Search results for “EPIC

About 17 results in articles

Open Access Pub publishes peer-reviewed, free-to-read open-access articles. Showing articles matching EPIC — open any to read the full text, or download the PDF or XML.

17 articles

EPIC® and High Reliability in Healthcare: An Evidence Based Commentary

Jan 2024 DOI 10.14302/issn.2641-5526.jmid-24-4893
J. Johnson RalphCorresponding author

This evidence-based brief commentary discusses the potential of EPIC ® medicalrecords software to help or hinder in advancing High Reliability in healthcare—namely, the intent to attain repeatable, increasingly high levels of quality and safety over time. Four of EPIC’s key aspects relevant to High Reliability are examined: Standardized (High Quality) Information / Data Collection, Technological Somnambulism, Enhanced Patient Safety, and Reminders / “Hardstops.” A conclusion is drawn that EPIC, if used correctly, has vast potential to advance High Reliability high-quality and safety, specifically in medical treatment and regarding healthcare organization practice in general. However, it has hidden costs that are more than money; if unfettered, those costs can hinder its usefulness and even render it counterproductive. EPIC only works well in terms of Maximum High Reliability in healthcare as long as users and leaders remain mindful, prudent, and balanced in its use.

A Comprehensive Research Study Literature Review of EPIC© in Terms of Enabling Healthcare Agility: A Report Card

Feb 2021 DOI 10.14302/issn.2641-5526.jmid-21-3739
Ralph J. JohnsonCorresponding author

Background As healthcare markets have become more dynamic and turbulent, healthcare organizations have evolved by becoming increasingly “Smart-Agile” in their business practices. Smart-Agility definition-ally ensures success due to its inherent ability to rapidly detect and react appropriately to varied and evolving unclear, complex, and seemingly tumultuous situations and produce high-quality, low-cost goods and services with high customer satisfaction. Thus, there is a vital need for Smart-Agile healthcare IT systems for collection, analyses, and reporting of substantial quantities of healthcare data to inform patient treatment and organizational decisions. EPIC® and its meaningful-use components appear increasingly popular, capturing a majority portion of the healthcare Electronic Healthcare Records (EHR) IT market (>~30%).Yet, there are few, if any, studies reporting on EPIC in terms of Smart-Agility. Aim The intent of this article is to report a systematic review of scientific literature regarding EPIC’s healthcare IT systems meaningful-use features cross-compared with Smart-Agility aspects to produce a positive vs. negative report card—and whether its features are critical vs. non-critical in terms of Smart-Agility. Method Findings reported herein derive from a grounded, iterative review of open-source, peer-reviewed scientific literature following PRISMA. Findings Report card results were mixed. EPIC clearly succeeds and excels (better than average) on Smart-Agile healthcare IT system core aspects that are the most central, critical and valuable in terms of informing healthcare organizations’ decisions and their patients’ care (6 out of 7; B+, -A), specifically: Standardized Data Collection / Connectivity, Real-Time Data Warehousing/Outcome Measures, Enhanced Patient Safety, Patient Tracking and Follow-up (Continuity of Care), Patient Involvement, and Potential Use in Medical Education. The only critical core criterion it failed on was End-User Satisfaction, and some of that appears to dissipate with new users’ software familiarity. Conclusion EPIC provides a solid and relatively inexpensive foundation with great potential for enabling Smart Agility in healthcare organizations with its high-quality collection and management of vast amounts of inter-connected raw data, auto-analysis, and fast report generation. But it does so with hidden costs and inefficiencies. Avenues of further inquiry are suggested.

