Cardiac Tumors

Cardiac tumors represent a relatively rare, yet challenging diagnosis. Secondary tumors are far more frequent than primary tumors of the heart. The majority of primary cardiac tumors is benign in origin, with primary malignant tumors accounting for 25% of cases. Metastatic tumors usually arise from lung, breast, renal cancer, melanomas, and lymphomas. Clinical manifestations of cardiac tumors depend on the size and location of the mass and the infiltration of adjacent tissues rather than the type of the tumor itself. Echocardiography is the main diagnostic tool for the detection of a cardiac mass. Other imaging modalities (C-MRI, C-CT, 3D Echo) may offer further diagnostic information and the establishment of the diagnosis is made with histological examination. Management depends on the type of the tumor and the symptomatology of the patient

Differential Diagnosis of a Left Atrial Mass: Role of 3D Transesophageal Echocardiography

An 81-year-old female patient was admitted to our clinic due to an episode of loss of consciousness... On admission the clinical examination revealed bradyarrhythmia with normal heart sounds, a soft systolic apical murmur consistent with mild mitral regurgitation and no signs of pulmonary congestion... A transthoracic echocardiogram showed a left ventricle of normal dimensions with a preserved systolic function and a mass inside the left atrium... (excerpt

Aerodynamic analysis of wind turbine blade equiped with flaps and slats

95 σ.Στην παρούσα εργασία γίνεται μελέτη πτερυγίου μεταβλητής γεωμετρίας στην ακμή εκφυγής (flap) καθώς και στην ακμή πρόσπτωσης (slat). Έχει στόχο να ελέγξει την επίδραση που έχει η μεταβλητή γεωμετρία στην τελική αποδιδόμενη ισχύ της ανεμογεννήτριας. Για τον σκοπό αυτό διεξήχθη ανάλυση τυπικής διάταξης αεροτομής με γεωμετρικά μεταβαλλόμενη ακμή εκφυγής αλλά και ακμής πρόσπτωσης σε σταθερές γωνίες, αρχικά σε πτερύγιο χωρίς πάχος και έπειτα σε πτερύγιο με πάχος. Η αεροδυναμική επίλυση του προβλήματος έγινε μέσω του υπολογιστικού πρότυπου General Unsteady Vortex Particle (GENUVP). Ο κώδικας αυτός αποτελεί ένα σύνθετο και ιδιαίτερο ευέλικτο υπολογιστικό εργαλείο με την δυνατότητα επίλυσης μη μόνιμης ασυμπίεστης και μη συνεκτικής ροής γύρω από περίπλοκες γεωμετρίες σωμάτων.The present thesis is a study of a trailing and leading edge blade using variable geometry. Its goal is to control the impact of the variable geometry in the final power of wind turbine. For this reason we conducted analysis of typical airfoil with geometrically varied flap and slat in constant angles, initially in thin and then in thick blade. The aerodynamic solution of the problem has been made possible using the code General Unsteady Vortex Particle (GENUVP). This code is complex and very flexible tool, which give us the possibility of solving uniform, incompressible and inviscid airflow. Main advantage of GENUVP, especially due to the particle approximation of the wake, is its capability of easily treating complex geometries and solid-wake interaction problems.Δημοσθένης Α. Μιχαλακέα

Multimarker approach in cardiovascular risk prediction

Various biomarkers express different pathways and pathophysiologic mechanisms of cardiovascular disease, such as inflammation, oxidative stress, myocardial injury, activation of the neurohormonal pathways, myocardial stress and renal function. Current thinking supports the notion that the combination of these biomarkers could increase their diagnostic and prognostic value. The multimarker approach offers benefits since it increases the diagnostic and prognostic information and may help in the design of a strategy for prevention or management of cardiovascular diseases. The purpose of the current review is to describe the characteristics of promising biomarkers which have shown an important additive value in the assessment of cardiovascular risk. Also, an extended reference is made regarding studies that address the prognostic value of multimarker models in the settings of primary prevention of cardiovascular disease and secondary prevention for patients with acute coronary syndromes, chronic coronary artery disease and heart failure

