19 results on '"Sangle, S"'
Search Results
2. Hyperkalemia due to fertilizer (N:P:K) poisoning
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Korade, M., Sangle, S., Deshpande, N., and Dhadke, S.
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Ethnic, cultural, racial issues/studies ,Social sciences ,Women's issues/gender studies - Abstract
Byline: M. Korade, S. Sangle, N. Deshpande, S. Dhadke Sir, Synthetic fertilizers are used increasingly all over the world due to their immediate effect as very high yield in food [...]
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- 2013
3. Hypothyroidism - gait matters
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Sangle, S., Lohiya, R., Sharma, D., and Bote, N.
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Gait disorders -- Reports ,Hypothyroidism -- Complications and side effects -- Reports ,Cerebellar ataxia -- Causes of -- Reports ,Ethnic, cultural, racial issues/studies ,Social sciences ,Women's issues/gender studies - Abstract
Byline: S. Sangle, R. Lohiya, D. Sharma, N. Bote Sir, Hypothyroidism-related neurological sequel has a wide spectrum ranging from mild difficulty in concentrating to deep coma. Ataxias are known to [...]
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- 2012
4. Authors' Reply
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Lohiya, R. and Sangle, S.
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Atropine -- Dosage and administration ,Salivary glands -- Diseases ,Ethnic, cultural, racial issues/studies ,Social sciences ,Women's issues/gender studies - Abstract
Byline: R. Lohiya, S. Sangle Sir, We appreciate the interest shown by the author in our article. [sup][1] The author has proposed an alternative mechanism for parotitis in a patient [...]
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- 2012
5. Uncommon manifestation of organophosphorus poisoning
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Lohiya, R. and Sangle, S.
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Poisoning -- Diagnosis -- Case studies ,Dacryocystitis -- Causes of -- Case studies ,Salivary glands -- Diseases ,Organophosphorus compounds -- Health aspects ,Ethnic, cultural, racial issues/studies ,Social sciences ,Women's issues/gender studies - Abstract
Byline: R. Lohiya, S. Sangle Organophosphorus compounds (OPC) act by inhibition of acetyl cholinesterase enzyme leading to the accumulation of acetylcholine at synapses, which results in acute cholinergic crisis. Excess [...]
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- 2011
6. The point prevalence of an abnormal ankle-brachial index in antiphospholipid antibody negative patients with livedo reticularis: a controlled study
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Sangle, S., Christodoulou, C., Paul, S., Hughes, G.R.V., and D'Cruz, D.P.
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Pigmentation disorders -- Development and progression ,Antiphospholipid antibodies -- Physiological aspects ,Ankle -- Physiological aspects ,Ankle -- Medical examination ,Brachial artery -- Physiological aspects ,Brachial artery -- Medical examination ,Blood pressure -- Measurement ,Blood pressure -- Analysis ,Health - Published
- 2008
7. Prevalence of an abnormal ankle-brachial index in patients with antiphospholipid syndrome with pregnancy loss but without thrombosis: a controlled study
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Christodoulou, C., Zain, M., Bertolaccini, M.L., Sangle, S., Khamashta, M.A., Hughes, G.R.V., and D'Cruz, D.P.
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Antiphospholipid syndrome -- Research ,Antiphospholipid syndrome -- Physiological aspects ,Pregnant women -- Research ,Pregnant women -- Physiological aspects ,Pregnant women -- Complications and side effects ,Atherosclerosis -- Diagnosis ,Antiphospholipid antibodies -- Research ,Antiphospholipid antibodies -- Physiological aspects ,Health - Published
- 2006
8. Livedo reticularis and pregnancy morbidity in patients negative for antiphospholipid antibodies
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Sangle, S., D'Cruz, D.P., and Hughes, G.R.V.
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Pregnancy, Complications of -- Risk factors ,Antiphospholipid antibodies -- Health aspects ,Antiphospholipid antibodies -- Research ,Systemic lupus erythematosus -- Complications and side effects ,Health - Published
- 2005
9. Renal artery stenosis in hypertensive patients with antiphospholipid (Hughes) syndrome: outcome following anticoagulation
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Sangle, S. R., D'Cruz, D. P., Abbs, I. C., Khamashta, M. A., and Hughes, G. R. V.
