Ultrasound-based quantitative tools in predicting renal involvement in asymptomatic primary hyperparathyroidism.

PURPOSE: Asymptomatic primary hyperparathyroidism (aPHPT) has been recognized as a condition that can lead to renal complications. Timely identification of prognostic indicators for renal impairment holds the potential to facilitate proactive monitoring and treatment strategies in these patients. This study aims to investigate the utility of acoustic radiation force impulse (ARFI) imaging and renal resistive index (RRI), in identifying renal parenchymal and vascular changes in patients with aPHPT. METHODS: Forty-two patients with aPHPT and 42 controls matched for age, sex, and body mass index were included in the study. The presence of renovascular changes was evaluated by RRI measurement with Doppler ultrasonography, and the presence of renal parenchymal involvement was evaluated by ARFI quantification, given as shear wave velocity (SWV). RESULTS: In aPHPT patients, both the mean RRI and mean SWV values exhibited substantial elevation compared to the control group (P < 0.001 for both). Significant associations were observed between SWV values and serum calcium, parathyroid hormone (PTH), and adenoma size within the patient group (P < 0.001, P < 0.001, P = 0.016, respectively). Similarly, the mean RRI demonstrated positive correlations with serum calcium and PTH levels in the patient group (P< 0.001, P = 0.011, respectively). Multivariate linear regression analysis underscored the connection between mean RRI and mean SWV values with serum calcium levels within the patient group. In addition, serum PTH levels affected mean SWV positively and significantly. CONCLUSION: The use of ARFI imaging and RRI measurements appears to hold potential in identifying renal involvement in patients with aPHPT.

Lycopene has a protective effect on septic shock­induced cardiac injury in rats.

OBJECTIVE: The aim of the present study is to investigate the cardioprotective effect of lycopene, known for its antioxidant and anti-inflammatory effect, in a rat sepsis model induced by lypopolysaccharide (LPS). METHODS: The oxidative stress parameters, antioxidant parameters and cytokine levels with or without lycopene treatment in LPS­induced septic rats as well as in controls were measured in serum and tissue. Histologic examinations of the cardiac tissues were also performed. The Kruskal-Wallis and the Bonferroni-adjusted Mann-Whitney U Test was used for analysis. A p value < 0.05 was considered significant. RESULTS: The data of this study showed that lycopene pretreatment reduced the oxidative stres parametersand , proinflammatory cytokines as well as increased the antoxidant enzyme activities in both serum and cardiac tissues in LPS­induced septic rats.. Moreover, hyperaemia and haemorrhage in the epicardium, myocardium and endocardium were lower in the lycopene pretreated group as compared to the LPS alone group. CONCLUSION: These results suggest that lycopene could be beneficial for the prevention of cardiac injury caused by sepsis through reducing the cytokine levels and oxidative stress parameters (Tab. 4, Fig. 1, Ref. 35).

Coronary rupture and pseudoaneurysm formation after extravascular migration of a paclitaxel eluting stent implanted in the left circumflex coronary artery.

As the implantation of drug eluting stents (DES) has become one of the most common clinical practices in interventional cardiology, the complications secondary to this procedure appear to have emerged increasingly over the past decade, with many cases of development of new coronary artery true aneurysms after DES implantation being reported. Here we present a case of coil embolization of a coronary pseudoaneurysm which presumably formed after extravascular migration of a DES.

Effect of sequential coronary artery bypass venous grafting on right ventricular functions assessed by tissue Doppler echocardiography.

BACKGROUND: Coronary artery bypass graft surgery is a well-known and proven method of treatment for coronary artery disease. A modification of this method is complete revascularisation of the right ventricle by sequential bypass grafting of the right coronary artery, the effects of which on ventricular function need to be clarified. We sought to determine the effect of the sequential bypass graft method on right ventricular (RV) function utilising tissue Doppler echocardiography. METHODS: A total of 35 coronary artery disease patients (group A: 20 sequential grafts; group B: 15 individual grafts) were enrolled. Patients were examined pre-operatively with tissue Doppler echocardiography for RV function, and again postoperatively after the first month. RESULTS: Pre-operatively, there were no significant differences with regard to demographics or basal echocardiographic findings. On the other hand, postoperative right ventricular diastolic function was found to have improved significantly as the right ventricular E wave and E/A increased (9.5 ± 1.6 vs 7.6 ± 2.7 cm/s, p = 0.009 and 1.4 ± 0.2 vs 0.9 ± 0.2, p ≤ 0.01, respectively), while the A wave and isovolumic relaxation times (6.8 ± 2.1 vs 8.3 ± 3.4 cm/s, p < 0.03 and 55.2 ± 11.9 vs 87.2 ± 16.2 ms, p < 0.001, respectively) decreased. Although the S-wave peak amplitude decreased in group A patients, it did not reach statistical significance. CONCLUSIONS: Sequential, but not single, complete revascularisation of the right coronary artery appeared to improve the diastolic function of the right ventricle.