Function Tests In Patients Research Articles

Liver function tests in patients with chronic obstructive pulmonary disease in a tertiary care hospital

Background: Cases of chronic obstructive pulmonary disease (COPD) increasing day by day. Smoking is the major causative agent for COPD. The present study undertaken to estimate the deterioration of liver functions in COPD patients due to smoking. Aims and Objectives: This study aims to investigate various liver function tests (LFTs) such as total bilirubin, alanine amino transferase/serum glutamic pyruvic transaminase (SGPT), aspartate amino transferase/SGPT, alkaline phosphatase (ALP), serum ammonia, and serum albumin among COPD patients. To correlate LFTs with forced expiratory volume at end of 1 second (FEV1) and FEV1/Forced vital capacity (FVC) ratio. Materials and Methods: In our present study, we selected 86 cases of COPD in the age group of 41–60 years. All subjects were smokers and having FEV1

THE EFFECT OF SPIRONOLACTONE ON SERUM ELECTROLYTES AND RENAL FUNCTION TESTS IN PATIENTS WITH SEVERE CHRONIC HEART FAILURE

The aim: To evaluate the effect of single daily 25 mg of spironolactone on serum electrolytes and kidney function tests in patients with severe chronic left sided heart failure. Materials and methods: 60 patients with severe chronic left sided heart failure were enrolled in this study and they were divided in to 2 equal groups’ one group with standard therapy of HF and the other with spironolactone in a dose of 25 mg / day, as an additive therapy to the standard one. Serum electrolytes and kidney function tests were assessed at the beginning of the study and after 3 months. Results: A significant increment in serum potassium (p<0.05) was observed in the spironolactone group after 3 months treatment, while no significant reduction in serum sodium (p>0.05) and no significant increase in serum creatinine and blood urea (p>0.05) was noticed in the same group, control group showed no significant changes (p>0.05), in both serum electrolytes (S.K and S.Na) and renal function tests (S.C and B.U). Conclusions: Spironolactone caused a significant elevation of serum potassium level but this elevation is still with the clinically accepted ranges when low dose of spironolactone is used and with intact renal function. Serum creatinine level was not significantly increased with 25 mgl day of spironolactone. We conclude that Renal function tests namely blood urea and serum Creatinine, and serum potassium should be closely monitored in patients on spironolactone therapy especially those patients who use ACEI and ARBs in addition.

Three-month Effects of Immunotherapy on Clinical Features and Pulmonary Function Tests of Patients with Allergic Rhinitis Concomitant with or without Asthma

Objective: We aimed to evaluate our patient’s treatment responses to three-month immunotherapy for allergic rhinitis with or without asthma, and to investigate the factors affecting treatment
 Material and Methods: A total of 53 patients receiving subcutaneous immunotherapy for allergic rhinitis with or without asthma were included in the study. All patients were positive for mite skin prick test. Asthma was present as a concomitant disease in 28(52.8%) patients. Patients with and without asthma were classified in two groups as “Allergic rhinitis + Asthma+” and “Allergic rhinitis+ Asthma-“. The values of pulmonary function tests of all patients, and in rhinitis with asthma patients, the Asthma Control Test scores before and after three months of treatment were recorded.
 Results: In “Allergic rhinitis + Asthma+” and “Allergic rhinitis + Asthma-“groups, male/female ratio was 7/21 and 10/15, mean age was 33±9 and 32±9 years. No statistically significant differences were present between the pre-treatment and 3-month-treatment values of pulmonary function test. The difference between the pre-treatment and 3-month treatment asthma control test scores was strongly significant.
 Conclusion: In allergic rhinitis, which is quite commonly associated with asthma, the control of asthma is also provided with the treatment of allergic rhinitis. By using pulmonary function test in allergic rhinitis and asthma control test in asthma, we showed that the effectiveness of allergen specific immunotherapy started in 3 months which was earlier from current literature.

Pulmonary function testing in patients with neuromuscular disease.

