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Feb 2017 DOI 10.14302/issn.2997-2086.jfs-16-1098
Burjonrappa SathyaprasadCorresponding author
Department of Pediatric Surgery, Winthrop University Hospital, Mineola, NY 11501
We report a twin gestation with one fetus afflicted by a left sided Extra-Lobar Sequestration (ELS) in a morbidly obese mother. The ELS was complicated by a left pleural effusion in the second trimester unresponsive to maternal steroid administration. We discuss the need for repeat shunt placement, in the setting of maternal morbid obesity and twin gestation. Shunt replacement was necessary secondary to dislodgement. Delivery at 34 weeks gestation was followed by successful surgical removal of the ELS. At one year follow up the infant has complete expansion of the left lung with no morbidity.
Aug 2014 DOI 10.14302/issn.2576-182X.jbsc-13-348
AG RuggeriCorresponding author
Department of Neurology e Psichiatry, Division of Neurosurgery, Policlinico Umberto I, “La Sapienza” Università di Roma
Melanocytoma is a rare benign lesion arising from leptomeningeal melanocytes. Meningeal melanocytomas are commonly seen in the thoracic region of the spinal canal and may also arise in the cervical or lumbar region, most often located in the intradural extramedullary compartment 1. To our knowledge, only 21 cases of intramedullary melanocytomas have been reported in the literature to date. The authors present a rare case of thoracic intramedullary melanocytoma and the review of the literature pointing out the role of diagnosis, surgical treatment and follow-up.
Feb 2024 DOI 10.14302/issn.2329-9487.jhc-24-4910
Mahamat-Azaki OumarCorresponding author
Ebstein’s anomaly is a rare congenital heart disease. It is usually associated with other congenital defects, particularly atrial septal defect/patent foramen ovale (PFO). We report here the case of Ebstein's disease revealed in a 23-year-old adult admitted for palpitations and exertional dyspnoea. He was in heart failure. The EKG showed atrial flutter . Cardiomegaly was present with a cardiothoracic index of 0.7. On echocardiography, the apical displacement of the tricuspid septal leaflet was 15 mm/m2 , the Celermajer index was Grade 3. There was a large thrombus floating in the right atrium. While awaiting surgical management, the patient was being treated with diuretics, digitalis and anticoagulants.
Dec 2022 DOI 10.14302/issn.2641-5518.jcci-22-4374
Soda Mbaye MarèmeCorresponding author
Thoracic and Cardiovascular Surgery Clinic, Fann University Hospital Center, Dakar, Senegal
Intrathoracic foreign bodies secondary to penetrating wounds are rare in children. We report the observation of a 10-year-old patient who presented an intrapulmonary metallic foreign body following a playful accident. Its migratory aspect, highlighted by imaging, required urgent extraction which was performed by thoracotomy, with good clinical outcome. The interest of the question lies in the circumstances of the incident, the type of foreign body and the terrain.
Jun 2022 DOI 10.14302/issn.2641-5518.jcci-22-4171
Dosoky Elayouty HamdyCorresponding author
Prof. of CT Surgery at Suez Canal University and Abo-Khalifa Emergency Hospitals; Ismailia; Egypt
Purpose Is it safe to excise only the external portion of the pacemaker wires? This presentation aims to find out the proper way to manage pacing wires postoperatively. Methods We report 5-cases of sub-xiphoid abscesses and sinuses after valve surgery. Each case presented with a recurrent abscess that opens and drains its contents through a sinus around the lower-most portion of the xiphoid process. The duration between open heart surgery and evolution of these abscesses varied between 18 and 60 months. Valve surgeries were mitral and/or aortic valve replacement. Surgeons usually insert pacemaker wires to control any persistent post-operative arrhythmias that can affect hemodynamic circulation. On the day of discharge, some surgeons (not in our center) usually excise the pacemaker wires. Results The remaining intra-thoracic portions underwent some degree of corrosion that caused a state of chronic inflammation, sinus track formation and abscess evolution. This indicated radiological examination and surgical exploration to extract these foreign bodies. These 5 cases were diagnosed and operated upon between 15th January 2022 and 1st March2022, all at Abo-Khalifa Emergency Hospital-Ismailia, Egypt. Conclusions This confirms the significance of total withdrawal of the external pacemaker wires. Surgeons should not apply tight sutures at the site of insertion of the wires.
