Search results for: coronary artery disease
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3877

Search results for: coronary artery disease

3607 Use of Beta Blockers in Patients with Reactive Airway Disease and Concomitant Hypertension or Ischemic Heart Disease

Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

Abstract:

The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

Procedia PDF Downloads 419
3606 3 Dimensional (3D) Assesment of Hippocampus in Alzheimer’s Disease

Authors: Mehmet Bulent Ozdemir, Sultan Çagirici, Sahika Pinar Akyer, Fikri Turk

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Neuroanatomical appearance can be correlated with clinical or other characteristics of illness. With the introduction of diagnostic imaging machines, producing 3D images of anatomic structures, calculating the correlation between subjects and pattern of the structures have become possible. The aim of this study is to examine the 3D structure of hippocampus in cases with Alzheimer disease in different dementia severity. For this purpose, 62 female and 38 male- 68 patients’s (age range between 52 and 88) MR scanning were imported to the computer. 3D model of each right and left hippocampus were developed by a computer aided propramme-Surf Driver 3.5. Every reconstruction was taken by the same investigator. There were different apperance of hippocampus from normal to abnormal. In conclusion, These results might improve the understanding of the correlation between the morphological changes in hippocampus and clinical staging in Alzheimer disease.

Keywords: Alzheimer disease, hippocampus, computer-assisted anatomy, 3D

Procedia PDF Downloads 447
3605 Nutritional Benefits of Soy: An Implication for Health Education

Authors: Mbadugha Esther Ifeoma

Abstract:

Soybeans, like other legumes are rich in nutrients. However, the nutrient profile of soybeans differs in some important ways from most other legumes. Among other nutrients, soy is high in protein, carbohydrates, and fibers, is rich in vitamins, minerals and unsaturated fatty acids and is low in saturated fatty acids. Because of its high nutritional value, it has been rated to be equivalent to meats, eggs and milk. Soy has many health benefits including prevention of coronary heart disease, prevention of cancer growth, improvement of cognitive function, promotion of bone health, prevention of obesity, prevention of type II diabetes and promotion of growth of normal floras in the colon. Soybean consumption is also associated with some side effects which include allergy, flatulence and abdominal discomfort. Nurses/health care providers should therefore, educate clients on the precautionary measures to be taken in preparing soy food products in order to reduce to the barest minimum the side effects, while encouraging them to include soy as part of their daily meals for optimal health and vitality.

Keywords: health benefit, health education, nutritional benefit, soybeans

Procedia PDF Downloads 453
3604 Considerations When Using the Beach Chair Position for Surgery

Authors: Aniko Babits, Ahmad Daoud

Abstract:

Introduction: The beach chair position (BCP) is a good approach to almost all types of shoulder procedures. However, moving an anaesthetized patient from the supine to sitting position may pose a risk of cerebral hypoperfusion and potential cerebral ischaemia as a result of significant reductions in blood pressure and cardiac output. Hypocapnia in ventilated patients and impaired blood flow to the vertebral artery due to hyperextension, rotation, or tilt of the head may have an impact too. Co-morbidities that may increase the risk of cerebral ischaemia in the BCP include diabetes with autonomic neuropathy, cerebrovascular disease, cardiac disease, severe hypertension, generalized vascular disease, history of fainting, and febrile conditions. Beach chair surgery requires a careful anaesthetic and surgical management to optimize patient safety and minimize the risk of adverse outcomes. Methods: We describe the necessary steps for optimal patient positioning and the aims of intraoperative management, including anaesthetic techniques to ensure patient safety in the BCP. Results: Regardless of the anaesthetic technique, adequate patient positioning is paramount in the BCP. The key steps to BCP are aimed at optimizing surgical success and minimizing the risk of severe neurovascular complications. The primary aim of anaesthetic management is to maintain cardiac output and mean arterial pressure (MAP) to protect cerebral perfusion. Blood pressure management includes treating a fall in MAP of more than 25% from baseline or a MAP less than 70 mmHg. This can be achieved by using intravenous fluids or vasopressors. A number of anaesthetic techniques could also improve cerebral oxygenation, including avoidance of intermittent positive pressure ventilation (IPPV) with general anaesthesia (GA), using regional anaesthesia, maintaining normocapnia and normothermia, and the application of compression stockings. Conclusions: In summary, BCP is a reliable and effective position to perform shoulder procedures. Simple steps to patient positioning and careful anaesthetic management could maximize patient safety and avoid unwanted adverse outcomes in patients undergoing surgery in BCP.

