One year prognosis of young Middle Eastern patients undergoing percutaneous coronary interventions

Background: There is scarcity of data about the outcome in young Middle Eastern patients who undergo percutaneous coronary intervention (PCI). We sought to assess clinical and coronary angiographic features and one year outcome of young compared with older patients following PCI.Methods: Baseline clinical and coronary angiographic features and major cardiovascular events from hospital admission to one year were assessed in young patients (45 years of age).Results: Of 2426 patients; 308 (12.7%) were young. Young and older patients were predominantly males (76.3% vs. 79.8%; p=0.18) and had similar prevalence of hypertension, diabetes, dyslipidemia, and cigarette smoking. There were no differences between young and older patients in the rates of acute coronary syndrome as an indication for PCI (75.6% vs. 76.1%; p=0.90). The two groups had similar prevalence of one-vessel coronary artery disease (55.2% vs. 58.1%; p=0.37) and intervention for one vessel (74.0% vs. 72.1%; p=0.53). No significant differences were observed in the incidence of in-hospital adverse events in young compared with older patients. Incidence of adverse events in young patients at one year were not different from those in older patients, including cardiac death (3.63% vs. 2.11%), stent thrombosis (3.63% vs. 2.08%), major bleeding (1.30% vs. 1.18%), and coronary revascularization (3.65% vs. 3.24%); all p=NS.Conclusions: Among Middle Eastern patients undergoing coronary intervention; 13% were 45 years of age or younger. No favourable risk profile, coronary angiographic features or cardiovascular outcome were observed in young compared with older patients

Reduction in Radiation Exposure in Cardiovascular CT Imaging

Advances of cardiac computed tomography angiography (CTA) have been developed for dose reduction, but their efficacy in clinical practice is largely unknown. This study was designed to evaluate radiation dose exposure and utilization of dose-saving strategies for contrast-enhanced cardiac CTA in daily practice

Two Cases of Gastrointestinal Delusional Parasitosis Presenting as Folie á Deux

Delusional parasitosis is a psychiatric illness in which patients believe that they are infested by parasites without any evidence to support this belief. Cases typically involve cutaneous manifestations. We present 2 cases of gastrointestinal delusional parasitosis, with one unfortunate fatal outcome. Our main goal is to highlight the importance of early recognition of this disease to facilitate appropriate management. Delusional infestation is considered a somatic delusional disorder, and first-line treatment involves the use of atypical antipsychotics, as recommended by the Diagnostic and Statistical Manual, 5th edition

Pancreatic Pseudocyst Hemorrhage Complicated by an Acute ST-Elevation Myocardial Infarction

ST-segment elevation myocardial infarction is a medical emergency that requires immediate treatment with potent anti-platelet and anti-coagulant therapies and reperfusion by percutaneous coronary intervention. The use of anti-platelet and anti-coagulant therapies can result in hemorrhagic complications, and their use is challenging in a patient with an active gastrointestinal bleed. We report the case of a patient who simultaneously presented with both an ST-segment elevation myocardial infarction and a hemorrhagic pancreatic pseudocyst. There are currently no comprehensive recommendations to guide treatment of these conditions when presenting concomitantly. This case outlines the multi-disciplinary approach taken by our cardiology and gastroenterology teams and highlights the need to develop management algorithms for these two life-threatening conditions. Keywords: pancreatic pseudocyst hemorrhage; st-elevation myocardial infarction (stemi); upper gi bleed

One year prognosis of young Middle Eastern patients undergoing percutaneous coronary interventions

Background: There is scarcity of data about the outcome in young Middle Eastern patients who undergo percutaneous coronary intervention (PCI). We sought to assess clinical and coronary angiographic features and one year outcome of young compared with older patients following PCI.Methods: Baseline clinical and coronary angiographic features and major cardiovascular events from hospital admission to one year were assessed in young patients (<45 years of age) compared with older patients (>45 years of age).Results: Of 2426 patients; 308 (12.7%) were young. Young and older patients were predominantly males (76.3% vs. 79.8%; p=0.18) and had similar prevalence of hypertension, diabetes, dyslipidemia, and cigarette smoking. There were no differences between young and older patients in the rates of acute coronary syndrome as an indication for PCI (75.6% vs. 76.1%; p=0.90). The two groups had similar prevalence of one-vessel coronary artery disease (55.2% vs. 58.1%; p=0.37) and intervention for one vessel (74.0% vs. 72.1%; p=0.53). No significant differences were observed in the incidence of in-hospital adverse events in young compared with older patients. Incidence of adverse events in young patients at one year were not different from those in older patients, including cardiac death (3.63% vs. 2.11%), stent thrombosis (3.63% vs. 2.08%), major bleeding (1.30% vs. 1.18%), and coronary revascularization (3.65% vs. 3.24%); all p=NS.Conclusions: Among Middle Eastern patients undergoing coronary intervention; 13% were 45 years of age or younger. No favourable risk profile, coronary angiographic features or cardiovascular outcome were observed in young compared with older patients

A Hydrogen-Bonded Organic Framework Equipped with a Molecular Nano-Valve

The concept of a molecular nano-valve is applied to a newly synthesized biocompatible hydrogen-bonded organic framework (HOF), termed RSS-140, in order to load, trap, and subsequently release an antioxidant on command. Specifically, we exploit the pore windows of RSS-140 (i.e., β-CD cavities) to first load and trap the antioxidant, Trolox, within the internal pores of the HOF (Trolox⊂RSS-140) and, to prevent it from leaching, utilize supramolecular chemistry to complex azobenzene (Azo) with β-CD (Trolox⊂Azo@RSS-140). The molecular nano-valve is fully realized upon exposing Trolox⊂Azo@RSS-140 to UV light with a specific wavelength, which induces Azo isomerization, Azo decomplexation from β-CD, and subsequent release of Trolox from the pores of RSS-140. The biocompatibility and non-toxicity of Trolox⊂Azo@RSS-140, together with the absolute control over the nano-valve opening, was established to yield a system that safely and slowly releases Trolox for longer-lasting antioxidant efficacy. As the field of supramolecular chemistry is rich with similar systems and many such systems can be used as building blocks to construct HOFs or other extended framework materials, we envision the molecular nano-valve concept to be applied widely for controllably delivering molecular cargo for diverse applications