The Exercise continuum and the role of Doctors
Published on: 3rd July, 2018
OCLC Number/Unique Identifier: 7795903510
Everyone can be placed somewhere on an exercise continuum with the idle at one end and the hyperactive at the other. At both extremes, health suffers. Exercise is essential to health and managing it is the responsibility of individuals but few know what they should do. Doctors seldom teach how to be healthy and act only when repair is needed.
Predictive vision on governance and total quality in sports
Published on: 15th July, 2019
OCLC Number/Unique Identifier: 8192127541
The aim of our study is to try to give a predictive vision on governance in the field of sports in Algeria.
This predictive approach looks at the overall quality of governance in order to be at the continental level or even across the Arab world.
To identify this and answer our questions, we conducted a survey of some leaders of the different sports institutions, namely the presidents of clubs (football, handball, athletics and judo), managers also have a sports experience and occupy currently responsible positions as managers of sports facilities.
The results of the survey we reveal significant figures on the component related to sports development prospects.
However, there are other aspects that are ambiguities in the management and organization that have an impact on good governance in sports.
The influence of physical activities on biological age parameters of females from 17 to 18 years old
Published on: 17th August, 2018
OCLC Number/Unique Identifier: 7844553552
The effect of weekly physical activity on biological age (BA) parameters, we have conducted a study 215 females from 17 to 18 years old who were divided into the experimental (EG, n=105) and control (CG, n=110) groups. It was established that if at the end of the experiment the BA parameters of the females CG weren’t a significantly different from the average data (p>0.05), then there was a statistically significant decrease in the BA parameters of the females EG. This was confirmed by statistical probability (p<0.01), which suggests the dependence of biological age parameters on the extent of weekly physical activity.
Analysis of static, dynamic, and pelvic stability in junior badminton players of South Asia
Published on: 19th October, 2018
OCLC Number/Unique Identifier: 7893702351
Badminton is a sport that requires a player to perform while being still, as well as in motion. Stability is the ability to maintain or control joint movement or joint position, in the static as well as dynamic state. Improvement in stability could help maintain body control and proper posture positions during play. Accordingly, the study was proposed to analyze stability in junior badminton players and understand its importance. A total of 106 players from South Asia between the ages of 8 and 15 years were analyzed. Prokin 252N and Balance trunk MF systems of Tecnobody Italy were used in the assessment and static, dynamic, and pelvic stability was recorded. The variables used were gender, age, body mass index, and experience in years, level at which they play, current pain, and clicks & catches in the past 1 year. Our study showed that there was significant difference in pelvic stability in terms of age and level at which players compete. There were a variety of other factors which do not affect stability. There needs to be a greater focus on stability training as part of the development of junior badminton players.
Final solution in femoroacetabular impingement - Threaded cups in hip revision surgery 2002-2012
Published on: 23rd October, 2018
OCLC Number/Unique Identifier: 7900083791
Purpose: Here, we report the complications of endoprosthesis with threaded cups according to our application in cases of complicated acetabulum (hip revisions and femoroacetabular impingement (FAI)).
Methods: A total of 504 patients was analyzed, including 189 men and 315 women. For re-implanted patients (n = 49), the mean time to re-implantation was 6.3 years and the average age at re-implantation was 54.7 years. For censored patients (n = 455), the mean time to censoring was 5.5 years and the average age of the implant was 55.7 years. Among the patients that were censored, 77 died and 378 patients did not experience an event necessitating re-implantation.
Results: For the total study population, the Kaplan-Meier estimate of 5 year survival is 0.94 and of 10 year survival is 0.85. 90% of the implants survived 7 years, 80% of the implants survived almost 12 years and 70% of implants survived almost 15 years. Kaplan-Meier survival analysis suggests that men have higher survival than women. Age of the patient at the time of implant was not a statistically significant factor for re-implantation (p value = 0.21) but sex was (p value = 0.02). Women had 2.25 times more risk of being re-implanted than men.