Keywords: beach chair position, cerebral oxygenation, cerebral perfusion, sitting position

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3603 Detecting Potential Biomarkers for Ulcerative Colitis Using Hybrid Feature Selection

Authors: Mustafa Alshawaqfeh, Bilal Wajidy, Echin Serpedin, Jan Suchodolski

Abstract:

Inflammatory Bowel disease (IBD) is a disease of the colon with characteristic inflammation. Clinically IBD is detected using laboratory tests (blood and stool), radiology tests (imaging using CT, MRI), capsule endoscopy and endoscopy. There are two variants of IBD referred to as Ulcerative Colitis (UC) and Crohn’s disease. This study employs a hybrid feature selection method that combines a correlation-based variable ranking approach with exhaustive search wrapper methods in order to find potential biomarkers for UC. The proposed biomarkers presented accurate discriminatory power thereby identifying themselves to be possible ingredients to UC therapeutics.

Keywords: ulcerative colitis, biomarker detection, feature selection, inflammatory bowel disease (IBD)

Procedia PDF Downloads 364
3602 Quantitative Wide-Field Swept-Source Optical Coherence Tomography Angiography and Visual Outcomes in Retinal Artery Occlusion

Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

Abstract:

Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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3601 The Burden of Leptospirosis in Terms of Disability Adjusted Life Years in a District of Sri Lanka

Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

Abstract:

Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

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3600 The Last of Centuries Old Cardamom Farming in Eastern Nepal: Crop Disease, Coping Strategies and Institutional Innovation

Authors: K. C. Sony

Abstract:

This paper investigates the coping strategies of households confronting disease in large cardamom (Amomum Subulatum Roxb.) in eastern Nepal. Cardamom farmers draw on various coping strategies to reduce the impact of crop disease in their livelihoods. Yet farmers face tremendous decline in production with a constant effort for revival. Past evidences provides dearth of information about coping strategies employed by farmers and institutional intervention to combat disease. Using factual data from Ilam district, and conducting a political economic analysis, this research addresses the gap by 1) understanding the impact of crop disease in farmers’ livelihoods, 2) identifying the coping strategies adopted by farmers and, 3) examining the existing institutional arrangements to address the disease. Coping strategies vary by household’s status defined by size of land, alternative income, and access to supporting institutions. Measures adopted are burning the cardamom field, changing land use pattern, diversifying crops, and visiting institutions for support. The local government’s support is limited to providing trainings and producing new varieties of cardamom. During crisis, farmers expect institutions to help revive the cardamom production, despite customary practice to combat disease. To retain and improve the livelihoods of farmers, there needs to be institutional innovation at the community level and policies that endorse immediate and sustainable support during hazards.

Keywords: cardamom, coping strategy, disease, institutions, Nepal

Procedia PDF Downloads 265
3599 A Basic Understanding of Viral Disease and Education Level Influences Disease Risk Perception, Disease Severity Perception, and Mask Wearing Behavior During the COVID-19 Pandemic

Authors: Ilse Kreme

Abstract:

To the best of this author’s knowledge, no studies have been identified on the connection between a refusal to engage in health-protective behaviors and a basic understanding of viral biology among community college students, faculty, and staff during the COVID-19 pandemic. Lack of scientific knowledge could prevent understanding of why these behaviors are important to prevent the community spread of COVID-19, even when they are not shown to offer much individual protection. In this study, a possible correlation was examined between a basic knowledge level of viral disease that comes from having taken a college biology course and disease perceptions of COVID-19. In particular, disease risk perception, disease severity percept and mask-wearing behaviors were examined as they correlated with having taken an undergraduate biology course. The effect of covariates of age, gender, and education level were investigated along with the main dependent variables. A representative sample of the population included students, faculty, and staff at Paradise Valley Community College (PVCC) in Phoenix, Arizona. Participants were recruited by an email sent to all students, faculty, and staff at PVCC using an all-college email distribution. Disease risk and severity perception were assessed with the Brief Illness Perception Questionnaire 5 (BIP-Q5), which was modified to include questions measuring participant age, education level, and whether they took or ever took a college biology course. Two additional questions measured compliance of willingness to wear a face mask. The results showed an effect of gender on mask-wearing behavior and a correlation between having taken a biology course and disease severity perception. No differences were seen in mask-wearing behavior and disease risk perception as a result of having taken a biology course. These findings suggest that taking an undergraduate biology course leads to a greater awareness of COVID-19 disease severity through an understanding of the basic biological principles of viral disease transmission. The results can be used to modify existing health education strategies. Further research is needed on how to best reach target audiences in all education brackets.

