Simple Treadmill Score: Does It Have Better Predictability for Coronary Artery Disease?

Coronary artery disease is one of the most prevalent causes of increasing mortalitiy in current time. Early detection of such dreadful condition by a non-invasive test like exercise treadmill test, is a much-required option to prevent future complications like myocardial infarction. The aim of this study was to find out how different the predictability of simple treadmill score in comparison to other treadmill scores namely the well-known Duke treadmill score and Cleveland clinic score. In a cross-sectional analytical study of total 130 individuals with stable angina were included according to criteria set before the study. The treadmill scores of these patients were calculated and compared to coronary angiogram findings where coronary artery angiograms were done according to clinical need. Simple treadmill test had similar predictability for coronary artery disease when we compared it with much-applied Duke Treadmill Test and Cleveland Clinic Score- which is currently used for mortality prediction. Receiver Operator Characteristics (ROC) Curve showd all scores had around 0.7 area under the curve (AUC) which is highly statistically significant (p<0.0001) though simple treadmill score in females has higher sensitivity (92.3%). Simple treadmill score can be considered to exclude female patients from undergoing invasive investigation as it has higher sensitivity than other currently practiced treadmill scores i.e., Duke treadmill score.

Overexpression of Serum Micro-RNA 152-3p in Type 2 Diabetes Mellitus with a Significant Elevation in Progressive Nephropathy.

Modulation of the immune inflammatory system has been implicated in the pathogenesis of type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN); nevertheless, many of the underlying mechanisms are still unknown. A possible role of micro-RNA 152-3p in T2DM and DN has been suggested due to its immunomodulatory effect on the innate immunity. This case control study aimed, first, to determine the possible role of micro-RNA 152-3p in the pathogenesis of T2DM and DN by evaluating its serum expression in T2DM and DN patients. Second, to assess the performance of serum micro-RNAs 16 and 24 as endogenous control in TaqMan assays of micro-RNA analysis by real time PCR in such disease. Quantification of the expression of micro-RNA 152-3p by qRT-PCR was performed using serum of 70 subjects enrolled in this study and grouped into 20 apparently healthy non-diabetic participants (control group), 15 patients with T2DM without nephropathy (DM group) and 35 diabetic patients with nephropathy (DN group). In diabetic patients with nephropathy (DN) (P<0.001), or without nephropathy (DM) (P 0.004), the expression of micro-RNA 152-3p demonstrated a significant elevation in comparison to the controls. Also, the level of micro-RNA 152-3p showed a positive correlation with HbA1c and the duration of diabetes mellitus. The severity of nephropathy as evaluated by markers of renal disease progression; estimated (e)GFR and albumin/creatinine ratio (ACR) revealed a significant correlation with the level of micro-RNA 152-3p. In the same context, serum level of micro-RNA 152-3p was elevated in diabetics with advanced stage of nephropathy (macroalbuminuria) versus the rest of diabetics (without albuminuria and with microalbuminuria). Two one sided T procedure provided a strong statistical support for equivalence of both micro-RNA s 16 and 24. In conclusion, such findings may indicate a pathologic role of micro-RNA 152-3p in Type 2 diabetes mellitus and in the progression of diabetic nephropathy.

Results of surgical excision of cirsoid aneurysm of the scalp without preoperative interventions.

CONTEXT: Cirsoid aneurysms of scalp are rare lesions which are mainly treated by surgical excision. Endovascular embolization was described either alone or prior to surgery in order to minimize the risk of bleeding. However, the endovascular therapy also carries the risk of scalp necrosis, escape of embolization material to circulation, and recurrence of the lesion. AIM: To evaluate the results of well-planned classic surgical excision of cirsoid aneurysm. STUDY DESIGN: This is a retrospective case series study. MATERIALS AND METHODS: This is a retrospective case series study on nine patients with cirsoid aneurysms who were treated with surgical excision. Preoperative Planning for location, size, feeding arteries, and venous drainage of the lesions were done by plain and contrast enhanced CT, MRI, MR angiogram, and selective internal and external carotid angiograms. Complete surgical excision for the lesions was done. Postoperative evaluation of excision was done by cranial magnetic resonance angiography in all the patients. The mean follow up period was 34.1 (±7.62 STD) months. RESULTS: The lesion was located in the occipital region in three (33.3%) cases, frontal region in two (22.2%) cases, temproparietal region in two (22.2%) cases, parietal region in one case (11.1%), and vertex in one case (11.1%). The superficial temporal artery was involved in seven (77.8%) cases, the occipital artery was involved in six (66.7%) cases, the posterior auricular artery was involved in five (55.6%) cases, the supraorbital artery was involved in two (22.2%) cases and the middle meningeal artery was involved in two (22.2%) cases. Total excision of the lesion was achieved in eight patients and en bloc resection and primary closure was done in one patient. Postoperative magnetic resonance angiogram showed no residual lesion in all patients. No postoperative complication related to the surgery had occurred. No recurrence had occurred during the follow-up period (mean 34.1 ± 7.62 STD months). CONCLUSION: Well-planned surgery of cirsoid aneurysm of the scalp without preoperative interventions could achieve complete excision of the lesion without any residual masses or recurrence and with a low incidence of complications.