Conclusions: In our case series, the failure rate, as a result of aseptic loosening, was 7.4% (n = 51). More than half the failure cases (56%) required re-implantation. Over one-third (37%) of the primary arthrosis cases, were found to be FAI, lessening the frequency of diagnosis of the former. In our clinic, the threaded cup seems to be indispensable in hip revision surgery and in treating FAI.
Contractions of athlete’s foot and its muscle oxygenation
Published on: 5th December, 2018
Sustained isometric contractions of skeletal muscles produce intramuscular pressures that leads to blood flow restriction. In result an active muscle feels deficit of oxygen what bring to muscle fatigue. In another side during exercise we have physiological contradiction between raising of oxygen demand by working muscle and restriction of blood flow due to vessel pressing. To clarify this issue many research has been performed based mainly on measurement of blood flow in muscle tissue. The purpose of this study was to assess real-time changes in muscle oxygenation during a sustained isometric contractions of dorsiflexor muscle of low (30%), moderate (60%) and submaximal (90%) intensity. Experiments were conducted using the subject’s dominant (right) leg. Volunteers was recruited from eight male students of USIPC (age: 19±2 years, weight: 75±6 kg). Tissue oxygenation index (StO2) were recorded from the tibialis anterior using NIRS device (NONIN). Saturation was higher at 30% compared with both 60% and 90% MVC at all time points after start exercise and higher at 60% than 90%. Oxygen consumption (VO2) permanently increased from slow (30%) to moderate (60%) and submaximal contractions. After cessation of the each contraction there was a large and immediate hyperemic response. Rate of StO2 increasing after effort cessation what reflects the resaturation of hemoglobin which depend on integrity and functionality of vascular system and reflects blood vessel vasodilation. StO2 restoration rate permanently increased from slow (30%) to moderate (60%) and submaximal contractions too. At last on final stage of experiment arterial occlusion test has been performed to determine the minimal oxygen saturation value in the dorsiflexors. Oxygen saturation reached a 24±1.77% what is significantly higher than StO2 after 60 and 90%MVC.
So, we can conclude that oxygen saturation at 60% and 90% MVC are similar and sharply decreased after start of exercise. It means that after 60% MVC take place occlusion of blood vessels due to intramuscular pressure. Oxygen consumption of active muscle increased depend on intensity of exertion according to increasing of oxygen demand. StO2 resaturation rate (Re) permanently increased from slow (30%) to moderate (60%) and to submaximal contractions. Re increasing after effort cessation reflects the resaturation of hemoglobin which depend on integrity and functionality of vascular system and reflects blood vessel vasodilation.
Role of physical activity in cancer survival and recurrence: A narrative review from relationship evidence to crucial research perspectives
Published on: 12th December, 2018
OCLC Number/Unique Identifier: 7964792160
Purpose: The benefits of Physical Activity (PA) considered as a major supportive care in cancer patients, on survival, and recurrence risk is largely disseminated in public communication. However, these data must be taken with caution. The main objectives were to review the evidence and limits of studies reported regarding the post-diagnosis PA role on cancer survival and recurrence risk to secondly discuss of research perspectives on PA programs.
Method: The narrative review included all published or ongoing studies in English during the last 20 years related to PA, survival and recurrence risk with a systematic search on main databases.
Results and discussion: The current evidences regarding the PA role on survival and recurrence risk were only based on cohort studies, mainly in breast cancer. The major methodological limits identified as the lack of PA change assessment, PA level assessed largely by self-reported methods and the significant inter- but also intra- variability make the interpretation of data very. Beyond the use of rigorous RCT, the major issue is to develop adapted and personalized interventions to progressively increase PA level overtime in cancer survivors.
Conclusion: Despite the lack of causal relationship between post-diagnosis PA, survival and recurrence risk, the review underlines several interesting research perspectives. The future PA interventions, using innovative tools and integrated to the “real-life” will argued for the potential antitumoral PA role growing in literature.
