Timing Is Important-Management of Metabolic Syndrome According to the Circadian Rhythm.

Physiological processes occur in accordance with a rhythm regulated by the endogenous biological clock. This clock is programmed at the molecular level and synchronized with the daily light-dark cycle, as well as activities such as feeding, exercise, and social interactions. It consists of the core clock genes, Circadian Locomotor Output Cycles Protein Kaput (CLOCK) and Brain and Muscle Arnt-Like protein 1 (BMAL1), and their products, the period (PER) and cryptochrome (CRY) proteins, as well as an interlocked feedback loop which includes reverse-strand avian erythroblastic leukemia (ERBA) oncogene receptors (REV-ERBs) and retinoic acid-related orphan receptors (RORs).

Predictions and Outcomes of Atrial Fibrillation in the Patients with Acute Myocardial Infarction.

The large epidemiological studies demonstrated that atrial fibrillation is correlated with high mortality and adverse events in patients with acute myocardial infarction. The aim of this study was to determinate predictors of atrial fibrillation develop during the hospital period in patients with acute myocardial infarction as well as short- and long-term mortality depending on the atrial fibrillation presentation. The 600 patients with an acute myocardial infarction were included in the study and follow-up 84 months.

Blood groups and acute aortic dissection type III.

Introduction: Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required.

Radiofrequency ablation of anteroseptal accessory pathway--a challenge to the electrophysiologist.

Introduction: Anteroseptal accessory pathways (APs) are located in the apex of the triangle of Koch's connecting the atrial and ventricular septum in the region of the His bundle. Ablation of anteroseptal pathway locations remains a challenge to the electrophysiologist due to a very high risk of transiet or permanent atrioventricular (AV) block.

Case Report: A male, 18-year-old, patient was hospitalized due to radiofrequency (RF) ablation of APs.

Emotional stress as a cause of syncope and torsade de pointes in patients with long QT syndrome.

Introduction: Long QT syndrome (LQTS) is a disorder of myocardial repolarization characterized by the prolongation of QT interval and high risk propensity of torsade de pointes (TdP) that can lead to syncope, cardiac arrest and sudden death. Episodes may be provoked by various stimuli depending on the type of the condition.

Case Report: A 25-year-old famele patient was hospitalized due to syncope that occurred immediately after her solo concert, first time in her life.

Papillary fibroelastoma of the aortic valve.

Introduction: Primary tumors of the heart are rare, usually benign and occur mostly in adults, and usually originate from the endocardium, followed by the myocardium and rarest of the pericardium. Papillary fibroelastoma accounts for less than 10% of all cardiac tumors, but they are most common valvular tumors. The clinical presentation of papillary fibroelastoma varies from asymptomatic cases to cases which have severe clinical presentation that is most likely due to embolic complications.

Successful implantation of a biventricular pacing and defibrillator device via a persistent left superior vena cava.

Introduction: Persistent left superior vena cava is the most common thoracic venous abnormality which is usually asymptomatic, found incidentally during pacemaker implantation. The main problem is related to reaching the appropriate pacing site and ensuring stable lead placement.

Case Report: We reported a successful implantation of a biventricular pacing and defibrillator device (CRT-D) via a persistent left superior vena cava in a 55-year-old man with dilated cardiomyopathy and severe heart failure.

Von Meyenburg complex (hamartoma of the bile duct) mimicking liver metastases.

Introduction: Hamartomas of the bile duct (von Meyenburg complex) are benign lesions of the liver that may mimic liver metastases. Histologically, they consist of cystic dilatations of the bile duct, encompassed by fibrous stroma.

Case Report: We reported a 68-year-old male patient in who gross, ultrasonic and MSCT appearance suggest multiple liver metastases.