Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 17 de 17
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
J Craniofac Surg ; 34(3): 1071-1075, 2023 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-36731026

RESUMEN

PURPOSE: Fibrous dysplasia (FD) is a benign condition, which is characterized by the replacement of normal bone with fibrous tissue and the deposition of woven bone in an irregular manner. Surgical resection, careful corrective osteotomies as debulking, and recontouring procedures are frequently performed, but can be complicated by postoperative regrowth of the lesion. The main aim of this study was to introduce a computer-guided technique for a predetermined technique of bone contouring of craniofacial FD involving the facial bones. METHODS: This case report was conducted on an 18-year-old girl complaining of unilateral craniofacial dysplasia. Upon clinical examination and radiographic examination, a customized computer-generated bone contouring guide was designed using virtual surgical software for accurate contouring of excess bone in the cranial vault and frontal bone. This guide was virtually designed after importing the multislice computerized tomography scans into the virtual surgical planning software. It was generated based on the mirroring option of the unaffected normal side along the median sagittal plane. In the surgery, the guide was seated in place and 5 mm implant drills were inserted through the guide depth holes. Bone removal was made using surgical burs connecting the guiding depth holes. RESULTS: At the end of the follow-up, the patient showed acceptance of her external appearance with no signs of infection or dehiscence. CONCLUSION: This patient-specific cutting guide shows a promising solution for preplanned bone removal in cases with unilateral craniofacial FD.


Asunto(s)
Implantes Dentales , Displasia Fibrosa Ósea , Cirugía Asistida por Computador , Humanos , Femenino , Adolescente , Tomografía Computarizada por Rayos X , Cirugía Asistida por Computador/métodos , Displasia Fibrosa Ósea/diagnóstico por imagen , Displasia Fibrosa Ósea/cirugía , Huesos Faciales/diagnóstico por imagen , Huesos Faciales/cirugía
2.
J Craniofac Surg ; 33(6): 1825-1828, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-35119415

RESUMEN

ABSTRACT: The main objective of this study was to evaluate the use of patient-specific polyamide 12 implants in cranial bone defect reconstruction.Ten patients who underwent prior decompression craniectomy were selected for the current study. Skull scanning by computerized tomography was performed and used to make virtual planning of the implants to be transformed into physical implant using selective laser sintering. Cranioplasty was performed through coronal surgical approach where cranial implants were fixated using 2.0-mm mini-screws, and plates. Patients follow-up was from 12 to 36 months. Glasgow Outcome Score recorded 1 (good recovery) for all patients. Patient and surgeon satisfaction for the esthetic outcome were measured using visual analog scale as mean of 10 ± 0 and 9 ± 1, respectively. Cranial symmetry index was calculated as mean score of 98% ± 1%, indicating highly accurate symmetry, and preoperative virtual planning and postoperative outcome were compared for accuracy analysis with a mean difference of 0.3197 ± 0.1649, which indicates high accuracy.Polyamide12 cranial implants seem to offer a promising option to cranial bone reconstruction with patient-specific implants. This study ensures proper cosmetic and clinical outcome.


Asunto(s)
Implantes Dentales , Procedimientos de Cirugía Plástica , Estética Dental , Estudios de Seguimiento , Humanos , Nylons , Prótesis e Implantes , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Cráneo/diagnóstico por imagen , Cráneo/cirugía
3.
Neurosci Lett ; 828: 137766, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38583505