Keywords: COVID-19, education, gender, mask wearing, disease risk perception, disease severity perception

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3598 Subjective Well-Being in Individuals Diagnosed with an Autoimmune Disease: Resilience, and Rumination as Moderating Factors

Authors: Renae McNair

Abstract:

Subjective well-being levels were assessed in individuals diagnosed with an autoimmune disease. The current exploratory analysis sought to examine two factors that impact subjective well-being in individuals diagnosed with a chronic health condition. The two factors, resilience, and rumination, were assessed as possible moderators in self-reported levels of subjective well-being were measured. The importance of understanding the psychological state of perceived well-being in an individual diagnosed with an autoimmune disease is important given the impact of the level of subjective well-being on life longevity. In previous research, higher levels of subjective well-being are correlated with longer life longevity, including those individuals who have been diagnosed with an autoimmune disease. Conversely, individuals who report higher levels of negative affect have a shorter length of life longevity. According to the Center for Disease Control (CDC) and a report from the National Health Council, currently, 8-10% of individuals in the United States have been diagnosed with at least one autoimmune disease. Although treatment plans are in place to help manage the physical effects of disease, the psychological state of the person impacts life longevity. Resilience and rumination impact subjective well-being as an outcome in individuals diagnosed with an autoimmune disease. Resilience is the ability to adjust or adapt effectively and positively to unfavorable life conditions or events. Resilience acts as a protective factor in life, allowing those who face adversity to successfully adapt, regardless of the health diagnosis. Rumination is the worry or dwelling on the negative aspects of a given situation. Rumination interrupts the adaptive response, leading to a decrease in well-being. The relationship between resilience and subjective well-being were examined correlated with higher levels of resilience and higher levels of self-reported subjective well-being.

Keywords: subjective well-being, rumination, resilience, autoimmune disease

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3597 An Unusual Case of Wrist Pain: Idiopathic Avascular Necrosis of the Scaphoid, Preiser’s Disease

Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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3596 Manual Dexterity in Patients with Motor Neuron Disease

Authors: Magdalena Barbara Kaziuk, Ilona Hubner, Jacek Hubner, Slawomir Kroczka

Abstract:

Background: The motor neuron disease is a progressive neurodegenerative disease causing malfunction. Irrespective of the form of the disease and its onset always leads to the worsening of the quality of life, with patients usually depending on the family. Materials and methods: The study included 20 persons (5 females, 15 males, aged 65,5 ± 20 years) with clinically certain or probable diagnosis of the motor neuron disease. Patients were examined three times in the period of six months. The diagnosis was established based on the criteria of El Escorial. Manual dexterity was assessed using the test of the card Rene Zazzo and the test of shading in with lines Mira Stambak. Results: All patients achieved unsatisfactory results in Rene Zazzo’s test of the card and most of the patients (60%) in Mira Stambak’s test of shading with lines. Significantly higher test results were achieved for Rene Zazzo’s test and lower test results for Mira Stambak’s test in consecutive measurements. Conclusions: Impairment of manual dexterity is present already at the moment of diagnosing the disease and is growing significantly during its course. The quality of life for MND patients undergoes gradual deterioration as a result of the malfunction.

Keywords: manual dexterity, motor neuron disease, quality of life, malfunction

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3595 The Effect of Aerobic Training and Aqueous Extract of C. monogyna (Hawthorn) on Plasma and Heart Angiogenic Mediators in Male Wistar Rats

Authors: Asieh Abbassi Daloii, Ahmad Abdi

Abstract:

Introduction: Sports information suggests that physical inactivity increases the risk of many diseases, including atherosclerosis. Coronary heart disease, stroke and peripheral vascular disease, atherosclerosis and clinical protests. However, exercise can have beneficial effects on risk factors for atherosclerosis by reducing hyperlipidemia, hypertension, obesity, plaque density, increased insulin sensitivity and glucose tolerance is improved. Despite these findings, there is little information about the molecular mechanisms of interaction between the body and its relation to sport and there arteriosclerosis. The present study aims to investigate the effect of six weeks of progressive aerobic training and aqueous extract of crataegus monogyna on vascular endothelial growth factor (VEGF) variations and angiopoetin-1/2 (ANG- 1/2) in plasma and heart tissue in male Wistar rats. Methods: 30 male Wistar rats, 4-6 months old, were randomly divided into four groups: control crataegus monogyna (N=8), training crataegus monogyna (N=8), control saline (N=6), and training saline (N=8). The aerobic training program included running on treadmill at the speed of 34 meters per minute for 60 minutes per day. The training was conducted for six weeks, five days a week. Following each training session, both experimental and control subjects of crataegus monogyna groups were orally fed with 0.5 mg crataegus monogyna extract per gram of the body weight. The normal saline group was given the same amount of the normal saline solution (NS). Eventually, 72 hours after the last training session, blood samples were taken from inferior Verna cava. Conclusion: It is likely that crataegus monogyna extract compared with aerobic training and even combination of both training and crataegus monogyna extract is more effective on angiogenesis.

