Osler-Weber-Rendu (OWR) Disease and Heart Failure

OWR is a genetic disease, transmitted as an autosomal dominant disorder characterized by arteriovenous malformations predominantly involving the mucocutaneous epithelium. One of the significant complications is the development of arteriovenous fistulas in different organs like the liver and brain. One of the rarest complications of this arteriovenous conduit is a high-output heart failure. We would like to describe a 66 years old woman who was admitted with a high-output cardiac failure who deteriorated clinically and was treated successfully by conservative management

Evaluating the boundary and covering degree of planar Minkowski sums and other geometrical convolutions

AbstractAlgorithms are developed, based on topological principles, to evaluate the boundary and “internal structure” of the Minkowski sum of two planar curves. A graph isotopic to the envelope curve is constructed by computing its characteristic points. The edges of this graph are in one-to-one correspondence with a set of monotone envelope segments. A simple formula allows a degree to be assigned to each face defined by the graph, indicating the number of times its points are covered by the Minkowski sum. The boundary can then be identified with the set of edges that separate faces of zero and non-zero degree, and the boundary segments corresponding to these edges can be approximated to any desired geometrical accuracy. For applications that require only the Minkowski sum boundary, the algorithm minimizes geometrical computations on the “internal” envelope edges, that do not contribute to the final boundary. In other applications, this internal structure is of interest, and the algorithm provides comprehensive information on the covering degree for different regions within the Minkowski sum. Extensions of the algorithm to the computation of Minkowski sums in R3, and other forms of geometrical convolution, are briefly discussed

Incidence and outcome of central nervous system relapse after hematopoietic stem cell transplantation in patients suffering from acute myeloid leukemia and acute lymphoblastic leukemia: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

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Clinical Characteristics of Diabetic Patients with Diabetic Retinopathy

Abstarct: Background: Proliferative diabetic retinopathy is a consequence of retinal ischemia due to capillary occlusion resulting from damage to the retinal endothelium, and is associated with increased risk of cardiovascular morbidity and mortality. Methods: We randomly assigned seventy three patients with DM type II and grouped them according to their retinal proliferative disease (Group A - 25 patients [12 males], mean age 62.8±10.8 years, no diabetic retinopathy; Group B - 25 patients [19 males], mean age 61.9±9.4 years, non-proliferative retinopathy; and Group C - 23 patients [13 males], mean age 59.2±10.3 years, proliferative retinopathy). Twenty three healthy subjects (14 males; mean age 44.3±11.6 years) served as the control group. We studied their retinal vasculopathy status, height, weight, body mass index (BMI), waist circumference, age, endothelial function (flow mediated diameter [FMD%] percent change) and their peripheral artery disease (ankle brachial index [ABI]). Results: A significant difference was found between the duration of length of DM type II between patients without retinopathy [group A] (9±6 years) and patients with non-proliferative retinopathy [group B] (17±9 years) (p=0.001). No difference in length of diabetes was observed between patients with non-proliferative retinopathy [group B] and patients with proliferative retinopathy [group C] (19±6 years) (p=0.30). A significant difference was observed in HgA1C% between group A (7.1±2.7%) and group B (8.5±1.5%) (p=0.02). No such difference was noted between group B and group C (8.5±1.6%) (p=0.98). Only 6 patients (out of 23) used insulin treatment in group A compared with 16 group B (out of 25) and 17 in group C (out of 25) (p=0.004). All three groups of diabetic patients were older (62.8±10.8, 61.9±9.4, 59.2±10.3 years, respectively) than volunteers (44.3±11.6 years) (p≤0.001), had a lower stature (1.65±0.09, 1.68±0.07, 1.65±0.09 meters, respectively) compared with controls (1.73±0.08 meters) (p≤0.05), had a larger waist circumference (110.04±14.17, 108.88±13.00, 109.30±13.49 cm, respectively) than controls (93.43±11.66 cm) (p≤0.001), and larger BMIs (30±6, 29±4, 30±5) compared with controls (25±4) (p≤0.001). All diabetic patients had severe endothelial dysfunction measured by FMD% (-1.9±7.4, -3.3±9.2, -3.1±6.6 %, respectively) compared with the control group (16.5±7.5%) (p≤0.001). ABI was within normal range in all patient (0.97±0.18, 1.14±0.24, 1.03±0.28, respectively), and in volunteers (1.06±0.18) (p≥0.05). There was no significant change within the 3 subgroups of diabetic retinopathy patients in age, height, weight, BMI, or FMD%. Conclusions: All patients with DM type II had severe endothelial dysfunction, higher BMIs, lower statures, larger waist circumferences; however they all had normal ABIs