RESUMEN

INTRODUCTION: The neuroimmune system performs a wide range of functions in the brain and the central nervous system. The microglial translocator protein (TSPO) has an established role as a cell marker in identification of the neuroimmune system. Previously, human studies have shown TSPO differences in neuropsychiatric disorders. Seasonal variability has also been demonstrated in multiple systems of healthy individuals. Therefore, in this study, we attempt to understand whether seasonal changes affect brain TSPO levels using [11C]PBR28 positron emission tomography (PET) imaging. METHODS: 46 healthy subjects (mean age ± SD = 32.5 ± 10); sex (M/F) = 32/14)) underwent PET imaging with [11C]PBR28 in a retrospectively conducted analysis. All PET scans were performed on the HRRT scanner. Volume of distribution (VT) values were generated for cortical and subcortical regions and the cerebellum. Spring/summer months were defined as March to August while fall/winter months were defined as September to February and were compared through 2-tailed t-tests (SciPy library v.1.10.1 and Pinguoin library on Python v.3.8.8). Average daylight hours and temperature in New Haven, CT were obtained online (www.wunderground.com) and compared to VT with Spearman's correlations. RESULTS: There were no significant differences observed between the TSPO levels of spring/summer and fall/winter months in the brain (t = 0.52, p = 0.61). Additional analysis on all individual brain regions also indicated non-significance. Likewise, no significant correlations were found between TSPO levels in the whole brain and brain regions against daylight hours (ρ= 0.05, p = 0.74), temperature (ρ = 0.04, p = 0.81), or month (ρ = 0.08, p = 0.60). Controlling TSPO gene polymorphisms and other variables had no significant effect on the outcome. CONCLUSION: To the best of our knowledge, this is the first human study to investigate seasonal changes in TSPO expression. Our results can be interpreted as the lack of seasonal variability in the neuroimmune system, but important limitations include high interindividual variability, test-retest variability, specificity of the tracer, and a limited sample size. Limitations notwithstanding, our results conclude that TSPO levels in the brain are not impacted by light and temperature changes in different seasons.


Asunto(s)
Encéfalo , Receptores de GABA , Humanos , Estaciones del Año , Estudios Retrospectivos , Receptores de GABA/metabolismo , Encéfalo/metabolismo , Tomografía de Emisión de Positrones/métodos , Proteínas Portadoras/metabolismo
4.
Artículo en Inglés | MEDLINE | ID: mdl-36661886

RESUMEN

The aim of current split-mouth study was to compare the implant treatment outcomes of hybrid-surface implants (minimally rough implant collar and moderately rough body) with moderately rough implants after 5 years in patients with a bar-supported mandibular overdenture. Fully edentulous patients were enrolled, and each patient received two implants: one moderately rough and one hybrid-surface implant. A total of 18 patients with 36 implants attended the 5-year recall, and the implant survival rate was 100%. The 5-year evaluation showed no significant difference in crestal bone loss or peri-implant health between the hybrid and moderately rough implants.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Arcada Edéntula , Humanos , Implantación Dental Endoósea , Pérdida de Hueso Alveolar/cirugía , Arcada Edéntula/cirugía , Diseño de Prótesis Dental , Resultado del Tratamiento , Prótesis de Recubrimiento , Prótesis Dental de Soporte Implantado
5.
PLoS One ; 17(3): e0264434, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35239702

RESUMEN

This research aimed to qualitatively explore whether the determinants of handwashing behaviour change according to the duration of displacement or the type of setting that people are displaced to. We conducted an exploratory qualitative study in three different post-conflict settings in Northern Iraq-a long-term displacement camp, a short-term displacement camp, and villages where people were returning to post the conflict. We identified 33 determinants of handwashing in these settings and, of these, 21 appeared to be altered by the conflict and displacement. Determinants of handwashing behaviour in the post-conflict period were predominantly explained by disruptions to the physical, psychological, social and economic circumstances of displaced populations. Future hygiene programmes in post-conflict displacement settings should adopt a holistic way of assessing determinants and design programmes which promote agency, build on adaptive norms, create an enabling environment and which are integrated with other aspects of humanitarian response.


Asunto(s)
Desinfección de las Manos , Higiene , Humanos , Irak , Investigación Cualitativa
6.
J Plast Reconstr Aesthet Surg ; 75(10): 3877-3903, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36089474

