Risk of adverse outcomes associated with cardiac sarcoidosis diagnostic schemes

BackgroundMultiple cardiac sarcoidosis (CS) diagnostic schemes have been published.ObjectivesThis study aims to evaluate the association of different CS diagnostic schemes with adverse outcomes. The diagnostic schemes evaluated were 1993, 2006, and 2017 Japanese criteria and the 2014 Heart Rhythm Society criteria.MethodsData were collected from the Cardiac Sarcoidosis Consortium, an international registry of CS patients. Outcome events were any of the following: all-cause mortality, left ventricular assist device placement, heart transplantation, and appropriate implantable cardioverter-defibrillator therapy. Logistic regression analysis evaluated the association of outcomes with each CS diagnostic scheme.ResultsA total of 587 subjects met the following criteria: 1993 Japanese (n = 310, 52.8%), 2006 Japanese (n = 312, 53.2%), 2014 Heart Rhythm Society (n = 480, 81.8%), and 2017 Japanese (n = 112, 19.1%). Patients who met the 1993 criteria were more likely to experience an event than patients who did not (n = 109 of 310, 35.2% vs n = 59 of 277, 21.3%; OR: 2.00; 95% CI: 1.38-2.90; P P P = 0.18 or OR: 1.51; 95% CI: 0.97-2.33; P = 0.067, respectively).ConclusionsCS patients who met the 1993 and the 2006 criteria had higher odds of adverse clinical outcomes. Future research is needed to prospectively evaluate existing diagnostic schemes and develop new risk models for this complex disease.Cardiolog

Rare case of neonate with meconium peritonitis

It's unusual to find a meconium cyst in a premature newborn. Meconium pseudo cyst is a consequence of meconium peritonitis, a sterile chemical peritonitis caused by a perforation of the uterine tract. When a puncture in the intestine does not heal and communication with the cyst continues after birth, the cyst can expand, the cyst can get infected, and the pseudo cyst can rupture. This is a case report of a newborn who developed perforated peritonitis due to the rupture of a meconium pseudo cyst [1]. Our patient was born prematurely at 34 weeks and had a caesarean procedure. She had a large abdominal distention that was later confirmed as a meconium cyst