Giant septal cavity due to coronary artery fistula and ventricular septal dissection after cardiac surgery

Ventricular septal dissection may rarely result from infectiveendocarditis, myocardial infarction or sinus of Valsalva aneurysmprogression. A rare case that developed in a 66-year-old femaleafter mitral valve replacement for severe mitral regurgitationwith cordal rupture is presented and discussed. It resultedfrom a coronary artery fistula, from a septal branch, to a 6cm wide saccular cystic cavity within the interventricular septum,which was detected by transthoracic echocardiography some monthsafter surgery. Coronary arteries were anatomically normal. Coronaryangiography was helpful to clarify the origin of the fistula.Later on the patient developed heart failure and atrial fibrillation,but she refused any further intervention. She has been followedup for more than 7 years and is presently stable on medicaltherapy. A review of the peculiar aspects of the case is done and themost relevant aspects and images are presented and discussed.     

Zur Methodik der Acetonkörper-Bestimmung

Ohne Zusammenfassung     

中医药对癌症支持性治疗的科学证据

辅助与替代疗法已被越来越多用于已发展国家的癌症患者。在各种另类疗法中,只有少数像中医药般既具坚实理论、又有完备的治病方法,包括对癌症的治疗。近年,许多证据表明中医药是有效的癌症支持性治疗,可在常规治疗的治疗期间和治疗后应用。本文特归纳一些已发表的临床报告和荟萃分析,综述中医药治疗方案对癌症支持性治疗的证据,其中包括中药材、针灸和气功治疗。     

Shame and the Fear of Feeling

TOPIC: Toxic shame and the concomitant fear of feeling are core issues needing to be addressed during group therapy with adult survivors of childhood sexual abuse. PURPOSE: To increase awareness of the toxic shame that survivors experience and to describe the impact of group therapy based on a family systems model. SOURCE: The authors' clinical experiences. CONCLUSIONS: Symptom management, repatterning of cognitive distortions, and the improvement of self-care strategies are identified as crucial aspects of healing shame-based feelings and behaviors. Group treatment offers members the opportunity to cease reenacting family rules and roles that create toxic shame.