The Experts below are selected from a list of 159 Experts worldwide ranked by ideXlab platform
Yoav Turgeman - One of the best experts on this subject based on the ideXlab platform.
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction
Journal of Thrombosis and Thrombolysis, 2020Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction.
Journal of thrombosis and thrombolysis, 2019Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p < 0.01, respectively) with a higher prevalence of hyperlipidemia, diabetes mellitus, and ischemic heart disease (p < 0.01 for all). There was no difference between the groups regarding INR, PT, aPTT, and serum levels of creatinine, urea, CPK, troponin, and fibrinogen. Endogenous thrombin potential (ETP), which represents the total thrombin concentration in the plasma, was significantly higher in the myocarditis group than in the NSTEMI group (2091.88 ± 336.41 vs. 1860.75 ± 438.02 nM × min, p < 0.03). Myocarditis and myocardial infarction have a different pattern of thrombin generation Thrombogram. The myocarditis group had significantly higher plasma ETP than the NSTEMI group. This finding requires further evaluation to define a numerical threshold, thus avoiding invasive or expensive assessment of myocarditis.
Fredrick M. Wigley - One of the best experts on this subject based on the ideXlab platform.
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A deceptive case of amyloid myopathy: clinical and magnetic resonance imaging features.
Arthritis and rheumatism, 2001Co-Authors: Keith M. Hull, Lawrence S.c. Griffith, Ralph W. Kuncl, Fredrick M. WigleyAbstract:Amyloid myopathy is a well-described, increasingly recognized clinical entity. Similar to inflammatory myopathies, amyloid myopathy presents with proximal muscle weakness and can be associated with elevated levels of muscle enzymes. We report the case of a 58-year-old woman who, at presentation to her physician with proximal muscle weakness and congestive heart failure, was antinuclear antibody positive and had muscle Biopsy findings "consistent with inflammatory myopathy." She was referred to Johns Hopkins University Medical Center with the diagnosis of polymyositis. Further investigation revealed a monoclonal gammopathy, a unique patterning of subcutaneous fat reticulation and hypodense bone marrow changes on magnetic resonance imaging (MRI), and an Endocardial Biopsy sample that was positive for light chain amyloid deposition. Paraffin sections of the muscle Biopsy sample from the time of her original presentation were obtained, and Congo red staining showed diffuse amyloid deposition throughout the sample, but no inflammation. This case not only illustrates that proximal muscle weakness due to primary amyloid myopathy (as found in light chain amyloidosis and transthyretin amyloidosis) can mimic that of polymyositis, but also shows that unique findings on MRI can alert the clinician to the diagnosis of amyloidosis prior to muscle Biopsy.
Ofir Koren - One of the best experts on this subject based on the ideXlab platform.
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction
Journal of Thrombosis and Thrombolysis, 2020Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction.
Journal of thrombosis and thrombolysis, 2019Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p < 0.01, respectively) with a higher prevalence of hyperlipidemia, diabetes mellitus, and ischemic heart disease (p < 0.01 for all). There was no difference between the groups regarding INR, PT, aPTT, and serum levels of creatinine, urea, CPK, troponin, and fibrinogen. Endogenous thrombin potential (ETP), which represents the total thrombin concentration in the plasma, was significantly higher in the myocarditis group than in the NSTEMI group (2091.88 ± 336.41 vs. 1860.75 ± 438.02 nM × min, p < 0.03). Myocarditis and myocardial infarction have a different pattern of thrombin generation Thrombogram. The myocarditis group had significantly higher plasma ETP than the NSTEMI group. This finding requires further evaluation to define a numerical threshold, thus avoiding invasive or expensive assessment of myocarditis.
Cornelia S Carr - One of the best experts on this subject based on the ideXlab platform.
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Right atrial tuberculoma: computed tomography and magnetic resonance imaging.
