Routine histopathology of septal myectomy for hypertrophic obstructive cardiomyopathy in a greek cohort

Hypertrophic cardiomyopathy (HCM) is a diverse inherited disease affecting 1 in 500 individuals irrespective of gender and ethnicity. A fraction of HCM patients will eventually develop drug refractory dynamic obstruction of the left ventricular outflow tract. For such patients, septal myectomy is the procedure of choice to alleviate their symptoms and improve their quality of life. The current histopathological study, the first from the Greek region, aims to examine the hallmark histopathological characteristics of Hypertrophic Obstructive Cardiomyopathy in a population of patients undergoing septal myectomy at a single center over a ten year period. Medical records and histopathology specimens of thirty nine (n=39) patients were evaluated. The sample comprised 22 males (56.4%) and 17 females (43.6%). Mean patient age at myectomy was 53.9±16.7 years, ranging from 12 to 79 years. Maximal IVS thickness on echocardiography was available for 35 patients with a median value of 2.08cm. Peak resting LVOT Pressure Gradient was available for 33 patients with a mean value of 104.88±44.20 mmHg. Central tendency of each histopathological attribute expressed as the median value was: moderate for myocyte hypertrophy, mild for cytoplasmic vacuolization, moderate for subendocardial fibrosis, moderate for interstitial fibrosis, mild for replacement fibrosis, moderate for myofibrillar disarray and mild for capillary stenosis. Myocyte hypertrophy, present in all specimens, was positively correlated with maximal IVS thickness (tau-b=0.43, p=0.002). Replacement fibrosis was positively correlated with the grade of microvascular stenosis (tau-b=0.45, p=0.004). LVEF was negatively correlated with the grade of interstitial fibrosis (taub=−0.43, p=0.035) and with the extent of myocardial fiber disarray (tau-b=−0.42, p=0.034). Histopathological attributes were not correlated with patient gender or age thus proving that HCM has a histological phenotype unique to each patient, mainly depending on each specific sarcomeric mutatio

Large main pulmonary artery aneurysm: Case report and brief review of the literature

Pulmonary artery aneurysms are a rare but often fatal clinical entity with an estimated incidence of 1 in 14,000 individuals in postmortem studies. They can be congenital or acquired. No specific guidelines regarding their optimal management, medical or surgical, currently exist and treatment is planned on a case-by-case basis since data regarding their clinical course and prognosis are limited. We present the case of a 77-year-old male patient who presented at the Emergency Department of our hospital with a complaint of exertional dyspnea and dull substernal pain over 1 week. Upon investigation, a main pulmonary artery true aneurysm measuring 61 mm on Computed Tomography was detected. The patient's history was remarkable for heavy smoking, arterial hypertension, dyslipidemia, known ascending aortic aneurysm, moderate COPD, and past tuberculosis. He was admitted to the Cardiology unit and treated as a case of decompensated heart failure with preserved ejection fraction. His symptoms improved with intravenous diuretics. A past chest MRI report, 7 years before his current event, described the main PA aneurysm measuring 51-52 mm. Regarding the main PA aneurysm, the heart team decided to follow a conservative approach with regular follow-up visits based on the patient's comorbidities, functional status, and slow growth rate of the PA aneurysm. Management of pulmonary artery aneurysms requires a heart-team approach in the context of the patient's underlying conditions and symptoms. More data are required in order to guide a treatment plan with an acceptable risk – benefit profile for each patient

Serious games as a means for holistically supporting Parkinson's Disease patients: The i-PROGNOSIS personalized game suite framework

Parkinson's Disease (PD) is a well-known progressive and neurodegenerative disorder, resulting in motor and non-motor symptoms that significantly reduce the quality of life. Motivated by the increased adoption of serious games in health care interventions sector in the last years, an unobtrusive approach is explored here, realised via the i-PROGNOSIS interventions platform (www.i-prognosis.eu), consisting of a game-based suite. In this way, targeting intelligent early detection and intervention in PD area, the Personalised Game Suite (PGS) design approach is presented, integrating different serious games in a unified platform. Overall, this comprehensive review gives an overview of studies examining motor and non-motor symptoms for PD along with the PGS design approach, in order to inform researchers and game designers for its consideration in the self-management of PD

On supporting Parkinson's disease patients: The i-prognosis personalized game suite design approach

The use of serious games in health care interventions sector has grown rapidly in the last years, however, there is still a gap in the understanding on how these types of interventions are used for the management of the Parkinson Disease (PD), in particular. Targeting intelligent early detection and intervention in PD area, the Personalized Game Suite (PGS) design process approach is presented as part of the H2020 i-PROGNOSIS project that introduces the integration of different serious games in a unified platform (i.e., ExerGames, DietaryGames, EmoGames, and Handwriting/Voice Games). From the methodological point of view, to facilitate the visualization of 14 game-scenarios, the system interface and the PD contexts, the storyboarding technique was adopted here. Overall, the realization of the PGS sets the basis for establishing a holistic framework that could aim at improving motor and non-motor symptoms, in order to inform health care providers and policy makers for its inclusion in routine management for PD