Keywords: angiopoietin 1, 2, vascular endothelial growth factor, aerobic exercise

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3594 Automated Ultrasound Carotid Artery Image Segmentation Using Curvelet Threshold Decomposition

Authors: Latha Subbiah, Dhanalakshmi Samiappan

Abstract:

In this paper, we propose denoising Common Carotid Artery (CCA) B mode ultrasound images by a decomposition approach to curvelet thresholding and automatic segmentation of the intima media thickness and adventitia boundary. By decomposition, the local geometry of the image, its direction of gradients are well preserved. The components are combined into a single vector valued function, thus removes noise patches. Double threshold is applied to inherently remove speckle noise in the image. The denoised image is segmented by active contour without specifying seed points. Combined with level set theory, they provide sub regions with continuous boundaries. The deformable contours match to the shapes and motion of objects in the images. A curve or a surface under constraints is developed from the image with the goal that it is pulled into the necessary features of the image. Region based and boundary based information are integrated to achieve the contour. The method treats the multiplicative speckle noise in objective and subjective quality measurements and thus leads to better-segmented results. The proposed denoising method gives better performance metrics compared with other state of art denoising algorithms.

Keywords: curvelet, decomposition, levelset, ultrasound

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3593 Fuzzy Inference System for Diagnosis of Malaria

Authors: Purnima Pandit

Abstract:

Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

Procedia PDF Downloads 268
3592 Assessing Arterial Blockages Using Animal Model and Computational Fluid Dynamics

Authors: Mohammad Al- Rawi, Ahmad Al- Jumaily

Abstract:

This paper investigates the effect of developing arterial blockage at the abdominal aorta on the blood pressure waveform at an externally accessible location suitable for invasive measurements such as the brachial and the femoral arteries. Arterial blockages are created surgically within the abdominal aorta of healthy Wistar rats to create narrowing resemblance conditions. Blood pressure waveforms are measured using a catheter inserted into the right femoral artery. Measurements are taken at the baseline healthy condition as well as at four different severities (20%, 50%, 80% and 100%) of arterial blockage. In vivo and in vitro measurements of the lumen diameter and wall thickness are taken using Magnetic Resonance Imaging (MRI) and microscopic techniques, respectively. These data are used to validate a 3D computational fluid dynamics model (CFD) which is developed to generalize the outcomes of this work and to determine the arterial stress and strain under the blockage conditions. This work indicates that an arterial blockage in excess of 20% of the lumen diameter significantly influences the pulse wave and reduces the systolic blood pressure at the right femoral artery. High wall shear stress and low circumferential strain are also generated at the blockage site.

Keywords: arterial blockage, pulse wave, atherosclerosis, CFD

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3591 A Theoretical to Conceptual Paper: The Use of Phosphodiesterase Inhibitors, Endothelin Receptor Antagonists and/or Prostacyclin Analogs in Acute Pulmonary Embolism

Authors: Ryan M. Monti, Bijal Mehta

Abstract:

In cases of massive pulmonary embolism, defined as acute pulmonary embolism presenting with systemic hypotension or right ventricular dysfunction and impending failure, there is indication that unconventional therapies, such as phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs may decrease the morbidity and mortality. Based on the premise that dilating the pulmonary artery will decrease the pulmonary vascular pressure, while simultaneously decreasing the aggregation of platelets, it can be hypothesized that increased blood flow through the pulmonary artery will decrease right heart strain and subsequent morbidity and mortality. While this theory has yet to be formally studied, the recommendations for treating massive pulmonary embolism with phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs in conjunction with the current standards of care in massive pulmonary embolism should be formally studied. In particular, patients with massive PE who are unable to undergo thrombolysis/surgical intervention may be the ideal population to study the use of these treatments to determine any decrease in mortality and morbidity (short term and long term).