Progressive neuromuscular disease leads to muscle weakness or failure that produces loss of pulmonary function and clinical respiratory morbidity. Tracking pulmonary function in a practical and effective way is very important because it can help identify a stage of disease when a morbidity, such as inadequate airway clearance or respiratory failure, may be present. There are four general categories of pulmonary function outcome measures such asvolume, flow, pressure, and gas exchange. These outcome measures have variable precision and accuracy in predicting clinical change, and practicality in performing them relative to age and condition. It is widely recommended to follow multiple measurements longitudinally and create an accurate and timely clinical picture. This manuscript will review the most commonly used and most practical measures for use in clinical practice and how they can help to assess morbidity, disease state, and help optimize patient management.

Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications.

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

The Correlation Between Lipid Profile and Renal Function Tests in Patients with Cardiovascular Disease

Cardiovascular disease patients frequently suffer from the incidence of renal dysfunctions, the prevalence of the correlation, however, remains ambiguous. This study aims to see how CVD and renal function are related to the subjected group of patients suffer from symptoms of CVD. The method recruited for this objective was using of serum lipid profile test as a marker for evaluating the CVD and making correlations to the blood urea, serum uric acid, and serum creatinine levels as markers for assessing renal function on 159 individuals with CVD symptoms in Erbil city. Two statistical analysis methods (The linear regression and Pearson’s correlation) were employed for determining the existence from a lack of relationship between them. The results showed a statistically significant correlation p<0.05 by both methods between the renal function markers and TC. The UA was correlated to TG, LDL-C, and VLDL-C p<0.05 by regression analysis. The SCr was correlated to TG and LDL-C p<0.05 by both methods, and to VLDL by regression analysis. According to the outcome of the current study both lipid profile and renal function markers are correlated in mostly a statistically significant manner. Yet, the results are not conclusive, further studies are needed in this area for indemnify the irrefutable evidence concerning this relation.

Analysis of ordering pattern and cost effectiveness of thyroid function tests for diagnosing thyroid diseases.

Objectives: To determine the ordering pattern and cost effective use of thyroid function tests for diagnosing thyroid diseases, aiming to minimize the total cost of diagnosis without compromising the diagnostic accuracy of the tests. Study Design: Retrospective Observational study. Setting: Department of Pathology, Pakistan Institute of Medical Sciences, Islamabad. Period: 1st December 2016 to 31st February 2017. Material & Methods: The data regarding the number of entitled patients and the cost of each of T3, T4 and TSH was determined. Also the number of cases where the thyroid profile was normal were determined and analysis was made about whether was there any need to prescribe full profile. Mean and standard were used for quantitative variables and frequency and percentages were applied for qualitative data. About 1491 patients were included in the study. Results: Mean age of the study sample was 25 ± 6.5 years (range: 1 years to 80 years). There were 579 (39%) males and 912 (61%) females. About 700 (46.9%) patients were entitled. Majority of the cases were from medicine and gynae obstetrics units of the hospital i.e 644 (43.2%) and 549 (36.8%) cases respectively. In about 838 (56.2%) cases, the thyroid function tests were normal. Conclusion: There is a huge financial burden on patients as well on the hospital regarding performing thyroid function tests in clinical setup. There is a need to spread awareness among junior doctors to ensure judicious advising of the thyroid function tests in patients especially in cases coming from low socioeconomic class and in cases of entitled patients, whose burden is from the government funds.

Relationship between infrared skin radiation and functional tests in patients affected by Emery-Dreifuss muscular dystrophy: Part 2

Hypothesis: This study represents a second part of a recently published study about a new form of evaluation and development of rare genetic neurodegenerative diseases. The objective is to provide a more global vision of thermography with respect to the Emery-Dreifuss pathology, through the analysis of the data collection carried out for one year. The basic hypothesis is that thermography could become a valid tool for the diagnosis and follow-up of this pathology because is a very specific tool for registering temperature changes produced by a constant degenerative evolution of this muscular dystrophy.

Abnormal Liver Function Tests in Patients With COVID-19: Relevance and Potential Pathogenesis.

