bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medizinisch-beruflich orientierte Rehabilitation für onkologische Rehabilitanden – kurzfristige Ergebnisse einer clusterrandomisierten Multicenterstudie
Authors: Wienert Julian , Bethge Matthias 
Published: May 2018

Zusammenfassung
Hintergrund Rehabilitative Programme zur beruflichen Wiedereingliederung gewinnen für Krebsüberlebende an Relevanz. In Deutschland haben sich solche Programme als medizinisch-beruflich orientierte Rehabilitation (MBOR) etabliert. Die Studie untersucht, ob die MBOR im Vergleich zur medizinischen Rehabilitation (MR) günstigere Ergebnisse erzielt. Es werden Effekte auf sekundären Zielkriterien zu Reha-Ende berichtet.
Methodik Teilnehmer wurden in Clustern zufällig der MBOR und der MR zugewiesen. Eingeschlossen wurden Rehabilitanden im erwerbsfähigen Alter und einem erhöhten sozialmedizinischen Risiko für einen ungünstigen Wiedereingliederungsverlauf. Die Umsetzung der Interventionen wurde anhand der erbrachten und wahrgenommenen Behandlungsdosis erfasst. Weitere Zielkriterien waren Funktions- und Symptomskalen, Fatigue, Krankheitsbewältigung sowie die subjektive Arbeitsfähigkeit. Behandlungseffekte wurden mit gemischten Modellen berechnet.
Ergebnisse Von 232 geplanten randomisierten Teilnehmergruppen wurden 165 (71%) realisiert. Es wurden 476 Rehabilitanden eingeschlossen. Das mittlere Alter der Teilnehmer betrug 50,7 Jahre (SD=7,3). 67% waren weiblich. Die häufigsten Neubildungen waren bösartige Neubildungen der Brustdrüse. Die Teilnehmer der MBOR berichteten am Ende der Rehabilitation signifikant bessere Werte für Lebensqualität (SMD=0,17–0,25), Fatigue (SMD=0,18–0,27), Krankheitsbewältigung (SMD=0,17–0,22) und subjektive Arbeitsfähigkeit (SMD=0,16) als Teilnehmer der MR (alle p<0,05).
Schlussfolgerung Die Ergebnisse zeigen kurzfristig einen positiven Effekt der MBOR für onkologische Rehabilitanden mit einem erhöhten Risiko für Teilhabeeinschränkungen.
Pineal Gland—A Spiritual Third Eye: An Odyssey of Antiquity to Modern Chronomedicine
Authors: Kumar Raj , Kumar Arushi , Sardhara Jayesh 
Published: May 2018

AbstractPineal gland or “spiritual third eye” is regarded as the gateway of spiritual life as per ancient concepts about the soul. Recently, modern neuroscience has proven that pineal gland is not only the melatonin-secreting neuroendocrine organ which controls the circardian rhythm, but it also has mystical and energetic associations with spirituality. It acts as a tremendous coordinator between molecular, hormonal, physiological, and chemical rhythmic orchestra. Thus, in this article, by highlighting the relation between ancient Indian methodology and modern chronomedicine, the author describes the odyssey of antiquity to modern science.
A Study of Effects of Addition of Coenzyme Q 10 to High Dose Statins in Patients of Coronary Artery Disease with Special Reference to Oxidative Balance
Authors: Dangeti Malleswara , Katkam Siva , Galla Raghu , Kiran Ravi , Garre Indrani 
Published: May 2018

