Osamah Hussein, Jamal Zidan, Michael Plich, Hana Gefen, Roberto Klein, Karina Shestatski, Kamal Abu-Jabal and Reuven Zimlichman
Background: Coronary slow flow phenomenon (CSFP) is a functional and structural disease that is diagnosed by coronary angiogram.
Objectives: To evaluate the possible association between CSFP and small artery elasticity in an effort to understand the pathogenesis of CSFP.
Methods: The study population comprised 12 patients with normal coronary arteries and CSFP and 12 with normal coronary arteries without CSFP. We measured conjugated diene formation at 234 nm during low density lipoprotein (LDL) oxidation, as well as platelet aggregation. We estimated, non-invasively, arterial elasticity parameters. Mann-Whitney non-parametric test was used to compare differences between the groups. Data are presented as mean ± standard deviation.
Results: Waist circumference was 99.2 ± 8.8 cm and 114.9 ± 10.5 cm in the normal flow and CSFP groups, respectively (P = 0.003). Four patients in the CSFP group and 1 in the normal flow group had type 2 diabetes. Area under the curve in the oral glucose tolerance test was 22% higher in the CSFP than in the normal group (P = 0.04). There was no difference in systolic and diastolic blood pressure, plasma concentrations of total cholesterol, triglycerides, high density lipoprotein, LDL and platelet aggregation parameters between the groups. Lag time required until initiation of LDL oxidation in the presence of CuSO4 was 17% longer (P = 0.02) and homocysteine fasting plasma concentration was 81% lower (P = 0.05) in the normal flow group. Large artery elasticity was the same in both groups. Small artery elasticity was 5 ± 1.5 ml/mmHgx100 in normal flow subjects and 6.1 ± 1.9 ml/mmHgx100 in the CSFP patients (P = 0.02).
Conclusions: Patients with CSFP had more metabolic derangements. Arterial stiffness was not increased in CSFP.
Eduard Ling, Shachaf Ofer-Shiber, Or Goren and Yair Molad
Background: Tight control of disease activity is the recommended target of therapy for rheumatoid arthritis (RA).
Objectives: To determine the outcome of RA with respect to disease activity and the rate of remission, as measured by the DAS-28, in a real-world inception cohort.
Methods: We conducted an observational cross-sectional study of a single-center real-world inception cohort of 101 consecutive patients being treated for RA in 2009–2010 in a rheumatology outpatient clinic. Patients were managed at the discretion of the attending rheumatologist with the goal of achieving remission. DAS-28 scores were calculated and analyzed by clinical and treatment variables derived from the medical files.
Results: Mean patient age was 58.6 ± 13.4 years and mean duration of disease 10.7 ± 7.9 years. Disease remission (DAS-28 < 2.6) was achieved in 26.7% of patients and low disease activity (> 2 .6 DAS-28 < 3.2) in 17%. Monotherapy with a conventional disease-modifying anti-rheumatic drug (C-DMARD, 21% of patients at last follow-up) was associated with a significantly lower mean DAS-28 score and C-reactive protein level than combined C-DMARD treatment (79% of patients), and with shorter disease duration than combined treatment with C-DMARDs or C-DMARD(s)+biological DMARD (40% of patients). Rheumatoid factor and anti-cyclic citrullinated peptide positivity had no effect on DAS-28 scores. Time from diagnosis was inversely correlated with DAS-28 scores.
Conclusions: The achievement of low disease activity and remission in a significant portion of our inception cohort of patients with RA suggests that the treat-to-target strategy is feasible and effective in routine clinical practice.
Michael Yulish, Noam Reshef, Aleks Lerner and Joseph Pikkel
Background: Eye injuries are common in sports. Sports-related eye injuries have the potential for major morbidity.
Objectives: To investigate the occurrence and to classify sport-related eye trauma in northern Israel.
Methods: We analyzed the records of the ophthalmology emergency department for the years 2007–2011 and classified the admissions according to type, severity of injury and demographic data.
Results: In 2% of the patients the injuries occurred during a sport activity. Most of the injuries occurred during soccer, basketball or school sport activity (74%). The majority of patients were young males.
Conclusions: Most sports-related eye injuries can be prevented with adequate eye protection.
Yacov Shacham, Eran Leshem-Rubinow and Arie Roth
Studies on trials conducted before the use of thrombolysis demonstrated both short- and long-term benefits of beta-blockers, and one meta-analysis of those trials showed a 25% reduction in 1 year mortality. Treatment with beta-blockers was and continues to be recommended for patients following ST elevation myocardial infarction (STEMI), but many patients failed to receive these agents, mostly because physicians were unconvinced of their benefit. A similar analysis of the studies in STEMI patients treated with thrombolysis also showed an overall 23% reduction in mortality associated with β-blocker use in the era of primary percutaneous coronary intervention (PCI). In the present review, we examine the relationship between the pharmacology of β-blockers and their potential utility in order to review early trials on their post-infarct efficacy and to place these findings in the context of this specific patient population in the era of primary PCI.
Ghassan Zaid MD, Sharif Dawod MD and Uri Rosenschein MD
Nir Samuel, Anat K. Politansky, Ron Hoffman, Shlomit Itzkovich and Hanna Mandel
Gleb Slobodin and Itzhak Rosner
Yael Milgrom, Gideon Goldman, Alex Gileles Hillel, Pojurovsky Svetlana and Zvi Ackerman
Gabriela Gayer and Simona Ben-Haim
Fernando Salvador, Ana Margarida Antunes, Joana Cunha and Carlos Dias
Howard Amital, Jacob Ablin, Valeire Aloush, Winfried Häuser and Dan Buskila