RESUMEN

PURPOSE: To demonstrate use of patient specific implants (PSIs) in the reconstruction of significant facial skeletal defects. Polyamide 12 implants were used to achieve good symmetric results with great projection and contours and minimal morbidity, all of which would not be predictably achievable with other reconstructive options. METHODS: Using a retrospective study design, three patients who had significant facial skeletal defects affecting the zygomaticomaxillary complex, frontal bone and also having an orbital component were used as subjects. The cases reported in this article were managed during the period from June 2015 to May 2016 with a minimum of 5 years follow up for all three cases. Outcomes were evaluated radiographically by overlapping postoperative x-rays with the virtual plan and also clinically using a virtual analogue scale (VAS). RESULTS: For the three patients, VAS assessment for patient satisfaction yielded promising results with the first case reporting an 8, with 10 being most satisfied. For the second patient, the VAS was 7.5 and for the third patient it was 8.5. Radiographically, the difference in transverse projection on all four points did not exceed 2.48 mm. When assessing antero-posterior projection accuracy, there was an average deviation of 0.68 mm at the infraorbital rim and 0.86 mm at the zygomaticofrontal point. CONCLUSION: This article aims to point out the significant advantages of the use of polyamide 12 PSIs for the major facial skeletal reconstructions regarding symmetry, anatomical contours, minimal morbidity and decreased costs. A larger number of patients is needed in future studies.


Asunto(s)
Órbita , Procedimientos de Cirugía Plástica , Humanos , Órbita/diagnóstico por imagen , Órbita/cirugía , Impresión Tridimensional , Prótesis e Implantes , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos
7.
Cureus ; 14(2): e21894, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35273855

RESUMEN

Introduction The decreased absolute circulating red blood cell count or the inability of red blood cells to meet physiological needs is called anemia. Anemia can affect mental health, learning capacity, and the ability to concentrate. The present study aimed to assess the prevalence of anemia among children and adolescents living in the rural areas of Khulais, Saudi Arabia. Methods This cross-sectional study including 417 individuals was conducted at Khulais Hospital in the rural areas in Saudi Arabia to estimate the prevalence of anemia among children and adolescents. The inclusion criterion for the study was that participants must be Saudi citizens. Data for this study were collected in March 2021. The age of the children ranged from 7 to 11 years, whereas that of adolescent males and females was between 12 and 18 years. Results In total, the study included 147 male adolescents, 123 female adolescents, and 147 children participants. The overall prevalence of anemia among adolescents was high (39.1%). The prevalence of anemia was 44.9% (66/147), 46.3% (57/123), and 27.2% (40/147) in male adolescents (age 12-18 years), female adolescents (age 12-18 years), and children (age 7-11 years), respectively. Statistical analysis revealed an association between the prevalence of anemia and the increasing age of participants from rural areas. Conclusion The present study results indicate that the prevalence of anemia in the rural areas of Saudi Arabia is high. The high prevalence can be explained by several factors, such as parents' low socioeconomic status and living in rural areas, which limits the availability as well as different types of nutritious food and thereby negatively affects the nutritional status of such children and adolescents.

8.
Curr Probl Cardiol ; 47(10): 101002, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34587490

RESUMEN

Coronary artery bypass surgery (CABG) has been the standard of care for revascularization for patients with obstructive unprotected left main coronary disease (ULMCA). There have been multiple randomized and registry data demonstrating the technical and clinical efficacy of PCI in certain patients with ULMCA. The purpose of this study is to evaluate clinical outcomes of ULMCA PCI as compared to CABG in patients requiring revascularization in three Gulf countries. All ULMCA cases treated by PCI with DES versus CABG were retrospectively identified from 14 centers in 3 Arab Gulf countries (KSA, UAE, and Bahrain) from January 2015 to December 2019. In total, 2138 patients were included: 1222 were treated with PCI versus 916 with CABG. Patients undergoing PCI were older, and had higher comorbidities and mean European System for Cardiac Operative Risk Evaluation (EuroSCORE). Aborted cardiac arrest and cardiogenic shock were reported more in the PCI group at hospital presentation. In addition, lower ejection fractions were reported in the PCI group. In hospital mortality and major adverse cardiovascular and cerebrovascular events (MACCE) occurred more in patients undergoing CABG than PCI. At median follow-up of 15 months (interquartile range, 30), no difference was observed in freedom from revascularization, MACCE, or total mortality between those treated with PCI and CABG. While findings are similar to Western data registries, continued follow-up will be needed to ascertain whether this pattern continues into latter years.


