Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the liver component of the metabolic syndrome. We investigated the diastolic and systolic functional parameters of patients with NAFLD and the impact of metabolic syndrome on these parameters. Methods: Thirty-five non-diabetic, normotensive NAFLD patients, and 30 controls, were included in this study. Each patient underwent transthoracic conventional and tissue Doppler echocardiography (TDI) for the assessment of left ventricular (LV) diastolic and systolic function. Study patients were also evaluated with 24-hour ambulatory blood pressure monitoring. Results: NAFLD patients had higher blood pressures, increased body mass indices, and more insulin resistance than controls. TDI early diastolic velocity (E&#8217; on TDI) values were lower in NAFLD patients than the controls (11.1 &#177; 2.1 vs 15.3 &#177; 2.7; p < 0.001). TDI systolic velocity (S&#8217; on TDI) values were lower in NAFLD patients than the controls (9.34 &#177; 1.79 vs 10.6 &#177; 1.52; p = 0.004). E&#8217; on TDI and S&#8217; on TDI values were moderately correlated with night-systolic blood pressure, night-diastolic blood pressure, and night-mean blood pressure in NAFLD patients. Conclusions: Patients with NAFLD have impaired LV systolic and diastolic function even in the absence of morbid obesity, hypertension, or diabetes. (Cardiol J 2010; 17, 5: 457-463

The association of epicardial fat thickness with blunted heart rate recovery in patients with metabolic syndrome

WOS: 000294273000003PubMed ID: 21737994Epicardial fat tissue has unique endocrine and paracrine functions that affect the cardiac autonomic system. Epicardial fat thickness (EFT) and blunted heart rate recovery (HRR) are newly identified cardiovascular risk factors in patients with metabolic syndrome (MS). The objective of this study is to evaluate the association between EFT and HRR in patients with MS. Forty patients with MS and 36 healthy controls were included in the study. Echocardiographic EFT and HRR at 1min after exercise termination (HRR-1) are measured and compared between the two groups. HRR-1 equal to or lower than 18 beats is considered as blunted HRR. EFT was increased (7.2 +/- 2 vs. 5.6 +/- 1.8 mm; p = 0.001) and HRR-1 was significantly reduced in patients with MS compared to control group (21 +/- 8 vs. 26 +/- 9; p = 0.006). Among the MS patients, subjects with blunted HRR had increased EFT compared to patients without blunted HRR (8.5 +/- 2.0 vs. 5.9 +/- 1.1 mm, p < 0.001). In multivariate analysis, EFT was the only independent predictor of blunted HRR in patients with MS (95% confidence interval = 1.42-3.87, OR = 2.34, p = 0.001). Furthermore, EFT of equal to or thicker than 5.5 mm was associated with the blunted HRR with 84% sensitivity and 52% specificity (ROC area under curve: 0.84, 95% confidence interval = 0.70-0.96, p < 0.001). In conclusion, EFT is an independent predictor of blunted HRR, a novel cardiovascular risk factor, in patients with MS

Giant Trichilemmal Cyst at the Neck Region

Trichilemmal cyst (TC) is an adnexal skin tumor that usually occurs on the scalp. There is a female dominance in this tumor. Proliferating pilar tumors or cysts arise from this lesion, and the clinical differential diagnosis from TCs must be taken because of aggressive behavior of proliferating pilar tumor. Trichilemmal cyst usually occurs in hair-bearing areas such as the neck, trunk, groin, and others. In this article, we report a case with giant TC involving the neck region

Composite Cartilage Island Grafts in Type 1 Tympanoplasty: Audiological and Otological Outcomes

Tympanoplasty is a surgical procedure used for eradicating chronic middle ear infection and for reconstructing hearing in infected cars. Independent from the graft placing technique, the atrophy and the insufficiency of the graft material would be seen

Paradoxical Vocal Cord Motion-Haloperidol Usage in Acute Attack Treatment

Paradoxical vocal cord motion (PVCM) is an uncommon disease characterized by vocal cord adduction during inspiration and/or expiration. It can create shortness of breath, wheezing, respiratory stridor, or breathy dysphonia. Possible etiological factors include asthma, underlying psychologic condition, gastroesophageal acid reflux disease, respiratory irritants exposure, central neurologic diseases, viral upper airway infections, and postsurgical procedures. Many treatment modalities were performed for acute attack of PVCM, including reassurance and onsite maneuvers, benzodiazepines, heliox, and so forth. We report a patient with PVCM who had stridor and dyspnea for 10 days and responded to intravenous haloperidol treatment

Mandibular Ramus Epidermal Inclusion Cyst

Epidermal inclusion cyst in the mandibular ramus is a very rare condition. Intraosseous epidermal cysts are benign cysts appearing clinically as radiolucent lytic bone lesions. Definitive diagnosis is made with histopathologic examination. Treatment is simple curettage and grafting if the defect is large. We present a case of a 78-year-old man who was admitted to our clinic with th

Laryngotracheal Reconstruction at Relapsing Polychondritis

Relapsing polychondritis (RP) is characterized by chronic, recurrent episodes of inflammation with eventual degeneration of cartilaginous tissues including the ears, nose, larynx, trachea, and so on. Tracheobronchomalacia and airway stenosis may be seen in RP. In this report, we describe 3 female patients presenting with progressive dyspnea owing to laryngotracheal involvement of RP who under-went laryngotracheal reconstruction

Excessive Reactive Lymphoid Hyperplasia in a Child With Persistent Obstructive Sleep Apnea Despite Previous Tonsillectomy and Adenoidectomy

Both lingual tonsil and adenoid are the lymphoid tissue members of Waldeyer ring. Enlargement of the lingual tonsil and adenoid occurs in children with persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy relatively frequently