Right ventricular thrombus in a 36-year-old man with Factor v Leiden

Factor V Leiden deficiency is the most common hereditary hypercoagulable disease in the United States and involves 5 of the Caucasian population. Up to 30 of patients who present with deep vein thrombosis (DVT) or pulmonary thromboembolism present with this condition. This is a case report of a 36-year-old man who experienced one episode of DVT within the previous year and was admitted to our hospital due to productive coughs and hemoptysis. Paraclinical studies demonstrated a right ventricular thrombus. Additional investigation was done to find the underlying cause. Laboratory tests were positive for Factor V Leiden mutation. Other factors for hypercoagulability states were normal. Given that Factor V Leiden mutation is a life-threatening condition with a relatively high prevalence and considering its thrombogenesis, screening tests are necessary in young patients without obvious reasons for recurrent thrombus formation. It seems that medical noninvasive treatments can be an alternative therapy to surgery when a ventricular thrombus is suspected in these patients. � 2015 Tehran Heart Center. All rights reserved

Left ventricular mass index and pulmonary artery pressure in patients with the obstructive sleep apnea syndrome

Background: Sleep apnea is accompanied by some cardiovascular complications. It has even been hypothesized that sleep apnea, itself, can induce some of these complications. Given such controversies, we assessed the left ventricular mass index (LVMI) and systolic pulmonary artery pressure in patients with sleep apnea. Methods: Through convenience sampling, 56 patients with the obstructive sleep apnea syndrome (OSAS) were included in the present descriptive cross-sectional study. Patients with any past history of hypertension and diabetes mellitus were excluded. The apnea severity was assessed via the polysomnography-derived apnea-hypopnea index (AHI). All the patients underwent transthoracic echocardiography. In this cross-sectional study-data regarding age, gender, smoking, systolic and diastolic blood pressures, polysomnographic parameters (AHI, severity of disease, mean heart rate, mean oxygen saturation SaO2, lowest SaO2, and duration of SaO2 below 90% d.SaO2 < 90%), and echocardiographic parameters (systolic pulmonary artery pressure and LVMI) were accumulated and processed. Results: Fifty-two men and 14 women at a mean age of 49.29 ± 11.79 years participated in this study. Systolic and was significantly high in the severe group compared with the mild group (128.21 ± 9.73 mmHg vs. 119.23 ± 12.5 mmHg; p value = 0.007). The LVMI was increased parallel to an increase in the severity of the OSAS, but that increase was not statistically significant (p value = 0.161). The d.SaO2 < 90% was positively correlated with the LVMI, and this relationship remained true after adjustment for the body mass index (r = 0.27; p value = 0.042). Conclusion: Severe OSAS was accompanied by a higher blood pressure. The LVMI did not differ significantly between the patients with the OSAS and those who did not suffer from other risk factors of cardiac diseases. © 2016, Tehran Heart Center. All rights reserved

Prasugrel results in higher decrease in high-sensitivity C-reactive protein level in patients undergoing percutaneous coronary intervention comparing to clopidogrel

Objectives: A growing body of clinical and laboratory evidence indicates that inflammation plays a crucial role in atherosclerosis. In the present study, we compared the effects of clopidogrel and prasugrel on high-sensitivity C-reactive protein (hs-CRP) in patients undergoing percutaneous coronary intervention (PCI). Methods: The present randomized, double-blind clinical trial included 120 patients who underwent PCI. Eligible patients were randomly assigned 2:1 to one of the two groups: 80 patients in the first group received clopidogrel (Plavix®; loading dose and maintenance dose of 300 and 75 mg daily, respec-tively) and 40 patients in the second group received prasugrel (Effient®; loading dose and maintenance dose of 60 and 10 mg, respectively) for 12 weeks. The hs-CRP levels between baseline and 12th week were compared.Results: Of the 120 patients, 69 patients (57.5) were male. Pretreatment hs-CRP level was statistically comparable in clopidogrel (median, 15.10 mg/dL; interquartile range IQR, 9.62-23.75 mg/dL) and prasugrel groups (median, 18 mg/dL; IQR, 14.25-22 mg/dL; P = 0.06). Patients taking clopidogrel showed a significant reduction in hs-CRP level compared with the baseline values (P < 0.001). Prasugrel administration also resulted in a significant reduc-tion in hs-CRP level (P < 0.001). A significant 73% overall reduction in the hs-CRP level was seen with prasugrel compared with 39% overall reduction in hs-CRP level with clopidogrel (P = 0.002). Conclusion: Prasugrel seems to be superior to clopidogrel in the reduction of hs-CRP in patients undergoing PCI. © the authors, publisher and licensee Libertas Academica Limited

Effective high compression of ECG signals at low level distortion

An effective method for compression of ECG signals, which falls within the transform lossy compression category, is proposed. The transformation is realized by a fast wavelet transform. The effectiveness of the approach, in relation to the simplicity and speed of its implementation, is a consequence of the efficient storage of the outputs of the algorithm which is realized in compressed Hierarchical Data Format. The compression performance is tested on the MIT-BIH Arrhythmia database producing compression results which largely improve upon recently reported benchmarks on the same database. For a distortion corresponding to a percentage root-mean-square difference (PRD) of 0.53, in mean value, the achieved average compression ratio is 23.17 with quality score of 43.93. For a mean value of PRD up to 1.71 the compression ratio increases up to 62.5. The compression of a 30 min record is realized in an average time of 0.14 s. The insignificant delay for the compression process, together with the high compression ratio achieved at low level distortion and the negligible time for the signal recovery, uphold the suitability of the technique for supporting distant clinical health care