Analysis of the characteristics of chinese traditional sports culture in the new period
Published on: 23rd July, 2019
OCLC Number/Unique Identifier: 8192136507
Through cultural consciousness, the characteristics of traditional Chinese sports culture in the new period are analyzed and studied, and the traditional Chinese sports culture in the new period has the following six characteristics: 1. Sports social model of “etiquette” 2. Sports personality model of the gentleman’s way; 3. The sports behavior mode of the golden mean; 4. The social nature of sports of socialism with Chinese characteristics; 5. Sports cultural nature of emotional culture; 6 limited competitive sports competition.
Comparison of selected lower limb biomechanical variables between university of ibadan sportsmen with and without patellofemoral pain syndrome
Published on: 16th August, 2019
OCLC Number/Unique Identifier: 8235051929
Patellofemoral pain syndrome is common among athletes who participate in jumping, running and pivoting sports. The aim of this study was to compare selected lower limb biomechanical variables between University of Ibadan students (athletes) with and without patellofemoral pain syndrome.
The research design for this study was a case control survey and a purposive sampling technique was used to recruit participants. Two hundred and twenty two (191(85.8%) males and 31 (14.2%) females) sportsmen participated in this study. The participants’ age was between 20-29 years. Fourty sportsmen tested positive to Clarke’s test while 27 sportsmen tested positive to Eccentric step test. Measurements of static quadriceps angle, hamstring tightness and navicular height were taken for all participants.
Data were analyzed using descriptive statistics of mean, standard deviation, percentages and inferential statistics of Independent ‘t’ test.
The mean lower limb biomechanical variables of participants with patellofemoral pain syndrome were 13.18 ± 2.37°, 106.46 ± 16.11° and 1.21 ± 0.61 cm while those without were 13.65 ± 2.46°, 128.95 ± 25.36° and 1.03 ± 0.58 cm for static quadriceps angle, hamstring tightness and navicular height respectively. There was no significant difference (p > 0.05) in selected lower limb biomechanical variables between participants with and without patellofemoral pain syndrome.
In conclusion there was no significant difference in static quadriceps angle, hamstring tightness and ankle pronation between participants with and without patellofemoral pain syndrome. It was recommended that PFPS development is probably multifactorial with other functional disorders of the lower extremity apart from the selected variables.
Anthropometric characteristics and somatotype of professional soccer players by position
Published on: 1st November, 2019
OCLC Number/Unique Identifier: 8304643029
The anthropometric characteristics are decisive for an optimal physical level and, therefore, a good level in the game; and they can be different depending on the game position.
The aim of this study was to identify the physical characteristics, body composition and somatotype of professional soccer players and to verify differences according to their playing positions: goalkeepers, defenders, forwards and midfielders.
The measurements were performed on 57 male players of a soccer team of the Spanish Football League One. Twenty seven anthropometric variables were measured (height and body weight, four bone breadths, eleven girths and ten skinfolds) and the Bioelectrical Impedance Analysis was also performed. The percentage of body fat has been determined from 11 different equations.
Goalkeepers showed the highest weight (80.2 ± 3.2 kg), supraespinal (10.5 ± 3.8 mm) and abdominal (15.6 ± 3.5 mm) skinfolds than others positions. In relation to body fat percentages, similar results were obtained from the equations of Jackson-Pollock (from 3 and 7 skinfolds), Carter, Withers, and Heyward and Stolarczyk (mean value 7.8 ± 1.5%). Higher results were obtained from the other equations applied. Differences among positions were also found concerning body composition; goalkeepers showed the highest body fat percentage (9.4 ± 1.4%). Mean somatotype was also different among positions; goalkeepers and forwards presented a balanced mesomorph somatotype while defenders and midfielders showed an ecto-mesomorph one.
