scholarly journals Case Report: Coexistent Wolff-Parkinson-White Syndrome and Brugada Phenocopy in a Patient With Pneumonia and Myocarditis

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Wang ◽  
Yana Zhao ◽  
Lan Ma
Keyword(s):  
Body Temperature ◽  
Troponin I ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Dynamic Changes ◽  
Wpw Syndrome ◽  
Delta Waves ◽  
Neutrophil Percentage ◽  
History Of ◽  
The Right ◽  
Brugada Pattern

Background: In recent years, Wolff-Parkinson-White (WPW) syndrome and Brugada electrocardiogram (ECG) patterns have been reported as coexistent in the same patient. In most cases, the two waveforms appeared separately. Here, we described combinations of different waveforms on one ECG, such as the Brugada pattern with delta waves and the Brugada pattern with paroxysmal supraventricular tachycardia (PSVT). Importantly, we recorded an alternate conversion of these combined ECG waveforms, which has not previously been reported in the literature. At the same time, we confirmed that the change in the waveform was related to fever by analyzing Holter data.Case: A 48-year-old male was admitted to our hospital due to palpitations and fever. The patient had a history of a cold 3 days ago. Laboratory examinations showed an elevated neutrophil percentage (85%) and troponin I level (0.86 ng/ml). A chest computed tomography (CT) scan showed inflammation in the right lung. The diagnosis of pneumonia and myocarditis was made. ECG indicated WPW syndrome and the Brugada pattern. We recorded the dynamic changes in this combination of delta waves and Brugada waves with a Holter monitor, and we found the changes would happen when the patient's body temperature rose. The doctors thought that the patient's pulmonary infection led to fever, which caused the changes in waveform. After treatment with antibacterial therapy and supportive care, his body temperature returned to normal. The various laboratory indicators also gradually returned to normal. The doctor recommended that the patient undergo further pre-excitation bypass radiofrequency ablation treatment, but the patient refused and was discharged.Conclusion: Delta waves and Brugada ECG patterns could appear on one ECG at the same time. There were dynamic changes of QRS complex, relating to fever.

scholarly journals Brugada ECG Sign & Chest Pain Mimicking ST Elevation Myocardial Infarction

2013 ◽  
Vol 1 (2) ◽  
pp. 86-90
Author(s):  
Omar Mousa ◽  
Haroonur Rashid
Keyword(s):  
Chest Pain ◽  
Previous History ◽  
Wave Inversion ◽  
History Of ◽  
Future Events ◽  
St Elevation ◽  
The Right ◽  
Brugada Pattern

Background: Management of patients with the brugada ECG sign who have no previous history of syncope is still negotiable. We present a case of a 57 year-old Caucasian lady who presented to the emergency department with substernal chest pain. Results: Her past medical history showed that she had two previous episodes of lightheadedness, but no syncope. She had a family history of sudden death secon­dary to unknown cause in her aunt at the age of 61. Physical exam was unremarkable except for diaphoresis. Electrocardiography (ECG) showed ST elevation in the right precordial leads (V1-V2) with T inversion, mimicking a STEMI. Emergent cardiac catheterization revealed normal coronary arteries. Echocardiogram was normal. Again, interpretation of ECG revealed a Brugada type 1 pattern, characterized by coved-type, gradually descending ST-T segment, elevated J point of more than 2 mm and T wave inversion. Electrophysiological (EPS) testing with a Sodium channel blocker challenge showed a persistent Brugada type 1 pattern with non-inducible ventricular tachycardia. This patient had Brugada type 1 ECG pattern with no previous history of syncope (asymptomatic). Thus she was considered at low risk of developing a serious arrhythmogenic event in the future. Conclusion: A history of syncope remains the best available predictor for arrhythmogenic events. EPS testing in such patients, to stratify the risk and predict for any future events, is still controversial. It is still unjustified to place an implantable cardioverter-defibrillator in asymptomatic non-inducible individuals with the Brugada pattern. These patients should follow up closely with a cardiologist and be aware of the risk of possible triggers of ventricular arrhythmias.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

COMMONWEALTH Forum: The Politics of Science or the Science of Politics

Commonwealth ◽  
2017 ◽  
Vol 19 (1) ◽  
Author(s):  
John Arway
Keyword(s):  
Public Policy ◽  
Natural Resource ◽  
Factual Information ◽  
The Past ◽  
Difference Of Opinion ◽  
History Of ◽  
The Right ◽  
Scientific Facts ◽  
Environmental Agency ◽  
Laws And Regulations

The challenges of including factual information in public policy and political discussions are many. The difficulties of including scientific facts in these debates can often be frustrating for scientists, politicians and policymakers alike. At times it seems that discussions involve different languages or dialects such that it becomes a challenge to even understand one another’s position. Oftentimes difference of opinion leads to laws and regulations that are tilted to the left or the right. The collaborative balancing to insure public and natural resource interests are protected ends up being accomplished through extensive litigation in the courts. In this article, the author discusses the history of environmental balancing during the past three decades from the perspective of a field biologist who has used the strength of our policies, laws and regulations to fight for the protection of our Commonwealth’s aquatic resources. For the past 7 years, the author has taken over the reins of “the most powerful environmental agency in Pennsylvania” and charted a course using science to properly represent natural resource interests in public policy and political deliberations.