ON THE COMPUTATION OF A PRECISE GEOID – TO – QUASIGEOID SEPARATION

In geodesy, orthometric and normal heights are considered as basic height systems on the earth. The reference surfaces for these heights are the geoid and quasigeoid respectively. Taking advantage of GNSS measurements, one can achieve a precise solution for the geoid and for the quasigeoid. Two methods, called direct and indirect, are worked out in this research for the computation of separation between geoid and quasigeoid in a mountainous region in the USA. The area selected for this purpose is mountainous and rough enough in order to be able to show the effect of roughness of topography in the sought quantity. The results of the two methods and testing them against GNSS-Levelling on 445 known points indicates an accuracy of 1.3 cm in RMS scale with the direct method, where there is 7 cm as an average difference between the observed geoid and quasigeoid separation and the same quantity derived from the direct method. Using Chi-squared goodness of fit test showed that the distribution of the residual quantities are normally distributed in the test area

Association between vitamin b12 serum level and staging of colorectal cancer in semnan city

Introduction: The prevalence of colorectal cancer is on the rise, with a high prevalence of vitamin B12 levels. Some studies have reported vitamin B12 deficiency as a risk factor for colorectal cancer. We aimed to determine the relationship between serum vitamin B12 levels and the stage of disease in colorectal cancer patients. Materials and Methods: This cross-sectional study was performed on 43 colorectal cancer patients referring to the Oncology Clinic of Semnan in 2016-2018. Patients received blood tests for serum vitamin B12 levels measurement. Data on age, gender, stage of disease, tumor penetration depth, regional lymph node involvement, remote metastasis, and tumor location were extracted from medical records and pathologic reports. Finally, the relationship between serum vitamin B12 levels and these variables was investigated. Results: The mean level of vitamin B12 among women was significantly higher than that of men (P = 0.015). On average, 62.5 of patients with the stages 2 and 3 as well as 41.8 of patients with the stage4 showed abnormal serum levels of vitamin B12 (deficiency and partial deficiency), while no significant difference was seen (P=0.613). Vitamin levels in patients with lymph node involvement were higher than those without lymph node involvement, but there was no significant difference between them (P = 0.236). Also, levels of vitamin B12 in patients with distant metastases were higher than those without such metastases, but there was insignificant difference between them (P= 0.290). Conclusion: More extensive studies with a larger sample size are recommended to evaluate the relationship between serum vitamin B12 levels and the disease stage in predicting the prognosis of colorectal cancer patients with vitamin B12 deficiency. © 2020, Advanced Scientific Research. All rights reserved

Neopterin serum level does not reflect the disease activity in rheumatoid arthritis: A systematic review and meta-analysis

Rheumatoid arthritis (RA) is a chronic autoimmune disease caused by established chronic inflammation. Neopterin levels have extensively been considered as a marker of immune activation during inflammation. In this study, we performed a systematic evaluation and meta-analysis to elucidate the overall relationship between neopterin concentration and RA disease activity. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted using PubMed, Google Scholar, Web of Science, and Scopus from 2000 to August 2020. The Newcastle�Ottawa scale was used to assess the quality of eligible studies. The effect size (ES) and corresponding 95 confidence intervals (CIs) were calculated to evaluate this association. A total of 15 studies out of 98 met our inclusion criteria. The pooled analysis found that patients with RA had high level of neopterin; however, no statistically significant association was found between neopterin levels with high, intermediate, and low diseases activity score (DAS)-28 (ES =11.18, 95 CI: 6.02 to 16.34, and I2 = 91.8; and ES = 8.57, 95 CI: 6.41 to 10.37, and I2 = 99.5; and ES =12.45, 95 CI: �1.68 to 26.58, and I2 = 99.0, respectively). Our results indicated that the neopterin concentration does not seem to have any substantial impact on the RA disease activity. © 2020 International Union of Biochemistry and Molecular Biolog

Mismanagement of Wilson′s disease as psychotic disorder

Wilson′s disease (WD) or hepatolenticular degeneration is an inherited neurodegenerative disorder of copper metabolism (autosomal recessive, chromosome13). Psychiatric disorders in WD include dementia, characterized by mental slowness, poor concentration, and memory impairment. Symptoms may progress rapidly, especially in younger patients, but are more often gradual in development with periods of remission and exacerbation. Delusional disorder and schizophrenia-like psychosis are rare forms of psychiatric presentation. In this report, the patient with WD presented by psychosis symptoms and treated mistaken as schizophrenia for almost ten years. Although he has treated with antipsychotics, he had periods of remissions and relapses and never was symptoms free. Since psychosis can be the manifestation of medical diseases such as WD, overall view of these patients is necessary and medical diseases should be considered as a differential diagnosis

Innate immune response in systemic autoimmune diseases: a potential target of therapy

Innate immunity refers to defense mechanisms that are always present, ready to combat microbes and other offending agents. Innate immunity acts as a first-line defense and activates the conventional immune responses; however, it has been speculated that the importance of innate immunity in initiation and development of some disorders is more than just the �first line of defense�. Autoimmune diseases, caused by immune system overactivation, are among the most challenging scientific and clinical problems, and there is still much to be learned about their pathogenesis. We aimed to provide a comprehensive overview of available documents about the role of innate immunity in systemic autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus, Sjögren�s syndrome, polymyositis, and systemic sclerosis. This study highlights the innate immunity pathways or molecules that are under investigation for therapy of these diseases. © 2020, Springer Nature Switzerland AG