scholarly journals Ruptured Thoracic Aortic Aneurysm Infected with Listeria Monocytogenes: A Case Report and a Review of Literature

2013 ◽  
Vol 6 ◽  
pp. OJCS.S11446 ◽  
Author(s):  
Shigeki Masuda ◽  
Nobuhiro Takeuchi ◽  
Masanori Takada ◽  
Koichi Fujita ◽  
Yoshiharu Nishibori ◽  
...  
Keyword(s):  
Listeria Monocytogenes ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Rupture ◽  
Prosthetic Graft ◽  
Sigmoid Colon Cancer ◽  
Causative Organism ◽  
Protein Levels ◽  
Reactive Protein ◽  
History Of

A 75-year-old male with a history of alcoholic liver cirrhosis, sigmoid colon cancer, and metastatic liver cancer was admitted to our institution with a complaint of a prickly feeling in his chest. On admission, a chest radiograph revealed a normal cardio-thoracic ratio of 47%. Echocardiography revealed pericardial effusion and blood chemical analyses revealed elevated C-reactive protein levels (14.7 mg/dL). On day 3, chest radiography revealed cardiomegaly with a cardio-thoracic ratio of 58% and protrusion of the left first arch. Contrast-enhanced chest computed tomography revealed a saccular aneurysm in the aortic arch with surrounding hematoma; thus, a ruptured thoracic aortic aneurysm was suspected. Emergency surgery was performed, which revealed a ruptured aortic aneurysm with extensive local inflammation. The diagnosis of an infected aortic rupture was therefore confirmed. The aneurysm and abscess were resected, followed by prosthetic graft replacement and omental packing. Histopathology of the resected aneurysm revealed gram-positive bacilli; and Listeria monocytogenes was confirmed as the causative organism by culture. Postoperative course was uneventful; on postoperative day 60, the patient was ambulatory and was discharged. Here we report the case of a male with a ruptured thoracic aortic aneurysm infected with L. monocytogenes.

scholarly journals Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study

Diabetologia ◽  
2021 ◽  
Vol 64 (4) ◽  
pp. 778-794 ◽  
Author(s):  
Matthieu Wargny ◽  
◽  
Louis Potier ◽  
Pierre Gourdy ◽  
Matthieu Pichelin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hospital Discharge ◽  
Microvascular Complications ◽  
White Cell Count ◽  
Symptom Duration ◽  
Protein Levels ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
History Of ◽  
Routine Therapy

Abstract Aims/hypothesis This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). Methods The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. Results We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th–75th percentile) 28.4 (25.0–32.4) kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5–14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. Conclusions/interpretation In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. Trial registration Clinicaltrials.gov identifier: NCT04324736 Graphical abstract

scholarly journals A post mortem assessment of a 25-year-old man with ascending aortic dissection and a novel MYLK variant

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Katelyn Hodge ◽  
Katherine G. Spoonamore ◽  
Christopher B. Griffith ◽  
David D. Weaver ◽  
Patricia B.S. Celestino-Soper ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Rupture ◽  
Clinical Consequence ◽  
Post Mortem ◽  
Variant Of Uncertain Significance ◽  
Pathogenic Variants ◽  
Aortic Aneurysm And Dissection

We report on the process of <em>post mortem</em> evaluation and genetic testing following the death of a 25-year-old man due to ascending aortic dissection leading to aortic rupture. Following the negative clinical testing of a 12- gene thoracic aortic aneurysm and dissection panel, research testing revealed a novel c.5732A&gt;T (p.E1911V) variant in exon 34 of the MYLK gene (NM_053025). Two likely pathogenic variants in this gene have been reported previously in individuals with familial thoracic aortic aneurysm and dissection. Given the unclear clinical consequence of the variant found in our proband, we have classified this change as a variant of uncertain significance. In addition to discussing the complexity involved in variant interpretation, we recognize the need for additional research for more accurate <em>MYLK</em> interpretation. Finally, we comment on the unique challenges of <em>post mortem</em> genetic testing.

Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection

2005 ◽  
Vol 13 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Yukio Kuniyoshi ◽  
Kageharu Koja ◽  
Kazufumi Miyagi ◽  
Tooru Uezu ◽  
Satoshi Yamashiro ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Thoracoabdominal Aorta ◽  
Omental Wrapping ◽  
Hospital Deaths

Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 ± 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.

scholarly journals Familial Thoracic Aortic Aneurysm with Dissection Presenting as Flash Pulmonary Edema in a 26-Year-Old Man

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sabry Omar ◽  
Tyler Moore ◽  
Drew Payne ◽  
Parastoo Momeni ◽  
Zachary Mulkey ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Thoracic Aortic Aneurysm ◽  
Ascending Aorta ◽  
Screening Methods ◽  
Significant Past Medical History ◽  
Iliac Arteries ◽  
Aortic Aneurysm And Dissection ◽  
History Of ◽  
Chest X Ray

