https://www.medsciencegroup.us/journals/annals-of-circulation A Peertechz Open Access Journal en-us 12 Nov, 2025 https://www.medsciencegroup.us/articles/AC-10-126.php Trauma-induced coagulopathy (TIC) is a common early complication in major trauma, typically presented with prolonged PT and aPTT. However, isolated or disproportionate aPTT prolongation warrants consideration of alternative diagnoses, such as acquired hemophilia A, a rare autoimmune disorder marked by factor VIII inhibitors and severe bleeding. This case describes a young, previously healthy trauma patient whose presentation mimicked TIC but was ultimately diagnosed with acquired hemophilia A, requiring immunosuppressive therapy and bypassing agents. The case underscores the importance of maintaining a broad differential diagnosis for coagulopathy in trauma settings to ensure timely recognition and appropriate management of rare but life-threatening conditions. 02 Aug, 2025 https://www.medsciencegroup.us/articles/AC-10-125.php Background: Chylothorax after pediatric cardiothoracic surgery is associated with increased morbidity and resource utilization. There is limited data on optimal management of chylothorax, as well as the effectiveness of individual components of previously reported management protocols. A chylothorax clinical management protocol was implemented at Advocate Children’s Hospital as a quality improvement initiative with the primary objective of determining the association of protocol implementation with chest tube duration. Secondary objectives were to determine the association of individual protocol elements with chest tube duration. Methods: The clinical management protocol was developed by a multidisciplinary work group after reviewing internal practice patterns as well as published data. Patient data was compared 21 months before and 21 months after implementation of the protocol in April 2019. Data collected included patient demographics, chest tube duration, and medical and dietary interventions such as the use of steroids and low low-fat diet. Outcomes analyzed included death, surgery, duration of chest tube, and hospital length of stay. Results: A total of 15 and 27 patients were analyzed before and after protocol implementation, respectively. There was no significant difference in demographic data. Protocol adherence was 96%. Methylprednisolone was used exclusively after protocol implementation. Patients tended to receive lower maximum doses of furosemide and chlorothiazide after protocol implementation. Multivariable analysis showed that the duration of chest tube after the onset of chylous output decreased by 3 days after protocol implementation. A cutoff of 10 mL/kg per 24 hours of chest tube output was shown to predict high volume chest tube output above the median. Conclusion: A chylothorax management protocol was associated with a 3-day decrease in chest tube output in pediatric cardiac patients. Review of the protocol components demonstrates that a 5-day course of steroids may be beneficial, while a low-fat diet may not. This initiative demonstrates how a quality improvement initiative can be successfully utilized in the clinical setting and provide not only protocol-level data but also component-specific data. 03 Dec, 2024 https://www.medsciencegroup.us/articles/AC-9-124.php The structure and proliferation of endothelial and muscle cells of the chorionic veins of the underdeveloped placenta were studied. Histological, histochemical, and morphometric studies of the fetal membrane of the placenta of 36 placentas of 280-300 g at 39-40 weeks of pregnancy were carried out in comparison with 15 placentas of 450-500 g. The Ki-67 proliferation marker (Ventana, USA) was studied immunohistochemically with the determination of the proliferation index on the Roche Benchmark XT Ventana (USA) immunohistostainer by counting 1000 nuclei of endothelial cells and myocytes in capillaries, venules, and veins of the stem, intermediate and terminal villi. The outer and inner diameters of the veins were measured. The data were processed using the variation statistics method. The stem villi are supplied with a vein, artery, and capillaries. Amygdaloid veins are present at the bases, venules are on the surface of the intermediate villi. Capillaries are distinguished in the terminal villi. In hypoplasia, sphincter-like and valve-like structures are formed in the veins. Subendothelial sphincter rings of circularly located myocytes protrude into the lumen. Intimal cushions are obturator longitudinal layers of myocytes. Between the sphincters, the veins are dilated. Valvelike elements with myocytes and collagen fibers are found in small veins. These formations ensure blood distribution in the underdeveloped placenta and a decrease in trophic and oxygen starvation of the fetus. Hypoplasia is accompanied by venodilation with an increase in the external and internal diameters and an increase in the proliferation of cells of the chorionic veins. 