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Medical management of symptomatic severe aortic stenosis in patients non-eligible for transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2020年第11期17卷 704-709页

作者： gabriela silvia gheorghe Andreea Simona Hodorogea Andrei Cristian Dan gheorghe Ioan Tiberiu Nanea Ana Ciobanu University of Medicine and Pharmacy Carol Davila BucharestProf.Dr.Th.Burghele HospitalBucharestRomania

1 Transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? Aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The preferred treatment in symptomatic severe aortic stenosis(SAS) is surgical aortic valve replacement(SAVR), but in the elderly, the surgical risk can be greater than the benefit.([3]).

关键词： Angiotensin-converting enzyme inhibitors Beta-blockers Calcium channel blockers Diuretics Symptomatic severe aortic stenosis Transcatheter aortic valve implantation

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Particular evolution in a 72-year-old diabetic patient with acute coronary syndrome

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Journal of Geriatric Cardiology 2018年第7期15卷 523-526页

作者： gabriela S gheorghe Ana Clobanu Ioan T Nanea Andreea S Serban Mihaela R Mititelu Department of Internal Medicine and Cardiology "Theodor Burghele" Clinical Hospital "Carol Davila " University of Medicine and Pharmacy Bucharest Romania Nuclear Medicine Department "Dr. Carol Davila " Central Emergency Military Clinical Hospital Bucharest Romania

Diabetes mellitus is an important risk factor for coronary atherosclerosis and many patients present extensive coronary stenosis at coronarography.However,in patients with diabetes,endothelial and microvascular dysfunction also participate in chronic and acute myocardial ischemia.Although the majority of diabetic patients with myocardial infarction have angiographic evidence of significant coronary artery disease,they can also experience myocardial infarctions with non-obstructive coronary arteries (MI-NOCA).[1] The mechanisms leading to myocardial necrosis in these cases are heterogeneous and patients often present atypical evolution,making the diagnostic process and the choice of optimal treatment difficult.

关键词：糖尿病症候群动脉粥样硬化急性进化风险因素机能障碍心肌

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Split-dose or hybrid nonsteroidal anti-inflammatory drugs and Nacetylcysteine therapy for prevention of post-retrograde cholangiopancreatography pancreatitis

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World Journal of Clinical Cases 2019年第3期7卷 300-310页

作者： Laura Pavel gheorghe Gh Balan Alexandra Nicorescu Georgiana Emmanuela Gilca-Blanariu Catalin Sfarti Stefan Chiriac Smaranda Diaconescu Vasile Liviu Drug gheorghe Balan gabriela Stefanescu Gastroenterology "Grigore T.Popa" University of Medicine and Pharmacy Endocrinology "Grigore T. Popa" University of Medicine and Pharmacy Department of Mother and Child Medicine "Grigore T. Popa" University of Medicine and Pharmacy

BACKGROUND Despite significant technical and training improvements, the incidence of postendoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) has not significantly dropped. Although many studies have evaluated the efficacy of various agents, e.g. nonsteroidal anti-inflammatory drugs, octreotide,antioxidants, administered via various dosages, routes(oral, intrarectal or parenteral), and schedules(before or after the procedure), the results have been conflicting.AIM To evaluate efficacy of three pharmacologic prophylactic methods for prevention of PEP.METHODS In this prospective, single-center randomized trial, patients who underwent firsttime ERCP for choledocholithiasis were randomly assigned to three groups. The first group received 600 mg N-acetylcysteine 15 min prior to ERCP, and perrectum administration of 50 mg indomethacin both prior to and after completion of the ERCP. The second group was administered only the 50 mg indomethacin per-rectum both prior to and after the ERCP. The third group was administeredper-rectum 100 mg indomethacin only after the ERCP, representing the control group given the guideline-recommended regimen. The primary end-point was PEP prevention.RESULTS Among the total 211 patients evaluated during the study, 186 fulfilled the inclusion criteria and completed the protocol. The percentages of patients who developed PEP in each of the three groups were not significantly different(χ2 =2.793, P = 0.247). Among the acute PEP cases, for all groups, 14 patients developed mild pancreatitis(77.77%) and 4 moderate. No severe cases of PEP occurred, and in all PEP cases the resolution was favorable. No adverse events related to the medications(digestive hemorrhage, rectal irritation, or allergies)occurred.CONCLUSION The efficacies of split-dose indomethacin and combined administration(Nacetylcysteine with indomethacin) for preventing PEP were similar to that of the standard regimen.

关键词： Endoscopic retrograde cholangiopancreatography Prophylaxis Postendoscopic retrograde cholangiopancreatography pancreatitis Nonsteroidal antiinflammatory drugs N-acetylcysteine

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Electrocardiographic measures of repolarization dispersion and their relationships with echocardiographic indices of ventricular remodeling and premature ventricular beats in hypertension

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Journal of Geriatric Cardiology 2017年第12期14卷 717-724页

作者： Ana Ciobanu Gary Tse Tong Liu Maria V Deaconu gabriela S gheorghe Adriana M Iliesiu Ioan T Nanea Department of Internal Medicine and Cardiology Theodor Burghele Clinical Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania Department of Medicine and Therapeutics Faculty of Medicine Chinese University of Hong Kong Hong Kong China Li Ka Shing Institute of Health Sci- ences Faculty of Medicine Chinese University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease Department of Cardiology Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University Tianjin China

ObjectiveTo 检验在 T 山峰- T 结束间隔( Tpe )和有室的早熟的敲击( VPB )并且在 hypertension.MethodsA 的左室的改变的出现的 Tpe/QT 比率 52 总计病人与对中等必要高血压温和被包括，经历监视的 echocardiography 和24小时的 Holt... 详细信息

ObjectiveTo 检验在 T 山峰- T 结束间隔( Tpe )和有室的早熟的敲击( VPB )并且在 hypertension.MethodsA 的左室的改变的出现的 Tpe/QT 比率 52 总计病人与对中等必要高血压温和被包括，经历监视的 echocardiography 和24小时的 Holter 。室的改变被 transmitral E 和 A 波浪速度和 E/A 比率被左室的集体索引(LVMI ) 用 Devereux 公式和心脏舒张的功能估计。Tpe 处于心前区的领先被测量。T 波浪的结束被正切的方法在领先 V 2 设为 T wave.ResultsTpe 和 Tpe/QT 的最陡峭的下降斜坡(r = 0.33， P = 0.01；r = 0.27， P = 0.04 分别地) 并且 V 3(r = 0.40， P = 0.002；r = 0.40， P = 0.003，分别地) 与 LVMI 显著地相关。一种重要反的关系在 E/A 比率和 QT 之间被观察(r = 0.33， P = 0.01 ) ，在 V 3 的 Tpe (r = 0.39， P = 0.003 ) 并且在 V 3 的 Tpe/QT (r = 0.31， P = 0.02 ) 。在 V 3, V 5,平均数 Tpe 的 Tpe 和有 60 ms ， 59 ms ， 62 ms 和 71 ms 的截止价值的最大的 Tpe ，分别地与左室的心脏舒张的功能和表演的 LVMI 和索引与室的早熟的 beats.ConclusionsThe 极化参数 Tpe 间隔和 Tpe/QT 比率相互关联的出现联系了更好预兆的值比象 QT 那样的传统的参数间隔和 QT 分散。铅 V 3 是为测量 Tpe 和 Tpe/QT 的最好的铅。这些 ECG 索引能因此在临床的实践被使用监视改变的 LV 并且预言 VPB 的出现。

关键词：极化参数高血压索引早熟分散 Holter Tpe 参数显示

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