Evaluating the Safety and Tolerability of Azilsartan Medoxomil Alone or in Combination With Chlorthalidone in the Management of Hypertension: A Systematic Review

Background: Azilsartan medoxomil (AZM) is the newest representative in the class of angiotensin receptor blockers. Azilsartan medoxomil in combination with the older diuretic chlorthalidone (CLD) in fixed-doses of AZM/CLD 40/12.5 mg and 40/25 mg has been approved by the FDA for use in patients with essential hypertension. We sought to evaluate the safety and tol-erability of AZL-M alone and in combination with CLD. Methods: We conducted a search in PubMed using the keywords ‘azilsartan’, ‘azilsartan medox-omil’, ‘chlorthalidone, ‘safety’, ‘tolerability’ in order to find scientific studies evaluating the safety of these drugs. We included studies reporting side effects of these drugs, alone or in combination, in comparison to placebo or other antihypertensive medications. For our systematic review, we followed the PRISMA guidelines. Results: Azilsartan medoxomil is a potent antihypertensive medicine with an acceptable safety pro-file. The most commonly reported adverse events are dizziness, headache, fatigue, upper respirato-ry tract infection and urinary tract infection. Chlorthalidone is more potent and has a considerably longer duration of action than the most commonly prescribed diuretic hydrochlorothiazide. Safety and tolerability between these two drugs are similar except higher serum uric acid and lower potas-sium levels with chlorthalidone. Conclusion: The combination of azilsartan medoxomil with chlorthalidone has been shown to be effective in lowering blood pressure with an acceptable safety and tolerability profile. This fixed-dose combination is an attractive treatment option for hypertension management. © 2021 Bentham Science Publishers

Effects of sertraline on circulating markers of oxidative stress in depressed patients with chronic heart failure: A pilot study

Background: Depression is a common comorbid condition in patients with chronic heart failure (CHF). This pilot study investigated the plasma levels of oxidative stress markers in depressed CHF patients as well as the effects of antidepressant treatment with sertraline on these markers in the same patient population. Methods and Results: Patients with positive depression screening [Beck Depression Inventory (BDI) score >10 and/or Zung Self-Rating Depression Scale >40] underwent a psychiatric interview. Patients newly diagnosed as depressed received pharmacologic treatment with sertraline for 3 months (arm A) and were compared with those who did not comply with the antidepressant treatment (arm B). Markers of oxidative stress [malondialdehyde (MDA) and protein carbonyls (PC)], and nitrosative stress [nitrotyrosine (NT)] were assessed at baseline and 3 months later. Fifty-two out of 254 screened hospitalized CHF patients were diagnosed as depressed. Depressed patients had significantly higher levels of MDA compared with age- and gender-matched nondepressed patients (n = 40; 3.2 ± 2.0 vs 2.8 ± 3.8 μmol/L; P =.02). Twenty-eight patients received sertraline (arm A), and 24 refused to receive antidepressant treatment on the top of optimal heart failure treatment (arm B). Although baseline levels of MDA and PC in arm A and arm B did not differ significantly (P >.05), arm A patients demonstrated a significant reduction in MDA (F = 4.657; P =.037) and arm B patients demonstrated no change after 3 months. Regarding the examined scores, arm A patients had a decrease in BDI score (28 ± 11 vs 21 ± 13; P =.008), and arm B patients had no change in BDI score at follow-up (P >.05). Arm A had an increase in 6-minute walking distance (291 ± 110 vs 361 ± 87 m; P =.02), and arm B experienced no change (P >.05). Conclusions: Increased oxidative stress may play a critical role in the pathophysiology of depression in CHF. Treatment with sertraline improves depressive symptoms and reduces plasma markers of oxidative stress in depressed CHF patients. © 2011 Elsevier Inc. All rights reserved