AIM: To investigate the possible association between Tako-tsubo cardiomyopathy(TTC)-a reversible clini-cal condition mimicking an acute myocardial infarction characterized by multifactorial pathophysiologic mecha-nism...AIM: To investigate the possible association between Tako-tsubo cardiomyopathy(TTC)-a reversible clini-cal condition mimicking an acute myocardial infarction characterized by multifactorial pathophysiologic mecha-nisms- and respiratory system diseases. METHODS: We systematically searched PubMed and EMBASE medical information sources, to identify the different triggering causes, limiting our search to ar-ticles in English. The search keywords were: "tako-tsubo cardiomyopathy", "takotsubo", "takotsubo cardiomyopa-thy", "broken heart syndrome", "stress-induced cardio-myopathy", "apical ballooning syndrome", and "ampulla cardiomyopathy in combination with respiratory dis-eases, lung, pulmonary disease. For each kind of dis-ease, we registered: author, year and country of study, patient sex, age, concurring situation, and outcome. RESULTS: Out of a total of 1725 articles found, we se-lected 37 papers reporting a total of 38 patients. As ex-pected, most patients were women(81.6%), mean age was 65 ± 10 years. Outcome was favorable in 100% of cases, and all the patients have been discharged un-eventfully in a few days. CONCLUSION: An association between respiratory diseases and TTC is likely to exist. Patients with severe respiratory diseases, due to the high dosages of β2-agonists used or to the need of invasive procedures, are highly exposed to the risk of developing TTC.展开更多
Lemierre’s syndrome(LS)is an uncommon condition with oropharyngeal infections,internal jugular vein thrombosis,and systemic metastatic septic embolization as the main features.Fusobacterium species,a group of strictl...Lemierre’s syndrome(LS)is an uncommon condition with oropharyngeal infections,internal jugular vein thrombosis,and systemic metastatic septic embolization as the main features.Fusobacterium species,a group of strictly anaerobic Gram negative rod shaped bacteria,are advocated to be the main pathogen involved.We report a case of LS complicated by pulmonary embolism and pulmonary septic emboli that mimicked a neoplastic lung condition.A Medline search revealed 173 case reports of LS associated with internal jugular vein thrombosis that documented the type of microorganism.Data confirmed high prevalence in young males with Gram negative infections(83.2%).Pulmonary embolism was reported in 8.7% of cases mainly described in subjects with Gram positive infections(OR=9.786;95%CI:2.577-37.168,P=0.001),independently of age and gender.Only four fatal cases were reported.LS is an uncommon condition that could be complicated by pulmonary embolism,especially in subjects with Gram positive infections.展开更多
BACKGROUND Masked diastolic hypotension is a new blood pressure(BP)pattern detected by ambulatory blood pressure monitoring(ABPM)in elderly hypertensives.The aim of this study was to relate ABPM and comorbidity in a c...BACKGROUND Masked diastolic hypotension is a new blood pressure(BP)pattern detected by ambulatory blood pressure monitoring(ABPM)in elderly hypertensives.The aim of this study was to relate ABPM and comorbidity in a cohort of fit elderly subjects attending an outpatient hypertension clinic.METHODS Comorbidity was assessed by Charlson comorbidity index(CCI)and CHA_(2)DS_(2)VASc score.All subjects evaluated with ABPM were aged≥65 years.CCI and CHA_(2)DS_(2)VASc score were calculated.Diastolic hypotension was defined as mean am-bulatory diastolic BP<65 mmHg and logistic regression analysis was carried out in order to detect and independent relationship between comorbidity burden and night-time diastolic BP<65 mmHg.RESULTS We studied 174 hypertensive elderly patients aged 72.1±5.2 years,men were 93(53.4%).Mean CCI was 0.91±1.14 and mean CHA_(2)DS_(2)VASc score of 2.68±1.22.Subjects with night-time mean diastolic values<65 mmHg were higher in females[54.7%vs.45.3%,P=0.048;odds ratio(OR)=1.914,95%CI:1.047−3.500].Logistic regression analysis showed that only CHA_(2)DS_(2)-VASc score was independently associated with night-time mean diastolic values<65 mmHg(OR=1.518,95%CI:1.161−1.985;P=0.002),but CCI was not.CONCLUSIONS ABPM and comorbidity evaluation appear associated in elderly fit subjects with masked hypotension.Com-orbid women appear to have higher risk for low ambulatory BP.展开更多