Feb 2022 DOI 10.14302/issn.2329-9487.jhc-22-4067
O AmaewhuleCorresponding author
Department of Paediatrics, University of Port Harcourt Teaching Hospital. Nigeria.
Introduction Congenital Heart Defects (CHDs) are structural abnormalities of the heart and intra-thoracic great vessels that are present at birth and may be of functional significance. They are the most frequently occurring congenital anomalies and babies born with severe forms of these defects are likely to die in the neonatal period. Objectives The aim of this study was to determine the prevalence of CHDs among neonates delivered in Port Harcourt, Rivers State, Nigeria Methods Using a stratified sampling technique, 530 neonates were selected from three hospitals in Port Harcourt. The biodata of the parents and socio-demographic information were obtained through an interviewer-administered questionnaire to the mothers. Physical examination and echocardiograghy were performed on all the neonates. Results Five hundred and thirty (530) neonates aged 0-7days (5.2±1.8) participated in this study and the male to female ratio was 1.1:1. Forty-three neonates were found to have CHD giving a prevalence of 8.1% 95%CI: 6.0. Thirty-nine were acyanotic and four cyanotic. Congenital Heart Defects were found in 21 (48.8%) males and 22 (51.2%) females. The more common heart defects were isolated Atrial Septal Defect in 16(37.2%), isolated Patent Ductus Arteriosus in 11(25.6%) and isolated Ventricular Septal Defect in 6 (13.9%). The most common cyanotic CHD was Transposition of the Great Arteries in 2 neonates (4.7%). The clinical features identified in neonates with CHD were tachypnoea, dysmorphia, cyanosis, hypoxia and murmur Conclusion The prevalence of CHD is considerably high in Port Harcourt and further studies need to be carried out to ascertain the risk factors.
May 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2847
Sharma BechanCorresponding author
Department of Biochemistry, Faculty of Science, University of Allahabad, Allahabad-211002, UP, India.
Background Carissa carandas L. is a well-known wild fruit plant distributed through-out the India and also present in other countries. The fruits are rich in nutrients and minerals. A number of medicinally important phytochemicals such as carrisone, carindone, carandinol, lupeol, scopoletin, stigmasterol, β-sitosterol, myo-inositol, β-amyrin, Des-n-methylnoracronycine etc. have been reported from the extract of this plant. Being safe and cost effective molecules, the activity of phytochemicals against HIV-1 enzymes needs to be screened. Objective The aim of this study was to screen the potent phytocompound of C. carandas against human immunodeficiency virus-1 using docking method. Methods Total nine compounds viz. carandinol, caridone, carrisone, lupeol, p-coumaric acid, gallic acid, rutin, scopoletin and ursolic acid were used for in-silico study towards drug development against human immunodeficiency virus-1 reverse transcriptase (HIV-1RT; PDB ID: 1REV) and human immunodeficiency virus-1 protease (PDB ID:1EBY) using Autodock software. Results The qualitative characterization of the extracts showed the presence of a number of phytochemicals such as phenolics, flavonoids, alkaloids, terepnoids, terpenes, steroids, glycosides etc. Carandinol was observed as most effective anti-HIV-1 molecule having lowest binding energy and small inhibition coefficient. Another compound, p-coumaric acid, showed least effectiveness against human immunodeficiency virus- 1 reverse transcriptase or human immunodeficiency virus-1 protease showing highest binding energy and inhibition coefficients among all the evaluated phytocompounds. Conclusion The in-silico study demonstrated that some phytoconstituents of C. carandas exhibit potential anti-human immunodeficiency virus -1 activity and hence can be optimized to develop as a drug candidate in future.
May 2019 DOI 10.14302/issn.2575-1212.jvhc-19-2722
Rodrigues Reina Moreira PamelaCorresponding author
Department of Veterinary Pathology, UNESP – FCAV – Faculdade de Ciências Agrárias e Veterinárias, Jaboticabal city, São Paulo State, Brazil.
