BACKGROUND: This study investigated the effects of the intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI).METHODS: Seventy-eight STEMI patients with age >65 years who underwent emergency PCI were consecutively enrolled. These patients received conventional PCI and were randomly divided into a control group and a treatment group (n=39 per group). The control group received an intracoronary injection of tirofi ban followed by a maintenance infusion for 36 hours after surgery. The treatment group received intracoronary injection of tirofiban and nicorandil, and then intravenous infusion of tirofi ban and nicorandil 36 hours after surgery. The following parameters were measured: TIMI grade, corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG), STsegment resolution (STR) rate 2 hours post-operatively, resolution of ST-segment elevation (STR) at 2 hours postoperatively, peak level of serum CK-MB, left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) at 7-10 days postoperatively, and major adverse cardiac events (MACEs) in-hospital and within 30 days post-operatively. RESULTS:Compared with the control group, more patients in the treatment group had TIMI 3 and TMPG 3, and STR after PCI was significantly higher. The treatment group also had significantly lower cTFC, lower infarction relative artery (IRA), lower peak CK-MB, and no refl ow ratio after PCI. The treatment group had signifi cantly higher LVEDD and LVEF but lower incidence of MACEs than the control group. CONCLUSION:The intracoronary injection of nicorandil combined with tirofi ban can effectively improve myocardial reperfusion in elderly STEMI patients after emergency PCI and improve shortterm prognoses.
We aimed to investigate the effects of febuxostat on IR and the expression of high-sensitivity C-reactive protein (hs-CRP) in patients with primary gout. Forty-two cases of primary gout patients without uric acid-lowering therapy were included in this study. After a physical examination, 20 age- and sex-matched patients were included as normal controls. The levels of fasting insulin (INS), fasting blood glucose (FBG), and hs-CRP were determined. IR was assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Gout patients had higher levels of UA, INS, HOMA-IR, and hs-CRP than normal controls (P < 0.05). After 4-, 12-, and 24-week febuxostat treatments, UA and hs-CRP concentrations were significantly lower than baseline (P < 0.05). INS and HOM-IR decreased slightly after a 4-week treatment with febuxostat but declined significantly after 12 and 24 weeks of treatment. Importantly, hs-CRP values positively correlated with those of HOMA-IR (r = 0.353, P = 0.018) and INS (r = 0.426, P = 0.034). Our findings confirm that IR exists in gout patients and implicate that febuxostat can effectively control the level of serum UA and increase insulin sensitivity in primary gout patients.
Background: The incidence of gout has increased rapidly in recent years, and the suspected lack of awareness of gout among general practitioners may lead to misdiagnosis and inappropriate treatment. Aim: To assess general practitioners’ management of gout at community health service clinics in the Tongzhou district of Beijing, as well as the factors that contributed to optimal decision making. Methods: A survey based on current guidelines for assessment and management of gout was sent to 245 general practitioners at community health service clinics in the Tongzhou district of Beijing. The questionnaire included personal information of general practitioners and ten items that addressed knowledge of gout. Our questionnaire was self-administered and distributed electronically via WeChat, and data were collected on a platform called ‘Wenjuanwang’. Statistical analysis was performed using SPSS version 19.0 software. Results: Totally, 216 general practitioners responded to the survey. About three-quarters (71.8%) reported having received Continuing Medical Education (CME) about gout. More than half (54.6%) reported an awareness of treat to target (T2T) for gout. However, the overall rate of good understanding of gout was only 6.5%, a basic knowledge of gout was 55.6%, and understanding about gout diagnosis and treatment was only 11.1%. The general practitioners’ understanding of basic concepts related to gout indicated that CME could improve their understanding (P < 0.05). An analysis of the general practitioners’ rate of comprehension of gout diagnosis and treatment showed that education level, CME, and familiarity with T2T could improve understandings of gout diagnosis and treatment (P < 0.05). Conclusion: There are serious deficits in understandings about gout among general practitioners in the Tongzhou district of Beijing. Quality CME is needed to improve Chinese general practitioners’ management of gout.
Patients with systemic lupus erythematosus (SLE) have a high risk of infection. Central nervous system infection and neuropsychiatric SLE are both major causes of death. It is vital to distinguish between these two conditions to improve prognosis due to the treatment paradigms required for each condition. Here, we report one case of meningoencephalitis by Listeria monocytogenes (LM) in a patient with SLE who presented with fever and developed headache and altered in consciousness in the hospital. The cerebrospinal fluid culture was positive for LM, and magnetic resonance imaging (MRI) findings were suggestive of ependymitis and periventricular white matter lesions. Amoxicillin/sulbactam, trimethoprim-sulfamethoxazole, and rifampicin were administered for 8 weeks. The patient had a relative good recovery without serious neurological sequelae after a follow-up of nearly 2 years. MRI abnormalities also had obvious resolution.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.