AbstractBackground: Oxidative stress is one of the most potent inductors of endothelial dysfunction and is involved at all stages of atherosclerotic plaque evolution. Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and are potent inhibitors of cholesterol biosynthesis. In clinical trials, statins are beneficial in the primary and secondary prevention of coronary heart disease. Statins also possess direct free radical scavenging activity. However, the prooxidant effect of statins has also been reported as statins block the mevalonate pathway and the synthesis coenzyme Q10. This Additional Coenzyme Q10 depletion by statins in patients with coronary artery disease (CAD) may be a critical issue as it may reduce absolute benefits of statins.Objectives: The purpose of this study was to investigate the effects of high dose statins on plasma Malondialdehyde (MDA) levels and plasma glutathione levels in CAD patients who underwent recent PCI and to study whether addition of coenzyme Q10 (100 mg/d) has any additional effect on plasma Malondialdehyde (MDA) levels and plasma glutathione levels in patients already receiving high dose statin therapy.Methods: Twenty-one consecutive patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in Department of Cardiology at our institute were studied. The cases (n = 21) were given high dose statins for first 1 week and then coenzyme Q10 (100 md /day) is added for next 1 week. Plasma Malondialdehyde(MDA) levels and plasma glutathione levels were analyzed at the time of admission before giving statins and at the end of 1 week of statin therapy and again after 1 week of Co-Q therapy.Results: Our results indicate that a relation exists between high plasma Malondialdehyde (MDA) levels and low plasma glutathione levels with coronary artery disease. High dose statins decrease MDA levels and increase plasma glutathione levels, even though they decrease coenzyme q levels in the body. It was also shown that addition of Coenzyme Q10 at 100 mg/d enhances plasma glutathione levels and decreases plasma MDA level still further in patients who have CAD, already receiving high dose statin therapy.Conclusions: Addition of Coenzyme Q10 at 100 mg/d has an additive effect with high dose statins in decreasing oxidative stress. Particularly in light of the excellent tolerance and affordability of this natural physiological compound, supplemental Coenzyme Q10 may emerge as an attractive option in future, and merits evaluation in additional large studies.
Comparision Between Clopidogrel and Prasugrel On hs-CRP Levels Post Percutaneous Intervention
Authors: Kumar A. , Garre Indrani 
Published: May 2018

AbstractAims: This study investigated the effect of clopidogrel versus prasugrel treatment on inflammatory activity as evidenced by high-sensitivity C-reactive protein (hs-CRP) levels among patients who underwent percutaneous intervention (PCI). The effect in clinical outcomes between both the treatment groups is also explored.Methods: The study included 53 patients into two cohorts with 30 from clopidogrel group and 23 from prasugrel group who underwent PCI for coronary artery disease. Patients were assigned either to clopidogrel or prasugrel group based on mehraan bleeding risk score. Hs-CRP was measured on 15thfollowup day. The predefined primary composite endpoint was myocardial infarction, stroke, vascular complications or death from cardiovascular causes.Results: In both treatment groups the changes in hs-CRP levels over time were identical (2.97±3.2 in clopidogrel vs. 4.47±4.1in prasugrel p:0.14). Clinical outcomes occurred in 3 cases in clopidogrel group and one patient had puncture site hematoma in prasugrel group (p: 0.72). In contrast no significant difference in hs-CRP was noted among those had adverse clinical outcomes (1.67±2.2 vs 3.12±3.3 p: 0.47). Baseline parameters height (158.3±7.7 vs 157.8±7.7p:0.80) weight (63.4±9.7 vs 63.8±9.6 p: 0.87) hypertension (17 vs 11 p: 0.58) diabetes (11 vs 8 p: 1.00) smokers (1 vs. 5 p: 0.06) are matched between both the groups. Clopidogrel group were elderly (63.1±9.6 vs 53.7±9.5 p: 0.001) and had higher systolic blood pressure (154.7±26.2 vs 138.7±18.7 p: 0.01). Clinical scenario like type of presentation (CSA 16 vs 9 p: 0.29) LV dysfunction (10 vs 10 p: 0.57) previousPCI (5 vs 4 p: 0.94) previous CABG (2 vs 0 p: 0.143) are identical in both groups. Lesion characteristics like calcification (15 vs 11 p:0.97) tortuosity(4 vs 3 p:0.94) angulation (2 vs 0p:0.49) ostial lesion ( 8 vs 5 p:0.75) thrombotic (0 vs 1 p:0.30) was similar in both the groups. Bifurcation lesion (6 vs 1 p:0.06) usage of Gp2B3A inhibitors(3 vs 0 p:0.06) was higher in clopidogrel group.Conclusions: Antiplatelet prasugrel and clopidogrel significantly did not affect inflammation post PCI as assessed by hs-CRP which is an established inflammatory marker. No significant difference in clinical outcomes in the follow-up between both the groups. Neither hs-CRP level was elevated in those with adverse clinical events.
Should We Confine the Cardio Hepatic Syndrome Only in Congestive Cardiac Failure Patients?
Authors: Rajendra B. , Sukanya B. , Joshi Nayana 
Published: May 2018

