1/27. Relapsing acute pancreatitis induced by re-exposure to the cholesterol lowering agent bezafibrate.We report a 75-yr-old patient, who presented three times with acute pancreatitis, accompanied by high temperature, shock, and multiorgan involvement and associated each time with exposure to the cholesterol lowering agent bezafibrate. Extensive workup excluded other possible causes for recurrent pancreatitis in this patient, further supporting bezafibrate as the cause of the patient's acute illness. Based on the short time elapsing between rechallenge and development of manifestations and the specific features of the attacks, we proposed hypersensitivity to bezafibrate as the underlying mechanism. The present report includes, for the first time, bezafibrate among definite causes of acute pancreatitis.- - - - - - - - - - ranking = 1keywords = attack (Clic here for more details about this article) |
2/27. Usefulness of coronary MR angiography prior to angioplasty.The range of indications for percutaneous transluminal coronary angioplasty (PTCA) has increased greatly since the procedure was initially introduced. The success rate depends on the anatomy and length of the occlusion and on the state of the distal vessel. We present a case where the use of magnetic resonance angiography (MRA) allowed to evaluate the length of a subtotal occlusion prior to PTCA, and thus could have had an impact on therapeutic decisions. Coronary MR angiography is one of the many applications of breathhold MRI, where breathholding and segmented k-space acquisition are combined to provide anatomical images of coronary vessels. Coronary MR angiography allows reproducible visualization of coronary vessels. Even under adverse circumstances (poor cardiac triggering) the images are sometimes of sufficient quality to help make a diagnosis. This capability may increase the as yet limited clinical use of MR technology in the practice of cardiology.- - - - - - - - - - ranking = 0.59043033634971keywords = cardiac (Clic here for more details about this article) |
3/27. Case 2. recurrence of myocardial infarction.A 50-year-old man arrives in the emergency room with signs and symptoms occurring intermittently over a period of 48 h consistent with a myocardial infarction. He has several major risk factors for a recurrent event. A number of management strategies have already been attempted. Two opinions for further management are presented.- - - - - - - - - - ranking = 410.8672616917keywords = myocardial infarction, infarction (Clic here for more details about this article) |
4/27. Spontaneous uterine perforation from uterine infarction: a rare case of acute abdomen.A case of spontaneous uterine perforation from uterine infarction is presented. The authors believe that this is the first reported case.- - - - - - - - - - ranking = 26.223563634635keywords = infarction (Clic here for more details about this article) |
5/27. myocardial infarction associated with methadone and/or dihydrocodeine.chest pain and myocardial infarction occurring in young people with angiographically normal coronary arteries is well documented. Opiates have a cardioprotective effect and are used in acute heart attacks. We described a 22-year-old opioid addicted male patient who suffered a myocardial infarction following the consumption of methadone and dihydrocodeine.- - - - - - - - - - ranking = 165.34690467668keywords = myocardial infarction, infarction, attack (Clic here for more details about this article) |
6/27. Coronary heart disease in familiar hypercholesterolemia.autopsy findings of a 36-year-old male with familiar hypercholesterolemia were reported and discussed. Hyperlipoproteinemia found in this case might belong to the type IIa in the classification of hyperlipoproteinemia while there was no skin lesion such as xanthoma and hypertension. Remarkable strictures due to atherosclerotic plaques in the lumens of the right and left coronary arteries and wide-spread myocardial infarction in the left ventricle were found. In the aorta just above the aortic valve there were atherosclerotic plaques in which foam cells could be seen. From the histological findings of the aortic valve the possibility that the thickening of the valve might have been induced by a similar mechanism as that of aorta and coronary arteries was suggested.- - - - - - - - - - ranking = 82.173452338341keywords = myocardial infarction, infarction (Clic here for more details about this article) |
7/27. Familial multiple trichoepithelioma associated with subclavian-pulmonary collateral vessels and cerebral aneurysm--case report.A 63-year-old woman presented with cerebellar infarction caused by occlusion of the right posterior inferior cerebellar artery. She had papules on her face that were identified histologically as multiple trichoepithelioma. Angiography revealed right subclavian-pulmonary collateral vessels and a cerebral aneurysm arising from the bifurcation of the right middle cerebral artery. Her grandmother, mother, and uncle had had similar papules, and the deaths of her mother and uncle were due to subarachnoid hemorrhage.- - - - - - - - - - ranking = 5.244712726927keywords = infarction (Clic here for more details about this article) |
8/27. Granulomatous hepatitis, increased platelet aggregation, and hypercholesterolemia.Two young patients presented with an unusual liver disease, granulomatous hepatitis with postnecrotic cirrhosis, and both underwent a splenorenal shunt procedure. Each developed an arterial embolic episode probably related to increased platelet aggregation. This represents the first report of a liver disease associated with increased platelet aggregation that was clinically significant, a myocardial infarction in one and a posterior cerebral infarction in the other. Also, unexpectedly, both patients became hypercholesterolemic after the splenorenal shunt was established.- - - - - - - - - - ranking = 87.418165065268keywords = myocardial infarction, infarction (Clic here for more details about this article) |
9/27. Thrombocytopenic purpura during therapy with simvastatin.The authors describe a case of very serious thrombocytopenic purpura occurring in a diabetic and hyperlipidemic woman during therapy with simvastatin, an HMG-CoA reductase inhibitor drug. Interruption of the medical treatment produced a prompt reversal of the thrombocytic attack: one year later the patient's platelet count remains within the normal range. The authors have not found other reports in the medical literature of similar serious reactions during therapy with an HMG-CoA reductase inhibiting substance; nevertheless, a causal nexus is hypothesized but not argued in this case, since further studies will be needed before this connection can be established.- - - - - - - - - - ranking = 1keywords = attack (Clic here for more details about this article) |
10/27. bezafibrate induced rhabdomyolysis.The case is presented of a 70 year old woman with mild hypercholesterolaemia and hypertension who was readmitted to hospital six months after a previous admission for angina pectoris. The patient was treated with verapamil, nifedipine, and aspirin, and had been receiving bezafibrate (400 mg every 12 hours) for the previous 40 days. Twenty four hours after admission she developed podagra, which was treated with indomethacin (100 mg daily). Eight days after admission myocardial infarction was suspected, and the next day she presented with symptoms of rhabdomyolysis, which was confirmed by laboratory tests. bezafibrate was withdrawn and the patient became asymptomatic after seven days. It is recommended that doctors should be aware of the possibility of patients, especially those with impaired renal function, developing rhabdomyolysis while being treated with bezafibrate.- - - - - - - - - - ranking = 82.173452338341keywords = myocardial infarction, infarction (Clic here for more details about this article) |
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