Right atrial tear associated with a tumour in the right atrium after blunt chest trauma

Occult cardiac injury following blunt trauma is more commonthan generally suspected. Myocardial contusion is not rare,however, it is generally a benign disorder which often remainsundiagnosed. We report a case of a right atrial rupture afterblunt chest trauma causing a tamponade. A 24-year-old man was involved in a violent car accident andhe presented in a state of collapse. A multislice computed tomographyindicated a pericardial effusion (Figure 1). A transthoracicechocardiography was performed and confirmed pericardial effusionwhich was hyperechoic (Figure 2, Movie 1). Concerns abouta possible mass in the right atrium led to examination withtransesophageal echocardiography (Figure 3, Movie 2) whichrevealed the presence of a voluminous mass in the right atrium.The patient successfully underwent cardiac surgery to removethe mass, identified as a blood clot, and to repair the atrialtear. The present case is of special interest because of therarity of documented incidents of blunt chest trauma causingright atrial tear and illustrates the usefulness of transesophagealechocardiography in completing the diagnosis in the event ofhaemopericardium.     

Imaging appearances of metastases from neuroendocrine tumours of the pancreas.

Endocrine tumours of the pancreas (ETPs) are rare neoplasms that are frequently malignant. Despite their usual slow growth, metastases do occur and have a major impact on prognosis. Metastases may be the first manifestation of disease, and recognition of particular radiological features of these hypervascular metastases should suggest their possible neuroendocrine origin. Although somatostatin receptor scintigraphy has changed the imaging strategy for these tumours and has become their principal imaging modality, radiological techniques are still required for precise localization of scintigraphic hot spots and monitoring of response to therapy. This pictorial review shows the typical radiological features of ETP metastases and emphasizes the role of different imaging modalities.     

Moderators of the intention-behaviour and perceived behavioural control-behaviour relationships for leisure-time physical activity

Background  

Intention is a key determinant of action. However, there is a gap between intention and behavioural performance that remains to be explained. Therefore, the aim of this study was to identify moderators of the intention-behaviour and perceived behavioural control (PBC)- behaviour relationships for leisure-time physical activity.     

Insomnia evaluation and treatment during peripartum: a joint position paper from the European Insomnia Network task force “Sleep and Women,” the Italian Marcè Society and international experts task force for perinatal mental health

Archives of Women's Mental Health - Insomnia symptoms are frequent during peripartum and are considered risk factors for peripartum psychopathology. Assessing and treating insomnia and related...     

The functional basis for hemophagocytic lymphohistiocytosis in a patient with co-inherited missense mutations in the perforin (PFN1) gene

About 30% of cases of the autosomal recessive immunodeficiency disorder hemophagocytic lymphohistiocytosis are believed to be caused by inactivating mutations of the perforin gene. We expressed perforin in rat basophil leukemia cells to define the basis of perforin dysfunction associated with two mutations, R225W and G429E, inherited by a compound heterozygote patient. Whereas RBL cells expressing wild-type perforin (67 kD) efficiently killed Jurkat target cells to which they were conjugated, the substitution to tryptophan at position 225 resulted in expression of a truncated ( approximately 45 kD) form of the protein, complete loss of cytotoxicity, and failure to traffic to rat basophil leukemia secretory granules. By contrast, G429E perforin was correctly processed, stored, and released, but the rat basophil leukemia cells possessed reduced cytotoxicity. The defective function of G429E perforin mapped downstream of exocytosis and was due to its reduced ability to bind lipid membranes in a calcium-dependent manner. This study elucidates the cellular basis for perforin dysfunctions in hemophagocytic lymphohistiocytosis and provides the means for studying structure-function relationships for lymphocyte perforin.