ABSTRACT
Non-bacterial thrombotic endocarditis (NBTE) is characterized by presence of sterile vegetations that develop from fibrin and platelets on heart valves. The main conditions predisposing to NBTE are malignancy, autoimmune diseases and other hypercoagulable states. The authors describe a case of a 25-year-old male, in whom NBTE was diagnosed on the bicuspid aortic valve. The presence of significant aortic regurgitation and dental caries were initially suggestive of infective endocarditis; although, serial blood culture were negative and procalcytonin concentration was within normal ranges. Empiric antibiotic therapy did not result in diminishing of vegetations, similarly to the anticoagulation treatment initiated when strongly positive lupus anticoagulant was detected in laboratory findings. Aortic valve replacement was necessary. Bacteriologic examination of the excised valve was negative. Widespread fibrin masses at different stages of organization on the leaflets confirmed NBTE in histopathologic assessment. Lupus anticoagulant was probably secondary to thyroid autoimmune disease.
Subject(s)
Aortic Valve/abnormalities , Endocarditis, Non-Infective/diagnosis , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation , Lupus Coagulation Inhibitor , Adult , Aortic Valve/surgery , Bicuspid Aortic Valve Disease , Diagnosis, Differential , Endocarditis, Non-Infective/surgery , Humans , MaleABSTRACT
The etiology of takotsubo cardiomyopathy (TC), defined as a transient left ventricular dysfunction in the absence of significant coronary artery stenoses, still reminds unclear. Its onset is often associated with emotional stress or progression in the course of various disorders (including gastrointestinal ones), miscellaneous diagnostic and therapeutic procedures. We describe a case of a 67-year-old man, in whom severe left ventricular function impairment, completely reversible after a week, was observed during hospitalization for gastroesophageal reflux disease (GERD) exacerbation. The authors review the literature on TC cases which were preceded by digestive system illness, examination or surgery and discuss the possible mechanisms of this relationship.
Subject(s)
Gastroesophageal Reflux/complications , Takotsubo Cardiomyopathy/diagnosis , Takotsubo Cardiomyopathy/etiology , Aged , Diagnosis, Differential , Electrocardiography , Gastroesophageal Reflux/diagnosis , Humans , MaleABSTRACT
In the historical context, theories of vision reflected gradual recognition of human anatomy, physiology and histology, including also the development of optics. Ancient Greeks and Romans believed that the lens is the part of the eye responsible for light reception. It was followed by misconception of the central localization of the lens within the eye. This approach outlasted until the 16th century. Then, due to such scholars as Leonardo da Vinci, Felix Platter, Hieronymus Fabricius d'Aquapendente, Johannes Kepler and Christopher Schemer, the previous concepts concerning the role of the lens were gradually questioned, and finally its role was limited to light refraction and focusing the light beam to the bottom of the eye. In the 17th century appeared a controversy concerning the two membranes--retina and choroidea--and question which one of them is responsible for the reception of light. Finally, it was only at the onset of the 19th century when the true function of retina was confirmed.
Subject(s)
Ocular Physiological Phenomena , Ophthalmology/history , Optics and Photonics/history , Eye , Eye Diseases/history , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , History, Medieval , Humans , Vision, Ocular , Visual PerceptionABSTRACT
In this article the author makes an attempt to explain causes of untimely death of Józef Hempel, a Cracow physician. In the Polish historiography there has been a strong belief that he was a victim of an unfortunate experiment with tuberculin administered to him by Robert Koch in Berlin in 1890. However, there was every indication that his death was caused by purulent appendicitis with complicated peritonitis. Memoirs of Stefan Dunin, a journalist, were the most probable source of this misinformation on the tuberculin experiment. The author emphasizes that hte memoirs should not be used in works on history of the Polish phthisiology. He draws our attention to dangers that were related to attempts of treating tuberculosis with tuberculin and also gives basic biographical information about Hempel.