Long-term reverse remodeling and clinical improvement by MultiPoint Pacing in a randomized, international, Middle Eastern heart failure study.

Purpose: Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing, MPP) has been shown to improve CRT response, although MPP response using automated pacing vector programming has not been demonstrated in the Middle East. The purpose of this study was to compare the impact of MPP to conventional biventricular pacing (BiV) using echocardiographic and clinical changes at 6-month post-implant.

Methods: This prospective, randomized study was conducted at 13 Middle Eastern centers.

Baseline Lighter Sleep and Lower Saturation Are Associated With Improved Sleepiness and Adherence on Continuous Rather Than Autotitrating Positive Airway Pressure.

The objective was to test whether there were better outcomes on switching from autotitrating positive airway pressure (APAP) to continuous positive airway pressure (CPAP) in a clinic sample of patients with obstructive sleep apnea (OSA). Patients prescribed APAP in 2015-2016 and belonging to a subset characterized by side effects, or suboptimal response or adherence, were advised a switch to CPAP following a CPAP titration polysomnography. The main analysis was for improvement (after switch from APAP to CPAP) in (1) sleepiness, wakefulness inability, and fatigue, using change from baseline in the Sleepiness-Wakefulness Inability and Fatigue Test (delta SWIFT), and Epworth Sleepiness Scale (delta ESS), and (2) adherence using percentage of days with ≥4-hour use and whether there was ≥4-hour use on ≥70% days.

A Phase II Trial of Older Adults With Metastatic Breast Cancer Receiving nab-Paclitaxel: Melding the Fields of Geriatrics and Oncology.

Introduction: Phase II clinical trials including geriatric assessment (GA) measures are critical for improving the evidence base for older adults with cancer. We assessed the efficacy and tolerability of nab-paclitaxel in older adults with metastatic breast cancer (MBC).

Patients And Methods: Patients aged ≥ 65 years with MBC and ≤ 1 previous line of chemotherapy received 100 mg of nab-paclitaxel on days 1, 8, and 15 of a 28-day cycle.

Treatment of acute myelogenous leukemia with outpatient azacitidine.

Background: Patients older than 55 years of age with acute myelogenous leukemia (AML) are less likely to achieve complete remission and more likely to experience toxicity with conventional induction chemotherapy than younger patients. Azacitidine administered in the outpatient setting is well tolerated and can induce complete hematological remission in patients with myelodysplastic syndromes (MDS). At higher doses, azacitidine has activity in AML.

[Interstitial pneumopathy revealing type B Niemann Pick disease in an adult].

Introduction: Niemann-Pick disease is an autosomal recessive disorder due to partial or total deficit in sphingomyelinase.

Exegesis: We report a case of type B Niemann-Pick disease revealed by pneumonia and splenomegaly associated with blue histiocyte syndrome. Investigations that were done 2 years prior to diagnosis had shown the existence of isolated chronic lipid pneumonia which is specific of overloading.

Acetaldehyde depresses myocardial contraction and cardiac myocyte shortening in spontaneously hypertensive rats: role of intracellular Ca2+.

Acetaldehyde (ACA), the major metabolite of ethanol, exerts both stimulatory and depressive actions on myocardial tissue. We have recently shown that ACA depresses myocardial contraction, cardiac myocyte shortening and intracellular Ca2+ transients in normal rat heart. The purpose of the present study was to determine the influence of hypertension on ACA-induced myocardial actions.

[Recurrent osteitis and Coxiella burnetii: the relation to chronic recurrent multifocal osteomyelitis].

Unlabelled: Chronic recurrent multifocal osteomyelitis (CRMO) is a disorder of suspected--but unproved-infectious etiology.

Observation: A girl presented with a typical CRMO involving successively the left fibula, radius, humerus and the right carpus. A Coxiella burnetii infection was indicated during the first attack.

Devic's neuromyelitis optica: a clinicopathological review of the literature in connection with a case showing fatal dysautonomia.

A new clinicopathological case of Devic's neuromyelitis optica, including unusual predominant clinical features (fatal dysautonomia) is described herein: pathological examination showed extensive and severe demyelination mainly involving the optic nerves, the medulla, and spinal cord, which was particularly pronounced in the thoracic segments, and thus explained the unusual vegetative symptomatology. In a review of 45 clinicopathological cases described in the literature as Devic's disease (DD), it turned out that only 22 cases, including the patient described here, fulfilled the recently defined diagnostic criteria [Devic 1980]. Among the other 23 cases, 15 did not fulfill the criteria because of the occurrence of relapses, 3 others had 2 separate pathological locations within the spinal cord, and the remaining 5 showed evidence that a disease other than DD was involved.

