AimControversy exists concerning the relation between Helicobacter pylori (HP) infection and coronary artery disease (CAD). We aimed to examine the relationship between HP infection and severity of coronary atherosclerosis in patients with chronic CAD.Patients and methodsA total of 150 patients (109 [73%] men; mean age 62.61±10.23 years) scheduled for coronary artery bypass grafting surgery were consecutively enrolled in the cross-sectional study. According to rapid urease test and/or gastric biopsy samples stained with hematoxylin and eosin and according to Giemsa, patients were classified as HP positive (n=87; 58%) or HP negative (n=63; 42%). Coronary angiograms were scored by quantitative assessment, using multiple angiographic scoring system: 1) vessel score (number of coronary arteries stenosed ≥50%), 2) Gensini score (assigning a severity score to each coronary stenosis according to the degree of luminal narrowing and its topographic importance) and 3) angiographic severity score (number of coronary artery segments stenosed ≥50%).ResultsIn comparison to HP-negative patients, HP-positive patients were more frequently hypertensive (P=0.014), had higher values of systolic (P=0.043) and diastolic (P=0.005) blood pressure and total cholesterol (P=0.013) and had lower values of high-density lipoprotein-cholesterol (HDL-C; P=0.010). There were no significant differences between the groups in the severity of coronary atherosclerosis: vessel score (P=0.152), Gensini score (P=0.870) and angiographic severity score (P=0.734).ConclusionIt is likely that HP infection is not a risk factor for the severity of coronary atherosclerosis in chronic CAD patients.
Introduction Despite some new treatment possibilities, the improvement in survival rate for hepatocellular carcinoma (HCC) patients is still poor due to late diagnosis. The aim of this study was to investigate the diagnostic sensitivity and specificity of protein induced by vitamin K absence or antagonist-II (PIVKAII), Glypican-3 (GP3), Cystatin B (CSTB), squamous cell carcinoma antigen 1 (SCCA1) and hepatocyte growth factor (HGF) as potential tumour markers for HCC in patients with alcoholic liver cirrhosis (ALC) using imaging techniques (MSCT and MRI) as reference standards. Patients and methods Eighty-three participants were included: 20 healthy volunteers, 31 patients with ALC and 32 patients with HCC. Peripheral blood sampling was performed for each participant, and serum concentrations of PIVKAII, GP3, CSTB, SCCA1 and HGF were determined using commercial ELISA kits. Results Only serum concentrations of PIVKAII were significantly higher in HCC patients as compared with ALC and healthy controls (cut-off: 2.06 µg/L; AUC: 0.903), whereas individual diagnostic performance of other individual compounds was inadequate. The 'best' combination of tumour markers in our study includes all tested markers with AUC of 0.967. Conclusion While novel diagnostic tumour markers are urgently needed, the examined potential tumour markers, with the exception of PIVKAII seem to be inadequate for diagnosing HCC in ALC. Furthermore, probably the future is in finding the best optimal combination of tumour markers for diagnosing HCC based on cost-effectiveness.
S100B protein and neuron-specific enolase (NSE) can be considered the markers of cerebral injury. To our knowledge the association of general anesthesia for elective non-cardiac surgery in children with these markers has not been studied before. The goal of this study was to find out whether these markers change after adenotonsillectomy with general anesthesia. The secondary goal was to determine whether different types of anesthesia, gender, age and body mass index are associated with the change of S100B and NSE after adenotonsillectomy with general anesthesia. This study was designed as a prospective clinical trial. We did a simple pre-post experiment with no control group. In 59 children (aged 6-13, ASA I-II) undergoing adenotonsillectomy and randomized to TIVA or inhalational general anesthesia, plasma S100B and NSE were measured during anesthesia before and after the surgery which lasted a median (interquartile range) of 16.5 (13.0-20.0) min. S100B and NSE assays were performed using the electrochemiluminescence immunoassay. Significance of the differences was assessed by two-tailed asymptotic Wilcoxon signed rank test. Main outcome measures were differences in the levels of S100B and NSE before and after the general anesthesia and surgery. There were significant increases in S100B and NSE levels after the surgery. S100B was increased by 38% (P < 0.001) and NSE was increased by 10% (P < 0.001). Increase of S100B was significantly negatively associated with age (P = 0.023). We have not found significant association of S100B and NSE with any other of the monitored variables. The values of neurological biomarkers S100B and NSE were significantly increased after general anesthesia for elective adenotonsillectomy in children.
Trenutna uloga trombolize u intrevencijskom kardiološkom laboratoriju -tromb u glavnom deblu lijeve koronarne arterije liječen intrakoronarnom alteplazom Current position of thrombolysis in cathlab -left main coronary artery thrombus treated by intracoronary alteplase U trenutnoj intervencijskoj praksi uloga trombolize tijekom perkutane koronarne intervencije (PCI) nije jasno definirana. Predstavljamo slučaj 49-godišnjeg muškarca hospitaliziranog pod kliničkom slikom akutnog infarkta miokarda s elevacijom ST-segmenta (STEMI) s neokluzivnim trombom u glavnom deblu lijeve koronarne arterije (LM) na koronarografiji. Primijenjen je intrakoronarni bolus alteplaze, a potom infuzija. Nakon pet dana ponovljena je koronarografija na kojoj je nađena potpuna regresija tromba u LM bez zaostalih stenoza. Prema objavljenim prikazima slučajeva terapijske mogućnosti su primarna PCI, žurno aortokoronarno premoštenje te inhibitori glikoproteinskih IIb/IIIa receptora ili tromboliza. Ovaj prikaz slučaja, STEMI bolesnika s trombom u LM, uspješno liječe-nog intrakoronarno alteplazom ukazuje na moguću ulogu intrakoronarne trombolize tijekom PCI.In the present interventional practice role of thrombolysis during percutaneous coronary intervention (PCI) is unclear. We present case of a 49-year old male patient presented as ST-segment elevation myocardial infarction (STEMI) with non occlusive left main coronary artery (LM) thrombus on coronarography. Intracoronary bolus of alteplase was applied followed by systemic infusion. Repeated coronarography after 5 days showed complete resolution of thrombus without residual stenosis. According to the current literature, therapeutic options are primary percutaneous coronary intervention (PCI) with aspiration, urgent coronary artery bypass grafting, glycoprotein IIb/IIIa receptors inhibitors or thrombolysis. This case of STEMI patient with LM thrombus successfully managed by intracoronary application of alteplase demonstrates the potential role of intracoronary thrombolytic therapy in PCI.
Prošireni sažetak Extended AbstractInterventna kardiologija Interventional Cardiology
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