Predictive Risk Assessment of D-Dimers and Troponin Levels of Thrombotic Events among COVID-19 Patients in a Community-Based Hospital, New York City |Chapter 9 | Medicine and Medical Research: New Perspectives Vol. 5

 

The coronavirus disease 2019 (COVID-19) continues to pose an unprecedented challenge for the entire world and the healthcare system. The role of D-dimer and troponin-I as markers of thrombosis or procoagulant state in COVID-19 infection has been under investigation since the inception of this disease. Different theories have been proposed elucidating the pathophysiological mechanisms attributing to high mortality and morbidity in COVID-19 infection. Out of them, thrombosis and procoagulant state have managed to earn the maximum limelight. The main objective of our study was to assess the risk and occurrence of thrombotic events (both venous and arterial) among hospitalized patients including the intensive care unit (ICU) and non-ICU admissions with confirmed COVID-19 infection. An observational study was conducted based on data from randomly selected 349 hospitalized patients with COVID-19 infection in a community-based hospital in New York City during the first wave of the COVID-19 viral surge in March 2020. Diagnoses were made during the inpatient clinical care, as screening for thrombotic events is not a standard method. The statistical analysis involved non-normally distributed continuous variables that were described as the median and interquartile range (IQR) while mean and standard deviation were used to describe normally distributed continuous variables. The primary outcome in our study was defined as the thrombotic events that included myocardial infarction (MI), deep venous thrombosis (DVT), cerebrovascular accidents (CVA), and pulmonary embolism (PE). The study correlated the association of thrombotic events with the level of biomarkers of interest: D-dimer >1000 ng/ml, troponin-I >1 ng/ml, or both. The association of D-dimers and troponin-I with thrombotic events was measured using both univariate and multivariate Cox proportional hazard (PH) regression analysis. Out of a total of 349 patients, 78 patients (22.35%) were found to have elevated biomarkers (D-dimer >1000 ng/ml and/or troponin-I >1 ng/ml) and were categorized as a high-risk group. Eighty-nine patients developed thrombotic complications (evidence of more than one thrombotic event was found in several patients). Two-hundred seventy-one (77.65%) patients had no documentation of thrombosis. The in-patient mortality rate among patients in our study group, with a high risk of thrombotic events was 44.87% (35/78) as compared to 38.80% (104/271) in patients without any thrombotic events. The incidence of thrombotic events included myocardial infarction (MI; N=45; 12.8%), cerebrovascular accidents (CVA; N=16; 4.5%), deep venous thrombosis (DVT; N=16; 4.5%), and pulmonary embolism (PE; N=9; 2.57%). The lack of prior immunity to COVID-19 has resulted in large numbers of infected patients across the globe and uncertainty regarding the management of the complications that arise in the course of this viral illness. Although D-dimer, sepsis, and microvascular thrombosis are associated with mortality, current data are inconclusive for the use of therapeutic doses of anticoagulation for these findings. With the resurgence of the COVID-19 wave, it is imperative to focus on optimal diagnostic and prophylactic strategies to prevent thromboembolic events and potentially improve survival in COVID-19 patients.

 

Author (s) Details

Ruchi Yadav
Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, USA.

 

Beka Aroshidze
Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, USA.

 

Vivek Yadav
Pulmonary and Critical Care, State University of New York Downstate Health Sciences University, New York, USA.

 

Umar Zahid
Nephrology, Brookdale University Hospital and Medical Center, Brooklyn, USA.

 

Apoorva Jayarangaiah
Internal Medicine, New York City (NYC) Health and Hospitals/Jacobi Medical Center, Bronx, USA.

 

Anjula Gandhi
Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, USA.