Keywords: acute pulmonary thromboembolism, treatment of pulmonary embolism, use of phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclin analogs in PE

Procedia PDF Downloads 197
3590 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial

Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

Abstract:

Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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3589 Epidemiological Profile of Patients with Painful Degenerative Lumbar Disc Disease

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Degenerative disc disease is a process of premature and accelerated deterioration of the intervertebral disc; it is of multifactorial origin and is responsible for chronic low back pain. Objectives: Determine an epidemiological profile of patients with painful lumbar degenerative disc disease. Patients and methods: We performed a prospective study of 104 patients operated on for degenerative painful lumbar disc disease over a period of 25 months. The parameters analyzed were: age, sex, Body Mass Index (BMI), comorbidities, family history of low back pain, and difficulty with professional activity. Results: The average age was 43.3 years, with a clear predominance of men: 72 men for 32 women, the average BMI was 26.80Kg / m2, and 63.5% of the patients were overweight. The occurrence of disc degeneration in pathological conditions was noted in 14.4% of cases. The notion of familial low back pain was found in 49% of cases. The majority of patients perform more or less arduous work (51%) in the cases. Conclusion: In our series, degenerative painful lumbar disc disease predominates in the male subject, active obese who performs more or less painful work, in whom we find a family history of low back pain.

Keywords: degenerative disc disease, low back pain, body mass index, disque intervertebrale

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3588 Periodontal Disease or Cement Disease: New Frontier in the Treatment of Periodontal Disease in Dogs

Authors: C. Gallottini, W. Di Mari, A. Amaddeo, K. Barbaro, A. Dolci, G. Dolci, L. Gallottini, G. Barraco, S. Eramo

Abstract:

A group of 10 dogs (group A) with Periodontal Disease in the third stage, were subjected to regenerative therapy of periodontal tissues, by use of nano hydroxy apatite (NHA). These animals induced by general anesthesia, where treated by ultrasonic scaling, root planning, and at the end by a mucogingival flap in which it was applied NHA. The flap was closed and sutured with simple steps. Another group of 10 dogs (group B), control group, was treated only by scaling and root planning. No patient was subjected to antibiotic therapy. After three months, a check was made by inspection of the oral cavity, radiography and bone biopsy at the alveolar level. Group A showed a total restitutio ad integrum of the periodontal structures, and in group B still mild gingivitis in 70% of cases and 30% of the state remains unchanged. Numerous experimental studies both in animals and humans have documented that the grafts of porous hydroxyapatite are rapidly invaded by fibrovascular tissue which is subsequently converted into mature lamellar bone tissue by activating osteoblast. Since we acted on the removal of necrotic cementum and rehabilitating the root tissue by polishing without intervention in the ligament but only on anatomical functional interface of cement-blasts, we can connect the positive evolution of the clinical-only component of the cement that could represent this perspective, the only reason that Periodontal Disease become a Cement Disease, while all other clinical elements as nothing more than a clinical pathological accompanying.

Keywords: nanoidroxiaphatite, parodontal disease, cement disease, regenerative therapy

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3587 Defining of the Shape of the Spine Using Moiré Method in Case of Patients with Scheuermann Disease

Authors: Petra Balla, Gabor Manhertz, Akos Antal

Abstract:

Nowadays spinal deformities are very frequent problems among teenagers. Scheuermann disease is a one dimensional deformity of the spine, but it has prevalence over 11% of the children. A traditional technology, the moiré method was used by us for screening and diagnosing this type of spinal deformity. A LabVIEW program has been developed to evaluate the moiré pictures of patients with Scheuermann disease. Two different solutions were tested in this computer program, the extreme and the inflexion point calculation methods. Effects using these methods were compared and according to the results both solutions seemed to be appropriate. Statistical results showed better efficiency in case of the extreme search method where the average difference was only 6,09⁰.

Keywords: spinal deformity, picture evaluation, Moiré method, Scheuermann disease, curve detection, Moiré topography

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3586 Maackiain Attenuates Alpha-Synuclein Accumulation and Improves 6-OHDA-Induced Dopaminergic Neuron Degeneration in Parkinson's Disease Animal Model

Authors: Shao-Hsuan Chien, Ju-Hui Fu

Abstract:

Parkinson’s disease (PD) is a degenerative disorder of the central nervous system that is characterized by progressive loss of dopaminergic neurons in the substantia nigra pars compacta and motor impairment. Aggregation of α-synuclein in neuronal cells plays a key role in this disease. At present, therapeutics for PD provides moderate symptomatic benefit but is not able to delay the development of this disease. Current efforts for the treatment of PD are to identify new drugs that show slow or arrest progressive course of PD by interfering with a disease-specific pathogenetic process in PD patients. Maackiain is a bioactive compound isolated from the roots of the Chinese herb Sophora flavescens. The purpose of the present study was to assess the potential for maackiain to ameliorate PD in Caenorhabditis elegans models. Our data reveal that maackiain prevents α-synuclein accumulation in the transgenic Caenorhabditis elegans model and also improves dopaminergic neuron degeneration, food-sensing behavior, and life-span in 6-hydroxydopamine-induced Caenorhabditis elegans model, thus indicating its potential as a candidate antiparkinsonian drug.