Splenectomy Reports

Aug 2024 DOI 10.14302/issn.2578-2371.jslr-24-5157
Uluc GünayCorresponding author

Introduction It was seen that splenectomy creates a disability situation in an individual, and in order to eliminate it, people applied to health boards to get a report to eliminate their social and economic losses recognized to them. Objective To examine the reason for surgery, method of surgery and the type of report they wanted to receive in splenectomised patients who applied to the general surgery committee polyclinic in 2017-2018-2019-2020 and 2023 when the pandemic ended. Materials and Methods Patients who applied to general surgery outpatient clinics were asked whether they had any surgery related to general surgery, and epicrises and pathology results of splenectomised patients were seen and recorded. Results Of the 23 splenectomised patients, 15 were female and 8 were male. Of the 15 female patients, 3 were splenectomised for ovarian ca, 3 for gastric ca, 2 for distal pancreatic ca, 2 for lymphoma, 1 for colon ca, 1 for traumatic cause, 2 for ITP, 1 for sarcoidosis. In male patients, 4 were splenectomised for traumatic, 1 for colon ca, 1 for ITP, 1 for thalassemia major and 1 for CML. The mean age of female patients was 48.1 years and the mean age of male patients was 37.4 years. The most common reason for splenectomy in women was malignancy and the most common reason for splenectomy in men was trauma. Conclusion Splenectomized patients had applied to receive the most DSR.

Human Health Research Open Access

Natural Polyphenols as Inhibitors for the Binding of Covid-19 S-RBD with ACE-2

Apr 2024 DOI 10.14302/issn.2576-9383.jhhr-24-4960
Hanai ToshihikoCorresponding author

The binding strength of Covid-19 variants, Omicron BQ.1, XBB.1.5, XBB 1.16, FE.1, EG.5, BA.2.86, HV.1, and JN.1, with the ACE-2, was calculated insilicoand evaluated with previous variants; the binding strength of new variants is XBB.1.5 << BA.2.86 < Delta < JN.1 < HV.1 < BA.1 << BA.2. The binding strength of Omicron JN.1 was similar to that of Delta, and that of others was less than that of BA.2.86. The binding inhibition of natural polyphenols was analyzed using a popular Omicron JN.1. The natural polyphenols were (-) Catechin, (+) Catechin, (+) epicatechin, apigenin, apigetrin, daidzein, quercetin, genistein, and oleuropein. The ionization of phenolic hydroxy groups was defined based on the atomic partial charge of oxygen. Polyphenols’ ionized hydroxy groups inhibited the binding of JN.1 S-RPB with ACE-2.

Thyroid Cancer Open Access

Molecular Diagnosis in Clinical Management and Diagnosis of Thyroid Cancer

Jan 2024 DOI 10.14302/issn.2574-4496.jtc-23-4835
Hussein Saleh Hussein AbbasCorresponding author

The prevalence of thyroid cancer is rapidly increasing worldwide, majorly due to overdiagnosis and overtreatment methods of differentiated thyroid cancer. The emergent and potent preclinical models, high-throughput molecular techniques, and genetic expression microarrays have delivered deeper insights into understanding the molecular features in oncogenesis. Thus, molecular markers have become a promising tool in managing thyroid cancer for differentiating benign and malignant tumors, prognosis, recurrence, and determination of novel therapeutic targets. In differentiated thyroid cancer, molecular markers are majorly utilized for guiding the development of indeterminate thyroid nodules on fine needle aspiration (FNA) histologies. Dissimilar to this, in advanced thyroid cancer, molecular markers permit targeted treatment of a modified signaling cascade. Determining causal mutation of targeted kinase receptors in advanced thyroid cancer can depict a promising treatment strategy with mutation-targeted tyrosine kinase inhibitors to reduce progression and eradicate mutation effects when conventional methods fail to manage. This review will focus on the molecular landscape and discuss the impact of molecular markers on the prognosis, treatment, and surveillance of differentiated and anaplastic thyroid cancer.

Cervical Cancer Open Access

One Out of Five Women Practiced Cervical Cancer Screening in Felege Hiwot Referral Hospital, Amhara, North West Ethiopia

Nov 2021 DOI 10.14302/issn.2997-2108.jcc-21-3975
Alemneh Sinishaw MulusewCorresponding author Clinical Chemistry department, School of Health Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia

