scholarly journals The Impact of Stressor Patterns on Clinical Features in Patients With Tako-tsubo Cardiomyopathy: Experiences of Two Tertiary Cardiovascular Centers

2012 ◽  
Vol 35 (11) ◽  
pp. E6-E13 ◽  
Author(s):  
Bong Gun Song ◽  
Hyun Suk Yang ◽  
Hweung Kon Hwang ◽  
Gu Hyun Kang ◽  
Yong Hwan Park ◽  
...  
Keyword(s):  
Clinical Features ◽  
Tako Tsubo Cardiomyopathy ◽  
The Impact

scholarly journals The Clinical Features and Emotional Stressors in Korean Patients with Tako-Tsubo Cardiomyopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Bong Gun Song ◽  
Ju Hyeon Oh ◽  
Yong Hwan Park ◽  
Gu Hyun Kang ◽  
Woo Jung Chun
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Hemodynamic Support ◽  
Qt Intervals ◽  
Tako Tsubo Cardiomyopathy ◽  
Hs Crp ◽  
The Impact

Background. Tako-tsubo cardiomyopathy (TTC) is typically triggered by an acute emotional or physical stress events. Aim of this study was to investigate the impact of emotional stressors on clinical features, laboratory parameters, electrocardiographic and echocardiographic findings in patients with TTC. Methods. Of 103 patients enrolled from the TTC registry database, fifteen patients had emotional triggers (E group), and 88 patients had physical triggers or no triggers (other group). Results. Most clinical presentations and in-hospital courses were similar between the groups. However, E group had higher prevalence of chest pain (87 versus 42 %, P=0.001), palpitation (27 versus 6%, P=0.008), whereas other group had higher prevalence of cardiogenic shock (35 versus 7%, P=0.027). E group had significantly higher corrected QT intervals (median, 477.5 versus 438 ms, P=0.001), and left ventricular ejection fraction (LVEF) (mean, 45.7 versus 39.6%, P=0.001), but lower hs-CRP (median, 0.1 versus 3.3 mg/L, P=0.001), CK-MB (median, 5.5 versus 11.9 ng/mL, P=0.047), troponin-I (median, 1.0 versus 3.2 ng/mL, P=0.011), and NT-proBNP levels (median, 2145 versus 4939 pg/mL, P=0.020). Other group required more frequent hemodynamic support and had significantly longer intensive care unit (median, 3 versus 1 days, P=0.005) and in-hospital (median, 17 versus 3 days, P=0.001) durations. Conclusion. The clinical features of TTC are different between groups with and without preceding emotional stressors. The TTC group with preceding emotional stressors was more likely to have preserved cardiovascular reserve and lesser likely to require hemodynamic support than other group although the entire prognosis of TTC is excellent regardless of triggering stressors.

How Variable Is the Volar Subcutaneous Tissue of the Digits on B-Mode and Color Doppler Ultrasound in Non-Psoriatic Individuals and Could It Be Included in a Dactylitis Score?

2020 ◽  
Author(s):  
Ana Rebollo-Giménez ◽  
Lina Martínez-Estupiñán ◽  
Otto Olivas-Vergara ◽  
Gema Fuensalida-Novo ◽  
Jesús Garrido ◽  
...  
Keyword(s):  
Blood Flow ◽  
Clinical Features ◽  
Subcutaneous Tissue ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Dominant Hand ◽  
Scanning Method ◽  
Skin Contact ◽  
Gel Layer ◽  
The Impact

