Tip of the iceberg: extracardiac CT findings in infective endocarditis.

Infective endocarditis (IE) is a disease with high morbidity and mortality rate, but diagnosis is confounded by diverse clinical presentations, which mimic other pathologies. A history of illicit intravenous drug use, previous cardiac valve surgery, and indwelling intracardiac devices increases the risk for developing infective endocarditis. The modified Duke criteria serve as the standard diagnostic tool, though its accuracy is reduced in certain cases. Radiologists in the Emergency Room setting reading body CT may be the first to identify the secondary extra-cardiac complications and facilitate expeditious management by considering otherwise unsuspected infective endocarditis. This review highlights common extracardiac complications of IE and their corresponding CT findings in the chest, abdomen, pelvis, and brain. If IE is suspected radiologists should suggest further investigation with echocardiography.

Prevalence of hyperprolactinemia in anovulatory women.

To determine the prevalence of hyperprolactinemia in an ovulatory patients presenting to a general gynecology clinic, a 1-year prospective study (1978) was instituted. A total of 119 patients with at least 3 months of anovulation were screened with serum prolactin determinations. Those patients demonstrating hyperprolactinemia were further evaluated with a serum TSH level and hypocycloidal polytomography of the pituitary sella. In patients with anovulation with or without galactorrhea, a hyperprolactinemia prevalence rate of 15% was established. Anovulatory patients with galactorrhea had a hyperprolactinemia prevalence rate of 43%. This was compared to the 9% prevalence of hyperprolactinemia in patients with nongalactorrheic anovulation (P less than .001). Twenty-two percent of the patients with nongalactorrheic anovulation (2 of 9) were found to have a prolactin-secreting pituitary adenoma. In patients with hyperprolactinemia, galactorrhea, and anovulation, 67% (6 of 9) of patients had a prolactin-secreting pituitary adenoma. The authors therefore conclude that the 15% prevalence rate of hyperprolactinemia in all anovulatory women is sufficiently high to warrant continued screening of serum prolactin determinations in all anovulatory women.

For those who wait.... Care of the status 1 patient awaiting cardiac transplantation.

In conclusion, successfully bridging a Status 1 patient to the time of heart transplant requires a variety of skills. Vigilance is key in averting potential complications and addressing patient issues. Also, health care professionals will be called on to use their knowledge and expertise to deal with psychosocial and medical matters. When skillfully executed, the result of a successful transplant is an improved quality of life and a longer life. A successful transplant reflects a job well done by the professionals and is the ultimate goals for all of those who care for those who wait.