Background Eighty five percent of cervical cancer occurrence in resource-poor countries. Contributing factors for these are inadequate knowledge about the disease, early initiation of sexual intercourse and multiple sexual partners. Early screening is an intervention in reduction of maternal deaths due to cervical cancer. Consequently this study was conducted aiming to find out about the practice of cervical cancer screening and its associated factors. Methods A facility based cross sectional study was conducted using a pretested structured questionnaire among women attended Maternal and Child Health (MCH) department of Felege Hiwot Referral Hospital (FHRH) from March15 to April 15, 2019. The study participants were selected systematically. The collected data were entered and analyzed using SPSS version 20. Logistic regression analysis was employed to examine factors association with cervical cancer screening that was confirmed using AOR with its 95% CI. Results A total of 400 study participants were included with a response rate of 99.5%. Of the total study participants only 78 (19.5%; 95% CI: 15.6, 23.4) practiced screening for cervical cancer. The cervical cancer screening practice was affected by age (AOR=2.025; 95% CI: 1.118, 3.668). Of those women who had ever heard of about cervical cancer were seven fold more likely to practice cervical screening (AOR=6.924; 95% CI: 1.602, 29.928) compared to those who did not have any information before. Moreover, knowing genital tract discharge as a problem of female organ implement fourfold more likely compared to that of knowing nothing about problem of genital tract (AOR=3.766; 95% CI: 1.761,8.055). Conclusion and Recommendation The study depicted there was low utilization of cervical cancer screening. Awareness creation about cervical cancer and knowledge of genital tract problems had positive influence for screening practice.

Distribution Spread and Environmental Risk Status of Pb, Cd And Cr in Soils of an Open-Air Waste Dumpsite along Tombia/Amassoma Road in Yenagoa Metropolis

Apr 2020 DOI 10.14302/issn.2637-6075.jpae-20-3322
Omozemoje Ayobami AigberuaCorresponding author Department partment of Environment, Research and Development, Anal Concept Limited, Elelenwo, Rivers State, Nigeria

In spite of the popularity of open-air waste dumping in Nigeria, it remains a relatively less effective waste management option across the globe because of its associated environmental impacts which includes the release of green house gases (GHGs), persistent organic pollutants (POPs), and metal micro-pollutants amongst others. This study aims to assess the potential environmental risks associated to metals released and vertically delineated across the soil profile within surroundings of dumpsite. Heavy metals in soil samples were acid-digested using the aqua-regia mixture of hydrochloric and nitric acid, followed by instrumentation analysis using the GBC 908 PBMT model atomic absorption spectrophotometer. Contaminated sites showed metal concentrations ranging from 1.493 to 109.460 mg/kg, 0.133 to 4.237 mg/kg, and 5.200 to 25.367 mg/kg for lead, cadmium and chromium respectively, with location 1 land area showing the most contamination. Only soil chromium was observed within regulatory stipulations in all cases. There was significant variation (p < 0.05) between the different sample locations, thereby indicating variations in composition of dumped wastes. Lead and cadmium showed the strongest positive correlation (r = 0.855, p < 0.01) and the application of some heavy metal pollution indicators revealed relatively higher metal loads and degree of contamination, as well as depicting potential ecological risk for soils of location 1. The significant heavy metal contamination of soils in the Tombia-Amassoma waste dumpsite requires that the local environmental sanitation and regulatory authorities take necessary remedial action to forestall the escalation of public health concerns that may emanate from this open-air dump.

The Follicular Benignancy- Desmoplastic Trichoepithelioma

Feb 2020 DOI 10.14302/issn.2689-5773.jcdp-20-3218
Bajaj AnubhaCorresponding author MD. (Pathology) Panjab University, Department of Histopathology, A.B. Diagnostics, A-1, Ring Road, Rajouri Garden, New Delhi, 110027, India.

Trichoepithelioma is a benign, cutaneous neoplasm originating from the hair follicle and is categorized into singular trichoepithelioma, multiple trichoepithelioma and desmoplastic trichoepithelioma wherein desmoplastic trichoepithelioma is cogitated as an  exceptional, cutaneous adnexal tumour. Desmoplastic trichoepithelioma was initially scripted by Hartzell in 1904 wherein the lesion was  described  as a benign, cystic epithelioma. Desmoplastic trichoepithelioma can be additionally nomenclated as epithelioma adenoides cysticum, morphea - like epithelioma or  sclerosing epithelial hamartoma 1. Familial instances of desmoplastic trichoepithelioma are  infrequent and can be misdiagnosed on account of adjunctive  benign, cutaneous, adnexal neoplasms depicting  subtle clinical features, excepting a nodular basal cell carcinoma. Cogent clinical and histological features can assist the diagnosis of desmoplastic trichoepithelioma 12.

