Medicine
-
Capillary leak syndrome (CLS) is characterized by hypoproteinemia, diffused pitting edema, noncardiogenic pulmonary edema, and hypotension. By far, there are no related reports of CLS secondary to malignant hypertension (MHT). A 33-year-old male was admitted to our hospital with the diagnosis of CLS on the background of MHT. ⋯ Up to now, there has been no case report of CLS caused by MHT. We should pay more attention to CLS induced by MHT, try to diagnose it as soon as possible, and give prompt treatment to CLS and primary disease.
-
Preoperative left ventricular dysfunction is a risk factor for postoperative mortality and morbidity in cardiovascular surgeries with cardiopulmonary bypass, including thoracic aortic surgery. Using a retrospective study design, this study aimed to clarify the short- and mid-term outcomes of patients who underwent acute type A aortic dissection (ATAAD) repair with reduced left ventricular function. Between July 2007 and February 2018, a total of 510 adult patients underwent surgical repair of ATAAD in a single institution. ⋯ The serial echocardiograms revealed no postoperative deterioration of LVEF during the 3-year follow-up. Even with a more conservative aortic repair procedure, the patients with preoperative left ventricular dysfunction are at higher surgical risk for in-hospital mortality. However, once such patients are able to survive to discharge, the midterm outcome can still be promising.
-
Diagnostic difficulty due to overlapped clinical findings exists in cardiac sarcoidosis (CS) patients who also have coronary artery disease. Since cardiac magnetic resonance (CMR) and fluorodeoxyglucose-positron emission tomography (FDG-PET) evaluate different pathological processes, that is, fibrosis and inflammation respectively, the combination may be useful in such a case. ⋯ Our case suggests that CMR and FDG-PET are complimentary, and the combination is useful for diagnosis of CS, particularly in cases that have previous MI.
-
Cerebrospinal venous anatomy and hemodynamics changes are associated with many central nervous system disorders. The aim of this study was to detect whether perihematomal edema (PHE) after spontaneous intracerebral hemorrhage (sICH) is associated with cerebral venous outflow volume (CVFV) in the internal jugular veins and vertebral veins. Newly diagnosed cases of sICH between April 2016 and March 2017 were enrolled and patients were grouped to the mean value of PHE according to previous study. ⋯ No significant difference was observed at 12 days in rPHE. The multivariate analyses showed that CVFV was independently associated with late PHE (PHE at 12 ± 3 days) but not with early PHE (PHE at 72 hours) and rPHE. These results suggest that CVFV may be closely related to PHE after sICH.
-
Observational Study
Delay of computed tomography is associated with poor outcome in patients with blunt traumatic aortic injury: A nationwide observational study in Japan.
According to guidelines from the Eastern Association for the Surgery of Trauma, computed tomography (CT) with intravenous contrast is strongly recommended to diagnose clinically significant blunt traumatic aortic injury (BTAI). However, it remains unclear whether the timing of CT scanning is associated with the prognosis of BTAI patients. We extracted data on emergency patients who suffered a BTAI in the chest and/or the abdomen from 2004 to 2015 from the Japanese Trauma Data Bank, a nationwide trauma registry. ⋯ Compared with the early group, the late group tended to have a higher rate of discharge to death (AOR: 1.438, 95% CI: 0.735-2.813). In the patients with shock, the AOR was 3.292 (95% CI: 0.495-21.902) in the middle group and 6.039 (95% CI: 0.990-36.837) in the late group compared with the early group. This study revealed that a longer time interval from hospital arrival to CT scanning was associated with higher mortality in the ED in patients with BTAI.