A Case Report: Unmasking a Singular Culprit for Cardiogenic Shock: Looking Beyond the Coronary Tree

BACKGROUND: Cardiogenic shock remains challenging in its therapy and aetiology. CASE SUMMARY: A 74-year-old woman admitted for cardiogenic shock requiring mechanical ventilation and high-dose inotropics and vasopressors with an electrocardiogram showing left ventricular (LV) lateral wall ischaemia had diffuse coronary artery disease but TIMI III flow in the coronary tree. An echocardiogram showed a suspicious mass invading the left ventricle and computed tomography scan revealed an advanced lung cancer with LV wall and pulmonary artery invasion as the cardiogenic shock cause. DISCUSSION: When managing cardiogenic shock, it is important to consider different and not obvious diagnosis. A high level of clinical suspicion and multimodality imaging assessment was very important in the present case to attain the diagnosis.info:eu-repo/semantics/publishedVersio

Tailoring restoration interventions to the grassland-savanna-forest complex in central Brazil

Made available in DSpace on 2019-09-18T00:41:29Z (GMT). No. of bitstreams: 1 Schmidtetal2019RestorationEcology.pdf: 228617 bytes, checksum: f2e62c1741a1f02b90f6b15189f85175 (MD5) Previous issue date: 2019bitstream/item/202063/1/Schmidt-et-al-2019-Restoration-Ecology.pd

Modificação de polietileno por copolimerização de enxerto induzida por radiação gama : sua aplicação na área dos biomateriais

Tese de doutoramento, Química (Química Tecnológica), 2009, Universidade de Lisboa, Faculdade de Ciência

Aneurismas Gigantes do Septo Interauricular Simulando Massas Quísticas. Dois Casos com Opções Terapêuticas Diferentes

With the recent technical improvement in echocardiography imaging (second harmonics) the number of interatrial septum aneurysms (ASA) increased and are easily recognized. We assist to an overdiagnosing number of cases and diagnostic criteria emerged to face this problem. In the great majority of the cases ASA are small and inoffensive, but as ASA is considered a risk factor for cardioembolism when associated with persistence of foramen oval (PFO), an examination by transesophageal echocardiography (TEE) for exclusion of PFO makes the sense and is a common testing in patients with cryptogenic stroke. Besides these frequent ASA, other forms exist; the authors describe two cases of uncommon and huge ASA, one mimicking a right atrial tumor and the other a quistic, hipoechoic mass. The first case was associated with mitral stenosis and was submitted to surgery and the second was closed with an Amplatzer occluder device usually used in atrial septal defect (ASD)

Nocardial Endocarditis after Mitral Valve Replacement: Case Report and Review of the Literature

A Nocardia é responsável por diversos tipos de infecção quer em receptores imunocompetentes, quer imunocomprometidos e pode afectar qualquer órgão. A endocardite a Nocardia spp é muito rara e tem mau prognóstico. Segundo o nosso conhecimento e após revisão da literatura, foram reportados apenas 12 casos de endocardite a Nocardia, a maioria tratada com substituição valvular. Reportamos o primeiro caso descrito em Portugal de endocardite protésica a Nocardia, tratado com sucesso apenas com terapêutica antimicrobiana (trimetoprimsulfametoxazol), sem necessidade de substituição valvular

CRYSTALLINE CLUSTER MODEL FOR IONIC SOLIDS - NACL

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Think twice before starting a new trial; what is the impact of recommendations to stop doing new trials?

ObjectivesIn evidence-based medicine, we base our conclusions on the effectiveness of interventions on the results of high-quality meta-analysis. If a new randomized controlled trial (RCT) is unlikely to change the pooled effect estimate, conducting the new trial is a waste of resources. We evaluated whether recommendations not to conduct further RCTs reduced the number of trials registered for two scenarios.MethodsAnalysis of registered trials on the World Health Organisation (WHO) International Clinical Trials Registry Platform (ICTRP). We regarded trial protocols relevant if they evaluated the effectiveness of (1) exercise for chronic low back pain (LBP) and (2) cognitive behavioural therapy (CBT) for chronic pain. We calculated absolute and relative numbers and change of registered trials in a pre-set time window before and after publication of the recommendations, both published in 2012.ResultsWe found 1,574 trials registered in the WHO trial registry for exercise in LBP (459 before 2012; 1,115 after) and 5,037 trials on chronic pain (1,564 before 2012; 3,473 after). Before 2012, 13 trials on exercise for LBP (out of 459) fit the selection criteria, compared to 42 trials (out of 1,115) after, which represents a relative increase of 33%. Twelve trials (out of 1,564) regarding CBT for chronic pain, fit the selection criteria before 2012 and 18 trials (out of 3,473) after, representing a relative decrease of 32%. We found that visibility, media exposure and strength of the recommendation were related to a decrease in registered trials.ConclusionsRecommendations not to conduct further RCTs might reduce the number of trials registered if these recommendations are strongly worded and combined with social media attention

Loeffler Endocarditis in a Patient with Non-Hodgkin's Lymphoma

info:eu-repo/semantics/publishedVersio