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Impact of Atrial Septal Defect Closure on Mortality in Older Patients

Congenital Heart Disease 2024年第1期19卷 93-105页

作者： Sipawath Khamplod Yodying Kaolawanich Khemajira Karaketklang Nithima Ratanasit Division of cardiology Department of MedicineFaculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand Her Majesty Cardiac Center Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand department of medicine Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

Background:Atrial septal defect(ASD)is a common form of adult congenital heart disease that can lead to long-term adverse outcomes if left *** closure of ASD has been associated with excellent outcomes and lower complication ***,there is limited evidence regarding the prognosis of ASD closure in older *** study aims to evaluate the mortality rates in older ASD patients with and without ***:A retrospective cohort study was conducted on patients aged 40 years or older with ASD between 2001 and *** were followed up to assess all-cause *** and multivariable analyses were performed to identify the predictors of mortality.A p-value of<0.05 was considered statistically signiﬁ***:The cohort consisted of 450 patients(mean age 56.6±10.4 years,77.3%female),with 66%aged between 40 and 60 years,and 34%over 60 *** the cohort,299 underwent ASD closure(201 with transcatheter and 98 with surgical closure).During the median follow-up duration of 7.9 years,51 patients *** unadjusted cumulative 10-year rate of mortality was 3%in patients with ASD closure,and 28%in patients without ASD closure(log-rank p<0.001).Multivariable analysis revealed that age(hazard ratio[HR]1.04,95%conﬁdence interval[CI]1.006–1.06,p=0.01),NYHA class(HR 2.75,95%CI 1.63–4.62,p<0.001),blood urea nitrogen(BUN)(HR 1.07,95%CI 1.03–1.12,p<0.001),right ventricular systolic pressure(RVSP)(HR 1.07,95%CI 1.003–1.04,p=0.01),and lack of ASD closure(HR 15.12,95%CI 5.63–40.59,p<0.001)were independently associated with ***:ASD closure demonstrated favorable outcomes in older ***,NYHA class,BUN,RVSP,and lack of ASD closure were identiﬁed as independent factors linked to mortality in this population.

关键词： Atrial septal defect congenital heart disease defect closure long-term survival mortality

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Efficacy and Safety of Ganyushu Granule in Treatment of Premenstrual Syndrome with Gan(Liver)Depression and Qi Stagnation Syndrome:A Randomized,Double-Blind,Multicenter,Phase-ⅡClinical Trial

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Chinese Journal of Integrative medicine 2024年第9期30卷 771-779页

作者： TENG Xiu-xiang XU Lian-wei LIN Jie ZHANG Jin-feng ZHANG Qin SUN Yun YANG De-feng LI Hong-mei ZHAO Pei LIU Jun department of Gynecology Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing100700China department of Gynecology Longhua HospitalShanghai University of Traditional Chinese MedicineShanghai200032China department of Gynecology The First Hospital of Hunan University of Chinese MedicineChangsha410021China department of Gynecology Shanxi Traditional Chinese Medicine HospitalTaiyuan030024China department of Gynecology Hangzhou Hospital of Traditional Chinese MedicineHangzhou310005China department of Gynecology Wenzhou Hospital Affiliated to Zhejiang University of Traditional Chinese MedicineWenzhouZhejiang Province325000China department of Gynecology Luoyang First People’s HospitalLuoyangHenan Province471000China department of Gynecology The Second Affiliated Hospital of Heilongjiang University of Chinese MedicineHarbin150001China

Objective:To confirm the efficacy and safety of Ganyushu Granule(GYSG)in treating premenstrual syndrome(PMS)in patients with Gan(Liver)depression and qi stagnation syndrome(GDQSS)and determine its effective ***:From June 2018 to March 2021,a total of 240 PMS women with GDQSS were included and randomly divided into 3 groups in a 1:1:1 ratio using central block randomization:high-dose GYSG group(n=78,GYSG 2 packs/time),low-dose GYSG group(n=82,GYSG and its simulant 1 pack/time),and placebo group(n=80,GYSG simulant 2 packs/time).Treatment with GYSG or placebo was given thrice daily and for up to 3 menstrual *** outcomes were PMS diary(PMSD)score and premenstrual tension syndrome self-rating scale(PMTS).Secondary outcomes were Chinese medicine(CM)syndrome ***,PMTS,and efficacy of CM were evaluated with menstrual cycles during the treatment *** indicators were analyzed after each menstrual *** analyses were performed using an intention-to-treat method,and clinical safety was ***:Of the 216 patients included in the effectiveness analysis,70,75,and 71 patients were in the high-,low-dose GYSG,and placebo groups,*** the 2nd treatment cycle,the change in PMSD scores in the high-and low-dose groups was lower than that in the placebo group(P<0.05).PMTS scores in the high-dose GYSG group after the 1st treatment cycle was lower than that in the placebo group(P<0.05),while after the 3rd treatment cycle,that in the low-dose group was lower than that in the placebo group(P<0.05).After the 2nd treatment cycle,the high-dose GYSG group had the best CM syndrome efficacy(P<0.05).No serious adverse reactions were ***:GYSG was safe and well-tolerated at both doses for treating PMS patients with ***-dose GYSG might be the optimal dose for a phaseⅢtrial.

