Posterior Reversible Leukoencephalopathy Syndrome During Hypertensive Crisis in Obstructive Sleep Apnea Syndrome: Searching for a Link.

Posterior reversible encephalopathy syndrome (PRES) may present with different clinical symptoms including visual disturbance, headache, seizures and impaired consciousness. Brain MRI shows oedema, usually involving the posterior subcortical regions. Triggering factors include hypertension and obstructive sleep apnea syndrome.

The role of sacubitril/valsartan in the treatment of chronic heart failure with reduced ejection fraction in hypertensive patients with comorbidities: From clinical trials to real-world settings.

Background: Sacubitril/valsartan, the first agent to be approved in a new class of drugs called angiotensin receptor neprilysin inhibitors (ARNIs), has been shown to reduce cardiovascular mortality and morbidity compared to enalapril in outpatient subjects with chronic heart failure (HF) and reduced left ventricular ejection fraction (HFrEF). However, there is little real-world evidence about the efficacy of ARNIs in elderly hypertensive patients with HFrEF and comorbidities.

Methods: In this prospective open-label study, 108 subjects, 54 of them (mean age 78.

Effectiveness and Safety of Novel Nutraceutical Formulation Added to Ezetimibe in Statin-Intolerant Hypercholesterolemic Subjects with Moderate-to-High Cardiovascular Risk.

The effectiveness of statins in the primary and secondary prevention of cardiovascular (CV) diseases has been widely proven. However, the onset of adverse events associated with their use prevents to achieve the therapeutic targets recommended by the guidelines (GL) for the management of dyslipidemia. In the event of statin intolerance, the GL recommend to use bile acid sequestrants, fibrates, and ezetimibe in monotherapy, but their benefits in improving lipid pattern are quite modest.

Long-term effect of the perindopril/indapamide/amlodipine single-pill combination on left ventricular hypertrophy in outpatient hypertensive subjects.

Background: Most antihypertensive drugs used in monotherapy or in combination therapy reduce the left ventricular mass index (LVMI). However, little is known about the effects on LVMI of a triple fixed-dose combination (TFC) therapy, containing in a single pill an angiotensin-converting enzyme inhibitor (ACEI), a diuretic and a calcium channel blocker (CCB).

Methods: In this prospective open-label study, 92 patients with essential hypertension were randomized to treatment with a TFC of perindopril/indapamide/amlodipine at different doses or a triple free combination therapy (FCT) including ACEI/diuretic/CCB.

Vitamin D and Male Sexual Function: A Transversal and Longitudinal Study.

Background: The effects of vitamin D on sexual function are very unclear. Therefore, we aimed at evaluating the possible association between vitamin D and sexual function and at assessing the influence of vitamin D administration on sexual function.

Methods: We retrospectively studied 114 men by evaluating clinical, biochemical, and sexual parameters.

Mood Disorders in Uncontrolled Hypertension Despite Multiple Anti-Hypertensive Medications: Searching for a Link.

Introduction: Resistant hypertension is a clinical condition in which blood pressure (BP) control is not achieved under a pharmacological therapy including a diuretic and at least two additional antihypertensive drug classes.

Aim: To discuss an unusual presentation of uncontrolled hypertension despite multiple anti-hypertensive medications.

Methods And Results: A 46-year-old woman presented with resistant hypertension (HT) and with a long history of polydipsia, polyuria, weight loss and psychiatric symptoms (sudden onset of personality disorder with free anxiety, negativism and asthenia) unsuccessfully treated with antidepressant drugs.

Selected case from the Arkadi M. Rywlin International Pathology Slide Series: Leiomyomatosis peritonealis disseminata: report of 3 cases with extensive review of the literature.

We present the clinicopathologic features of 3 cases of leiomyomatosis peritonealis disseminata (LPD). The patients were 33, 34, and 41 years old at the time of diagnoses. The 3 women had undergone laparoscopic removal of multiple uterine leiomyomas between 1 and 6 years before the diagnoses of LPD.

Intrathoracic rhabdoid carcinoma: a clinicopathological, immunohistochemical, and ultrastructural study of 6 cases.

We evaluated the clinicopathological spectrum of intrathoracic rhabdoid carcinoma, including its immunophenotype and ultrastructural features. Our series included 6 cases arising from the lung (4 cases) and the anterior mediastinum (2 cases). The patients were 4 men and 1 woman aged between 40 and 63 years (median, 53 years).

Epidemiology and clinical features of sleep disorders in extrapyramidal disease.

Sleep disturbances are common in extrapyramidal diseases, including not only insomnia but excessive daytime sleepiness and parasomnias. In particular, complaints related to sleep are extremely common among patients affected by Parkinson's disease (PD). The underlying causes may include: patient age, associated illnesses, cognitive impairment, motor dysfunction caused by disease, neurochemical changes related to the disease, drugs, and secondary psychological responses to the disease.

Sixteen-year results of composite aortic root replacement for non-dissecting chronic aortic aneurysms.

Background: The aim of this study was to evaluate the early and long-term outcomes in patients undergoing a Bentall procedure or its button modification for chronic aortic aneurysms with aortic valve incompetence.

Methods: Between January 1986 and January 2002, 65 patients (84% males, mean age 58.9 +/- 11 years) underwent aortic root replacement with a Bentall or a button-Bentall operation.

Successful repair of a coronary artery to pulmonary artery fistula with saccular artery aneurysm and critical stenosis of the left anterior descending coronary artery.

We report an infrequent case of an adult patient with a coronary artery to pulmonary artery fistula associated with a coronary artery aneurysm, a critical stenosis of the left anterior descending coronary artery (LAD) and a LAD dissection located distally to the stenosis. The fistula was successfully closed with direct sutures by opening the aneurysm under complete cardiopulmonary bypass. The excess aneurysm wall was excised and aneurysmorrhaphy was performed.

Analysis of cystic intracranial lesions performed with fluid-attenuated inversion recovery MR imaging.

Background And Purpose: T1-, T2-, and proton density (PD)-weighted sequences are used to characterize the content of cystic intracranial lesions. Fluid-attenuated inversion recovery (FLAIR) MR sequences produce T2-weighted images with water signal saturation. Therefore, we attempted to verify whether FLAIR, as compared with conventional techniques, improves the distinction between intracranial cysts with a free water-like content versus those filled with a non-free water-like substance and, consequently, aids in the identification of these lesions as either neoplastic/inflammatory or maldevelopmental/porencephalic.