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https://www.readbyqxmd.com/read/29299356/fluoropyrimidine-induced-cardiac-toxicity-challenging-the-current-paradigm
#1
Suparna C Clasen, Bonnie Ky, Rupal O'Quinn, Bruce Giantonio, Ursina Teitelbaum, Joseph R Carver
Background: Fluoropyrimidine chemotherapy [5-fluorouracil (5-FU) and capecitabine] are commonly used agents in the treatment of various solid malignancies. However, their use has been limited by cardiac toxicity, presenting as a wide spectrum of asymptomatic (e.g., EKG changes) and symptomatic (e.g., chest pain) manifestations related to coronary vasospasm leading to myocardial ischemia. Historically, patients with suspected coronary vasospasm have been treated with traditional acute ischemic workup and various combinations of anti-anginal therapies...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/29287596/gamma-aminobutyric-acid-b-limbic-encephalitis-and-asystolic-cardiac-arrest-a-case-report
#2
Christopher A Ovens, Angelo Jayamanne, Andrew Duggins
BACKGROUND: Gamma-aminobutyric acid-B receptor autoantibodies are becoming an increasingly recognized contributor to the spectrum of autoimmune limbic encephalitis. They are classically associated with seizures and behavioral disturbance, and may coexist with other autoantibodies. Many are paraneoplastic, most commonly associated with small cell lung cancer. Until now there have been no reports of cardiac dysrhythmias in these patients. CASE PRESENTATION: A 65-year-old Caucasian man presented with multiple seizures, dysarthria and behavioral disturbance of unclear etiology, with associated asystolic cardiac arrest...
December 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29274604/interictal-cardiac-repolarization-abnormalities-in-people-with-epilepsy
#3
Nirmeen A Kishk, Yasser Sharaf, Asmaa M Ebraheim, Yasser Baghdady, Nelly Alieldin, Ahmed Afify, Ahmed Eldamaty
BACKGROUND AND OBJECTIVE: The occurrence of cardiac electrical abnormalities such as repolarization disorders in patients with epilepsy was previously documented and may, in part, clarify the mechanism of sudden unexpected death in those patients. The aim of this study was to investigate the frequency of cardiac repolarization disorders among patients with epilepsy and whether specific demographic- or disease-related features were associated with their occurrence. SUBJECTS AND METHODS: This cross-sectional study was carried out on 1000 subjects with epilepsy who were compared with age- and sex-matched 2500 subjects without epilepsy...
December 20, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29260587/right-ventricular-longitudinal-strain-a-tool-for-diagnosis-and-prognosis-in-light-chain-amyloidosis
#4
Charles Uzan, Olivier Lairez, Pascale Raud-Raynier, Rodrigue Garcia, Bruno Degand, Luc P Christiaens, Michaela B Rehman
OBJECTIVES: Light-chain (AL) amyloidosis can lead to an infiltrative cardiomyopathy with increased wall thickness (IWT) of very poor prognosis. Our primary aim was to analyse the right ventricle (RV) in patients with IWT to discriminate AL amyloidosis from IWT due to hypertrophic cardiomyopathy (HCM) or to arterial hypertension (HTN). Our secondary aim was to assess if RV dysfunction predicts overall mortality in cardiac AL amyloidosis. METHODS: We retrospectively and consecutively compared clinical, biological and echocardiographic data of 315 patients with IWT: 105 biopsy-proven AL amyloidosis patients, 105 patients with HCM and 105 patients with HTN...