- Abstract
Objective. We have demonstrated a point prevalence of 26% renal artery stenosis in patients with antiphospholipid syndrome (APS) and uncontrolled hypertension. We describe the effect of anticoagulation on blood pressure control and renal function.Methods. We studied 23 patients retrospectively with renal artery stenosis (RAS). Fourteen received oral anticoagulation for more than 1 yr (target International Normalized Ratio (INR) of 3.0–4.5). Five patients had primary APS. Patients were divided into two groups based on their INR (<3.0 and ≥3.0). Nine patients had repeat magnetic resonance angiography (MRA) or an angiogram of the renal arteries after 2 yr.Results. Only 8/14 patients managed to maintain their INR ≥3.0 (median INR 3.1, range 2.8–3.7) while six had a INR <3.0 (median INR 1.9, range 1.2–2.4). Patients with a median INR <3.0 had poorly controlled blood pressure and there was significant deterioration in mean serum creatinine values (Wilcoxon's test, P<0.03). Nine patients underwent follow-up renal artery imaging. Three of nine patients with an INR <3.0 (median INR 1.9) had re-stenosis and a fourth developed bilateral renal artery stenosis. Five patients with INR ≥3.0 (median INR 3.1) did not show re-stenosis of the renal arteries; their renal function was stable and blood pressure was well controlled. One other patient with secondary APS (mixed connective tissue disorder) with INR >3.0 showed recanalization of the stenosed renal artery.Conclusion. Anticoagulation with INR maintained ≥3.0 helped to control the blood pressure and prevent the progression of renal disease.
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- 2005
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10. Adult onset Still's disease and collapsing glomerulopathy: successful treatment with intravenous immunoglobulins and mycophenolate mofetil
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Bennett, A. N., Peterson, P., Sangle, S., Hangartner, R., Abbs, I. C., Hughes, G. R. V., and D'Cruz, D. P.
- Abstract
In this Grand Round we present a 32-yr-old African man who became severely ill after a 5-month history of weight loss, pyrexia, arthralgia, sweats and rash. He went on to develop pericarditis, pericardial effusion with tamponade, hepatomegaly with abnormal liver function tests, lymphadenopathy, massive proteinuria and required ventilatory, circulatory and renal support. The differential diagnosis was adult onset Still's disease, systemic lupus erythematosus (SLE), infection and lymphoma. Primary infection and lymphoma were excluded and he was treated, with dramatic success, with intravenous immunoglobulins (IVIG). Subsequent renal biopsy excluded SLE but confirmed collapsing glomerulopathy. The proteinuria improved dramatically following treatment with mycophenolate mofetil. We discuss some of the difficult diagnostic and management issues raised by this patient and the different uses and mechanisms of action of IVIG.
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- 2004
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11. Topical tacrolimus therapy of resistant cutaneous lesions in lupus erythematosus: a possible alternative
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Lampropoulos, C. E., Sangle, S., Harrison, P., Hughes, G. R. V., and D'Cruz, D. P.
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Objective. To determine the efficacy of tacrolimus ointment 0.1% on resistant cutaneous lesions in patients with lupus erythematosus.Methods. Twelve patients with skin manifestations were studied. Six had discoid lupus (DL), four subacute cutaneous lupus erythematosus (SCLE) and two systemic lupus erythematosus (SLE). All patients had extensive skin lesions refractory to previous treatment. Patients received topical tacrolimus 0.1% for a minimum of 6 weeks and response was evaluated by physicians’ and patients’ assessment and documented with photographs at baseline and at the end of the treatment.Results. Eleven of 12 patients completed the therapy. One patient with DL discontinued because of side-effects—peeling and a burning sensation. Six patients were clearly improved, one patient had a minor remission of his face lesion while in four the rashes remained the same. Two patients with SCLE had significant regression of their lesions while the other two had no improvement. In DL, two had certain improvement, one minor improvement and two were without response. The patients with SLE had significant amelioration of their extensive photosensitive rash.Conclusion. Tacrolimus ointment 0.1% may be an effective alternative in patients with severe resistant cutaneous manifestations in lupus erythematosus.
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- 2004
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12. Regression of cardiac hypertrophy in hypertensive patients—comparison of Abana with propranolol
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Yegnanarayan, Radha, Sangle, S. A., Sirsikar, S. S., and Mitra, D. K.
