Cerebellar artery infarction with sudden hearing loss and vertigo as initial symptoms: A case report

BACKGROUNDSudden hearing loss (SHL) is associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury. Some authors report that SHL can be an early warning sign of impending vertebrobasilar ischemic stroke. It is important to distinguish stroke from benign disease. CASE SUMMARYA 48-year-old male patient presented with SHL and vertigo as first symptoms. Diffusion-weighted imaging revealed high signal intensity in the left posterior inferior cerebellar artery territory of the cerebellar hemisphere and high signal intensity in the right pons and bridge cerebellar arm, confirming that the patient had cerebral infarction. Treatment with antiplatelet drugs, steroid anti-inflammatory drugs, and neurotrophic nerve therapy promoted blood circulation and removed blood stasis, and the symptoms of the patient were significantly improved. CONCLUSIONSHL and vertigo could be the initial symptoms of vertebrobasilar ischemic stroke.     

Registro Español de Desfibrilador Automático Implantable. XV Informe Oficial de la Sección de Electrofisiología y Arritmias de la Sociedad Española de Cardiología (2018)

Introduction and objectivesThis article presents the data corresponding to automated implantable cardioverter-defibrillator (ICD) implants in Spain reported to the Spanish Registry in 2018.MethodsThe data in this registry include both primary implants and generator replacements and were gathered from a data collection sheet voluntarily completed by implantation centers.ResultsIn 2018, 6421 implant sheets were received compared with 7077 reported by Eucomed (European Confederation of Medical Suppliers Associations). This represents data on 90.7% of the devices implanted in Spain. Compliance ranged between 99.6% for the field “name of the implanting hospital” and 12.4% for “population of residence”. A total of 173 hospitals reported their data to the registry, representing a slight decrease compared with hospitals participating in 2017 (n = 181).ConclusionsAfter the reduction in ICD implants in 2017, the number of implants increased in 2018, with the highest number of ICDs implanted in Spain. The total number of implants remains much lower than the European Union average, with substantial differences between autonomous communities.     

Unexpected death in a young child associated with anomalous aortic origin of the left main coronary artery without physical exertion: A case of an anomalous coronary artery with highly abundant elastic fibers

Sudden death due to anomalous aortic origin of a coronary artery is far less common among young children in the absence of exercise stress. This report describes the case of a 2-year-old boy with a lower respiratory tract infection who suffered sudden cardiac arrest in his bed at home. The autopsy revealed that the left coronary artery (LCA) originated from the right sinus of Valsalva with an acute angle takeoff and traveled between the aorta and the pulmonary trunk (an interarterial course). Upon histological examination, the LCA, before reaching its major branches, was located adjacent to the outside of the aortic wall without an intramural passage, and the arterial wall was composed almost exclusively of elastic fibers without media containing smooth muscle cells throughout the entire length of the abnormal running. Screening tests for respiratory virus infection detected enterovirus in the lung tissue. In association with an acute angle takeoff and interarterial course, the wall structure with highly abundant elastic fibers that are more flexible tissues among blood vessel components might suggest their vulnerability to compression during the great vessels’ systolic expansion in the sympathetic activation induced by the viral infection, leading to fatal myocardial ischemia without physical exertion.     

糖尿病患者饥饿感中医病机浅识

糖尿病患者饥饿感病机有胃火炽盛、胃强脾弱、脾胃虚弱、瘀热消谷、痰热消谷等。糖尿病初期,痰热、火热之证常见,患者出现多食易饥表现,应考虑痰热消谷、火热消谷,选用白虎汤、玉女煎、消渴方等加减治疗;病程日久,火热伤阴,壮火食气,出现气阴两虚等表现,此时出现多食易饥症状,则需考虑胃强脾弱、脾胃虚弱等病机,采用半夏泻心汤、附子理中丸、参苓白术散等治疗;瘀血贯穿糖尿病始终,故在使用以上方法治疗糖尿病患者消谷易饥效果欠佳时,可考虑瘀热消谷的因素,采用桃核承气汤、白虎汤合桂枝茯苓丸治疗。糖尿病与痰湿关系密切,针对该病机引起的饥饿感,在清热的同时,还应化痰除湿。糖尿病病程日久患者,饥饿感病机复杂,宜"观其脉证,知犯何逆,随证治之"。     

针刺结合高压氧治疗低频下降型突发性聋的临床研究

目的探讨针刺结合高压氧治疗低频下降型突发性聋的临床疗效,为临床运用提供证据。方法将105例突发性聋的患者随机分为A组(高压氧组)、B组(针刺组)、C组(针刺结合高压氧组),每组35例,3组患者均进行基础药物治疗,连续治疗4周,治疗前后采用测听仪对其临床疗效进行评价。结果高压氧、针刺及针刺结合高压氧治疗低频下降型突发性聋,总有效率分别为68.6%、62.9%和82.9%。针刺结合高压氧治疗低频下降型突发性聋的疗效在全部受损听阈(低频段)、500Hz听阈和250Hz听阈不但优于针刺疗法(P=0.010、P=0.007、P=0.030),还优于高压氧疗法(P=0.016、P=0.002、P=0.010)。而高压氧和针刺疗法在治疗突发性聋的疗效上无统计学差异(P=0.843、P=0.661、P=0.701)。结论针刺结合高压氧治疗低频下降型突发性聋具有一定临床优势。