Onychogryphosis is one of the main clinical findings in dogs with visceral leishmaniasis (VL); however, research focusing on the subungual area of infected dogs is scarce. This study aims to assess the subungual area of dogs with VL that presented or not onychogryphosis by means of histopathological analyses and immunohistochemical studies (parasite burden). The third digit of the thoracic and pelvic limbs of Leishmania infantum naturally infected dogs was collected regardless of sex, breed or age. The animals were split into two groups, dogs with onychogryphosis (G1; n=7) and without onychogryphosis (G2; n=9). The digits were evaluated in four areas (dorsal epidermis/dermis, ventral epidermis/dermis, dorsal matrix/dermis and ventral matrix/dermis). All lesions observed (mononuclear inflammatory infiltrate, vacuolar degeneration of basal keratinocytes, dermoepidermal clefting and pigmentary incontinence) were present in both groups, being more severe in the digits of G1 group. Immunostaining of the amastigote forms of Leishmania infantum were observed in the different areas of the digit, with statistical difference between the dorsal epidermis/dermis area and the dorsal matrix/dermis of G1 group. In conclusion, the main histopathological alteration of the digit of dogs with VL is mononuclear inflammatory infiltrate and parasite burden, especially in cutaneous tissue adjacent to the nail matrix. This aspect can influence the onychogryphosis development, due to the presence of the parasite and by inflammatory mediators released in the nail microenvironment.
Mar 2019 DOI 10.14302/issn.2642-9241.jrd-18-2499
A. S. Sardenberg RodrigoCorresponding author
Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil
Distant metastases generally indicate disseminated disease and the standard treatment for these patients is palliative chemotherapy. Retrospective series showed that selected patients with metastatic lung cancer and a solitary extrathoracic disease could be effectively treated with curative intention by resection of both primary tumor and the single site of metastatic disease. According to current data, adrenalectomy might be considered as an alternative option for patients with isolated adrenal metastases. Significant morbidity and mortality may be happened by these procedures, and a cautious analysis of pros and cons should be discussed with the patient. We present a review of the literature and updated recommendations focusing lung cancer with solitary adrenal metastasis.
Mar 2019 DOI 10.14302/issn.2642-9241.jrd-19-2689
A. S. Sardenberg RodrigoCorresponding author
Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil
Background The aim of this study is to evaluate the outcomes of patients submitted to diaphragmatic pacing, and the impact on quality of life of patients who chronically depend on mechanical ventilation, as well as the effectiveness of phrenic stimulation to eliminate the need for mechanical ventilation. Methods From 2010- 2014, 10 patients completely dependent on mechanical ventilation were operated upon, with the implantation of phrenic pacing device. The diagnoses were quadriplegia and congenital central hypoventilation syndrome (CCHS). All patients underwent bilateral approach to the phrenic nerves, by video-assisted thoracic surgery or mini-thoracotomy. Results All patientsstarted pacing 30-40 days post-operatively. The mean age of patients was 12.1 years (2-27 years range) with a median of ten years. Six patients (54.5%) were as old as ten years, and three (27.2%) were older than 20 years. Younger patients had CCHS and older ones were quadriplegic. All patients with CCHS (n = 4) were nine years old or younger while only two quadriplegic patients were in this age group. Conclusions Diaphragmatic pacing can provide improvement in the quality of life of patients who depend on mechanical ventilation, allowing freedom to conduct daily activities, lower respiratory infections, and tracheostomy decannulation.
Mar 2019 DOI 10.14302/issn.2641-5518.jcci-19-2692
Vijiala SergiuCorresponding author
Department of Cardiology, Centre Hospitalier du Valais Romand, Sion Hospital, Switzerland
Percutaneous device closure of atrial septal defects (ASD) has proven to be safe and it is nowadays the standard treatment for ASDs. Immediate or late device embolization is a rare but potential complication of every attempted ASD device closure. We report a case of asymptomatic Amplatzer Septal Occluder into the left ventricular outflow tract (LVOT) detected by routine transthoracic echocardiography 3 months after successful implantation in a stable patient.
