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Sökning: WFRF:(Rezaei N)

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221.
  • Niederdöckl, Jan, et al. (författare)
  • The ABC-Stroke Score Refines Stroke Risk Stratification in Patients With Atrial Fibrillation at the Emergency Department
  • 2022
  • Ingår i: Frontiers in Medicine. - : Frontiers Media S.A.. - 2296-858X. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To evaluate the performance of the ABC (Age, Biomarkers, Clinical history) and CHA(2)DS(2)-VASc stroke scores under real-world conditions in an emergency setting.Methods and Results: The performance of the biomarker-based ABC-stroke score and the clinical variable-based CHA(2)DS(2)-VASc score for stroke risk assessment were prospectively evaluated in a consecutive series of 2,108 patients with acute symptomatic atrial fibrillation at a tertiary care emergency department. Performance was assessed according to methods for the development and validation of clinical prediction models by Steyerberg et al. and the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis. During a cumulative observation period of 3,686 person-years, the stroke incidence rate was 1.66 per 100 person-years. Overall, the ABC-stroke and CHA(2)DS(2)-VASc scores revealed respective c-indices of 0.64 and 0.55 for stroke prediction. Risk-class hazard ratios comparing moderate to low and high to low were 3.51 and 2.56 for the ABC-stroke score and 1.10 and 1.62 for the CHA(2)DS(2)-VASc score. The ABC-stroke score also provided improved risk stratification in patients with moderate stroke risk according to the CHA(2)DS(2)-VASc score, who lack clear recommendations regarding anticoagulation therapy (HR: 4.35, P = 0.001). Decision curve analysis indicated a superior net clinical benefit of using the ABC-stroke score.Conclusion: In a large, real-world cohort of patients with acute atrial fibrillation in the emergency department, the ABC-stroke score was superior to the guideline-recommended CHA(2)DS(2)-VASc score at predicting stroke risk and refined risk stratification of patients labeled moderate risk by the CHA(2)DS(2)-VASc score, potentially easing treatment decision-making.
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229.
  • Rezaei, N, et al. (författare)
  • Severe congenital neutropenia or hyper-IgM syndrome? A novel mutation of CD40 ligand in a patient with severe neutropenia
  • 2008
  • Ingår i: International archives of allergy and immunology. - : S. Karger AG. - 1423-0097 .- 1018-2438. ; 147:3, s. 255-259
  • Tidskriftsartikel (refereegranskat)abstract
    • Severe congenital neutropenia (SCN) and CD40 ligand deficiency (CD40LD) are two primary immunodeficiency diseases caused by different underlying genetic defects. In this report, we present a case who clinically presented as a SCN patient, but subsequent mutation analysis of this patient was compatible with CD40LD. The patient is a 3-year-old boy, who was referred to our center because of pneumonia, oral and anal ulcers, and periodontitis. As severe consistent neutropenia and maturation arrest in the myeloid series were observed in the bone marrow, a diagnosis of SCN was made. However, no mutations were found in the <i>ELA2</i> and <i>HAX1</i> genes. As functional T cell defects were observed, we suspected CD40LD. DNA sequencing showed a 17-base pair deletion in the <i>CD40L</i> gene. Although the patient did not have a decreased serum level of IgA, and his serum IgM level was within the normal range, the diagnosis of CD40LD was confirmed, suggesting that CD40LD should be suspected in any male patient with recurrent infections and neutropenia.
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