Assessment of Heavy Metals Contamination of Water and Cupscale Grass (Sacciolepisafricana) along the Epie Creek in Bayelsa State, Nigeria

Nov 2019 DOI 10.14302/issn.2637-6075.jpae-19-3074
Aigberua AyobamiCorresponding author Department of Chemical Sciences, Faculty of Science, Niger Delta University, Wilberforce Island, PMB 71, Yenagoa, Bayelsa State.

This study was conducted to investigate the concentration of three heavy metals; iron, chromium and lead in surface water and plant (Sacciolepisafricana) tissues along the Epie creek. This was aimed at determining the heavy metal loading of surface waters and the extent of bioaccumulation in the most prevalent grass species found growing within the river course. Metals were determined using atomic absorption spectrophotometer. Result of water analysis recorded the least and most significant iron concentrations of 3.42 ± 0.06 mg/L and 12.06 ± 0.06 mg/L for Agudama and Edepie axis respectively. Contrastingly, water samples showed chromium and lead levels which were below their instrument measurable limits. Consequently, lead (Pb) and chromium (Cr) levels were within WHO permissible limits, while iron (Fe) exceeded regulatory standard for water samples collected from all field locations. Similarly, iron recorded elevated iron concentrations in plant (cupscale grass) with the least amount being revealed for Igbogene stem (196.63 ± 5.21 mg/kg), and the most concentration been reflected for Edepie root sample (9,423.17 ± 48.55 mg/kg). Even though iron levels prevalently exceeded recommended threshold in plants, the stem were mostly within limit for iron. The only grass sample depicting significant lead amount (0.34 mg/kg) was the stem section collected at Akenfa location. Evidently, metals were least stored in plant stems and most bioaccumulated in plant roots. Furthermore, Cr and Fe are the only significantly correlating metals in plants (r = 0.700, p < 0.01). Overall, the increasing level of Fe in the water environment is further indication of the impact of unregulated dumping of scraps and domestic waste along the creeks embankment.

Obesity Management Open Access

Hirsutism and Anthropometric Profiles Among Subjects with Polycystic Ovarian Morphology? A Cross-Sectional Analysis

Sep 2019 DOI 10.14302/issn.2574-450X.jom-19-3000
Hayat Khan SikandarCorresponding author Department of pathology PNS HAFEEZ

Background Polycystic ovarian syndrome (PCOS) is increasingly being diagnosed and treated with sometimes variable lifestyle advice and pharmacological interventions. Obesity is considered as the sole culprit and variable definitions in clinics compound the understanding of pathogenic heterogeneity of this syndrome. We evaluated the differences between various simple to calculate anthropometric indices along with some anthropometric-biochemical equations in subjects with or without PCOS. Objective To compare traditional measures like waist to hip and height ratio (WHpR and WHtR), BMI, newer markers depicting central obesity like Abdominal Volume index(AVI), Body roundness index (BRI), A Body Shape index (ABSI), Conicity index (C-index) along with biochemical-anthropometric equations like lipid Accumulation Products (LAP), Visceral Adiposity Index (VAI) and Chinese Visceral Adiposity Index (CVAI) for diagnosing PCOS as per the Rotterdam criteria Design Cross-sectional analysis Place & Study Duration Naval hospital, Islamabad from Jan- 2018 to July- 2019 Subjects and Methods From our finally evaluated 333 female subjects we initially compared the differences for the presence of hirsutism as per modified Ferrimen Gallwey scores and biochemical hyperandrogenism by measuring free androgen index (Total testosterone/SHBG x 1000. We evaluated waist circumference, BMI, WHpR, WHtR,AVI, BRI, ABSI, C-index along with biochemical-anthropometric equations like LAP, VAI and CVAI for differences in subjects diagnosed to have PCOS by Rotterdam criteria or ultrasonography alone. Results Differences in hirsutism as defined by modified FG score between subjects defined to have PCOS or otherwise as per Rotterdam defined criteria were as [(PCOS=169, Mean=17.33 + 9.05) (No PCOS=164, Mean=8.21 + 5.74), p< 0.001] and ultrasound [(PCOS=87, Mean=16.95 + 9.57) (No PCOS=246, Mean=11.38 + 8.51), p< 0.001]. Similarly, the differences in FAI between subjects defined to have PCOS or otherwise as per Rotterdam criteria and ultrasound were as [(PCOS=169, Mean=6.41 + 4.88) (No PCOS=164, Mean=2.77 + 1.79), p< 0.001] and [(PCOS=87, Mean=5.75 + 5.01) (No PCOS=246, Mean=4.22 + 3.68), p= 0.011]. Anthropometric measures and anthropometric-mathematical equations were raised in non-PCOS subjects than PCOS subjects. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS. Conclusion Hirsutism and free androgen indices were raised in PCOS females. Anthropometric based measurements were not different in PCOS cases and non-PCOS females. Lean-PCOS demonstrated lower degree of hirsutism and biochemical hyperandrogenism in comparison to obese-PCOS.