Abnormal liver function tests (LFTs) are reported frequently in hospitalized coronavirus disease 2019 (COVID-19) patients. A review of the literature shows that 46% of admitted COVID-19 patients had elevated plasma aspartate aminotransferase (AST) and 35% had elevated alanine aminotransferase (ALT) levels on admission. Elevations of both AST and ALT are mostly below 5 times the upper reference limit and are associated with severe disease and increased inflammatory markers. AST and ALT elevations are more frequent in US patients compared to Chinese patients. Mild elevations in gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP) and total bilirubin are also reported, although less frequently. Significant impairment of liver function or overt liver failure as the cause of death in COVID-19 rarely occur. There is no direct evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hepatic infection, although a subset of hepatocytes and cholangiocytes express the host receptor utilized for cellular entry by SARS-CoV-2. The presence of pre-existing liver disease in patients with elevated LFTs on admission has not been comprehensively assessed in most studies but is unlikely to account for all abnormalities in LFTs. Although abnormal LFTs are already frequently present upon admission before the start of treatment, drug-induced liver injury should be taken into consideration, especially after the use of acetaminophen, lopinavir/ritonavir and remdesivir, which are potentially hepatotoxic. In conclusion, these initial observations suggest that the prevalence of abnormal LFTs is high in COVID-19 patients, but that the clinical relevance is limited and that treatment is not required. The mechanisms underlying abnormal LFTs in COVID-19 are likely multifactorial and related to a hyper-inflammatory status and thrombotic microangiopathy that are observed in severe COVID-19 disease.

Rationale and design of a multicenter, randomized, patients-blinded two-stage clinical trial on effects of endothelial function test in patients with non-obstructive coronary artery disease (ENDOFIND)

Abnormal peripheral and coronary endothelial function has been associated with increased risk of major adverse cardiovascular events (MACE) in cross-sectional retrospective and observational studies. However, prognostic value of routine clinical evaluation, diagnosis and treatment of endothelial dysfunction on incident MACE in patients with non-obstructive coronary artery disease (NOCAD) remains unknown. Endothelial Function Guided Management in Patients with NOCAD (ENDOFIND) is a multicenter, randomized, patients-blinded, parallel-controlled, two-stage clinical trial evaluating the impact of routine clinical peripheral endothelial function testing on initiation and/or intensification of cardiovascular preventive therapies in Stage I, and on the risk of MACE in Stage II in patients with NOCAD. One thousand participants with NOCAD on clinically indicated coronary computed tomography or invasive angiography will be enrolled and randomized 1:1, after baseline peripheral endothelial function evaluation, to either endothelial function guided treatment group or standard of care control group. In Stage I, patients will be followed for 12 months and primary outcome will be the proportion of patients receiving prescriptions for cardiovascular evidence-based lipid, blood pressure and glucose lowering medications at the clinic visit immediately after endothelial function evaluation. Secondary outcomes are change in endothelial function measured as reactive hyperemia index and patients' adherence to evidence-based medications in 12 months. Study will be extended into Stage II where sample size and follow up duration will be reevaluated to ensure statistical power, and primary outcome will be incident MACE. ENDOFIND is proof-of-concept clinical trial of a disruptive endothelial function guided clinical intervention with potential benefits to NOCAD patients. Condensed abstractENDOFIND is a proof-of-concept clinical trial of a disruptive endothelial function guided clinical intervention with potential benefits to patients with no obstructive coronary artery disease (NOCAD). It is a multicenter, randomized, patients-blinded, parallel controlled two-stage clinical trial to evaluate the impact of routine clinical peripheral endothelial function testing on initiation and/or intensification of cardiovascular disease preventive therapies in Stage I, and on the risk of MACE in Stage II.

Association between Hepatic Enzymes Levels and Persistent Hepatomegaly in Sickle Cell Patients