The differences in morphological characteristics according to the team position were notice only in goalkeepers, especially regarding their weight, abdominal and supraespinale skinfolds and the percentage of fat tissue.
Parents Take-On Concussion: Advances in Sideline Research and Culture in Youth Sports
Published on: 16th March, 2017
OCLC Number/Unique Identifier: 7286354252
Identifying concussion and initiating removal from play is challenging for even the most diligent youth sports organizations. Empowering parents to implement removal from play protocols and sideline testing may be the most practical plan at community levels to protect young athletes. We developed paradigms for community-based youth sports teams that incorporated both standard concussion protocols and research investigations. The research studies were designed to determine how sideline tests of vision, cognition and balance augment the capacity for parents and other responsible adults to identify youth athletes with concussion in ice hockey, football, lacrosse and cheerleading. Research-based sideline tests were performed at pre-season baseline sessions and during the season at the time of injury or as soon as symptoms were recognized by trained volunteer parent team testers. The combination of standard concussion protocols and research studies were performed for 510 athletes, aged 5-17 years, over 2.5 years through 5 athletic seasons. To implement the protocols and studies, approximately 80 student volunteers and parents were educated and trained on early concussion recognition and on baseline and sideline test administration. Over 80% of parent-identified head injuries were physician-confirmed concussions. Of the sideline tests performed, over two-thirds were administered within 24 hours of injury; the rest were performed within an average of 2.6 days post-injury since some athletes had delayed development of symptoms. Removal from play guidelines and standard concussion evaluation protocols were maintained in the context of the sideline testing research investigations. Based on this observational study, parents of youth athletes can be successfully empowered to perform rapid sideline tests in the context of existing concussion protocols. Implementation of objective testing may improve concussion identification and shift the culture of advocacy and responsibility towards parent groups to promote safety of young athletes. Ongoing investigations will further examine the impact of these programs on concussion management in youth sports.
Short and Medium-Term Evaluation of Patients in Coronary Post-Angioplasty: Préliminary results at the Cardiology Department of the Hospital University Aristide Le Dantec of Dakar (Senegal): Study on 38 Cases
Published on: 20th February, 2017
OCLC Number/Unique Identifier: 7286354250
Introduction: Coronary angioplasty is a safe therapeutic method for coronary disease. However, its major obstacles remain the occurrence of stent thrombosis (ST) and in-stent restenosis (ISR). The aim of this study was to evaluate the short-term and medium-term results of coronary angioplasty patients in the cardiology department of Aristide Le Dantec hospital in Dakar.
Methodology: It was a longitudinal, descriptive and analytical study over a period of 12 months (April 2014 to April 2015) with a follow-up at 6 months. Was included any patient who had a coronary angioplasty with stent placement.
Results: Thirty-eight patients had been included with a male predominance and a sex ratio of 5.32. The average age was 57.94 years. Cardiovascular risk factors were mainly smoking (57.9%) and coronary heredity (42.1%), followed by hypertension (39.5%) and diabete (34.2%). The indications for angioplasty were acute coronary syndromes TS(+) and TS(-) respectively (50%) and (23.7%) and stable angina (26.3%). The right femoral approach was almost exclusive (97.4%). Coronary angiography revealed a predominance of anterior interventricular affection (84.2%). Type B lesions were the most frequent (68.4%). The single-truncal valve affection was predominant (76.3%). Direct stenting accounted for 63.2% of procedures. Twenty-one bare stents (55.3%) and 17 active stents (44.7%) were implanted. The results were excellent (94.7%). One case of acute stent thrombosis was noted. Echocardiography of dobutamine stress during follow-up was positive in 04 patients (12.5%). The control coronary angiography performed in two patients revealed an ISR. The predictive factors for restenosis were dominated by a deterioration in the segmental kinetics (p=0.009), in the diastolic function (p=0.002), the systolic function (p=0.003), a high post angioplasty troponin (p=0.004), the presence of calcifications (p=0.004) and a high SYNTAX score (p=0.021).
