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G1 Patients (g1 + patient)

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Selected Abstracts

Angioplasty and stenting of symptomatic and asymptomatic vertebral artery stenosis: to treat or not to treat

EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2010
V. Parkhutik
Background and purpose:, Comprehensive indications for treatment of symptomatic vertebral stenosis remain unavailable. Even less is known about endovascular treatment of asymptomatic cases. We treated symptomatic and asymptomatic vertebral ostium stenosis with angioplasty and stenting and investigated the long term outcome. Methods:, Consecutive patients with two different indications were included. Group 1 (G1) had symptomatic >50% stenosis. Group 2 (G2) had asymptomatic >50% stenosis and severe lesions of anterior circulation and were expected to benefit from additional cerebral blood supply. Results:, Twenty nine vertebral origin stenoses in 28 patients (75% men, mean age 64 ± 9 years) were treated. There were 16 G1 and 13 G2 cases. Technical success rate was 100%. Immediate neurological complications rate was 3.4% (one G1 patient with vertebral TIA due to release of emboli). Two further strokes were seen during follow up (32 ± 24 months): vertebrobasilar stroke in a G2 patient with permeable stent in V1 segment, new ipsilateral V3 occlusion and high-risk cardioembolic source, and carotid stroke in a G1 patient who had had ipsilateral carotid stenting. There were no deaths of any cause. Asymptomatic restenosis was observed in one out of 19 patients from both groups who underwent a follow up angiography. Conclusions:, Angioplasty and stenting appears to be technically feasible and safe in asymptomatic and symptomatic vertebral stenosis. More studies are needed in order to clarify its role in primary and secondary prevention of vertebrobasilar stroke. High risk anterior circulation lesions should be taken into account as a possible indication in patients with asymptomatic vertebral stenosis. [source]

Human platelet antigens polymorphisms and susceptibility of thrombosis in hemodialysis patients

HEMODIALYSIS INTERNATIONAL, Issue 3 2008
Yousr GORGI
Abstract To investigate the association between the polymorphisms of human platelet antigen (HPA)-1,2,3,4,5 and susceptibility to develop thrombosis accident in arteriovenous fistula (AVF), genomic DNA of 112 hemodialysis (HD) patients and 100 healthy blood donors were genotyped by PCR-SSP. The patients were classified into 2 groups: G1 included 54 HD patients presented at least one thrombotic episode on the level of the AVF, and G2 included 58 HD patients without any episode of thrombosis. The allelic frequencies of HPA-1, 2, 3, and 5 among patients and controls did not reveal significant differences. However, the HPA-4b allele was significantly more frequent in G1 than in controls or in G2 patients (23.1% vs. 11.5% and 0.9%, respectively), p<0.01 and p<0.001. The genotype distribution of HPA-4 polymorphism reveals that the HPA-4a4b genotype was more frequent in G1 patients (23/54: 42.6%) than in all HD patients (25/112: 22.3%) or in G2 patients (1/58: 1.72%) (p<0.001, odds ratio: 45.6). Among 24 HD patients with HPA-4a4b genotype, 23 (96%) developed at least 1 or more thrombotic episode on the level of their AVF. However, 30 patients (34.5%) among 87 HD patients with HPA-4a4a genotype presented thrombotic episode (p<0.001). These results reveal a significant association between HPA-4a4b and thrombosis, and it is likely that HPA polymorphisms could be useful markers for potential risk of thrombosis in hemodialysis. [source]

Regional anticoagulation and antiaggregation for CVVH in critically ill patients: a prospective, randomized, controlled pilot study

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2010
L. P. FABBRI
Background: The aim of this study is to assess the efficacy and clinical safety of regional anticoagulation (heparin pre-filter plus post-filter protamine) plus antiaggregation (pre-filter prostacyclin) [Group 1 (G1)] vs. only systemic heparin anticoagulation without antiaggregation [Group 2 (G2)] in critically ill patients with acute renal failure undergoing continuous veno-venous haemofiltration (CVVH). Methods: One hundred and ten patients were randomized in a prospective, controlled pilot study. G1 patients received 1000 U/h pre-filter heparin, 10 mg/h post-filter protamine sulphate and 4 ng/kg/min pre-filter prostacyclin, while G2 patients received 1000 U/h pre-filter heparin. The haemofilter transmembrane pressure (TMP) and lifespan, as well as the platelet count were observed 1 h before, and at 6, 12, 18, 24 and 36 h from the beginning of CVVH. Results: Haemofilter TMP remained unchanged in G1 while it increased up to three times in G2 (P=0.0002). The median filter lifespan was 68 h in G1 and 19 h in G2. The rate of spontaneous circuit failure was 24% in G1 and 93% in G2 (P=0.0001). The platelet count was stable over the treatment period in G1 while in G2 it decreased progressively (P=0.0073). Conclusion: In critically ill patients suffering from acute renal failure, regional anticoagulation with pre-filter heparin and post-filter protamine plus antiaggregation during CVVH is a simple and safe procedure that prevents increases in filter TMP and increases circuit life time compared with systemic anticoagulation with pre-filter heparin only. [source]

Review article: the role of rapid virological response in determining treatment duration for chronic hepatitis C

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 12 2010
F. F. POORDAD
Aliment Pharmacol Ther,31, 1251,1267 Summary Background, For patients with chronic hepatitis C, attaining rapid virological response (RVR) is highly predictive of attaining SVR. Aim, To consider the predictive value of RVR in terms of SVR and relapse. Methods, Data were collected from published clinical trials to define the predictive value of RVR for SVR and evaluate the proposed continuum linking RVR to relapse. Results, These data support a 24-week regimen among genotype (G)1 patients who attain RVR with positive predictive values (PPVs) of 77.8% and 85.7% in patients with G1 infection treated for 24 and 48 weeks. Conversely, failure to attain RVR among G1 patients should not be viewed as a criterion for extending treatment duration beyond 48 weeks: negative predictive values (NPVs) were 60.9% and 52.7% in G1 patients without RVR treated for 48 and 72 weeks. Among G2/3 patients, RVR has a high PPV; however, the NPV varied with treatment duration indicating that a 24-week treatment regimen is warranted in G2/3 patients who fail to attain RVR. Conclusions, The present analysis confirms RVR as a strong predictor of SVR that can be used to tailor treatment duration, but which also should be appreciated in the context of treatment duration and regimen. [source]