19. ALEXANDER KP, SHAW LJ, SHAW LK, DELONG ER, MARK DB, PETERSON ED. Value of exercise treadmill testing in women . J Am Coll Cardiol. 1998; 32 :1657-64.
20. KLIGFIELD P, LAUER MS. Exercise electrocardiogram testing: beyond the ST segment. Circulation. 2006; 114 :2070–2082.
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22. GULATI M, ARNSDORF MF, SHAW LJ, PANDEY DK, THISTED RA
Diana Aniela Moldovan, Maria Despina Baghiu, Alina Balas and Sorana Teodora Truta
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
Dana Pop, P. Peter, Alexandra Dădârlat, Adela Sitar-Tăut and D. Zdrenghea
Ghrelin, a newly discovered bioactive peptide, was originally reported to induce growth hormone release. Recent studies have shown beneficial hemodynamic effects of ghrelin in the cardiovascular system to support the wide distribution of its receptors in cardiovascular tissues. The aim of the study was to determine whether cardiovascular risk factors influence plasma ghrelin levels.
Methods. We evaluated in the Rehabilitation Hospital Cluj-Napoca, Cardiology - Department 88 consecutive subjects, 65 (73.86%) being women, with mean age 61.7±10.33 years. We assessed the presence of cardiovascular risk factors (obesity, arterial hypertension, diabetes mellitus, metabolic syndrome, smoking and lipid fractions). Plasma ghrelin levels were determined with a commercial ELISA kit (pg/ml).
Results. After the evaluation of cardiovascular risk factors, we found no statistically significant difference between ghrelin levels in the patients with vs those without cardiovascular risk factors (p>0.05). A negative correlation was found between ghrelin levels and age, r = −0.32 (p <0.05). Using the HeartScore Internet tool we calculated the cardiovascular risk for each patient according to the risk score system (SCORE) for high cardiovascular risk countries. Statistically, the risk of fatal cardiovascular events in the next 10 years was indirectly correlated with the ghrelin levels in each patient - correlation between ghrelin levels and SCORE system r=−0.25, p=0.015. In conclusion, low serum ghrelin concentrations are associated with an increased global cardiovascular risk, calculated based on the European SCORE scale. However, we could not demonstrate a direct relationship between any of the major risk factors and ghrelin.
Loredana Mӑdӑlina Popa, Bogdan Timar, Amorin Remus Popa and Mircea Ioachim Popescu
, Simmons RK, Sharp SJ, Griffin SJ, Wareham NJ. Cardiovascular risk assessment scores for people with diabetes: a systematic review. Diabetologia 52: 2001-2014, 2009.
9. Pearson TA, Mensah GA, Alexander RW et al. Markers of inflammation and cardiovascular disease: application to clinical public health practice: A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation 107: 499-511, 2003.
10. Sinderman AJ, Williams K, Contois JH et al. A metaanalysis of low
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.
Shahinul Alam, SKM Nazmul Hasan, Golam Mustafa, Mahabubul Alam, Mohammad Kamal and Nooruddin Ahmad
Only few studies and pilot trials of PTX[ 14 - 16 ] suggested that pentoxifylline reduced plasma TNF- α and IL-6, ALT and AST levels but there is scarcity of data to observe improvement of NAFLD activity score (NAS) and fibrosis score in patients with nonalcoholic steatohepatitis (NASH). The aim of this study was to observe the effect of pentoxifylline on histological activity and fibrosis of Bangladeshi nonalcoholic steatohepatitis patients.
Materials and methods
This study was conducted from August 2014 to December 2015 as an open label Randomized
Nikolina Basic-Jukic, Bozidar Vujicic, Josipa Radic, Dragan Klaric, Zeljka Grdan, Goran Radulovic, Klara Juric, Karmela Altabas, Marko Jakic, Valentina Coric-Martinovic, Ivana Kovacevic-Vojtusek, Marijana Gulin, Nikola Jankovic, Dragan Ljutic and Sanjin Racki
Introduction. Residual diuresis (RD) is an important predictor of mortality and cardiovascular (CV) deaths in peritoneal dialysis (PD) patients, and contributes more to overall survival compared to PD clearance. In this study we investigated the correlation between RD and CV outcomes in PD patients.
Methods. A total of 190 PD patients from 13 dialysis centers, a national representation, were included in this analysis. Biomarkers of anemia, nutritional status [malnutrition inflammation score (MIS), subjective global assessment (SGA), serum albumin, anthropometric measurements including body mass index (BMI)], dialysis dose (Kt/V) and laboratory measurements were determined. RD was estimated using the volume of daily urine.
Results. There were 78(41.05 %) females and 112 (58.95 %) males; aged 57.35±14.41 years, on PD for 24.96±24.43 months. Fifty-six patients had diabetes type II (44 as primary kidney disease). The mean RD was 1170±673.6 ml (range 0-3000 mL). Statistically significant correlations between RD and BMI, hip circumference, time on PD, Kt/V, MIS, SGA, erythrocytes (E), Hemoglobin (Hb), PTH, and serum albumin were observed.
Conclusions. We demonstrated a significant correlation between RD and MIS score, SGA, anthropometry and albumin. Every effort should be invested to maintain RD for as long as possible to achieve optimal treatment results and to decrease CV mortality in PD population.
Syed Mudassir Laeeq, Abbas Ali Tasneem, Farina M. Hanif, Nasir Hassan Luck, Rajesh Mandhwani and Rajesh Wadhva
dysfunction and increased risk of vascular malformation. [ 2 ]
Since GI diseases are common in ESRD patients, multiple studies have been conducted to study the endoscopic findings in this population. Most common reason for endoscopic evaluation has been UGIB. [ 2 , 4 ] Several scoring systems have also been developed to classify patients with UGIB according to their outcome. One such scoring system is the Glasgow Blatchford bleeding Score (GBS), a well-established tool to stratify patients in dire need of intervention from UGIB on the basis of their history, physical
Jawaid Iqbal, Muhammad Ali Khalid, Farina M. Hanif, Rajesh Mandhwani, Syed Mudassir Laeeq, Zain Majid and Nasir Hassan Luck
Stage Liver Disease (MELD) is a validated chronic liver disease (CLD) severity scoring system that includes serum bilirubin, serum creatinine, and the international normalized ratio (INR). An increasing MELD score is associated with progression of hepatic dysfunction, severity and three-month mortality risk.[ 5 ] MELD is also used to prioritize patients on liver transplant waiting list. It is considered better than the Child-Turcotte-Pugh (CTP) score, in part, because of the inclusion of creatinine, which reflects the prognostic impact of renal function.[ 6