ABSTRACT
Rise of medical oncology, aging of populations and survival rates' improvement of patients suffering from cancer are all factors contributing to exponential rise of the exposure of patients to -cardiotoxic therapies. A multidisciplinary approach including a close cooperation between general practitioner and specialists will -promote an early identification and treatment of cardiovascular complications related to cancer treatments. This strategy has proven to have a truly positive impact on both cardiovascular and onco-logic prognosis. We will summarize throughout this article the last recommendations established by the European Society of Cardiology in terms of cardiovascular risk stratification and follow up planning through the use of clinical, biological and cardiac imaging data.
L'essor de l'oncologie médicale, le vieillissement des populations et l'amélioration de la survie des patients atteints de cancer sont autant de variables qui expliquent l'exposition grandissante à des thérapies anticancéreuses potentiellement cardiotoxiques. Une approche multidisciplinaire entre le médecin de première ligne et les différents spécialistes permettra de prévenir et de repérer précocement les complications cardiovasculaires liées aux traitements, avec un impact réel sur le pronostic oncologique et cardiovasculaire. Nous résumons dans cet article les dernières recommandations de la Société européenne de cardiologie en matière de stratification du risque cardiovasculaire à travers l'utilisation de données cliniques, biologiques et de l'imagerie cardiaque.
Subject(s)
General Practitioners , Humans , Heart , Medical Oncology , Aging , Cardiac Imaging TechniquesABSTRACT
Background: We aimed to examine the quality of life of children who engage in regular physical activities. Methods: We conducted a cross-sectional study with intersectional 301 children (182 boys and 119 girls) involved in regular sporting activities and the control group of 100 children (67 boys and 33 girls), not involved in extracurricular sports. Children in both groups were from 8 to 13 years, attending elementary school, and without any associated illnesses. The quality of life (QOL) was assessed using the Quality of Life questionnaire Kidscreen-27 version for parents. For comparison of groups, we used χ2 test, and for comparison of mean values among groups we used ANOVA test. Results: More boys were engaged in sport than girls and the choice of sport is gender-dependent (P<0.01). Boys preferred collective sports, while girls were more oriented towards individual sports (P<0.01). A significant statistical difference in the mean values of the socializing dimension was given to children who trained football (P=0.04) and basketball (P=0.02). In children engaged in volleyball, a statistical difference in the mean values was observed in all dimensions of the questionnaire. In children who trained water polo, a statistically significant difference in the mean values for dimensions of health (P<0.01), mood (P<0.01) and friendship (P=0.01) was seen. Conclusion: KIDSCREEN scores were significantly higher in the examined group than in the control group, with a statistically significant difference between scores for different sports. Children involved in regular extracurricular physical activities had better QOL.
ABSTRACT
BACKGROUND: The SARS-CoV2 virus has been an emerging virus since December 2019 and is the cause of a global pandemic whose clinical manifestations extend far beyond respiratory disease. CASE SUMMARY: A patient with severe coronavirus disease 2019 respiratory infection, carrying a mechanical mitral valve and under anticoagulation, was admitted to our cardiology department because of a new atrial fibrillation, which turned out to be related to thrombosis of the mitral mechanical valve. CONCLUSION: The pro-coagulant effect of the SARS-CoV2 virus does not spare patients at risk of thrombosis, even under effective anticoagulation. In patients with mechanical valves under vitamin K antagonist treatment, there is a high risk of thrombus formation. The treatment is based on thrombolysis by therapeutic anticoagulation, fibrinolysis, or surgery depending on the size, composition of thrombus, and clinical manifestation.
ABSTRACT
Heart failure has become a real public health problem impacting both the hospital system and the outpatient sector. In constant evolution, the therapeutic armamentarium has been enriched with new molecules, making treatment more effective. Optimal management of patients suffering from heart failure are multileveled and require a multidisciplinary team. The team consists of the in-charge general physician, a cardiologist, a trained nurse in therapeutic education, and optimally a dietician and/or physiotherapist. A limiting step towards the efficiency of patient management is the communication skills of the network.
