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  1. Article: Acute Spontaneous Subdural Hematoma in a Patient With an End-Stage Renal Disease After Starting Dual Antiplatelet Therapy Post Drug-Eluting Stent Insertion: A Case Report.

    Mousa, Aliaa / Hassan, Ahmed / Oudah, Bashar / Arslan, Kudret Isilay / Parang, Pirouz

    Cureus

    2023  Volume 15, Issue 7, Page(s) e41761

    Abstract: Dual antiplatelet therapy (DAPT) has been widely utilized for secondary prevention in patients with cardiovascular diseases, such as post-drug eluting stent insertion, stroke, and peripheral vascular disease. The occurrence of bleeding complications, ... ...

    Abstract Dual antiplatelet therapy (DAPT) has been widely utilized for secondary prevention in patients with cardiovascular diseases, such as post-drug eluting stent insertion, stroke, and peripheral vascular disease. The occurrence of bleeding complications, including intracranial hemorrhage, has been extensively studied in relation to DAPT. However, the occurrence of acute spontaneous subdural hematomas in this context is relatively rare. These hematomas can manifest through various symptoms, including altered mental status (AMS) and confusion. The risk of intracranial hemorrhage is particularly higher in patients receiving aspirin with ticagrelor, especially in those with reduced estimated glomerular filtration rate (eGFR) and liver disease. In this case report, we present the case of a patient with end-stage renal disease undergoing peritoneal hemodialysis and a remote history of liver transplant. The patient presented to the hospital with chest pain, subsequently underwent drug-eluting stent placement, and was initiated on DAPT. Following the initiation of DAPT, the patient developed confusion and was diagnosed with an acute spontaneous subdural hematoma. The patient underwent middle meningeal artery embolization to manage the hematoma.
    Language English
    Publishing date 2023-07-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.41761
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Acute Mitral Regurgitation: An Unusual Cause of Unilateral Pulmonary Consolidation.

    Mahdi, Mohammed / Abbasi, Fatemeh / Mironova, Maria / Gugnani, Manish / Parang, Pirouz

    Cureus

    2021  Volume 13, Issue 1, Page(s) e12707

    Abstract: Unilateral pulmonary consolidation generally indicates infectious pneumonia. In this case report, we describe a patient with infective endocarditis and acute mitral valve regurgitation who developed acute unilateral pulmonary consolidation that resolved ... ...

    Abstract Unilateral pulmonary consolidation generally indicates infectious pneumonia. In this case report, we describe a patient with infective endocarditis and acute mitral valve regurgitation who developed acute unilateral pulmonary consolidation that resolved dramatically after mechanical ventilation and diuretic therapy. The prompt resolution of the consolidation with treatment suggests pulmonary edema. This case report highlights that rare conditions such as acute pulmonary edema should be considered in the differential diagnosis of patients who present with unilateral pulmonary consolidation to avoid delay in appropriate treatment.
    Language English
    Publishing date 2021-01-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.12707
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Coronary vein graft disease: pathogenesis and prevention.

    Parang, Pirouz / Arora, Rohit

    The Canadian journal of cardiology

    2009  Volume 25, Issue 2, Page(s) e57–62

    Abstract: Not long after coronary artery bypass grafting surgery was described, several reports presented follow-up angiographic data on large cohorts of patients, demonstrating that approximately one-half of saphenous vein grafts fail within 10 to 15 years of ... ...

    Abstract Not long after coronary artery bypass grafting surgery was described, several reports presented follow-up angiographic data on large cohorts of patients, demonstrating that approximately one-half of saphenous vein grafts fail within 10 to 15 years of surgery and that graft failure is associated with worse clinical outcomes. Three processes are responsible for vein graft failure. Thrombosis, intimal hyperplasia and accelerated atherosclerosis contribute to graft failure in the acute, subacute and late postoperative periods, respectively. Studies have shown that perioperative antiplatelet therapy can reduce early thrombosis and graft failure. As in native coronaries, intensive lipid lowering can attenuate the process of atherosclerosis in vein grafts. Intimal hyperplasia in the vein graft is thought to be an adaptation of the vein to higher pressures in the arterial circulation. This process is further promoted by the loss of inhibition from the endothelial layer, which is injured during surgery. A new 'no-touch' technique for harvesting grafts may be effective in preventing disruption to the endothelial layer, and subsequent intimal hyperplasia and graft loss. Off-pump surgery and endoscopic vein harvesting, which are known to reduce surgical morbidity, have been shown to be no worse than on-pump surgery and open vein harvesting, respectively, in terms of vein graft patency. Various gene therapies can prevent intimal hyperplasia in animal models, but human data obtained so far have been disappointing. Placing an external stent around a vein graft may reduce tangential wall stress and subsequent intimal hyperplasia.
    MeSH term(s) Anticholesteremic Agents/therapeutic use ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels/pathology ; Coronary Vessels/physiopathology ; Genetic Therapy ; Graft Occlusion, Vascular/pathology ; Graft Occlusion, Vascular/physiopathology ; Graft Occlusion, Vascular/prevention & control ; Graft Survival ; Humans ; Risk Factors ; Stents ; Veins/pathology ; Veins/physiopathology
    Chemical Substances Anticholesteremic Agents
    Language English
    Publishing date 2009-02-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/s0828-282x(09)70486-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Metabolic modulators for chronic cardiac ischemia.

    Parang, Pirouz / Singh, Bramah / Arora, Rohit

    Journal of cardiovascular pharmacology and therapeutics

    2005  Volume 10, Issue 4, Page(s) 217–223

    Abstract: Many patients with ischemic heart disease continue to experience anginal symptoms despite revascularization and treatment with antianginal medications. The effectiveness of current anti-ischemic medications is limited by their hemodynamic side effects, ... ...

    Abstract Many patients with ischemic heart disease continue to experience anginal symptoms despite revascularization and treatment with antianginal medications. The effectiveness of current anti-ischemic medications is limited by their hemodynamic side effects, such as hypotension and bradycardia, which result in compromised organ perfusion. In this article, we review five novel agents (ranolazine, trimetazidine, L-carnitine, ribose, and dichloroacetate) under investigation for treatment of ischemic heart disease that work by enhancing the efficiency of the myocardium, rather than decreasing its work. This new paradigm promises to eliminate these side effects.
    MeSH term(s) Acetanilides ; Animals ; Carnitine/pharmacology ; Carnitine/therapeutic use ; Chronic Disease ; Drug Evaluation, Preclinical ; Enzyme Inhibitors/pharmacology ; Enzyme Inhibitors/therapeutic use ; Heart/drug effects ; Humans ; Lipid Metabolism/drug effects ; Myocardial Ischemia/drug therapy ; Myocardial Ischemia/metabolism ; Myocardium/metabolism ; Piperazines/pharmacology ; Piperazines/therapeutic use ; Randomized Controlled Trials as Topic ; Ranolazine ; Trimetazidine/pharmacology ; Trimetazidine/therapeutic use ; Vasodilator Agents/pharmacology ; Vasodilator Agents/therapeutic use ; Vitamin B Complex/pharmacology ; Vitamin B Complex/therapeutic use
    Chemical Substances Acetanilides ; Enzyme Inhibitors ; Piperazines ; Vasodilator Agents ; Vitamin B Complex (12001-76-2) ; Ranolazine (A6IEZ5M406) ; Trimetazidine (N9A0A0R9S8) ; Carnitine (S7UI8SM58A)
    Language English
    Publishing date 2005-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1329372-2
    ISSN 1074-2484
    ISSN 1074-2484
    DOI 10.1177/107424840501000402
    Database MEDical Literature Analysis and Retrieval System OnLINE

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