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Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)
Momar Sokhna Diop,
Ndeye Fatou Sow,
Pape Ousmane Ba,
Magaye Gaye,
Papa Amath Diagne,
Pape Adama Dieng,
Souleymane Diatta,
Pape Salmane Ba,
Moussa Seck Diop,
Mareme Soda Mbaye,
Amadou Gabriel Ciss,
Assane Ndiaye,
Mouhamadou Ndiaye
Issue:
Volume 3, Issue 1, March 2019
Pages:
1-5
Received:
23 October 2018
Accepted:
6 December 2018
Published:
24 January 2019
Abstract: Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to evaluate the results of the surgery. Materials and Methods: This was a descriptive retrospective study over a 12-years period from December 2005 to February 2018. Results: The total number of our series was 12 cases. The average age at the time of surgery was 37 years old [17-83 years]. There was no predominance of sex. There was a notion of smoking in 3 cases / 12. There was no concept of addiction. Four out of 12 cases had a known concept of heart disease with mitral insufficiency, aortic insufficiency, and complete atrioventricular block. A patient presented in this antecedents a notion of syphilis treated and declared cured. The clinical symptomatology was made of fever in 4 cases out of 12, pain in 11 cases out of 12 with 3 cases of intermittent claudication. The clinical examination had shown a swelling with vascular characters in 11 cases out of 12. Two out of 12 patients had signs of acute limb ischemia. The arterial echodoppler was performed in 11cases out of 12 which had made the diagnosis. The angioscan was performed in 8 cases and showed 4 cases of sacciform aneurysms. All patients benefited from open surgery. The exploration showed 9 cases of false aneurysms with signs of local infection in 5 cases. Flattening with excision of the infected tissues was performed in all cases. The restoration of vascular continuity was immediate in all cases by end-to-end direct anastomosis in 8 cases, 2 cases of extra-anatomical bypass using a dacron tube and two cases of anatomical bypass using the saphenous vein in situ. Early complications were dominated by 2 cases of acute limb ischemia, 2 cases of superficial surgical site infection, 1 case of deep surgical site infection, 1 case of false aneurysm of a common femoral artery and 1 case of hematoma. Follow-up was performed in all patients with an average delay of 14 months [1-60]. There were 1 case of operative mortality and 2 cases of late mortality.
Abstract: Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to...
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The Short-Term and Long-Term Effects of Cardiac Resynchronization Therapy in Heart Failure Patients
Xuefang Zhang,
Ying Qin,
Gaoxing Zhang,
Weidong Gao,
Yucheng Peng,
Qiang Ren,
Gang Sun,
Jinxue Liu,
Bin Zhang,
Juan Wu
Issue:
Volume 3, Issue 1, March 2019
Pages:
6-9
Received:
14 December 2018
Accepted:
11 January 2019
Published:
19 February 2019
Abstract: Objective to evaluate the short-term and long-term effects of cardiac resynchronization therapy in heart failure patients. Methods We continuous assessed forty-eight heart failure patients who underwent CRT implantation in our hospital from January 2008 to December 2012, evaluate/measure NYHA grade, left ventricular diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF) and B-type natriuretic peptides (BNP) before cardiac resynchronization therapy and half year, one year, two years after cardiac resynchronization therapy. Results Compared to the results before cardiac resynchronization, half year, one year and two years later, NYHA grade, LVEF, LVEDd, BNP improved significantly (P <0.05); Compared to the results of half year after cardiac resynchronization therapy, one year and two years later, NYHA grade, LVEF, LVEDd, BNP also improved significantly (P<0.05); However, compared the results between one year and two years later after cardiac resynchronization therapy, there were no difference as to NYHA grade, LVEF, LVEDd and BNP (P>0.05). Conclusions CRT could improve cardiac function in patients with congestive heart failure, however, when we followed up the patients for two years, cardiac function did not improve further.
Abstract: Objective to evaluate the short-term and long-term effects of cardiac resynchronization therapy in heart failure patients. Methods We continuous assessed forty-eight heart failure patients who underwent CRT implantation in our hospital from January 2008 to December 2012, evaluate/measure NYHA grade, left ventricular diastolic diameter (LVEDd), left...
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Research Progress in Formation and Application of Tp-Te Interval
Baoxia Yue,
Hui Tian,
Biao Xu
Issue:
Volume 3, Issue 1, March 2019
Pages:
10-13
Received:
2 January 2019
Accepted:
21 January 2019
Published:
19 February 2019
Abstract: Tp-Te interval refers to the duration from the peak to the end time points of T wave in electrocardiogram. Tp-Te interval is an electrocardiogram index reflecting mail-gnant ventricular arrhythmia, while Tp-Te interval mainly reflects ventricular transmural repolarization dispersion. The increase of ventricular transmural repolarization dispersion makes it easy to appear depolarization after repolarization, and forms functional conduction block between different regions, which leads to malignant arrhythmias. In this review we discuss how these markers have demonstrated to be effective to predict malignant arr- hythmias in medical conditions such as long and short QT syndromes, Brugada syndrome and so on. However, the same results have not been found in all conditions. Further studies are needed to reach a global consensus in order to incorporate these VR parameters in risk stratification of these patients.
