CASE REPORT-ST-Segment Elevation During Treadmill Exercise Test in a Patient without Prior Myocardial Infarction. A Case Report and Literature Review

Author Name: Vasiliki Katsi

Journal Name: The Open Cardiovascular Medicine Journal

ABSTRACT

Exercise-induced ST-elevation is extremely uncommon especially in patients without prior myocardial infarction. It is more common among post-infarction patients with Q waves on the resting ECG. In the current case we report a 50-year-old man with a history of chest pain on exertion started four months ago. During the exercise test, ST-elevation was observed in leads II, III, AVF. Coronary angiography revealed significant stenoses in the right coronary artery and left circumflex artery, which were treated with percutaneous coronary intervention. This case highlights the rare finding of exercise-induced ST-elevation and reviews possible mechanisms.

Keywords: ST -elevation, Treadmill exercise test, Coronary angiography, Hypercholesterolemia, ECG, Myocardial infraction.

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REVIEW ARTICLE-Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

Author Name: Palaniraj Rama Raj

Journal Name: The Open Ophthalmology Journal 

ABSTRACT

Pathology involving the Cavernous Sinus (CS), generally referred to as Cavernous Sinus Syndrome (CSS), can arise from vascular disorders, neoplasms, infections, and non-infectious inflammatory disorders. An acute understanding of the CS and its regional anatomical structures is therefore pertinent in expounding the highly variable clinical manifestations seen in CSS as well as laying the groundwork for surgical intervention. Though the neuroanatomy of the cavernous sinus has been substantially chronicled in literature, their correlation to clinical signs has only been minimally described. This narrative review serves to address this knowledge gap and aims to comprehensively correlate the clinical manifestations of CSS with the relevant neuroanatomy, thereby allowing medical practitioners to better navigate the diagnostic quandary. We conducted a scoping review of the literature concerning CS anatomy and CSS, complied through MEDLINE/OVID and cross-referencing of articles on PubMed and Google Scholar with the keywords cavernous sinus, cavernous sinus syndrome, clinical signs/manifestations, neuroanatomy, CS pathology, Cavernous Sinus Thrombus (CST) and cavernous sinus neoplasms/tumours.

Keywords: Cavernous sinus syndrome, Cavernous sinus neuroanatomy, Cavernous sinus, Neuro ophthalmology, Cavernous sinus disease, CSS manifestations.

To access this article, please visit: https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/

RESEARCH ARTICLE-Association between Higher CD32a+CD4+ T Cell Count and Viral Load in the Peripheral Blood of HIV-infected Patients

Author Name: Natalia A. Arsentieva

Journal Name: The Open AIDS Journal

ABSTRACT

Background:

The significance of CD32a receptor expression in individuals infected with Human Immunodeficiency Virus (HIV) is currently unclear. Previously, B. Descours et al. (2017) concluded that in patients infected with HIV-1, CD32a is expressed on resting T cells that contain HIV DNA. According to the authors, these cells are reservoirs for inducible, replication-competent viruses. However, other studies have reported that CD32a expression is associated with activated T cells and is not a marker of HIV-1 reservoirs. The aims of this study were: to determine the significance of the CD32a marker in HIV infection, to assess its expression on T helper (Th) subpopulations in peripheral blood of HIV-infected individuals and to clarify the relationship between this expression and viral load.

Methods:

For comparative analysis, the following groups were used: 27 HIV-infected patients; 11 individuals with Hepatitis C Virus (HCV) infection; 16 individuals with Hepatitis B Virus (HBV) infection; and 13 healthy donors. Peripheral blood served as the study material. The expression of CD32a receptor on Th cell subpopulations was assessed using flow cytometry. Nonparametric statistical methods were used for data analysis.

Results:

It was found that relative CD32a+ Th cell counts in HIV-infected individuals significantly exceeded corresponding values in other groups: healthy individuals (p<0.0001), those with HCV infection (p=0.0008) and those with HBV infection (p <0.0001). Among the Th subpopulations in HIV-infected patients, the CD32a receptor was predominantly expressed on Th1 cells (p<0.0001) and Th2 cells (p<0.0001), compared with Th17. We found a strong, direct correlation (r=0.78; p<0.0001) between viral load and CD32a+CD4+ T cell count in peripheral blood of HIV-infected individuals.