Conclusion: According to these results, Angioplasty is an effective therapy for coronary disease. However, a correct intake of double platelet antiaggregants and clinical and non-invasive screening are required for follow-up to avoid stent thrombosis or restenosis.
Indications and Results of Coronarography in Senegalese Diabetic Patients: About 45 Cases
Published on: 20th February, 2017
OCLC Number/Unique Identifier: 7286426513
Introduction: Coronary disease accounts for 75% of diabetic mortality. Coronary angiography reveals lesions that are often diffuse, staggered and multi-truncated. The objective of this study was to determine the indications and results of coronary angiography in diabetic patients.
Method: This is a cross-sectional, descriptive and analytical study which took place from May 2013 to July 2015 at the cardiology clinic of the Aristide Le Dantec hospital. We have included all diabetics who have benefited from coronary angiography by studying clinical and paraclinical data, particularly coronary angiography ones.
Results: During this period, 400 patients had coronary angiography, including 45 diabetics, a hospital prevalence of 11.25%. The average age of our patients was 62.27 y/o with extremes of 44 and 85 y/o. The sex ratio was 1.6 in favor of men. Diabete was revealed in 42 patients. Almost all patients were type II diabetics (44 patients) since 9.94 years in average. The associated cardiovascular risk factors were hypertension 66.7% and dyslipidemia 49.6%. Only 4 patients had typical chest pain. The electrocardiogram was abnormal in 84.4% of cases with 26 cases of SCA ST +. Coronary angiography was abnormal in 37 patients with significant stenosis in 30 patients. A single-truncular lesion was found in 14 cases, 8 had bi-truncular and other 8 had tri-truncular one. The anterior interventricular artery and the segment II of the right coronary were the most affected branches. Concerning the management, 14 patients had angioplasty with an active stent, 8 patients had medical treatment alone and 9 patients had coronary artery bypass surgery. Accidents occured for 4 patients, two of whom had arterial spasm, one of a vagal discomfort and another had an occlusion of the circumflex that led to the implantation of a stent.
Conclusion: Diabetes is accompanied by progressive coronary atherosclerosis, which has an adverse effect on patients' prognosis. Tri-truncal affection and indications for coronary artery bypass surgery are common
Procedure utilization, latency and mortality: Weekend versus Weekday admission for Myocardial Infarction
Published on: 19th May, 2017
OCLC Number/Unique Identifier: 7286355059
Background: Due to variations in hospital protocols and personnel availability, individuals with myocardial infarction admitted on the weekend may be less likely to receive invasive procedures, or may receive them with a greater latency than those admitted during the week. Whether or not this occurs, and translates into a difference in outcomes is not established.
Method: Using the Nationwide Inpatient Sample (2008-2011) database, we identified all patients admitted with a principle diagnosis of acute myocardial infarction. They were stratified by weekend or weekday admission. Baseline clinical characteristics, procedure utilization and latency to procedure were compared, and logistic regression models were constructed to assess the relationship between these variables and in-hospital mortality.
Results: Patient demographics and provider-related characteristics (hospital type, geography) were similar between weekend and weekday admission for myocardial infarction. Adjusted for covariates, we found that the odds of mortality for a weekend admission are 5% greater than for a weekday admission (OR: 1.05; 95% CI: 1.01, 1.09, p=0.009). For the utilization of an invasive procedure, we found that the odds of receiving a procedure for a weekend admission were 12% less than the odds for a weekday admission, adjusted for the other covariates (OR: 0.88; 95% CI: 0.86, 0.91, p<0.001). In addition, we found that the time to procedure was an average of 0.18 days (4.32 hours) longer for weekend admissions compared to weekday admissions (95% CI: 0.16, 0.20, p<0.001). However, we did not observe a significant difference in the overall length of stay for weekend and weekday admissions (0.004 days; 95% CI: -0.04, 0.05, p=0.87).