Feb 2019
P Dargan DallanCorresponding author
Mersey Regional Burns and Plastic Surgery Centre, Whiston Hospital, Warrington Road, Prescot, Merseyside, L35 5DR, United Kingdom
Background: Chest wall deformities may be managed with skeletal manipulation, which risks life-threatening complications. Custom-made prostheses are a less invasive surgical option, manufactured from silicone elastomer using 3D computed tomographic reconstruction and 3D-printed thoracic models. Methods: All patients undergoing custom-made implants between January 2010 and March 2017 were identified from the prosthetic department records. A retrospective review of the clinical records was performed. Mean follow up period was 1.8 years. A comparison was made with our earlier results from 1995 to 2009. Results: Twenty-six patients underwent insertion of custom-made implants for chest wall deformity. Pectus excavatum was present in 50% (n=13), and Poland syndrome 42% (n=11). All 11 female patients underwent 3D reconstruction and 3D printed models, and 3 of 15 males. Four underwent simultaneous bilateral breast augmentation, and three had staged breast augmentation. Seroma occurred in 27% (n=7), and hypertrophic scar in 12% (n=3). The reoperation rate was 23% (n=6), including autologous fat graft in two patients. Surgical suction drains were used in 42% (n=11) patients, of whom 36% (n=4) developed seroma, compared with 17% (n=2) of those without drains (p=0.08). Conclusions: Custom-made prostheses are an effective and safe option for patients with chest wall deformities. The majority have a short postoperative inpatient stay (81%) and are satisfied with the outcome (77%). Seroma was the commonest complication (27%), and drains did not reduce seroma risk. Single dose intravenous antibiotic prophylaxis is adequate. A minority of patients opt for further aesthetic procedures.
Jun 2018 DOI 10.14302/issn.2372-6601.jhor-18-2139
S. Afriyie-Mensah JaneCorresponding author
Department of Medicine and therapeutics, School of Medicine and Dentistry, College of Health Sciences university of Ghana, Accra, Ghana.
Pulmonary hypertension (PH) has become an increasingly recognized complication in sickle cell anaemia (SCA) and is a major cause of morbidity and mortality. Though the burden of SCA in sub-Saharan Africa is high, there is paucity of data on SCA-associated PH with little or no attention given to it in routine patient care. The current study therefore sought to determine the prevalence of PH and its associated risk factors among adult patients with SCA. This was a cross-sectional study involving 76 clinically stable, hydroxyurea-naive participants. We obtained socio-demographic and clinical history. Measurement of Tricuspid Regurgitant jet Velocity (TRV) was obtained via transthoracic echocardiography and lung function was assessed using spirometry and pulse oximetry. Other investigations were complete blood counts, free plasma haemoglobin, serum urea and creatinine. Twenty-five (32.9%) of study participants had elevated TRV (≥ 2.5m/s) on Doppler echocardiography, which was suggestive of raised pulmonary artery systolic pressure. There were significant associations between elevated TRV and steady-state haemoglobin (p < 0.001), blood urea level (p = 0.030), presence of chronic leg ulcers (p = 0.043) and oxygen saturation (p < 0.001) and these may be identifiable and modifiable risk factors for selective screening with echocardiography in a resource poor setting.
Feb 2018 DOI 10.14302/issn.2640-690X.jfm-17-1900
Ali M. Elzohry AlaaCorresponding author
Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University.
Background PMPS nowadays is common due to advances in both; diagnosis and treatment of cancer breast. Choosing proper treatments can improve the patients’ quality of life. Cancer breast is common and quite important disease and female in our family must be aware of it. Improvement of the diagnosis and treatment PMPS lead to increased patient’s satisfaction and decrease fear of cancer breast. Objective Discuss different methods for management of PMPS with less side effects, adequate analgesia, improvement of quality of life, and better patient satisfaction in the future. Methods Treatment approaches include both pharmacological interventions and non-pharmacological strategies. However, current treatments of the PMPS are near-optimal and prevention much better than treatment. Conclusion Continuous perioperative thoracic epidural Fentanyl–bupivacaine infusion was much better in pain relief, less sedating effect and shorter duration of hospital and ICU stay than continuous perioperative entanyl intravenous infusion in patients undergoing major upper gastrointestinal cancer surgery.
Dec 2017 DOI 10.14302/issn.2997-2086.jfs-17-1846
Amin RuchiCorresponding author
Pediatric Surgery, Children’s Hospital of Wisconsin
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.
