European Journal of Cardiovascular Medicine

Atrial fibrillation (AF) is the most common form of arrhythmia in the world. As the population ages, it is estimated that the prevalence of AF will increase by 2.5 fold in the next 50 years.1 At the same time, diabetes has become a pandemic disease in the western world as well as in developing countries. Independent risk factors for chronic AF include hypertension, heart failure, valvular heart disease and cardiomyopathy. The development of AF is likely to be multifactorial and the mechanism is elusive, while there is emerging evidence on the correlation between AF and diabetes mellitus (DM). DM and AF share common antecedents such as hypertension, atherosclerosis and obesity. Population-based studies suggested that DM is an independent risk factor for atrial fibrillation.2 Both DM and AF are marked predictor for stroke and mortality. The causal relation between DM and AF is still debatable and will be discussed.

Purpose of the study: To review the zonal features of the blood supply to the kidneys and to identify the venous basins, depending on the options for the structure of the arterial and venous bed of the kidney. Materials and methods. The study was carried out on 124 polychrome corrosive preparations of the arterial and venous systems of the human kidney. For digitization, the preparations were subjected to 3D scanning. The authors identified the zones of local blood supply to the areas of the renal parenchyma and venous drainage depending on the variants of the division of the renal artery and the fusion of the renal vein in a 3D projection in a computer program. Results. It has been established that the features of the local regional blood supply to the kidney zones and venous outflow from its parenchyma have a dependence associated with the variants of the division of the main renal artery in the renal hilum on the 2nd order arteries, that is, zonal arteries, A. zonal (II), which have their own quantitative and topographic characteristics in the hilum of the kidney, and later in the parenchyma of the organ, where they form the corresponding vascular basins. Conclusion. The structure of the vascular basins will depend on the loose or magistral types of intra-organ branching of the zonal arteries, A. zonal (II) into the arteries of the 3rd, 4th, etc. order. The system of venous outflow from the kidney has a similar structure, except for the absence of zones or regions of isolated venous outflow from the kidney.

Background: Candida spp rarely encountered in urine is in healthy people with structurally normal urinary tract. However, It is of common occurrence in hospitalized patients.The current study to detect the risk factors of funguria in nosocomial septic patients in surgical ICU. Patients and methods:A Cross sectional study included nosocomial patients with septic criteria after 7 days of admission at surgical ICU. Presence and duration of risk factors of funguria (urinary bladder Catheter, central vein catheter, mechanical ventilation, total parenteral nutrition, diabetes mellitus, chemotherapy, surgical operation, burns, immunosuppression, trauma and organ transplantation) were recorded. Results: Diabetes mellitus was found in (35.5%), followed by hypertension and ischemic heart disease in (32.3% & 19.4%) respectively, COPD and Hepatic disease were found in 9.7% and 3.2% of the studied patients respectively. There was a significant difference in age and sex in relation to occurrence of funguria that was statistically higher among females and older patients. There was a highly statistically significance funguria in DM, HTN and IHD respectively. No significance difference in COPD and Hepatic diseases.All patients were catheterized by UBC and CVC. Patients on mechanical ventilation, on parenteral nutrition, DM and Surgical operation were statistically more susceptible to funguria. Conclusion: Funguria commonly affected those above 40 years of age among surgical ICU patients. Females were more commonly affected than males. Pseudomonas aeruginosa was the most recurrent causative organism Urinary bladder catheter and central vein catheter were the most frequently detected risk factor, followed by parenteral nutrition and mechanical ventilation.

Objectives:To analyze the spread rate and the cumulative risk of COVID-19 infection among healthcare workers (HCWs) over the first year of the pandemic. Method: An online, cross-sectional study involved HCWs who were in-service during the first year of COVID-19 crisis, including all healthcare institutions of Jeddah. History and date of COVID-19 infection were collected to estimate the COVID-19-free time, by reference to 03 March 2020, when the first case in Saudi Arabia was identified. Kaplan-Meier survival and Cox regression methods were used to analyze the cumulative risk of COVID-19 infection and the associated factors. Results: There were three peaks of COVID-19 incidence among HCWs; the highest (7.2%) was in September 2020. The cumulative hazard reached 0.10 by the first trimester, then escalated exponentially during the 3rd trimester to reach a plateau at 0.35. The hazard ratio was independently associated with the HCW’s nationality, department affiliation, and receipt of influenza vaccine, as well as the facility type and bed capacity. Receipt of the BCG vaccine in the last year was associated with 40% reduction of the cumulative hazard. Conclusion: The identified risk factors and high-exposure clusters constitute a weak link in the national management strategy of COVID-19 crisis and highlight the urgent need to reinforce the in-hospital protective measures. Findings from the present study have strong implication for the viability and resilience of the healthcare system during major health crises.

Ventricular tachycardia (VT) is one of the major causes of sudden cardiac death (SCD). In general, VT could be managed with antiarrhythmic drugs (AADs) therapy, catheter ablation and implantable cardioverter de brillators (ICD). While the AADs therapy and catheter ablation have been shown to reduce the recurrence of VT, only the ICD therapy is effective in aborting SCD. The recently published VANISH trial reveals that VT catheter ablation signi cantly decreases the rate of death, VT storm and appropriate ICD shock comparing with an escalation of AADs therapy for ischemic cardiomyopathy (ICM). However, the mapping strategies and feasibility of VT catheter ablation are often limited by the hemodynamically intolerant VT. Substrate modi cation strategy and percutaneous left ventricular assist device (pLVAD) are often used to overcome the hemodynamic intolerance. So far there are no large-scale randomized clinical trials comparing different mapping strategies in the setting of hemodynamically unstable VT, speci cally when it comes to risk strati cation for patients with hemodynamic instability. The aim of the present article is to systemically review different VT mapping strategies, the role of pLVAD in hemodynamically intolerant VT ablation with a special consideration of high risk VT.

Background: Clopidogrel has largely replaced ticlopidine in antiplatelet therapy after coronary artery stenting because of the higher risk of blood dyscrasias with the latter agent. However, haemorrhage in this setting is not a rare event. We aimed to investigate by meta-analysis the risk of haemorrhage with ticlopidine plus aspirin versus clopidogrel plus aspirin after coronary artery stenting.Methods: A literature search was conducted for studies comparing ticlopidine plus aspirin with clopidogrel plus aspirin in patients undergoing coronary artery stenting procedures. Studies were included in the meta-analysis if they provided data on haemorrhage for both therapies.Results: Seven randomised and 5 non-randomised studies met the entry criteria. After adjustment for a significant imbalance in use of abciximab in one study, the total number of haemorrhages was 82 with ticlopidine (among 4093 patients) and 78 for clopidogrel (among 3714 patients). Meta- analysis found that ticlopidine plus aspirin was associated with a lower risk of haemorrhage than clopidogrel plus aspirin (odds ratio 0.69; 95% confidence interval 0.50-0.97; p=0.03).In the studies providing information on these events, the rate of blood dyscrasias was higher with ticlopidine than with clopidogrel (0.66% vs 0.45%), but this was offset by the lower rate of haemorrhage with ticlopidine (0.71% vs 1.00%).Conclusion: This meta-analysis found that ticlopidine plus aspirin was associated with a significantly lower risk of haemorrhage than clopidogrel plus aspirin after coronary artery stenting. Given the similar efficacy of the two regimens, it may be worth reconsidering the role of ticlopidine as an antiplatelet therapy.