Conclusion: In a large and diverse subset of patients admitted with myocardial infarction, weekend admission was associated with fewer procedures, increased latency to those procedures, and a non-significant trend towards greater in adjusted in-hospital mortality.
Thrombolysis, the only Optimally Rapid Reperfusion Treatment
Published on: 23rd June, 2017
OCLC Number/Unique Identifier: 7286427398
Thrombolysis with tissue plasminogen activator (tPA) has been plagued by inadequate efficacy and a high risk of intracranial hemorrhage (ICH), which led to its replacement by procedures like percutaneous coronary intervention (PCI) whenever possible. Since this requires hospitalization, it is time-consuming, and compromising salvage of brain tissue and myocardium. Thrombolysis is the only first-line treatment that can provide sufficiently timely treatment for optimal recovery of organ function. However, for this potential to be realized, its efficacy and safety must be significantly improved over the current method. By adopting the sequential, synergistic fibrinolytic paradigm of the endogenous system, already verified by a clinical trial, this becomes possible. The endogenous system’s function is evidenced by the fibrinolytic product D-dimer that is invariably present in blood, and which increases >20-fold in the presence of thromboembolism. This system uses tPA to initiate lysis, which is then completed by the other fibrin-specific activator prourokinase (proUK). Since tPA and proUK in combination are synergistic in fibrinolysis, it helps explain their efficacy at their low endogenous concentrations.
Incidence of symptom-driven Coronary Angiographic procedures post-drug-eluting Balloon treatment of Coronary Artery drug-eluting stent in-stent Restenosis-does it matter?
Published on: 29th June, 2017
OCLC Number/Unique Identifier: 7286426167
Objectives: The clinical impact of drug-eluting balloon (DEB) coronary intervention for drug-eluting in-stent restenosis (DES-ISR) is not fully known. To further evaluate this impact, we aimed to describe the incidence of symptom-driven coronary angiography (SDCA), an under-reported but potentially informative outcome metric in this cohort of patients. Methods: We retrospectively identified all patients (n=28) who had DEB-treated DES-ISR at University Hospital Limerick in between 2013-2015 and evaluated the incidence of subsequent SDCA as the primary endpoint. Data were expressed as mean ± SD and %. Results: Baseline demographics demonstrate a mean age 63±9 years with 61% of DEB-treated DES-ISR presenting with acute coronary syndrome. Mean number of ISR per patient and number of DEB per lesion was 1.2±0.6 lesions and 1.2±0.6 balloons, respectively. The incidence of SDCA was 54% after mean follow-up duration of 179±241 days. 67.8% of patients had follow-up data beyond 12 months. Within the first year of follow-up, the incidence of SDCA with and without target lesion revascularization (TLR) was 11% and 36% respectively. Among patients with SDCA without TLR, 30% had an acute coronary syndrome not requiring percutaneous coronary intervention. Conclusions: A high incidence of SDCA was observed, particularly within the first 12 months after DEB-treated DES-ISR. This under-reported metric may represent a cohort at higher cardiovascular risk but requires further confirmation in larger studies.
Investigation of Retinal Microvascular Findings in patients with Coronary Artery Disease
Published on: 7th July, 2017
OCLC Number/Unique Identifier: 7286351578
Objectives: Retinal microvascular anomalies may be a marker for cardiovascular diseases. Our aim in this study was to investigate the utility of ocular fundoscopic examination as a noninvasive method in specifying the patients who carry a risk for coronary artery disease.
Material and Method: Patients who were diagnosed with coronary artery disease by coronary angiography were included in our study. Bilateral fundoscopic examination was performed in these patients. Fundoscopic findings and risk factors for coronary artery disease were evaluated.