基金Supported by A scientific grant(FAR–Fondo Ateneo Ricerca)from the University of Ferrara,Italy(in part)
文摘AIM: To investigate the possible association between Tako-tsubo cardiomyopathy(TTC)-a reversible clini-cal condition mimicking an acute myocardial infarction characterized by multifactorial pathophysiologic mecha-nisms- and respiratory system diseases. METHODS: We systematically searched PubMed and EMBASE medical information sources, to identify the different triggering causes, limiting our search to ar-ticles in English. The search keywords were: "tako-tsubo cardiomyopathy", "takotsubo", "takotsubo cardiomyopa-thy", "broken heart syndrome", "stress-induced cardio-myopathy", "apical ballooning syndrome", and "ampulla cardiomyopathy in combination with respiratory dis-eases, lung, pulmonary disease. For each kind of dis-ease, we registered: author, year and country of study, patient sex, age, concurring situation, and outcome. RESULTS: Out of a total of 1725 articles found, we se-lected 37 papers reporting a total of 38 patients. As ex-pected, most patients were women(81.6%), mean age was 65 ± 10 years. Outcome was favorable in 100% of cases, and all the patients have been discharged un-eventfully in a few days. CONCLUSION: An association between respiratory diseases and TTC is likely to exist. Patients with severe respiratory diseases, due to the high dosages of β2-agonists used or to the need of invasive procedures, are highly exposed to the risk of developing TTC.
文摘Lemierre’s syndrome(LS)is an uncommon condition with oropharyngeal infections,internal jugular vein thrombosis,and systemic metastatic septic embolization as the main features.Fusobacterium species,a group of strictly anaerobic Gram negative rod shaped bacteria,are advocated to be the main pathogen involved.We report a case of LS complicated by pulmonary embolism and pulmonary septic emboli that mimicked a neoplastic lung condition.A Medline search revealed 173 case reports of LS associated with internal jugular vein thrombosis that documented the type of microorganism.Data confirmed high prevalence in young males with Gram negative infections(83.2%).Pulmonary embolism was reported in 8.7% of cases mainly described in subjects with Gram positive infections(OR=9.786;95%CI:2.577-37.168,P=0.001),independently of age and gender.Only four fatal cases were reported.LS is an uncommon condition that could be complicated by pulmonary embolism,especially in subjects with Gram positive infections.
文摘BACKGROUND Masked diastolic hypotension is a new blood pressure(BP)pattern detected by ambulatory blood pressure monitoring(ABPM)in elderly hypertensives.The aim of this study was to relate ABPM and comorbidity in a cohort of fit elderly subjects attending an outpatient hypertension clinic.METHODS Comorbidity was assessed by Charlson comorbidity index(CCI)and CHA_(2)DS_(2)VASc score.All subjects evaluated with ABPM were aged≥65 years.CCI and CHA_(2)DS_(2)VASc score were calculated.Diastolic hypotension was defined as mean am-bulatory diastolic BP<65 mmHg and logistic regression analysis was carried out in order to detect and independent relationship between comorbidity burden and night-time diastolic BP<65 mmHg.RESULTS We studied 174 hypertensive elderly patients aged 72.1±5.2 years,men were 93(53.4%).Mean CCI was 0.91±1.14 and mean CHA_(2)DS_(2)VASc score of 2.68±1.22.Subjects with night-time mean diastolic values<65 mmHg were higher in females[54.7%vs.45.3%,P=0.048;odds ratio(OR)=1.914,95%CI:1.047−3.500].Logistic regression analysis showed that only CHA_(2)DS_(2)-VASc score was independently associated with night-time mean diastolic values<65 mmHg(OR=1.518,95%CI:1.161−1.985;P=0.002),but CCI was not.CONCLUSIONS ABPM and comorbidity evaluation appear associated in elderly fit subjects with masked hypotension.Com-orbid women appear to have higher risk for low ambulatory BP.
