Dressler's Syndrome

Obesity and its associated complications such as insulin resistance and non-alcoholic fatty liver disease are reaching epidemic proportions. In mice, the TGF-β superfamily is implicated in the regulation of white and brown adipose tissue differentiation. The kielin/chordin-like protein (KCP) is a secreted regulator of the TGF-β superfamily pathways that can inhibit both TGF-β and activin signals while enhancing bone morphogenetic protein (BMP) signaling. However, KCP's effects on metabolism and obesity have not been studied in animal models...

PURPOSE OF REVIEW: Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS: In acute idiopathic pericarditis, pleural effusions tend to be left-sided and, if bilateral, they are usually larger on the left. Less than 5% are unilateral right-sided. About 90% of the effusions occupy less than one-third of the hemithorax, and 99% meet Light's exudative criteria with a predominance of lymphocytes in three fourths of the cases...

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T-cell-mediated immunity has been linked not only to a variety of heart diseases, including classic inflammatory diseases such as myocarditis and post-myocardial infarction (Dressler's) syndrome, but also to conditions without an obvious inflammatory component such as idiopathic dilated cardiomyopathy and hypertensive cardiomyopathy. It has been recently proposed that in all these conditions, the heart becomes the focus of T-cell-mediated autoimmune inflammation following ischaemic or infectious injury. For example, in acute myocarditis, an inflammatory disease of heart muscle, T-cell responses are thought to arise as a consequence of a viral infection...

AIM: We sought to investigate the prognostic impact of the SYNTAX (Synergy between PCI with TAXUS and Cardiac Surgery) score (SS) on 1-year clinical outcomes in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) undergoing medical therapy only. METHODS AND RESULTS: Among the 13 819 patients enrolled in the ACUITY trial and undergoing coronary angiogram, 4491 patients were treated with medical therapy as the initial strategy. Of those, baseline SS and complete angiographic analysis were available in 1275 patients...

PURPOSE: Animal and human studies suggest that vitamin D regulates functions of the reproductive system. Vitamin D deficiency is prevalent in women of reproductive age. Vitamin D status has been associated with in vitro fertilisation outcome, features of polycystic ovarian syndrome (PCOS) and endometriosis. The aims of our study were to investigate the prevalence of vitamin D deficiency of infertile women living in central Germany, to identify risk factors for vitamin D deficiency and to specify seasonal variations of vitamin D status...

BACKGROUND: Incomplete revascularisation is common after percutaneous coronary intervention and is associated with increased mortality and adverse cardiovascular events. We aimed to assess whether adjunctive anti-ischaemic pharmacotherapy with ranolazine would improve the prognosis of patients with incomplete revascularisation after percutaneous coronary intervention. METHODS: We performed this multicentre, randomised, parallel-group, double-blind, placebo-controlled, event-driven trial at 245 centres in 15 countries in Europe, Israel, Russia, and the USA...

BACKGROUND: This exploratory study evaluated the safety/efficacy of nintedanib or sunitinib as first-line therapy in patients with advanced renal cell carcinoma (RCC). METHODS: Ninety-six patients were randomised (2:1) to either nintedanib (200 mg twice daily) or sunitinib (50 mg kg(-1) once daily (4 weeks on treatment; 2 weeks off)). Primary endpoint was progression-free survival (PFS) at 9 months. P-values reported are descriptive only; the study was not powered for such comparisons...

Postinfarction pericarditis can be classified as "early," referred to as pericarditis epistenocardica, or "delayed," referred to as Dressler syndrome. The incidence of postinfarction pericarditis has decreased to <5% since the introduction of reperfusion therapies and limitation of infarct size. We report on a 57-year-old man who suffered sudden cardiac death as a result of acute myocardial infarction. Autopsy revealed an area of previous infarction and fibrinous pericarditis related to the previous infarction, leading to a diagnosis of Dressler syndrome...

BACKGROUND: Down syndrome is the most commonly occurring chromosomal condition with a prevalence of 11.2-10000 life-births in Europe. The most important concern consists of various degrees of intellectual disability and sensory deficits. The overall prevalence of ophthalmologic abnormalities has been reported to be as high as 46-100%. Impairment of vision potentially hampers the capacity of learning and communication and thus of social integration. The aim of our study is to assess prospectively the occurrence of vision problems in patients with DS with special emphasis on adaptive behaviour and cognition...

UNLABELLED: There is strong evidence for the use of the ketogenic diet (KD) in Dravet syndrome (DS). The purpose of this study was to evaluate both effectiveness and tolerability in comparison with various antiepileptic drugs (AEDs). METHODS: 32 children (19 males) with genetically confirmed DS treated at our center since 1999 were analyzed retrospectively. Data collected from patients' files included type of mutation, age at treatment initiation and treatment lag, overall seizure frequency and frequency of different seizure types, especially prolonged seizures and status epilepticus (SE)...