Keywords: maackiain, Parkinson’s disease, dopaminergic neurons, α-Synuclein

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3585 Micro/Nano-Sized Emulsions Exhibit Antifungal Activity against Cucumber Downy Mildew

Authors: Kai-Fen Tu, Jenn-Wen Huang, Yao-Tung Lin

Abstract:

Cucumber is a major economic crop in the world. The global production of cucumber in 2017 was more than 71 million tonnes. Nonetheless, downy mildew, caused by Pseudoperonospora cubensis, is a devastating and common disease on cucumber in around 80 countries and causes severe economic losses. The long-term usage of fungicide also leads to the occurrence of fungicide resistance and decreases host resistance. In this study, six types of oil (neem oil, moringa oil, soybean oil, cinnamon oil, clove oil, and camellia oil) were selected to synthesize micro/nano-sized emulsions, and the disease control efficacy of micro/nano-sized emulsions were evaluated. Moreover, oil concentrations (0.125% - 1%) and droplet size of emulsion were studied. Results showed cinnamon-type emulsion had the best efficacy among these oils. The disease control efficacy of these emulsions increased as the oil concentration increased. Both disease incidence and disease severity were measured by detached leaf and pot experiment, respectively. For the droplet size effect, results showed that the 114 nm of droplet size synthesized by 0.25% cinnamon oil emulsion had the lowest disease incidence (6.67%) and lowest disease severity (33.33%). The release of zoospore was inhibited (5.33%), and the sporangia germination was damaged. These results suggest that cinnamon oil emulsion will be a valuable and environmentally friendly alternative to control cucumber downy mildew. The economic loss caused by plant disease could also be reduced.

Keywords: downy mildew, emulsion, oil droplet size, plant protectant

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3584 CMT4G: Rare Form of Charcot-Marie-Tooth Disease in Slovak Roma Patient

Authors: Dana Gabriková, Martin Mistrík, Jarmila Bernasovská, Iveta Tóthová, Jana Kisková

Abstract:

The Roma (Gypsies) is a transnational minority with a high degree of consanguineous marriages. Similar to other genetically isolated founder populations, the Roma harbor a number of unique or rare genetic disorders. This paper discusses about a rare form of Charcot-Marie-Tooth disease – type 4G (CMT4G), also called Hereditary Motor and Sensory Neuropathy type Russe, an autosomal recessive disease caused by mutation private to Roma characterized by abnormally increased density of non-myelinated axons. CMT4G was originally found in Bulgarian Roma and in 2009 two putative causative mutations in the HK1 gene were identified. Since then, several cases were reported in Roma families mainly from Bulgaria and Spain. Here we present a Slovak Roma family in which CMT4G was diagnosed on the basis of clinical examination and genetic testing. This case is a further proof of the role of the HK1 gene in pathogenesis of the disease. It confirms that mutation in the HK1 gene is a common cause of autosomal recessive CMT disease in Roma and should be considered as a common part of a diagnostic procedure.

Keywords: gypsies, HK1, HSMN-Russe, rare disease

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3583 Validity of Clinical Disease Activity Index (CDAI) to Evaluate the Disease Activity of Rheumatoid Arthritis Patients in Sri Lanka: A Prospective Follow up Study Based on Newly Diagnosed Patients

Authors: Keerthie Dissanayake, Chandrika Jayasinghe, Priyani Wanigasekara, Jayampathy Dissanayake, Ajith Sominanda

Abstract:

