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Register a new userThe Prevalence Of Cardiogenic Shock In Acute Myocardial Infarction
انتشار الصدمة القلبية لدى مرضى الاحتشاء الحاد
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Tishreen University ورقة بحثية
Publication date
2016
fields
Medicine
and research's language is
العربية
Authors
باسم معروف( باحث )
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Shamra Editor
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المقدمة: ان الصدمة القلبية هي السبب الأاشيع لحدوث الوفاة لدى المرضى احتشاء العضلة القلبية الحاد (AMI) اذ تحدث بنسبة 7-10% من مجموع المرضى الذين يقبلون في العناية المشددة بسبب احتشاء حاد عدد كبير من المرضى يطورون صدمة قلبية بعد الوصول الى المشفى ففي الدراسة GUSTO 11% من المرضى وصلوا الى المشفى بحالة صدمة القلبية بينما 89% طوروا صدمة بعد الاستشفاء , و في دراسة SHOCK اكثر من نصف المرضى يطورون صدمة خلال اليوم الاول من الاستشفاء ان الصدمة القلبية تحدث لدى مرضى الاحشاء مع تزحل STEMI ST نحو الاعلى بنسبة 7.5 % في حين انها تحدث نسبة 2.5 % لدى مرضى الاحتشاء دون تزحل ST نحو الاعلى كما ان الصدمة القلبية التي تحدث لدى مرضى الاحتشاء السكريين أعلى بضعفين من المرضى غير سكريين لكنه في المقابل ان الانذار متساو لدى المجموعتين وسائل الدراسة : ان دراستنا دراسة مستقبلية تم اجراءها في وحدة العناية المشددة في مشفى الأسد الجامعي في اللاذقية حيث شملت جميع المرضى الذين تم قبولهم في العناية المشددة بقصة احتشاء عضلة قلبية و ذلك خلال الفترة الممتدة بين كانون الثاني لعام 2014 و كانون الثاني لعام 2016 النتائج :ان نسبة الصدمة القلبية لدى مرضى الاحتشاء الذين تضمنتهم دراستنا (17\140 =12.1%) , (5\17 = 29.4%) من المرضى وصلوا الى المشفى بحالة صدمة مقابل (12\17 = 70.6. % ) تم تشخيص حدوث الصدمة القلبية لديهم بعد الاستشفاء كما انة تبين ان عدد المرضى الذين طوروا صدمة قلبية باكرة خلال 24 ساعة بما فيهم مرضى الصدمة القلبية لدى القبول 7\17= 41.7% بلغ عدد المرضى السكريون الذين طورا صدمة قلبية (11 = 70.6 %) مقابل (5 + 29.4% ) مرضى طوروا صدمة قلبية دون ان يكون لديهم داء سكري ان التقييم بالأمواج فوق صوتية اظهر ان الالية المرضية المسؤولة عن الصدمة القلبية موزعة كما يلي: سوء وظيفة البطين الايسر (11 =58 %) , صدمة بطين ايمن معزول (4 =24% ) , قصور الدسام التاجي الحاد (2 = 11%) , تمزق الحاجز بين البطينين (1 = 5%).
Introduction: The cardiogenic chock is the most cause of death following to acute myocardial infarction (IMA) ,it occurs( 10%) in patients who are hospitalized in soins intensive for acute myocardial infarction Lot of patient with acute myocardial infarction develops cardiogenic shock after arriver to hospital The cardiogenic chock with STEMI (7.5%) is more than its with NSTEMI (2.5%) The cardiogenic chock occurs in diabetic patients two field more than non diabetic patient may the prognosis is the same Study methods: our study is retrospective has been done in soins intensive in University Alassad hospital in Lattaquie It includes all patients admitted for acute myocardial infarction pendant the period from January 2014 to January 2016 Results :The percentage of cardiogenic shock in our study is( 12%) .(29.4%)of them are arrived to hospital with cardiogenic shock while( 70.6%) developed cardiogenic shock pendant their hospitalization The responsible pathologies of cardiogenic shock were as following: left ventricular dysfunction (58%) isolated right ventricular shock( 24% ) acute mitral valve insufficiency (11%),septa l interventricular rupture(5%)
References used
Webb JG, Sleeper LA, Buller CE, et al. Implications of the timing of onset of cardiogenic shock after acute myocardial infarction: a report from the SHOCK trial registry. J Am CollCardiol. 2000;36:1084–90
Tipoo FA, Quraishi AR, Najaf SM, et al. Outcome of cardiogenic shock complicating acute myocardial infarction. J Coll Physicians Surg Pak. 2004;14:6–9
Hasdai D, Holmes DR Jr, Califf RM, et al. Cardiogenic shock complicating acute myocardial infarction: predictors of death. Global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO) Investigators. Am Heart J. 1999;138:21–31
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Background: primary percutaneous coronary intervention PCI is the treatment of
choice in civilized countries for acute myocardial infarction, the aim of the treatment here
is the revascularization as soon as possible. Patients and methods: it is re
trospective study
of 133 patients of acute MI have been divided into two subgroups. The first subgroup has
been treated with streptokinase infusion, and the other subgroup has beet treated by PCI.
We monitored the patients within hospitalization , reinfarction, mortality, cardiogenic
shock, heart failure, also we recorded the time needed to apply the method of treatment and
Timi score by diagnostic cardiac catheterization after applying the treatment.
