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  • ISSN: 2378-9344
    Volume 7, Issue 5
    Case Report
    Antonio Baule*, Antonello Caddeo, Stefalo Pala, Giuseppe Deiana, and Antonio Manca
    Takayasu arteritis usually affects young women between 10 and 40 years old, while is uncommon diagnosis after 50 years old. Symptoms at onset are often subacute and aspecific and this can be the reason for delay in diagnosis. Less frequently the first manifestation of disease can be a stroke or a transient ischaemic attack. We report here a rare case of a woman with a past medical history of tuberculosis infection, diagnosed with Takayasu arteritis at the age of 61 years old, with a minor stroke as first manifestation of disease. She presented to the emergency department for a sudden onset episode of facial weakness and difficulty with speech regressed in about 10 minutes. She was admitted in Stroke Unit where a Colour Doppler ultrasonography of the sovra-aortic branches was performed and it showed an occlusion from its origin of the right common carotid artery and severe thickening and luminal narrowing of left CCA wall with ipsilateral ICA occlusion from its beginning. Antiplatelet and high dose statin was introduced, she was discharged from Stroke Unit after 3 days and a Rheumatologic consultation and follow up was arranged. Past medical history of the patient was interesting as she referred a pulmonary and cutaneous Mycobacterium tuberculosis infection when she was 12 and 22 years old. Relationship between Tuberculosis infection, both latent and active, and Takayasu arteritis is suggested in many studies but so far no causal relationship between the two conditions could be established. New studies should be done in the future in order to understand mechanisms at the basis of this relationship. At the moment, a practical advice could be tuberculosis infection screening for TAK patients before initiating immunosuppressive therapies, especially in high prevalence TB infection countries.
    Abhishek Chakraborty, D. Byron Holt, Karen Wright and Hitesh Agrawal*
    Cardiac catheterization was done in a patient with Trisomy 18 and atrio-ventricular septal defect, large inlet VSD, and poly-valvular dysplasia prior to consideration of surgical AVSD repair. The patient had severe pulmonary hypertension with severely elevated end diastolic pressures in both ventricles. Pulmonary vascular resistance was found to be 7.5 Woodunits.m2, with poor reactivity to oxygen and nitric oxide. Patient was thus managed conservatively without any surgical interventions.
    Original Article
    Wenyang Pan*, Pascale Kulisa, Xavier Escriva, Benyebka Bou-Saïd, Marine Menut, Patrick Lermusiaux, Antoine Millon
    In cardiovascular disease, aortic dissection is relatively unknown and difficult to treat. Endovascular treatment seeks to obliterate the entrances to the false lumen with a stent. The currently available surgical tools for endovascular procedures are selected only from information based on medical imaging techniques. The images are carried out before the intervention and therefore do not consider the deformation of the vascular structure by the implementation of the prosthesis. While many biomechanical studies have been done on the endovascular treatment of aneurysms of the abdominal aorta, there are, however, very few such studies on aortic dissections. This paper aims to present a numerical tool, from the open-source software FOAM-Extend®, allowing for Multiphysics numerical simulations performing the fluid-structure coupling between the hemodynamics and the arterial deformation to assist in the planning process. And, in addition using Abaqus software we realize the placement of the surgical tools in a ‘biomecano-faithful’ model.
    Research Article
    Nazire Belgin Akilli*, Hüseyin Mutlu, Yahya Kemal Günaydin, Ramazan Koylu, Levent Oktar and Basar Cander
    Objective: The rates of out-of-hospital cardiac arrest are increasing day by day in a progressive manner. Despite all the improvements in care after cardiac arrest, the majority of fatalities occur in the first 24-hours following the cardiac arrest. In recent years, the ratio of the peripheral neutrophils to lymphocytes has been accepted as a prognostic marker in many diseases. We also aimed to investigate the correlation of the NLR with mortality in patients with OHCA.
    Methods: The study design was planned by retrospective scanning of all OHCA patients with ROSC. The demographic features and laboratory data were recorded. The survival rates for the 24-hours and 14-days were calculated.
    Results: 91 patients were included out of 191 cases who had returned from OHCA to spontaneous circulation. When the patients who had died and survived in the first 24-hours were compared, significant differences were found between the neutrophil counts, NLR, lactate and arrest rhythms on admission (p<0.05). The survival rates calculated by Kaplan Meier curves were significantly lower in the group with NLR values lower than 3.05 (Log Rank 5.07, p=0.02). With the multivariable Cox-regression model, it was determined that the NLR value being lower than 3.05, is a predictive factor for the 24-hour mortality independent of age, gender, blood lactate and creatinine values and the arrest rhythm on admission (Hazard Ratio: 0.34 (0.15-0.79), p=0.01).
    Conclusion: Among the OHCA patients with ROSC, low NLR levels on admission is an independent predictor of mortality in the first 24-hours.
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