An Unexpected Etiology of Myocardial Ischemia in Young

Apr 2019 DOI 10.14302/issn.2329-9487.jhc-19-2719
Bouomrani SalemCorresponding author Department of Internal medicine. Military Hospital of Gabes. Gabes 6000. Tunisia

Introduction The cardiac localization of hydatid cyst (HC) is rare and little known. It is exceptionally primary and isolated. Myocardial ischemia remains an exceptional and unusual manifestation of this localization. We report the original observation of cardiac HC revealed by acute myocardial ischemia in a young subject. Observation A 35-year-old patient with no notable pathological history was admitted to our department via the emergency room for acute anterior chest pain. The somatic examination was without abnormalities as well as the baseline biological tests. The electrocardiogram demonstrated epicardial ischemia in the infero-lateral territory without other abnormalities. The cardiac troponin I was slightly elevated (32ng/l, N<19ng/l). Subsequent controls after 30min, 60min and 180min did not show significant variations. Subsequent investigations (CT, coro-CT, coronary angiography) led to the diagnosis of intramyocardial HC of the left ventricle, with no abnormalities of the coronary arteries. After surgical excision, the evolution was favorable with normalization of the electrocardiogram and the troponin Ic. Conclusion Cardiac localization of this parasitosis is exceptional and characterized by an important clinical polymorphism making its diagnosis a real challenge. It seems useful to discuss the diagnosis of cardiac HC in front of any unexplained electrocardiogram abnormality occurring in endemic zone.

Agronomy Research Open Access

The Sprout Regulating Compound 1,4-Dimethylnaphthalene Exhibits Fungistatic Activity

Jan 2019 DOI 10.14302/issn.2639-3166.jar-18-2502
Campbell MichaelCorresponding author Lake Erie Regional Grape Research and extension Center, 662 North Cemetery Road, North East, PA 16428

The compound 1,4-dimethylnaphthalene, originally isolated from dormant potatoes, is currently in use as a commercial sprout inhibitor. Growers and processors report a reduction in fungal infections in potatoes treated with DMN resulting in increased yields. To assess the effects of DMN on fungal growth a culture of Fusarium oxysporum was isolated from potato tubers and identified via DNA fingerprinting using the 18ITS ribosomal region. Growth of F. oxysporum was inhibited by 31% after four days of exposure to DMN but overall rate of spore germination was not affected by DMN treatment. The growth of additional fungi, including Alternaria alternata, Aspergillus niger, Epicoccum nigrum, Gnomoniopsis smithogilvyi, Phoma medicaginis, and Pythium ultimum was inhibited by DMN as was suppression of sporulation in A. niger. These results suggest that DMN is fungistatic at the application levels examined.  

The Anemone, The Porcupine: Hairy Cell Leukaemia

Nov 2018 DOI 10.14302/issn.2689-5773.jcdp-18-2435
Bajaj AnubhaCorresponding author Consultant Histopathologist