Asunto(s)
Enfermedad de la Arteria Coronaria , Stents Liberadores de Fármacos , Intervención Coronaria Percutánea , Puente de Arteria Coronaria , Humanos , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Resultado del Tratamiento
9.
J Craniomaxillofac Surg ; 49(10): 943-949, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34099374

RESUMEN

The main aim of this study was to evaluate the accuracy of immediate CAD/CAM reconstruction of the temporal hollowing following temporalis muscle surgery, using a patient-specific implant (PSI) PEKK model. This case series included ten patients who underwent maxillofacial reconstruction using temporalis muscle flap (TMF). The study involved the preoperative planning and fabrication of the temporal implant using virtual surgical planning software. The planning was based on multislice CT scans, from which DICOM files were used to fabricate a 3D model of the temporalis muscle using polyetherketoneketone (PEKK). The patients were followed up for 12 months, to check for any signs of infection or mobilization, and to assess accuracy. At the end of the follow-up period, all the patients showed acceptance of the external appearance, with no signs of infection or rejection. These customized implants were measured and compared with their original 3D preoperative planning using a point-based analysis. This revealed a mean difference (±SD) of 0.0373 (±0.3036) mm and a median difference (Q1 to Q3) of 0.0809 (-0.2108 to 0.2769) mm. The study demonstrated that a highly accurate duplication of PSIs can be achieved using this template-molding workflow. The use of PEKK PSIs resulted in uneventful healing and esthetic acceptance by the patients and, therefore, is a relevant treatment option when temporal hollowing has to be corrected.


Asunto(s)
Implantes Dentales , Benzofenonas , Diseño Asistido por Computadora , Estética Dental , Humanos , Polímeros
10.
Vet Med Int ; 2021: 6739220, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34540194

RESUMEN

The current situation of antibiotic resistance of most bacterial pathogens was a threat to the poultry and public health with increasing economic losses. Regarding this problem, monitoring of the circulating microorganisms occurred with the antibiotic resistance profile. A total of 657 different samples from internal organs (liver, heart, lung, and yolk) and paper-lining chick boxes were collected from native chicken farms which were submitted to the Reference Laboratory for Veterinary Quality Control on Poultry Production in the period from 2014 to 2018 for the detection of Salmonella, Escherichia coli (E. coli), and Staphylococcus. The bacterial isolates were tested for their antimicrobial susceptibility by disk diffusion technique. Salmonella was isolated from 128 out of 657 (19.5%), E. coli was isolated from 496 out of 657 (75.5%), and Staphylococcus species was isolated from 497 out of 657 (75.6%). All Salmonella positive samples were examined for antibiotic resistance against 10 different antibiotics, and the highest percentage all over the five years was against penicillin, ampicillin, and tetracycline. All E. coli positive samples were examined for antibiotic resistance against 14 different antibiotics, and the highest percentage all over the five years was with ampicillin, tetracycline, norfloxacin, streptomycin, and danofloxacin. All Staphylococcus positive sample species were examined for antibiotic resistance against 14 different antibiotics, and the highest percentage of resistance all over the five years was shown with tetracycline, streptomycin, ampicillin, and nalidixic acid.

11.
Egypt Heart J ; 72(1): 33, 2020 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-32495302

RESUMEN

BACKGROUND: We examined the impact of left anterior descending (LAD) wrapping on left ventricular (LV) mechanics in patients with normal coronary angiography. Seventy-one patients with evidence of normal coronary angiography (LAD wrapping: n = 52, 73%) and LAD non-wrapping (n = 19, 27%) were included in the study. Using 2D-strain imaging, we measured LV longitudinal and circumferential (circ) strain (εsys), systolic strain rate (SRsys), early (SRe) and atrial (SRa) diastolic SR, LV electromechanical dyssynchrony (TTP-SD), and LV twist and torsion in study groups. RESULTS: No significant difference in age, gender, body surface area (BSA), or ejection fraction (EF%) between groups. LAD-wrapping group showed higher deceleration time (DT) (P < 0.0001), global longitudinal εsys % (P < 0.02), circ SRa at the basal segments (P < .02), circ SRsys and SRe, and SRa (P < 0.0001) at the apical segments and apical rotation compared with the non-wrapped group. LV twist was correlated negatively with LV electromechanical dyssynchrony (r = .25, P < 0.03) and positively with longitudinal εsys (r = .47, P < .0001), circ εsys% (r = .55, P < .0001), circ SRsys (r = .23, P < .05), and circ SRe (r = .55, P < .0001). Using multivariate regression analysis, DT: OR 0.932, CI 0.877-0.991, and P < 0.02 and circ at atrial diastole (SRa): OR 0.000, CI .000-.271, and P < 0.03 were independent predictors of LAD wrapping around LV apex. CONCLUSION: Wrapped LAD is associated with better myocardial relaxation and rotational mechanics in patients with normal coronary angiography. This could explain the worse prognosis in such population when LAD occlusion acutely emerges.

