OBJECTIVETo summarize the clinical features of Takayasu arteritis (TA) patients with pulmonary hypertension due to pulmonary artery involvement.METHODSNinety-four TA patients with pulmonary artery involvement treated in Fuwai Hospital from Jun 1988 to Jun 2014 were retrospectively summarized. Patients were divided into two groups according to whether aorta and its main branches affected (APTA, n=48) or not (PTA, n=46). Clinical features and angiographic data were further analyzed.RESULTSOf all the patients, male to female rate was 1∶3.3, age ranged from 8 to 60 years with median age of 33.5 years when symptom onset. Main symptoms included dyspnea on exertion. Heart murmur and mid-systolic murmur in pulmonic area were commonly found by physical examination. All patients had pulmonary hypertension by echocardiographic examination. Angiographic data showed that multi-lobular and multi-segmental pulmonary branches were predominantly affected, followed by sub-segmental and peripheral branches. Both sides of pulmonary artery involvement were more common than one side involvement, while the right pulmonary arteries were more often affected than the left. Most of the clinical symptoms and signs between APTA group and PTA group were comparable. However, erythrocyte sedimentation rate and N-terminal pro-natriuretic peptide were significant higher in APTA group than that in PTA group when admission [14.0(5.0, 28.0) vs 8.5(3.0, 19.3) mm/1 h and (1 936±1 769) vs (1 627±1 153) ng/L, both P<0.05].CONCLUSIONSDyspnea on exertion may be the main manifestation of TA with pulmonary artery involvement. All patients present with pulmonary hypertension and moderate to severe heart failure when symptom onset.

2014-10-01·The American Surgeon™4区 · 医学

Aspirin Increases the Risk of Venous Thromboembolism in Surgical Patients

4区 · 医学

Article

作者: Margulies, Daniel R. ; Barmparas, Galinos ; Bloom, Matthew ; Melo, Nicolas ; Mehrzadi, Devorah ; Chung, Rex ; Ley, Eric J. ; Jain, Monica

The risk of venous thromboembolism (VTE) for patients taking an antiplatelet agent is largely unknown. This study aimed to investigate the association between antiplatelet agent use before admission with the risk of in-hospital VTE in surgical intensive care unit (ICU) patients. A retrospective review of all patients admitted to the surgical ICU at a Level I trauma center over 30 months was performed. Patients who underwent diagnostic imaging for VTE were selected. Patients were divided based on whether or not antiplatelet agents were used before admission (APTA vs NAPTA). The primary outcome was VTE occurrence. A forward logistic regression model was used to identify factors independently associated with the primary outcome. During the study period, 461 (24%) patients met inclusion criteria: 70 (15%) APTA and 391 (85%) NAPTA. After adjusting for confounding factors, APTA patients were at a significantly higher risk for developing VTE (59 vs 40%; adjusted odds ratio, 1.8; 95% confidence interval, 1.0 to 3.0; adjusted P = 0.04). Whether or not antiplatelet agents were resumed during the hospital stay and the day on which they were resumed did not affect VTE risk. In conclusion, surgical ICU patients receiving antiplatelet agents before admission are at a significantly higher risk for development of VTE.

2013-03-01·The Journal of Maternal-Fetal & Neonatal Medicine4区 · 医学

Management of severe idiopathic oligohydramnios: is antepartum transabdominal amnioinfusion really a treatment option?

4区 · 医学

Article

作者: Norbert Pásztor ; Zoltan Kozinszky ; Melinda Vanya ; János Sikovanyecz ; Attila Pál

OBJECTIVEThe aim of this study was an evaluation of the role of antepartum transabdominal amnioinfusion (APTA) in the management of severe idiopathic oligohydramnios with a view to improving the pregnancy outcome.METHODSThe study comprised an analysis of 20 pregnant women with severe oligohydramnios who were treated with APTA in 2009 and 2012. The pregnancy outcomes and the complications of the procedure were analysed.RESULTSThe mean gestational age at first treatment was 22 weeks 3 days. The preprocedure amniotic fluid index of <5 cm was restored by the treatment to 8 cm. More than a half of the pregnancies (66.7%, 8/12) treated with APTA finished with spontaneous abortion in the second trimester, mostly due to rupture of the membranes (as a consequence of retroamniotic filling with saline in four cases). The later the oligohydramnios developed, the higher the probability of a significant prolongation of the gestation.CONCLUSIONSAlthough APTA is a useful procedure in the management of severe oligohydramnios, it may be followed by a relatively high rate of rupture of the membranes, particularly in the second trimester. Paradoxically, a higher volume of infused saline into the amniotic cavity is associated with a significantly lower risk of rupture.

100 项与 Apta-thrombin (University of Bonn) 相关的药物交易

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