Prevalence and Clinical Correlates of Spontaneous Echo Contrast in Patients on Oral Anticoagulation Undergoing Catheter Ablation for Atrial Fibrillation
Christian Grebmer, Carsten Lennerz, Amir Brkic, Patrick Blazek, Severin Weigand, Verena Semmler, Marc Kottmaier, Felix Bourier, Lena Friedrich, Elena Risse, Stephanie Brooks, Marie Kornmayer, Marta Telishevska, Tilko Reents, Christof Kolb, Gabriele Hessling and Isabel Deisenhofer
Article Type: Research Article | First Published: June 19, 2019
Spontaneous echo contrast (SEC) in the left atrial appendage (LAA) is associated with an increased risk of cerebral embolism in patients with atrial fibrillation (AF). Novel oral anticoagulants (NOACs) are increasingly prescribed as first-line therapy and have shown a comparable benefit-risk ratio compared to vitamin K antagonists (VKAs). The aim of this study was to investigate whether NOACs decrease the incidence of SEC compared to VKA. ...
Unroofed Coronary Sinus Syndrome Presenting with Early Pulmonary Hypertension
Maria E Franco-Fuenmayor, MD, Numra A Aleem, MD, Jorge D Salazar, MD, and Ashraf M Aly, MD
Article Type: Case Report | First Published: June 13, 2019
Isolated partial or complete absence of the coronary sinus roof hemodynamically behaves like an atrial septal defect and rarely causes pulmonary hypertension. We report a case of unroofed coronary sinus (URCS) presenting with post-operative cyanosis due to pulmonary hypertensive crisis following surgical repair of a ventricular septal defect at 6 months of age. He had progressively decreased stamina with gradual increase in pulmonary pressure requiring surgical closure of the URCS by 6 years of age with resolution of symptoms and normalization of the RV pressure. ...
Case Report: Necrotizing Fasciitis due to Cryptococcus Infection in Non-HIV Non-Organ Transplant
Rbab Taha, Mohamed Alama, Hessa Aljhdali, Ayaz khan and Reham Kaki
Article Type: Case Report | First Published: June 12, 2019
We are presenting 67-year-old female, known to have diabetes for 10 years, not compliance to medication. Presented with 3 weeks history of isolated right lower limb and left thigh pain. Then she started to develop redness and swelling in same areas. She had also History of dry cough for one week. Admitted as a case of necrotizing fasciitis based on clinical laboratory and radiological features. She was treated empirically with vancomycin and meropenem and went for debridement twice. Histopathology and culture showed Cryptococcus neoformans. Investigations were done to rule out other immune sys...
Novel Anti-Snoring Mouthpiece to Reduce Snoring in At-Home Study
Jonathan Greenburg, DDS, Jesse Cozean, MBA and Colette Cozean, PhD
Article Type: Clinical Trial | First Published: June 10, 2019
Habitual snoring affects millions of individuals and their partners, but often goes unresolved due to the high cost of care and other barriers to treatment. The purpose of this study was to evaluate the effectiveness of a novel intraoral device that restrains the tongue in an overthe- counter setting in a population of habitual snorers. Individuals who self-reported snoring enrolled in the study and were sent an investigational device. After signing the informed consent, they completed an initial questionnaire about their symptoms and another following 10 days of using the device....
Association of Pulmonary Function with Waist Circumference (WC) and Body Mass Index (BMI) among the Students of Management & Science University, Malaysia
Aniruddha Bhattacharjee, Aye Aye Myat, Shakunthala VT and Rajeev Sharma
Article Type: Research Article | First Published: June 10, 2019
Obesity is rapidly escalating in Malaysia in all age groups. Prevalence of obesity and overweight is increasing in adults and in children in both developed and developing countries. Obesity is a risk factor for many conditions including respiratory disorders regardless of BMI. However, studies investigating pulmonary functions in obese adolescents in Malaysia are few. Hence, the present study was aimed to investigate pulmonary function variables in the adolescent obese students of management and science university (MSU) in Malaysia. To evaluate the effect of obesity on pulmonary function among...
S-Nitrosoglutathione Modulates Expansion of Activated CD4CD25 Cells by Apoptosis under Inflammatory Condition
Article Type: Research Article | First Published: June 08, 2019
The regulation checkpoints of CD4CD25 expansion in presence and absence of transcription factor FOXP3 are critical to maintain balance between inflammatory TH17 and anti-inflammatory FOXP3CD4CD25 Treg cells. We investigated impact of potent inflammatory mediator nitric oxide NO(.) on commitment of normal spleen T cells following activation. The single cell suspension of healthy C57BL/6 mice splenic CD4 cells was stimulated by plate-bound antiCD3/antiCD28 antibodies in presence of cytokine cocktail IL2, IL6, TGFβ and anti-IL4, anti-IFN γ antibodies with and without GSNO for 72h. The results s...
Psychogenic Hemiplegia after Cervical Spine Discectomies and Fusion
Siavash S Haghighi
Article Type: Case Report | First Published: June 08, 2019
A case report of psychogenic hemiplegia following a two level anterior cervical discectomies and fusion was contradicted by a thorough electrophysiological findings. To report an unusual case of post-operative hemiplegia in spite of normal electrophysiological and noncompromising radiographic findings. Conversion disorder with sensory or motor system symptoms is a subtype which includes symptoms such as impaired motor balance, paraplegia, muscle weakness, and urinary retention....
Lactate Dehydrogenase in Hypertensive Disorders in Pregnancy: Severity or Diagnosis Marker?
Fernando Vazquez-Alaniz, Jose Manuel Salas-Pacheco, Ada Agustina Sandoval-Carrillo, Osmel La-llave-Leon, Edna Madai-Mendez Hernandez, Marcelo Barraza-Salas, Eda Guadalupe Ramirez- Valles, Norma Urtiz-Estrada, Mario Lumbreras Marquez, Jose Miguel Montes-Herrera and Cesar Yhamel Sanchez-Bernal
Article Type: Research Article | First Published: June 06, 2019
Lactate dehydrogenase has had an exciting journey as a utility marker in different illnesses, but currently, its clinical utility has been relegated to confirm hemolysis, as a tumor marker, and as a diagnostic biomarker of preeclampsia. The findings of lactate dehydrogenase concentrations taking reference values to healthy persons are not consistent when these are related to hypertensive disorders in pregnancy, mainly to begin symptoms or little severity presentation. The goal in this work was to evaluate the maternal serum concentration of lactate dehydrogenase and its utility as a severity o...
The Effect on Disc Height and Sagittal Alignment in 56 Consecutive Patients Undergoing Lateral Access Surgery
Donald A Deinlein, Sakthivel Rajaram, Jorge L Perez and Mason B Frazier
Article Type: Research Article | First Published: June 06, 2019
The lateral approach to the spine, for spinal fusion, has gained interest from spine surgeons in recent years. The approach is less invasive, with less blood loss, decreased morbidity, and decreases length of stay in the hospital. The procedure has been shown to allow indirect decompression of the spinal canal and the intervertebral foramen. Segmental interbody arthrodesis may result in improved coronal and sagittal balance....