Abstract Background Digital subcutaneous tissue (SCT) changes are involved in dactylitis, a hallmark feature of psoriatic arthritis (PsA). There are no studies on the ultrasound (US) characteristics of the digital SCT in the general population. Objectives To investigate the variability in US-measured thickness (TH) and color Doppler (CD)-detected blood flow of the SCT of the volar aspects of the fingers in a non-psoriatic population and to investigate the impact of the scanning method and demographics and clinical features on these measurements. Methods SCT TH and semiquantitative (SQD) and quantitative (QD) Doppler signals were measured in the bilateral second finger at the proximal and middle phalanges in 81 non-psoriatic volunteers [49 female, 32 men; 18–78 years]. Two scanning methods with and without (thick gel layer interposition) probe-skin contact were used. Demographics and clinical features were collected. Results There was high variability of SCT TH and Doppler measurements between individuals. All US measurements obtained without probe-skin contact were significantly greater than their corresponding measurements obtained with the probe contacting the skin (p < 0.001). SCT TH was positively related to dominant hand, age, masculine gender, weight, height, body mass index, and alcohol consumption while Doppler measurements were positively related to age and non-dominant hand. Conclusions US-measured SCT thickness and Doppler-detected SCT blood flow of the volar aspect of the fingers seem to be highly variable in the non-psoriatic population as well as highly dependent on the US scanning method. This variability is of utmost importance for assessing dactylitis in PsA.

Waldenström’s Macroglobulinemia: Clinical Features, Complications, and Management

2000 ◽  
Vol 18 (1) ◽  
pp. 214-214 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Panayiotis Panayiotidis ◽  
Lia A. Moulopoulos ◽  
Petros Sfikakis ◽  
Marinos Dalakas
Keyword(s):  
Clinical Features ◽  
Nucleoside Analogs ◽  
Low Grade ◽  
Waldenström’S Macroglobulinemia ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Waldenstrom's Macroglobulinemia ◽  
Waldenstrom’S Macroglobulinemia ◽  
The Impact ◽  
Waldenström's Macroglobulinemia

PURPOSE: To review the clinical features, complications, and treatment of Waldenström’s macroglobulinemia, a low-grade lymphoproliferative disorder that produces monoclonal immunoglobulin (Ig) M. METHODS: A review of published reports was facilitated by the use of a MEDLINE computer search and by manual search of the Index Medicus. RESULTS: The clinical manifestations associated with Waldenström’s macroglobulinemia can be classified according to those related to direct tumor infiltration, to the amount and specific properties of circulating IgM, and to the deposition of IgM in various tissues. Asymptomatic patients should be followed without treatment. For symptomatic patients, standard treatment consists primarily of oral chlorambucil; nucleoside analogs, such as fludarabine and cladribine, are effective in one third of previously treated patients and in up to 80% of previously untreated patients. Preliminary evidence suggests that anti-CD20 monoclonal antibody may be active in about 30% of previously treated patients and that high-dose therapy with autologous stem-cell rescue is effective in most patients, including some with resistance to nucleoside analogs. CONCLUSION: Waldenström’s macroglobulinemia has a wide clinical spectrum that practicing physicians need to recognize early to reach the correct diagnosis. When therapy is indicated, oral chlorambucil is the standard primary treatment, but cladribine or fludarabine can be used when a rapid cytoreduction is desirable. Prospective randomized trials are required to elucidate the impact of nucleoside analogs on patients’ survival. A nucleoside analog is the treatment of choice for patients who have been previously treated with an alkylating agent.

The impact of sex and cannabis on clinical features in first–admitted patients with psychosis

2020 ◽  
Vol 36 ◽  
pp. 235-243
Author(s):  
Sara Arranz ◽  
Anna Mané ◽  
Dani Bergé ◽  
Clara Monserrat ◽  
Angel cabezas ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Impact

Retrospective Analysis of Lymphomas in the Setting of Autoimmune Disease and the Impact of Immunosuppression

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2737-2737
Author(s):  
Adam M. Petrich ◽  
Stefan Klaus Barta ◽  
Frederick Lansigan ◽  
Trent Wang ◽  
Ananta Bhatt ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Retrospective Analysis ◽  
Clinical Features ◽  
Research Funding ◽  
Cytotoxic Chemotherapy ◽  
Prior Exposure ◽  
Primary Therapy ◽  
Histologic Subtype ◽  
The Impact