Aim of study: to compare between streptokinase and PCI in our hospitals to know
which way is better in which we can give the best medical care for this critical patients.
Results: 63 patients undergo to pci and 70 patients undergo to streptokinase therapy.
Streptokinase group had higher rates in mortality for noncardiac reasons 100%,
cardiogenic shock 60% , reinfarction 81%, mortality for cardiac reasons 80%, while it was
faster in applying the treatment and equal to pci in timi score. While pci group has higher
rated in hospitalization for cardiac reasons 70% and in cases that has new congestive heart
failure 63%, and nearly equal to streptokinase group in timi score.
Conclusion: pci was better in mortality and cardiogenic shock and reinfarction than
streptokinase but it was worse in hospitalization for cardiac reasons and congestive heart
failure cases . pci was too late than streptokinase in applying the treatment . we notice that
the two methods of treatment was nearly equal in timi score.
This research tries to the rate of arrhythmia manifested during the first (48) hours of heart infarction and define its nature as well as its relationship with heart infarction in regard to patients subjected to anti-coagulation (streptokinase) ther
apy and patients who were not subjected to it. Moreover, it also aims to detect the relationship between arrhythmia and the death rates of the patients during their stay in the Heart Intensive Care Unit.
The study started in October 2012 and lasted twelve months, up to October 2013.
The sample of study here consisted of (187) patients hospitalized in the Heart Intensive Care Unit having acute myocardial infarction. The sample included (142) males (76 % of the sample) and (45) females (24%). The research reached the following findings:
A hundred and seven of the patients monitored in the study were smokers; and smoking was the most important risk factor causing myocardial infarction.
Ventricular extra systole were the most common symptoms of acute myocardiac infarction arrhythmia during the first (48) hours of hospitalization reaching (79%). The second was increased auto ventricular rhythms rating (43 %).
High rates of dangerous arrhythmia like (VT) and (VF) rating (9%) in patients who were not subjected to streptokinase (anti-coagulation) compared with those subjected to it (4. 5%), and (3.8) respectively.
Decreased (EF) increased the possibility of life-threatening ventricular arrhythmia like (VT).
Diabetes did not increase the dangers of arrhythmia monitored in this research
INTROUDACTION : Arterial chronic hypertension (HTN) is a well-known associated with myocardial infarction because it is un cardiovascular risk factor for development of atherosclerosis, And there are risk factors shared by the two diseases, such as g
enetic risk, insulin resistance, sympathetic hyperactivity, and vasoactive substances (i.e., angiotensin II); In patients with acute myocardial infarction (AMI) with ST elevation , the prevalence of antecedent hypertension is 32% and these percentage increases with age and in women
METHODES:Our study is formed in service of soine intensive in al Assad hospital in Lattaquia ,it includes every patient was admitted in our service for myocardial infarction with ST elevation within period from January 2014 to juin 2015 At admission we took the following information: age .sex, history of hypertension . therapy And the cardiovascular risk factures as diabetes , hyperlipidemia, smoking, familial history, obesity RESULTS: in our study,in patients with acute myocardial infarction (AMI)withST elevation , the prevalence of antecedent hypertension is 43%(39\90) women48.5(17\35) men 40%(22\55) and this percentage increase with age and more in women , reaching 100% in patients over the age of 80 year ,in our study 48%of patients with hypertension don’t take their treatment And 90%have more than one risk factor CONCLUSION :The proportion of hypertension in patients with myocardial infarction with ST elevation in our study was 43%.
113 psoriatic patients participated in the study. The patients were selected from the Dermatology and Venereology department at Alasad hospital in Lattakia city between 2012-2013 years. Mycological examination was carried out in all patients showing
psoriatic nail changes .The aim of the study is to evaluate : the frequency of nail changes in psoriatic patients, the frequency of onychomychosis in patients with nail psoriasis and the factors that may have a role in the incidence of onychomcosis in patients with nail psoriasis.
Nail changes were seen in (61.9%) of psoriatic patients (70 patients). Positive mycological cultures were obtained from 34 patients (48.6%). There was an increase of the incidence of onychomycosis in patients with high levels of NAPSI and long duration of psoriasis and nail psoriasis. There was a relationship between onychomycosis and the age of the patient. We found an increase of the incidence of onychomycosis among the patients who had a systemic therapy for psoriasis (methotrexate,cyclosporine) and the patients who had a history of contusion on nails. There was no relationship between onychomychosis and the gender of the patient.
This study confirmed that onychomycosis may occur in patients with nail psoriasis
Serglycin is an intracellular proteoglycan in hematopoietic cells. It
has been studied in normal and tumor hematopoietic cell, so it was
suggested to have an important role in immunity and cancers as leukemia.
The challenge to make a diagnosis for
acute leukemia and to
differentiate between myeloid or lymphoblastic leukemia, is the reason
we go to assay concentration of serglyc in normal people and
patient with acute myeloid leukemia and acute lymphoblastic leukemia
from children and adult at hematology department in the
main hospitals in Damascus ( Pediatric’shopital, Almouasat and Al
asaad hospital) before beginning any kind of treatment and studying
the relation with white blood cells count. We found clear difference
between the concentration in patient with acute leukemia and normal
people. There was a high level of this marker in paint with
AML in contrast with ALL patients. We found a relation between
concentration of serglycin and the count of white blood cells.
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