Multiple subluxations and comminuted fracture of the cervical spine in a sheep

2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan
Keyword(s):  
Cervical Spine ◽  
Pain Perception ◽  
Cervical Vertebrae ◽  
Traumatic Injury ◽  
Spinal Reflexes ◽  
Spine Trauma ◽  
Blunt Force Trauma ◽  
Comminuted Fracture ◽  
History Of ◽  
The Right

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

Accelerating Agricultural Growth—Is Irrigation Institutional Reform Necessary? (Distinguishedl Lecture)

1996 ◽  
Vol 35 (4I) ◽  
pp. 399-417 ◽  
Author(s):  
John W. Mellor
Keyword(s):  
Growth Rates ◽  
Irrigation System ◽  
Institutional Reform ◽  
Residual Effect ◽  
Agricultural Growth ◽  
The Past ◽  
Major Reform ◽  
History Of ◽  
The Right ◽  
Economic Growth Rates

The right to the flow of income from water is vigorously pursued, protected, and fought over in any arid part of the world. Pakistan is of course no exception. Reform of irrigation institutions necessarily changes the rights to water, whether it be those of farmers, government, or government functionaries. Those perceived rights may be explicit and broadly accepted, or simply takings that are not even considered legitimate. Nevertheless they will be fought over. Pakistan has a long history of proposals for irrigation reform, little or none being implemented, except as isolated pilot projects. Thus, to propose major changes in irrigation institutions must be clearly shown to have major benefits to justify the hard battles that must be fought and the goodwill of those who might win those battles for reform. Proponents of irrigation institution reform have always argued the necessity of the reforms and the large gains to be achieved. Perhaps, however, those arguments have not been convincing. This paper will briefly outline the failed attempts at irrigation reform to provide an element of reality to the discussion. It will then proceed to make the case of the urgency of reform in a somewhat different manner to the past. Finally, current major reform proposals will be presented. This paper approaches justification of irrigation reform by focusing on the agricultural growth rate. It does so because that is the critical variable influencing poverty rates and is a significant determinant of over-all economic growth rates. The paper decomposes growth rates and suggests a residual effect of deterioration of the irrigation system that is large and calls for policy and institutional reform. The data are notional, suggesting the usefulness of the approach and paves the way for more detailed empirical analysis and enquiry for the future.

MASJID BESAR RAJA HAJI ABDUL GHANI PULAU BURU KEPULAUAN RIAU

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Nurman Kholis
Keyword(s):  
Qualitative Research ◽  
Research Methods ◽  
19Th Century ◽  
Qualitative Research Methods ◽  
District Level ◽  
History Of ◽  
Chinese Buddhists ◽  
The Right ◽  
The 19Th Century ◽  
Level Government

Abstract. Many Muslims in the Riau Islands do not know the history of the development of Islamic theory from the center of power to spread to various corners. This is as the existence of the Great Mosque of Raja Haji Abdul Ghani (MBRHAG) on Buru Island, Karimun. Thus, to uncover the existence of this mosque, qualitative research methods are used so that history, architecture, and socio-religious functions can be known. Based on the results of the study it was concluded that the establishment of MBRHAG was initiated by Raja Haji Abdul Ghani. He was the first Amir (sub-district level government) of the kingdom of Riau-Lingga on Buru Island, in the 19th century. The architecture is a Chinese. Therefore, on the right side of this mosque is around 200 m, there is also the Sam Po Teng Temple and the Tri Dharma Dewa Bumi. Thus, the close location of the mosque with Chinese and Confucian worship houses's shows a harmonious relationship between Malay Muslims and Chinese Buddhists. In fact, in the continuation of this relationship there was information that a Chinese Buddhist had joined a Muslim friend to fast for half a month of Ramadan.Keywords: Mosque, Malay Muslims, Chinese Buddhists/Confucians, Harmonious RelationsAbstrak. Umat Islam di Kepulauan Riau banyak yang tidak mengenal sejarah perkembangan ajaran Islam dari pusat kekuasaan hingga tersebar ke berbagai pelosok. Hal ini sebagaimana keberadaan Masjid Besar Raja Haji Abdul Ghani (MBRHAG) di Pulau Buru, Karimun. Dengan demikian, untuk mengungkapkan keberadaan masjid ini digunakan metode penelitian kualitatif  agar dapat diketahui sejarah, arsitektur, dan fungsi sosial keagamaannya.  Berdasarkan hasil penelitian diperoleh kesimpulan bahwa pendirian MBRHAG diprakarsai oleh Raja Haji Abdul Ghani. Ia adalah Amir (pemerintah setingkat kecamatan) pertama kerajaan Riau-Lingga di Pulau Buru, pada abad ke-19. Adapun arsitekturnya adalah seorang Tionghoa. Karena itu, di sebelah kanan masjid ini sekitar 200 m juga terdapat Kelenteng Sam Po Teng dan cetya Tri Dharma Dewa Bumi. Dengan demikian, dekatnya lokasi masjid dengan rumah ibadah umat Tionghoa dan Khonghucu ini menunjukkan hubungan yang harmonis antara muslim Melayu dengan Budhis Tionghoa. Bahkan, dalam kelangsungan hubungan ini terdapat informasi seorang Buddhis Tionghoa pernah ikut temannya yang beragama muslim untuk berpuasa selama setengah bulan Ramadhan.Kata Kunci: Masjid, Muslim Melayu, Buddhis/Khonghucu Tionghoa, Hubungan Harmonis

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

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