Activity

CONTEXT The prevalence of diabetes mellitus (DM) in patients with primary aldosteronism (PA) is higher than in those with essential hypertension and the general population. Although DM is a common major risk factor for the cardio-cerebrovascular (CCV) diseases and renal complications, details of its effects in PA have not been demonstrated. OBJECTIVE The aim of this study was to determine the effects of co-existent DM on the risk of CCV events and progression of renal complications in PA patients. DESIGN Multi-institutional cross-sectional study. PATIENTS AND METHODS PA patients experienced between January 2006 and October 2016 and with available data of CCV events and DM were enrolled from the Japan PA registry of the JPAS/JRAS (n=2,524). CCV events and renal complications were compared between DM group and non-DM group by logistic and liner-regression analysis. RESULTS DM significantly increased the odds ratio of CCV events (OR 1.59, 95% CI 1.05-2.41) and that of proteinuria (OR 2.25, 95% CI 1.59-3.16). DM correlated significantly with the declines in eGFR (β=0.05, p=0.02). CONCLUSIONS This the first report to demonstrate the presence of DM as an independent risk factor for CCV events and renal complications even in PA patients. Management of DM should be considered in addition to the specific treatment of PA. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail [email protected] authors informed the journal that an error occurred in their manuscript.Figure 3C was mistakenly merged by the authors.The new version of the Figure 3C is as below.Reference1. Meng Zhang, Xiuxiu Tan, Junjie Huang, Zekai Ke, Yukun Ge, Hu Xiong, Wei Lu, Lu Fang, Zhiming Cai, Song Wu Association of 3 Common Polymorphisms of IL-27 Gene with Susceptibility to Cancer in Chinese Evidence From an Updated Meta-Analysis of 27 Studies. Med Sci Monit 2015; 21 2505-2513. DOI 10.12659/MSM.895032.We describe the management, focusing on the anesthetic preparedness, of a 44-year-old man who presented with impalement of a 1 m long serrated rod through the right supraclavicular fossa extending up to the right iliac fossa, along with rib fractures and laceration of the liver and diaphragm.In patients with critical tracheal stenosis, particularly involving the lower part of trachea, a highly experienced team of anesthesiologists to tackle the difficulties of securing and maintaining the ventilation, cardiac surgeon who can swiftly establish cardiopulmonary bypass, an experienced surgeon for tracheal reconstruction are a prerequisite for managing these highly complex cases. The present paper describes three patients suffering from severe tracheal narrowing wherein spontaneous bag-mask ventilation was used for establishing cardiopulmonary bypass via mid-sternotomy as a rare life-saving procedure for urgent tracheal reconstructive surgery. A highly experienced team of anesthesiologists to tackle the difficulties of securing and maintaining the ventilation, cardiac surgeon who can swiftly establish CPB, and an experienced surgeon for tracheal reconstruction are a prerequisite for managing these highly complex cases. The present paper describes three patients suffering from severe tracheal narrowing wherein spontaneous bag-mask ventilation was used for establishing CPB via mid-sternotomy as a rare life-saving procedure for urgent tracheal reconstructive surgery.Though respiratory complications after cardiac surgery for congenital heart disease are common, and malformations of the diaphragm can be expected in these patients, the presence of an occult diaphragmatic defect unrecognisible preoperatively and complicating the post operative course is very rare and need a high index of suspicion for diagnosis in the setting of post operative respiratory failure. We present here a case of post operative respiratory failure from a delayed presenting diaphragmatic hernia in a 2-month-old boy who underwent corrective surgery for Taussig bing anomaly and hypoplastic aortic arch. Surgical repair of the diaphragmatic defect and reduction of the bowel loops to the abdomen resulted in rapid weaning from ventilation and recovery with subsequent discharge from hospital.Long-term survival of patients submitted to a Fontan procedure is reduced because of arrhythmias. Late post-Fontan ventricular tachycardia is extremely rare, but it can be fatal. Consequently, the implantation of an implantable cardioverter defibrillator may be required. The implantation of such a device after a Fontan operation can be rather difficult due to anatomic reasons that exclude transvenous approach. Epicardial ICD implantation is a treatment option for these patients. Transatrial approach, shock ICD coils placement in azygos vein or directly in the pericardium are possible alternatives. We hereby present a successful epicardial implantable cardioverter defibrillator implantation in a post-Fontan 39-year-old man suffering from ventricular tachycardia.We present a case of D-transposition of great arteries with atrial septal defect and patent ductus arteriosus electively posted for Senning’s operation at 10 months of age. The patient developed signs of lung congestion immediately after termination of cardiopulmonary bypass. CDK inhibitor A stenosis in the pulmonary venous baffle was detected in transesophageal echocardiography showing a peak gradient of 10 mmHg and a mean gradient of 5 mmHg. Hence, revision of baffle was planned. The stenotic area was excised and augmented with homologous pericardium. Post-correction, lung compliance improved and the peak and mean gradient decreased to 3 and 1 mm Hg, respectively. The patient was extubated in the intensive care unit after 36 h and shifted to ward after 5 days with stable hemodynamics.Giant coronary artery aneurysms are exceptionally uncommon with an incidence of 0.02%. The natural history and prognosis of giant coronary artery aneurysm are still not well known.Induction of general anesthesia in patients with mediastinal mass can lead to life threatening respiratory and cardiovascular complications during induction, maintenance and emergence. The inability of pediatric patient to cooperate for local anesthesia further complicates the management of such cases. Here we report the management of a child with anterior mediastinal mass causing airway compression and massive pericardial effusion posted for right pleuropericardial window.