Direct left ventricular endocardial pacing: an alternative when traditional resynchronization via coronary sinus is not feasible or effective.

Background: Biventricular pacing through the coronary sinus (CS) is effective for the treatment of patients with heart failure and left bundle-branch block. However, this approach is not always feasible. Although surgical epicardial lead implantation is an alternative, the technique may be deleterious in some patients.

High-risk diabetic patients with unprotected left main coronary artery disease: characteristics and medium-term outcomes of percutaneous revascularization with drug-eluting stents.

Percutaneous coronary intervention with drug-eluting stents is an alternative for patients with high-risk unprotected left main coronary artery disease; those with diabetes mellitus are at even higher risk. Recent advances in percutaneous coronary intervention could lead to better results. The aim of this study was to evaluate medium-term results in a real-world sample of high-risk diabetic patients undergoing percutaneous coronary intervention with drug-eluting stents for unprotected left main coronary artery disease.

The efficacy of romiplostim in the treatment of severe thrombocytopenia associated to Evans syndrome refractory to rituximab.

We present a case of a man diagnosed with systemic lupus erythematosus, associated antiphospholipid syndrome and Evans syndrome, who developed a severe thrombocytopenia refractory to treatment with first-line drugs, cyclophosphamide and rituximab, and who responded to romiplostim with a normalization of the platelet recount, which later enabled a therapeutic splenectomy to be performed.

Transradial occlusion of a large intercostal branch of a left internal mammary artery graft with the novel amplatzer vascular plug 4 using a 4 French diagnostic catheter: treatment of coronary steal phenomenon.

Sidebranches of the left internal mammary artery that are not ligated at the time of coronary artery bypass surgery can cause coronary steal syndrome, resulting in angina. Several isolated case reports have demonstrated successful resolution of this steal syndrome after transcatheter embolization of these branches. Here, we describe successful occlusion of such a sidebranch using an Amplatzer vascular plug via the transradial route with a 4 Fr Judkins Right coronary artery diagnostic catheter.

Permanent His-bundle pacing: seeking physiological ventricular pacing.

Aims: Right ventricular apical pacing can have deleterious effects and the His bundle has been widely reported to be an alternative site. This paper presents our experience with permanent His-bundle pacing (HBP).

Methods And Results: Patients referred for pacemaker implants (regardless of block type) were screened to determine if temporary HBP corrected conduction dysfunctions (threshold < or =2.

Transanal rectocele repair using linear stapler and bioabsorbable staple line reinforcement material: short-term results of a prospective study.

Purpose: This study was designed to determine the short-term results of transanal rectocele repair with use of a linear stapler and Bioabsorbable Seamguard.

Methods: Ten women (median age, 56.1 y) with obstructed defecation syndrome were enrolled in the study.

Endosonography of the anal canal: findings in children.

Purpose: The aim of this study was to determine the endosonographic anatomy in children to define normal age-related differences in sphincter morphology and measurements.

Methods: One hundred ten consecutive children (76 males and 34 females; mean age, 3.94 years; range, 1.

Expression of P-glycoprotein and metallothionein in gastrointestinal stromal tumor and leiomyosarcomas. Clinical implications.

We investigated the expression of P-glycoprotein (P-GP) and metallothionein (MT) in a series of 92 GIST and 14 gastrointestinal leiomyosarcomas (GILMS) with the purpose to expand our knowledge on the biological bases of GIST chemo-resistance and to ascertain their significance in patients' prognosis. P-GP expression was more frequent in GIST than in GI-LMS (83.7% vs.

Yellow fever vaccine-associated viscerotropic disease and death in Spain.

Yellow fever vaccine-associated viscerotropic disease (YEL-AVD) is a recently described severe adverse event after yellow fever vaccination, and some cases have been reported in different countries [Anonymous. Effects of yellow fever and vaccination. Lancet 2001;358(9296):1907-9].

Cardiac resynchronization through selective His bundle pacing in a patient with the so-called InfraHis atrioventricular block.

We present a case of infraHis AV block in which selective His bundle pacing with His-ventricular conduction through the conduction system was accomplished. While further investigations are developed, this approach may be an alternative for cardiac resynchronization in cases of difficult coronary sinus access.

Tamponade as the clinical onset of a cardiac angiosarcoma.

Primary tumors of the heart are usually benign, with the malignant forms being rare. In this article we report the case of an angiosarcoma with the only manifestation being a cardiac tamponade. When the patient being admitted to the hospital, an important differential diagnosis was pulmonary tumor.