1/20. Cardiovascular complications on upper vagal rootlet section for glossopharyngeal neuralgia; case report.Acute hypotension and right bundle-branch block occurred when the authors sectioned the uppermost rootlet of the vagus nerve in a case of glossopharyngeal neuralgia. hypotension lasted for 20 minutes and arrhythmia for 4 days. A possible mechanism is discussed and cardiovascular disorders are reviewed in similar cases.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/20. maintenance of health behavior change in preventive cardiology. Internalization and self-regulation of new behaviors.Long-term health behavior maintenance remains a challenge for patients and health behavior interventionists. Resource-intensive systems of external reinforcement and behavioral cues can support behavior maintenance; an alternative approach is to promote patient internalization and self-regulation of health behaviors. Based in part on organismic internalization theory, self-determination theory, and the experience of patients successful at maintaining health behaviors, the health behavior internalization model (HBIM) is proposed to describe motivational factors associated with internalization processes and hypothesizes that integrated internalization may be associated with long-term health behavior maintenance. The HBIM identifies four self-needs (ownership, self-determination, security, and support) and four behavior-related needs (preference, context, competence, and coping) as motivating health behavior internalization. Behavior change strategies promoting integrated internalization are identified from self-determination theory, motivational interviewing, and transtheoretical model interventions. Other health behavior change constructs are reviewed in relation to internalization processes, and potential limits to the model are discussed.- - - - - - - - - - ranking = 0.87057013232514keywords = organ (Clic here for more details about this article) |
3/20. Post-mortem findings in familial partial lipodystrophy, Dunnigan variety.AIMS: Familial partial lipodystrophy, Dunnigan variety (FPLD), is an autosomal dominant disorder due to missense mutations in the lamin A/C gene and is characterized by gradual loss of subcutaneous fat from the extremities and trunk, fat accumulation in the head, neck and intra-abdominal areas, insulin resistance and its metabolic complications. We studied autopsy findings in two patients with FPLD to determine fat distribution and organ involvement. RESULTS: Patient 1, a 66-year-old woman with the R482Q mutation, had diabetes mellitus, dyslipidaemia, and coronary artery disease and died suddenly. autopsy confirmed the typical body fat distribution and further revealed excess fat deposition in the subpectoral regions extending to the axillae, in the axillary lymph nodes and in the retroperitoneum. Atherosclerotic vascular disease including old infarcts of the myocardium, temporal lobe and kidneys were noted. Severe amyloidosis of the pancreatic islets and grouped muscle atrophy of the quadriceps and diaphragmatic muscles were present. Patient 2, a 29-year-old woman belonging to a pedigree with the R62G mutation, died of hyperlipidaemia-induced acute pancreatitis. autopsy of patient 2 revealed extensive pancreatitis, hepatic steatosis and polycystic ovaries. CONCLUSIONS: Our study confirms typical body fat distribution and describes new sites of excess fat deposition. Our data show predisposition to atherosclerosis and polycystic ovaries and suggest that pancreatic amyloidosis may underlie development of hyperglycaemia in FPLD patients.- - - - - - - - - - ranking = 0.87057013232514keywords = organ (Clic here for more details about this article) |
4/20. Use of a biventricular assist device in the treatment of acute doxorubicin-induced cardiotoxicity.This report describes a patient treated for metastatic leiomyosarcoma, who acutely developed doxorubicin-induced cardiotoxicity, and consequently developed heart failure. Medical therapy was initiated; however, her condition deteriorated and a surgical alternative was proposed. A biventricular assist device was implanted, allowing her multisystem organ failure to improve. During the next 9 days while on the assist device, her heart failure resolved, her organs were well perfused, and her heart entered a recovery period. After 9 days of mechanical support with the biventricular assist device, she was explanted from the assist device, and with inotropic support and an intra-aortic balloon pump, she maintained adequate hemodynamics. Eighteen days after implantation of the assist device, she was discharged from the hospital with hospice care, where she later died. Although the patient's cardiac function did not have long-term recovery, short-term recovery after doxorubicin toxicity was achieved. The authors maintain that the use of a biventricular assist device in the treatment of acute heart failure resulting from doxorubicin-induced cardiomyopathy is an effective way to manage this patient population.- - - - - - - - - - ranking = 1.7411402646503keywords = organ (Clic here for more details about this article) |
5/20. Primary sjogren's syndrome presenting with generalized autonomic failure.A 64 year-old woman developed Raynaud's phenomenon and dry eyes/mouth. Laboratory examination revealed positive Schirmer's test, rheumatoid factor and anti-nuclear antibody, and lymphocytic sialoadenitis on salivary gland biopsy. These features strongly suggested the diagnosis of primary sjogren's syndrome. Three years later, she gradually developed generalized autonomic failure without apparent sensory neuropathy on nerve conduction study. She had systolic pressure fall of 51 mmHg on head-up tilt test, cardiovascular supersensitivity to diluted norepinephrine infusion, cardiac denervation in [123I]-MIBG scintigraphy, impaired R-R variability, decreased sweating and prolonged colonic transit time. Autoimmune autonomic ganglionopathy was mostly responsible for her autonomic failure.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