December 20, 2017: Amyloid: the International Journal of Experimental and Clinical Investigation
https://www.readbyqxmd.com/read/29246718/lower-extremity-arterial-calcification-on-preoperative-knee-radiographs-as-a-predictor-of-postoperative-cardiovascular-events-after-primary-total-knee-arthroplasty
#5
David Cantu Morales, Justin de Beer, Danielle Petruccelli, Conrad Kabali, Mitch Winemaker
BACKGROUND: A cross-sectional study of total knee arthroplasty (TKA) patients was conducted to determine the association of lower-extremity arterial calcification (LEAC) with acute perioperative cardiovascular events (CVEs). METHODS: Regression modeling was used to examine the association of radiographic presence of LEAC and acute myocardial infarction (MI), perioperative CVE, 30-day CVE readmit, and 30-day and 1-year mortality. RESULTS: Of 900 TKA patients, LEAC was identified in 21...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29230129/paraneoplastic-cardiac-involvement-in-renal-cell-carcinoma-with-dermatomyositis-sine-dermatitis
#6
Htoo Kyaw, Atif Z Shaikh, Cesar Ayala-Rodriguez, Misra Deepika
Background: Dermatomyositis is an idiopathic inflammatory myopathy that has been established as one of the many paraneoplastic phenomena. Cardiac involvement can occur with dermatomyositis but has rarely been reported in the literature because symptoms are usually subclinical. Case Report: A 72-year-old female presented with generalized weakness for 1 month after a recent diagnosis of renal cell carcinoma. Her weakness was attributed to a myopathic process that was identified as dermatomyositis after muscle biopsy...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29229895/prevalence-and-predictors-of-myocardial-ischemia-by-preoperative-myocardial-perfusion-single-photon-emission-computed-tomography-in-patients-undergoing-noncardiac-surgery
#7
Abdelkareem Saleh Al-Oweidi, Hesham Albabtain, Suleiman M Kharabsheh, Peter Kimme, Mahmoud Almustafa, Samer Seder, Mohamed Shoukri, Ahmed L Fathala
BACKGROUND: The prevalence and predictors of myocardial ischemia before noncardiac surgery are unknown. In addition the predictive value of myocardial perfusion single-photon emission computed tomography (SPECT) before noncardiac in individual patients is uncertain. OBJECTIVE: Evaluate the prevalence and predictors of myocardial ischemia before noncardiac surgery, and determine the postoperative cardiac outcome based on results of myocardial perfusion SPECT. DESIGN: Retrospective...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29229215/atrial-fibrillation-neurogenic-or-myogenic
#8
REVIEW
Alina Scridon, Răzvan Constantin Şerban, Philippe Chevalier
A 55-year-old hypertensive patient presents atrial fibrillation after vasovagal syncope. Non-invasive cardiac workup is normal. Without antiarrhythmic therapy, the patient has no recurrence for the next 3years, then presents with a stroke. Echocardiography eventually reveals left atrial dilation. This sequence of events illustrates the well-known links between age, arterial hypertension, atrial fibrillation, atrial neuromyopathy and stroke. A frequently neglected common denominator in this equation is impaired sympathovagal balance...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29210110/paediatric-breath-holding-spells-are-associated-with-autonomic-dysfunction-and-iron-deficiency-may-play-a-role
#9
H Tomoum, N Habeeb, I Elagouza, H Mobarez
AIM: This study assessed cardiac performance and iron in subjects aged 12-36 months with breath-holding spells (BHS). METHODS: We consecutively recruited 40 subjects (55% male) experiencing BHS from the general paediatric outpatients department at the Children's Hospital, Ain Shams University, Egypt from 2015-2016. The 20 matched comparisons were mainly healthy siblings. The workup included iron levels and electrocardiograms. RESULTS: The age at the onset of BHS was 5-24 months with a median monthly frequency of 13...
