Medicine
-
Case Reports
Proximal complete occlusion of right coronary artery presenting with precordial ST-segment elevation: A case report.
It is well known that cardiologists empirically judge the culprit lesion of acute ST-segment elevation myocardial infarction (STEMI) according to the corresponding electrocardiographic leads. However, In addition to the obstruction of left anterior descending (LAD) coronary artery, rare cases with the occlusion of proximal right coronary artery (RCA) and/or isolated right ventricular (RV) branch showed the ST-segment elevation in precordial leads V1-V3 as well. ⋯ Undoubtedly, coronary angiography is usually the definite measurement for the diagnosis of culprit lesion. However, bedside echocardiography, ST-segment features in left and right precordial leads, and heart rate will be the additional information for judging ST-segment elevation in precordial leads V1-V3 resulting from occlusion of RCA or LAD.
-
Observational Study
Diagnosing ANCA-associated vasculitis in ANCA positive patients: A retrospective analysis on the role of clinical symptoms and the ANCA titre.
Currently no validated diagnostic system for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is available. Therefore, diagnosing AAV is often challenging. We aimed to identify factors that lead to a clinical diagnosis AAV in ANCA positive patients in a teaching hospital in The Netherlands. ⋯ MPO and PR3 ANCA can be positive in a variety of diseases that mimic AAV. A higher ANCA titre and multiple affected organ systems may help to discriminate between AAV and other systemic illnesses in anti-PR3 and anti-MPO positive patients. A diagnostic scoring system incorporating these factors should be considered.
-
Observational Study
Association of the preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios with lymph node metastasis and recurrence in patients with medullary thyroid carcinoma.
The preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are known to be prognostic factors in several cancers. However, no previous investigation has been performed to evaluate the significance of the NLR and PLR in medullary thyroid carcinoma (MTC). The aim of this study was to identify the ability of the preoperative NLR or PLR to predict lymph node metastasis and recurrence in patients with MTC. ⋯ The optimal cutoff points of the NLR and PLR for predicting recurrence were 2.8 and 129.8, respectively. Using the cutoff values, we found that PLR>105.3 (odds ratio [OR] 4.782, 95% confidence interval [CI] 1.4-16.7) was an independent predictor of lymph node metastasis and that PLR>129.8 (OR 3.838, 95% CI 1.1-13.5) was an independent predictor of recurrence. Our study suggests that the preoperative PLR, but not NLR, was significantly associated with lymph node metastasis and recurrence in patients with MTC.
-
Observational Study
Community involvement in out of hospital cardiac arrest: A cross-sectional study assessing cardiopulmonary resuscitation awareness and barriers among the Lebanese youth.
Out of hospital cardiac arrest (OHCA) is a leading cause of death worldwide. Developing countries including Lebanon report low survival rates and poor neurologic outcomes in affected victims. Community involvement through early recognition and bystander cardiopulmonary resuscitation (CPR) can improve OHCA survival. ⋯ University students in Lebanon are familiar with the symptoms of cardiac arrest, however, they are not well trained in CPR and lack confidence to perform it. The attitude towards the importance of bystander CPR and the need to learn CPR is very positive. Interventions should focus on public awareness campaigns regarding the importance of initiating bystander CPR while activating emergency medical services (EMS) and on making CPR training more available.
-
Observational Study
Preliminary investigation of cardiopulmonary function in stroke patients with stable heart failure and exertional dyspnea.
The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF). This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I-III) were recruited. ⋯ Stroke patients with stable CHF and exertional dyspnea had restrictive lung disorder and respiratory muscle weakness, which were associated with the neurological status of the affected limbs. FVC was more strongly associated with MIP and MEP than predicted FVC%. FEV1/FVC may be used as a reference for the pulmonary dysfunction.