Cardiol J
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Inappropriate sinus tachycardia (IST) is an uncommon disorder characterized by an exaggerated heart rate (HR). It is mostly treated with b-blockers or verapamil leaving the sinus node modulation for refractory cases. Ivabradine, a pure HR lowering agent, has proven anti-anginal efficiency linked to the If current inhibition. We conducted a small prospective experience investigating its efficacy in IST. ⋯ IST causes an elevated HR and its control is the treatment objective. If future data confirm our results, ivabradine could be used for this purpose. More information is necessary in order to define its role: initial option, second step (beta-blockers non-responders or intolerants) or combined (refractory cases).
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Review Case Reports
Lead-dependent infective endocarditis: an old problem, a new name.
This paper presents a literature review on right heart endocarditis in patients with a permanent pacemaker (PM) or implantable cardioverter-defibrillator (ICD). We postulate putting a great deal more emphasis on separation of lead-dependent infective endocarditis from other types of infective endocarditis. We stress the need for screening patients with PM/ICD and pulmonary signs using transesophageal echocardiography. Antibiotic therapy and PM/ICD removal is the treatment of choice in such patients.
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The identification of a good prognostic factor of neurological outcome after cardiac arrest is needed. S-100B protein seems to be a promising early predictor of brain damage. Yet it is necessary to reach a consensus on cut-off values, time of blood sampling and the predictive accuracy of S-100B protein. The present review summarizes the data about the clinical implications of S-100B protein after brain injury, especially in patients after cardiac arrest.
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Over the centuries, opium has been the most frequent substance abused in the Middle East. There are many controversial aspects about the effects of opioids on the atherosclerosis process, which is still unclear. ⋯ Our investigations demonstrate that opium is not cardioprotective, as has been claimed by some previous studies, and does not even decelerate atherosclerosis of carotid arteries in opium-addicted patients, but more evidence is still needed to completely prove the case.
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Review
Clinical implication of gastrointestinal bleeding in degenerative aortic stenosis: an update.
Gastrointestinal (GI) bleeding due to colonic angiodysplasias can be associated with calcifying aortic stenosis (AS). GI angiodysplasias and AS are defined as chronic degenerative disorders, and the prevalence of both diseases increases with age. ⋯ Aortic valve replacement is the first line therapy for advanced stage AS-patients, but can also be an effective treatment for co-existent bleeding angiodysplasias and acquired von Willebrand disease. In this study, we tried to collect as well as systemized data about the etiopathogenesis of AS coagulation abnormalities and diagnostic, clinical and therapeutic implications of AS-patient with GI angiodysplasias.