Evidence of Myocardial Edema in Obstructive Tako-tsubo Cardiomyopathy Complicated by Cardiogenic Shock

the contemporary presence of left ventricular (LV) outflow tract obstruction, systolic anterior motion of the anterior mitral leaflet, and acute mitral regurgitation may occur in t ako-tsubo cardiomyopathy. Although myocardial edema has been reported in patients with tako-tsubo cardiomyopathy, to the best of our knowledge it has never been described in the setting of LV outflow obstruction and the presence of cardiogenic shock. We report the case of a 65-year-old woman who developed t ako-tsubo cardiomyopathy followed by acute cardiogenic shock. the echo-Doppler assessment revealed LV apical ballooning, moderate-to-severe mitral regurgitation, and an estimated peak systolic pressure gradient at LV outflow tract of 64 mmHg. the LV outflow obstruction and mitral regurgitation resolved shortly after the intravenous administration of atenolol (1.25 mg). the cardiogenic shock was completely resolved following the infusion of low-dose dobutamine: 2 γ/kg/min. In the following days, an echo-Doppler examination revealed a marked reduction in the thickness of the LV proximal hypertrophied septum (from 20 mm to 14 mm), while a cardiac magnetic resonance imaging study showed signs of mild edema of the mid-ventricular and apical septum

Salts of 5-amino-2-sulfonamide-1,3,4-thiadiazole, a structural and analog of acetazolamide, show interesting carbonic anhydrase inhibitory properties, diuretic, and anticonvulsant action

Three salts of 5-amino-2-sulfonamide-1,3,4-thiadiazole (Hats) were prepared and characterized by physico-chemical methods. The p-toluensulfonate, the methylsulfonate, and the chlorhydrate monohydrate salts of Hats were evaluated as carbonic anhydrase (CA, EC 4.2.1.1) inhibitors (CAIs) and as anticonvulsants and diuretics, since many CAIs are clinically used as pharmacological agents. The three Hats salts exhibited diuretic and anticonvulsant activities with little neurotoxicity. The human (h) isoforms hCA I, II, IV, VII, IX, and XII were inhibited in their micromolar range by these salts, whereas pathogenic beta and gamma CAs showed similar, weak inhibitory profiles.Fil: Diaz, Jorge R. A.. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Área Química General e Inorgánica; ArgentinaFil: Camí, Gerardo Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Investigaciones en Tecnología Química. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Investigaciones en Tecnología Química; ArgentinaFil: Liu González, Malva. Universidad de Valencia; EspañaFil: Vega, Daniel Roberto. Comisión Nacional de Energía Atómica. Gerencia del Área de Investigaciones y Aplicaciones no Nucleares. Gerencia de Física (Centro Atómico Constituyentes); Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Vullo, Daniela. Università degli Studi di Firenze; ItaliaFil: Juárez, Américo. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia; ArgentinaFil: Pedregosa, Jose Carmelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Investigaciones en Tecnología Química. Universidad Nacional de San Luis. Facultad de Química, Bioquímica y Farmacia. Instituto de Investigaciones en Tecnología Química; ArgentinaFil: Supuran, Claudiu T.. Università degli Studi di Firenze; Itali

Evidence of Myocardial Edema in Obstructive Tako-tsubo Cardiomyopathy Complicated by Cardiogenic Shock

The contemporary presence of left ventricular (LV) outflow tract obstruction, systolic anterior motion of the anterior mitral leaflet, and acute mitral regurgitation may occur in Tako-tsubo cardiomyopathy. Although myocardial edema has been reported in patients with Tako-tsubo cardiomyopathy, to the best of our knowledge it has never been described in the setting of LV outflow obstruction and the presence of cardiogenic shock. We report the case of a 65-year-old woman who developed Tako-tsubo cardiomyopathy followed by acute cardiogenic shock. The echo-Doppler assessment revealed LV apical ballooning, moderate-to-severe mitral regurgitation, and an estimated peak systolic pressure gradient at LV outflow tract of 64 mmHg. The LV outflow obstruction and mitral regurgitation resolved shortly after the intravenous administration of atenolol (1.25 mg). The cardiogenic shock was completely resolved following the infusion of low-dose dobutamine: 2 γ/kg/min. In the following days, an echo-Doppler examination revealed a marked reduction in the thickness of the LV proximal hypertrophied septum (from 20 mm to 14 mm), while a cardiac magnetic resonance imaging study showed signs of mild edema of the mid-ventricular and apical septum