关键词： premenstrual syndrome Chinese medicine Ganyushu Granule randomized controlled trial

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Transcatheter Aortic Valve Replacement in Patients With Pure Native Aortic Regurgitation:Results From a Multicenter Registry Study

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cardiology Discovery 2024年第2期4卷 134-141页

作者： Xiaofei Gao Juan Zhang Xiangquan Kong Jing Chen Xiang Chen Longyan Zhang Xinyong Cai Jiancheng Zhui Nailiang Tian Zhen Ge Bin Wang Qing Zhou Xi Su Lang Hong Yan Wang Hong Jiang Junjie Zhang Shaoliang Chen department of cardiology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210000China department of cardiology Renmin Hospital of Wuhan UniversityWuhan UniversityWuhanHubei 430000China department of cardiology Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujian 361000China department of cardiology Wuhan Asian Heart HospitalWuhanHubei 430000China department of cardiology Jiangxi Provincial People's HospitalNanchang UniversityJiangxi 330000China

Objective:Patients with untreated severe aortic regurgitation(AR)have a high risk of *** transcatheter aortic valve replacement(TF-TAVR)is a treatment option for AR;however,the safety and efficacy of this technique have not been sufficiently *** study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure ***:Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese *** primary endpoint was device success at 1 month after *** secondary endpoint was the composite of major adverse cardiovascular events(MACE)at 6 months,including all-cause death,ischemic stroke,emergency conversion to cardiac surgery,and permanent pacemaker *** was used to analyze the left ventricular function before the TAVR procedure and during *** logistic regression and Cox regression analyses were performed to find relevant independent risk ***:Between September 2019 and February 2022,79 patients with AR were enrolled in the *** 1 month,device success was achieved in 60(75.9%)*** 6 months,29(36.7%)patients had *** revealed improved left ventricular function after *** regression analysis demonstrated that the Society of Thoracic Surgeons risk score(odds ratio 0.760,95%confidence interval(Cl):0.584-0.989;P=0.041)and annulus perimeter(odds ratio 0.888,95%Cl:0.796-0.992;P=0.035)were 2 predictors of device ***,annulus perimeter(<80.2mm),but not Society of Thoracic Surgeons risk score,was associated with a significant reduction in MACE at 6 months(hazard ratio 2.223,95%Cl:1.060-4.659;P=0.028).Conclusions:TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR,particularly those with a less enlarged annulus.

关键词： Aortic valve Aortic regurgitation Transcatheter aortic valve replacement Device success Self-expanding valve

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Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

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World Journal of Emergency medicine 2024年第1期15卷 3-9页

作者： Rashed Alremeithi Quincy K.Tran Megan T.Quintana Soroush Shahamatdar Ali Pourmand department of Emergency medicine George Washington University School of Medicine and Health SciencesWashington DC 20037USA department of Emergency medicine University of Maryland School of MedicineBaltimore 21201USA Program in Trauma the R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimore 21201USA Center for Trauma and Critical Care Department of Surgerythe George Washington University School of Medicine&Health SciencesWashington DC 20037USA

BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare *** there have been advances in treatment modalities,survival rates for TCA patients remain *** narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating ***:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,*** search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English *** the search,943 articles were retrieved,and two independent reviewers conducted a screening ***:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable *** were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital *** thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt *** endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic *** implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality ***-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,*** the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ***:TCA remains a signifi cant challenge for emergency medical services due to its high m

关键词： Traumatic cardiac arrest Emergency thoracotomy Resuscitative endovascular balloon occlusion of the aorta

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Endoscopic ultrasound-guided lauromacrogol injection for treatment of colorectal cavernous hemangioma:Two case reports

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 966-973页

作者： Hua-Tuo Zhu Wen-Guo Chen Jing-Jie Wang Jia-Nan Guo Fen-Ming Zhang Guo-Qiang Xu Hong-Tan Chen department of Gastroenterology The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Colorectal cavernous hemangioma is a rare vascular malformation resulting in recurrent lower gastrointestinal hemorrhage,and can be misinterpreted as *** resection is currently the mainstay of treatment,with an emphasis on sphincter *** SUMMARY We present details of two young patients with a history of persistent hematochezia diagnosed with colorectal cavernous hemangioma by endoscopic ultrasound(EUS).Cavernous hemangioma was relieved by several EUS-guided lauromacrogol injections and the patients achieved favorable clinical *** Multiple sequential EUS-guided injections of lauromacrogol is a safe,effective,cost-efficient,and minimally invasive alternative for colorectal cavernous hemangioma.

关键词： Endoscopic ultrasound Lauromacrogol injection Colorectal cavernous hemangioma Case report

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