Journal of Vessels and Circulation
Volume:3 Issue: 4, Autumn 2022

The need for more fetal echocardiography by a specialist in isolated single umbilical artery (SUA) pregnancies is controversial. Therefore, this study aimed to investigate the frequency of SUA in fetal ultrasound in neonates with congenital heart disease (CHD) compared to neonates without CHD referred to Hazrat Masoumeh Hospital in 2019.

The files of all the neonates who underwent fetal ultrasound and echocardiography in 2019 were reviewed. Based on the results of the fetal echocardiography, these neonates were divided into two groups with/without cardiac abnormalities. Then, the results of fetal ultrasound performed in terms of the frequency of SUA were examined in the groups, and variables, such as birth, weight, gestational age, and gender were entered into the checklist. Finally, the frequency of SUA in fetuses with/without cardiac abnormalities was compared between the two groups.

The mean age of mothers in the SUA group was 32.47±8.7 years and in the normal group was 32.07±11.5 years. A total of 135 boys (54%) and 115 girls (46%) were examined in this study. No statistically significant relationship was found between maternal age (P=0.72), fetal gender (P=0.92), gestational age (P=0.42), and parity (P=0.92) despite the finding of a SUA. In the group of patients with CHD, 12 out of 125 patients (4.8%), and in the group without CHD, five out of 125 patients (2%) had an SUA. Although this number was highest in the group who had CHD, no statistically significant difference was found between the two groups (0.07).

The relationship between SUA in a fetus with normal ultrasound and CHD varies significantly with population selection criteria. The risk of CHD after diagnosing SUA in a normal fetus from an unselected population appears to be low and may not warrant specialized fetal echocardiography.

In the current situation of the COVID-19 pandemic, patients with multiple sclerosis (MS) represent a population of particular interest because they may be at higher risk of contracting COVID-19. The present study aims to determine the risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity and symptomatic COVID-19 in MS patients, in Qom Province, Iran.

In this cross-sectional study, 486 patients diagnosed with MS were included in the study. First, the demographic characteristics of patients were collected. Then, the patients underwent serology tests for anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies. Later, the risk factors for SARS-CoV-2 seropositivity and symptomatic COVID-19 were assessed. Finally, SPSS software, version 22 was used to analyze the data.

Fifty-five patients (11.8%) were seropositive for SARS-CoV-2 immunoglobulin G (IgG), of whom 25% were symptomatic. The results showed a significant difference between the seropositive and seronegative groups in terms of MS type and comorbidity. Further, comorbidities, including hypertension and hypothyroidism were identified as the major risk factors for developing symptomatic disease. However, none of the variables were statistically associated with the severity of COVID-19.

The present study revealed a significantly lower seroprevalence of COVID-19 in MS patients than in the population. Based on the results, most seropositive patients were asymptomatic. Comorbidity was identified as the major risk factor for both SARS-CoV-2 seropositivity and symptomatic COVID-19. However, no relationship was observed between patients’ characteristics and MS features with the severity of COVID-19, which reinforces the continuation of regular treatment during the COVID-19 pandemic.

Aging is a process, in which the physiological capacity of the body decreases. One of these basic changes is the reduction of blood supply caused by the inability of angiogenesis. This article was conducted to investigate the effect of aerobic exercise on angiogenic factors, including leucine-rich α-2-glycoprotein 1 (LRG-1) and thrombospondin-1 (TSP-1) in middle-aged women.

This quasi-experimental study was conducted on 18 middle-aged women. The samples were randomly divided into two groups, including the aerobic (n=9) and control (n=9) groups. The experimental group performed aerobic exercise for eight weeks (three sessions per week). Then, 5 mL of blood samples was taken from each person 48 hours before and after training to measure LRG-1 and TSP-1 protein levels. The dependent and independent t-tests were used to analyze the data.

The levels of LRG-1 in the experimental group showed a significant increase in post-test compared to the control group. Also, in the experimental group, TSP-1 levels showed a significant decrease in post-test compared to the control group.

The results of this study showed that aerobic exercise can increase the levels of LRG-1 protein and decrease the serum TSP-1 protein levels; therefore, by increasing LRG-1 and decreasing TSP-1 levels, the angiogenesis process in the body is enhanced. Accordingly, middle-aged women are advised to do aerobic exercise as a tool to improve angiogenesis and improve blood circulation.

One of the critical differences between outpatient and inpatient treatment is to have appropriate vascular access. Hospitalization usually begins with a venipuncture. Considering the lack of documented and sufficient studies in this field, the present study was designed to determine the difference between peripherally inserted central venous catheters (PICCs) and peripheral intravenous (PIV) in terms of complications during hospitalization, such as sepsis and other possible complications caused by venipuncture.