Sep 2017 DOI 10.14302/issn.2576-9359.jot-17-1594
Seguchi OsamuCorresponding author
Department of Transplantation, National Cerebral and Cardiovascular Center, Japan
Constrictive pericarditis (CP) represents a rare complication after heart transplantation (HTx), resulting from various postoperative events such as mediastinitis, pericardial effusion, or allograft rejection. We describe our recent experience with managing an HTx recipient who developed atypical patterns of CP predominantly involving the right ventricle. A 52-year-old male who had received heart transplantation 2.5 years before was admitted to our institution because of progressive symptoms of heart failure. The patient had experienced acute rejection twice post-HTx, both with International Society for Heart and Lung Transplantation grade 1R, undergoing an additional endomyocardial biopsy other than those performed during regular check-ups. On admission, echocardiography revealed paradoxical septal motion and a large cystic-like mass with a thick capsule in front of the right ventricle. Right heart catheterization revealed elevation of right atrial pressure, with severely reduced cardiac index. Magnetic resonance imaging revealed both seroma and a thick cystic-like capsule tightly adhered to the right ventricle. CP was suspected despite the atypical patterns of presentation. Seroma was removed through exploratory lateral thoracotomy, without improvement in symptoms, which was only achieved via subsequent pericardiectomy involving resection of the thickened parietal pericardium, removal of effusion fluid, and further excision of diffusely thickened visceral pericardium and epicardium. The patient is currently recovering uneventfully. The possibility of CP after HTx should be considered despite the rarity of this condition and HTx recipients should be closely monitored using various imaging modalities because CP typically demonstrates non-specific symptoms and physical findings of heart failure, with high mortality.
Jun 2017 DOI 10.14302/issn.2576-9359.jot-17-1570
A. ForsbergCorresponding author
Institute of Health Sciences at Lund University, Sweden.
Chronic bodily pain after lung transplantation has received little attention. Therefore, the aim was to provide a multidimensional assessment of self-reported chronic pain 1-5 years after lung transplantation and its relationship with self-reported psychological general well-being (PGWB) and self-efficacy. This multicenter, cross-sectional study is a part of the Swedish national study: Self-management after thoracic transplantation (SMATT). In total, 117 lung transplant recipients, all white, due for their yearly follow-up at one (n=35), two (n=28), three (n=23), four (n=20) or five years (n=11) after transplantation were included. Of these, 113 reported their pain on the Pain-O-Meter (POM), which provides information about pain intensity, quality, location, and duration. In addition, they responded to the PGWB instrument and the Self-Efficacy instrument for managing chronic disease. The prevalence of pain was 51% after 1 year, 68 % after 2 years, 69.5 % after 3 years, 75 % after 4 years and 54.5 % after 5 years. Women experienced higher pain intensity and worse sensory and affective burden than men. Psychological general well-being was the main factor that contributed to the experience of pain. Better perceived psychological well-being lowered the odds for pain, while higher self-efficacy reduced the probability of experiencing pain. Many of the lung recipients lacked pain treatment and were uncertain about the reasons behind their pain. Chronic bodily pain is a common and serious symptom up to five years after lung transplantation. Female lung recipients experience more pain and pain related illness than men.
Nov 2016 DOI 10.14302/issn.2574-4526.jddd-16-1311
M DarouichiCorresponding author
Department of radiology
Adenosquamous carcinoma of the stomach (ASCS) is extremely rare with less than one hundred cases published in the world literature. It is defined by combined adenocarcima and squamous cells carcinoma of the stomach. ASCS is clinically aggressive and has a poor prognosis, even when discovered at an early stage. This intriguing entity is characterized by non specific symptoms or radiological signs. Integrate 18F-fluorodeoxyglucose positron emission tomography/computed tomography 18F FDG.PET/CT is useful morphologic and functional modalities for evaluating primary tumor, local extend and invasion beyond gastric wall or distant metastatic and eventually for management. Diagnosis of ASCS requires immunohistochemical confirmation. We report a 77-year-old man who was admitted to hospital because of epigastric pain, vomiting and melena since more than a month. Gastroscopy with biopsies had initially suggested gastric squamous cell carcinoma .Thoracic and abdominal computed tomography scan (CT) showed a huge mass in the gastric body, largely necrotic, infiltrating the adjacent structures without metastases. Partial gastrectomy with resection of the proximal 2/3 of the stomach, the spleen, the body and tail of pancreas and the left transverse colon was performed. Immunohistochemical analysis demonstrated ASCS with mixed adenocarcinomatous and squamous cells carcinoma with invasion of gastric lymph nodes. Unfortunately, two months after surgery, a CT of the abdomen revealed diffuse metastasis and the patient died three months later. In light of this case, we discuss the pathogenesis, staging and monitoring of this rare entity by combined 18F-FDG PET/CT with review of the literature.