The routine use of Disease Activity Score-28 (DAS28) to assess the disease activity in rheumatoid arthritis (RA) is limited due to its dependency on laboratory investigations and the complex calculations involved. In contrast, the clinical disease activity index (CDAI) is simple to calculate, which makes the "treat to target" strategy for the management of RA more practical. We aimed to assess the validity of CDAI compared to DAS28 in RA patients in Sri Lanka. A total of 103 newly diagnosed RA patients were recruited, and their disease activity was calculated using DAS 28 and CDAI during the first visit to the clinic (0 months) and re-assessed at 4 and 9 months of the follow-up visits. The validity of the CDAI, compared to DAS 28, was evaluated. Patients had a female preponderance (6:1) and a short symptom duration (mean = 6.33 months). The construct validity of CDAI, as assessed by Cronbach's α test, was 0.868. Convergent validity was assessed by correlation and Kappa statistics. Strong positive correlations were observed between CDAI and DAS 28 at the baseline (0 months), 4, and 9 months of evaluation (Spearman's r = 0.9357, 0.9354, 0.9106, respectively). Moderate-good inter-rater agreements between the DAS-28 and CDAI were observed (Weighted kappa of 0.660, 0.519, and 0.741 at 0, 4, and 9 months respectively). Discriminant validity, as assessed by ROC curves at 0, 4th, and 9th months of the evaluation, showed the area under the curve (AUC) of 0.958, 0.985, and 0.914, respectively. The suggested cut-off points for different CDAI disease activity categories according to ROC curves were ≤ 2 (Remission), >2 to ≤ 5 (low), >5 to ≤ 18 (moderate), > 18 (high). These findings indicate that the CDAI has good concordance with DAS 28 in assessing the disease activity in RA patients in this study sample.

Keywords: rheumatoid arthritis, CDAI, disease activity, Sri Lanka, validation

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3582 Vaccine Development for Newcastle Disease Virus in Poultry

Authors: Muhammad Asif Rasheed

Abstract:

Newcastle disease virus (NDV), an avian orthoavulavirus, is a causative agent of Newcastle disease named (NDV) and can cause even the epidemics when the disease is not treated. Previously several vaccines based on attenuated and inactivated viruses have been reported, which are rendered useless with the passage of time due to versatile changes in viral genome. Therefore, we aimed to develop an effective multi-epitope vaccine against the haemagglutinin neuraminidase (HN) protein of 26 NDV strains from Pakistan through a modern immunoinformatic approaches. As a result, a vaccine chimaera was constructed by combining T-cell and B-cell epitopes with the appropriate linkers and adjuvant. The designed vaccine was highly immunogenic, non-allergen, and antigenic; therefore, the potential 3D-structureof multi epitope vaccine was constructed, refined, and validated. A molecular docking study of a multiepitope vaccine candidate with the chicken Toll-like receptor-4 indicated successful binding. An In silico immunological simulation was used to evaluate the candidate vaccine's ability to elicit an effective immune response. According to the computational studies, the proposed multiepitope vaccine is physically stable and may induce immune responses, whichsuggested it a strong candidate against 26 Newcastle disease virus strains from Pakistan. A wet lab study is under process to confirm the results.

Keywords: epitopes, newcastle disease virus, paramyxovirus virus, vaccine

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3581 Endothelial Progenitor Cell Biology in Ankylosing Spondylitis

Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

Abstract:

Aim: Endothelial progenitor cells (EPCs) are unique populations which have reparative potential in overcoming the endothelial damage and reducing cardiovascular risk. Patients with ankylosing spondylitis (AS) have increased risk of cardiovascular morbidity and mortality. The aim of this study was to investigate the endothelial progenitor cell population in AS patients and its potential relationships with disease variables. Methods: Endothelial progenitor cells were measured in peripheral blood samples from 20 AS and 20 healthy controls by flow cytometry on the basis of CD34 and CD133 expression. Disease activity was evaluated by using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Functional ability was monitored by using Bath Ankylosing Spondylitis Functional Index (BASFI). Results: EPCs were depleted in AS patients as compared to the healthy controls (CD34+/CD133+: 0.027 ± 0.010 % vs. 0.044 ± 0.011 %, p<0.001). EPCs depletion were significantly associated with disease duration (r=-0.52, p=0.01) and BASDAI (r=-0.45, p=0.04). Conclusion: This is the first study to demonstrate endothelial progenitor cells depletion in AS patients. EPCs depletion inversely correlates with disease duration and disease activity, suggesting the pivotal role of inflammation in depletion of EPCs. EPC would possibly also serve as a therapeutic target for preventing cardiovascular disease in AS.