À l'heure actuelle, l'insuffisance cardiaque est devenue un réel problème de santé publique qui impacte le système hospitalier comme le secteur ambulatoire. En constante évolution, le traitement médicamenteux s'est étoffé de nouvelles molécules, rendant la prise en charge plus efficace. Les défis pour une prise en charge optimale des patients souffrant d'insuffisance cardiaque sont multiples et requièrent une approche multidisciplinaire incluant bien évidemment le généraliste, le cardiologue mais aussi l'infirmière spécialisée en éducation thérapeutique, la diététicienne ou encore le physiothérapeute. L'augmentation du nombre d'intervenants nécessite une communication optimale et active entre les intervenants de l'hôpital et du cabinet.
Subject(s)
General Practitioners , Heart Failure , Heart Failure/therapy , Humans , Patient Care TeamABSTRACT
In daily practice, ischemia of embolic origin is frequent. The clinical spectrum can range from minor ischemia to stroke or myocardial infarction. This article summarizes the common etiologies of a cardioembolic event, such as atrial fibrillation or atrial flutter, presence of a patent foramen ovale or intracardiac masses (endocarditis, thrombi or tumors). This paper aims to serve as a short repository of information to guide every physician might need to initiate the diagnostic investigations and therapy according to recent recommendations.
Dans son quotidien, le praticien sera couramment confronté à une ischémie d'origine embolique. L'éventail clinique va d'une ischémie mineure à un AVC ou un infarctus du myocarde. Cet article résume les étiologies courantes d'un événement cardioembolique, notamment la fibrillation ou le flutter auriculaire, la présence d'un foramen ovale perméable ou de masses intracardiaques (végétations, thrombi, tumeurs). Il vise à guider le praticien dans sa prise en charge diagnostique et thérapeutique selon les recommandations cliniques récentes. Cette prise en charge est très souvent multidisciplinaire.
Subject(s)
Atrial Fibrillation , Endocarditis , Foramen Ovale, Patent , Stroke , Thromboembolism , Foramen Ovale, Patent/complications , Foramen Ovale, Patent/diagnosis , Foramen Ovale, Patent/epidemiology , Humans , Stroke/diagnosis , Stroke/epidemiology , Stroke/etiology , Thromboembolism/epidemiology , Thromboembolism/etiologyABSTRACT
Histologically confirmed small cell lung cancer associated with Cushing's syndrome and elevated amylase is rarely described in the literature. We present a case of a 63-year-old patient admitted to cardiology department due to shortness of breath, exhaustion, palpitations and nausea. Elevated values of troponin and electrocardiography suggested that he could have acute coronary syndrome. According to the radiologist's opinion, plane lung radiography was normal. Elevated level of amylase was found in both serum (3802 U/L, normal range 28-100) and urine (12012 U/L, normal range 0-450 U/L), as well as elevated sodium (156 mmol/L, normal range 137-147 mmol/L), hyperglycemia (12 mmol/L, normal range 3.8-6.1 mmol/L) and lowered serum potassium (1.7 mmol/L, normal range 3.5-5.3 mmol/L). Computerized tomography (CT) of the abdomen revealed a tumor of the left adrenal gland and enlargement of the right adrenal gland with normal structure of the pancreas. During hospitalization, the patient had blood while coughing and CT scan of the lungs showed a tumor 48x38x51 mm in size localized in the laterobasal segment of the left lung with mediastinal lymphadenopathy. He also had bilateral pleural effusions with signs of pulmonary embolism, which explained elevated troponin values. Biopsy confirmed microcellular lung carcinoma and tumor cells were diffusely positive for TTF-1 and focally for CK7, expressing markers of neuroendocrine differentiation (chromogranin +++, synaptophysin +++, NSE ++). Since neuroendocrine tumor was confirmed and the patient had low potassium and high glucose, hypercortisolism was suspected. High morning cortisol (1784 mmol/L, normal range 171-536) and unsuppressed ACTH (214 pg/L, < 60), as well as a high level of chromogranin (1339 µg/L, < 65) were determined. During hospital stay, the patient developed heart and respiratory failure and died in the second week of hospitalization.
