Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 8 Articles
Maternal diabetes mellitus (DM) affects early organogenesis.Metabolic disorders of DMare associated with a depleted zinc status.\nThis study evaluated the effect of maternal DM on cardiac development of rat fetuses and protective roles of prenatal zinc versus\ninsulin supplementation. Pregnant rats were divided into 4 groups ((I) control, (II) STZ-induced DM, (III) STZ-induced DM\ntreated with Zn, and (IV) STZ induced DM treated with insulin), all sacrificed on GD 20. Fetal heart weight of diabetic rats\nshowed significant decrease compared to controls (...
Ventricular arrhythmogenesis is thought to be a common cause of sudden cardiac death following myocardial infarction (MI).\nNerve remodeling as a result of MI is known to be an important genesis of life-threatening arrhythmias. It is hypothesized that\nneural modulation might serve as a therapeutic option of malignant arrhythmias. In fact, left stellectomy or ...
Aim. This study aimed to assess the role of echocardiography as a diagnostic tool in evaluating syncope patients with normal versus\nabnormal electrocardiogram. Methods. We conducted a retrospective study of 468 patients who were admitted with syncope in\n2011 at St. Joseph�s Regional Medical Center, Paterson, NJ. Hospital records and patient charts, including initial emergency room\nhistory and physical, were carefully reviewed. Patients were separated into normal versus abnormal electrocardiogram groups and\nthen further divided as normal versus abnormal echocardiogram groups. Causes of syncope were extrapolated after reviewing\nall test results and records of consultations. Results. Three hundred twelve of the total patients (68.6%) had normal ECG. Twothirds\nof those patients had echocardiograms; 11 patients (5.7%) had abnormal echo results. Of the aforementioned patients, three\npatients had previous documented history of severe aortic stenosis on prior echocardiograms.The remaining eight had abnormal\nbut nondiagnostic echocardiographic findings. Echocardiography was done in 93 of 147 patients with abnormal ECG (63.2%).\nEcho was abnormal in 27 patients (29%), and the findings were diagnostic in 6.5% patients. Conclusions.This study demonstrates\nthat echo cardiogram was not helpful in establishing a diagnosis of syncope in patients with normal ECG and normal physical\nexamination....
Outcomes of allogeneic hematopoietic stem cell transplantation (AHSCT) usingHLA-half matched related donors (haploidentical)\nhave recently improved due to better control of alloreactive reactions in both graft-versus-host and host-versus-graft directions.\nThe recognition of the role of humoral rejection in the development of primary graft failure in this setting has broadened our\nunderstanding about causes of engraftment failure in these patients, helped us better select donors for patients in need of AHSCT,\nand developed rational therapeutic measures for HLA sensitized patients to prevent this unfortunate event, which is usually\nassociated with a very high mortality rate. With these recent advances the rate of graft failure in haploidentical transplantation\nhas decreased to less than 5%....
Despite the advent of targeted therapies and novel agents, allogeneic hematopoietic stem cell transplantation remains the only\ncurative modality in the management of hematologic disorders. The necessity to find an HLA-matched related donor is a major\nobstacle that compromises the widespread application and development of this field. Matched unrelated donors and umbilical\ncord blood have emerged as alternative sources of donor stem cells; however, the cost of maintaining donor registries and cord\nblood banks is very high and even impractical in developing countries. Almost every patient has an HLA haploidentical relative\nin the family, meaning that haploidentical donors are potential sources of stem cells, especially in situations where cord blood or\nmatched unrelated donors are not easily available. Due to the high rates of graft failure and graft-versus-host disease, haploidentical\ntransplant was not considered a feasible option up until the late 20th century, when strategies such as ââ?¬Å?megadose stem cell infusionsââ?¬Â\nand posttransplantation immunosuppression with cyclophosphamide showed the ability to overcome the HLA disparity barrier\nand significantly improve the rates of engraftment and reduce the incidence and severity of graft-versus-host disease. Newer\ntechnologies of graft manipulation have also yielded the same effects in addition to preserving the anti leukemic cells in the donor\ngraft....
Nonpenetrating, blunt chest trauma is a serious medical condition with varied clinical presentations and implications. This can\nbe the result of a dense projectile during competitive and recreational sports but may also include other etiologies such as motor\nvehicle accidents or traumatic falls. In this setting, themanifestation of ventricular arrhythmias has been observed both acutely and\nchronically. This is based on two entirely separate mechanisms and etiologies requiring different treatments. Ventricular fibrillation\ncan occur immediately after chest wall injury (commotio cordis) and requires rapid defibrillation. Monomorphic ventricular\ntachycardia can develop in the chronic stage due to underlying structural heart disease long after blunt chest injury.The associated\narrhythmogenic tissue may be complex and provides the necessary substrate to forma reentrant VT circuit. Ventricular tachycardia\nin the absence of overt structural heart disease appears to be focal in nature with rapid termination during ablation. Regardless of\nthe VT mechanism, patients with recurrent episodes, despite antiarrhythmic medication in the chronic stage following blunt chest\ninjury, are likely to require ablation to achieve VT control. This review article will describe the mechanisms, pathophysiology, and\ntreatment of ventricular arrhythmias that occur in both the acute and chronic stages following blunt chest trauma....
Isolated left ventricular noncompaction (LVNC) is a genetic cardiomyopathy characterized by prominent ventricular trabeculations\nand deep intertrabecular recesses, or sinusoids, in communication with the left ventricular cavity. The low prevalence of patients\nwith this cardiomyopathy presents a unique challenge for large, prospective trials to assess its pathogenesis, management, and\noutcomes. In this paper we review the embryology and genetics of LVNC, the diagnostic approach, and propose a management\napproach based on the current literature available....
Atrial fibrillation (AF) is a common arrhythmia in adults associated with thromboembolic complications. External electrical\ncardioversion (DCCV) is a safe procedure used to convert AF to normal sinus rhythm. We sought to study factors that affect\nutilization of DCCV in hospitalized patients with AF.The study sample was drawn from the Nationwide Inpatient Sample (NIS) of\nthe Healthcare Cost and Utilization Project in the United States. Patients with a primary discharge diagnosis of AF that received\nDCCV during hospitalization in the years 2000ââ?¬â??2010 were included. An estimated 2,810,530 patients with a primary diagnosis\nof AF were hospitalized between 2001 and 2010, of which 1,19,840 (4.26%) received DCCV. The likelihood of receiving DCCV\nwas higher in patients who were males, whites, privately insured, and aged < 40 years and those with fewer comorbid conditions.\nHigher CHADS2 score was found to have an inverse association with DCCV use. In-hospital stroke, in-hospitalmortality, length of\nstay, and cost for hospitalization were significantly lower for patients undergoing DCCV during AF related hospitalization. Further\nresearch is required to study the contribution of other disease and patient related factors affecting the use of this procedure as well\nas postprocedure outcomes....
Loading....