Internal medicine
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Brugada syndrome is characterized by ST-segment elevation in the right precordial leads (V1-V3) and an episode of ventricular fibrillation (VF) in the absence of structural heart disease. A number of reports from the world have unveiled the clinical, electrocardiographic, electrophysiologic and prognostic features of Brugada syndrome, and two recent consensus reports have suggested the diagnostic criteria of Brugada syndrome and the risk stratification for the identification of high risk Brugada patients for sudden cardiac death. ⋯ On the other hand, advances in the understanding of the cellular mechanism for Brugada phenotype derived from experimental studies have suggested possibilities for the development of strategies for managing and treating patients with Brugada syndrome. In this review, the recent understanding and knowledge of Brugada syndrome will be updated.
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We report a 51-year-old Japanese man with chronic alcoholism who complained of mental confusion following respiratory and intestinal infections. The splenium of the corpus callosum showed hyperintensity on both diffusion-weighted MR images and fluid-attenuated inversion recovery images and hypointensity on T1-weighted images. ⋯ He showed complete neurological recovery within 2 months. We suspected that he had mild encephalopathy with a reversible splenial lesion after systemic viral or bacterial infection.
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Bacteremia is one of the most serious health problems associated with high morbidity and mortality. The aim of this study was to identify risk factors for bacteremia in daily medical care to facilitate rapid and accurate clinical decisions about treatment. ⋯ Our study highlights the risk factors of bacteremia in vulnerable patients.
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The aim of the present study was to determine the effects of glucose intolerance on oxidative stress in patients with coronary artery disease (CAD). ⋯ Glucose intolerance was associated with the high levels of thioredoxin. High levels of thioredoxin were related to the presence of CAD. The measurement of thioredoxin as the marker of oxidative stress may be useful for monitoring the development of the cardiovascular diseases.
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Case Reports
Development of calciphylaxis after long-term steroid and methotroxate use in a patient with rheumatoid arthritis.
Calciphylaxis may be considered a small vessel vasculopathy which is generaly associated with end-stage renal disease and hyperparathyroidism. The precise pathogenesis of the disease is not known. It needs sensitizers and challengers to occur. ⋯ Here we describe a case of calciphylaxis associated with active rheumatoid arthritis. This patient had active disease despite treatment of steroids and methotrexate for a long time. She died shortly after the diagnosis of calciphylaxis due to sepsis.