12.
Health Psychol Res ; 8(3): 9263, 2020 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-33553792

RESUMEN

Globally, students suffer from stress, anxiety, and depression in higher education and seek counselling since education process has negative impacts on mental health of some students. This study was aimed at measuring the depression, stress, and anxiety and their associated social determinants like (income, education, residence, marital status, and educational difficulties) in undergraduate students of Umm Al-Qura University (UQU). Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21) validated from the original English version instrument by Lovibond and Lovibond (1995) was used; A sample of 373 respondents through clustered sampling was drawn from the five randomly chosen faculties of the University. Data was analyzed by running ANOVA and t-test procedures in SPSS software. The study found that the prevalence of stress, anxiety, and depression in the students was 30%, 60%, and 50% respectively. A statistically significant difference was found in the stress levels of students of different colleges (p=0.000). Students' stress levels were significantly higher (p=0.000) in the Applied Medical Sciences and in the final year students (p=0.015). Significantly high levels of depression (p=0.000), anxiety (p=0.000), and stress (p=0.000) were found in the students belonging to the poor economic strata. Depression (p=0.038), Anxiety (p=0.022), and stress (p=0.001) were statistically high in the students whose father had a low level of education. Statistically high level (p=0.028) of stress was also found in the students whose mothers had a low level of education. Students who reported educational difficulties had significantly (p=0.001) high levels depression. However, the results of stress, anxiety, and depression in married students and the location of the students' variables were not found statistically significant. The findings may be useful for informed policymaking in the higher learning institutions and initiation of counseling provisions in the concerned faculties for the distressed students with a view to enhancing their educational outcomes.

13.
Vet World ; 12(1): 141-145, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30936668

RESUMEN

AIM: This work aimed to determine the occurrence of antibiotic and disinfectant resistance genes in Escherichia coli isolated from chickens in Egypt. MATERIALS AND METHODS: Organs (liver, lung, heart, yolk sac, and bone marrow) of 1500 chicken samples were collected from diseased chickens suffered from colibacillosis with PM findings as CRD, diarrhea and omphalitis from different governorates of Egypt as: Giza, EL-Bahira, Fayoum, El-Dakahlia, El-Ismalia, and El-Sharkia during 2015-2016. These samples were labeled and transported immediately on ice to the Reference laboratory for quality control on poultry production (RLQP). The samples were cultured onto MacConkey agar and Eosin Methylene Blue Agar. Isolation and identification of the E. coli were performed based on morphology, cultural, staining, and biochemical properties. Antimicrobial resistance test was carried out using disk diffusion method. The PCR employing tetA, qacED1 and qacA/B were carried out for detection of these genes in isolated E.coli. RESULTS: The prevalence of E. coli in chicken was 34%. Predominant serotypes of E. coli which serologically identified were O128, O111, O44, O158, and O2. Antibiotic susceptibility test of E. coli revealed that 100% of isolates were resistant to ampicillin, erythromycin, and sulfamethoxazole-trimethoprim, while 73.53% and 38.23% of them were sensitive for colistin sulfate and levofloxacin, respectively. Antibiotic resistance genes as tetA gene were tested for isolated E. coli and detected by incidence rate of 91.18%. qac resistance genes resembling as qacED1 and qacA/B genes were detected in isolated E. coli 70.6% and 14.7%, respectively. CONCLUSION: E. coli isolated from chickens in Egypt was carried qac and antibiotic-resistant genes that affect the poultry industry.