INTRODUCTION: In the search for a biodegradable device that leaves nothing but the tissue of the patient after complete endotheliazation and absorption, the BioSTAR® device was introduced in 2007 (CE Mark in European community and HPB in Canada) for ASD and PFO closure. It consists of a metal framework covered by a biodegradable membrane generated from a layer of porcine collagen that is broken down and absorbed over time. In a sheep model, the results were promising, showing complete closure of the defect with degradation of approximately 90% of the implanted membrane material after two years...

A 76-year-old woman with idiopathic dilated cardiomyopathy and left bundle branch block was admitted for biventricular pacemaker implantation. The procedure was complicated by perforation of a coronary sinus tributary vein and ensuing pericardial effusion without tamponade. Three months later, she presented with fever, pleuritic chest pain and functional class worsening. Pericardial and pleural effusions were noted. Sterile blood and pleural fluid cultures and failure to respond to antibiotic therapy led to the hypothesis of a Dressler-like syndrome...

Tonic dystonia of the limbs in complex regional pain syndrome (CRPS) is associated with considerable disability. Treatment options are scarce. Botulinum toxin (BoNT) is sometimes used, but the effect is often said to be disappointing. However, this notion stems from case reports and clinicians' opinions but has never been formally studied. We therefore investigated responsiveness to BoNT in CRPS patients with tonic dystonia. We injected the extensor digitorum brevis (EDB) muscle with BoNT-A in 17 patients with CRPS and tonic dystonia to compare the response between affected and unaffected legs...

Identification of drug exposure as a cause for dystonia is important since cessation of the causative agent offers a chance for remission. We describe two patients with a cranial, cervical, pharyngo-laryngeal and axial dystonia, akathisia, breathing dysrhythmias together with depression and anxiety. Both patients were started on the calcium channel blocker (CCB) amlodipine 1 month before symptom onset. They symptoms were non-acute and due to CCBs well-known D2 antagonism; hence they were classified as a tardive dystonic syndrome...

Myocardial rupture is an uncommon and life threatening event which may occur in the setting of acute myocardial infarction. In this case report we describe a rare instance of a patient presenting with signs of ventricular rupture as a late presentation of myocardial infarction. The findings of cardiac computed tomography are demonstrated as well as intra-operative images. Despite its very high attendant mortality risk, our patient's life was saved by the earlier development of Dressler's syndrome, an intense inflammatory process in the pericardium, resulting in dense adhesions, which effectively tamponaded the leak from the ventricular free wall rupture and prevented extravasation...

OBJECT: Outcomes following functional hemispherotomy in patients with drug-resistant epilepsy have been well described. However, studies reporting long-term longitudinal outcomes after subhemispheric disconnective epilepsy surgery are still limited. METHODS: The authors conducted a retrospective review of prospectively collected data of 10 children who underwent temporoparietooccipital (TPO) disconnective surgery at the Vienna Pediatric Epilepsy Center. RESULTS: There were 3 males and 7 females (median age 8...

BACKGROUND: Recessive X-linked dystonia-parkinsonism almost exclusively affects men. We investigated the genetic mechanisms causing this disorder in a female patient. METHODS: We confirmed the presence of an X-linked dystonia-parkinsonism-specific change in our patient by sequencing. In addition, we employed quantitative real-time PCR and array comparative genomic hybridization to determine the patient's X-chromosome copy number. RESULTS: The patient's sequence electropherogram suggested a higher amount of the mutated allele compared with the wild-type allele...

Percutaneous catheter ablation is now a well-established, efficient and effective treatment strategy for recurrent, symptomatic atrial fibrillation (AF). Major complications though occur in up to 5.9% of procedures. New complications still continue to emerge. Delayed tamponade is only recently recognized as a major complication after ablation. We present a 68-year-old female patient who develops cardiac tamponade requiring pericardiocentesis 12 days after AF ablation. Subsequently, the tamponade triggers a Dressler syndrome with repetitive pleural effusions only adequately responsive to corticosteroids...

AIM: to elucidate risk factors and special features of myocardial infarction (MI) in elderly women. MATERIAL AND METHODS: We included into the study 217 women aged 34 to 89 years who had Q-wave or non Q-wave MI and were admitted for treatment in the cardiology department. These patients were divided into two age groups - younger than 60 years (n=79, mean age 51.6+/-5.9 years) and more or equal 60 years (n=138, mean age 71.7+/-6.9 years). RESULTS: The following risk factors were more frequent among older women: hypertension (95...