febrile children younger than 3 years old. Acad Emerg Med. 2014;21:171-9. 15. Nijman RG, Vergouwe Y, Thompson M, et al. Clinical prediction model to aid emergency doctors managing febrile children at risk of serious bacterial infections: diagnostic study. BMJ. 2013:346:f1706. 16. Galetto-Lacour A, Zamora SA, Gervaix A. A score identifying serious bacterial infections in children with fever without source. Pediatr Infect Dis. 2008;27:654-6. 17. Galetto-Lacour A, Zamora SA, Andreola B, et al. Validation of a laboratory index score for the identification of severe
Diana Aniela Moldovan, Maria Despina Baghiu, Alina Balas and Sorana Teodora Truta
Diana Opincariu, Monica Chițu, Nora Rat and Imre Benedek
The objective of this study was to study the integrated score of ST-segment resolution (ISSTE) and in-hospital death in patients undergoing primary percutaneous intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI).
Material and Methods: This prospective study included 586 consecutive patients admitted with STEMI to the Cardiology Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș, between January 1st, 2013 and December 31, 2014, who underwent pPCI in less than twelve hours after the onset of symptoms. Clinical and demographic data were analyzed in 539 (91.9%) survivors (Group 1) and 47 (8.1%) nonsurvivors (Group 2). The Integrated Score of ST elevation (ISSTE) was calculated by summing the amplitude of the ST segment elevation in all the 12 leads, before and at 2 hours after revascularization.
Results: The ISSTE score calculated at baseline, immediately before the primary percutaneous coronary intervention, was significantly higher in Group 2 as compared to Group 1 (13.9 ± 1.2 vs. 11.0 ± 0.2, p = 0.026). At the same time, the ISSTE score calculated at 2 hours after the coronary intervention was significantly higher for patients in Group 2 (7.36 ± 1.12 vs. 2.9 ± 0.1, p <0.0001). Analysis of the dynamics of the ISSTE score indicated that patients who survived presented a more expressed reduction in the ISSTE score following pPCI, as compared to those who subsequently died (73.5% reduction in Group 1 compared to 47.2% reduction in Group 2, p <0.0001). In-hospital mortality was significantly higher in the group of patients with >50% reduction in the ISSTE score. The in-hospital death rate was 5.4% in patients with >50% reduction in the ISSTE score, compared to 19.4% for those who presented less than 50% reduction in the ISSTE score following pPCI (p <0.0001). The rate of successful reperfusion rate, expressed by the reduction in ISSTE score, was 83.8% in Group 1, compared to 55.3% in Group 2 (p <0.0001), indicating that the absence of an efficient reperfusion after pPCI is associated with a higher mortality in STEMI patients, and could be evaluated using regression of the ISSTE score, which proved to be directly associated with mortality.
Conclusion: The ISSTE score is shown to be an effective ECG-derived marker of myocardial damage in STEMI patients. A high ISSTE score is associated with higher mortality, while a reduction in the ISSTE score after pPCI may indicate an efficient reperfusion and a decrease in mortality in the first days after infarction.
Emese Rapolti, Theodora Benedek, István Kovács, Szilamér Korodi, Zsuzsanna Suciu, Sebastian Condrea, Edvin Benedek, András Mester and Imre Benedek
Introduction: Peripheral artery disease, a frequent consequence of atherosclerosis, is usually associated with concomitant ischaemic coronary artery disease and with a high rate of cardiovascular mortality.
Material and methods: The study population consisted of 24 patients, admitted to our clinic with peripheral artery disease, 10 of them with critical limb ischaemia. In all cases, cardiovascular risk factors, left ventricular dysfunction and ejection fraction were analyzed. Peripheral Multislice Angio CT examination was used to determine the TASC class and to assess the peripheral arterial lesions. The Coronary Calcium Score and the Syntax Score were determined with angio CT of the coronary arteries.
Results: Patients were between 39 and 84 years of age, and 54% were in Fontaine class 2B, 21% in Fontaine class 3 and 25% in Fontaine class 4. 12.5% of patients presented TASC class A, 33.3% TASC class B, and 54.2% TASC class C. Coronary Calcium Scores were between 0 and 100 in 16.6% of patients, between 100 and 400 in 41.8%, and >400 in 41.6% of patients. The SYNTAX Score was <22 in 54% of patients, between 22 and 32 in 37.5%, and >32 in 8.5% of patients. A significant correlation was found between the Coronary Calcium Score and the SYNTAX Score (r = 0.82, p = 0.03). The Syntax Score was 22.43 ± 3.2 in TASC A patients, 26.2 ± 5.4 in TASC B patients, 32.1 ± 2.3 in TASC C patients (p = 0.005).
Conclusions: The severity of coronary artery disease characterized by the Syntax Score, by the presence of left main stenosis and segmental left ventricular hypokinesis presents significant correlation with the severity of peripheral artery disease, characterized by the TASC classification.
