Objectives To present the most serious complications cations from mass circumcision was statistically significantly higher than that from circumcisions from circumcision and to compare the complications caused during mass and single circumcisions perperformed singly in operating room conditions (relative ratio 3.05 and P<0.001). formed by medically trained or untrained operators. Patients and methods The study comprised both a retroConclusion Circumcision can have serious lifethreatening and prolonged complications. It should spective and prospective analysis of 220 cases of complications from circumcisions occurring during only be performed in medical institutions by suitably trained surgeons. Mass circumcisions organized for the last decade and a comparison of the frequency and distribution of complications in mass (n=700) any purpose carry significantly greater risk and should be prevented. and single (n=600) circumcisions. Results Traditional (medically untrained) circumcisers Keywords Circumcision complications, traditional, medical, ritual circumcision were responsible for 85% of the complications and almost all the disastrous ones. The frequency of compli-
European Journal of Rheumatology (Eur J Rheumatol) is an international, open access peer reviewed journal committed to promoting the highest standards of scientific exchange and education. The journal is published quarterly on January, April, July and October.The aim of the European Journal of Rheumatology is to cover various aspects of rheumatology for its readers, encompassing the spectrum of diseases with arthritis, musculoskeletal conditions, autoinflammatory diseases, connective tissue disorders, osteoporosis, translational research, the latest therapies and treatment programs. European Journal of Rheumatology publishes original articles, invited reviews, case based reviews, letters to the editor and images in rheumatology. The publication language of the journal is English.
Introduction
It is well known that chronic hepatitis B virus infection (CHBV) can be associated with cirrhosis and hepatocellular carcinoma but it can also be associated with extra‐hepatic effects, of which cardiac manifestations are the one of the least known. There is a limited amount of data about myocardial dysfunction in CHBV and insufficient data of strain echocardiography in CHBV. The aim of this study was to detect early myocardial dysfunction in CHBV using strain echocardiography.
Method
This prospective study included 40 CHBV patients without anti‐viral treatment, 40 CHBV patients under anti‐viral treatment, and 40 healthy volunteers as control group from 2017 October to 2018 May. The patients in all groups were aged 30–60 years, with no co‐morbid diseases. Any patients with pathologies that would cause myocardial dysfunction were excluded from the study. All patients were evaluated with transthoracic two‐dimensional (2D), tissue Doppler, and strain echocardiography.
Results
The mean age and gender distribution were similar in all groups (P = 0.677). A statistically significant difference was determined between the groups in respect of the global circumferential strain and global longitudinal strain values (P < 0.01). The difference in the mean lateral s′ was of statistical significance between the CHBV patients and the control group (P = 0.035). No statistically significant difference was determined in respect of the other echocardiographic parameters.
Conclusion
As it is a chronic necro‐inflammatory period, chronic HBV can affect myocardial functions. Traditional echocardiographic parameters may not be useful in the detection of early myocardial dysfunction. The results of this study showed that strain echocardiography may be more valuable in early myocardial dysfunction rather than routine 2D echocardiography in CHBV patients.
Background: Since its first introduction, the spectrum and frequency of use of transcatheter aortic valve implantation (TAVI) have increased throughout the world. Therefore, it is crucial to determine which patients are at high mortality risk with TAVI. The Intermountain Risk Score (IMRS) is a score calculated from laboratory parameters. This study aimed to determine the long-term mortality of TAVI patients using the IMRS and to compare it with traditional scoring systems.
Methods:The study included a total of 133 patients undergoing TAVI at our hospital from 2010 to 2019. Demographic data, co-morbid diseases, echocardiographic and laboratory parameters were collected retrospectively. The performance of IMRS was assessed as compared to the mortality determined in the overall patient population.Results: During the follow-up, 54.9% of patients (60 patients) (Group 1) survived; the mortality in Group 2 (60 patients) was 45.1%. The survival period had a mean of 1433 (±124) days. The mean IMRS was 1.67 (0.7) in Group 1 and 2.33 (0.72) in Group 2 (P <0.001). In multivariable analyses, only high risk of IMRS (hazard ratio [HR], 3.430; 95% confidence interval [CI], 1.537-7.653; P = 0.003) and EuroSCORE II (HR, 1.141; 95% CI, 1.011-1.288; P = 0.03) independently predicted long-term mortality.
Conclusions:From the evaluation of all laboratory and echocardiography parameters, long-term mortality (>30 days) following the TAVI procedure can be said to be higher in patients with a high IMRS. The data from this study can be considered of value in demonstrating the clinical significance of IMRS calculation before the TAVI procedure.
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