 

Vladimir Gotlieb
Hematology/Oncology, Brookdale University Hospital and Medical Center, Brooklyn, USA.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v5/1997

Determining the Homocysteine and D-Dimer Levels and Multilayer Computed Tomography for Diagnosis of Pulmonary Artery Thromboembolism | Chapter 15 | Advancement and New Understanding in Medical Science Vol. 6

The aim of our investigation was to assess the importance of measuring D-dimer and homocysteine levels, along with the use of multilayer computer tomography (CT), in the diagnosis of patients with suspected PATE. According to reports, D-dimer is crucial in the diagnosis of pulmonary embolism. Furthermore, homocysteine has been shown to be a risk factor for thrombosis, vascular disease, and atherosclerosis. The purpose of this chapter is to assess the diagnostic utility of multi-detector computed tomography (CT) in conjunction with D-dimer and homocysteine levels in cases of suspected pulmonary embolism. We examined 54 patients from 18 to 76 years of age, who were suffering from conditions and complaints that are typical of PATE, such as chest pain, haemoptysis, dyspnoea, tachycardia, arterial hypotension and signs of vein thrombosis in the inferior limbs.  In these patients, PATE was found in different localizations with varying rates of severity. D-dimer levels were measured in patients with suspected PATE using enzyme-linked immunosorbent assays. Homocysteine levels were determined by an enzymatic method. Pulmoangiography is the method of choice in pulmonary embolism diagnostics. All patients were examined to evaluate the presence of pulmonary embolism by multi-detector CT angiopulmonography. Changes in homocysteine levels can be considered a separate independent factor for PATE diagnostics. The correlation between multi-detector CT angiopulmonography, elevated D-dimer levels, and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. Multi-detector CT angiopulmonography, D-dimer levels and related hyperhomocysteinemia can serve as significant laboratory markers in the diagnosis and treatment efficacy of PATE. The changes in homocysteine levels can be considered as a separate independent factor for PATE diagnostics. The interdependence between D-dimer and concomitant hyperhomocysteinemia can be used not only for diagnostics but also for the assessment of the effectiveness of PATE treatment. It can be concluded that multilayer CT pulmoangiography is a non-invasive highly informative method, providing a very low level of complications, and is thus indicated for acute PATE diagnostics, and for control of the disease dynamics after anticoagulation treatment.

Author(s) Details:

Fridon Todua,
Todua Clinic, 0112 Tbilisi, Georgia.

Manana Akhvlediani,
Todua Clinic, 0112 Tbilisi, Georgia.

Elena Vorobiova,
Todua Clinic, 0112 Tbilisi, Georgia.

Giorgi Tsivtsivadze,
Todua Clinic, 0112 Tbilisi, Georgia.

Anna Baramidze,
Todua Clinic, 0112 Tbilisi, Georgia.

Please see the link here: https://stm.bookpi.org/ANUMS-V6/article/view/13395

Cardiac Hydatid Cyst: An Uncommon Presentation of Echinococcosis Infection | Chapter 16 | Advancement and New Understanding in Medical Science Vol. 4

Cystic hydatid disease is a common health problem in low- and middle-income countries. It commonly affects the liver and lungs. Cardiac involvement is a relatively rare manifestation. Among all infected patients, 0.5-2% exhibit cardiac hydatidosis.  Cardiac hydatid cyst is a diagnostic challenge. It can cause fatal complications, including anaphylactic shock, systemic or pulmonary embolism, dissemination, arrhythmias, valvular dysfunction or sudden death.

Author(s) Details:

Med Amin Mesrati,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Yosra Mahjoub,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Nouha Ben Abdejlil,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Marwa Boussaid,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Meriem Belhaj,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Hiba Limem,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Ali Chadly,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Abdelfeteh Zakhama,
Department of Pathology, University of Monastir, Monastir, 5000, Tunisia.

Abir Aissaoui,
Department of Forensic Medicine, University of Monastir, Mahdia, 5100, Tunisia.

Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13224

A Brief Overview on Thrombophlebitis: Diagnosis and Clinical Treatment | Chapter 14 | Current Progress in Medicine and Medical Research Vol. 3

 Thrombophlebitis is the instigative condition of the vein guide one or more blood clots. If it wait untreated, it can results in harsh complications that are fatal. The snags may include Deep mood thrombosis (DVT) and Pulmonary clotting (PE). If a deep vein clot enhances dislodged, it can travel to internal organs and blocks blood vessels, the obstruction of blood containers reduces the blood flow that leads to a life ominous situation. The types of thrombophlebitis includes detail, septic and seasonal thrombophlebitis. Migratory and Septic thrombhleplebitis are the fatal types. They are very dangerous environments because the immune order is over responsive. These environments requires a next medical treatment and breakneck diagnostic measures. The drugs usable for the treatment of thrombophlebitis are very less and supports only the symptomatic relaxation. Recent studies have proven that low microscopic weight heparins like Dalteparin is active in the treatment of thrombophlebitis. The present issue is emphasized on the launch, types, causes, diagnosis, screening models, non pharmacological and pharmacological situation of thrombophlebitis.

Author(s) Details:

G. Sai Sri Lakshmi,

Department of Pharmaceutical Analysis, Nirmala College of Pharmacy, Mangalagiri, A.P 522503, India.

Kondumahanti V. N. Lakshmi,

Department of Pharmacology, Nirmala College of Pharmacy, Mangalagiri, A.P 522503, India.

T. Vinay Kumar,

Department of Pharmacology, Nirmala College of Pharmacy, Mangalagiri, A.P 522503, India.

Sk. Abdul Rahaman,

Department of Pharmaceutical Analysis, Nirmala College of Pharmacy, Mangalagiri, A.P 522503, India.

V. L. Anusha,

Department of Pharmacology, SIMS College of Pharmacy, Guntur, India and Nirmala College of Pharmacy, Mangalagiri, 522503, India.

N. Asritha,

Department of Pharmacology, SIMS College of Pharmacy, Guntur, India and Nirmala College of Pharmacy, Mangalagiri, 522503, India.

G. Srujana,

Department of Pharmacology, SIMS College of Pharmacy, Guntur, India and Nirmala College of Pharmacy, Mangalagiri, 522503, India.

S. Shyamananda,

Department of Pharmacology, SIMS College of Pharmacy, Guntur, India and Nirmala College of Pharmacy, Mangalagiri, 522503, India.

Please see the link here: https://stm.bookpi.org/CPMMR-V3/article/view/11250

Association between Pulmonary Embolism and Vitamin B12 Deficiency | Chapter 14 | New Advances in Medicine and Medical Science Vol. 4

 We present a case of mutual pulmonary embolism in a active female with source of nourishment B12 deficiency to further support the vicinity a causal connection. The patient developed liberal dyspnea and fatigue of four days. She had heart attack, tachypnea, and hypotension. CTPA showed mutual PE. Her labs excluded added causes of thrombosis. On discharge, the patient was exceptionally stable and afebrile, and her hemoglobin was resistant. She was given warfarin and make inquiries with hematology. We decided that vitamin B12 inadequacy causes elevation in homocysteine levels. This can influence the endothelium and platelets and result in raised risk of thromboses.

Author(s) Details:

Abdulkareem A. Jaragh,
Department of Internal Medicine, Farwaniya Hospital, Farwaniya, Kuwait.

Naser Alhadhood,
Department of Rheumatology, Farwaniya Hospital, Farwaniya, Kuwait.

Please see the link here: https://stm.bookpi.org/NAMMS-V4/article/view/10717

Angio-behçet’s Disease with Concomitant Neurologic, Pulmonary and Cardiac Involvement: A Case Report| Chapter 5 | Current Overview on Disease and Health Research Vol. 7

Concomitant neurological, cardiac, and pulmonary vascular involvement in Behçet’s disease is very rare and characterized by high mortality. Management is challenging because of the very high risk of bleeding. We report the case of a 25-year-old man, of Maghreb descent, who was admitted with acute motor deficit in all four limbs. A thoracic computed tomography angiogram (CTA) showed thrombosis of an aneurysm of the inferior lobar pulmonary arteries bilaterally, with an obstructive intraluminal thrombus of a segmental branch of the right superior lobe. Transthoracic echocardiography (TTE) revealed a mobile right atrial thrombus measuring 13 × 10 mm. The patient was treated with methylprednisolone (1 g), cyclophosphamide, colchicine, and low weight heparin followed by oral antivitamin K anticoagulation. The outcome was satisfactory with complete resolution of the atrial thrombus and the aneurysm, and mild neurological sequelae at six months.