Background Sickle cell disease is one of group of blood disorders and diseases that affect red blood cells. Like other haemoglobinopathies, sickle cell disease is inherited single-gene disorders inherited as autosomal co-dominant traits characterized by a single point mutation in the ?-chain of human haemoglobin leading to life-long illness. The severity of the disease varies widely from person to person essentially due to resultant multi-organ failure including liver dysfunction, which can be multifactorial. Broad Objective This study, was carried out to determine the association and potential role hepatic enzymes as biochemical indices may have on the severity of sickle cell anaemia diseases. Methods This was cross-sectional study that was done at sickle cell clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania using an English checklist as a main research tool with a sample size of 75 eligible sickle cell patients. All sickle cell patients who had been attending clinic from September 2016 to October 2016 and had hepatic enzymes test being done were included in the study. Categorical variables were compared using Chi-Square (c2) and binary variables tested using Cochran–Mantel–Haenszel test with p-values <0.05 considered statistically significant. The main findings show that, there was significant association between hepatomegally and liver function tests in patients with sickle cell disease. The association between hepatomegaly and abnormalities in all liver function tests, including alanine transaminase (ALT), aspartate transaminase (AST), bilirubin, albumin and total protein levels was statistically significant (p < 0.05). The Cochran–Mantel–Haenszel test (CMH) for binary categorical variables as well as the association between liver function tests abnormalities and hepatomegaly had exact match (p = 0.05). Conclusion This study found association between abnormalities in liver function tests and hepatomegaly in sickle cell patients to advocate regular screening as an urgent remedy to prevent adverse lethal complications in African setting. Key Words: Hepatic Enzymes, Hepatomegaly, Sickle Cell Disease.

S3249 Abnormal Liver Function Tests in Patients Presenting With COVID-19

INTRODUCTION: Recent studies from China reported have reported various rates of abnormal liver function tests in patients hospitalized with COVID-19 infection. However, data from the United States is limited. We sought to evaluate abnormalities in liver function tests (LFTs) in patients presenting with COVID-19 in the United States and compared them to a control group of hospitalized patients tested negative for COVID-19. METHODS: Patients with confirmed COVID-19 infection at our institution between January and March of 2020 were included. Patients who were suspected to have COVID-19 but tested negative served as controls. Information regarding patient demographics and laboratory values was recorded. RESULTS: A total of 139 patients with COVID-19 and 131 were controls were included. There was no difference between COVID-19 patients and controls in age (67.4 years versus 67.8 years, P = 0.8) or gender (female: 46% versus 59.4%, P = 0.5). Upon presentation, LFTs were abnormal in 44.9% of COVID patients compared to 35.8% controls (P = 0.12) There was no difference in the proportion of patients with elevated total bilirubin and international normalized ratio (INR) among COVID patients and controls. A higher proportion of COVID patients than controls had abnormal serum Alanine Aminotransferase (ALT) (27.9% versus 16.5%, P = 0.02) and serum Aspartate Aminotransferase (AST) levels (41.8% versus 22.1%, P < 0.001). A lower proportion of COVID patients had abnormal serum alkaline phosphatase (ALP) levels (10% versus 22.7%, P = 0.005) as compared to controls [Table 1]. Elevation in ALT and AST greater than 3 times the upper limit of normal was only seen in 5 COVID-19 patients. CONCLUSION: Abnormal LFTs are common on presentation in COVID-19 patients. However, the liver injury is predominantly mild and hepatocellular. Synthetic liver dysfunction is uncommon in COVID-19 patients.Table 1.: Proportion with elevated liver function tests in COVID patients and controls

Platelet function testing in patients with post-operative tonsillectomy bleeding may be a useful early identifier of inherited platelet function disorders.

Post-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before. To assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients. An observational cohort study was conducted using hospital digital records. Platelet function analyser 100 ('PFA-100') closure time was tested on post-tonsillectomy bleed patients who presented to hospital. Between 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent. The prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.

S0239 A Comparison of Anorectal Function Testing in Patients With Ulcerative Colitis and Defecation Disorders vs Defecation Disorders Alone

S0239 A Comparison of Anorectal Function Testing in Patients With Ulcerative Colitis and Defecation Disorders vs Defecation Disorders Alone

Determinants of Health-Related Quality of Life and Physical Performance-Based Components of Frailty in Patients Undergoing Hemodialysis