14.
Nutrients ; 10(4)2018 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-29661995

RESUMEN

There are ethnic differences recorded in glycaemic response and rates of type 2 diabetes mellitus (DM) between Chinese and Caucasian populations. Whether these differences are evident in matched healthy, lean, active, young adults is unclear. This study compares the postprandial glycaemic response of a group of Chinese participants (n = 49) with a group of similar Caucasians, (n = 48) aged 23.8 (±4.35 years), body mass index (BMI) 22.7 (±2.6) kg/m², healthy (free from non-communicable disease), and lean (body fat % 23.28% (±5.04)). Participants undertook an oral glucose tolerance test to identify any significant differences in postprandial blood glucose response. Body fat percentage, body mass, age, physical activity, baseline glucose and HbA1c did not significantly differ between groups. Data from food frequency questionnaires indicated that the Chinese participants consumed less starchy foods, candy and "other" sweets and sugary drinks, and more rice than the Caucasians (all p ≤ 0.001), but not a greater overall intake of carbohydrates or any other macronutrient (all p > 0.05). The two groups' postprandial blood glucose responses and 2-h incremental area under the curve values (iAUC)-156.67 (74.12) mmol/L 120 min for Caucasians versus 214.03 (77.49) mmol/L 120 min for Chinese-indicate significant differences (p = 0.003 and p < 0.001 respectively) between groups. Findings suggest that the difference between the two groups' iAUC values do not relate to obvious lifestyle factors. The Chinese group were eating the least sugary and starchy food but had the highest iAUC. It is argued that the Chinese group in this investigation have the most favourable BMI, body fat percentage, and body mass, yet "poorest" glycaemic response.


Asunto(s)
Pueblo Asiatico , Glucemia , Índice de Masa Corporal , Prueba de Tolerancia a la Glucosa , Población Blanca , Adolescente , Adulto , Humanos , Adulto Joven
15.
Glob Cardiol Sci Pract ; 2015: 15, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26779503

RESUMEN

BACKGROUND: Left ventricular outflow tract obstruction (LVOT) is an independent predictor of adverse outcome in hypertrophic cardiomyopathy (HCM). It is of major importance that the provocation modalities used are validated against each other. AIM: To define the magnitude of LVOT gradients provocation during both isosorbide dinitrate (ISDN) inhalation and treadmill exercise in non-obstructive HCM and analyze the correlation to the electromechanical delay using speckle tracking. METHODS: We studied 39 HCM pts (64% males, mean age 38 ± 13 years) regional LV longitudinal strain and electromechanical delay (TTP) was analyzed at rest using speckle tracking. LVOT gradient was measured at rest and after ISDN then patients underwent a treadmill exercise echocardiography (EE) and LVOT gradient was measured at peak exercise. RESULTS: The maximum effect of ISDN on LVOT gradient was obtained at 5 minutes, it increased to a significant level in 12 (31%) patients, and in 14 (36%) patients using EE, with 85.6% sensitivity & 100% specificity. Patients with latent obstruction had larger left atrial volume and lower E/A ratio compared to the non-obstructive group (p < 0.01). LVOTG using ISDN was significantly correlated with that using EE (p < 0.0001), resting LVOTG (p < 0.0001), SAM (p < 0.0001), EF% (p < 0.02) and regional electromechanical delay but not related to global LV longitudinal strain. Using multivariate regression, resting LVOTG (p = 0.006) & TTP mid septum (p = 0.01) were found to be independent predictors of latent LVOT obstruction using ISDN. CONCLUSION: There is a comparable diagnostic value of nitrate inhalation to exercise testing in provocation of LVOT obstruction in HCM. Latent obstruction is predominantly dependent on regional electromechanical delay.