22 Oct, 2024 https://www.medsciencegroup.us/articles/AC-9-123.php Vertebral and carotid artery dolicoarteriopathies, including elongation, kinking, and coiling, are linked to various cerebrovascular dysfunctions. Kinking, categorized by Metz, et al. is graded by angle severity: Grade 1 (90° - 60°), Grade 2 (60° - 30°), and Grade 3 (< 30°). In Grades 2 and 3, reduced blood flow heightens ischemic risk, contributing to hemodynamic instability and cerebrovascular insufficiency. While most symptomatic cases undergo endovascular or surgical correction, some patients with severe kinking remain asymptomatic, questioning current understanding. In 150 cases of carotid or vertebral artery kinking, we observed stenosis in symptomatic patients, differing from the expected arterial enlargement seen in dolicoarteriopathies. This suggests two potential kinking types: stenotic and enlarged. A notable case presented bilateral Grade 3 internal carotid artery kinking, with right-sided stenosis and cerebral hypoperfusion, yet left-sided transient ischemic attacks occurred. This finding challenges existing classifications and suggests further investigation is warranted. 27 Feb, 2024 https://www.medsciencegroup.us/articles/AC-9-122.php The SARS-COV 2 pandemic has disrupted many processes of care related to prevention, diagnostic, and therapeutic interventions, including emergency cardiac conditions. Primary care focused on COVID-19 management and vaccination has led to a preventive and therapeutic gap of many chronic conditions and risk factors, including hypertension, a main trigger for Acute Aortic Dissection (AAD). 31 Dec, 2022 https://www.medsciencegroup.us/articles/AC-7-120.php Congenital Heart Disease (CHD) is the most common kind of birth defect. Congenital heart disease is the most common birth defect and the leading cause of death in newborns. The causes of CHD are complicated and involve both genes and the environment. Congenital heart disease includes problems with the septum, the valves, and the outflow tract. Correctional heart surgery and new strategies for managing CHD have massively enhanced life expectancy. 490 percent of CHD newborns who live through their first year will become adults. Studies of the molecular genetics of humans and animal models of development are enhancing our understanding of normal heart development and cardiac diseases. A recent study demonstrates that microRNAs are implicated in congenital heart diseases. Epigenetic variables were eventually revealed to influence heart development. Several genes are responsible for congenital cardiac abnormalities as well as genetic disorders. This paper describes the categorization, environmental, and genetic causes of Coronary Heart Disease (CHD), the role of key CHD-causing genes, and potential options for preventing CHD. 31 Dec, 2022 https://www.medsciencegroup.us/articles/AC-7-119.php Background: The Common Femoral Artery (CFA) is the most frequently used peripheral artery for Trans-catheter aortic valve implantation (TAVI) and Endovascular Aortic Repair (EVAR)/ Thoracic Endovascular Aortic Repair (TEVAR) procedures. CFA access hemostasis could be obtained by manual compression, surgical cut-down, or using arteriotomy closure devices, including ProGlide. Method: During a retrospective cohort study we compared ProGlide with surgical cut-down hemostasis in 225 patients who underwent TAVI or EVAR/TEVAR, including 290 access sites, during a 10 years period in terms of access site complications, procedure length and post-procedural hospitalization duration. Results: The success rate of hemostasis was 100% in the PP device group and 98.3% in the SCD group. The mean Procedure length was significantly shorter in ProGlide device hemostasis and the mean post-procedural hospitalization length had a non-significant difference between the two groups. Access site complications occurred in 21.1% of the ProGlide group and 26% of the SCD group. Conclusion: Perclose ProGlide device is safe and effective for access site closure in procedures that need large sheaths and it is non-inferior to standard surgical cut-down. Training, experience and careful application of the device have significant importance in ensuring successful hemostasis. 