Gastropericardial fistula: getting to the heart of the matter.

BACKGROUND: Gastropericardial fistula is a rare life-threatening condition, being reported only 65 times in modern literature. CASE PRESENTATION: A 67 year-old man who presented with weight loss, chest pain and epigastric pain was found to have pericardial effusion and pneumopericardium on computed imaging. Endoscopy and histology confirmed a gastric adenocarcinoma within a hiatus hernia, which had fistulated to the pericardium. His condition was complicated by pulmonary emboli and lobar infarction, all contributing to rapid deterioration and death. CONCLUSION: Review of all previously published cases reveals that factors which predict poorer prognosis are older age, cancer etiology and conservative management. Conversely, protective factors include younger age at presentation, previous gastroesophageal surgery or ulcers as an etiology, and aggressive procedural and surgical management. Although the diagnosis is viewed as largely fatal by many clinicians, operative management has contributed to a statistically significant reduction in mortality from 69 % in the pre-2000 era to 11 % in the post-2000 era. This study summarizes diagnostic methods and treatment interventions and prognostication in this rare condition

Modulation of fruit ripening, storage time and quality of fruits with emulsion of Chitosan alone and loaded with Salicylic acid or Oxalic acid

Efficacy of chitosan emulsion, salicylic acid (SA) or oxalic acid (OA) alone and chitosan loaded with SA or OA on ethylene production, extending storage life and maintenance of climacteric (nectarine and plum) and non-climacteric fruit (sweet orange) quality at ambient temperature and cold conditions was investigated. Beneficial effects of these coating treatments in regulating ethylene production, fruit softening, reducing weight loss and diseases and quality parameters varied between climacteric and non-climacteric fruits, cultivars and storage conditions

A rare cardiac cause of hoarseness of voice

To The Editor: Hoarseness of voice caused by the damage of the recurrent laryngeal nerve as a result of cardiac causes is known as Ortner’s or cardio-vocal syndrome. This syndrome was described by Nobert Ortner, an Austrian physician, in 1897 [1]. Initially it wasthought to be due to the enlargement of the left atrium as a result of severe mitral stenosis in rheumatic heart disease. However, it wasfound, later, to be caused by other conditions rather than rheumatic heart disease. The accepted mechanism of this syndrome is thecompression of the recurrent laryngeal nerve from the enlargement of the pulmonary artery in the window area between the aorta andligamentum arteiosum. This condition was quite common at the beginning of last century due to a high incidence of untreated rheumatic heart disease. Although,it is very rare to see itnowadays, it still poses a treatment challenge. We would like to share our experience in diagnosing and treating a patient with Ortner’s syndrome caused by severe mitral valve prolapse. To the best of our knowledge Ortner’s caused by mitral valve prolapse hasbeen reported only once

Making heads or tails of mitochondrial membranes in longevity and aging: a role for comparative studies

Mitochondria play vital roles in metabolic energy transduction, intermediate molecule metabolism, metal ion homeostasis, programmed cell death and regulation of the production of reactive oxygen species. As a result of their broad range of functions, mitochondria have been strongly implicated in aging and longevity. Numerous studies show that aging and decreased lifespan are also associated with high reactive oxygen species production by mitochondria, increased mitochondrial DNA and protein damage, and with changes in the fatty acid composition of mitochondrial membranes. It is possible that the extent of fatty acid unsaturation of the mitochondrial membrane determines susceptibility to lipid oxidative damage and downstream protein and genome toxicity, thereby acting as a determinant of aging and lifespan. Reviewing the vast number of comparative studies on mitochondrial membrane composition, metabolism and lifespan reveals some evidence that lipid unsaturation ratios may correlate with lifespan. However, we caution against simply relating these two traits. They may be correlative but have no functional relation. We discuss an important methodology for body mass and phylogenetic correction in comparative studies

Adipose Tissue-Liver Cross Talk in the Control of Whole-Body Metabolism: Implications in Nonalcoholic Fatty Liver Disease.