December 6, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29205690/refinement-of-detecting-atrial-fibrillation-in-stroke-patients-results-from-the-track-af-study
#10
Florian Reinke, Markus Bettin, Linda Sarah Ross, Simon Kochhäuser, Ilka Kleffner, Martin Ritter, Jens Minnerup, Dirk Dechering, Lars Eckardt, Ralf Dittrich
BACKGROUND: Detection of occult atrial fibrillation (AF) is crucial for optimal secondary prevention in stroke patients. We determined the AF detection rate by implantable cardiac monitor (ICM) compared to the prediction rate of the probability of incident AF by software based analysis of continuously monitored ECG at follow up (Stroke risk analysis=SRA) and propose an optimized AF detection algorithm by combining both tools. METHODS: In a monocentric prospective study we investigated 105 out of 389 patients with cryptogenic stroke despite extensive diagnostic workup with two additional cardiac monitoring tools: (a) 20 month monitoring by ICM and (b) SRA during hospitalization at the Stroke Unit...
December 4, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29194292/fetal-splenomegaly-a-review
#11
Marta Moreira, Rafael Brás, Daniela Gonçalves, Inês Alencoão, Gonçalo Inocêncio, Maria Rodrigues, Jorge Braga
Enlargement of the fetal spleen is usually found secondary to systemic diseases and is frequently associated with hepatomegaly. By far, the most common causes of fetal splenomegaly are infectious. Other etiologies responsible for this sign are hemolytic anemia, congestive cardiac failure, metabolic disorders, and rarely, leukemia, lymphoma, and histiocytosis.We report a case of prenatal splenomegaly diagnosed at 35 weeks, confirmed in the postnatal period. The postnatal workup showed the newborn had a familial type 3 form of hemophagocytic lymphohistiocytosis (HLH)...
November 29, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29173672/acute-valvular-heart-disease
#12
REVIEW
Varun Maheshwari, Brian Barr, Mukta Srivastava
Valvular heart disease (VHD) is a common clinical entity. Recognition of decompensated VHD is crucial to instituting appropriate workup and management. Initial evaluation focuses on hemodynamics, peripheral perfusion, volume overload, and active myocardial ischemia. Initial therapy is targeted at improving hemodynamics, fluid status, and decreasing myocardial ischemia before intervention. Echocardiography can rapidly identify VHD etiology and severity along with physical examination findings. Owing to improved survival with cardiac surgery over the past several decades, prosthetic valve dysfunction should be recognized and initial treatment understood...
February 2018: Cardiology Clinics
https://www.readbyqxmd.com/read/29171184/structural-malformations-of-the-brain-eye-and-pituitary-gland-in-phace-syndrome
#13
Jack E Steiner, Garrett N McCoy, Christopher P Hess, William B Dobyns, Denise W Metry, Beth A Drolet, Mohit Maheshwari, Dawn H Siegel
PHACE syndrome is the association of segmental facial hemangiomas with congenital arterial, brain, cardiac, and ocular anomalies. Structural brain malformations affect 41-52% of PHACE patients and can be associated with focal neurologic deficits, developmental delays, and/or intellectual disability. To better characterize the spectrum of structural brain and other intracranial anomalies in PHACE syndrome, MRI scans of the head/neck were retrospectively reviewed in 55 patients from the PHACE Syndrome International Clinical Registry and Genetic Repository...
January 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29150036/thoracic-surgery-considerations-in-the-child-and-young-adult
#14
REVIEW
Marvin D Atkins, Stephanie Fuller
Vascular rings and slings may represent life-threatening compression of the esophagus and trachea. Such anatomic variants, although rare, are encountered by all thoracic surgeons in the scope of their practice at some time. The thoracic surgeon, whether treating such patients in the practice of congenital heart surgery, or in the practice of adult cardiac or thoracic surgery must have a requisite understanding of such anatomic variants, their diagnostic workup and radiologic interpretation, as well as their surgical management...