Health-related quality of life (HRQoL) measures capture the patient's experience of the burden of chronic disease and are strongly associated with adverse health-related outcomes across multiple populations. The SF-36 score is the most widely used HRQoL measure among patients with end-stage renal disease. Current understanding of determinants of the physical component summary (PCS) and the mental component summary (MCS) and their association with objectively measured physical performance and activity is limited. As an index of HRQoL, we prospectively examined the association of SF-36 and its component scores with physical function among 155 incident dialysis patients from the Hemodialysis Center. We investigated associations of HRQoL with the physical performance-based components of the frailty using multivariate linear and logistic regression after adjustment for confounders. Impaired physical performance was defined as having either slow usual gait speed or weak handgrip strength based on standardized and validated criteria derived from a large cohort study of older adults. The patients had a mean age of 65±11years, and 52.3% were male. After adjusting confounders, lower PCS was independently associated with decreased physical performance and reduced physical activity, but MCS was not associated. Among the PCS subscales, only physical functioning 10 (PF-10) was consistently associated with outcomes, and every 1 point increase in PF-10 score was associated with 4% lower odds of impaired physical performance (95% confidence interval 2-7, P=.01) after adjustment. SF-36, especially PF-10, is a valid surrogate that discriminates low physical performance and physical inactivity in the absence of formal physical function testing in patients on hemodialysis. The routine implementation of the PF-10 in clinical care has important clinical implications for medical management and therapeutic decision-making in patients undergoing hemodialysis.

Platelet Function Testing in Patients on Antiplatelet Therapy before Cardiac Surgery.

Bleeding and transfusion, common challenges in cardiac surgery, are influenced by comorbidity, the complexity of surgery, hypothermia, and the specifics of cardiopulmonary bypass inducing hemodilution, thrombin generation, fibrinolysis, and platelet dysfunction.1-4 Nearly 11% of patients with acute coronary syndromes undergo coronary artery surgery during dual antiplatelet therapy.5 Although preoperative P2Y12 receptor inhibitor therapy may reduce ischemic events, late preoperative exposure to P2Y12 receptor inhibitors increases the risk of surgery-associated bleeding and reoperation for bleeding.2,6-8.

Effects of ɷ - 3 Fatty Acids on Liver Function Tests in Patients with Diabetes Mellitus

Introduction: Patients with type-2 Diabetes are augmented the risk of non alchoholic fatty liver disease that rises liver enzymes and total protein.To observe the favourable effects of fish oil capsule on liver function tests in patients with type 2 DM.&#x0D; Materials and Methods: A prospective interventional study was conducted from January 2017 to December 2017. A total numbers of 52 diagnosed type 2 diabetic patients of both sexes were scrutinized with age ranging from 40 to 50 years. Among them, 27 type 2 diabetic patients those who taken oral fish oil gel (2g/day) for 12 weeks were preferred as study group. Another 25 type 2 diabetic patients without supplementation of omega 3 fatty acid were nominated as control group for comparison. The study subjects were selected from Dhaka Medical College Hospital, Dhaka and personal contact from Dhaka city on the basis of criteria. The research work was administrated with ethical clearance from concerned authority.&#x0D; Results: In this study ALP, LDH, total protein were reduced in diabetic patients after supplementation with omega-3 fatty acid in comparison to that of their baseline value. Again, after 12 weeks, ALP (Alkaline Phosphatase) LDH (Lctate dehydrogenase) and total protein were decreased in diabetic patients after supplementation with omega-3 fatty acid in comparison to control group.&#x0D; Conclusion: After analyzing the results of the study, it can be concluded that omega-3 fatty acid can reduce ALP, LDH and total protein levels in diabetic patients may be helpful to minimize the risk of fatty liver in type-2 diabetes mellitus.&#x0D; Medicine Today 2020 Vol.32(2): 91-94

