Background Wellens’ syndrome is known to be associated with left anterior descending artery occlusion that could lead to an extensive anterior wall myocardial infarction. Thus, emergency cardiac catheterization is needed. However, during coronavirus disease 2019 (COVID-19) pandemic, it is recommended for hemodynamically stable acute coronary syndrome patients with COVID-19 infection to be treated conservatively in an isolated hospital ward. Case presentation We report an 85-year-old patient with chief complaints of typical, squeezing chest pain in the past 4 h. The patient had a high fever, dyspnea, sore throat, and fatigue for 3 days. He had previously come into contact with COVID-19 positive relatives. The patient was hemodynamically stable and pulmonary auscultation revealed coarse rales in the entire lung. Electrocardiography (ECG) evaluation during the pain episode showed non-specific ST-T changes in lead V2-V5. After sublingual nitrate was administered, ECG evaluation during the pain-free period revealed a biphasic T wave inversion in lead V2 and V3. Laboratory workup showed elevated cardiac marker and leucopenia with neutrophilia and lymphopenia. Rapid immunochromatographic test and initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) evaluation from nasopharyngeal swab showed negative results. However, radiographic evaluations suggest the diagnosis of COVID-19 infection. While waiting for the second RT-PCR evaluation, the patient was diagnosed with Wellens’ syndrome with suspected COVID-19 infection. The patient was treated conservatively according to national guidelines and scheduled for elective cardiac catheterization. On the third day, the patient felt better and insisted on being discharged home. Ten days after discharged, the patient died of myocardial infarction. Conclusion Emergency cardiac catheterization should be done for patient with Wellens’ syndrome, regardless of the COVID-19 infection status.
Background: Atherosclerosis is a condition in which the medium to large arteries become inflamed over time. The cornerstone to the atherosclerosis process is endothelial dysfunction. Simvastatin is a cholesterol-lowering drug known for its endothelial cell pleiotropic properties. The role of genetic polymorphisms in simvastatin-resistance difficulties has recently piqued people’s interest. This problem is thought to be linked to the pleiotropic action of simvastatin, particularly in terms of restoring endothelial function. The goal of this study is to see if there is a link between the single nucleotide polymorphism (SNP) c.521T>C and the pleiotropic effect of simvastatin as determined by the endothelial function parameter, flow-mediated dilation (FMD). Methods: This research was a multicentre cross-sectional study including 71 hypercholesterolemia patients who have been on simvastatin for at least 3 months. The real-time polymerase chain reaction identified SNP c.521T>C. The right brachial artery ultrasonography was used to measure FMD. Results: In 71 hypercholesterolemia patients, the SNP c.521T>C was found in 9.9% of them. On χ2 analysis, there was no significant association between SNP c.521T>C (TC genotype) and FMD ( p = 0.973). On logistic regression analysis, the duration of simvastatin medication was linked with an increased incidence (Adj. OR (adjusted odds ratio) = 2.424; confidence interval (CI) = 1.117–5.260, p = 0.025) and a reduction in systolic blood pressure (Adj. OR = 0.92; CI = 0.025–0.333, p = 0.001). Conclusion: There was no association between FMD and the SNP c.521T>C (TC genotype). The duration of simvastatin medication and systolic blood pressure were both associated to FMD.
Diabetes Mellitus adalah penyakit kronik progresif yang akan ditandai dengan peningkatan kadar glukosa darah (hiperglikemia) akibat penurunan fungsi sekresi atau penurunan fungsi sekresi insulin yang menjadi penyebab resistensi insulin. Pemberian antioksidan merupakan usaha menghambat produksi radikal bebas intraseluler atau meningkatkan kemampuan enzim pertahanan terhadap radikal bebas guna mencegah munculnya stres oksidatif dan komplikasi vaskuler terkait diabetes. Tujuan pengabdian kepada masyarakat untuk meningkatkan pengetahuan tentang bahan makanan untuk pencegahan diabetes mellitus. Metode yang digunakan dalam kegiatan ini adalah edukasi bahan makanan diberikan melalui media poster dengan pemaparan materi dan booklet, pengukuran kadar glukosa darah. Hasil yang didapatkan dari pengabdian kepada masyarakat adalah dari 20 responden yang memiliki kadar glukosa darah > 200 mg/dl sebanyak 3 (15%) responden dan < 200 mg/dl sebanyak 17 (85%) responden. Pada penelitian sebelumnya antioksidan memiliki manfaat dapat mengurangi kerusakan oksidatif pada penderita diabetes. Berdasarkan hasil rata rata nilai pretest didapatkan hasil 26,5 dan hasil rata rata nilai posttest 91,9. Terjadi peningkatan hasil dan edukasi bahan makanan yang dapat mencegah diabetes mellitus. Pendidikan gizi adalah kegiatan dalam bidang kesehatan untuk membantu suatu masyarakat baik individu maupun kelompok yang berguna untuk meningkatkan pengetahuan dan kemampuan mereka menuju masyarakat yang sehat dan bergizi. Kesimpulan dari pengabdian kepada masyarakat ini adalah terdapat 17 responden memiliki kadar glukosa dibawah normal dan terjadi peningkatan kemampuan responden yang terlihat dari hasil posttest yang telah diberikan kepada responden
Takayasu arteritis (TA) is defined as granulomatous inflammation of large arteries involving the aorta and its primary branches. Takayasu arteritis with renal artery stenosis (TARAS) is a common cause of pediatric renovascular hypertension. The main purposes of TARAS management are to improve high blood pressure and recover renal function. When general medication fails to improve symptoms, renal revascularization may be attempted. Implantation of a drug-eluting stent (DES) has been used as an alternative strategy for pediatric renal revascularization. Here, we report on a 10-year-old, female, Javanese patient with bilateral TARAS who underwent DES implantation. Her clinical presentation was hypertensive crisis and worsened renal function. Bilateral renal artery DES implantation was performed successfully without complications. The child’s blood pressure was controlled using two anti-hypertensive medications after DES implantation and her renal function recovered. Dual anti-platelet therapy was given to minimize the risk of stent thrombosis.
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