29 Sep, 2021 https://www.medsciencegroup.us/articles/AC-6-118.php The article is presented in the form of a review and analysis of the literature, which additionally helps to reveal the mechanisms of the pathogenesis of the development of atherosclerosis. This article provides a completely new understanding of the stages and sequence of atherosclerosis development. The modern vision is refuted, which states that all types of lesions in atherosclerosis are developed successively, one after another. The article sheds a light on a significant difference between type IV atherosclerotic lesions and between types V and VI atherosclerotic lesions. Type IV atherosclerotic lesions consists of one lipid core with molten extracellular lipid. Stretches the middle and outer layers of an artery from one side and protrudes beyond the anatomical artery dimensions over the years. In contrast, type V atherosclerotic lesions type is a long, concentric, soft, strong, elastic, yellow, uniform structure, in the form of a tube with a hole in the middle, located in the lumen, which is easily removed from the artery. This types V and VI atherosclerotic lesions - the author suggests calling “cylindrical cholesterol plaque”. Type V atherosclerotic lesions (cylindrical cholesterol plaque) has nothing to do with types I-V atherosclerotic lesions. There are many “coincidences” that make it impossible to see the difference between them. Type V atherosclerotic lesions (cylindrical cholesterol plaque) is an independent pathological structure that appears in a short period of time (few minutes) in the lumen of a healthy artery in case of artery spasm and appearance of a strong obstruction to blood flow. Low density lipoproteins are retained within the wall, in front of the site of arterial narrowing, and quickly create a CCP in the form of a hollow cylinder. All subsequent forms of types V and VI atherosclerotic lesions - concentric and eccentric, are the result of the destruction of the original concentric structure of the type V atherosclerotic lesions (cylindrical cholesterol plaque). 20 Mar, 2021 https://www.medsciencegroup.us/articles/AC-6-117.php Since Scipiano Riva-Rocci [1] created the device to measure Blood Pressure (BP), more than a century has passed with gains in knowledge of this way of assessing BP. Currently, the methods for assessing blood pressure in the 24 hours using devices capable of making these records are well established [2]. 25 Feb, 2020 https://www.medsciencegroup.us/articles/AC-5-116.php In the treatment of Chronic Venous Insufficiency (CVI) High Ligation (HL) and stripping of the saphenous varicose veins, and percutaneous phlebectomy have been the main options for many years. Modern management of CVI includes treatment of the cause (reflux) and result (varicose veins). Reflux should be treated before varicosities because if the cause is not eliminated, the varicose veins will recur [1]. 12 Feb, 2020 https://www.medsciencegroup.us/articles/AC-5-115.php Duplex ultrasound involves B-mode and Doppler ultrasound. Duplex ultrasonography is a radiological examination requested by clinicians in patients with symptoms of deep venous thrombosis such as upper or lower limb swelling, pain and tenderness. Deep venous thrombosis is a pathology in which clot formation causes obstruction of blood flow. 05 Aug, 2019 https://www.medsciencegroup.us/articles/AC-4-114.php Background: The impact on workfl ow is an important component in determining whether an HIT implementation will be successful. 10 Mar, 2018 https://www.medsciencegroup.us/articles/AC-3-113.php Congenital disorders of cardiac repolarization are associated with risk of serious arrhythmias and sudden death. The Long QT Syndrome (LQTS) is well-established to predispose towards torsades de pointes [1]. 