Theobjective of reviewing Hairy Cell Leukaemia may be achieved by emphasising the condition as a category of chronic lymphocytic leukaemia with hair like protrusions of the cytoplasm situated on the aberrant B cell surface. An infrequent disorder, hairy cell leukaemia contributes an estimated 2% of lymphoid malignancies with a male predominance ( M:F ::4-5:1). A majority (90%) of instances depict a mutant immunoglobulin heavy chain variable region (IGHV). The haematopoietic stem cells (HSCs) elucidate a B raf proto-oncogene( BRAF V600E gene- 7q34). An enlarged spleen may be discerned along with pancytopenia as a presenting symptom. The morphology of specific hairy cell leukaemia may be on account of an in vitro interaction of primary hairy cells with BRAF genes and MEK inhibitors, which incite a prominent MEK - ERK dephosphorylation, thereby curtailing transcriptional outpourings of the RAS- RAF- MEK-ERK pathway. Bone marrow aspiration or bone marrow trephine biopsy may be inadequate for diagnosis in 30%-50% individuals on account of extensive fibrosis and the bone marrow sections depict a characteristic interstitial infiltration of leukaemia cells.. Reticulin stains exhibit broad, dense reticulum fibres surrounding the individual or aggregates of leukaemia cells with fibrotic extensions into the abutting bone marrow. The immune reactivity of classic hairy cell leukaemia is concurrent CD19+ CD20+,CD 11c+, CD25+, CD103+ and CD123+. Immune staining for CD20+, annexin 1 and VE1 (a BRAF V600E stain) validates the diagnosis and analyses the extent of malignant bone marrow infiltration. Application of inhibitors of BRAF V600E gene is efficacious in patients resistant to standard therapy. An enlarged spleen beyond 3 centimetres of the left costal margin, a white blood cell count greater than 10000 cells/µL , circulating hairy cells in the peripheral blood greater than 5000 cells/µL and a β 2 micro-globulin level exceeding twice the normal range of 3 µg/ml delineate an inferior outcome with resistance to purine analogues (PNAs). CD38+ elucidation ensures a worse prognosis as does the lack of an IGHV mutation with a reduced overall survival,. A lack of BRAF genetic mutation in 10% -20% of hairy cell leukaemia comprises of inferior prognosis.

Reproductive Performance and Factors Influencing Fetal Outcome: A Practical Guide to Experiments on Lung Development in A Nitro Fen-Induced Rat Model for Congenital Diaphragmatic Hernia

Jun 2018
Depres JanCorresponding author Department of Obstetrics and Gynecology, Division Woman and Child, University Hospital Gasthuisberg.

Our study aims to help researchers calculate resources based on a rat breeding colony for experiments on fetal lung development. The Wistar rat is commonly used in experimental research. In the context of fetal lung studies, the nitrofen rat is a model for pulmonary hypoplasia and congenital diaphragmatic hernia. Data needed to calculate resources for new experiments are not easily available. We prospectively acquired data on the reproductive performance and fetal outcome of 314 consecutive virgin Wistar dams in our fetal lung research breeding colony. We define the impact of breeding conditions on rat fertility and evaluate different methods to diagnose early rat gestation. Effects of nitrofen exposure as well as fetal surgery in terms of prenatal mortality and gross anatomical parameters of lung development are quantified in nitrofen-exposed and -unexposed fetuses from embryonic day 19 to 21 in 12h intervals. A reduced mating interval (1h) provides a great degree of experimental control with feasible pregnancy rates and a large litter size. Nitrofen exposure, as well as fetal surgery, depict high fetal survival rates. Fetal lung findings were very reproducible and could allow for reduction of animals utilized within experimental groups.

Fractures of the Humeral Condyles in Children – A Review

Feb 2018 DOI 10.14302/issn.2766-6204.jmpt-17-1913
NF TepeneuCorresponding author Department of Pediatric and Adolescent Surgery, General Hospital Klagenfurt, Austria

The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50–70%), lateral condylar (17–34%), and medial epicondylar fractures (10%). The mechanism of injury varies, but the most commonly described mechanism involves a fall on an outstretched hand with varus, valgus or rotational force or a combination thereof. The vectors of force and the degree of chondro-osseous development dictate the type of injury incurred. A review of the literature was conducted to see the most frequent injuries and complications.

