Seizure following removal of Swan Ganz Catheter

Venous air embolism (VAE) is an infrequent incident with fatal consequences during insertion or removal of central venous catheters. It is befalling when air or gas arrives at the vascular system. In this case report, we present a case of a 38-year-old female patient with an air embolism after removal of the Swan Ganz catheter that caused the seizure and cardiac arrest. There is an overview of the causes and ways to prevent VAE in the patien

Superselective Angioembolisation: A Report of Two Rare Cases of Hemoptysis

Superselective bronchial embolization is recently performed with a high success rate. The current study aimed at discussing the procedure and reporting two cases underwent embolization in the Masih-Daneshvari Hospital, a large center for this procedure, in Iran

Remdesivir associated sinus bradycardia in patients with COVID-19: A prospective longitudinal study

Background: Remdesivir is effective against SARS-Cov-2 with little evidence of its adverse effect on the cardiac system. The aim of the present study is investigating the incidence of bradycardia in COVID-19 patients treated with Remdesivir.Methods: This prospective longitudinal study was conducted in a tertiary center on COVID-19 patients for Remdesivir therapy. The objectives were to investigate the incidence of sinus bradycardia, and also the association between their demographics, underlying diseases, and the disease severity with developing bradycardia in COVID-19 patients treated with Remdesivir.Results: Of 177 patients, 44% were male. The mean (±standard deviation) age of patients was 49.79 ± 15.16 years old. Also, 33% were hospitalized due to more severe symptoms. Oxygen support was required for all hospitalized subjects. A total of 40% of the patients had comorbidities, with the most common comorbidity being hypertension. The overall incidence of bradycardia (heart rate<60 bpm) in patients receiving Remdesivir was 27%, of whom 70% had extreme bradycardia (heart rate <50 bpm). There was also a statistically significant reduction in heart rate after five doses of Remdesivir compared to the baseline heart rates. In the multivariable model, none of the covariates including age above 60 years, female sex, CRP>50 mg/L, O2 saturation<90%, underlying cardiovascular disease, hypertension and diabetes mellitus, and beta-blockers were associated with Remdesivir-induced bradycardia. No association was found between the COVID-19 severity indicators and bradycardia.Conclusion: As sinus bradycardia is a prevalent adverse cardiac effect of Remdesivir, it is recommended that all COVID-19 patients receiving Remdesivir, be evaluated for heart rate based on examination; and in the case of bradyarrhythmia, cardiac monitoring should be performed during administration to prevent adverse drug reactions

Characteristics of convalescent plasma donors for Covid-19: Barriers for consent

Background and Objective: Covid-19 pandemic is a worldwide bothersome issue. Although the appropriate strategy for plasma donation from recovered Covid-19 cases should be based on clinical, laboratory, and demographic characteristics of cases, consent for plasma donation is crucial. Moreover, the safety of donation is important not only for receiving cases but also for donor subjects. Accordingly in this study, the existing conditions in plasma donors for Covid-19 were assessed. Materials and Methods: In this descriptive cross-sectional study, 264 consecutive cases with positive Covid-19 infection history were enrolled in 2020 a total of 64 cases were eligible for plasma donation. The initial two stages for consent and medical history were done by phone call and two final steps including laboratory results and physical examination were carried out after patients’ attendance to the hospital. Results: Mean (standard deviation) age was 45.3 (9.1) years. There were 58 male cases (90.6%). Totally 70.3% had academic literacy and 90.6% were married. Even thirteen cases (20.3%) had underlying diseases. There was not any significant early or late complication during donation. Causes for plasma donation were mentioned help to humankind, severe disease experience, and help to research projects in 41 (64.1%), 14 (21.8%), and 9 (14.1%) cases, respectively. Conclusions: It is necessary to inform the post-covid-19 patient about the advantages of plasma donation as a safe way for critically ill patients to decrease the burden of the disease in their current condition without confirmed drugs