Abstract Introduction: Post-transplant lymphoproliferative disease (PTLD) encompasses a heterogeneous array of cases of lymphoma/lymphoma-like conditions arising in the setting of immunosuppression (IS) for prior organ or marrow transplant. Such pts face heightened risk of toxicity from exposure to cytotoxic chemotherapy, and may be best treated in the frontline with reduction of IS (RI) and anti-CD20 monoclonal antibody treatment (Trappe, 2012). Autoimmune (AI) disease has been associated with an increased risk of developing lymphoma; however, the relative impact of baseline clinical features, including prior IS, is unknown. Methods: We conducted a multicenter, retrospective analysis of adult pts with pre-existing AI conditions who were diagnosed with lymphoma since 1997. Baseline clinical features at diagnosis of lymphoid malignancy, including International Prognostic Index (IPI) risk factors; underlying AI disease; duration and type of IS; EBV status (by EBER in-situ hybridization); and primary therapy received (RI, rituximab [R] monotherapy, chemotherapy [+/- R]); were collected. Survival analyses were performed using Kaplan-Meier method. We then focused on those who had A) received IS other than corticosteroids (CS) alone; and B) those diagnosed with DLBCL. Those variables found to have significant correlation with OS by univariate analyses (UVA) were used to construct Cox proportional hazards model (multivariate analysis [MVA]) in order to determine which might have the strongest association with OS. Lastly, we sought to evaluate a potential role for RI and/or R as frontline therapy for those with DLBCL. Results: A total of 130 pts were included (Table 1). The most frequent AI disease was rheumatoid arthritis and for all cases, 76% had documented exposure to IS, for a median duration of 4.5 years (range 0.17-57 years) prior to diagnosis of lymphoma. The most common histologic subtype was DLBCL (52%). EBV status was reported for only 34% of pts, but was positive in 68% (25/37), all of whom had received prior exposure to IS beyond CS, and 80% of whom (20/25) were diagnosed with DLBCL. EBV status was infrequently tested in pts not previously exposed to IS (3/31). At a median follow-up of 61 months for the entire cohort, 2-year PFS and OS were 79% and 91%, respectively (Figure 1, Panel A). By UVA, age>60; PS>1; LDH> upper limit of normal (ULN); DLBCL (vs all other histologies); underlying rheumatoid arthritis (RA; vs all other AI diseases); and prior exposure to IS, each correlated with inferior OS (Table 1). By MVA, PS>1 and prior IS maintained significance (p<0.05). If those receiving only CS are grouped with those not previously exposed to IS, the correlation of this factor with OS was strengthened (p 0.008), and by MVA, PS>1 (p 0.002) and prior IS (p 0.010) maintain significance (data not shown). Among 67 pts with DLBCL, median age was 61 (range 26-90), 60% had advanced stage disease, and 32% had IPI of 4 or 5. At a median follow-up of 32 months, the 2-year PFS and OS were 82% and 84%, respectively. There were no differences in frequency of any IPI factors between patients exposed to prior IS (n=53) and those who were naïve to prior IS (n=14). For those not exposed to prior IS, the 2-year OS was 100%, compared to 80% in those who received prior IS (p 0.24); corresponding 2-year PFS were 92% and 79%, respectively (p 0.41). Age>60 and PS>1 were associated with an inferior OS but use of IS was not associated with outcome (Table 2). The 2 year OS for those treated with R plus CHOP(like) chemotherapy, CHOP(like) chemotherapy (without R), R alone (+/- RI), and with RI alone were 92%, 75%, 90%, and 67%, respectively (Figure 1, Panel B; log-rank p value 0.55). Patients who received CHOP-like therapy +/- R, as compared to R and/or RI were more likely to be naïve to IS therapy (15/46 vs 0/22, p = 0.003) and have 2 or more EN sites of disease (15/46 vs 2/22, =0.041). These differences notwithstanding, the 2-year PFS for the two groups were 86% and 74% (p 0.16), and 2-year OS for the two groups were 88% and 82%, respectively (Figure 1, Panel C; p 0.91). Conclusions: Pts with immunosuppression-related lymphoma have high rates of 2-year OS and in DLBCL, IS does not appear to be associated with an inferior outcome. Similar to evolving treatment paradigms in PTLD, rituximab monotherapy and other cytotoxic chemotherapy-free regimens as well as risk-adapted approaches may warrant further evaluation in IS-related DLBCL. Disclosures Petrich: Seattle Genetics: Consultancy, Honoraria, Research Funding. Barta:Seattle Genetics: Research Funding. Feldman:Celgene: Honoraria, Speakers Bureau; Pharmacyclics/JNJ: Honoraria, Speakers Bureau; Seattle Genetics: Honoraria, Speakers Bureau. Savage:Seattle Genetics: Honoraria, Speakers Bureau; BMS: Honoraria; Infinity: Honoraria; Roche: Other: Institutional research funding.

