111 research outputs found
Pulmonary function derangements in isolated or predominant mitral stenosis-Preoperative evaluation with clinicohemodynamic correlation
No full textIntroduction: It is well known that mitral stenosis (MS) is complicated by pulmonary hypertension (PH) of varying degrees. The hemodynamic derangement is associated with structural changes in the pulmonary vessels and parenchyma and also functional derangements. This article analyzes the pulmonary function derangements in 25 patients with isolated/predominant mitral stenosis of varying severity. Aims: The aim of the study was to correlate the pulmonary function test (PFT) derangements (done by simple methods) with: a) patient demographics and clinical profi le, b) severity of the mitral stenosis, and c) severity of pulmonary artery hypertension (PAH) and d) to evaluate its signifi cance in preoperative assessment. Subjects and Methods: This cross-sectional study was conducted in 25 patients with mitral stenosis who were selected for mitral valve (MV) surgery. The patients were evaluated for clinical class, echocardiographic severity of mitral stenosis and pulmonary hypertension, and with simple methods of assessment of pulmonary function with spirometry and blood gas analysis. The diagnosis and classifi cation were made on standardized criteria. The associations and correlations of parameters, and the diff erence in groups of severity were analyzed statistically with Statistical Package for Social Sciences (SPSS), using nonparametric measures. Results: The spirometric parameters showed signifi cant correlation with increasing New York Heart Association (NYHA) functional class (FC): forced vital capacity (FVC, r =-0.4, p = 0.04), forced expiratory volume in one second (FEV1, r =-0.5, p = 0.01), FEV1/FVC (r =-0.44, p = 0.02), and with pulmonary venous congestion (PVC): FVC (r =-0.41, p = 0.04) and FEV1 (r =-0.41, p = 0.04). Cardiothoracic ratio (CTR) correlated only with FEV1 (r =-0.461, p = 0.02) and peripheral saturation of oxygen (SPO2, r =-0.401, p = 0.04). There was no linear correlation to duration of symptoms, mitral valve orifi ce area, or pulmonary hypertension, except for MV gradient with PCO2 (r = 0.594, p = 0.002). The decreased oxygenation status correlated signifi cantly with FC, CTR, PVC, and with deranged spirometry (r = 0.495, p = 0.02). Conclusions: PFT derangements are seen in all grades of severity of MS and correlate well with the functional class, though no signifi cant linear correlation with grades of severity of stenosis or pulmonary hypertension. Even the early or mild derangements in pulmonary function such as small airway obstruction in the less severe cases of normal or mild PH can be detected by simple and inexpensive methods when the conventional parameters are normal. The supplementary data from baseline arterial blood gas analysis is informative and relevant. This reclassifi ed pulmonary function status might be prognostically predictive. © 2014 Akadémiai Kiadó, Budapest
Pulmonary function derangements in isolated or predominant mitral stenosis - Preoperative evaluation with clinico-hemodynamic correlation
No full textIntroduction: It is well known that mitral stenosis (MS) is complicated by pulmonary hypertension (PH) of varying degrees. The hemodynamic derangement is associated with structural changes in the pulmonary vessels and parenchyma and also functional derangements. This article analyzes the pulmonary function derangements in 25 patients with isolated/predominant mitral stenosis of varying severity. Aims: The aim of the study was to correlate the pulmonary function test (PFT) derangements (done by simple methods) with: a) patient demographics and clinical profi le, b) severity of the mitral stenosis, and c) severity of pulmonary artery hypertension (PAH) and d) to evaluate its signifi cance in preoperative assessment. Subjects and Methods: This cross-sectional study was conducted in 25 patients with mitral stenosis who were selected for mitral valve (MV) surgery. The patients were evaluated for clinical class, echocardiographic severity of mitral stenosis and pulmonary hypertension, and with simple methods of assessment of pulmonary function with spirometry and blood gas analysis. The diagnosis and classifi cation were made on standardized criteria. The associations and correlations of parameters, and the diff erence in groups of severity were analyzed statistically with Statistical Package for Social Sciences (SPSS), using nonparametric measures. Results: The spirometric parameters showed signifi cant correlation with increasing New York Heart Association (NYHA) functional class (FC): forced vital capacity (FVC, r =-0.4, p = 0.04), forced expiratory volume in one second (FEV1, r =-0.5, p = 0.01), FEV1/FVC (r =-0.44, p = 0.02), and with pulmonary venous congestion (PVC): FVC (r =-0.41, p = 0.04) and FEV1 (r =-0.41, p = 0.04). Cardiothoracic ratio (CTR) correlated only with FEV1 (r =-0.461, p = 0.02) and peripheral saturation of oxygen (SPO2, r =-0.401, p = 0.04). There was no linear correlation to duration of symptoms, mitral valve orifi ce area, or pulmonary hypertension, except for MV gradient with PCO2 (r = 0.594, p = 0.002). The decreased oxygenation status correlated signifi cantly with FC, CTR, PVC, and with deranged spirometry (r = 0.495, p = 0.02). Conclusions: PFT derangements are seen in all grades of severity of MS and correlate well with the functional class, though no signifi cant linear correlation with grades of severity of stenosis or pulmonary hypertension. Even the early or mild derangements in pulmonary function such as small airway obstruction in the less severe cases of normal or mild PH can be detected by simple and inexpensive methods when the conventional parameters are normal. The supplementary data from baseline arterial blood gas analysis is informative and relevant. This reclassifi ed pulmonary function status might be prognostically predictive. © 2014 Akadémiai Kiadó, Budapest