22 Feb, 2018 https://www.medsciencegroup.us/articles/AC-3-112.php Computer model coupled blood pressure dynamics in magisterial and small arteries networks and its stabilizing effect on heart functioning has been suggested. The Fermi-Pasta-Ulam auto recurrence in the description of the electrical activity of the heart has demonstrated the universal role of the FPU recurrence in the study of distributed dynamical systems. The heart electrical dynamics was described by the coupled Van der Pol differential equations with a time lag, linked with two additively coupled nonlinear differential equations circumscribing the blood pressure dynamics in the networks of magisterial and small arteries. 05 Feb, 2018 https://www.medsciencegroup.us/articles/AC-3-111.php Daily oscillations in the concentrations of segmented neutrophils and lymphocytes in mice and humans (both healthy and affected by acute and genetically inherited leukemia, solid tumors and some infl ammatory diseases) were studied. The analysis showed the breakage of phase synchronization of daily oscillations only in all cases of tumor diseases whereas is in cases of infl ammatory diseases the phase remained synchronized. 14 Oct, 2017 https://www.medsciencegroup.us/articles/AC-2-110.php By the method of biomicroscopy it was shown that a single application of a dissolved glycine on the parietal region of the rat brain (“open window” technique) leads to a vasodilatation - an increase in arteriolar diameter about 1.5-2 times. There were no changes in the microcirculation when saline applied under similar conditions. 15 Sep, 2017 https://www.medsciencegroup.us/articles/AC-2-109.php Objective: The aim of this study is to calculate cardiovascular risk (CVR), vascular age (VA), and prevalence of peripheral arterial disease (PAD) in the multi-pathological population admitted to Internal Medicine services, as well as to study the relationship between PAD and Mönckeberg’s calcifi cation with VA and cardiovascular risk factors (CRF) in this population. 03 Jul, 2017 https://www.medsciencegroup.us/articles/AC-2-108.php Brugada syndrome is a heterogeneous genetic channelopathy that predisposes to ventricular arrhythmias and sudden cardiac death (SCD). 22 May, 2017 https://www.medsciencegroup.us/articles/AC-2-107.php Zero-fl ow pressure (ZFP) is an important parameter of a microcirculation. The aim is to determine the status of the ZFP at concomitant traumatic brain injury with and without the development of intracranial hematomas. 30 Mar, 2017 https://www.medsciencegroup.us/articles/AC-2-106.php Introduction: Transradial access has been shown to be safe and effective in the setting of percutaneous coronary intervention (PCI) and even being benefi cial in regards to vascular complications and perceived quality of life after the intervention. 07 Mar, 2017 https://www.medsciencegroup.us/articles/AC-2-105.php Histological, morphometric, cytophotometry and statistical methods studied isolated smooth muscle cells at sites of the renal arteries with different hemodynamic conditions in newborns. 06 Feb, 2017 https://www.medsciencegroup.us/articles/AC-2-104.php Background: There are no safe operations in cardiac surgery. Every operation can possibly go wrong. We therefore retrospectively evaluated all cardiac operations lasting more than 300 minutes of bypass time at our institution to evaluate outcome and factors relevant for perioperative mortality and morbidity. 06 Feb, 2017 https://www.medsciencegroup.us/articles/AC-2-103.php A female patient, 43 years of age, was scheduled for coronary angiography due to suspicion of coronary heart disease on the basis of cardiovascular risk factors: obesity, arterial hypertension, hypercholesterolemia, CCS II angina and positive ECG exercise test. 30 Dec, 2016 https://www.medsciencegroup.us/articles/AC-1-102.php Vitamin D deficiency rickets (VDDR) is commonly recognised disease in Egypt. The most striking biochemical finding in this illness is hypocalcaemia which may affect ventricular contraction. 19 Apr, 2016 https://www.medsciencegroup.us/articles/AC-1-101.php The purpose of this study was to investigate changes of the effective and shear stresses level on the surface of atherosclerotic plaques in comparison with the healthy vessel wall, as well as distribution of the hemodynamic forces. Two software modules were used: ANSYS CFX for simulating blood flow, and Structural (Mechanical) for simulating the stress-strain state of the walls. Geometric models of vessels were built on basis of healthy and diseased vessels casts in the CAD system Solid Works.