AbstractIntroduction: Liver function abnormalities are not uncommon in patients with heart failure. Multiple reasons have been cited like impaired perfusion or elevated right-sided cardiac pressures, or are secondary to drug toxicity. In this study, we analyzed the patients admitted at our center to detect the profile of cardio-hepatic syndrome. This analysis may explore new etiologies for cardio-hepatic syndrome.Materials And Methods: This is an observational retrospective study done at our institute. We collected the liver function tests which were conducted in patients admitted in cardiology in 2015 (Jan to Dec at our center. Patients having abnormal liver function tests were analyzed for various etiologies. SGPT value > 45 Units per liter is considered as elevated.Results: Out of the patients admitted to cardiology department, SGPT and SGOT values are available in 2803 and 4577 patients respectively. Mean age of these patients was 58±12.9 yrs.In SGPT group 1881 were males. In 432(15.4%) patients SGPT was elevated. In them 326 (76%) were males. Among the patients in whom SGPT is elevated, also had elevated CPK and CPK-MB due to MI were in 154 patients (35.6%). In 24 patients (5.6%) SGPT was elevated along with NT pro BNP levels. Rest of the SGPT elevated patients (254 – 58.8%) does not come under CCF or MI category and out these patients about 146 patients were on either on statin or other drugs which can increase the liver enzymes. Still we require to evaluate the cause of hepatic abnormality in 106(24.5%) patients admitted with cardiac disease.Conclusions: Cardio-hepatic syndrome is not just confined to heart failure. Though heart failure, MI and drug induced hepatic dysfunction accounted for 75.5% of the etiology, we require to see present unknown the etiology for this sub group of cardio hepatic syndrome. Further elucidating the etiology for the remaining 24.5% cardio hepatic syndrome is of much interest.
Complex Cardiac Defect in a Fetus with Trisomy 18: A Case Report
Authors: Aggarwal Shagun 
Published: May 2018

AbstractThis is a case report of a foetus which was brought for postmortem evaluation following antenatal detection of a complex cardiac defect. Presence of dysmorphism and other malformations like gut malrotation, bladder outlet obstruction, and esophageal stenosis led to suspicion of a syndromic diagnosis. Fetal karyotyping confirmed a diagnosis of Trisomy 18 (Edwards syndrome). This facilitated appropriate genetic counseling of the family and guidance for prenatal diagnosis in subsequent pregnancies.
Post PCI Vascular and Bleeding Complications in Patients with or Without CKD
Authors: Oruganti Harish , Maddury Jyotsna 
Published: May 2018

AbstractBACKGROUND: There is increasing trend of both Cardiovascular disease (CVD) and chronic kidney diseases (CKD) in general populations. The individuals with CKD are more likely to die of CVD than of kidney failure. Both diagnostic and therapeutic interventions are crucial in management of CKD patients with coronary artery disease. As CKD itself is associated with more bleeding complications we aim to study the incidence of vascular complications (vessel thrombosis, distal embolisation, dissection, poorly controlled bleeding at puncture site, pseudoaneurysm, arteriovenous fistula, retroperitoneal hematoma, and development of femoral neuropathy) in Percutaneous intervention (PCI) patients with renal failure.METHODS: 950 patients who underwent PCI procedures were classified into CKD (GFR<60ml/min/m2) (n=380, 40%) and non-CKD (n=570, 60%) groups. Two groups were analyzed for the occurrence of vascular complications post PCI.RESULTS: Vascular complications were seen in 28 out of 380 patients with CKD (7.37%) and 17 out of 570 patients without CKD (2.98%). Patients with renal failure (GFR<60ml/min/m2) were found to have higher risk of vascular complications post PCI. [p = 0.03, OR = 2.588 (1.344-5.017)]. Non access site complications were more common in patients with CKD compared to non CKD. 16 patients with CKD developed non access site complications compared to 9 in patients without CKD.[p=0.001, odds ratio 2.793(1.15-6.916)CONCLUSIONS: This study demonstrates higher risk of vascular complications post-PCI in patients with CKD compared to non CKD patients. Higher incidence of non access site complications was also observed in CKD patients.
Pulmonary Hypertension Due to Left Heart Disease
Authors: Basha S. , Deepthi G. 
Published: May 2018

AbstractThe most common cause of pulmonary hypertension is left heart disease, arising in response to increased left ventricular or left a trial filling pressures[1,2,3]. During the 5th World Symposium held in Nice, France, in 2013, the consensus was reached to maintain the general scheme of previous clinical classifications, placing the Pulmonary Hypertension due to left heart disease in Group 2 [4]. PH is defined by a mean pulmonary arterial pressure >25 mmHg. In the case of PH associated with LHD, this is associated with a pulmonary capillary wedge pressure >15 mmHg or left ventricular end-diastolic pressure (LVEDP) > 18 mm Hg [1,5]. Pulmonary hypertension due to left-sided heart disease is associated with higher morbidity and mortality [6,7,8]. This study is done to know the pattern of clinical presentation of pulmonary hypertension and to see the gender difference.
Cardiac Resynchronization Therapy in Women
Authors: Sharada K. 
Published: May 2018