Structure of 2-(2,6-Dimethoxyphenyl)-2,5-dimethylbicyclo[3.2. l]octane-6,8-dione
No full textC18H2204, orthorhombic, P212~21, a = 7.343 (4), b = 11.251 (4), c = 19.357 (4)A, Z = 4, Dr, ' = 1.20, D e = 1.254 g cm -3, F(000) = 648, p(Mo Ka) = 0.94 cm -~. X-ray intensity data were collected on a Nonius CAD-4 diffractometer and the structure was solved by direct methods. Full-matrix least-squares refinement gave R = 0.052 (R w = 0.045) for 1053 observed reflections. The stereochemical configuration
at C(2) has been shown to be 2-exo-methyl-2-endo-
(2,6-dimethoxyphenyl), i.e. (3) in contrast to the structure (2) assigned earlier based on its ~H NMR data
Reversal of abnormal cardiac parameters following mitral valve replacement for severe mitral stenosis in relation to pulmonary artery pressure: A retrospective study of noninvasive parameters - Early and late pattern
No full textBackground and objectives: Although the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods. Methods: The preoperative, early, and 1-year postoperative data - functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) - of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson's), and their change (t-test), in relation to that in PAP. PH group-based [Group (Gp)-I PAP0 ≤ 60 mmHg, Gp-II PAP >60 mmHg] analysis highlighted the differences. Results: All parameters significantly correlated with the baseline PAP (p < 0.05), except LA (r = 0.081, p = 0.577). Postoperatively, there was significant reduction in all parameters (p < 0.001) and increase in LV (p < 0.003). The PAP regression was 39.42%; with the decrease in CTR, LA, and RA related to it, the early changes being significant (p < 0.01). The RV and PA showed lesser reduction (8.61% and 9.42%), late reduction being more conspicuous. The changes were greater and significant in Gp-II (especially PAP, RV, and PA). At 1 year, PAP normalized in only 19 (38%). Residual PH and chamber enlargement prevailed more in Gp-II. Conclusions: This study emphasizes the importance of the baseline PAP in MS to which was proportionate the functional disability and the cardiac chamber alterations (except LA). Their postoperative improvement accompanying the PAP regression differed in degree and time frame relative to PAP. The higher pressure group showed greater regression, but greater prevalence of residual abnormalities, suggesting that the pathologic changes in them might take longer to resolve, necessitating further evaluation. © 2016 The Author(s)
Reversal of abnormal cardiac parameters following mitral valve replacement for severe mitral stenosis in relation to pulmonary artery pressure: A retrospective study of noninvasive parameters - Early and late pattern
No full textBackground and objectives: Although the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods. Methods: The preoperative, early, and 1-year postoperative data - functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) - of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson's), and their change (t-test), in relation to that in PAP. PH group-based [Group (Gp)-I PAP0 ≤ 60 mmHg, Gp-II PAP >60 mmHg] analysis highlighted the differences. Results: All parameters significantly correlated with the baseline PAP (p < 0.05), except LA (r = 0.081, p = 0.577). Postoperatively, there was significant reduction in all parameters (p < 0.001) and increase in LV (p < 0.003). The PAP regression was 39.42%; with the decrease in CTR, LA, and RA related to it, the early changes being significant (p < 0.01). The RV and PA showed lesser reduction (8.61% and 9.42%), late reduction being more conspicuous. The changes were greater and significant in Gp-II (especially PAP, RV, and PA). At 1 year, PAP normalized in only 19 (38%). Residual PH and chamber enlargement prevailed more in Gp-II. Conclusions: This study emphasizes the importance of the baseline PAP in MS to which was proportionate the functional disability and the cardiac chamber alterations (except LA). Their postoperative improvement accompanying the PAP regression differed in degree and time frame relative to PAP. The higher pressure group showed greater regression, but greater prevalence of residual abnormalities, suggesting that the pathologic changes in them might take longer to resolve, necessitating further evaluation. © 2016 The Author(s)
Emotional intelligence, perceived stress, and internet use behaviour among undergraduate medical students - a cross sectional study
Get PDFAim: To find the pattern and characteristics of Problematic internet use and to determine the relationship between Internet Addiction, Perceived stress and Emotional Intelligence among medical students.