The Features of Comorbidity of Childhood ADHD in Patients With Obsessive Compulsive Disorder

2016 ◽  
Vol 24 (7) ◽  
pp. 973-980 ◽  
Author(s):  
Fahri Çelebi ◽  
Ahmet Koyuncu ◽  
Erhan Ertekin ◽  
Behiye Alyanak ◽  
Raşit Tükel
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Rating Scales ◽  
School Age Children ◽  
Adhd Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Childhood Adhd ◽  
Episodic Course ◽  
The Impact

Objective: Our aim is to investigate the impact of childhood ADHD comorbidity on the clinical features of obsessive compulsive disorder (OCD). Method: Ninety-five adult outpatients with a diagnosis of OCD were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version, ADHD module, and the Yale–Brown Obsessive Compulsive Scale. Patients with or without childhood ADHD were compared in terms of the sociodemographic and clinical features, psychiatric comorbidities, and rating scales. Results: The rate of episodic course of OCD ( p < .001), religious and sexual obsessions ( p = .009, p = .020, respectively), lifetime comorbidity of bipolar disorder (BD), social anxiety disorder (SAD; p = .001, p = .009, respectively), and tic disorder (TD) comorbidity ( p < .001) were higher in the OCD + ADHD group than in the OCD without ADHD group. Conclusion: Childhood ADHD may be associated with higher rates of BD, SAD, and TD comorbidity and episodic course of OCD as well as higher frequency of certain types of obsessions.

scholarly journals Analysis of hospitalized COVID-19 patients in the Mount Sinai Health System using electronic medical records (EMR) reveals important prognostic factors for improved clinical outcomes

2020 ◽  
Author(s):  
Zichen Wang ◽  
Amanda B. Zheutlin ◽  
Yu-Han Kao ◽  
Kristin L. Ayers ◽  
Susan J. Gross ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Health System ◽  
Electronic Medical Records ◽  
Clinical Features ◽  
Medical Records ◽  
Tertiary Care ◽  
Significant Risk ◽  
Markers Of Inflammation ◽  
Mount Sinai ◽  
The Impact