Adipose tissue and the liver play significant roles in the regulation of whole-body energy homeostasis, but they have not evolved to cope with the continuous, chronic, nutrient surplus seen in obesity. In this review, we detail how prolonged metabolic stress leads to adipose tissue dysfunction, inflammation, and adipokine release that results in increased lipid flux to the liver. Overall, the upshot of hepatic fat accumulation alongside an insulin-resistant state is that hepatic lipid enzymatic pathways are modulated and overwhelmed, resulting in the selective buildup of toxic lipid species, which worsens the pro-inflammatory and pro-fibrotic shift observed in nonalcoholic steatohepatitis

Using Coronary Artery Calcification Combined with Pretest Clinical Risk Assessment as a Means of Determining Investigation and Treatment in Patients Presenting with Chest Pain in a Rural Setting

462 patients presenting with chest pain to a rural district general hospital underwent calcium scoring and pretest clinical risk assessment in order to stratify subsequent investigations and treatment was retrospectively reviewed. The patients were followed up for two years and further investigations and outcomes recorded. Of the 206 patients with zero calcium score, 132 patients were immediately discharged from cardiac follow-up with no further investigation on the basis of their calcium score, low pretest risk of coronary artery disease, and no significant incidental findings. After further tests, 267 patients were discharged with no further cardiac therapy, 88 patients were discharged with additional medical therapy, and 19 patients underwent coronary artery by-pass grafting or percutaneous intervention. 164 patients with incidental findings on the chest CT (computed tomography) accompanying calcium scoring were reviewed, of which 88 patients underwent further tests and follow-up for noncardiac causes of chest pain. The correlations between all major risk factors and calcium scores were weak except for a combination of diabetes and hypertension in the male gender (P=0.012), The use of calcium scoring and pretest risk appeared to reduce the number of unnecessary cardiac investigations in our patients: however, the calcium scoring test produced a high number of incidental findings on the associated CT scans

Extensive cardiac infiltrative melanoma

We report an unusual clinical case of a 66-year-old patient with cardiac involvement from a metastatic melanoma, causing the formation of a large right atrial mass with extensive infiltration of the right atrial free wall, the interatrial septum, the coronary sinus, and up to the mitral annulus and posterior wall of the right ventricle, unamendable to complete surgical excision. As secondary cardiac tumors are not part of routine daily clinical practice, we thought that this clinical case would be a good educational opportunity for the practicing clinicians, both specialists and nonspecialists

A prototypical small-molecule modulator uncouples mitochondria in response to endogenous hydrogen peroxide production

A high membrane potential across the mitochondrial inner membrane leads to the production of the reactive oxygen species (ROS) implicated in aging and age-related diseases. A prototypical drug for the correction of this type of mitochondrial dysfunction is presented. MitoDNP-SUM accumulates in mitochondria in response to the membrane potential due to its mitochondria-targeting alkyltriphenylphosphonium (TPP) cation and is uncaged by endogenous hydrogen peroxide to release the mitochondrial uncoupler, 2,4-dinitrophenol (DNP). DNP is known to reduce the high membrane potential responsible for the production of ROS. The approach potentially represents a general method for the delivery of drugs to the mitochondrial matrix through mitochondria targeting and H2O2-induced uncaging

A quantitative approach to the socio-economic valuation of pollinator-friendly practices: a protocol for its use

In agro-ecosystems, pollinators are essential for orchard, oilseed crops, horticultural and forage production, as well as the production of seed for many root and fibre crops. Pollinators such as bees, birds and bats affect 35 percent of the world?s crop production, increasing the outputs of 87 of the leading food crops worldwide, plus many plant-derived medicines for the world?s pharmacies. Pollinators contribute significantly to human health; pollinator dependent crops supply major proportions of micronutrients. In terms of ecosystem health, approximately 90 percent of wild plants rely on pollinators that support wider biodiversity.Fil: Garibaldi, Lucas Alejandro. Universidad Nacional de Río Negro. Sede Andina. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Dondo Bühler, Mariana Beatriz. Universidad Nacional de Río Negro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Hipólito de Sousa, Juliana. Universidad Nacional de Río Negro. Sede Andina. Instituto de Investigaciones en Recursos Naturales, Agroecología y Desarrollo Rural; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Azzu, Nadine. Food and Agriculture Organization of the United Nations; ItaliaFil: Felipe Viana, Blandina. Universidade Federal da Bahia; BrasilFil: Muo, Kasina. Kenya Agricultural and Livestock Research Organization; Keni