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The effect of Abana and propranolol on left ventricular hypertrophy in hypertensive individuals was studied by echocardiography. The study showed an improvement in cardiac function as indicated by an increase in ejection fraction and fractional shortening in both the Abana‐ and propranolol‐treated groups.
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- 1997
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13. Regression of cardiac hypertrophy in hypertensive patientscomparison of Abana with propranolol
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Yegnanarayan, Radha, Sangle, S. A., Sirsikar, S. S., and Mitra, D. K.
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The effect of Abana and propranolol on left ventricular hypertrophy in hypertensive individuals was studied by echocardiography. The study showed an improvement in cardiac function as indicated by an increase in ejection fraction and fractional shortening in both the Abana- and propranolol-treated groups. A decrease in cardiac mass with propranolol was seen at 12 weeks and was maintained up to 36 weeks. With Abana the reduction in mass was seen from 18 weeks onwards and lasted up to 42 weeks. In five patients on Abana and two on propranolol, the trial was continued for a further period of 84 weeks, but the effects seen at 84 weeks were not significantly different from these at 60 weeks. © 1997 John Wiley & Sons, Ltd.
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- 1997
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14. Hepatomegaly as a rare presentation of Churg–Strauss syndrome
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Bennett, A. N., Sangle, S. R., Jan, W., Jenner, M., Cavenagh, J., Hughes, G., and D'Cruz, D. P.
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- 2005
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15. Intracerebral arterial stenosis with neurological events associated with antiphospholipid syndrome
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Wong, M., Sangle, S., Jan, W., Hughes, G. R. V., and D'Cruz, D. P.
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- 2005
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16. Dermatomyositis developing in a Duchenne muscular dystrophy carrier
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Bennett, A. N., Sangle, S. R., Hughes, G. R. V., and D’Cruz, D. P.
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- 2004
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17. Abstracts
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Doulaptsis, C, Masci, PG, Goetschalckx, K, Janssens, S, Bogaert, J, Ferreira, VM, Piechnik, SK, DallArmellina, E, Karamitsos, TD, Francis, JM, Ntusi, N, Holloway, C, Choudhury, RP, Kardos, A, Robson, MD, Friedrich, MG, Neubauer, S, Miszalski-Jamka, T, Sokolowska, B, Szczeklik, W, Karwat, K, Miszalski-Jamka, K, Belzak, K, Malek, L, Mazur, W, Kereiakes, DJ, Jazwiec, P, Musial, J, Pedrotti, P, Masciocco, G, DAngelo, L, Milazzo, A, Quattrocchi, G, Zanotti, F, Frigerio, M, Roghi, A, Rimoldi, O, Kaasalainen, T, Kivistö, S, Holmström, M, Pakarinen, S, Hänninen, H, Sipilä, O, Lauerma, K, Banypersad, S.M, Fontana, M, Maestrini, V, Sado, D.M, Pinney, J, Wechalekar, A.D, Gillmore, J.D, Lachmann, H, Hawkins, P.N, Moon, J.C, Barone-Rochette, G, Pierard, S, Seldrum, S, de