Sudden cardiac arrest due to subtotal absence of left-sided pericardium--case report and review of the literature.

Congenital absence of the pericardium is a very rare cardiac malformation, usually diagnosed fortuitously on autopsy or surgery. Symptoms related to these abnormalities are usually benign, and fatalities reported in the literature are almost exclusively secondary to herniation of the heart through a partial defect. We present the unusual case of a 44-year-old woman admitted for sudden cardiac arrest. Initial evaluation suggested acute anterior myocardial infarction, but further investigation ruled out coronary heart disease. No arrhythmia could be initiated on electrophysiological study, and absence of most of the left pericardium was confirmed by cardiac magnetic resonance imaging. After the exclusion of common etiologies such as idiopathic ventricular fibrillation, transient great vessel torsion due to hypermobility of the heart with secondary malignant arrhythmia was considered to be the most likely mechanism for the sudden cardiac arrest. A review of the available literature on clinical presentation, diagnostic tools, and therapeutic options is also presented.

Effects of sildenafil citrate on torsion/detorsion-induced changes in red blood cell and plasma lipid peroxidation, antioxidants, and blood hematology of male rats.

OBJECTIVE: The aim of this work was to determine effects of intrapertoneally-administered sildenafil citrate (SC) for prevention testicular injury after unilateral testicular torsion/detorsion (T/D) in rats on red blood cell (RBC) and plasma lipid peroxidation, antioxidants and blood hematology. STUDY DESIGN: Thirty seven adult male Wistar albino rats were divided into four groups: sham operated (group 1), T/D+saline (group 2), T/D+0.7mg SC (group 3) and T/D+1.4mg SC (group 4). Testicular torsion was created by rotating the right testis 720° in a clockwise direction for 2h in all the groups, except for group 1. RESULTS: Our results showed that that testicular injury significantly induced erythrocyte reduced glutathion (GSH) (p<0.05), malondialdehyde (MDA) in RBC (p<0.01) and plasma (p<0.05) and blood lymphocyte (p<0.01) counts. Administration of low dose SC led to significantly increase in the levels of RBC GSH (p<0.05), plasma paraoxonase (PON1) (p<0.01), nitric oxide (NO) (p<0.01) and blood lymphocyte counts (p<0.01), but to decreases in the levels of MDA in plasma and RBC, blood mean corpuscular volume (MCV) (p<0.05) and eosinophil counts (p<0.05). Treatment with high dose SC caused a significantly increase in PON1, vitamin E and ß-carotene in plasma, levels of GSH in RBC and blood lymphocyte counts. On the other hand, results showed that high dose sildenafil significantly decreased plasma and RBC MDA levels. Total tissue damage scores of the group 2 were significantly higher than group 1 and 3. CONCLUSION: Low dose SC appears to be beneficial in reducing the effects of injury to the testicular torsion.

[Ocular tilt reaction in thalamic infarct]. / Reacción ocular de inclinación en infarto talámico.

Ocular tilt reaction (OTR) includes skew deviation, eye torsion and head tilt. It is usually accompanied by a tilt in the subjective visual vertical. OTR seems to reflect an otolithic dysfunction. This case report shows an OTR of central origin as a result of simultaneous paramedial thalamic and mesencephalon rostral infarcts.

Dietary xylitol supplementation prevents osteoporotic changes in streptozotocin-diabetic rats.

The effects of 10% and 20% dietary xylitol supplementation on the biomechanical properties, trabeculation, and mineral content of long bones were studied in streptozotocin-diabetic rats. Forty 3-month-old male Wistar rats were divided randomly into four groups of 10. Rats in three groups were administered a single injection of streptozotocin (50 mg/kg body weight) to induce type I diabetes, while animals in the fourth group were given a sham injection of physiological saline. The sham-injected group and one of the streptozotocin-diabetic groups were fed the basal diet, while the two diabetic groups were fed the same diet supplemented with 10% and 20% xylitol (wt/wt). After 3 months, the rats were killed and the long bones were prepared for analysis. The 10% and 20% dietary xylitol supplementation significantly prevented the type I diabetes-induced decrease in the mechanical stress resistance of the tibia in the three-point bending test, the shear stress of the femur in the torsion test, and the stress resistance of the femoral neck in the loading test. No statistically significant differences were found between any groups in the values for strain or Young's modulus in the three-point bending test, or in the values for the shear modulus of elasticity in the torsion test. These findings indicate that dietary xylitol protects against the weakening of the bone strength properties of both cortical and trabecular bone without affecting the elastic-plastic properties. Supplementation with 10% and 20% dietary xylitol significantly prevented the type I diabetes-induced decrease of humeral ash weight and tibial density. Histomorphometric data for the secondary spongiosa of the proximal tibia showed that 10% and 20% dietary xylitol supplementation also significantly prevented the type I diabetes-induced loss of trabecular bone volume. In conclusion, dietary xylitol supplementation protects against the weakening of bone biomechanical properties in streptozotocin-diabetic rats. This is related to the preserved bone mineral content and preserved trabecular bone volume.