{"title":"The outcome of complete coronary artery surgical revascularization on left ventricular function","authors":"Zaid Mohammed Abdulwahhab Al-Noori , Laith Saleh Al-Kaaby , Heba Khaled Hatem","doi":"10.1016/j.mcpsp.2025.100515","DOIUrl":"10.1016/j.mcpsp.2025.100515","url":null,"abstract":"<div><div>Coronary artery disease (CAD) is the leading cause of myocardial ischemia, contributing significantly to global cardiovascular mortality. Coronary artery bypass grafting (CABG) remains a cornerstone in the management of multivessel CAD.</div><div>Our objective was to evaluate the effects of complete coronary artery surgical revascularization on left ventricular function in patients with ischemic heart disease.</div><div>This prospective cross-sectional study was conducted at the Iraqi Center for Cardiac Diseases, Baghdad, from July to December 2019. Fifty patients who underwent CABG were included. Preoperative, early postoperative (2 weeks), and late postoperative (1 year) echocardiographic evaluations were performed. Echocardiographic data were obtained using the biplane modified Simpson’s method. Variables analyzed included left ventricular ejection fraction (LVEF), left ventricular internal diameters, and wall thicknesses.</div><div>No significant changes in LVEF or ventricular dimensions were observed within two weeks post-surgery. However, at one-year follow-up, patients with preoperative EF <<!--> <!-->50% (n<!--> <!-->=<!--> <!-->15) demonstrated a 10% increase in LVEF. Mild changes in left atrial diameter, septal wall thickness, and ventricular dimensions were also observed.</div><div>In conclusion, Patients with impaired preoperative systolic function showed significant improvement in LVEF following complete surgical revascularization. The absence of preoperative myocardial viability assessment and incomplete adherence to guideline-directed therapy were noted limitations.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 4","pages":"Article 100515"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amparo Ruiz Carbonell , Florencia Laffont Oscoz , Begoña Navarro Lluesma , Alexander Sammel , Ginés Gómez Úbeda , Miguel Ángel García García
{"title":"Valoración de la importancia de la confidencialidad y del manejo adecuado de la historia clínica en el servicio de urgencias hospitalarias","authors":"Amparo Ruiz Carbonell , Florencia Laffont Oscoz , Begoña Navarro Lluesma , Alexander Sammel , Ginés Gómez Úbeda , Miguel Ángel García García","doi":"10.1016/j.mcpsp.2025.100510","DOIUrl":"10.1016/j.mcpsp.2025.100510","url":null,"abstract":"<div><h3>Objective</h3><div>Healthcare professionals sometimes forget their obligations regarding professional secrecy and confidentiality. Violating them is punishable by law. We carried out a study to evaluate the degree of knowledge about the use of secrecy and confidentiality of patients' medical information in the care practice of the professionals of the Hospital Emergency Service of a second level hospital.</div></div><div><h3>Methods</h3><div>An anonymous survey was designed with questions about daily activity in the Emergency Department related to confidentiality. They tried to evaluate, by all the professional groups involved in the care of patients in the Emergency Department, 4 aspects: the degree of workers' perception of confidentiality; knowledge in confidentiality and the desire to obtain that knowledge; the perception of unauthorized exchange or search for information; and the perception of physical means to safeguard privacy. The statistical tests chi-square, t-Student and ANOVA were used, with a level of statistical significance of <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>100 workers from all professional groups responded to the survey. Knowledge of confidentiality was adequate (69.25% of positive responses), and the perception of unauthorized information exchange and physical means to safeguard privacy were less good (55 and 55.9% of positive responses).</div></div><div><h3>Conclusions</h3><div>The management of confidentiality in the emergency department of our hospital has a large room for improvement.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 4","pages":"Article 100510"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictors of mortality in individuals infected with dengue: An Indian case study","authors":"Parthraj Shenoy, Ashok Kumar Pannu, Atul Saroch, Sourabh S. Sharda, Mandeep Bhatia, Deba Parsad Dhibar","doi":"10.1016/j.mcpsp.2025.100511","DOIUrl":"10.1016/j.mcpsp.2025.100511","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Dengue infection and its associated complication contributes to a significant number of deaths as per World Health Organization (WHO) statistics. The aim of the study is to identify Predictors associated with mortality in Dengue infection.</div></div><div><h3>Materials and methods</h3><div>In this prospective observational study conducted at the tertiary care hospitals of north India from August 2023 to December 2024, confirmed cases of dengue fever with a duration of less than seven days were recruited. Patients classified into Survivors or non-survivors, variables that were found to have statistically significant associations on univariate analysis were subjected to multivariate analysis by logistic regression by enter method for predictors of dengue mortality.</div></div><div><h3>Results</h3><div>A total of 158 dengue patients were recruited of which 18 (11.4%) died from the disease. Altered mental status, dyspnea at rest, and decreased urine output were significantly more frequent among non-survivors. Regarding laboratory parameters, non-survivor group exhibited significantly elevated levels of total leukocyte count, urea, creatinine, liver enzymes and International normalized ratio. Application of logistic regression using 3 factors-qSOFA (quick sequential organ failure assessment), creatinine and ferritin were performed which showed a statistically significant association with creatinine and ferritin. Odd Ratio (OR) for creatinine 1.449 indicates that for every unit increase in creatinine, the odds of mortality increase by 44.9%. Although the OR is exactly 1, the tight CI around 1 suggests that elevated ferritin is associated with mortality, but with a small effect size (p – 0.047).</div></div><div><h3>Conclusions</h3><div>The presence of raised creatinine and elevated serum ferritin were predictors associated with a higher risk of mortality.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 3","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mediastinal air leak following intense exercise in a patient with uncontrolled asthma","authors":"Martin Fullana , Romina Bustos , Cynthia Padilla","doi":"10.1016/j.mcpsp.2025.100506","DOIUrl":"10.1016/j.mcpsp.2025.100506","url":null,"abstract":"","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 3","pages":"Article 100506"},"PeriodicalIF":0.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angel Orera , Ines Gomez Segui , Javier de la Rubia , Ricardo Gimeno
{"title":"Púrpura trombótica trombocitopénica: importancia del trabajo multidisciplinar","authors":"Angel Orera , Ines Gomez Segui , Javier de la Rubia , Ricardo Gimeno","doi":"10.1016/j.mcpsp.2025.100505","DOIUrl":"10.1016/j.mcpsp.2025.100505","url":null,"abstract":"<div><div>Thrombotic thrombocytopenic purpura (TTP) is a medical emergency with life-threatening complications. It presents itself as a diagnostic challenge, as it involves multiple organs affected by widespread microthrombosis that can rapidly cause severe ischemic impairment. Early recognition and treatment are crucial. Treatment includes prompt initiation of plasma exchange (PEX), immunosuppressive therapy, and caplacizumab, along with close monitoring of clinical signs, especially brain and cardiac function.</div><div>We present a case report with a witnessed cardiac arrest, in which the extracorporeal cardiopulmonary resuscitation (ECPR) protocol was performed, and the first dose of intra-arrest caplacizumab together with plasma infusion, were administered due to the suspected diagnosis of TTP. The first PEX session was done within the first three hours after cardiac arrest. Despite thrombocytopenia and anemia, the cannulation of the ECMO device was achieved in less than 40 min. The patient's evolution was favorable with minimal neurological sequelae and cardiac function recovery.</div></div>","PeriodicalId":36921,"journal":{"name":"Medicina Clinica Practica","volume":"8 3","pages":"Article 100505"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}