Objective High levels of mean platelet volume (MPV) may be associated with adverse outcomes in patients with myocardial infarction (MI). We examined the association between MPV and the risk of death and adverse cardiovascular outcomes in patients with MI. Methods We studied consecutive patients with MI admitted to a tertiary-care hospital during a period of 1 year. MPV was measured at admission and at third month. Patients were followed up for 1-year primary composite outcome of cardiovascular death, stroke, fatal or non-fatal MI and cardiac failure. Patients were classified according to tertile of baseline MPV. Results A total of 1206 patients with MI, including 934 men (77.4%) and 272 women (22.6%) were studied. The mean age of the study population was 56 years. At 1-year follow-up, 292 (28.57%) primary outcome occurred: cardiovascular mortality 78 (7.6%), fatal or non-fatal MI 153 (15.0%), stroke 30 (2.9%) and cardiac failure 128 (12.52%). Patients with the highest tertile MPV had higher primary outcome as compared with those with MPV in the lowest tertile (adjusted OR=2.31; 95% CI 1.60 to 3.35; p<0.001). Total mortality was also more in high-MPV group (adjusted OR 2.62; 95% CI 1.47 to 4.70; p<0.001). There were no significant changes in mean MPV values at admission from those at third month interval (9.15, (SD 0.99) vs 9.19 (SD 0.94); p=0.2). Conclusions Elevated MPV was associated with worse outcome in patients with acute MI. Elevated MPV in these patients may be due to inherently large platelets. Trial registration number http://ctri.nic.in/ Clinicaltrials/rmaindet.php?trialid=5485&EncHid=98036. 61144&modid=1&compid=19; CTRI/2012/12/003222.
There were significantly lower mitral annular motion parameters including MAPSE in patients with rheumatic mitral stenosis. Those with atrial fibrillation had higher MPI. Immediately after BMV, there was improvement in LV long axis function with a gradual improvement in global LV function. There was no significant change of MAPSE after BMV.
Ivabradine or atenolol can be used for heart rate control in patients with moderate mitral stenosis in sinus rhythm. Ivabradine is not superior to atenolol for controlling heart rate or exercise capacity. Left ventricular MPI was unaffected by either of the drugs.
The paper suggests a model for the developing countries, especially in South Asia, that are faced with common catastrophic events (e.g., floods, earthquakes, epidemics) every year at a large scale causing innumerable deaths, injuries, and damage. The disaster management measures in these countries either are not available or have not been implemented properly. As such, the population remains extremely vulnerable to the adverse health consequences from natural disasters.Disaster preparedness, emergency relief, and management of disasters are the three main lines of action that provide an effective public-health management of disasters. This could be facilitated by a well-managed global network making use of latest communication technologies that facilitate access to and dissemination of timely information and knowledge for these countries. The model suggested will have its operational utility both at micro and macro levels. At the micro level, the aim will be to utilize modern technology in bringing the internet to the community by setting up of Internet Radio Stations, Community Information Centres, and Community Telecentres. At the macro level, the aim will be to provide health network connectivity between countries of South Asia by stationing a Health Satellite and creation of HDINR (Health and Disaster Information Network) for the Region. A total of 231 tele-consultation cases were collected. The evaluation criteria were: 1) the quality of the consultation; 2) the duration of the tele-consultation; 3) the time required of preparation for the available and transferring materials; 4) the status of the available equipment; 5) the availability of the computer function; 6) the lack of the clear materials; 7) the satisfaction of the doctors; 8) the benefit to the patients; and 9) the charges. The purposes of the project were to establish computer networks between selected hospitals and through the high speed communication and high power computer processing, to electronically exchange medical information, and to conduct clinical examination and consultation. It aimed to provide on-time, quality medical services to patients in the remote rural areas such as villages and small towns in the mountains, and on the coasts and islets distant from Taiwan. It also was intended to facilitate onthe-job training and education for doctors in those areas. Results: We collected the cases of the tele-consultation from the available telemedicine between Taipei VGH and Kinmen-Granite County Hospital from July 1997 to June 1999. The data included 253 Taipei-VGH doctors and 253 Kinmen doctors. The peak age of the participants was 21-30 years. The most involved medical section was radiology, followed by chest medicine, dermatology, orthopedics, neurosurgery, general surgery, etc. The questionnaire results: 1) Searching for a second opinion, 72.3%; 2) The compliance of the patients after receiving the teleconsultation, >89%; 3) >97% of the participating doctors think telemedicine system will affect the quality of the consultation and tha...
Low BMI and normal WC were associated with a worse short-term outcome in patients with acute MI. Neither BMI nor WC independently predicted cardiac events or death after acute MI.
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