Chronic constrictive pericarditis associated with asbestosis

Observation of chronic constrictive pericarditis associated with pulmonary asbestosis is reported here. Heart catheterization revealed typical patterns of cardiac constriction. The diagnosis of asbestosis was based on pathologic features associated with a long history of asbestos dust exposure without evidence for tuberculosis. The etiology of this constrictive pericarditis was related to an asbestosis pericarditis involvement.     

Kaposi's sarcoma in a child after autologous bone marrow transplantation for non-Hodgkin's lymphoma

A case of Kaposi's sarcoma in a child with no serologic evidence of human immunodeficiency virus (HIV) infection is reported. A 7-year-old boy with Stage IV non-Hodgkin's lymphoma, after conventional chemotherapy, underwent autologous bone marrow transplantation (ABMT). Five months later he presented with supraclavicular mass and mediastinal enlargement. A bone marrow biopsy showed hypoplasia with no signs of the underlying disease, whereas the excised mass revealed a typical histologic pattern of Kaposi's sarcoma. The child is currently being treated with recombinant alpha-interferon (alpha-IFN) and regression of the disease has been achieved.     

A new species of <Emphasis Type="Italic">Dichelyne</Emphasis> (Nematoda,Cucullanidae) parasitizing sciaenid fishes from off the South American Atlantic coast

A new nematode species Dichelyne (Cucullanellus) sciaenidicola sp. nov. is described based on specimens collected from the Whitemouth croaker Micropogonias furnieri (Desmarest) and the Argentine croaker Umbrina canosai Berg, from coastal waters of Argentina and Brazil. These nematodes were firstly identified as D. (C.) elongatus (Törnquist, 1931), a commonly reported species from M. furnieri in South American Atlantic waters. However, other species of Dichelyne have so far been reported from this host in the same area, namely D. (C.) rodriguesi (Pinto, Fábio et Noronha, 1970), D. (C.) amaruincai (Freitas, Vicente et Ibañez, 1969) and D. (Dichelyne) micropogonii Pereira et Costa, 1996. A careful re-examination of these parasites, as well as of type specimens of all species reported from M. furnieri, revealed that these nematodes represented a new species. The new species is distinguished from most of its congeners by having papillae 5–7 and 9 forming a subventral line close to cloaca, this feature is shared with other 6 species [D. (C.) dichelyneformis (Szidat, 1950), D. (C.) fraseri (Baylis, 1929), D. (C.) abbreviatus (Rudolphi, 1819), D. (C.) adriaticus (Törnquist, 1931), D. (C.) minutus (Rudolphi, 1819) and D. (C.) mariajuliae Alarcos, Timi, Etchegoin et Sardella, 2006)], which are readily distinguished by their body size, spicules length, distribution patterns of other papillae and position of the excretory pore and deirids. Also, D. (C.) elongatus from Umbrina canariensis (Valenciennes) from West Africa is established as a new species Dichelyne (Cucullanellus) yvonnecampanae sp. nov.; D. (C.) amaruincai from Pacific waters is considered as a valid species, D. (D.) micropogonii is regarded as species inquirendae and D. (C.) rodriguesi is identified as Cucullanus sp.     

Nighttime Blood Pressure in Normotensive Subjects With Chronic Insomnia: Implications for Cardiovascular Risk

Objective:

To assess as whether insomniacs have higher nighttime blood pressure (BP) and a blunted day-to-night BP reduction, recognized markers of increased risk of cardiovascular morbidity and mortality.

Design:

Prospective case-control study.

Setting:

University hospital-based sleep research laboratory.

Participants:

Thirteen normotensive subjects with chronic primary insomnia (9 women, 42 ± 7 y) and 13 sex- and age-matched good sleepers.

Measurements and results:

Subjects underwent 2-week sleep diary and 3 sleep studies to provide subjective and objective sleep variables, and 24-h beat-to-beat BP recording to provide daytime, night-time and day-to-night BP changes ([nighttime-daytime]/daytime)*100) (BP dipping). Spectral analysis of the electroencephalogram (EEG) was also performed during sleep of night 3 to assess EEG activity in the β frequency (16-32 Hz), a measure of brain cortical activation. Nighttime SBP was higher (111 ± 15 vs 102 ± 12 mm Hg, P < 0.01) and day-to-night SBP dipping was lower (−8% ± 6% vs −15% ± 5%, P < 0.01) in insomniacs than good sleepers. Insomniacs also had higher activity in EEG β frequency (P < 0.05). Higher nighttime SBP and smaller SBP dipping were independently associated with increased EEG β activity (P < 0.05).