AbstractDespite underrepresentation of women in cardiac resynchronization therapy studies, it has been conclusively shown that women demonstrate greater benefit than men in functional status, reverse cardiac remodeling, and survival and female gender remains an independent predictor of greater response to cardiac resynchronization therapy after adjustment for various other factors. Eligible female patients are less likely to receive this beneficial therapy and various performance enhancement initiatives can reduce this gender-based disparity with favorable outcomes.
Idopathic Pulmonary Hypertension Mimicking Pulmonary Veno-Occlusive Disease – A Case Report.
Authors: Prasad K. , Kumar A. 
Published: May 2018

AbstractPVOD is rare cause of pulmonary artery hypertension which is associated with worse prognosis and limited treatment options apart from lung transplantation. Differentiating IPAH patients from PVOD is sometimes difficult relying on catheterization data alone. But differentiation between these two diseases is important as there are many evolved treatment options for IPAH. Here we are reporting a case of IPAH where catheterization data shows conflicting results which on further evaluation diagnosis confirmed as idiopathic pulmonary hypertension.
Reversible Cardiomyopathy in Cushing Syndrome-A Rare Presentation
Authors: Rao D. 
Published: May 2018

AbstractCushing syndrome (CS) is the result of extended exposure to excessive glucocorticoids from endogenous or exogenous sources. Cushing's syndrome (CS) is associated with reduced life quality and increased mortality, mostly due to cardiovascular disease. We report the case of a 26-year-old female patient who presented with heart failure who was found to have Cushing syndrome and recovered after supportive treatment.
Outcomes with Longterm Dual Antiplatelet Therapy After Coronary Angioplasty
Authors: Arigonda Ashok , Prasad K. , Hareesh O. , Keerthika R. 
Published: May 2018

AbstractIntroduction: The optimal duration of dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation is an important, unanswered question. This study was designed to evaluate the association of varying durations of DAPT on clinical outcomes after DES implantation for the treatment of coronary artery disease.Methods: Registry is maintained about the follow up of patients on DAPT therapy post percutaneous transluminal coronary angioplasty (PTCA) and the complications are noted in the follow up period between December 2015and May 2016 in NIMS hospital. Results were analyzed using appropriate Statistical tests.Results: The number of evaluated patients was 127 with median age of 62 years. There were 27 females in them. Mean DAPT score was 1.68, with majority in the score range of one or two. Mean follow up period was 5.92 years (1 to 15 years). Among 127patients only 4 patients had complications, 3 of them had chronic stable angina and one had ischaemic stroke with no bleeding complication.Conclusion: DAPT beyond one year has benefits in terms of low associated complications and low incidence of coronary events.
Incidence and Outcomes of Patients with Peri-Procedural Creatine Kinase (CK-MB) Elevation
Authors: Gundam S , Saibaba K. 
Published: May 2018

AbstractAims: Peri-procedural myocardial infarction (MI) is not an uncommon complication of percutaneous coronary intervention (PCI). We investigated the incidence and clinical outcomes of patients with peri-procedural creatine kinase elevation over one year followup.Methods: We prospectively evaluated the consecutive patients undergoing PCI either with acute coronary syndrome (ACS) or chronic stable angina (CSA) as presentation in our unit from July 2014 to December 2015. The term enzymatic infarct (EI) is used to include all patients with peri-procedural CK-MB elevation more than upper limit of normal (ULN). These patients are divided into three categories based on level of enzyme elevation and type of presentation. Type A includes those with CK-MB between 1 to 3 times the ULN, type B includes true peri-procedural MI that means CK-MB >3 times ULN, type C includes patients with baseline CK-MB elevation due to acute MI. We used the PMI definition from the third universal definition of MI: creatine kinase (CK-MB)>3 times upper limit of normal. We followed them up to one year for the major adverse cardiovascular events (MACES) and other complications. We compared the mortality rate between peri-procedural enzymatic infarct group and non peri-procedural enzymatic infarct patients along with incidence of peri-procedural EI in CSA versus ACS subgroups and tested for the significance.Results: Out of total 748 patients who undergone PCI in our unit, the total incidence of peri-procedural EI was 7.7%. Among total 58 peri-procedural EI events, 23(3%) were in patients with ACS presentation (p=0.001) and 34(4.5%) were in patients with CSA presentation (p=0.0001). Patients with peri-procedural EI had significantly higher risk of mortality than those without peri-procedural EI (5.1% versus 0.2%, p= 0.001). In subgroup analysis among patients with peri-procedural EI the mortality is higher in patients with ACS presentation compared to those with CSA as presentation (8.6% versus 2.9%(p=0.01)), and the total mortality is confined to the type B enzymatic infarct group.Conclusion: Among patients undergoing PCI, the occurrence of peri-procedural EI measured by CK-MB mass assay was 7.7% and Peri-procedural EI type B was associated with significant increase in mortality over one year followup.
Use of Modified CHA2DS2-VASC Score for Risk Prediction in Patients Undergoing PCI
Authors: Kumar M. , Koul Subhash 
Published: May 2018