Conclusion:

Thus, our results provide evidence that the CD32a receptor can serve as a marker of HIV infection, and its expression depends on viral load. Clinical material was used here, for the first time, to show that CD32a is predominantly expressed on Th1 and Th2 cells.

Keywords: CD32a, HIV infection, Th cells, HCV, HBV, Viral load, Flow cytometry.

To access this article, please visit: https://openaidsjournal.com/VOLUME/15/PAGE/35/FULLTEXT/

RESEARCH ARTICLE-Outcomes of Patients with Cardiac Myxoma: A Retrospective Multicentre Study

Author Name: Umit Duman

Journal Name: The Open Cardiovascular Journal

ABSTRACT

Background:

We present a 15-year follow-up of patients with Cardiac Myxoma (CM) who underwent tumour resection.

Patients and Methods:

Between 2001 and 2016, 38 patients with CM were operated on. We retrospectively reviewed, their clinical presentations. We also analysed the echocardiographic, electrocardiographic and pathology reports.

Results:

No mortality was seen after surgery. The mean age of the patients was 41.7±7.8 years and the female/male ratio was 22/16. Two patients with CM were children. The main symptoms of left atrial CM were dyspnoea on exertion, chest pain and congestive heart failure. Tricuspid valve pathology, and leg oedema were the main symptoms in patients with right atrial CM combined with right heart failure. CM as a cause of nephrotic syndrome was detected in 2 patients. In 5 asymptomatic patients (13.1%), CM was detected incidentally. We detected a pericardial invasion by the tumour in 1 patient. We performed secondary surgery because of tumour recurrence in 2 patients. Overall, survival for patients after surgical excision was 96.4±1.6% at 1 year, 91.7±2.4% at 5 years, 87.6±2.6% at 10 years and 85±1.9% at 15 years.

Conclusion:

The symptoms of CM may include congestive heart failure or nephrotic syndrome. Because CM may be associated with serious cardiac symptoms, tumour excision should be performed immediately after diagnosis. The use of right anterior thoracotomy for CM resection is a safe surgical approach.

Keywords: Cardiac myxoma, Echocardiography, Surgery, Pathologic classification, Cardiac tumour, Heart failure.

To access this article, please visit: https://opencardiovascularmedicinejournal.com/VOLUME/13/PAGE/24/FULLTEXT/

RESEARCH ARTICLE-Influence of the Arabic-Coffee on the Overall Color of Glazed or Polished Porcelain Veneers – In vitro Study

Author Name: Mohammed M. Al Moaleem

Journal Name: The Open Dentistry Journal.

ABSTRACT

Background:

Sometimes, porcelain restorations experience some degree of colour change in oral environment, which could be related to the quality of diet and surface roughness of these restorations.

Objective:

The aim of this in-vitro study was to evaluate the influence of Arabic-Coffee on the overall color of glazed or polished porcelain veneers fabricated from four different porcelain materials and two different thicknesses.

Materials and Methods:

A total of 160 porcelain disc of tested specimens were fabricated to a standardized thickness of 1.00 mm and 0.6mm using the following materials: Feldspathic porcelain, Zircon, E-max Press, and E-max CAD; (80 discs for each thickness and 20 specimens of each material used). Veneer specimens from each material were randomly divided into two subgroups (n = 10): 10 specimens were kept as glazed, were the other 10 tested specimens were adjusted with diamond burs, and then polished with Ivoclar Vivadent ceramic polishing kits using the recommended protocol for polishing provided by the company. A color of all tested specimens was measured using Vita Easy Shade Spectrophotometer. Then, all specimens were immersed in Arabic coffee (Al Mosafer Coffee, Saudi Arabia) and theromcycled for 1 week, and the colors of all tested specimens were then recorded again.

Results:

It was shown that there is a significant difference in the average color changes before and after immersing in Arabic-Coffee for all materials and thicknesses used in the current study. In-addition, significant differences in color changes were noticed between glazed and polished specimens. Moreover, colour change caused by the coffee was not significantly related to the thickness of the specimens used.