Organ Transplantation Open Access

Atypical Patterns of Constrictive Pericarditis after Heart Transplantation: A Case Report

Sep 2017 DOI 10.14302/issn.2576-9359.jot-17-1594
Seguchi OsamuCorresponding author Department of Transplantation, National Cerebral and Cardiovascular Center, Japan

Constrictive pericarditis (CP) represents a rare complication after heart transplantation (HTx), resulting from various postoperative events such as mediastinitis, pericardial effusion, or allograft rejection. We describe our recent experience with managing an HTx recipient who developed atypical patterns of CP predominantly involving the right ventricle. A 52-year-old male who had received heart transplantation 2.5 years before was admitted to our institution because of progressive symptoms of heart failure. The patient had experienced acute rejection twice post-HTx, both with International Society for Heart and Lung Transplantation grade 1R, undergoing an additional endomyocardial biopsy other than those performed during regular check-ups. On admission, echocardiography revealed paradoxical septal motion and a large cystic-like mass with a thick capsule in front of the right ventricle. Right heart catheterization revealed elevation of right atrial pressure, with severely reduced cardiac index. Magnetic resonance imaging revealed both seroma and a thick cystic-like capsule tightly adhered to the right ventricle. CP was suspected despite the atypical patterns of presentation. Seroma was removed through exploratory lateral thoracotomy, without improvement in symptoms, which was only achieved via subsequent pericardiectomy involving resection of the thickened parietal pericardium, removal of effusion fluid, and further excision of diffusely thickened visceral pericardium and epicardium. The patient is currently recovering uneventfully. The possibility of CP after HTx should be considered despite the rarity of this condition and HTx recipients should be closely monitored using various imaging modalities because CP typically demonstrates non-specific symptoms and physical findings of heart failure, with high mortality.

High Rate of Asymptomatic Myocardial Ischemia in HIV Infected Population in Bobo-Dioulasso in Burkina Faso

Nov 2016 DOI 10.14302/issn.2324-7339.jcrhap-16-1271
S. J. B. TougooumaCorresponding author

Introduction The cardiovascular complications have became the 3rd cause of death and the 4th reason for hospitalization of the patients infected by the HIV. The objective of this work was to determine the frequency of asymptomatic myocardial ischemia among patients infected by the HIV receiving antiretroviral therapy. Patients and Methods It was a descriptive cross-sectional study which was conducted in November 2015. The patients infected by HIV1 receiving antiretroviral treatment, with asymptomatic myocardial ischemia were included in the study and they were followed up in the HIV clinic of the in Infectious diseases service of the University Hospital Souro Sanou of Bobo-Dioulasso(CHUSS).. The includes patients benefited from a collection of cardiovascular risk factors, and of two measurements of the blood pressure in a sitting position after 10 minutes of rest and an electrocardiogram 12 derivations after rest. Results A total sample of 123 patients infected by HIV1 was selected, with a median age of 42 years (IQR: 36-50). It was composed of 79% of female. The cardiovascular risk factors found were distributed as follows: HTA (31.7%), obesity (33%), dyslipidemia (10.57%), active smoking (0.8%), diabetes (0.8%). All the known hypertensive cases (5.7%) were insufficiently treated. The median duration of exposure to the antiretroviral therapy was 5.3 years (IIQ: 3-7.7). The disorders of the repolarization were observed in 26 cases (21.13%). They were divided into under epicardic ischemia in 20 cases (16.26%), under endocardic lesion in 2 cases (1.63%) and after-effect of necrosis in 4 cases (3.25%). The Left ventricular hypertrophywas observed in 12 cases (9.76%) and all of them were hypertensive patients. QTc was lengthened among 7 patients (5.69%) independently of the class of antiretroviral therapy administrated. Conclusion In this study about patients infected by HIV1, it emerges that asymptomatic myocardial ischemia is frequent. It would be advisable to reinforce its tracking by using more powerful tests of ischemia, in order to better specify its gravity in this population with an increased cardiovascular risk.  

Frequently asked questions

Are these articles peer-reviewed?
Yes. Articles published at Open Access Pub go through single-blind peer review (double-blind on request) under an editorial board before publication.
Are the articles free to read?
Yes. Every article is open access — read the full text online for free and download the PDF or XML, with no paywall or subscription.
How do I cite an article?
Use the DOI shown on each result and on the article page; it is the permanent, citable link to the article.
How do I read or download an article?
Click "Read full text" to open the article HTML, or use the PDF / XML buttons on each card to download it.