Valvular heart disease and 3-dimensional echocardiography: ready for prime-time?

Significant advances in 3-dimensional echocardiography (3DE) technology have ushered its use into clinical practice. The recent advent of real-time 3DE using matrix array transthoracic and transesophageal transducers has resulted in improved image spatial resolution, and therefore, enhanced visualization of the patho-morphological features of the cardiac valves. Three-dimensional echocardiography provides unique perspectives of valvular structures by presenting "en face" views of valvular structures, allowing for a better understanding of the topographical aspects of pathology, and a refined definition of the spatial relationships of intracardiac structures.

Rosuvastatin slows the development of diastolic dysfunction in calcific aortic stenosis.

Background And Aim Of The Study: The study aims were to test the effect of rosuvastatin on the progression of left ventricular (LV) diastolic function in patients with aortic stenosis (AS), and to evaluate the use of beta-natriuretic-peptide (BNP) as a marker of diastolic dysfunction in this condition.

Methods: Sixty-one hypercholesterolemic, consecutive new referrals with moderate AS were administered rosuvastatin (Crestor) 20 mg/day for 18 months, while a further 60 subjects with normal cholesterol levels remained untreated. The LV diastolic function was determined using conventional Doppler echocardiography, tissue Doppler imaging (TDI); BNP plasma levels were monitored when subjects entered the study and then assessed prospectively at six-month intervals until the study end.

Valvular lesions in patients with systemic lupus erythematosus and antiphospholipid syndrome: an old disease but a persistent challenge.

Valvular heart disease is common in systemic lupus erythematosus (SLE) and antiphospholipid syndrome. Immunologic insult plays a fundamental role in its pathogenesis but data on the role of antiphospholipid antibodies have been inconsistent, particularly regarding SLE-associated valvular lesions. Although timely diagnosis is essential to prevent progression of valvular lesions, treatment remains a challenge because of the lack of large systematic studies.

New cardiovascular biomarkers: clinical implications in patients with valvular heart disease.

Valvular heart disease (VHD) is characterized by an ongoing, inflammatory cellular response which results in a left ventricular hemodynamic stress change in response to valvulopathy. The current inflammatory hypothesis suggests that as the heart valve disease progresses the inflammatory cytokine response is activated causing continuation of deleterious effects on the heart and vasculature. This can lead to progression of heart failure and left ventricular dysfunction.

Prevalence, awareness, treatment and control of hypertension in Portugal: the PAP study.

Background: The objective of this study was to estimate the prevalence and distribution of hypertension and to determine the status of hypertension awareness, treatment and control in the Portuguese adult population.

Methods: This study was conducted in 2003, and a multistage cluster sampling method was used to select a national representative sample. A total of 5023 adults, age 18-90 years, were examined.

Endosonographic characteristics of perigastrointestinal lymphnodes studied ex-corpore.

Objectives: Assessment of morphological characteristics of lymphnodes studied ex-corpore by echoendoscopy--shape, sharpness of limits, echogenicity and dimensions--to categorize them either as metastatic or non-metastatic.

Material And Methods: Fifty-four lymphnodes were studied. They were identified and studied by echoendoscopy in fresh surgical specimens of oesophagus, stomach and rectum.

Ethical dimension of paediatric cochlear implantation.

In congenitally or prelingually deaf children cochlear implantation is open to serious ethical challenge. The ethical dimension of this technology is closely related to both a social standard of quality of life and to the uncertainty of the overall results of cochlear implantation. Uncertainty with regards the acquisition of oral communicative skills.

Is the lack of concurrence of bacterial vaginosis and vaginal candidosis explained by the presence of bacterial amines?

Objective And Study Design: We report for the first time an inhibitory effect on cell division and germ tube formation by Candida albicans and strains of other Candida species by putrescine and cadaverine.

Results: Both bacterial amines showed a dose-dependent inhibition of germ tube formation by C albicans, as well as budding (inhibition of cell division) of strains of other Candida species (ie, C glabrata, C krusei, and C tropicalis).

Conclusions: We hypothesize that the presence of these and possibly other bacterial amines produced by anaerobes in the vaginal flora and seen in bacterial vaginosis, as in the healthy gut, may explain why candidosis is rarely seen in these instances.

Prevalence of high blood pressure in children and adolescents. Influence of obesity.

Obesity is associated with high blood pressure BP, mainly in adults. It has been suggested that body fat patterning plays a role in the etiology of hypertension. This relationship also exists in children, however it is less well known.

Morphometric study of the frontal cortex in subacute sclerosing panencephalitis.