Endoscopic sinus surgery and its effects on pulmonary function test in patients of chronic rhinosinusitis with nasal polyposis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The human upper and lower respiratory tract share a close relationship in respect to existence of diseases. The objectives of this study were to evaluate the outcome of endoscopic sinus surgery with the Lund- Mackay staging system and to find any objective changes between the pre and post-operative pulmonary function test values in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 50 patients of CRSwNP refractory to maximal medical treatment (for 1 month) planned for endoscopic sinus surgery were included in the study. Results were assessed on the basis of pre and post-operative endoscopic and CT scores and PFT (FEV1, FVC and FEV1/FVC) values. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Postoperatively, Lund Mackay endoscopic and CT scores improved from the preoperative values, which were statistically significant with p values&amp;lt;0.05. Comparing FEV1/FVC, FVC and FEV1 values in three situations- preoperative versus postoperative 1 month, preoperative versus postoperative 3&lt;sup&gt;rd&lt;/sup&gt; month and post-operative 1&lt;sup&gt;st&lt;/sup&gt; month versus postoperative 3&lt;sup&gt;rd&lt;/sup&gt; month, the difference between the means were found to be statistically significant (p=0.000), except for FVC between postoperative 3&lt;sup&gt;rd&lt;/sup&gt; month and 1&lt;sup&gt;st&lt;/sup&gt; month.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; This study provides objective evidence that patients with CRSwNP may have non clinical lower airway disease detected by PFT and ESS is effective in improvement of both nasal and lower airway disease as evident from the improvements in PFT values.&lt;/p&gt;

Utility of P2Y12 Reactive Unit Assessment on Ticagrelor in Cerebral Aneurysms Treated with Intracranial Stenting and Flow Diversion: Cohort Study and Case Report From Two Neurovascular Centers

Dual antiplatelet therapy consisting of aspirin and clopidogrel is the standard of care for neurointerventional stenting and flow diversion. Platelet function testing has been increasingly performed to identify patients with a hypo- or hyper-response to clopidogrel. Ticagrelor has been a popular alternative antiplatelet agent for such patients. We assessed the role of platelet function testing in patients receiving ticagrelor and undergoing stenting or flow diversion. The data from patients who had undergone stent-assisted coiling or Pipeline flow diversion of a cerebral aneurysm with ticagrelor therapy at any point during their treatment course from May 2017 to August 2019 at a single academic institution in the United States were retrospectively reviewed. Platelet function testing was used to determine the P2Y12 reactive units (PRUs), and the results were correlated with the procedural complications. A total of 28 patients with 29 aneurysms were treated while receiving ticagrelor. Of the 29 aneurysms, 16 (55.2%) were treated with flow diversion and 13 (44.8%) with stent-assisted coiling. Four thromboembolic complications (13.8%) and no hemorrhagic complications developed. Of the 8 patients with ≥1 PRU value >100, 4 (50%) had experienced a thromboembolic complication. The patients without a PRU value >100 did not experience any complications. A risk of thromboembolic complications exists for patients receiving ticagrelor, which correlated with the PRUs in the present preliminary study. The findings from the present study suggest that the safe PRU range for patients receiving ticagrelor should be shifted to 0-100, which is lower than that of clopidogrel, thought to be 60-210. Further validation of the optimal PRU range for patients receiving ticagrelor is necessary.

Integrated assessment of cerebral blood flow and cerebrovascular reactivity based on functional tests data in patients with Parkinson’s disease and vascular pathology

Objective. To evaluate cerebral blood flow parameters and cerebrovascular reactivity indices based on data of functional tests in patients with Parkinson’s disease (PD) and vascular pathology.Material and Methods. A total of 148 people were examined, divided into 4 groups: (1) main group comprised 24 patients with idiopathic PD; (2) comparison group 1 included 21 patients with vascular parkinsonism; (3) comparison group 2 included 26 patients with a diagnosis of chronic cerebral ischemia of severity degree 2 with no signs of parkinsonism; and (4) comparison group 3 included 77 patients with PD and cerebrovascular disease. All patients received transcranial duplex scanning of cerebral blood vessels (TCD) through the temporal window (Toshiba Aplio 500, Japan, 2–2.5 MHz sector probe) using standard protocols for the assessment of blood flow velocity characteristics. An assessment of cerebrovascular reactivity (reserve) was performed using the diagnostic and treatment complex “Carbonic”. The range of cerebrovascular and vasomotor hypercapnia reactivity to hypercapnia was evaluated in the “Testing of cerebrovascular reactivity” mode.Results. A comprehensive study of cerebral blood flow parameters using functional tests suggested that the absence of changes in the cerebrovascular reactivity index (VRhyperCO2 ) observed in patients with idiopathic PD may be considered a differential diagnostic criterion for Parkinson’s disease and cerebrovascular pathology with Parkinson’s symptoms.