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ABSTRACT: Priapism is a rare disorder defined as a persistent penile erection that continues hours beyond, or is unrelated to, sexual stimulation. There are two types of priapism; ischemic low-flow type or non-ischemic high flow, with differing etiologies. Priapism associated with thrombophilia is a well-recognized entity. However, the pathogenesis of this association is not fully understood. We report a rare case of recurrent (stuttering) priapism in a patient with protein C deficiency while maintained on Warfarin therapy. This therapy was also complicated by Warfarin-induced skin necrosis.
International Journal of Laboratory Hematology 09/2008; 30(4):339-43. · 1.18 Impact Factor
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ABSTRACT: Left ventricular function is an independent predictor of operative mortality. The outcome of myocardial revascularization is greatly affected by the severity of impairment of cardiac function. The present study was undertaken to find the early and midterm mortality and morbidity among patients with different degrees of myocardial function undergoing off-pump bypass.
Hundred and forty two patients with isolated coronary revascularization were divided into three groups according to left ventricle ejection fraction (LVEF). Forty eight patients with LVEF<30% (group I), 48 patients with LVEF between 30-40% (group II), and 46 patients with LVEF >40% (group III). Clinical, operative and post operative outcome were compared. Patients were followed up to find midterm survival and control of symptoms.
The mean age for the patients observed was 56.5+/-9.8 years. Preoperative predicted mortality according to euroSCORE was much higher in group I due to high incidence of preoperative heart failure and recent myocardial infarction. The extent of coronary vessel involvement was similar among the three groups, but those in group III had more single vessel disease. The number of grafts performed per patient was lowest in group I (1.7+/-0.6) and highest in group III (2.0+/-0.6) P=0.03. Overall hospital mortality was 4.2%.The mean euroSCORE of patients who died was 18.7+/-22.5. All in-hospital mortality was among patients who belonged to the high risk group I, 6 (12.5%). Morbidity was similar among all groups. The incidence of myocardial infarction, atrial fibrillation, and acute renal failure were slightly higher in group I; 95.6% of patients were followed up for 7-69 months (mean 27.6+/-17.6). The incidence of angina in group I, II, and III was 20%, 6.5%, and 2.2%. Symptomatic heart failure was seen in 17.5% in group I, 6.5% in group II, and 2.2% in group III. Cardiac interventions among group I, II, III was 12.5%, 4.3% and 2.3% respectively. Redo coronary artery bypass CABG was higher in group II (4.3%) compared to 2.5% in group I. Late mortality was similar among all groups.
Off-pump bypass can be used safely among patients with different degrees of myocardial function. The results of surgery were better than the preoperative predicted euroSCORE. Early mortality and morbidity were directly related to ejection fraction .This is true only when LVEF is below 30%. Midterm mortality was similar among different risk groups.
The Journal of cardiovascular surgery 09/2008; 49(4):519-26. · 1.56 Impact Factor
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ABSTRACT: Myocardial revascularization among patients with porcelain aorta is a real dilemma regarding bypass technique, choice of conduit and site of proximal anastomosis. The experience reported here is about two cases of patients (aged 28 and 73 years) with porcelain aorta. Both patients had successful myocardial revascularization using beating heart technique. The younger patient had much more complicated surgical approach.
Minerva chirurgica 01/2008; 62(6):503-5. · 0.77 Impact Factor
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ABSTRACT: In a cross-sectional survey conducted in 2005, we determined the prevalence metabolic syndrome (MetS) and other atherosclerotic cardiovascular disease risk factors among a sample of 342 Palestinians > or = 20 years in East Jerusalem. Participants were interviewed and anthropometric measurements and blood testing were done. MetS was found in 115 (33.6%) participants, with no significant difference between the sexes. The prevalence of obesity, diabetes and other cardiovascular risk factors was also high, with central obesity and obesity (BMI > or = 30 kg/m2) being significantly higher in women (P <0.01). With the exception of low-density lipoprotein cholesterol and haemoglobin, there was a significantly higher prevalence of atherosclerotic markers among the MetS group.
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ 15(6):1464-73.
