Search

The modern management of coronary artery disease (CAD) uses coronary computed tomography angiography (CCTA) to enhance plaque evaluation and cardiovascular risk assessment. CCTA identifies high-risk plaques, and the latest CT technologies based on calculation of fat attenuation index (FAI) allow assessment of inflammation at the level of the target coronary artery. We present a series of case studies with chest pain and positive CCTA, in whom a significant stenosis was detected in the left anterior descendent coronary artery, and the existence of high-risk, inflamed plaques was documented even in the context of a zero calcium score. A severe narrowing of the left anterior descending artery, exhibiting the pattern of high-risk anatomy, was associated with a very high inflammation depicted by FAI analysis in all three cases, an association that may be extremely dangerous. In this case series, CCTA examination led to immediate stenting of the obstructive stenosis, sealing the dangerous plaque.

Complex coronary atherosclerosis may exhibit different phenotypes of coronary plaques, from non-calcified highly vulnerable atheroma to heavily calcified ones. Computed coronary tomography angiography (CCTA) may identify these different phenotypes and the recently introduced CCTA-based techniques for mapping coronary inflammation along the coronary arteries may provide useful additional information on cardiovascular risk. Here we present the case of a 68-year-old male patient with acute coronary syndrome in whom invasive coronary angiography and CCTA revealed a severe three-vessel disease with a heavily calcified lesion. Mapping of the CT fat attenuation index along the coronary arteries identified a high level of coronary inflammation, especially associated with the non-calcified lesions. All lesions were successfully revascularized by implantation of drug-eluting stents. A cutting balloon was used for the lesion identified by CCTA as heavily calcified, followed by stent implantation, with good results. In conclusion, CCTA, in association with novel techniques for mapping coronary inflammation, may represent an extremely useful tool for preparing complex interventions in multivessel diseases, helping preprocedural planning in high-risk patients.

In the modern management of coronary artery disease (CAD), cardiac computed tomography angiography (CCTA) has emerged as a pivotal diagnostic tool, offering detailed visualization of coronary artery lumens and atherosclerotic plaques. We present the case of a 49-year-old woman, with no prior cardiovascular history but with several risk factors, in whom CCTA identified a highly inflamed atherosclerotic plaque, which led immediately to an acute myocardial infarction. Significantly, this case spotlights the vital role of perivascular inflammation mapping in CCTA, crucial for identifying high-risk plaques. The case emphasizes the necessity for a comprehensive, multifaceted diagnostic approach in the evaluation and management of CAD, incorporating advanced techniques like perivascular inflammation mapping for a more accurate and predictive assessment.

Introduction: Pharmacy-based vaccination services are now available in 56 countries, including Romania, that started administering the flu-vaccines in the community pharmacies from 2022. Assessing how pharmacists managed this new pharmaceutical service in Romania is the subject of this study. Methods: A cross-sectional study was conducted among all the pharmacies from Romania that were authorized to provide this service (442 pharmacies, from which 53 were in rural areas). An online survey was created using Google Forms and included 28 items, with 24 closed-ended questions and 4 open-ended questions. The questionnaire covered six sections: General information, Patient perspective, Authorization and training within the pharmacy, Administration of flu vaccine services, Pharmacy logistics, and Staff satisfaction. Descriptive statistics and chi-squared tests were applied. Results: In total, 180 pharmacists participated (response rate was 41%), and the respondents were the pharmacists who administered flu vaccines in these pharmacies. Among the respondents, 92.8% were from urban community pharmacies, and most of them were from Bucharest (26.1%) and East Romania. 88% of respondents considered that this new service will significantly impact the future increase in vaccine coverage rates in Romania. Regarding patients' perception of this pharmaceutical service (provided by pharmacists), the vaccination service was evaluated very positively by 63% patients and positively by 18% patients, with statistically different perceptions between the types of the pharmacies (p < 0.01). A very positive vaccination evaluation was observed more often among national chain pharmacies (73.1%) rather than among local chain pharmacies (35.9%) or independent pharmacies (36.4%). Regarding logistical barriers, 39% of pharmacies reported no issues with vaccine supply. Moreover, 97% of pharmacies had adequate protective materials to safely administer vaccines. In terms of overall satisfaction, 23% of pharmacists reported being very satisfied, while 39% indicated they were satisfied with the new pharmaceutical service they were providing. The majority (82%) felt that their salaries should be increased related to the vaccination service. Additionally, there is a need for improvements in the pharmacy schedule and the advance scheduling of vaccinations. Conclusion: This study was developed to assist future health policies through expansion of advanced pharmaceutical services, and adding other vaccines to community pharmacy portfolios. [ABSTRACT FROM AUTHOR]