Author(s) Details:

Reine Joephane Bikouta Ouadika,
Neurology Department, University Teaching Hospital Mohammed VI, Marrakesh, Morocco.

Nissrine Louhab,
Neurology Department, University Teaching Hospital Mohammed VI, Marrakesh, Morocco and Laboratory of Clinical and Experimental Neuroscience Research, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.

Laila Benjilali,
Neurology Department, University Teaching Hospital Mohammed VI, Marrakesh, Morocco and Laboratory of Clinical and Experimental Neuroscience Research, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.

Najib Kissani,
Neurology Department, University Teaching Hospital Mohammed VI, Marrakesh, Morocco and Laboratory of Clinical and Experimental Neuroscience Research, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.

Please see the link here: https://stm.bookpi.org/CODHR-V7/article/view/9433

Determination of Pulmonary Embolism in Lungs using Computer Assisted System |Chapter 2 | Research Developments in Science and Technology Vol. 7

 A pulmonary embolism (PE) occurs when a blood clot in the lungs produces an unexpected occlusion of a blood artery in the lungs. PE is a life-threatening illness that should be caught as soon as possible. This research provides a novel approach for detecting PE in contrast-enhanced CT images. Computed tomography is the most used method for gathering images in order to diagnose PE (CT). It's a quick test that yields high-resolution photographs with more contrast and multi-sliced images. Candidate identification, feature calculation, and classification are all part of the system. The major aims of candidate detection are to include PE even with total occlusions and to reduce erroneous tissue and parenchymal illness diagnosis. When defining characteristics, the location and structure of the pulmonary vascular tree, as well as the severity, form, and size of an embolus, are all taken into account. The ability of the CAD tool to detect emboli in the pulmonary Arterial Tree (PAT) sectional and sub sectional was studied.

Author(s) Details:

M. Sucharitha,
Department of ECE, Malla Reddy College of Engineering and Technology, Hyderabad-500100, India.

M. Mohammed Mohaideen,
Department of Aeronautical Engineering, Malla Reddy College of Engineering and Technology, Hyderabad-500100, India.

P. H. V. Sesha Talpa Sai,
Department of Mechanical Engineering and Dean- R & D, Malla Reddy College of Engineering and Technology, Hyderabad-500100, India.

Please see the link here: https://stm.bookpi.org/RDST-V7/article/view/7074

Thrombolytic Therapy in a Patient with Extensive Pulmonary Embolism Complicated by Cardiac Arrest | Chapter 26 | Issues and Developments in Medicine and Medical Research Vol. 9

 After cerebrovascular accidents and myocardial infarction, pulmonary embolism is the third most common cause of mortality. This condition can develop as a result of a thromboembolic event that occurs as a result of recent immobilisation. Massive pulmonary thromboembolism (MPT) is a potentially fatal illness that can result in cardiac arrest, stroke, and death. The patient in this case report is a 60-year-old obese diabetic male who was taken to the emergency room with complaints of shortness of breath and exhaustion. Following a work-related knee injury, the patient was diagnosed with a meniscal and anterior cruciate ligament tear. S1 Q3 T3 was seen on an echocardiogram, and a transthoracic echocardiography revealed considerable right ventricular dilation and heart strain. D Dimer levels were found to be greater in the lab, and a computed tomography lung angiography was also performed. At the bifurcation, an evident saddle-shaped pulmonary artery (PA) embolism was discovered, which extended to both the right and left pulmonary arteries. The patient's abrupt deterioration due to cardiogenic shock was caused by this massive pulmonary embolism. For 18 minutes, the patient experienced nine cycles of cardiac irregularity and was treated with cardiopulmonary resuscitation and thrombolytic treatment. The diagnosis of pulmonary embolism was made based on the patient's history of knee injury immobilisation and the clinical picture of shortness of breath and tachycardia. The patient was diagnosed and treated with thrombolytic treatment and CPR to relieve cardiac arrest caused by pulmonary embolism and subglottal laryngeal edoema in this case study.

