Internal medicine
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Comparative Study
Body mass index can similarly predict the presence of multiple cardiovascular risk factors in middle-aged Japanese subjects as waist circumference.
Adiposity is closely associated with the clustering of metabolic risk factors such as high blood pressure, dyslipidemia, and glucose intolerance. Waist circumference and body mass index (BMI) are the established markers of abdominal adiposity and general adiposity, respectively. However, it has not been examined whether these two markers can detect the clustering of metabolic risk factors in Japanese subjects. ⋯ The BMI values can similarly predict the presence of multiple metabolic risk factors just as the waist circumference in Japanese middle-aged subjects.
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Case Reports
Removal of glomus tumor in the lower tracheal segment with a flexible bronchoscope: report of two cases.
Tracheal glomus tumor is an extremely rare neoplasm resected mostly by open surgery or through rigid bronchoscopy. We report two cases presenting with polypoid masses arising from the tracheal membrane in the posterior wall of the lower tracheal segment. The tumor was removed by high-frequency electrocautery and flexible bronchoscopic argon-plasma coagulation, and follow-up bronchoscopy and chest CT did not reveal tumor recurrence 12 months after the operation. In patients with tracheal glomus tumor who have poor surgical tolerance or are not willing to receive an open surgery, flexible bronchoscopic tumor removal can be a good alternative to relieve the airway obstruction symptoms.
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Takotsubo cardiomyopaty is a recently described syndrome characterized by transient left ventricular dysfunction, mimicking an acute coronary syndrome and usually precipitated by a physical or emotional stress. We report the first case of Takotsubo cardiomyopathy after acute diarrhea in a man. It may be argued that severe diarrhea in predisposed individuals may cause an acute stress resulting in increased sympathetic activity leading to this syndrome. Probably the relationship between the adrenergic system and the heart is more complex than general thought and the stimuli which favor an autonomic imbalance and precipitate the syndrome are very disparate in clinical practice.
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Intravenous thrombolysis using tissue plasminogen activator (tPA) can improve patient outcomes in acute stroke if administered within 3 hours of onset. However, patients with aortic dissection should avoid tPA therapy due to the possibility of tPA administration inducing rupture of the aortic dissection. We studied the frequency and clinical characteristics of stroke patients presenting with aortic dissection within 3 hours of onset. ⋯ Aortic dissection may not be a rare complication in acute stroke within 3 hours of onset. Right pulse weakness and left hemiparesis are often present. Carotid ultrasonography may be useful in diagnosing aortic dissection before tPA infusion.
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Case Reports
Endobronchial actinomycosis associated with a foreign body--successful short-term treatment with antibiotics--.
Primary endobronchial actinomycosis is a very rare condition. We report herein the case of a healthy 66-year-old woman who presented with right lower lobe endobronchial actinomycosis associated with aspiration of a foreign body, which was presumed to be a fish bone swallowed 28 months previously. The patient achieved complete clinical and radiological recovery after removal of the foreign body and 1-month antibiotic therapy of oral amoxycillin. Our experience in the management of this patient should help clinicians to realize the importance of bronchoscopic investigation and the management of this rare but treatable condition.