Conclusion:

Color stability of porcelain materials could be affected by surface treatment whether glazing or polishing. All aesthetic restorations should be deglazed whenever any adjustments have been done to maintain the color match and stability in an oral environment. Also, Arabic-Coffee is considered as a staining drink to a limited extend where patient should be assured to maintain their oral health to maintain the colour stability of their restorations.

Keywords: Arabic-coffee, Color stability, Glazed ceramic, Polishing, Ceramic, Feldspathic porcelain, Color

To access this article, please visit: https://opendentistryjournal.com/VOLUME/13/PAGE/364/ABSTRACT/

RESEARCH ARTICLE- Enhancing Dental Carving Skills of Preclinical Dental Hygiene Students Using Online Dental Anatomy Resources

Author Name: Abdullah A. H. Alzahrani

Journal Name: The Open Dentistry Journal

ABSTRACT

Background:

A key role of dental carving is enhancing manual proficiency and dexterity of dental hygiene students. Yet, utilizing Supplementary Online Dental Anatomy Resources (SODAR) as a supportive teaching approach has demonstrated the ability to improve carving skills.

Objective:

This study aims to examine the effectiveness of SODAR training in improving the quality of dental carving skills and knowledge among preclinical Saudi male students in Saudi Arabia.

Methods:

A basic double-blinded randomized controlled trial of 30 preclinical Saudi dental male students was conducted between January and April 2019. Participants were classified into an experimental group that received SODAR training (n = 15) and a control group comprising students who did not receive SODAR training (n = 15). The t-test and Fisher’s exact test were performed to assess differences in theoretical knowledge between the two groups. While Cohen’s d test, t-test, and Pearson correlation were conducted to evaluate differences in students’ dental carvings.

Results:

Students with SODAR training performed better on practical carving sessions than those without intervention (P-value < 0.001). However, SODAR intervention had no significant effect on the theoretical knowledge evaluations in both the groups.

Conclusion:

SODAR training demonstrated its ability to support students learning in practical carving sessions; however, no effect on theoretical knowledge was observed. Future research should focus on factors that impact carving teaching strategies, including the quality and depth of online learning content, students’ perceptions of online learning, and experiences of teachers who run the online resources.

Keywords: Dental hygiene students, Dental anatomy, Morphology, Online learning, E-learning, RCT, Medic

To access this article, please visit: https://www.opendentistryjournal.com/VOLUME/13/PAGE/499/FULLTEXT/

REVIEW ARTICLE-Anatomical Basis of Clinical Manifestations Seen in Cavernous Sinus Syndrome: A Narrative Review

Author Name: Palaniraj Rama Raj

Journal Name: The Open Ophthalmology Journal

ABSTRACT

Pathology involving the Cavernous Sinus (CS), generally referred to as Cavernous Sinus Syndrome (CSS), can arise from vascular disorders, neoplasms, infections, and non-infectious inflammatory disorders. An acute understanding of the CS and its regional anatomical structures is therefore pertinent in expounding the highly variable clinical manifestations seen in CSS as well as laying the groundwork for surgical intervention. Though the neuroanatomy of the cavernous sinus has been substantially chronicled in literature, their correlation to clinical signs has only been minimally described. This narrative review serves to address this knowledge gap and aims to comprehensively correlate the clinical manifestations of CSS with the relevant neuroanatomy, thereby allowing medical practitioners to better navigate the diagnostic quandary. We conducted a scoping review of the literature concerning CS anatomy and CSS, complied through MEDLINE/OVID and cross-referencing of articles on PubMed and Google Scholar with the keywords cavernous sinus, cavernous sinus syndrome, clinical signs/manifestations, neuroanatomy, CS pathology, Cavernous Sinus Thrombus (CST) and cavernous sinus neoplasms/tumours.

Keywords: Cavernous sinus syndrome, Cavernous sinus neuroanatomy, Cavernous sinus, Neuro ophthalmology, Cavernous sinus disease, CSS manifestations.