Keywords: ankylosing spondylitis, endothelial progenitor cells, inflammation, vascular damage

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3580 Acupuncture in the Treatment of Parkinson's Disease-Related Fatigue: A Pilot Randomized, Controlled Study

Authors: Keng H. Kong, Louis C. Tan, Wing L. Aw, Kay Y. Tay

Abstract:

Background: Fatigue is a common problem in patients with Parkinson's disease, with reported prevalence of up to 70%. Fatigue can be disabling and has adverse effects on patients' quality of life. There is currently no satisfactory treatment of fatigue. Acupuncture is effective in the treatment of fatigue, especially that related to cancer. Its role in Parkinson's disease-related fatigue is uncertain. Aims: To evaluate the clinical efficacy of acupuncture treatment in Parkinson's disease-related fatigue. Hypothesis: We hypothesize that acupuncture is effective in alleviating Parkinson's disease-related fatigue. Design: A single center, randomized, controlled study with two parallel arms. Participants: Forty participants with idiopathic Parkinson's disease will be enrolled. Interventions: Participants will be randomized to receive verum (real) acupuncture or placebo acupuncture. The retractable non-invasive sham needle will be used in the placebo group. The intervention will be administered twice a week for five weeks. Main outcome measures: The primary outcome will be the change in general fatigue score of the multidimensional fatigue inventory at week 5. Secondary outcome measures include other subscales of the multidimensional fatigue inventory, movement disorders society-unified Parkinson's disease rating scale, Parkinson's disease questionnaire-39 and geriatric depression scale. All outcome measures will be assessed at baseline (week 0), completion of intervention (week 5) and 4 weeks after completion of intervention (week 9). Results: To date, 23 participants have been recruited and nine have completed the study. The mean age is 63.5±14.2 years, mean duration of Parkinson’s disease is 6.4±1.8 years and mean MDS-UPDRS score is 8.3±2.8. The mean general fatigue score of the multidimensional fatigue inventory is 13.5±4.6. No significant adverse event related to acupuncture is noted. Potential significance: If the results are as expected, this study will provide preliminary scientific evidence for the efficacy of acupuncture in Parkinson's Disease-related fatigue, and opens the door for a larger multicentre trial to be performed. In the longer term, it may lead to the integration of acupuncture in the care of patients with Parkinson's disease.

Keywords: acupuncture, fatigue, Parkinson's disease, trial

Procedia PDF Downloads 274
3579 Role of HLA Typing in Celiac Disease

Authors: Meriche Hacene

Abstract:

Introduction: Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by gluten found in wheat or oats or rye. Celiac disease is associated with the HLA-DQ2 and HLA-DQ8 susceptibility alleles. This association with the HLA DQ2/DQ8 molecules confirmed the responsibility of genetic factors that intervene in the triggering of the autoimmune process of this condition. Objective: To evaluate the results of HLA DQ2 and HLA DQ8 typing of 40 patients suspected of having CD by PCR-SSP (Polymerase Chain Reaction Sequence Specific Primers). Material and method : 40 patients suspected of celiac disease with IgA transglutaminase serology (-) and duodenal biopsy (+). HLADR/DQ PCR-SSP (fluogen-innotrain) typing was carried out. Results : The average age of adults was 40 years, children: 4 years, the sex ratio was 1M/3F. In our patients the HLA DQ2 allele is found with a frequency of 75%, the DQ8 with a frequency of 25%, 17.5% were HLA-DQ2 homozygous and 15% were HLADQ2/HLADQ8. In our series, HLADQ2, DQ8 are found in almost all patients with a frequency of 95%. 30% of patients in our study had associated positivity of HLA-DRB3, DRB4 or DRB5 alleles. Conclusion : A high prevalence of positivity of HLADQ2 alleles at the expense of HLA DQ8 was found, which is consistent with literature data. These molecules constitute an additional marker for screening and diagnosis of CD.

Keywords: HLA typing, coeliac disease, HLA DQ 2, HLA DQ8

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3578 Disease Level Assessment in Wheat Plots Using a Residual Deep Learning Algorithm

Authors: Felipe A. Guth, Shane Ward, Kevin McDonnell

Abstract:

The assessment of disease levels in crop fields is an important and time-consuming task that generally relies on expert knowledge of trained individuals. Image classification in agriculture problems historically has been based on classical machine learning strategies that make use of hand-engineered features in the top of a classification algorithm. This approach tends to not produce results with high accuracy and generalization to the classes classified by the system when the nature of the elements has a significant variability. The advent of deep convolutional neural networks has revolutionized the field of machine learning, especially in computer vision tasks. These networks have great resourcefulness of learning and have been applied successfully to image classification and object detection tasks in the last years. The objective of this work was to propose a new method based on deep learning convolutional neural networks towards the task of disease level monitoring. Common RGB images of winter wheat were obtained during a growing season. Five categories of disease levels presence were produced, in collaboration with agronomists, for the algorithm classification. Disease level tasks performed by experts provided ground truth data for the disease score of the same winter wheat plots were RGB images were acquired. The system had an overall accuracy of 84% on the discrimination of the disease level classes.

Keywords: crop disease assessment, deep learning, precision agriculture, residual neural networks

Procedia PDF Downloads 295