In this cross-sectional-analytical study, the files of patients and neonates with less than 1250 g birth weight who had PICC or PIV were examined based on the inclusion criteria. Confounding variables, such as birth weight, gestational age, the need for resuscitation, birth Apgar score, premature rupture of membranes (PROM) >18 hours, method of delivery, leukopenia at birth, positive C-reactive protein (CRP) on admission, and positive culture at admission were assessed.

Death rate due to infection, pneumothorax, need for patent ductus arteriosus (PDA) treatment, positive blood culture, C-reactive protein (CRP) >6 mg/dL, the need for antifungal treatment, the need for intravenous immunoglobulin (IVIG) prescription due to malaise, the prevalence of respiratory diseases, such as pneumonia and arrhythmia, tamponade, vein rupture, and chemical burns caused by the release of drugs showed no significant difference in the PICC and PIV groups; however, the rate of surfactant administration and referral for the cause of retinopathy of prematurity (ROP) was significantly higher in the PICC group, which seems logical considering the lower birth age and lower weight of this group.

The lack of significant difference in many variables (especially the lack of significant difference in the rate of infection) in the two groups indicates that PICC, despite being a central catheter with easy insertion, does not increase the risk of infection compared to conventional venipuncture, and considering the rest aspects, it can be considered as a reliable and low-risk method to access the central vessels.

High blood pressure is an important global healthcare concern, and its prevalence is increasing worldwide. Self-care practice is a cost-effective method in controlling blood pressure. This study aims to assess the adherence to self-care behaviors among hypertensive patients during the COVID-19 pandemic in Qom, Iran.

This is a descriptive-analytical study with a cross-sectional design that was conducted in 2021 on 218 hypertensive patients in Qom City who were selected using a convenience sampling method. The data collection tool was a two-part questionnaire; the first part surveyed demographic characteristics, while the second part was the modified version of the Hypertension Self-Care Activity Level Effects (H-SCALE) questionnaire. Data analysis was performed in SPSS software using independent t-test, ANOVA, Pearson's correlation test, and chi-square test.

The participants had a mean self-care score of 79.32. Among the self-care subscales, smoking exposure (90.1%), medication adherence (85.7%), healthy eating plan (42.8%), weight management (35.1%), and physical exercise (28.5%) showed the highest scores. Only patients with a university education demonstrated higher and more significant self-care scores.

The COVID-19 pandemic has had an impact on hypertensive patients’ adherence to self-care behaviors in Qom. Considering the results, particularly in weight management and physical activity with the lowest scores, it is important to implement educational programs to inform hypertensive patients about the seriousness of the complications of the disease and encourage them to adhere to self-care behaviors.

Following the prevalence of severe acute respiratory syndrome-coronavirus (SARS-CoV2) in the world, a type of severe involvement in children was reported as multisystem inflammatory syndrome in children (MIS-C) involving various organs, such as lung, skin, heart, kidney, gastrointestinal tract, and eyes, acute abdomen as a manifestation of this syndrome is rarely reported. To introduce children with MIS-C with fever and acute abdomen who underwent appendectomy.

Case Report: 

Six children between the ages of 8 to 12 years (3 boys and 3 girls) presented with acute abdominal pain, fever, and vomiting, due to obvious tenderness and rebound tenderness in the right lower quadrant of the abdomen and other clinical and laboratory symptoms, 4 of them underwent emergency appendectomy.

Due to the lack of improvement in abdominal pain and the symptoms and problems in various organs in patients, such as heart (three cases of myocarditis, one case of pericardial effusion), kidneys (two cases of increased urea and creatinine), skin (four cases of skin rash), lung (six cases of pulmonary involvement and two cases of pleural effusion), gastrointestinal tract (abdominal pain and vomiting and three cases of diarrhea), and laboratory symptoms in the form of increased acute phase reactors and (D dimer ) and most cases of lymphopenia (six cases) and evidence of COVID-19 infection (positive polymerase chain reaction [PCR] or COVID-19 positive serology, or compatible imaging and laboratory symptoms), MIS-C was diagnosed and treated for these patients. Patients were treated with corticosteroids and intravenous immune globulin (IVIG) and enoxaparin and other medications and fortunately, all cases improved. In addition, the pathology report after appendectomy was appendicitis in most cases.

Four cases that showed clinical manifestations of acute abdomen underwent surgery without overall complications. In some of these patients, appendicitis was the cause of abdominal pain, and in some patients, inflammatory response to COVID-19 (e.g. mesenteric adenitis) was the cause of pain and no mortality was reported. In most patients, inflammatory markers, such as CRP and ESR were elevated, and albumin levels were mildly decreased during admission and ferritin and D-dimer levels were abnormal in most patients. Four cases had cardiac involvement and all MIS-C patients were treated with steroids and IVIG, respectively. Also, no mortality was reported in patients treated with corticosteroids.

Therefore, it is essential to note that in children with a complaint of abdominal pain and have symptoms in favor of an acute abdomen; attention should be paid to the symptoms of the involvement of other body systems due to (MIS-C).