Ravensteen, CM, Melchior, J, Maes, F, Pouleur, A-C, Vancraeynest, D, Pasquet, A, Vanoverschelde, J-L, L Gerber, B, Captur, G, Muthurangu, V, Flett, AS, Wilson, R, Barison, A, Anderson, S, Cook, C, Sado, DM, McKenna, WJ, Mohun, TJ, Elliott, PM, Moon, JC, Pepe, A, Meloni, A, Gulino, L, Rossi, G, Paci, C, Spasisno, A, keilberg, P, Restaino, G, Resta, MC, Positano, V, lombardi, M, Reiter, U, Reiter, G, Kovacs, G, Schmidt, A, Olschewski, H, Fuchsjäger, M, Macmillan, A, Dabir, D, Rogers, T, Monaghan, M, Nagel, E, Puntmann, V, Semaan, E, Spottiswoode, B, Freed, B, Carr, M, Wasielewski, M, Fortney-Campione, K, Shah, S, Carr, J, Markl, M, Collins, J, Sung, YM, Hinojar, R, Ucar, EA, Dabir, D, Voigt, T, Gaddum, N, Schaeffter, T, Nagel, E, Puntmann, VO, Dabir, D, Rogers, T, Ucar, EA, Kidambi, A, Plein, S, Gebker, R, Schnackenburg, B, Voigt, T, Schaeffter, T, Nagel, E, Puntmann, VO, McAlindon, E, Bucciarelli-Ducci, C, Sado, D, Maestrini, V, Piechnik, S, Porter, J, Yamamura, J, Fischer, R, Moon, J, Symons, R, Doulaptsis, C, Masci, P.G, Goetschalckx, K, Dymarkowski, S, Janssens, S, Bogaert, J, Yalin, K, Golcuk, E, Ozer, CS, Buyukbayrak, H, Yilmaz, R, Dursun, M, Bilge, AK, Adalet, K, Reinstadler, SJ, Klug, G, Feistritzer, HJ, Mayr, A, Harrasser, B, Krauter, L, Mair, J, Schocke, MF, Pachinger, O, Metzler, B, Rigolli, M, To, A, Edwards, C, Ding, P, Christiansen, J, Rodríguez-Palomares, JF, Ortiz, JT, Bucciarelli, C, Lee, D, Wu, E, Bonow, RO, Karwat, K, Tomala, M, Miszalski-Jamka, K, Licholaj, S, Mazur, W, Kereiakes, DJ, Nessler, J, Zmudka, K, Jazwiec, P, Miszalski-Jamka, T, Peltonen, J, Kaasalainen, T, Kivistö, S, Holmström, M, Lauerma, K, Rutz, T, Meierhofer, C, Martinoff, S, Ewert, P, Hess, J, Stern, H, Fratz, S, Groarke, JD, Waller, AH, Blankstein, R, Kwong, RY, Steigner, M, Alizadeh, Z, Alizadeh, A, Khajali, Z, Mohammadzadeh, A, Kaykhavani, A, Heidarali, M, Singh, A, Bekele, S, Gunarathne, A, Khan, J, Nazir, SN, Steadman, CD, Kanagala, P, Horsfield, MA, McCann, GP, Duncan, RF, Dundon, BK, Nelson, AJ, Williams, K, Carbone, A, Worthley, MI, Zaman, A, Worthley, SG, Monney, P, Piccini, D, Rutz, T, Vincenti, G, Koestner, S, Stuber, M, Schwitter, J, Gripari, P, Maffessanti, F, Pontone, G, Andreini, D, Bertella, E, Mushtaq, S, Caiani, EG, Pepi, M, El ghannudi, S, Nghiem, A, Germain, P, Jeung, M-J, Roy, C, Gangi, A, Nucifora, G, Muser, D, Masci, PG, Barison, A, Piccoli, G, Rebellato, L, Puppato, M, Gasparini, D, Lombardi, M, Proclemer, A, Nucifora, G, Muser, D, Masci, PG, Barison, A, Piccoli, G, Rebellato, L, Puppato, M, Gasparini, D, Lombardi, M, Proclemer, A, Pöyhönen, P, Kivistö, S, Holmströn, M, Hänninen, H, Thorning, C, Bickelhaupt, S, Kampmann, C, Wentz, KU, Widmer, U, Juli, CF, Miszalski-Jamka, K, Klys, J, Glowacki, J, Kijas, M, Miszalski-Jamka, T, Adamczyk, T, Kwiecinski, R, Bogucka-Czapska, J, Ozaist, M, Mazur, W, Kluczewska, E, Kalarus, Z, Kukulski, T, Karakus, G, Marzluf, B, Bonderman, D, Tufaro, C, Pfaffenberger, S, Babyev, J, Maurer, G, Mascherbauer, J, Kockova, R, Tintera, J, Kautznerova, D, Cerna, D, Sedlacek, K, Kryze, L, El-Husseini, W, Sikula, V, Segetova, M, Kautzner, J, Vasconcelos, M, Lebreiro, A, Martins, E, Cardoso, JS, Madureira, AJ, Ramos, I, Maciel, MJ, Florian, A, Ludwig, A, Rösch, S, Sechtem, U, Yilmaz, A, Monmeneu, J.V, López-Lereu, M.P, Bonanad, C, Sanchis, J, Chaustre, F, Merlos, P, Valero, E, Bodí, V, Chorro, F.J, Yalin, K, Golcuk, E, Ozer, CS, Buyukbayrak, H, Yilmaz, R, Dursun, M, Bilge, AK, Adalet, K, Klug, G, Reinstadler, SJ, Feistritzer, HJ, Mayr, A, Riegler, N, Schocke, M, Esterhammer, R, Kremser, C, Pachinger, O, Metzler, B, Siddiqi, N, Cameron, D, Neil, C, Jagpal, B, Singh, S, Schwarz, K, Papadopoulou, S, Frenneaux, MP, Dawson, D, Robbers, LFHJ, Eerenberg, ES, Teunissen, PFA, Jansen, MF, Hollander, MR, Horrevoets, AJG, Knaapen, P, Nijveldt, R, Levi, MM, van Rossum, AC, Niessen, HWM, Marcu, CB, Beek, AM, van Royen, N, Everaars, H, Robbers, LFHJ, Nijveldt, R, Beek, AM, Teunissen, PFA, Hirsch, A, van Royen, N, Zijlstra, F, Piek, JJ, van Rossum, AC, Goitein, O, Grupper, A, Hamdan, A, Eshet, Y, Beigel, R, Medvedofsky, D, Herscovici, R, Konen, E, Hod, H, Matetzky, S, Cadenas, R, Iniesta, AM, Refoyo, E, Antorrena, I, Guzman, G, Cuesta, E, Salvador, O, López, T, Moreno, M, López-Sendon, JL, Alam, SR, Spath, N, Richards, J, Dweck, M, Shah, A, Lang, N, Semple, S, MacGillivray, T, Mckillop, G, Mirsadraee, S, Pessotto, R, Zamvar, V, Newby, DE, Henriksen, P, Reiter, G, Reiter, U, Kovacs, G, Olschewski, H, Fuchsjäger, M, Ahmad, S, Raza, U, Malik, A, Sun, JP, Eisner, R, Mazur, W, ODonnell, R, Positano, V, Meloni, A, Santarelli, MF, Landini, L, Tassi, C, Grimaldi, S, Gulino, L, De Marchi, D, Chiodi, E, Renne, S, Lombardi, M, Pepe, A, Wu, L, Germans, T, Güçlü, A, Allaart, CP, van Rossum, AC, Kalisz, K, Lehenbauer, K, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, M-P, Freed, B, Shah, S, Markl, M, Flukiger, J, Carr, J, Collins, J, Osiak, A, Tyrankiewicz, U, Jablonska, M, Jasinski, K, Jochym, PT, Chlopicki), S, Skorka, T, Kalisz, K, Semaan, E, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, MP, Freed, B, Flukiger, J, Lee, D, Kansal, P, Shah, S, Markl, M, Carr, J, Collins, J, Groarke, JD, Shah, RV, Waller, AH, Abbasi, SA, Kwong, RY, Blankstein, R, Steigner, M, Chin, CWL, Semple, S, Malley, T, White, A, Prasad, S, Newby, DE, Dweck, M, Pepe, A, Meloni, A, Lai, ME, Vaquer, S, Gulino, L, De Marchi, D, Cuccia, L, Midiri, M, Vallone, A, Positano, V, Lombardi, M, Pedrotti, P, Milazzo, A, Quattrocchi, G, Roghi, A, Rimoldi, O, Barison, A, De Marchi, D, Masci, P, Milanesi, M, Aquaro, GD, Keilberg, P, Positano, V, Lombardi, M, Positano, Vincenzo, Barison, Andrea, Pugliese, Nicola Riccardo, Masci, Piergiorgio, Del Franco, Annamaria, Aquaro, Giovanni Donato, Landini, Luigi, Lombardi, Massimo, Dieringer, MA, Deimling, M, Fuchs, K, Winter, L, Kraus, O, Knobelsdorff-Brenkenhoff, FV, Schulz-Menger, J, Niendorf, T, Hinojar, R, Ucar, EA, DCruz, D, Sangle, S, Dabir, D, Voigt, T, Gaddum, N, Schaeffter, T, Nagel, E, Puntmann, VO, Sung, YM, Pontone, G, Andreini, D, Bertella, E, Mushtaq, S, Gripari, P, Cortinovis, S, Loguercio, M, Baggiano, A, Conte, E, Pepi, M, El ghannudi, S, Hop, O, Germain, P, Jeung, M-J, De Cesare, A, Roy, C, Gangi, A, Barone-Rochette, G, Pierard, S, Seldrum, S, De Meester de Ravensteen, C, Melchior, J, Maes, F, Pouleur, A-C, Vancraeynest, D, Pasquet, A, Vanoverschelde, J-L, L