16.
J Am Soc Echocardiogr ; 26(12): 1397-406, 2013 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24094559

RESUMEN

BACKGROUND: Although patients with hypertrophic cardiomyopathy (HCM) have normal ejection fractions at rest, the investigators hypothesized that these patients have differentially abnormal systolic function reserves, limiting their exercise capacity compared with patients with hypertension (HTN). METHODS: Forty patients with HCM (mean age, 39.1 ± 12 years), 20 patients with HTN with LVH, and 33 healthy individuals underwent resting and peak exercise echocardiography using two-dimensional strain imaging. Peak longitudinal systolic strain (εsys) and strain rate were measured in apical views. Circumferential εsys and left ventricular (LV) twist were analyzed from short-axis views. LV systolic dyssynchrony was measured from regional longitudinal strain curves as the standard deviation of time to peak strain (time from the beginning of the Q wave on electrocardiography to peak εsys) between 12 segments. The differences between resting and peak exercise values were analyzed, and functional reserve was calculated as the difference divided by the resting value. RESULTS: In patients with HCM, resting values for longitudinal εsys, systolic strain rate, early diastolic strain rate, and atrial diastolic strain rate were significantly lower, while circumferential εsys and twist were higher, compared with patients with HTN and controls (P < .0001). Functional systolic reserve increased during exercise in controls (17 ± 6%), increased to a lesser extent in patients with HTN (10 ± 16%), and was markedly attenuated in patients with HCM (-23 ± 28%) (P < .001). At peak exercise, even with augmented circumferential εsys and twist in patients with HCM (P < .01) compared with those with HTN, both remained lower than in controls (P < .001). LV dyssynchrony was amplified during exercise in patients with HCM compared with those with HTN (P < .001). Within the entire population, exercise capacity was clearly correlated with systolic functional reserve. However when taken separately, it was mainly related to resting LV dyssynchrony and diastolic function in patients with HCM, whereas it was linked to age and LV wall thickness in those with HTN. CONCLUSIONS: Patients with HCM have significantly limited systolic function reserve and more dynamic dyssynchrony with exercise compared with those with HTN. Two-dimensional strain imaging during stress may provide a new and reliable method to identify patients at higher cardiovascular risk.


Asunto(s)
Cardiomiopatía Hipertrófica/diagnóstico por imagen , Cardiomiopatía Hipertrófica/fisiopatología , Diagnóstico por Imagen de Elasticidad/métodos , Hipertensión/diagnóstico por imagen , Hipertensión/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/fisiopatología , Adulto , Cardiomiopatía Hipertrófica/complicaciones , Ecocardiografía/métodos , Tolerancia al Ejercicio , Femenino , Reserva del Flujo Fraccional Miocárdico , Humanos , Hipertensión/complicaciones , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Disfunción Ventricular Izquierda/complicaciones
17.
Appl Clin Genet ; 5: 111-8, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23776387

RESUMEN

BACKGROUND: Vascular α2B-adrenoreceptors have the potential to increase blood pressure by mediating vasoconstriction. A nine-nucleotide deletion in the receptor enhances vasoconstriction and exacerbates hypertension. The aim of this study was to determine the association between insertion/deletion (I/D) polymorphism of the α2B-adrenoceptor and hypertension with and without diabetes. METHODS: The study was carried out in 35 hypertensive patients with diabetes, 35 hypertensive patients without diabetes, and 30 healthy controls. Clinical data, blood lipid profiles, and I/D polymorphism were assessed. RESULTS: Hypertensive patients were significantly older, with significantly higher systolic/diastolic blood pressures and worse plasma lipid profiles than controls. The frequency of the DD genotype was significantly higher in both hypertensive patients with (77.14%, P < 0.01) and without (71.43%, P < 0.05) diabetes versus controls (40%). Also, the D allele was significantly more common in both hypertensive patients with (84.29%, P < 0.01) and without (80%, P < 0.05) diabetes versus controls (58.33%). Hypertensive patients were more likely to have the D allele with (3.83-fold) and without (2.85-fold) diabetes. The frequencies of the DD genotype and the D allele were not significantly (P > 0.05) different between the patient groups. The DD genotype was associated with significantly lower high-density lipoprotein (P = 0.001) and significantly higher low-density lipoprotein (P = 0.017) levels versus the II and ID genotypes in the hypertensive group without diabetes. CONCLUSION: A marked and statistically significant association between DD genotype and D allele of I/D polymorphism in the α2B-adrenoceptor gene may be a risk factor for hypertension ± diabetes. The association between the DD genotype and dyslipidemia may partially explain its role in precipitating hypertension.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA