Hydrosoluble and Liposoluble Vitamins: New Perspectives through ADMET Analysis.

Background and Objectives: The present study demonstrates that apart from the well-known toxicity of liposoluble vitamins, some hydrosoluble vitamins may also exert toxicity; thus, routine supplementation with vitamins or ingestion of fortified foods should not be considered harmless. The study addresses the possible correlations between the physico-chemical properties and the side effects of vitamins when taken in high doses or for a too long a period. Materials and Methods: The FAFDrugs4.0 computational tool was used for computational assessment of the ADMET profile of several hydro- and liposoluble vitamins. Results: ADMET analysis revealed the following major data: vitamin B3 and B13 showed reduced structural complexity; thus, a relative toxicological potential may be exerted. Vitamins B1 and B7 were found to have good oral absorption and thus good bioavailability, while Vitamin B3 was found to have decreased oral absorption. In addition, all of the liposoluble vitamins reflected higher complexity, much greater than most of the potentially therapeutically-proven compounds. Conclusions: The present study emphasizes the importance between the physico-chemical properties of vitamins and their possible toxicological impact.

Impending Aortic Rupture in a Patient with Syphilitic Aortitis.

We report the case of a 48-year-old man, admitted for atrial fibrillation with rapid heart rate and intense chest pain. A quick evaluation revealed a giant aortic aneurysm with severe aortic regurgitation and pericardial fluid without a trace of aortic dissection. Because of high suspicion of aortic rupture, an emergency surgery was planned, and a Bentall procedure was performed. On examination of the aortic wall revealing vertical wrinkling with a tree bark aspect, suspicion of syphilitic aortitis arose. The diagnosis was confirmed through postoperative serologic testing and histological examination. Histopathologic differential diagnosis, special treatment and follow-up are presented.

A rare case of anaerobic streptococci endocarditis in a young female with bicuspid aortic valve: case report.

BACKGROUND: Bicuspid aortic valve is the most common congenital cardiovascular malformation and occurs in 1-2% of the population. The haemodynamic changes appear early, leading to tissue damage and predisposing to germs attachment. The development of perivalvular extension is a constant in bicuspid aortic valve endocarditis. Infective endocarditis with anaerobic bacteria is a rare condition with a high rate of mortality. CASE SUMMARY: We report a case of a young female with bicuspid aortic valve infective endocarditis. Involved bacteria were anaerobic streptococci, and the clinical course of the diseases was very aggressive. The echocardiographic evaluation revealed aortic and mitral regurgitation, perivalvular abscess, ventricular septum defect, and pericardial effusion. The surgery approach consisted of the aortic valve replacement with a mechanical prosthesis after radical resection of aortic root abscess and reconstruction of the annulus. The ventricular septum defect was also closed with a pericardial patch. Anticoagulation started the first day after surgery. The patient was received antibiotic therapy for 10 days before and 4 weeks after surgical intervention. Evolution was very good at 1 and 6 months follow-up. DISCUSSION: This is a severe case of endocarditis, complicated with extensive valvular destruction, aortic root abscess, and fistula. Perivalvular complications are frequent in patients with bicuspid aortic valve endocarditis. The 'take away' message is that echocardiography is an essential tool for diagnosis, management, and follow-up of patients with infective endocarditis.

Unusual cause of heart failure in a 65-year-old woman.

Left ventricular (LV) free wall rupture is a potentially lethal mechanical complication after myocardial infarction (MI). Pericardial adhesions or slow extracardiac leak and pericardial inflammation may result in a contained cardiac rupture. LV pseudoaneurysm is a relatively uncommon clinical entity. It may occur after MI, but also as a complication of infective endocarditis, cardiac surgery, or trauma. Patients developing LV pseudoaneurysm after MI may present angina pectoris or signs of congestive heart failure (HF) but often are asymptomatic. Surgery is the treatment of choice for LV pseudoaneurysms diagnosed in the first months after MI. The management of chronic LV pseudoaneurysms is still subject of debate. This report highlights a 65-year-old patient newly hospitalized for acute decompensated HF who was diagnosed with a large chronic LV pseudoaneurysm and severe mitral regurgitation. The patient underwent successful resection of the pseudoaneurysm and patch repair of the ruptured ventricular wall.