Evidence of Myocardial Edema in Obstructive Tako-tsubo Cardiomyopathy Complicated by Cardiogenic Shock

the contemporary presence of left ventricular (LV) outflow tract obstruction, systolic anterior motion of the anterior mitral leaflet, and acute mitral regurgitation may occur in t ako-tsubo cardiomyopathy. Although myocardial edema has been reported in patients with tako-tsubo cardiomyopathy, to the best of our knowledge it has never been described in the setting of LV outflow obstruction and the presence of cardiogenic shock. We report the case of a 65-year-old woman who developed t ako-tsubo cardiomyopathy followed by acute cardiogenic shock. the echo-Doppler assessment revealed LV apical ballooning, moderate-to-severe mitral regurgitation, and an estimated peak systolic pressure gradient at LV outflow tract of 64 mmHg. the LV outflow obstruction and mitral regurgitation resolved shortly after the intravenous administration of atenolol (1.25 mg). the cardiogenic shock was completely resolved following the infusion of low-dose dobutamine: 2 γ/kg/min. In the following days, an echo-Doppler examination revealed a marked reduction in the thickness of the LV proximal hypertrophied septum (from 20 mm to 14 mm), while a cardiac magnetic resonance imaging study showed signs of mild edema of the mid-ventricular and apical septum

High prevalence of epilepsy in a village in the Littoral Province of Cameroon

Purpose: In the Littoral Province of Cameroon, in the Sanaga River Valley, a door-to-door epidemiological study was carried out in order to evaluate the prevalence of epilepsy in a small village located in a geographically isolated area, hyper-endemic for onchocerciasis. It was followed by an electro-clinical evaluation of patients and a case-control study. Methods: The study involved a three-phases design: in phase I, a screening questionnaire was administered, in phase II, the presence of epilepsy was confirmed with electro-clinical evaluation, and in phase III, risk factors for epilepsy, socio-economical factors and life habits were evaluated in patients and two matched controls for the age (+/- 1 year) residents in the same village. Endemicity level of onchocerciasis was assessed in the village by measuring the prevalence of nodules in adult mates aged >= 20 years (PNAM). Results: One hundred eighty-one subjects (100 mate and 81 female) were examined (91.9% of the overall population). The crude prevalence rate of active epilepsy was 105 per 1000 pop (CI 95% 60-150) while the age-adjusted prevalence rate was 134.5 cases per 1000 pop (CI 95% 90-178). Seizures were classified as generalized in 10 patients (52.6%) and partial in nine (47.4%). In 17 patients EEG was recorded. Afterward the electro-clinical classification this distribution was inverted: generalized seizures occurred in 35.3% of cases and partial seizures in 64.7% of cases. The PNAM was 62.5%. The surveyed village was classified as hyper-endemic for onchocerciasis. Among risk factors, only positive family history for epilepsy was found (p=0.031). A sample pedigree of a family with 10 epileptic cases (4 included in the epidemiological study) was showed. Conclusions: To our knowledge, this is the first door-to-door study that produce an adjusted prevalence rate on epilepsy in Cameroon. In according to studies done in Tanzania, Liberia, Uganda, and Ethiopia, our results (i.e., the high prevalence rate in a restricted area, the clinical characteristics of epileptic seizures, the positive family history for epilepsy and the type of pedigree of a family with epileptic patients) may be accounted for by the presence of an strong interaction between environmental and genetic factors in some circumscribed areas. (C) 2008 Elsevier B.V. All rights reserved