We are reporting a case of familial thoracic aortic aneurysm and dissection in a 26-year-old man with no significant past medical history and a family history of dissecting aortic aneurysm in his mother at the age of 40. The patient presented with cough, shortness of breath, and chest pain. Chest X-ray showed bilateral pulmonary infiltrates. CT scan of the chest showed a dissection of the ascending aorta. The patient underwent aortic dissection repair and three months later he returned to our hospital with new complaints of back pain. CT angiography showed a new aortic dissection extending from the left carotid artery through the bifurcation and into the iliac arteries. The patient underwent replacement of the aortic root, ascending aorta, total aortic arch, and aortic valve. The patient recovered well postoperatively. Genetic studies of the patient and his children revealed no mutations in ACTA2, TGFBR1, TGFBR2, TGFB2, MYH11, MYLK, SMAD3, or FBN1. This case report focuses on a patient with familial TAAD and discusses the associated genetic loci and available screening methods. It is important to recognize potential cases of familial TAAD and understand the available screening methods since early diagnosis allows appropriate management of risk factors and treatment when necessary.

C-reactive protein levels are related to suicidality in euthymic patients with bipolar disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S337-S337
Author(s):  
M. Pantovic Stefanovic ◽  
B. Dunjic-Kostic ◽  
M. Lackovic ◽  
A. Damjanovic ◽  
A. Jovanovic ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Previous History ◽  
Control Group ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Course Of Illness ◽  
Protein Levels ◽  
Reactive Protein ◽  
History Of ◽  
Competing Interest

IntroductionImmune alterations are believed to be an important part in etiopathogenesis of affective disorders. However, it is not clear if the altered immune mediators are related to distinct disorders or particular psychopathology.AimsThe aim of our study was to explore the differences in C-reactive protein levels (CRP) between euthymic BD patients and healthy controls, as well as to explore the relationship between CRP and lifetime presented psychopathology within BD.MethodsThe study group consisted of 83 patients diagnosed with BD, compared to the healthy control group (n = 73) and matched according to age, gender, and body mass index (BMI). Lifetime psychopathology has been assessed according to predominant polarity as well as previous history of suicide attempts and psychotic episodes.ResultsThe CRP levels were significantly higher in BD patients when compared to healthy controls. After covarying for confounders, we observed that CRP levels, in euthymic BD patients, were related to number of previous suicide attempts, but not other indicators of lifetime psychopathology.ConclusionsBD patients per se, and particularly those with more suicide attempts, are more likely to present with proinflammatory state, even when in remission. Previous history of suicide attempts could bear specifically vulnerable endophenotype within BD. Systemic, longitudinal monitoring of the course of illness, and potential inflammatory mediators that underlie its systemic nature is warranted.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Physical Inactivity is Related to Unheralded Myocardial Infarction More Than Uncomplicated Stable Angina

2018 ◽  
Vol 7 (3) ◽  
pp. 46-52
Author(s):  
Ali Vasheghani-Farahani ◽  
Somayeh Afshar ◽  
Maryam Salimnejad ◽  
Ebrahim Kasaian ◽  
Mohammad Ali Boroumand ◽  
...  
Keyword(s):  
Stable Angina ◽  
Physical Inactivity ◽  
Positive Family History ◽  
Chronic Stable Angina ◽  
Premature Coronary Artery Disease ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
History Of ◽  
Artery Disease

ABSTRACT Background: Ischemic heart disease can vary substantially in its clinical presentation. Some patients have acute myocardial infarction (MI) without any previous signs of myocardial ischemia, whereas other patients may have stable angina pectoris for years without periods of acute instability; this suggests the possibility of different risk influence in these 2 groups of patients. Methods: Cardiovascular risk factors were compared in 112 consecutive patients with unheralded MIs (81 men; 59.9 ± 11.6 years) and in 168 consecutive patients with chronic stable angina (108 men; 58.2 ± 10.5 years) with at least 60% occlusion in lumen diameter in 1 of the coronary vessels. Results: Logistic-regression analysis revealed that physical inactivity (odds ratio [OR]: 4.32, 95% CI = 2.07, 8.99; P &lt; 0.0001), the values of high sensitive-C-reactive protein levels (OR: 1.05, 95% CI = 1.00, 1.11; P = 0.043), diabetes (OR: 2.88, 95% CI = 1.42, 5.83; P = 0.003), and positive family history of premature coronary artery disease (OR: 1.96, 95% CI: 1.04, 3.71; P = 0.038) were independent predictors of unheralded MI versus chronic stable angina. Conclusion: In our subjects, sedentary life, diabetes mellitus, positive family history of premature coronary artery disease, and higher high sensitive-C-reactive protein levels were important independent predictors for unheralded MI, which suggests that these factors are involved in thrombosis, plaque rupture, or both.

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