6/20. An unusual case of massive gastric distension with catastrophic sequelae.We report a case of massive gastric distension presenting with abdominal pain, shock and lower limb ischaemia. At laparotomy, gastric distension was found to be secondary to gastric outflow obstruction compounded by gas formation from antacid ingestion. Both the aorta and inferior vena cava were directly compressed by the distended stomach. This mode of presentation and combined aetiologies remain unreported. Gastric decompression resulted in profound cardiovascular compromise, multiorgan failure and eventually death.- - - - - - - - - - ranking = 0.87057013232514keywords = organ (Clic here for more details about this article) |
7/20. Acute pseudobulbar or suprabulbar palsy.We studied 13 patients with supranuclear lower cranial nerve ("pseudobulbar" or "suprabulbar") palsy of acute onset. While seven patients had had a prior stroke, six patients had no history of stroke. Eight patients experienced a complete bilateral supranuclear lower cranial nerve palsy, which was isolated in five patients and associated with hemiplegia and with hemiparesis in three patients. pseudobulbar palsy was partial in five patients. Only one patient had neuropsychologic impairment. The pseudobulbar features improved or recovered within a few weeks in all patients. The common characteristic of the lesions on computed tomography or magnetic resonance imaging was the interruption of the corticonuclear pathways contrasting with marked sparing of the corticospinal pathways in both hemispheres. These lesions were either an opercular infarct, or a deep infarct in the corona radiata or internal capsule, or a lenticular hemorrhage. hypertension was the most prevalent concomitant. Our findings suggest that acute pseudobulbar or suprabulbar palsy has rather stereotyped anatomic-vascular correlates and time course.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
8/20. Cardiovascular and bacteremic manifestations of campylobacter fetus infection: case report and review.A case of bacteremia due to campylobacter fetus subspecies fetus with concomitant pleuropericarditis in a previously healthy patient is presented. The organism is ubiquitous, but most commonly causes infection in patients with chronic underlying illnesses. The pathogenesis of human infection has not been definitively elucidated. bacteremia is the most common clinical manifestation of this infection, although cases of thrombophlebitis, mycotic aneurysm, endocarditis, and pericarditis have also been reported. The treatment of choice for most infections is gentamicin, with chloramphenicol recommended for infection involving the central nervous system. tetracyclines and erythromycin are alternative agents. Prolonged therapy is essential to the prevention of relapse. A high index of suspicion is necessary for the recognition of this organism in the appropriate clinical settings.- - - - - - - - - - ranking = 1.7411402646503keywords = organ (Clic here for more details about this article) |
9/20. Cardiac amyloidosis involving the conduction system and the aortocoronary neuroreceptors. Clinicopathologic correlates.In a patient with cardiac primary amyloidosis with conduction disturbances and dynamic cardiocirculatory disorders, the specialized system of the heart and the hitherto neglected cardiac nerve plexus and annexed aortocoronary glomera were studied histologically. Amyloid deposition in the conduction system and in the nerves and neuroreceptors seemed to correlate with the dysrhythmic manifestations, and, respectively, with some undue responses to vasodilator therapy. The possible hazards deriving from involvement of the aortocoronary glomera in patients with amyloidosis have been pointed out accordingly.- - - - - - - - - - ranking = 2keywords = nerve (Clic here for more details about this article) |
10/20. Adverse cardiovascular effects of anticholinesterase medications.Anticholinesterase medications (anti-ChEs) play a significant role in the diagnosis and treatment of myasthenia gravis (MG). The primary effect on the heart produced by a surfeit of ACh is bradyarrhythmias with consequent fall in cardiac output and hypotension; yet, adverse cardiac reactions to these agents have been reported relatively infrequently. The authors describe 12 patients with MG from a pool of more than 1,000 who suffered hypotensive episodes related to use of anti-ChEs. The 12 patients (seven male, five female) had a mean age of 62.6 years; of these, eight adverse reactions occurred after edrophonium, two after neostigmine, and two after pyridostigmine. Seven patients had a recent increase in anti-ChEs and none had a decrease in dosage. Nine patients suffered either from severe sinus bradycardia, (20 beats/min), junctional bradycardia, or complete AV dissociation. Two patients had paradoxic sinus tachycardia and all had syncopal or near-syncopal episodes. Evidence for cholinergic stimulation of other organs was generally lacking. No recurrence appeared with reduction of the dose of anti-ChEs or discontinuation of the drug. The authors believe that these agents should be given with caution to patients with inflammatory, infiltrative, or degenerative disease of the conduction systems, patients being treated with digitalis, calcium-channel antagonists or beta blockers, patients with myocardial ischemia, and elderly patients. Appropriate resuscitative equipment should be readily available.- - - - - - - - - - ranking = 0.87057013232514keywords = organ (Clic here for more details about this article) |
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