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OBJECTIVES: To assess gender differences in training-related electrocardiographic (ECG) patterns of athletes, highlighting the importance of these differences for ECG interpretation used in the cardiovascular screening of athletes. DESIGN: Observational cross-sectional study. METHODS: 315 athletes were enrolled in the study (150 males and 165 females, mean age 23,7±6,6 and 20,7±6,8, respectively). All study participants underwent clinical examination and 12-lead electrocardiogram (12-lead ECG), scored according to 2017 International recommendations for electrocardiographic interpretation in athletes. RESULTS: Males were older (23,7±6,6 years vs. 20,7 years±6,8; p<0,0001) and had more years of training (11,8±6,7 vs. 9,07±6,1; p=0,0003) than female athletes. Female athletes had significantly higher resting heart rates (67/min vs. 61/min; p<0,0001) and QTc intervals (424,5±19,4ms vs. 338,6±22,3ms; p<0,0001). Male athletes were more likely to have isolated QRS voltage criteria for left ventricular hypertrophy (Sokolow-Lyon index) (2,6±0,8mV vs. 2,05±0,5mV; p<0,0001) and QRS duration (96,1±13,1ms vs. 86,9±9,4ms; p<0,0001). Sinus bradycardia <50bpm was more commonly seen in male athletes than in female (14% vs. 5,45%; p=0,009). Sinus arrhythmia occurred more frequently in female athletes (21,8% vs. 12,6%; p=0,03). CONCLUSIONS: This study demonstrates gender-related differences in ECGs of trained athletes that should be considered in their cardiovascular screening.
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In this histopathological study we looked at 303 cases of breast carcinomas, managed though conservative breast surgery and later analysed with the help of a classical histopathological technique, paraffin embedding. The carcinomas were assessed in terms of tumor size, lymph node status, histological type, correlation between invasive tumors and an situ carcinoma component, resection margins, grading and patients age. Following assessment, we looked at associations between above morphological and clinical parameters and ipsilateral local recurrences. We concluded that more than half of our cases were carcinomas, measuring between 2 cm and 5 cm, with no associated lymph node involvement, in keeping with pTNM criteria for stage II. By far, in our study, the most frequent histopathological type was type NOS (63.37%) followed by invasive lobular carcinoma (10.56%) and mixed ducto-lobular invasive carcinoma (6.27%). Other types of invasive carcinoma were rarer, each representing less than 4% of cases. In regards to in situ carcinomas we noted the most common histological types to be both cribriform intraductal carcinoma and comedocarcinoma, each identified in 1.65% of cases. Amongst invasive breast carcinomas, infiltrating ductal carcinoma not otherwise specified (NOS) was found to be most commonly associated with in situ ductal carcinoma lesions. This was seen in 34.9% of cases, and was the only type associated with an extensive in situ component. Analysing the grading of mammary carcinomas in our study showed that the vast majority of cases (63.04%) were grade 3 tumors. In regards to surgical resection margins, ¾ of cases were noted to have negative margins. Tumor recurrences were noted in 12 cases. These cases were most commonly noted to reoccur following initial poorly differentiated, infiltrating ductal carcinomas, not otherwise specified (NOS), with positive resection margins, measuring less than 2 cm. Patiens tended to be under the age of 40 and had positive lymph nodes. The emergence of local recurrences after conservative surgery for early breast cancer is singnificantly linked to poorly differentiated primary tumors (p <0.05) but not correlated with histological type, presence of extensive intraductal carcinoma component, size of primary breast tumor or lymph node status ( p> 0.05). In terms of increasing the risk of ipsilateral recurrence the most important aspect highlighted in our sudy was the status of the resection margins. Patients with positive resection margins had a significantly high risk to develop recurrences after the conservative surgery, compared to those with negative margins (p <0.001).
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Bicuspid aortic valve (BAV) is generally considered to be a contraindication to sutureless aortic valve replacement (AVR). Implantation of the Edwards Intuity aortic bioprosthesis is an innovative approach associated with superior hemodynamic performance, significantly reduced myocardial ischaemia and cardiopulmonary bypass times and proves to be suitable for type 1 and 2 of bicuspid aortic valves replacement. We report a case of successful AVR using a fast deployment bioprosthesis,the Edwards Intuity Valve System, in a 67-year-old woman with a bicuspid aortic valve and concomitant severe aortic stenosis.
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Aim- To find normal values of implicit time and amplitudes of full-field electroretinogram and to determine their changes with age in healthy Romanian subjects. Material and Methods- The prospective study included 59 healthy subjects aged between 20 and 80 years old; in the end, we had valid ERG recordings for all tests from 54 subjects. All of the participants underwent full-field ERG, recorded with Metrovision MonPack One system. The implicit times and amplitudes were analyzed for a and b waves in dark-adapted 0.01 ERG, dark-adapted 3.0 ERG, dark-adapted oscillatory potentials, light-adapted 3.0 ERG, and 30Hz flicker ERG according to International Society for Clinical Electrophysiology of Vision (ISCEV) protocols. Results- ERG latency values were bigger in subjects above 50 years old than in younger subjects for b wave in dark adapted 0.01, dark adapted 3.0, light adapted 3.0 and dark adapted 3.0 flicker and for a wave in dark adapted 0.01 and dark adapted 3.0 ERG. There was no significant difference in latency values for dark adapted 3.0 oscillatory potentials between young and old subjects. Because of increased variability, we could not prove that observed differences for amplitudes held statistical significance. Conclusions- This study proves there is a major loss in retinal activity due to aging, most of it being caused by the rod cells delayed response. Also, oscillatory potentials do not seem to be affected by age, and could prove a valuable test to investigate for changes in patients with Diabetes mellitus.
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PURPOSE: A case presentation is used to discuss the value of full-field ERG in the diagnosis of cone-rod dystrophy. CASE REPORT: A 49 year old female patient known with amblyopia and myopic astigmatism since childhood, visited us complaining of decreased visual acuity and photophobia. Her BCVA was 0.6 in the RE and 0.4 in the LE. The fundus examination revealed normal colored and sharply limited papilla, normal macula and narrower vascularization. The Ishihara test was 10/15 in both eyes. The fundus autofluorescence and optical coherence tomography were normal. The DA 3 ERG was decreased and slightly delayed as well as the DA 0.01 ERG. Regarding the cone response, the LA 3.0 and 30 Hz flicker ERG were markedly reduced and delayed. The ERG findings indicated cone-rod dystrophy. At the 8 years follow-up examination, the BCVA decreased to 0.4 and 0.2 in the right and left eye, respectively, the Ishihara test was 1/15 in both eyes and the fundus examination showed a macula with no reflex, otherwise no changes compared to the first examination. The fundus autofluorescence and OCT were still normal. The ERG showed a much decreased and delayed rod response compared to the first examination, while the cone response was undetectable. CONCLUSION: Our case demonstrates the importance of standard full-field ERG in diagnosing CRD. The Full-field ERG responses were decreased and delayed, or even undetectable, while morphological examinations were still unchanged.