AbstractImportanceThere is an urgent need to understand patient characteristics of having COVID-19 disease and evaluate markers of critical illness and mortality.ObjectiveTo assess association of clinical features on patient outcomes.Design, Setting, and ParticipantsIn this observational case series, patient-level data were extracted from electronic medical records for 28,336 patients tested for SARS-CoV-2 at the Mount Sinai Health System from 2/24/ to 4/15/2020, including 6,158 laboratory-confirmed cases.ExposuresConfirmed COVID-19 diagnosis by RT-PCR assay from nasal swabs.Main Outcomes and MeasuresEffects of race on positive test rates and mortality were assessed. Among positive cases admitted to the hospital (N = 3,273), effects of patient demographics, hospital site and unit, social behavior, vital signs, lab results, and disease comorbidities on discharge and death were estimated.ResultsHispanics (29%) and African Americans (25%) had disproportionately high positive case rates relative to population base rates (p<2e-16); however, no differences in mortality rates were observed in the hospital. Outcome differed significantly between hospitals (Gray’s T=248.9; p<2e-16), reflecting differences in average baseline age and underlying comorbidities. Significant risk factors for mortality included age (HR=1.05 [95% CI, 1.04-1.06]; p=1.15e-32), oxygen saturation (HR=0.985 [95% CI, 0.982-0.988]; p=1.57e-17), care in ICU areas (HR=1.58 [95% CI, 1.29-1.92]; p=7.81e-6), and elevated creatinine (HR=1.75 [95% CI, 1.47-2.10]; p=7.48e-10), alanine aminotransferase (ALT) (HR=1.002, [95% CI 1.001-1.003]; p=8.86e-5) white blood cell (WBC) (HR=1.02, [95% CI 1.01-1.04]; p=8.4e-3) and body-mass index (BMI) (HR=1.02, [95% CI 1.00-1.03]; p=1.09e-2). Asthma (HR=0.78 [95% CI, 0.62-0.98]; p=0.031) was significantly associated with increased length of hospital stay, but not mortality. Deceased patients were more likely to have elevated markers of inflammation. Baseline age, BMI, oxygen saturation, respiratory rate, WBC count, creatinine, and ALT were significant prognostic indicators of mortality.Conclusions and RelevanceWhile race was associated with higher risk of infection, we did not find a racial disparity in inpatient mortality suggesting that outcomes in a single tertiary care health system are comparable across races. We identified clinical features associated with reduced mortality and discharge. These findings could help to identify which COVID-19 patients are at greatest risk and evaluate the impact on survival.

scholarly journals Impact of vitamin D supplementation on cardio-metabolic status and androgen profile in women with polycystic ovary syndrome: placebo-controlled clinical trial

2019 ◽  
Vol 24 (1) ◽  
Author(s):  
Nearmeen M. Rashad ◽  
Azza H. Abd El-Fatah ◽  
Mohamed El-Bakry Lashin ◽  
Hala G. Abomandour ◽  
Reem M. Allam
Keyword(s):  
Vitamin D ◽  
Regression Analysis ◽  
Polycystic Ovary Syndrome ◽  
Clinical Features ◽  
Polycystic Ovary ◽  
Linear Regression Analysis ◽  
Vitamin D Supplementation ◽  
Metabolic Status ◽  
Ovary Syndrome ◽  
The Impact

Abstract Background Polycystic ovary syndrome (PCOS) is a heterogeneous disorder of reproductive, endocrine, and metabolic functions. Vitamin D has an influence on metabolic and reproductive functions. This study was designed to explore the levels of free 25 hydroxycholecalciferol [25(OH)-D] in PCOS patients. We also aimed to clarify the impact of vitamin D supplementation on cardio-metabolic status, androgen profile, and clinical features of PCOS. Results Our results revealed significant lower levels of serum 25(OH)-D in PCOS women compared with healthy controls. Even more importantly, our results reported that 25(OH)-D levels were negatively correlated with cardio-metabolic risk factors, androgenic profile, and clinical features of PCOS. Stepwise multiple linear regression analysis revealed that carotid intima-media thickness (CIMT), fasting serum insulin (FSI), and fasting plasma glucose (FPG) were the main predictors of 25(OH)-D levels among other clinical and laboratory biomarkers. Considering the impact of VD supplementation in the PCOS group, there were significant improvements of cardio-metabolic risks, PCOS phenotype, and androgenic profile. Even more important, these results are associated with increasing 25(OH)-D serum levels after VD supplementations. Logistic regression analysis observed that androstenedione, FSI, and hirsutism score were independent predictors of response to VD supplementation. Conclusion The supplementation of VD for 12 weeks improved the cardio-metabolic and androgenic profiles of PCOS. Furthermore, VD supplementation could be a promising treatment of PCOS and its associated morbidity in PCOS-deficient women. Trial registration NCT04117750

Sign in / Sign up

Export Citation Format

Share Document