Endometriosis is a benign disease but with malignant behavior, sharing numerous features with cancers. Endometriosis is the development of endometrial tissue outside the uterus, with the presence of both glands and stroma. Approximately 10% of women of reproductive age suffer from endometriosis; it involves high social costs and affects the patient's quality of life. In this review, we attempt to capture the pathogenesis mechanisms that are common to endometriosis and cancer based on molecular biology, focusing more on the principle of immunological changes and stemness. Clinical applicability will consist of targeted treatments that represent future directions in these diseases, which impose a burden on the healthcare system. Unlike endometriosis, cancer is a disease with fatal evolution, with conventional treatment based on chemo/radiotherapy. Here, we focus on the niche of personalized treatments that target molecular pathways. Our findings show that, in both pathologies, the resistance to treatments is due to the stemness of the stem cells, which might play a role in the appearance and evolution of both diseases. More research is needed before we can draw firm conclusions. [ABSTRACT FROM AUTHOR]

Long COVID-19 syndrome increases the risk of cardiovascular events. Although rare in young people, acute coronary syndromes occur more often in those recently infected with COVID-19. This report discusses a rare case of myocardial infarction in a 28-year-old male with no prior medical issues, occurring four weeks after a mild COVID-19. Initially, the patient refused invasive coronary angiography, so a coronary computed tomography angiography (CCTA) was conducted during an ST-elevation myocardial infarction (STEMI). The CCTA, using fat attenuation index (FAI) technology, revealed significant inflammation at the culprit lesion. This CCTA and FAI analysis were done shortly after the STEMI onset, before revascularization, highlighting the case's uniqueness. In patients with recent COVID-19, CCTA combined with FAI analysis of perivascular inflammation can help identify those at risk for acute coronary events. In this case, FAI analysis detected high inflammation, suggesting a potential cause for STEMI in a young patient with long COVID-19. [ABSTRACT FROM AUTHOR]

In the modern management of coronary artery disease (CAD), cardiac computed tomography angiography (CCTA) has emerged as a pivotal diagnostic tool, offering detailed visualization of coronary artery lumens and atherosclerotic plaques. We present the case of a 49-year-old woman, with no prior cardiovascular history but with several risk factors, in whom CCTA identified a highly inflamed atherosclerotic plaque, which led immediately to an acute myocardial infarction. Significantly, this case spotlights the vital role of perivascular inflammation mapping in CCTA, crucial for identifying high-risk plaques. The case emphasizes the necessity for a comprehensive, multifaceted diagnostic approach in the evaluation and management of CAD, incorporating advanced techniques like perivascular inflammation mapping for a more accurate and predictive assessment. [ABSTRACT FROM AUTHOR]

Complex coronary atherosclerosis may exhibit different phenotypes of coronary plaques, from non-calcified highly vulnerable atheroma to heavily calcified ones. Computed coronary tomography angiography (CCTA) may identify these different phenotypes and the recently introduced CCTA-based techniques for mapping coronary inflammation along the coronary arteries may provide useful additional information on cardiovascular risk. Here we present the case of a 68-year-old male patient with acute coronary syndrome in whom invasive coronary angiography and CCTA revealed a severe three-vessel disease with a heavily calcified lesion. Mapping of the CT fat attenuation index along the coronary arteries identified a high level of coronary inflammation, especially associated with the non-calcified lesions. All lesions were successfully revascularized by implantation of drug-eluting stents. A cutting balloon was used for the lesion identified by CCTA as heavily calcified, followed by stent implantation, with good results. In conclusion, CCTA, in association with novel techniques for mapping coronary inflammation, may represent an extremely useful tool for preparing complex interventions in multivessel diseases, helping preprocedural planning in high-risk patients. [ABSTRACT FROM AUTHOR]

The modern management of coronary artery disease (CAD) uses coronary computed tomography angiography (CCTA) to enhance plaque evaluation and cardiovascular risk assessment. CCTA identifies high-risk plaques, and the latest CT technologies based on calculation of fat attenuation index (FAI) allow assessment of inflammation at the level of the target coronary artery. We present a series of case studies with chest pain and positive CCTA, in whom a significant stenosis was detected in the left anterior descendent coronary artery, and the existence of high-risk, inflamed plaques was documented even in the context of a zero calcium score. A severe narrowing of the left anterior descending artery, exhibiting the pattern of high-risk anatomy, was associated with a very high inflammation depicted by FAI analysis in all three cases, an association that may be extremely dangerous. In this case series, CCTA examination led to immediate stenting of the obstructive stenosis, sealing the dangerous plaque. [ABSTRACT FROM AUTHOR]