Gerber, B, Bekele, S, Singh, A, Khan, JN, Nazir, SA, Kanagala, P, McCann, GP, Singh, A, Steadman, CD, Bekele, S, Khan, JN, Nazir, SA, Kanagala, P, McCann, GP, Paelinck, BP, Vandendriessche, T, De Bock, D, De Maeyer, C, Parizel, PM, Christiaan, J, Trauzeddel, RF, Gelsinger, C, Butter, C, Barker, A, Markl, M, Schulz-Menger, J, von Knobelsdorff, F, Florian, A, Schäufele, T, Ludwig, A, Rösch, S, Wenzelburger, I, Yilmaz, A, Sechtem, U, López-Lereu, M.P, Bonanad, C, Monmeneu, J.V, Sanchís, J, Estornell, J, Igual, B, Maceira, A, Chorro, F.J, Focardi, M, Cameli, M, Bennati, E, Massoni, A, Solari, M, Carbone, F, Banchi, B, Mondillo, S, Miia, H, Kirsi, L, Helena, H, Tiina, H, Jyri, L, Pauli, P, Sari, K, Schumm, J, Greulich, S, Grün, S, Ong, P, Klingel, K, Kandolf, R, Sechtem, U, Mahrholdt, H, Raimondi, F, Ou, P, Boudjemline, Y, Bajolle, F, Iserin, F, Bonnet, D, Collins, J, Kalisz, K, Benefield, B, Sarnari, R, Katz, D, Bi, X, Cordts, M, Guetter, C, Jolly, M-P, Freed, B, Flukiger, J, Kansal, P, Lee, D, Shah, S, Markl, M, Carr, J, Sokolowska, B, Miszalski-Jamka, T, Szczeklik, W, Karwat, K, Miszalski-Jamka, K, Belzak, K, Mazur, W, Kereiakes, DJ, Jazwiec, P, Musial, J, Silva, G, Almeida, AG, Resende, C, Marques, JS, Silva, D, David, C, Amaro, C, Costa, P, Silva, JAP, Diogo, AN, Tsokolov, AV, Senchilo, VG, Vertelkin, AV, Hoffmann, P, Mykjåland, G, Wangberg, H, Tønnessen, T, Sjaastad, I, Nordsletten, L, Hjørnholm, U, Løset, A, Rostrup, M, Meloni, A, Gulino, L, Keilberg, P, Palazzi, G, Maddaloni, D, Ascioti, C, Missere, M, Salvatori, C, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Filosa, A, Gulino, L, Pulini, S, Salvatori, C, Chiodi, E, Ascioti, C, Keilberg, P, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Gulino, L, Pietrapertosa, A, Izzi, G, De Marchi, D, Valeri, G, Preziosi, P, Positano, V, Lombardi, M, Pepe, A, Meloni, A, Ruffo, GB, Keilberg, P, Gulino, L, Gerardi, C, Sallustio, G, Tudisca, C, Positano, V, Lombardi, M, Pepe, A, Greulich, S, Backes, M, Schumm, J, Grün, S, Sechtem, U, Mahrholdt, H, Dorniak, K, MSc, AS, Szurowska, E, Fijalkowski, M, Rawicz-Zegrzda, D, Dudziak, M, Raczak, G, Hamdan, A, Baker, FA, Klein, M, Di Segni, E, Goitein, O, Fibisch, G, Konen, E, Müller-Bierl, B, Tanaka, K, Buls, N, Fierens, Y, van Cauteren, T, Willekens, I, van Laere, S, Luypaert, R, de Mey, J, Muzzarelli, S, Faragasso, E, Pedrazzini, G, Sürder, D, Pasotti, E, Moccetti, T, Faletra, F, Qayyum, AA, Hasbak, P, Larsson, HB, Mathiasen, AB, Vejlstrup, NG, Kjaer, A, Kastrup, J, Moschetti, K, Favre, D, Pinget, C, Pilz, G, Petersen, S, Wagner, A, Wasserfallen, JB, Schwitter, J, Ghosh Dastidar, A, Cengarle, M, McAlindon, E, Augustine, D, Nightingale, AK, Bucciarelli-Ducci, C, Dandekar, VK, Ertel, AW, Dickens, C, Gonzalez, RC, Farzaneh-Far, A, Ripley, DP, Higgins, D, McDiarmid, AK, Bainbridge, GJ, Uddin, A, Kidambi, A, Herzog, B, Greenwood, JP, Plein, S, Khanji, M, Newton, T, Westwood, M, Sekhri, N, and Petersen, SE
- Abstract