Results: This study enrolled 100 patients (male: 72 (72%), mean age: 58.25±7.1) who were diagnosed with coronary artery disease by coronary angiography. Upon fundoscopic examination, 87% of the study population had atherosclerotic changes. Grade I atherosclerosis was found in 54% of the patients, grade II atherosclerosis was found in 32% of the patients and grade III atherosclerosis was found in 1% of the patients. Increased retinal tortuosity was present in 65% of the patients. Hollenhorst plaque was observed in 3 patients. Drusenoid bodies were observed with a statistically significantly higher rate in the patients who were not using clopidogrel compared to the patients who were using clopidogrel (p<0.001).
Conclusions: Retinal findings are frequently found in patients with coronary artery disease. Therefore, fundoscopic examination is a noninvasive and feasible examination method which can be frequently used in the evaluation of cardiac functions.
A rare Congenital Coronary Artery Anomaly: Woven Right Coronary Artery associated with Myocardial Infarction
Published on: 7th July, 2017
OCLC Number/Unique Identifier: 7286355563
Woven coronary artery (WCA) is an extremely rare and still not a clearly defined coronary anomaly. It is characterized by the division of epicardial coronary artery into thin channels which then reanastomose with the distal part of the abnormal coronary artery [1]. Since the angiographic imaging of WCA looks like an intracoronary thrombus and dissection; the differential diagnosis between atherothrombotic coronary arteries with recanalization of organized thrombi in coronary arteries and WCA may be very difficult for invasive cardiologists, especially in patients with single or two coronary artery involvements [2].
Subacute infectious endocarditis-associated membranoproliferative glomerular nephritis: A Case Report and Review
Published on: 17th August, 2017
OCLC Number/Unique Identifier: 7286354493
We experienced a case of membranoproliferative glomerulonephritis (MPGN) caused by subacute infectious endocarditis (SIE). A 57-year-old male farmer complained of fatigue, lack of appetite and gross haematuria for a month; he had no cough, chest pain, or exertion dyspnea. After admission, lab tests showed mild proteinuria(1.04g/d) and heavy dysmorphic red blood cells(RBC) (543/HP), with serum creatinine(Scr) slightly elevated(1.46mg/dl) and anemia(hemoglobin Hb 85g/L). A renal biopsy revealed MPGN lesion with 16.6% cellular crescents. The echocardiogram test revealed mitra valve prolapse with perforation of the anterior lobe, vegetation, and severe regurgitation. He was diagnosed as SIE induced MPGN. Then he underwent mitral valve replacement after systemic antibiotic treatment without immunosuppressive agents. Follow-up showed that he dramatically regained normal kidney function in total 1 year after the operation. Thus, antibiotic administration and valve replacement may be efficient enough for some of SIE induced MPGN. We did a brief review of the literature on SIE induced MPGN, which was sometimes misdiagnosed due to its silent characteristics; some SIE patients may initially have other organs involved.
A new heart: portraying the physiologic anatomo-functional reconstruction in ischemic cardiomyopathy
Published on: 15th September, 2017
OCLC Number/Unique Identifier: 7286353710
Fiber-based model of the left ventricle is known since 1628 but the complex 3D structure of myocardial fibers has not taken into account in normalcy or in disease until the last decade. We here present the case of a 60-year-old female patient affected by ischemic cardiomyopathy and severe left ventricular dysfunction. Left ventricle was reconstructed according to a novel surgical technique aimed at rebuilding an elliptical ventricular chamber and redirecting myocardial bundles of fibers in a near-normal orientation, by means of an original suturing technique. Left ventricular torsion was restored, proving the reorientation of myocardial fibres’ bundles. The restored physiologic shape was maintained along the years, gradually improving global ejection fraction and diastolic indices, showing a positive remodeling induced by the optimised geometrical and functional parameters.
The unexpected and never proven before renewal of ventricular torsion is an adjunctive element of ventricular efficiency, mainly in ventricles that work at a critical mechanics. A new fiber-based reading of heart function could improve clinical and functional outcomes and address some unsolved issues in the surgical treatment of ischemic cardiomyopathy as well as in medical approaches to the diseased myocardium.
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