In biopsic material collected from the frontal cortex of 6 patients with subacute sclerosing panencephalitis (SSPE) and 5 patients with posterior fossa tumors, we estimated the neuronal and synaptic numerical densities as well as the mean volume of the neurons from layers II and III. The thickness of these layers was also determined. The evaluation of the layer's thickness suggested that there was no difference in the shrinkage in SSPE as compared to controls.

Adult pancreatic tissue fate after pancreatic fragment autotransplantation into the spleen of the pancreatectomized dog.

As far as we know, after adult enzyme-digested pancreatic fragment autotransplantation, the fate of the inoculated pancreatic tissue has never been reported and the hypothetic engrafted islet mass growth by mitotic division or by a true islet neogenesis from ductular precursor cells has never been demonstrated. In dogs with total or near-total (90%) pancreatectomy that preserves the duodenum and the common bile duct, morphologic study of the pancreatic tissue inoculated into the spleen has demonstrated an exuberant ductular-acinar-islet regenerative process, with progressive cystic degeneration of the newly formed ductular-acinar structures occurring simultaneously with the selective survival and growing predominance of extraductal tissue scattered as distinct islets, clusters of islet cells, or single islet cells. In addition to the B, A2, and D cell types of the normal adult dog islet, we have also seen a peculiar ultrastructural pleomorphism of the insular B cells, frequently combined with their ductular or glandular arrangement in maturing islets.

Ultrastructural characterization of a regular schwann-axon-islet complex after the autograft of pancreatic fragments into the spleen of the adult dog.

After autotransplantation of pancreatic fragments into the dog's spleen, the morphogenesis of the reinnervating process has evolved as an highly differentiated model, reproducing the most peculiar and systematic relationships between schwann cells, axons, and islet cells reported in the dog's islet, despite it's modulation by the restrictive conditions derived from the intrasplenic location of the dispersed pancreatic tissue. The reinnervating process is described, emphasizing the peculiar ultrastructural features and topography of the schwann cells and of the axonal network that impose the concept of a true anatomical reinnervation, which make previsible the possibility of a very selective and direct neurochemical and/or electrotonic control of the engrafted islet cells. The schwann-axon-islet complexes are a very peculiar and regular arrangement between islet cells and nervous elements and are reproduced after the autotransplant without the engrafted ganglia, whose potential but aleatory contribution could not be unequivocally characterized.

Renal adenoma: identification of two histologic types.

In this paper the morphologic characteristics of renal adenoma are studied in 4 groups of kidneys from 500 unselected autopsies performed for legal reasons, 5,000 autopsies from the files of a general hospital, 16 kidneys with adenoma and without carcinoma, and 200 kidneys with carcinoma. All the tumors were classified by pattern, cytology and sclerosis of the renal nontumoral stroma. The relationship between tumor size, tumor histological type and sclerosis was evaluated by statistical analysis.

Left ventricular function after total correction of tetralogy of Fallot.

Conflicting data are available concerning left ventricular (LV) function in patients after total correction of tetralogy of Fallot (TOF). The response to afterload stress determined by methoxamine challenge and the peak systolic blood pressure-end-systolic volume relationship were evaluated echocardiographically in 20 postoperative TOF patients (age range 9 to 15 years, mean 12 +/- 2). All patients were without significant residual shunts or pulmonary stenosis.

The influence of the geometry of the dialyzer and the composition of the dialysate in activating the complement system.

During hemodialysis there is a complex interaction between the patient and the extracorporeal circuit that activates the complement system, among others. To better understand the influence of the dialyzer geometry and the dialysate composition, we compared hollow fiber versus parallel plate dialyzers and acetate versus bicarbonate dialysates and their role in the production of C3a, C4a and C5a. There was no significant difference in the plasmatic levels of these anaphylotoxins and their des-Arg derivates, as measured by RIA, in either dialyzer.

Long-term alcohol consumption reduces the number of neuronal nuclear pores. A morphometric study undertaken in CA3 hippocampal pyramids of rats.

A close relationship between the number of nuclear pores and the cellular protein synthesis activity is known to exist. Previous biochemical investigations lead to admit that the widespread neuronal alcohol-induced degenerative changes could depend on a decrease in the neuronal protein synthesis. The morphometric analysis made on the nuclear pore complexes of CA3 hippocampal pyramids of long-term alcohol-fed rats fully supports this attractive hypothesis, since it has been found a marked reduction in the number of pores per unit surface area of nuclear membrane, together with a reduction in their total number per nucleus.

Skeleton, blood vessels and viscera: overlooked targets in fetuses of small species during the external examination for teratogenicity assessment.

Due to the translucency of the skin and underlying soft tissues, the external examination of near-term mouse fetuses can be extended to parts of the skeletal, visceral and vascular systems which are not taken into account in the protocols of teratogenicity tests. The importance of such visualization for improving the accuracy of such tests is discussed.