Background-Aims: Early post-infarction pericardial injury is a common finding but its diagnosis remains elusive. Though C-reactive protein (CRP) is considered a marker of myocardial damage, reflecting myocardial inflammation at the infarcted area, we sought to assess the relationship between CRP and pericardial injury depicted by cardiovascular magnetic resonance (CMR) imaging in patients with ST elevation myocardial infarction (MI). Methods and results: 181 MI patients (84% male) were studied with CMR in the first week and at 4 months post-infarction to assess infarct characteristics, left ventricular volumes/function and pericardial injury. The latter was defined as pericardial fluid >4mm and/or enhancement on late gadolinium enhancement CMR. The CRP-value at day 2 (according to previous literature) was used for correlation with CMR and clinical parameters. Pericardial injury was noted in 87 patients, i.e. effusion (n = 30), inflammation (n = 46), both (n = 11). Patients with pericardial injury had significantly higher peak values of cardiac biomarkers (p<0.001) and higher peak CRP-values than patients with normal pericardium (median 13 vs 43 mg/dl, p<0.001). A strong correlation was found between peak CRP-values and a) left venticular ejection fraction and infarct size both at 1 week and 4 months, b) myocardial hemorrhage, microvascular obstruction (MVO) and pericardial injury at 1 week, c) cardiac biomarkers values and time to PCI. However in a multiple regression model only pericardial injury (p = 0.003) and less importantly time to PCI (p = 0.022) were the independent predictors of CRP values. Conclusion: Pericardial damage described by cardiac MRI occurs often after acute ST elevation MI. CRP-values at the acute phase of MI reflect not only inflammation at the infarcted area but even more the inflammation of the surrounding pericardial tissue.
Table 1 Comparison of baseline clinical and biochemical parameters of patients with or without evidence of early post-infarct pericardial damage on CMR Normal Group (n = 94) Pericardial injury group (n = 87) p-value Agem, years 59±11 60±12 0.48 Male, n(%) 83 (88) 69 (79) 0.10 Diabets, n(%) 12 (13) 9 (10) 0.61 Smoker, n(%) 52 (55) 44 (51) 0.52 Hyperlipidemia, n(%) 56 (60) 55 (63) 0.62 BSA m2 2.0 ± 0.2 2.0 ± 0.2 0.20 Time to PCI, min 195 (155 − 274) 223 (160 − 335) 0.20 Troponin I, μ/l 44 (19 − 92) 90 (44 − 149) >0.001 CK-MB, U/L 128 (77 − 216) 250 (143 − 443) >0.001 CRP, mg/dL 13 (7 − 28) 43 (16 − 96) >0.001 Day of peak CRP 2 (1 − 3) 2 (1 − 3) 0.39 Table 2 Significant correlations between CRP Values and corresponding CMR measurements, cardic biomarkers and clinical related parameters Varibles Spearmanscorrelations r p-value CMR parameters 1 week LV EF −0.28 >0,001 Infractsize(%ofLV) 0.40 >0,001 Microvasular obstruction 0.27 >0,001 Hemorrhage 0.33 >0,001 Size of area atrisk 0.31 >0,001 Transmurality 0.30 >0,001 Pericaldial damage 0.43 >0,001 CMR parameters 4 months LVEF −0.43 >0,001 Infarctsize(%ofLV) 0.46 >0,001 Cardiac Biomarkers Peak TnI 0.34 >0,001 Peak CK-MB 0.32 >0,001 Other Time to PCI 0,182 0,007 - Published
- 2013
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18. Reply
- Author
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Sangle, S., Karim, Y., Hughes, G. R., and D'Cruz, D. P.
- Published
- 2003
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19. Sulphamethoxazole-trimethoprim in the treatment of limited paranasal Wegener's granulomatosis
- Author
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Sangle, S., Karim, M. Y., Hughes, G. R. V., and D'Cruz, D. P.
- Published
- 2002
- Full Text
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