Materials and methods:
In this cross-sectional study, using convenience sampling, 368 study participants were selected from the undergraduate medical students of a medical college in North Kerala. After getting written informed consent, socio-demographic data sheet, Internet Addiction Test (IAT), Schutte Self Report Emotional Intelligence Test (SSEIT) and Perceived Stress Scale (PSS) were filled up by the participants. Completed responses were scored and analyzed using SPSS 18.0.
Results: Problematic internet use among the participants was 65.7%. In the sample, 42.9% had mild internet addiction, and 22.8% had moderate internet addiction. There was a positive correlation between scores of IAT and PSS and a negative correlation between scores of IAT and SSEIT. A pattern of increased levels of perceived stress and decreased levels of emotional intelligence was noticed with increasing levels of internet addiction scores.
Conclusion: Young medical students were found to have mild and moderate levels of internet addiction and were high in perceived stress. Those with an addiction pattern of internet use also showed lower levels of emotional intelligence. It is crucial to identify those with lower levels of emotional intelligence and intervene effectively for stress management to reduce the internet overuse and emotional sequelae of it
Evaluation of Anti-diabetic Potential of Anti-microbial Carbon Quantum Dots from Vitis vinifera Seeds
Get PDFCarbon quantum dots (CQDs) have a size of 10 nm (or less), with lots of biomedical advantages, creating huge excitement in different research fields. The aim of this study includes an eco-friendly synthesis of biogenic CQDs from grape (Vitis vinifera) seeds, identifying the characteristics and assessing its anti-diabetic as well as anti-microbial activity. CQDs are prepared by the pyrolysis method. Synthesized CQDs were confirmed by ultraviolet (UV)–visible (Vis) spectrophotometer, and the characterization study was done by X-ray diffractometer, photoluminescence spectroscopy, Fourier transform infra-red spectroscopy, and transmission electron microscopy with selected area electron diffraction (SAED). Anti-diabetic activity of CQDs was analyzed by in vitro α-glycosidase, α-amylase inhibition assays, and glucose uptake studies. The anti-bacterial activity of CQDs was analyzed by anti-microbial assay technique against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus mutans. The results showed that the CQDs synthesized from a natural source like grape seeds, were amorphous in nature, the average particle size was 4 nm, and they contain functional groups like carboxyl and hydroxyl. Subsequently, it showed that the sp2 domains also produce green fluorescence. The anti-diabetic experimental method revealed that the CQDs enhance glucose uptake and inhibit carbohydrate hydrolyzing enzymes. CQDs also exhibit anti-bacterial properties against both Gram-positive and Gram-negative bacteria, according to their antimicrobial impact. Due to their small size and higher activity, CQDs will become strong anti-diabetic agents as well as anti-bacterial ones
Allogeneic hematopoietic stem cell transplant outcomes in adults with inherited myeloid malignancies
Get PDFFinal version published online 17 February 2023There is increasing recognition that pathogenic germline variants drive the development of hematopoietic cancers in many individuals. Currently, patients with hereditary hematologic malignancies (HHMs) receive similar standard therapies and hematopoietic stem cell transplant (HSCT) approaches as those with sporadic disease. We hypothesize that patients with myeloid malignancies and deleterious germline predisposition variants have different post-transplant outcomes compared to those without such alleles. We studied 472 patients with myeloid neoplasms, of whom 26% had deleterious germline variants (DGVs) and 34% underwent HSCT. DGVs in CHEK2 and DDX41 were most commonly seen in American and Australian cohorts, respectively. Patients with deleterious germline DDX41 variants had a higher incidence of severe (stage 3-4) acute graft versus host disease (GVHD) (38%) compared to recipients with deleterious CHEK2 variants (0%), other HHM variants (12%), or patients without such germline variants (9%) (p= 0.002). Importantly, the use of post-transplant cyclophosphamide reduced the risk of severe acute GVHD in patients receiving HSCT for deleterious germline DDX41-associated myeloid neoplasms (0% vs 53%, p=0.03). Based on these results, we advocate the use of post-transplant cyclophosphamide when individuals with deleterious germline DDX41 variants undergo allogeneic HSCT for myeloid malignancies, even when transplantation has been performed using wild-type donors.Caner Saygin, Gregory Roloff, Christopher N. Hahn, Rakchha Chhetri, Saar Gill, Hany Elmariah, Chetasi Talati, Emma Nunley, Guimin Gao, Aelin Kim, Michael Bishop, Satyajit Kosuri, Soma Das, Deepak Singhal, Parvathy Venugopal, Claire C. Homan, Anna Brown, Hamish S. Scott, Devendra Hiwase, and Lucy A. Godle
IL-17 Inhibition in Spondyloarthritis Associates with Subclinical Gut Microbiome Perturbations and a Distinctive IL-25-Driven Intestinal Inflammation
Get PDFTo characterize the ecological effects of biologic therapies on the gut bacterial and fungal microbiome of psoriatic arthritis (PsA)/spondyloarthritis (SpA) patients
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