Publications by authors named "G Kostandy"

Cholangiocarcinoma is one of the most common malignancies of the biliary tree. Most cases are perihilar. Cholangiocarcinoma usually has an indolent, slowly progressive course and is associated with a high mortality rate.

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Women with coronary artery disease are less likely to undergo coronary artery bypass surgery, and this may represent a potential referral bias in favor of men. A higher in-hospital mortality rate in women compared with men has been reported earlier. Accumulating evidence currently suggests, however, that variables other than gender, such as advanced age, late referral, angina classification, diabetes mellitus, concurrent medical conditions, the number of diseased vessels, the caliber of coronary arteries, and the decreased body surface area in women may have accounted for this difference.

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The term torsade de pointes refers to a ventricular tachycardia characterized by QRS complexes of changing amplitude that appears to twist around the isoelectric line and occurs at rates of 200-250/minute. Most cases of torsade de pointes are iatrogenically induced by drugs or electrolyte abnormalities. The most important feature is QT interval prolongation.

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The authors report a unique case that presented with hemodynamic abnormalities and severe bradycardia, necessitating the insertion of a temporary pacemaker, as well as metabolic disturbances, hematologic changes, and hepatic and renal dysfunction in an elderly individual owing to lithium intoxication. This case also demonstrates that these various serious side effects of lithium resolved with prompt recognition and discontinuation of lithium. Lithium should be used with extreme caution and frequent monitoring especially in the elderly.

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