Author(S) Details

Hesham Hussien Aly
Critical care Unit, Madinat Zayed Hospital, United Arab Emirates.

Ashraf Alakkad
Internal Medicine Unit, Madinat Zayed Hospital, United Arab Emirates.

Mohamed Abdel Rahman El. Hussein
Internal Medicine Unit, Madinat Zayed Hospital, United Arab Emirates.

Noor Ullah Hussaini
Cardiology Unit, Madinat Zayed Hospital, United Arab Emirates.

Shanavaskhan Shamsudeenkutty
Cardiology Unit, Madinat Zayed Hospital, United Arab Emirates.

Ahmed Essam Mohammad
Critical care Unit, Madinat Zayed Hospital, United Arab Emirates.

Mostafa Mohamed Ezzeldin
Critical care Unit, Madinat Zayed Hospital, United Arab Emirates.

Lubna Suboohi
Cardiology Unit, Madinat Zayed Hospital, United Arab Emirates.

View Book:- https://stm.bookpi.org/IDMMR-V9/article/view/5861

Inflammatory Markers in Critically Ill Patients with Venous Thrombosis: A Cross-Sectional Study in a Tertiary Hospital | Chapter 1| New Innovations in Chemistry and Biochemistry Vol. 3

 the United States. In hospitalised patients, venous thrombosis is a leading cause of morbidity and mortality, and it is potentially preventable. Over the last decade, deep vein thrombosis (DVT) has grown in popularity as a potentially preventable cause of morbidity and mortality in hospitalised patients. The researchers wanted to investigate inflammatory indicators in venous thrombosis.

Materials and Procedures: Patients admitted to tertiary hospitals were studied in a cross-sectional research. The study examined 59 cases of venous thrombosis that were confirmed by radiography. Written informed consent was obtained for participation in the study and the conduct of investigations. Between November 2017 and September 2019, the study was conducted.

Results: The average age of the study participants was 43.6 years (SD=16.4), with a range of 20 to 72 years. Among the 59 cases, 48 were males (81.4%) and 11 were girls (18.6 percent). The patients' average Body Mass Index was 24.33 2.84 kg/m2. CRP levels were increased in 48 of the 59 individuals (81.3%). Serum homocysteine levels were increased in 46 individuals (77%) (>15 mol/L). Low HDL was found in 74.6 percent of the 59 participants, whereas high LDL was found in 61 percent and high Triglycerides was found in 45 percent. The level of total cholesterol has risen by 40.7 percent. D dimer levels were found to be high in 98.3% of the cases.

Conclusion: We discovered that spontaneous venous thrombosis is a common cause of worry among men aged 20 to 29, who have a BMI of more than 25 kg/m2. Inflammatory markers were found to be significantly greater in venous thrombosis patients.

Author(S) Details

Shaheen B. Shaikh
Department of Biochemistry, Yenepoya Medical College Hospital, Mangaluru, Karnataka, India.

H. M. Ismail
Department of Critical Care Medicine, Yenepoya Medical College Hospital, Mangaluru, Karnataka, India.

R. Bhavya
MVJ Medical College and Research Hospital, Hoskote Taluk, Bangalore Rural, India.

P. Ganesh
Department of Biochemistry, Yenepoya Medical College Hospital, Mangaluru, Karnataka, India.

Sarfaraz Shaikh
Department of Emergency Medicine, DM WIMS Medical College Wayanad, Kerala, India.

View Book:- https://stm.bookpi.org/NICB-V3/article/view/4005