Endovascular Treatment of a Right-Sided Ureteroiliac Fistula in a Patient with a Simultaneous Left-Sided Ureteroileal Fistula

We describe an 80-year-old female with a left ureteroileal fistula and simultaneously a right ureteroiliac fistula. Her history highlights the predisposing factors of radiation, major surgery in the region, and presence of bilateral double-J-stents. She was successfully treated with an endovascular approach after being initially misdiagnosed. There seems to be an increase in reporting ureteral fistulas, however this entity remains a rare clinical condition that can lead to life-threatening situations. A fast and accurate diagnosis of an ureteroarterial fistula remains a challenge

Il Nordest prima del Nordest

L'articolo introduce un volume monografico dedicato a casi di conflitto sociale (scioperi, occupazioni, vertenze sindacali, ma anche trasformazioni più lente) nel Veneto degli anni settanta, illustrando l'evoluzione del dibattito sul "decentramento produttivo" e sui distretti industriali e come questa prospettiva teorica abbia finito per negare il ruolo determinante svolto dai conflitti sociali (non sempre di classe e non sempre di fabbrica) nel consentire una evoluzione socialmente sostenibile di un modello produttivo inizialmente caratterizzato dal semplice abbassamento dei costi consentito dalla minore regolamentazione ambientale e sociale della piccola impresa e dell'artigianato

Association between Global Left Ventricular Longitudinal Strain and Left Ventricular Remodeling after STEMI

Cardiolog

Association between left ventricular global longitudinal strain and adverse left ventricular dilatation after ST-segment-elevation myocardial infarction

BACKGROUND: Myocardial infarct size is a major determinant of left ventricular (LV) remodeling after ST-segment-elevation myocardial infarction. We evaluated whether LV global longitudinal strain (GLS), proposed as a novel marker of infarct size, is associated with 3- and 6-month LV dilatation after ST-segment-elevation myocardial infarction. METHODS AND RESULTS: In the first ST-segment-elevation myocardial infarction patients treated with primary percutaneous coronary intervention, baseline LVGLS was measured with 2-dimensional speckle-tracking echocardiography. Patients were dichotomized according to median value. The independent relationship between GLS groups and LV end-diastolic volume at 3 and 6 months (adjusted for clinical and echocardiographic variables) was assessed. The final study population comprised 1041 patients (60±12 years; 76% men). Median LVGLS was -15.0%. Patients with baseline LVGLS>-15.0% exhibited greater LV dilatation at 3 and 6 months compared with patients with GLS≤-15.0% (LV end-diastolic volume 123±44 versus 106±36 mL and 121±43 versus 102±34 mL, respectively; global group-time interaction P<0.001). This association retained the same statistical significance after adjustment for various relevant demographic, clinical, and echocardiographic characteristics. Further, net reclassification improvement index demonstrated significant incremental value of LVGLS for prediction of LV end-diastolic volume increase (0.14 [95% confidence interval, 0.00034-0.29]; P=0.04). CONCLUSIONS: LVGLS before discharge after ST-segment-elevation myocardial infarction is independently associated with LV dilatation at follow-up.Emer Joyce, Georgette E. Hoogslag, Darryl P. Leong, Philippe Debonnaire, Spyridon Katsanos, Helèn Boden, Martin J. Schalij, Nina Ajmone Marsan, Jeroen J. Bax, Victoria Delgad

Left ventricular twist during dobutamine stress echocardiography after acute myocardial infarction: association with reverse remodeling

Left ventricular (LV) twist is emerging as a marker of global LV contractility after acute myocardial infarction (AMI). This study aimed to describe stress- induced changes in LV twist during dobutamine stress echocardiography (DSE) after AMI and investigate their association with LV reverse remodeling at 6 months follow-up. In 82 consecutive first AMI patients (61±12 years, 85 % male) treated with primary percutaneous coronary intervention, DSE was performed at 3 months follow-up. Two-dimensional speckle-tracking-derived apical and basal rotation and LV twist were calculated at rest, low- and peak- dose stages. LV reverse remodeling was defined as C 10 % decrease in LV end-systolic volume between baseline and 6 months follow-up. Patterns of LV twist response on DSE consisted of either a progressive increase throughout each stage (n=18), an increase at either low- or peak-dose (n = 53) or no significant increase (n =11). LV reverse remodeling occurred in 28 (34 %) patients, who showed significantly higher peak-dose LV twist (8.51° vs. 6.69°, p =0.03) and more frequently progressive LV twist increase from rest to peak-dose (39 vs. 13 %, p \0.01) compared to patients without reverse remodeling. Further- more, increase in LV twist from rest to peak-dose was the only independent predictor of LV reverse remodeling at 6 months follow-up (OR 1.3, 95 % CI 1.1-1.5, p = 0.005). Both the pattern of progressive increase in LV twist and the stress-induced increment in LV twist on DSE are significantly associated with LV reverse remodeling at 6 month follow-up after AMI, suggesting its potential use as a novel marker of contractile reserve.Emer Joyce, Darryl P. Leong, Georgette E. Hoogslag, Paul L. van Herck, Philippe Debonnaire, Elena Abate, Eduard R. Holman, Martin J. Schalij, Jeroen J. Bax, Victoria Delgado, Nina Ajmone Marsa

IMPACT OF FLOW AND LEFT VENTRICULAR SYSTOLIC FUNCTION ON OUTCOME OF PATIENTS WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION AND LOW GRADIENT SEVERE AORTIC VALVE STENOSIS UNDERGOING AORTIC VALVE REPLACEMENT

Cardiolog

Left Ventricular Functional Recovery and Remodeling in Low-Flow Low-Gradient Severe Aortic Stenosis after Transcatheter Aortic Valve Implantation

Cardiolog

Value of the "TAVI(2)-SCORe" Versus Surgical Risk Scores for Prediction of One Year Mortality in 511 Patients Who Underwent Transcatheter Aortic Valve Implantation

Cardiolog