To access this article, please visit: https://openophthalmologyjournal.com/VOLUME/15/PAGE/70/FULLTEXT/

RESEARCH ARTICLE-The Relationship between the Risks of Developing Type 2 Diabetes Mellitus and Cardiovascular Diseases

Author Name: Carlos Sotomayor-Beltran

Journal Name: The Open Cardiovascular Medicine Journal

ABSTRACT

Background:

Type 2 Diabetes Mellitus (T2DM) has significantly increased in the past decades due to changes in lifestyles. This chronic disease is expected to be ranked in the seventh position by the year 2030 among the 15 leading causes of death. Poorly treated T2DM can be an important risk factor for cardiovascular diseases as well (CVD).

Objective:

We have sought to determine a relationship between the risks of developing T2DM and CVD in a healthcare facility in the district of Breña (Lima, Peru).

Methods:

The Finnish Diabetes Risk Score survey and the Pan American Health Organization risk calculator were used on a sample of 150 patients. The inclusion criteria were: patient age 40-80 years, attended their medical appointment more than once, were overweight or showed cholesterol levels above normal values and lived within the catchment area of the healthcare center where the study was carried out.

Results:

Only 8.7% of our sample was at a low risk of developing T2DM, whereas the rest was at a slightly elevated, moderate and high risk. Additionally, 79.3% of the patients were at low risk of developing CVD. Using the Fisher’s Exact test, there was a significant difference (p=0.026) between the risk of developing T2DM and CVD.

Conclusion:

The risk of developing CVD in our population is expected to rise in the future due to the high risk of developing T2DM. It is hoped that this work serves Peruvian (and other) health authorities to bolster their prevention programs, especially focusing on lifestyle interventions (e.g. increased physical activity), which have proven to be successful and economical.

Keywords: Type 2 Diabetes Mellitus, Cardiovascular disease, Healthcare facilities, Lifestyle, Interventions, Developing.

To access this article, please visit: https://opencardiovascularmedicinejournal.com/VOLUME/14/PAGE/13/FULLTEXT/

CASE REPORT-Endovascular Surgery or Both: A Case Report of Hybrid Procedure in a Patient with Abdominal Aortic Aneurysm and Tasc D Aortoiliac Occlusive Disease

Author Name: Sidhi Laksono Purwowiyot

Journal Name: The Open Cardiovascular Medicine Journal

ABSTRACT

Hybrid procedure, a combination of endovascular and open surgical approach, has emerged as the first-line treatment for patients with severe aortoiliac diseases because of its effectiveness. We report a hybrid procedure in a 72 year old man with an Abdominal Aortic Aneurysm (AAA) and Trans-Atlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease. After two failed attempts using the intraluminal technique (retrograde and antegrade), we successfully performed an endovascular approach with subintimal and Subintimal Arterial Flossing Antegrade-retrograde Intervention (SAFARI) technique with the help of roadmap technology. The vascular surgeon completed the procedure by creating femorofemoral bypass using a Great Saphenous Vein (GSV) graft. The graft was patent and there were no complications at 1 week, 1 month and 6 months follow-up.

Keyword: Aortoiliac disease, Femorofemoral bypass graft, Hybrid procedure, Roadmap technology, SAFARI technique, Severe ischaemia.

To access this article, please visit: https://opencardiovascularmedicinejournal.com/VOLUME/14/PAGE/48/FULLTEXT/

REVIEW ARTICLE-Donor-recipient Matching in Heart Transplantation

Author Name: Hubert Mado

Journal Name: THE OPEN CARDIOVASCULAR MEDICINE JOURNAL

ABSTRACT

Heart transplantation remains the treatment of choice for end-stage Heart Failure (HF). Due to the shortage of organs for transplantation and the occurrence of perioperative complications, a key problem is donor matching, which should result in increased survival and improved quality of life for patients. The success of this procedure depends on various parameters such as gender, weight, ABO blood group and Human Leukocyte Antigen (HLA) system of both the recipient and the donor. Furthermore, non-HLA antigens may also be valuable in donor-recipient matching. The aim of this article is to summarize the recent knowledge on the impact of various factors on accurate donor-recipient matching to heart transplantation.

Keywords: Heart failure, Heart transplant, Donor-recipient matching, Non-HLA, Chronic graft vasculopathy, Ventricular assist device.

To access this article, please visit: https://opencardiovascularmedicinejournal.com/VOLUME/14/PAGE/42/FULLTEXT/