February 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29122275/bleeding-complications-after-percutaneous-mitral-valve-repair-with-the-mitraclip
#15
Maria Isabel Körber, Julia Silwedel, Kai Friedrichs, Victor Mauri, Michael Huntgeburth, Roman Pfister, Stephan Baldus, Volker Rudolph
Bleeding after cardiac surgery or cardiovascular interventions is associated with worse patient outcome. Only very limited data are available on the subject of bleeding after percutaneous edge-to-edge mitral valve repair (PMVR). We performed a single center analysis including 347 consecutive patients who underwent PMVR. Bleeding was defined according to the Mitral Valve Academic Research Consortium (MVARC) end point definition. The incidence of MVARC bleeding was 21.6% (n = 75), whereas major MVARC bleeding (hemoglobin decrease ≥3 g/dl) occurred in 7...
October 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29120023/role-of-liver-magnetic-resonance-imaging-in-hyperferritinaemia-and-the-diagnosis-of-iron-overload
#16
Axel Ruefer, Christine Bapst, Rudolf Benz, Jens Bremerich, Nathan Cantoni, Laura Infanti, Kaveh Samii, Mathias Schmid, Jean-Paul Vallée
Hyperferritinaemia is a frequent clinical problem. Elevated serum ferritin levels can be detected in different genetic and acquired diseases and can occur with or without anaemia. It is therefore important to determine whether hyperferritinaemia is due to iron overload or due to a secondary cause. The main causes of iron overload are intestinal iron hyperabsorption disorders and transfusion-dependent disorders. Iron homeostasis and iron overload are quantified by different diagnostic approaches. The evaluation of serum ferritin and transferrin saturation is the first diagnostic step to identify the cause of hyperferritinaemia...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29118884/breast-arterial-calcifications-on-mammography-do-not-predict-myocardial-ischemia-on-myocardial-perfusion-single-photon-emission-computed-tomography
#17
Ahmed Fathala, Salma Salem, Fahad Alanazi, Deema Abunayyan, Abdelmoneim M Eldali, Abdulaziz Alsugair
Background: The aim of this study was to determine if breast arterial calcification (BAC) on mammography predicts myocardial ischemia (MI) on stress myocardial perfusion single-photon emission computed tomography (MPS). BAC is a type of medial artery calcification that can be seen incidentally on mammography, but the relationship between coronary artery calcification and MI on MPS is yet unknown. Methods: A total of 435 consecutive women underwent mammography and stress MPS within 1 year of each other...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29114418/stop-being-so-sensitive-an-exceptionally-rare-report-of-ustekinumab-induced-sub-acute-hypersensitivity-pneumonitis
#18
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29099425/unexpected-cardiac-computed-tomography-findings-in-patients-with-postoperative-myocardial-injury
#19
Remco B Grobben, Judith A R van Waes, Tim Leiner, Linda M Peelen, Gert Jan de Borst, Henri C Vogely, Diederick E Grobbee, Pieter A Doevendans, Wilton A van Klei, Hendrik M Nathoe
BACKGROUND: Postoperative myocardial injury (PMI) is a strong predictor of mortality after noncardiac surgery. PMI is believed to be attributable to coronary artery disease (CAD), yet its etiology is largely unclear. We aimed to quantify the prevalence of significant CAD in patients with and without PMI using coronary computed tomography angiography (CCTA). METHODS: This prospective cohort study included patients of 60 years or older without a history of cardiac disease and with and without PMI after intermediate- to high-risk noncardiac surgery...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29099419/acute-systemic-complications-of-convulsive-status-epilepticus-a-systematic-review
#20
REVIEW
Raoul Sutter, Tolga Dittrich, Saskia Semmlack, Stephan Rüegg, Stephan Marsch, Peter W Kaplan
OBJECTIVES: Status epilepticus is a neurologic emergency with high morbidity and mortality requiring neurointensive care and treatment of systemic complications. This systematic review compiles the current literature on acute systemic complications of generalized convulsive status epilepticus in adults and their immediate clinical impact along with recommendations for optimal neurointensive care. DATA SOURCES: We searched PubMed, Medline, Embase, and the Cochrane library for articles published between 1960 and 2016 and reporting on systemic complications of convulsive status epilepticus...
January 2018: Critical Care Medicine
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