The Journal of thoracic and cardiovascular surgery, 2007Co-Authors: Abdul M. Alkhulaifi, Cornelia S CarrAbstract:A 31-year-old Eritrean man presented with a 10-day history of fever, cough, and dyspnea. He was pyrexial and tachypneic with right lung crepitations and a discharging scrotal sinus. Chest radiography showed patchy consolidation of the right lower zone. Pneumonia was diagnosed, and antimicrobial therapy was started. Sputum was negative for acid-fast bacilli (AFB), and blood cultures grew Gram-positive cocci. Computed tomography (Figure 1) showed massive alveolar opacities; pleural, pericardial, and peritoneal thickening; ascites; and a right atrial mass. A transesophageal echocardiogram confirmed a 3 4-cm mass encroaching into the right atrium related to the superior vena cava. The patient’s condition deteriorated, and he required intubation. He was human immunodeficiency virus negative, and pleural and ascitic fluids were AFB negative, but antituberculosis treatment was started for presumed miliary tuberculosis and right atrial mass. Peritoneal Biopsy (via laparoscopy) showed epithelioid granulomas. He was extubated after 7 days, and in view of the atrial mass, warfarin was started. Endocardial Biopsy (under transesophageal echocardiogram) showed myocardial fibers, necrotic foci, and inflammatory cells, but no myxoma or malignancy. The scrotal wound was AFB negative, and there was azoospermia. Because there was no hemodynamic compromise, we decided to assess the patient with serial imaging. Magnetic resonance imaging performed 4 months later (Figure 2) showed a marked reduction in size (3 2 2.5 cm) with peripheral gadolinium enhancement and inflammation/obliteration of the seminal vesicle lumens. This patient presented with overwhelming sepsis, and initially it was thought that the atrial mass may be incidental, but he remains well with warfarin and antituberculous treatment. The combination of the patient’s ethnic origin, pneumonic process, sepsis, and discharging scrotal wound led to the diagnosis of tuberculosis, although no AFBs have ever been isolated. Previous myocardial tuberculomas have regressed with antituberculosis treatment, adding support to our diagnosis of right atrial tubercu-
Mazen Elias - One of the best experts on this subject based on the ideXlab platform.
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction
Journal of Thrombosis and Thrombolysis, 2020Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p
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Role of thrombin generation assays in the diagnosis of acute myocarditis and non-ST myocardial infarction.
Journal of thrombosis and thrombolysis, 2019Co-Authors: Ofir Koren, Mohamed Azaizah, Ehud Rozner, Mazen Elias, Yoav TurgemanAbstract:Myocarditis and myocardial infarction share a common clinical characteristics despite significant differences in etiology and pathogenesis. Current guidelines recommend using cardiac magnetic resonance imaging (MRI) or Endocardial Biopsy for a definite diagnosis; however, these guidelines are not fully implemented due to the high cost and low availability. We used a thrombin generation assay and simple blood test to characterize both diseases. We conducted a cross-sectional study from April to December 2018. Patients with initial clinical suspicions of non-ST elevation myocardial infarction (NSTEMI) or myocarditis were eligible. All patients were recruited prior to anticoagulant treatment. Patients in both groups underwent acceptable standard clinical evaluation. Twenty-eight patients were enrolled; 12 patients in the NSTEMI group and 16 in the myocarditis group. Patients in the NSTEMI group were significantly older than those in the myocarditis group (64.25 ± 9.67 vs. 37.94 ± 19.66 years, p < 0.01, respectively) with a higher prevalence of hyperlipidemia, diabetes mellitus, and ischemic heart disease (p < 0.01 for all). There was no difference between the groups regarding INR, PT, aPTT, and serum levels of creatinine, urea, CPK, troponin, and fibrinogen. Endogenous thrombin potential (ETP), which represents the total thrombin concentration in the plasma, was significantly higher in the myocarditis group than in the NSTEMI group (2091.88 ± 336.41 vs. 1860.75 ± 438.02 nM × min, p < 0.03). Myocarditis and myocardial infarction have a different pattern of thrombin generation Thrombogram. The myocarditis group had significantly higher plasma ETP than the NSTEMI group. This finding requires further evaluation to define a numerical threshold, thus avoiding invasive or expensive assessment of myocarditis.