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