Abstract: Tp-Te interval refers to the duration from the peak to the end time points of T wave in electrocardiogram. Tp-Te interval is an electrocardiogram index reflecting mail-gnant ventricular arrhythmia, while Tp-Te interval mainly reflects ventricular transmural repolarization dispersion. The increase of ventricular transmural repolarization dispersion ...
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The Importance of Ambulatory Venous Hypertension Should Be Revised
Issue:
Volume 3, Issue 1, March 2019
Pages:
14-17
Received:
6 January 2019
Accepted:
27 February 2019
Published:
26 March 2019
Abstract: Inadequate decrease of venous pressure in patients with varicose vein while walking and exercising is called ambulatory venous hypertension (AVH). It has been considered as the main cause of chronic venous insufficiency. However, venous pressure in lower limbs while standing (95 mmHg) and sitting (70 mmHg) remains higher most of the day compared to AVH (healthy persons 26 mmHg, patients with varicose veins 41 mmHg). Published values of venous pressure in lower limbs in healthy persons and in patients with varicose veins in lower limbs, obtained while lying, standing, standing with small movements, sitting and walking, and the reported times, were used to calculate the mean venous pressure for 24 hours. Photoplethysmographic testing was used for indirect evaluation of venous haemodynamics in intensive and moderate exercise in sitting subjects. Patients with varicose veins restrict standing times; taking into account this fact, mean venous pressure for 24 hours reached 48.71 mmHg in healthy persons and 49.56 mmHg in patients with varicose vein (CEAP C2 stage). The difference is very small and cannot be the fundamental pathophysiological mechanism of development of venous insufficiency. Conclusion: 24-hour venous pressure in legs in healthy persons and in persons with varicose veins in lower limbs shows only a very small difference. The importance of AVH, particularly in initial stages of the disease, should be revised.
Abstract: Inadequate decrease of venous pressure in patients with varicose vein while walking and exercising is called ambulatory venous hypertension (AVH). It has been considered as the main cause of chronic venous insufficiency. However, venous pressure in lower limbs while standing (95 mmHg) and sitting (70 mmHg) remains higher most of the day compared to...
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Acute Coronary Syndrome in Patient with Viral Hepatitis C: An Underdiagnosed Condition in Sub-Saharan Africa
Helles Murielle Lema,
Mazou Ngou Temgoua,
Ngam Mary Engonwei,
Mounpou Blaise,
Tonleu Carole,
Mefire Aicha,
Ahinaga Andre Jules,
Boombhi Jerome,
Menanga Alain
Issue:
Volume 3, Issue 1, March 2019
Pages:
18-21
Received:
9 February 2019
Accepted:
11 March 2019
Published:
26 March 2019
Abstract: Viral hepatitis C (VHC) infection is associated with many systemic diseases. Amongst these, the association with ischemic heart disease is underdiagnosed in Sub-Saharan Africa context. We present a case of acute coronary syndrome in a Cameroonian patient with viral hepatitis C with low cardiovascular risk. A 75 years old female followed up for hepatocellular carcinoma secondary to VHC cirrhosis. She was admitted in the hospital for a sudden, resting, intense constrictive thoracic pain lasting more than one hour. This patient initially consulted the gastroenterologist, but secondarily the cardiologist 24 hours after the previous consultation. The initial workup showed ST segment elevation in lead V1 to V4 with Q Wave in the same territory and elevated value of Troponin Ius and CPKMB. Cardiac ultrasonography found akinesia in the anteroseptal and apical segments. Other biological exams showed a dyslipidemia without other cardiovascular risk factors. Despite poor financial resources, the patient was managed with Enoxaparine 8000 UI/12H, Clopidogrel 75mg/24H, Aspirine 100mg/24h. Rosuvastatine 10Mg/24h, Ramipril 2,5mg/24h and Nebivolol 2.5mg/24h, tramadol 100mg/8h, trimetazidine 35mg/12h, omeprazole 40mg/24h, molsidomine 1mg/8h. The pain disappeared 24hours after the beginning of the treatment. In sub-Saharan Africa with high burden of viral hepatitis C infection, we should consider this possibility in patients who present ischemic heart disease with lowcardiovascular risk.
Abstract: Viral hepatitis C (VHC) infection is associated with many systemic diseases. Amongst these, the association with ischemic heart disease is underdiagnosed in Sub-Saharan Africa context. We present a case of acute coronary syndrome in a Cameroonian patient with viral hepatitis C with low cardiovascular risk. A 75 years old female followed up for hepa...
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