Victoria Rus, Diana Opincariu, Roxana Hodas, Tiberiu Nyulas, Marian Hintea and Theodora Benedek
-0959.2004.17603.x. 15. Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, et al. CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp. 2005;20:38-45. 16. Iwakami N, Nagai T, Furukawa TA, et al. Prognostic value of malnutrition assessed by Controlling Nutritional Status score for long-term mortality in patients with acute heart failure. Int J Cardiol. 2017;230:529-536. doi: 10.1016/j.ijcard.2016.12.064. 17. Toyokawa T, Kubo N, Tamura T, et al. The pretreatment Controlling Nutritional Status (CONUT) score is
Alina Cordunean, Roxana Hodaş, Sorin Pop, Nora Rat, Laura Jani, Alexandra Stănescu, Imre Benedek and Theodora Benedek
C, Callister TQ, Browner WS. What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk. BMC Med . 2004;2:31. 11. Moses JW1, Leon MB, Popma JJ et al. Sirolimus-Eluting Stents versus Standard Stents in Patients with Stenosis in a Native Coronary Artery. N Engl J Med . 2003;349(14):1315-23. 12. Wiebe J, Nef HM, Hamm CW. Current status of bioresorbable scaffolds in the treatment of coronary artery disease
Mihai Roman, Radu Prejbeanu, Andrei-Marian Feier, Octav Russu, Adrian Todor, Vlad Predescu, Bogdan Codorean, Tiberiu Bățagă and Radu Fleaca
ligament injuries. Clin Orthop Relat Res. 1985;(198):43-49. 4. Mitsou A, Vallianatos P, Piskopakis N, et al. Anterior cruciate ligament reconstruction by over-the-top repair combined with popliteus tendon plasty. J Bone Joint Surg Br. 1990;72:398-404. 5. Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS) - development of a selfadministered outcome measure. J Orthop Sports Phys Ther. 1998;28:88-96. 6. Irrgang JJ, Anderson AF, Boland AL, et al. Development and validation
Ipek Saadet Edipoglu, Behiye Dogruel, Sevda Dizi, Melis Tosun and Nahit Çakar
Med 2012; 38: 1654-1661. doi: 10.1007/s00134-012-2629-6 4. Sacanella E, Pérez-Castejón JM, Nicolás JM, Masanés F, Navarro M, Castro P, et al. Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study. Crit Care 2011; 15: R105. doi: 10.1186/cc10121 5. Leong IY, Tai DY. Is increasing age associated with mortality in the critically ill elderly. Singapore Med J 2002; 43: 33-36 6. Huang Y, Chen J, Zhong S, Yuan J. Role of APACHE-II scoring system in the prediction of
Sebastian Trancă, Cristina Petrișor, Natalia Hagău and Constantin Ciuce
predictor of sepsis and outcome in severe trauma patients: a prospective study. J Lab Physicians. 2013;5:100-8. 8. Angus DC, Wax RS. Epidemiology of sepsis: an update. Crit Care Med. 2001;29:S109-16. 9. Antonelli M, Moreno R, Vincent JL, et al. Application of SOFA score to trauma patients. Sequential Organ Failure Assessment. Intensive Care Med. 1999;25:389-94. 10. Mica L, Furrer E, Keel M, Trentz O. Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients. Eur J Trauma Emerg Surg
Roxana Hodaş, Sorin Pop, Diana Opincariu, Nora Rat, Laura Jani, Alexandra Stanescu, Edvin Benedek, Imre Benedek, Theodora Benedek and Monica Chitu
Background: Epicardial fat has been recently identified as a major player in the development of the atherosclerotic process.
Study aim: The aim of this study was to correlate the epicardial fat volume (EFV), determined by Multisclice CT, and the severity of the coronary lesions, expressed by the Coronary Calcium Score (CCS) and Syntax Score (SxS) in patients with established coronary artery disease (CAD).
Material and methods: One-hundred-twenty-six patients underwent Multisclice 64 CT assessment of coronary lesions and epicardial fat quantification. Calculation of CCS was performed on all the three coronary vessels and was followed by determination of SxS according to guidelines. The patients were divided into 2 groups: Group 1 – patients with CCS >400 (n = 26), and Group 2 — patients with CaS <400 (n = 100).
Results: The mean age of the study population was 65.32 years for Group 1 and 54 years for Group 2 (p <0.0001). However, patients >65 years of age had a high CCS in a more significant extent than younger patients (50% in Group 1 vs. 17% in Group 2, p = 0.0115). Female gender was recorded in 48% of cases in Group 2 and in 19% of cases in Group 1 (p = 0.008). Several factors were identified in a higher extent in the group with high CCS as compared with the group with low CCS, such as the presence of significant stenosis (>50%) of the left anterior descending artery (LAD) (46% vs. 9%, p <0.0001), the presence of multi-vessel coronary disease (50% vs. 5%, p <0.0001) and a high SxS, above 23 (23% vs. 4%, p = 0.006). The epicardial fat volume was 117.81 ± 40.4 ml (95% CI: 97.98–138.2 ml) in Group 2 and 89.77 ± 37.7 ml (95% CI: 80.4–101.5 ml) in Group 1 (p = 0.0033).
Conclusions: Epicardial fat volume could represent a new imaging-derived biomarker, useful for classification of the severity of coronary artery disease, increased values of EFV being associated with other biomarkers of disease severity, such as calcium score.
patients who developed ventilator-associated pneumonia. Annals of Thoracic Medicine. 2015;10:137-42. 4. Antonelli M, Moreno R, Vincent JL, Sprung CL, Mendoça A, Passariello M, et al. Application of SOFA score to trauma patients. Sequential Organ Failure Assessment. Intensive Care Med. 1999;25:389-94. 5. Mica L, Furrer E, Keel M, Trentz O. Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients. Eur J Trauma Emerg Surg. 2012;38:665-71 6. Agarwal A, Agrawal A, Maheshwari R