پیامدهای قلبی دسته ی دارویی گلیفلوزین در بیماران دیابتی نوع 2 مبتلا به نارسایی قلبی با کسر جهشی حفظ شده

زمینه: نارسایی قلبی یک سندرم بالینی است که منجر به اختلال در پر شدن بطن یا خروج خون از قلب می شود. تا 40 درصد از بیماران نارسایی قلبی، همزمان دیابت نوع 2 دارند و نسبت مشابهی، با اختلال تحمل گلوکز تظاهر می کنند که هر دو باعث افزایش مرگ و میر می شوند. مهارکننده‌های ناقل سدیم-گلوکز-2 ، دسته جدیدی از داروهای کاهنده ی قند خون هستند که توانایی خود را در بیماران در معرض خطر و مبتلا به دیابت نوع 2 ثابت کرده‌اند. بحث: مطالعات زیادی اثر این دسته ی دارویی بر کاهش حوادث قلبی و بستری شدن در بیمارستان به دلیل نارسایی قلبی را در بیماران مبتلا به دیابت نوع 2 و بیماری عروقی آترواسکلروتیک همزمان، بیماران دیابتیک با عوامل خطر متعدد قلبی یا بیماران نفروپاتی دیابتی بررسی کردند. نتیجه گیری: این مطالعه ی مروری نشان می دهد که در بیماران مبتلا به دیابت نوع 2 و خطر حوادث قلبی عروقی بالا، امپاگلیفلوزین، علاوه بر مراقبت استاندارد، بستری شدن در بیمارستان ناشی از نارسایی قلبی و مرگ ناشی از حوادث قلبی عروقی را کاهش می دهد

پیامدهای کلیوی دسته ی دارویی گلیفلوزین در بیماران دیابتی نوع 2 مبتلا به نارسایی قلبی با کسر جهشی حفظ شده

Abstract Background: Type 2 diabetes mellitus (T2DM) as a major risk factor for macrovascular and microvascular disease develops kidney disease in approximately 35% of patients. Kidney disease is associated with increased mortality and intensive glucose-lowering strategies have been shown to reduce surrogate markers of renal complications in T2DM patients. Empagliflozin, as a selective sodium-glucose cotransporter 2 (SGLT2)  inhibitor, reduces hyperglycemia in patients with T2DM by reducing the renal reabsorption of glucose, thereby increasing urinary glucose excretion. In conclusion, SGLT2 inhibition can reduce a broad range of risks for kidney outcomes including the risk of dialysis, transplantation, or death due to kidney disease in people with type 2 diabetes mellitus. Discussion: Many studies have shown promising effects on a range of albuminuria and serum creatinine-based kidney outcomes in patients with, or at high risk of, atherosclerotic cardiovascular disease. In these trials, as a result, event rates for kidney failure were low, with few participants requiring dialysis or kidney transplantation, or dying from kidney disease, in each trial. Conclusion: This review suggests that SGLT-2 inhibitor therapy may prove beneficial for the management of patients with chronic kidney disease and albuminuria, contributing to reductions in the risk of end-Stage Renal Disease, worsening of kidney function, in addition to cardiovascular death and hospitalization for heart failure.چکیده زمینه: دیابت نوع 2 به عنوان یک عامل خطر اصلی برای بیماری های ماکروواسکولار و میکروواسکولار، تقریباً در 35٪ از بیماران منجر به بیماری کلیوی می شود. بیماری کلیوی با افزایش مرگ و میر همراه است و نشان داده شده است که استراتژی های سختگیرانه کاهش گلوکز، مارکرهای مرتبط با عوارض کلیوی را در بیماران دیابتی نوع 2 کاهش می دهند. داروی امپاگلیفلوزین، به عنوان یک مهارکننده انتقال دهنده همزمان سدیم-گلوکز2[1]،  با کاهش بازجذب کلیوی گلوکز، هیپرگلیسمی را در بیماران مبتلا به دیابت نوع 2 کاهش می دهد و در نتیجه دفع گلوکز از طریق ادرار را افزایش می دهد. لذا مهارکننده های انتقال دهنده همزمان سدیم-گلوکز2، می توانند طیف گسترده ای از خطر پیامدهای کلیوی از جمله خطر نارسایی کلیوی منجر به دیالیز، پیوند، یا مرگ ناشی از بیماری کلیوی در افراد مبتلا به دیابت نوع 2 را کاهش دهند بحث: . مطالعات، شواهد حمایتی در رابطه با استفاده از مهارکننده های انتقال دهنده همزمان سدیم-گلوکز2، برای جلوگیری از پیامدهای کلیوی مهم بالینی در افراد مبتلا به دیابت نوع 2، ارائه می دهند. درمان با مهارکننده های انتقال دهنده همزمان سدیم-گلوکز2، ممکن است برای مدیریت بیماران مبتلا به بیماری مزمن کلیه و آلبومینوری مفید باشد و به کاهش خطر نارسایی کلیوی، بدتر شدن عملکرد کلیه، علاوه بر مرگ قلبی عروقی و بستری شدن در بیمارستان به دلیل نارسایی قلبی کمک کند. نتیجه گیری: این مطالعه ی مروری نشان می دهد که در بیماران مبتلا به دیابت نوع 2 و نارسایی قلبی با کسر جهشی حفظ شده[2]، مهارکننده‌های انتقال دهنده همزمان سدیم-گلوکز2، بر بهبود پیامدهای کلیوی بیماران موثرند.   [1] Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors [2] Heart failure with preserved ejection fraction (HFpEF