[Infantile polycystic hepatorenal disease. 2 consecutive cases in a patient. Ultrasonic diagnosis and indication for elective pregnancy termination].

We report a case of infantile polycystic kidney disease, during the course of two consecutive pregnancies in the same woman. Observed rates of recurrence in families at risk is higher than theoretical rates (25%). Antenatal ultrasound can show signs of bilateral involvement, which is always lethal and generally leads to elective termination of pregnancy.

[Giant breast fibroadenoma].

We report a case of giant fibroadenoma of the breast, "juvenile type", in a 15 year old girl. We study the characteristics of this tumor that occurs in adolescents females, the differential diagnosis with cystosarcoma phylloide and benign virginal hypertrophy, and treatment. Follow-up is recommended because of possible recurrent tumor of a short time.

[Benign papillomatosis of Wirsung's duct associated with adenomyoma of the distal common bile duct].

We report the case of a 42 year-old man, with a history of alcohol and tobacco abuse, who was referred for suspicion of carcinoma of the head of pancreas. Pancreatoduodenectomy was performed. Histological study demonstrated obstructive benign adenomyoma of the distal common bile duct associated with villous papillomatosis of the pancreatic ducts and patchy lesions of chronic pancreatitis.

[Visceral leishmaniasis associated with Hodgkin's disease: diagnostic difficulties].

A case of Hodgkin's disease associated from the start with visceral leishmaniasis in the absence of antitumoral treatment shows that leishmaniasis is a severe opportunistic infection in endemic areas and can be masked by the tumoral syndrome of an underlying pathology. Conversely, patients with visceral leishmaniasis must be investigated for a cause of immunosuppression with, in particular, biopsy of accessible lymph nodes. The exceptionally favourable course of this particular case deserved to be high-lighted.

Fryns syndrome: report on 8 new cases.

The name Fryns syndrome was given to a new variable multiple congenital anomaly syndrome, almost always lethal, described in 1978, and now known to be autosomal recessive. Since that date, 20 patients have been reported in the literature. We describe 8 new cases, 6 of which were diagnosed in a series of 112,276 consecutive births (livebirths and perinatal deaths).

[A case of papillary tumor of the pancreas].

The authors report a case of papillary cystic tumor which is a rare form of pancreatic tumor of exocrine origin. A young woman presenting with a painful abdominal mass was operated on for a tumor of the head of the pancreas. Gross and microscopic examination revealed a papillary cystic tumor of the pancreas.

[The register of stillbirths in Bouches-du-Rhône: evaluation after 3 years in operation].

A register of stillbirths from the Bouches-du-Rhône area in France was settled in 1982 with the double goal to provide epidemiological data on mortinatality and to help organizing a network of post-mortem examination. The results on 409 stillbirths out of 21.292 consecutive births are presented.

[Factor X deficiency and systemic amylosis].

The case of a 52-year-old patient with systemic amylosis diagnosed upon examination of an osteomedullary biopsy specimen is reported. The most prominent clinical manifestation was a major hemorrhagic syndrome which was recognized as being a result of severe factor Stuart deficiency. The new classification of amyloses based on the latest biochemical and immunological findings is recalled.

[Characteristic ultrastructural features of parathyroid gland cancer. A report on 9 cases (author's transl)].

Authors have studied 9 parathyroid carcinomas under electron microscope (3% of their parathyroid lesions). Two types of the ultrastructural features were significant: 1) architectural: basal membrane abnormalities, sparse desmosomes, absence of nerve fiber; 2) cytological: nuclei atypism and abnormal mitochondria in tumors cells resembling dark chief cells. Also noticed were signs of cell hyperactivity and/or trouble in parathormon production or regulation.

[An unusual case of uterine leiomyoma: exophylic grapelike development in the pelvic peritoneum (author's transl)].

A 34 years old woman had a hysterectomy for persistent menorrhagias. The uterine vault was covered by an exophytic grape-like tumor measuring 10 cm in length, formed by little red nodules with focal adjacent lesions. This tumor is cytologically benign and of leiomyomatous nature on the ultrastructural study.