Conclusions:

Higher nighttime SBP and blunted day-to-night SBP dipping are present in normotensive subjects with chronic insomnia and are associated with a hyperactivity of the central nervous system during sleep. An altered BP profile in insomniacs could be one mechanism implicated in the link between insomnia and cardiovascular morbidity and mortality documented in epidemiological studies.

Citation:

Lanfranchi PA; Pennestri MH; Fradette L; Dumont M; Morin CM; Montplaisir J. Nighttime blood pressure in normotensive subjects with chronic insomnia: implications for cardiovascular risk. SLEEP 2009;32(6):760-766.     

Cardiac overexpression of melusin protects from dilated cardiomyopathy due to long-standing pressure overload

We have previously shown that genetic ablation of melusin, a muscle specific beta 1 integrin interacting protein, accelerates left ventricle (LV) dilation and heart failure in response to pressure overload. Here we show that melusin expression was increased during compensated cardiac hypertrophy in mice subjected to 1 week pressure overload, but returned to basal levels in LV that have undergone dilation after 12 weeks of pressure overload. To better understand the role of melusin in cardiac remodeling, we overexpressed melusin in heart of transgenic mice. Echocardiography analysis indicated that melusin over-expression induced a mild cardiac hypertrophy in basal conditions (30% increase in interventricular septum thickness) with no obvious structural and functional alterations. After prolonged pressure overload (12 weeks), melusin overexpressing hearts underwent further hypertrophy retaining concentric LV remodeling and full contractile function, whereas wild-type LV showed pronounced chamber dilation with an impaired contractility. Analysis of signaling pathways indicated that melusin overexpression induced increased basal phosphorylation of GSK3beta and ERK1/2. Moreover, AKT, GSK3beta and ERK1/2 were hyper-phosphorylated on pressure overload in melusin overexpressing compared with wild-type mice. In addition, after 12 weeks of pressure overload LV of melusin overexpressing mice showed a very low level of cardiomyocyte apoptosis and stromal tissue deposition, as well as increased capillary density compared with wild-type. These results demonstrate that melusin overexpression allows prolonged concentric compensatory hypertrophy and protects against the transition toward cardiac dilation and failure in response to long-standing pressure overload.     

Comparison between spectral analysis and the phenylephrine method for the assessment of baroreflex sensitivity in chronic heart failure.

Baroreflex sensitivity assessed by means of the phenylephrine test plays a prognostic role in patients with previous myocardial infarction, but the need for drug injection limits the use of this technique. Recently, several non-invasive methods based on spectral analysis of systolic arterial pressure and heart period have been proposed, but their agreement with the phenylephrine test has not been investigated in patients with heart failure. The two methods (phenylephrine test and spectral analysis) were compared in a group of 49 patients with chronic congestive heart failure both at rest and during controlled breathing. The linear correlation and the limits of agreement between the phenylephrine test slope and the alpha-index [alpha(c); corrected by the coherence function between the interbeat interval (RR interval) and systolic arterial pressure] were evaluated. Only 16 patients had a measurable alpha-index at rest in both the low-frequency (LF) and high-frequency (HF) bands; the alpha(c)-index allowed measurements in all patients. It correlated moderately with the phenylephrine test slope at rest (r=0. 71 and P<0.001 in LF; r=0.57 and P<0.001 in HF) and during controlled breathing (r=0.51 and P<0.001 in LF; r=0.63 and P<0.001 in HF). Multivariate regression analysis showed that only alpha(c)LF during rest and alpha(c)HF during controlled breathing contributed significantly to baroreflex gain estimation. However, the agreement between methods was weak; the normalized limits of agreement and bias were -162 to 243% (0.46 ms/mmHg) for alpha(c)LF and -185 to 151% (-0.99 ms/mmHg) for alpha(c)HF. Thus the comparison between baroreflex sensitivity measurements obtained by the phenylephrine test and spectral analysis showed a moderate correlation between the two methods; however, despite the linear association, a consistent lack of agreement between the two techniques was found. Because both systematic and random factors contribute to the difference, these two techniques cannot be considered as alternatives for the assessment of heart failure.