Candida albicans osteomyelitis as a cause of chest pain and visual loss.

Candida albicans osteomyelitis is a rare disease that occurs in immunocompromised individuals, sometimes with a late diagnosis related to the mismatch between symptoms and candidemia. This case refers to a 36-year-old male patient with a history of oesophageal surgery for achalasia with multiple subsequent surgeries and hospitalisation in the intensive care unit for oesophageal fistula complication. Four months after discharge, the patient was admitted to the infectious diseases department with pain in the 10th-12th left ribs, swelling of the 4th-6th costal cartilage and decreased visual acuity.

Mind the gap: Management of an emergent and threatening invasive fungal infection-a case report of rhino-orbital-cerebral and pulmonary mucormycosis.

Mucormycosis is an emergent and threatening invasive fungal invasion underdiagnosed by clinicians due to lack of awareness and aspecific clinical picture. The authors describe a clinical case of a diabetic and cirrhotic patient who developed rhino-orbital-cerebral and pulmonary mucormycosis, non-responsive to treatment. Typical gaps in the management of this deadly disease are addressed.

The role of echocardiography in thromboembolic risk assessment of patients with nonvalvular atrial fibrillation.

Echocardiography is a widely used and versatile technique that can provide comprehensive information concerning thromboembolic risk in patients with atrial fibrillation. The authors review the potential contributions of echocardiography to thromboembolic risk stratification and to decreasing the thromboembolic risk associated with procedures such as cardioversion and ablation. Unsolved questions and new possibilities that have arisen from the development of strain and strain rate imaging are also discussed.

Mean corpuscular volume and red cell distribution width as predictors of left atrial stasis in patients with non-valvular atrial fibrillation.

Background: The role of erythrocyte indexes for the prediction of left atrial stasis, assessed by transesophageal echocardiography in patients with non-valvular atrial fibrillation, has not been previously clarified.

Methods: Single center cross-sectional study comprising 247 consecutive patients admitted to the emergency department due to symptomatic atrial fibrillation and undergoing transesophageal echocardiogram evaluation for exclusion of left atrial appendage thrombus (LAAT) before cardioversion. All patients had a complete blood count performed up to 12 hours prior to the transesophageal echocardiogram.

Nesidioblastosis: an undescribed cause of transient loss of conscience in young adults.

A young woman with recurrent episodes of traumatic transient loss of consciousness was found to have severe hypoglycaemia during episodes after negative investigation for common causes. She was diagnosed nesidioblastosis and total pancreatectomy was performed leading to symptom resolution.

Decreased glomerular filtration rate and markers of left atrial stasis in patients with nonvalvular atrial fibrillation.

Background: It is currently unknown if the increased risk of stroke in subjects with chronic kidney disease and atrial fibrillation (AF) is due to the presence of left atrial stasis or to any other vascular or systemic conditions.

Methods: This was a retrospective study of 372 subjects undergoing evaluation during an AF episode. The following markers of left atrial stasis were sought on transesophageal echocardiogram: left atrial or left atrial appendage thrombus (LAAT), dense spontaneous echocardiographic contrast (DSEC), and low flow velocities (LFV) in the left atrial appendage.

Cardiovascular risk assessment of pulmonary embolism with the GRACE risk score.

Despite the existence of several risk scores, the accurate prediction of the prognosis in pulmonary embolism (PE) remains a challenge. The Global Registry of Acute Coronary Events (GRACE) risk score has a high diagnostic performance for adverse outcomes in acute coronary syndrome. We aimed to assess the applicability and extend the use of the GRACE risk score to PE.

The Role of Echocardiography as a Predictor of the Incidence and Progression of Atrial Fibrillation.

Atrial fibrillation is the most frequent sustained arrhythmia and is an independent risk factor for stroke and death. In recent years, major echocardiographic advances have been made with the development of new techniques and applications that can be extremely useful for the management of these patients. This paper describes the role of echocardiography as a predictor of the incidence and progression of atrial fibrillation.

Perforation of the right ventricle during cardiac resynchronisation therapy upgrade not related to a coexisting persistent left superior vena cava.

Right ventricle (RV) perforation is a complication that may arise during device implants. We present the case of a patient undergoing cardiac resynchronisation therapy upgrade that was complicated with an RV perforation. The lead was successfully repositioned with a good final outcome.

Emerging and under-recognized Chagas cardiomyopathy in non-endemic countries.

Due to recent population emigration movements, an epidemic of Chagas disease is currently menacing most developed countries. The authors report the case of a 53-year-old Brazilian woman living in Europe for the last 10 years who developed heart failure symptoms, having a previous symptomatic sinus node disease with a pacemaker implant at age of 40 years. The diagnosis was based on serology and myocardial biopsy and the patient was treated with nifurtimox.

Risk stratification of patients with atrial fibrillation: Biomarkers and other future perspectives.

Risk stratification of atrial fibrillation (AF) and adequate thromboembolism prophylaxis is the cornerstone of treatment in patients with AF. Current risk stratification schemes such as the CHADS(2) and CHA(2)DS(2)-VASc scores are based on clinical risk factors and suboptimally weight the risk/benefit of anticoagulation. Recently, the potential of biomarkers (troponin and NT-proBNP) in the RE-LY biomarker sub-analysis has been demonstrated.

Cardiac troponin I: prothrombotic risk marker in non-valvular atrial fibrillation.

Background: Evidence of a link between small rises in cardiac troponin I (cTnI) and an increased risk of thromboembolic events (TE) in atrial fibrillation (AF) is currently scarce.

Objectives: We aimed to assess the relation between cTnI and findings of an increased thromboembolic risk in patients with non-valvular AF using transesophageal echocardiography.

Methods: We have included 245 patients performing transthoracic and transesophageal echocardiogram, alongside with laboratory assessment (including cTnI) in a cross-sectional survey.