Acute chest pain of coronary origin in patients without diabetes : how multidetector computed tomography (MDCT) angiography helps in diagnosis

Background: To assess the diagnostic value of MDCT coronary angiography for evaluation of acute chest pain of coronary origin in non-diabetic patients. Material/Methods: In 22 patients without DM, we assessed coronary arteries with multidetector CT angiography and invasive conventional angiography. Results: CT coronary angiography revealed positive coronary artery disease findings in 16 patients; LAD was affected in 16 (72.3%), RCA in 14 (63.3%), and LCX in 8 (36.4%) cases. The proximal part of LAD was the most commonly affected coronary artery (14 cases, 63.3%) in the studied patients who underwent MSCT coronary angiography. As regards the calcium score, 4 patients (18%) had low calcium scores, 6 cases (27%) had moderate calcium scores, and 12 cases (55%) had high calcium scores. There were 6 patients with positive findings of coronary artery disease detected on MDCT coronary angiography that were not mirrored by conventional angiography. Conclusions: MDCT angiography of the coronaries is a good and rapid method for evaluation of the coronary anatomy and for early detection and grading of coronary lesions in non-diabetic patients

Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (riyadh cohort 2): a decade of an epidemic

<p>Abstract</p> <p>Background</p> <p>Follow-up epidemiologic studies are needed to assess trends and patterns of disease spread. No follow-up epidemiologic study has been done in the Kingdom of Saudi Arabia to assess the current prevalence of major chronic, noncommunicable diseases, specifically in the urban region, where modifiable risk factors remain rampant. This study aims to fill this gap.</p> <p>Methods</p> <p>A total of 9,149 adult Saudis ages seven to eighty years (5,357 males (58.6%) and 3,792 females (41.4%)) were randomly selected from the Riyadh Cohort Study for inclusion. Diagnosis of type 2 diabetes mellitus (DMT2) and obesity were based on the World Health Organization definitions. Diagnoses of hypertension and coronary artery disease (CAD) were based on the Seventh Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and American Heart Association criteria, respectively.</p> <p>Results</p> <p>The overall crude prevalence of DMT2 was 23.1% (95% confidence interval (95% CI) 20.47 to 22.15). The age-adjusted prevalence of DMT2 was 31.6%. DMT2 prevalence was significantly higher in males, with an overall age-adjusted prevalence of 34.7% (95% CI 32.6 to 35.4), than in females, who had an overall age-adjusted prevalence of 28.6% (95% CI 26.7 to 29.3) (<it>P </it>< 0.001). The overall crude prevalence of obesity was 31.1% (95% CI 30.1 to 32.0). The age-adjusted prevalence of obesity was 40.0%. The prevalence of obesity was higher in females, with an overall prevalence of 36.5% (95% CI 35.1 to 37.83), than in males (25.1% (95% CI 23.7 to 26.3)) (<it>P </it>< 0.001). The age-adjusted prevalence of hypertension and CAD were 32.6% (95% CI 31.7 to 33.6) and 6.9% (95% CI 6.4 to 7.4), respectively.</p> <p>Conclusion</p> <p>Comparisons of our findings with earlier data show that the prevalence of DMT2, hypertension and CAD in Riyadh, Saudi Arabia, has alarmingly worsened. Aggressive promotion of public awareness, continued screening and early intervention are pivotal to boosting a positive response.</p

Prognostic Value of Urokinase Plasminogen Activator Receptor (Upar) and Neutrophil CD64 Expression in Acute Respiratory Distress Syndrome Patients

The outcome of acute respiratory distress syndrome (ARDS) may vary from complete recovery to multiorgan failure and death. The current study evaluates the prognostic performance of plasma uPAR and Neutrophil expression of CD64 in patients with ARDS of different etiologies and tests the possible correlation with other prognostic markers, namely APACHE-II score and serum CRP. The current study included 2 groups: 68 patients with ARDS and 25 age- and sex-matched, randomly selected, healthy control subjects. Blood samples were taken for routine laboratory tests on admission to ICU. Plasma uPAR was measured using a commercially available ELISA kit, and neutrophil CD64 expression was measured using flow cytometry. Plasma uPar was significantly higher in bacteremic ARDS patients than those without bacteremia. There was also a significant increase in plasma uPAR in ARDS survivors than in those who died. CD64 expression showed a similar pattern of increase in bacteremic ARDS. Using ROC curves plasma uPAR outperformed CD64 expression and CRP as a prognostic indicator in the studied ARDS patients. A cut-off value for plasma uPAR which almost always predicted mortality was 15.1 ng/ml with PPV of 100% and NPV 97%. Plasma uPAR is significantly elevated in ARDS patients and has a superior prognostic value to both neutrophil CD64 expression and scrum CRP in ARDS patients. A plasma uPAR cutoff value of 15.1 ng/ml has a PPV of 100% and NPV of 97% in predicting mortality in the ARDS patient included in the current study