Objective: AngioJet rheolytic thrombectomy (ART) has been used as a catheter-based treatment for acute pulmonary embolism (PE). In this study, based on our 7-year experience with ART in patients with PE, we evaluated the efficacy and safety outcomes of ART. Methods: Our study is based on retrospective evaluation of 56 patients with high-and intermediate-high-risk PE, with an average age of 62 years [interquartile range (IQR) 50-73 years] who underwent ART. Results: High and intermediate-high risks were noted in 21.4% and 78.6% of the patients, respectively. The ART duration was 304 (IQR: 246-468) seconds. Measures of obstruction, right to left ventricle diameter ratio, right to left atrial diameter ratio, and pulmonary arterial pressures were improved (p<0.001 for all). During the hospital stay, acute renal failure, major and minor bleeding, and mortality rates were 37.5%, 7.1%, 12.5%, and 8.9%, respectively. Aging related to post-procedural nephropathy while high-risk status was associated with in-hospital mortality (p=0.006) and long-term mortality. Conclusion: ART resulted in significant and clinically relevant improvements in the pulmonary arterial thrombotic burden, right ventricle strain, and hemodynamics in patients with PE at high and intermediate-high risk. Aging increased the risk of post-procedural nephropathy, whereas baseline high-risk status predicted in-hospital and long-term mortality.
Th e aim of this study compares to the increase in tissue temperature and the thermal histological eff ects of ultrasonic scalpel, bipolar and unipolar electrosurgery incisions in the tongue tissue of rabbits. Th is study evaluates the histopathological changes related to thermal change and the maximum temperature values in the peripheral tissue brought about by the incisions carried out by the three methods in a comparative way. To assess thermal tissue damage induced by the three instruments, maximum tissue temperatures were measured during the surgical procedure and tongue tissue samples were examined histopathologically following the surgery. Th e mean maximum temperature values of the groups were .±. Cº for the unipolar electrocautery group, whereas .±. Cº for the bipolar electrocautery group, and .±. Cº for the ultrasonic scalpel group. Th ere was a statistically signifi cant relationship between the increase in maximum temperature values and the separation among tissue layers, edema, congestion, necrosis, hemorrhage, destruction in blood vessel walls and fi brin accumulation, and between the existence of fi brin thrombus and tissue damage depth (p<.). It was concluded that the bipolar electrocautery use gives way to less temperature increase in the tissues and less thermal tissue damage in comparison to the other methods.
BACKGROUND: The purpose of this study was to assess the relationship between the triglyceride/high density lipoprotein cholesterol ratio and the risk of acute myocardial infarction in young adults. PATIENTS AND METHODS: A total of 621 patients, who underwent coronary angiography (CAG) due to Myocardial Infarction (MI) at our hospital were included in this study. Demographic characteristics, risk factor profi le, laboratory test results, electrocardiographic and CAG fi ndings were assessed in the selected groups. RESULTS: Total cholesterol, triglyceride/high density lipoprotein cholesterol (Tg/HDL) ratio, Tg levels, were higher in younger patients with MI, while glucose and high-density lipoprotein levels were lower. Using propensity score matching in the matched population comparing young patients to the older ones, serum triglyceride levels [179 (145-231) vs 148 (101-197)] and triglyceride to high density lipoprotein cholesterol ratio [5.8 (4.1-9.1) vs 3.0 (1.8-4.6)] were signifi cantly higher, whereas high density lipoprotein levels were observed dramatically lower (32.6 ± 8.2 vs 41.7 ± 8.8). CONCLUSION: This study demonstrated that Tg/HDL ratio may be an important predictor for an acute coronary syndrome in the young adult population. Tg/HDL ratio can be used to prevent MI in young adults (Tab. 3, Fig. 1, Ref. 32.
Background:
There is limited data on moderate-dose with slow-infusion thrombolytic regimen by ultrasound-asssisted-thrombolysis (USAT) in patients with acute pulmonary embolism (PE).
Aim:
In this study, our eight-year experience on USAT with moderate-dose, slow-infusion tissue-type
plasminogen activator (t-PA) regimen in patients with PE at intermediate-high- and high-risk was presented, and short-, and long-term effectiveness and safety outcomes were evaluated.
Methods:
Our study is based on the retrospective evaluation of 225 patients with PE having multiple
comorbidities who underwent USAT.
Results:
High- and intermediate-high-risk were noted in 14.7% and in 85.3% of patients, respectively.
Mean t-PA dosage was 35.4±13.3 mg, and the infusion duration was 26.6±7.7 h. Measures of pulmonary artery (PA) obstruction and right ventricle (RV) dysfunction were improved within days (p<0.0001
for all). During the hospital stay, major and minor bleeding and mortality rates were 6.2%, 12.4%, and
6.2%, respectively. Bleeding and unresolved PE accounted for 50% and 42.8% of in-hospital mortality,
respectively. Age, rate, and duration of t-PA were not associated with in-hospital major bleeding and
mortality. Oxygen saturation exceeded 90% in 91.2% of patients at discharge. During follow-up of median 962 (610-1894) days, high-risk status related to 30-day mortality, whereas age >65 years was associated with long-term mortality.
Conclusions:
Our real-life experience with USAT with moderate-dose, slow-infusion t-PA regimen in
patients with PE at high-and intermediate-high risk demonstrated clinically relevant improvements in
PA obstructive burden and RV dysfunction. Age, rate or infusion duration of t-PA was not related to
major bleeding or mortality risk, whereas unresolved obstruction remained as a lethal issue.
BackgroundThe association between periatrial adiposity and atrial arrhythmias has been shown
in previous studies. However, there are not enough available data on the
association between epicardial fat tissue (EFT) thickness and parameters of
ventricular repolarization. Thus, we aimed to evaluate the association of EFT
thickness with indices of ventricular repolarization by using T-peak to T-end
(Tp-e) interval and Tp-e/QT ratio.MethodsThe present study included 50 patients whose EFT thickness ≥ 9 mm (group 1)
and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic
echocardiographic examination was performed in all participants. QT parameters,
Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead
electrocardiogram.ResultsQTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7
± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1
when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8,
p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001),
Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc
ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in
group 1 in comparison to group 2. Significant positive correlations were found
between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval
(r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios
(r = 0.560, p < 0.001).ConclusionThe present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios
were increased in subjects with increased EFT, which may suggest an increased risk
of ventricular arrhythmia.
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