Copyright of Medic.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Over the last years, a vast majority of serum biomarkers and imaging techniques have been used alone or combined in the diagnosis, management and prognosis of numerous pathologies. This review provides a brief insight into the novelties from the last 6 years (2010–2016) regarding serum and imaging markers in heart failure (HF). New information about natriuretic peptides (NPs), soluble ST2 (Sst2), growth differentiation factor 15 (GDF-15), myeloperoxidase (MPO), C-reactive protein (CRP), procalcitonin (PCT), troponins (Tns), myoglobin (Mb), galectin-3 (Gal-3), micro ribonucleic acids (microRNAs) and long non-coding ribonucleic acids (IncRNAs), copectin and cardiac magnetic resonance (CMR) measurements were summarized in this review in order to guide the practitioner.

Copyright of Dietetician.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Farmacia is the property of Societatea de Stiinte Farmaceutice Romania and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Vascular calcification is an independent risk factor related to cardiovascular mortality in CKD patients. Advanced aortic arch calcification assessed by semi-quantitative estimation on posteroanterior chest X-ray is a strong independent predictor of cardiovascular events in CKD and non-CKD patients, beyond traditional risk factors. An association between aortic arch calcification and hypertension has been previously reported however, the presence of CKD has not recorded in most studies. The aim of our study was to identify risk factors related to aortic arch calcification in hypertensive CKD patients. Material and method. A retrospective observational study on 63 hypertensive patients with CKD stages G2 to G4, that had a posteroanterior chest X ray available was conducted. The study population was divided into 2 groups according to presence or absence of aortic arch calcification on chest X-rays. Chest X-ray identified 43 patients with aortic arch calcification. Laboratory data were recorded for every individual simultaneously with the following comorbidities: coronary artery disease, carotid stenosis, hypertensive cardiopathy, lower extremity arterial disease. Outcomes. Groups were homogenous regarding gender distribution, creatinine levels and diabetes mellitus prevalence. We found no a statistically significant difference regarding comorbidities between the two groups. Lactate dehydrogenase and alkaline phosphatase had a statistically significant association with aortic arch calcification (p = 0.043, p = 0.006 respectively). Conclusions. Increased alkaline phosphatase remains an important risk factor for aortic arch calcification even in patients with less advanced CKD. Lactate dehydrogenase is yet to be validated as a marker for aortic arch calcification in CKD patient, however, our study reports a statistically significant association between lactate dehydrogenase and aortic arch calcification in patients with CKD. [ABSTRACT FROM AUTHOR]

Objective: To assess, using statistical analysis, if and to what extent the final outcome of surgical treatment for burst fractures depends on operation type, fracture level and initial deformity severity., Methods: A database of 287 patients with single-vertebral-level thoracic and lumbar spine fractures analysed using simple and multiple linear regression analyses models. The dependent variable was last follow-up (LFU) kyphotic angle and the predictor variables were operation type [anterior approach (AA), posterior short-segment fixation (PSSF) and posterior monosegmental fixation (PMF)], fracture level (T11-L1, L2-L3 and L4-L5) and preoperative kyphotic angle. The models were applied on either the whole sample or on the operation type subgroups., Results: In simple linear regression analysis models, fracture level accounted for 32% and 18% of the variation in LFU kyphotic angle in the AA and PMF subgroups, respectively. In the multiple linear regression models for the same subgroups, up to 40% of the variation in LFU kyphotic angle was accounted for by fracture level. Surgical treatment, as predictor variable, indicated that patients treated by PSSF developed a post-surgical kyphotic angle 8.51° more severe than those treated by AA. However, the model accounted for only 2% of the variation in LFU kyphotic angle. Simple linear regressions performed on each subgroup with preoperative kyphotic angle as the independent variable revealed that the variable accounted for 15% (PSSF subgroup), 17% (AA subgroup) and 34% (PMF subgroup) of the variation in LFU kyphotic angle., Conclusion: All valid regression models displayed modest explanatory power, suggesting that factors other than those taken into consideration are involved.