AbstractBackground: Most of the existing risk prediction models include angiographic or procedural variables thus making it difficult for their application in decision making at the outset of treatment. This study we used modified CHA2DS2-VASC score as a simple tool for risk stratification of patients with PCI, regardless of atrial fibrillation (AF).Methods: This is a prospective observation study of patients who had undergone PCI, with diagnosis of either ACS or chronic stable angina between the age group of 18 to 85 years. Modified CHA2DS2-VASC score (CAD presence was not given one point) was calculated in the patients before PCI and followed for occurrence of MACCE or death. Score was correlated with primary outcome death or MACCE.Results: Total of 676 patients were considered for this study, Mean modified CHA2DS2-VASC score of the study population is 1.86± 1.26. Sub group analysis of the patients by dividing into groups with a score less than 1 and greater than 1 revealed that there is no statistical difference in either MACCE ( p = 0.31) or death (p=0.6) between the groups. Subgroup analysis of ≤1 and ≥5 modified CHA2DS2VASc score has no statistically significant difference in MACCE (p=0.45), but has statistically significant difference in death rate by Fischer exact test(p=0.02) and by chi-square Yates correction (p=0.01). Further analysis also shows that patients with score ≥5 had 13 times increased risk of death when compared with score ≤1.Conclusion: Modified CHA2DS2-VASc Score is a simple clinical tool for predicting outcome in patients planned for PCI. Risk of death clearly correlate with the score when score was more than 5 point.
Post MI Pericardial Effusion-“Size Does Matter”
Authors: Varma G. 
Published: May 2018

AbstractPost myocardial infarction pericardial effusion (PE) is a relatively common, however the prognosis and management is not always straightforward in patients with moderate pericardial effusion (MPE). This article describes four case scenarios we encountered and reviews existing literature regarding etiology and management of post MI pericardial effusion.
Sub-Massive Pulmonary Thromboembolism with Out Deep Vein Thrombosis
Authors: Vankudoth Seetharam , banoth Madhurima 
Published: May 2018

AbstractVenous thromboembolism, causing Pulmonary Embolism (PE), is one of the major cardiovascular causes of death. We are reporting three cases of pulmonary thromboembolism without deep vein thrombosis and with normal levels of homocysteine, protein C and S, anti-thrombin III levels. All three cases managed with thrombolysis with streptokinase, out of three cases two cases systemic thrombolysis given and one case catheter guided thrombolysis given and discharged on oral anticoagulant with target range of PT with INR 2-3.on subsequent follow-up one case was diagnosed lymphoma and he was treated successfully in our institution.
Dynamic regimes of electrified liquid filaments
Authors: Kong Tiantian , Stone Howard A. , Wang Liqiu , Shum Ho Cheung 
Published: May 2018

Significance
A viscous liquid filament subjected to an axial electric field exhibits different behaviors including jetting, coiling, and whipping, which result from the delicate interplay of viscous, electrostatic, and surface tension stresses. Control over these dynamic behaviors of electrified liquid filaments is crucial for applications such as the fabrication of nanosized architectures and analytical instrumentation. However, due to the narrow window of system parameters, the three dynamic regimes are never reported in a single system, which has prevented the investigation of transitions among these regimes. Using a low-interfacial-tension liquid−liquid system, we systematically characterize the transitions among all three dynamic regimes and elucidate underlying mechanisms, thus providing an important missing piece of the puzzle to the physics of electrified liquid filaments.
Oxygen radicals, nitric oxide, and peroxynitrite: Redox pathways in molecular medicine
Authors: Radi Rafael 
Published: May 2018

SignificanceAerobic life in humans imposes the hazard of excess oxidation in cell and tissue components that may compromise cell function and viability. The formation and accumulation of oxidized products in biomolecules such as proteins and lipids are observed in various pathologies and during the normal aging process. This review article aims to integrate some early and remarkable discoveries in the field, with more recent developments that helped to define a causative role of oxygen radicals, nitric oxide, and peroxynitrite in human physiology and pathology. These aspects of human redox biochemistry contribute to the understanding of the molecular basis of diseases and aging and open avenues for the development of preventive and therapeutic strategies in molecular medicine.