Bronchial Artery Embolization for Life-Threatening Hemoptysis in COVID-19 Patients

After the outbreak of the novel coronavirus at the end of December 2019 in China, it has become a global pandemic. Clinical manifestation of COVID-19 has a wide range of presentations ranging from asymptomatic to severe multi-organ involvement. Hemoptysis appears to be one of the major manifestations of severe acute respiratory syndrome that is related to COVID-19 infection. The occurrence of hemoptysis is multifactorial. However, massive hemoptysis is usually related to pulmonary aspergillosis or severe bronchiectasis due to corticosteroid pulse therapy which can be life-threatening. This manuscript presents five cases of successful life-saving bronchial artery embolization in patients with COVID-19 infection who were suffering from massive hemoptysis that were mostly related to aspergillosis and bronchiectasis. These cases are followed by a review of the literature.12 month embargo; first published 19 May 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

The Outcome of Patients with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension during the COVID-19 Pandemic

Background: The coronavirus 2019 (COVID-19) has affected the lives of many people worldwide. Patients with chronic underlying morbidities are vulnerable to get the severe form of the infection. The goal of this study was to evaluate the outcome of patients with pulmonary arterial hypertension during the COVID-19 pandemic in Iran. Methods: This cross-sectional study was conducted at a large tertiary center for pulmonary artery hypertension (PAH) patients. The primary end point was the prevalence of SARS-CoV-2 infection in PAH patients. The secondary end points were investigating the severity and mortality of COVID-19 infection in PAH patients during the COVID-19 pandemic. Results: Totally 75 patients were enrolled in the study from December 2019 to October 2021 and 64% were female. The mean ± SD age was 49 ± 16 years. The prevalence of COVID-19 in PAH/chronic thromboembolic pulmonary hypertension patients was 44%. About 66.7% of patients had comorbidities, which was a prognostic factor for COVID-19 infection in PAH patients (P < 0.001). Fifty-six percent of infected patients were asymptomatic. The most reported symptoms in symptomatic patients were fever (28%) and malaise (29%). Twelve percent of patients were admitted with severe symptoms. The mortality rate in infected individuals was 3.7%. Conclusions: COVID-19 infection in PAH/chronic thromboembolic pulmonary hypertension patients seems to be associated with high mortality and morbidity. More scientific proof is needed to clarify different aspect of COVID-19 infection in this population12 month embargo; first published 23 March 2023This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]