Dec 2015 DOI 10.14302/issn.2471-2140.jaa-15-715
Kevers ClaireCorresponding author
Plant Molecular Biology and Biotechnology and CEDEVIT B22, University of Liège Chemin de la Vallée, 4, Sart Tilman, 4000 Liège Belgium
Since a few years, more and more attention has been specifically given to dietary antioxidants as agents promoting health and preventing the incidence of diseases. As part of these efforts, analytical methods and assays have been developed to measure the antioxidant content in food substances. In this paper, the antioxidant capacity of 17 orange juices is determined by various assays (DPPH, ORAC, heamolysis, xanthine/xanthine oxidase) as the content in ascorbic acid and total phenolics. The results evidence all the complexity to evaluate the in vitro antioxidant capacity of foods. In very general terms, in spite of the wide utilization in these tests (FRAP, TAC, ORAC TRAP and others), their significance remains obscure. The discrepancy of the results and the absence of good correlation between the assays clearly highlight all the importance of understanding the strengths and weakness of assays evaluating antioxidant potential of a food at the risk of giving erroneous information to the consumer. It is clear that the use of "total antioxidant capacity" assays for the in vitro assessment of antioxidant quality of food does not be employed by food industrials as a marketing argument or for the assessment of the "wholesomeness" of a food.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-12-155
Matteo Ciccone MarcoCorresponding author
Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
We report the case of a 22 year-old-male patient affected by Sotos syndrome was preoperatively and urgently evaluated for tracheal stent implantation due to respiratory insufficiency caused by idiopathic tracheal stenosis. Rest electrocardiogram detected a ventricular pre excitation; a transthoracic echocardiography showed a classic pattern fulfilling criteria for isolated left ventricular non compaction. At the best of our knowledge this is the first report of a patient suffering from Sotos syndrome and simultaneously affected by isolated left ventricular non compaction and ventricular pre excitation.
Nov 2013 DOI 10.14302/issn.2329-9487.jhc-13-272
Choudhary RaghvendraCorresponding author
Department of Cardiology, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Background: Conventional transthoracic echocardiography (TTE) and tissue Doppler imaging (TDI) are usually unable to reveal very early subtle abnormalities in left ventricular (LV) systolic function caused by hypertension, prior to manifestation of hypertrophy (LVH). This study was undertaken to assess whether speckle tracking echocardiography (STE) provides more insight into early hypertension induced LV systolic dysfunction, with the purpose of identifying patients at higher risk for heart failure (HF). Methods: Fifty patients (54.16 ± 8.4 years) and 50 controls (52.17 ± 8.6 years) were enrolled. According to the presence or absence of LVH, patients were classified as LVH(+) and LVH(–), respectively. Global longitudinal function was calculated by TDI, global strains (longitudinal (LS), radial (RS), and circumferential (CS)) were assessed by STE. Results: Conventional TTE showed a normal systolic function in all patients. TDI was able to detect a systolic dysfunction only in the LVH(+) group (P < 0.001) whereas STE revealed an impairment of systolic LS and CS in all patients, including those without hypertrophy (P =<0.0001). Furthermore, in the LVH(+) group, STE showed increased RS . Conclusion: In hypertensive patients, STE provides more detailed information than conventional echocardiography and TDI, since it reveals a systolic dysfunction before hypertrophy occurs (Stage A of ACC/AHA classification of HF) and identifies some early LV mechanic changes that might improve the clinical management of these patients
Mar 2013 DOI 10.14302/issn.2329-9487.jhc-12-153
Matteo Ciccone MarcoCorresponding author
Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
We describe a rare case of multiple coronary artery-left ventricular fistulas associated with apical hypertrophic cardiomyopathy in a 62 year asymptomatic old male admitted to our department for a perioperative evaluation of non cardiac surgery, already diagnosed for multiple coronary artery-left fistulae. He underwent transthoracic echocardiography and then to accelerated dipiridamole stress-echo.
A. S. Sardenberg RodrigoCorresponding author
Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil
Distant metastases generally indicate disseminated disease and the standard treatment for these patients is palliative chemotherapy. Retrospective series showed that selected patients with metastatic lung cancer and a solitary extrathoracic disease could be effectively treated with curative intention by resection of both primary tumor and the single site of metastatic disease. According to current data, adrenalectomy might be considered as an alternative option for patients with isolated adrenal metastases. Significant morbidity and mortality may be happened by these procedures, and a cautious analysis of pros and cons should be discussed with the patient. We present a review of the literature and updated recommendations focusing lung cancer with solitary adrenal metastasis.