Atrial Septal Hematoma After Mitral Valve and Left Coronary Artery Surgery in a Child

Atrial septal hematoma (ASH) has been reported mostly in adult patients to occur after spontaneous ascending aortic dissection (Circulation 46(3):537–545, 1972) and after surgery for coronary artery (Anesthesiology 83(3):620–621, 1995), mitral valve, and aortic valve (Rev Esp Cardiol 55(8):867–871, 2002). ASH in the pediatric age group is rare, and to our knowledge only two cases have been published (Am J Perinatol 27(6):481–483, 2010; J Am Soc Echocardiogr 1087–1089, 1998). We report a case of ASH diagnosed by intraoperative transesophageal echocardiography in a 28-month-old child who underwent mitral valvuloplasty and left main coronary arterioplasty for anomalous origin of the left coronary artery from pulmonary artery. ASH subsided on its own within 24 h.     

Role of reactive oxygen species (ROS) and JNKs in selenite-induced apoptosis in HepG2 cells

Dietary selenium (Se) supplementation has been shown to be effective against reducing the risk of incidence of different human cancers. Selenium exists in both organic and inorganic forms. Different chemical forms of selenium metabolize differently in vivo, activate distinct molecular mechanisms and exhibit varying degree of anti-carcinogenicity in different cancer types. The effectiveness of a Se compound could also vary depending on the genetic background of the tumor cells. Therefore, understanding the molecular mechanism(s) by which different Se compounds exert their anti-tumorigenic effects is necessary for their use in cancer chemoprevention.     

Association between early initiation of breastfeeding and reduced risk of respiratory infection: Implications for nonseparation of infant and mother in the COVID‐19 context

Early initiation of breastfeeding, within 1 h of birth, is vital for the health of newborns and reduces morbidity and mortality. Secondary analysis of the 2016 Nepal Demographic and Health Survey (DHS) showed that early initiation of breastfeeding significantly reduced the risk of acute respiratory infection (ARI) in children under 2 years. Early initiation of breastfeeding requires maternal proximity. Separation of infant and mother inhibits early initiation of breastfeeding and increases the risk that infants will suffer from ARIs. However, during the COVID‐19 pandemic, guidance varied, with some recommending that infants and mothers with SARS‐CoV‐2 be isolated from one another. Nepal''s Ministry of Health and Population recommended nonseparation, but the adherence to this guidance was inconsistent. Maternal proximity, nonseparation and early initiation of breastfeeding should be promoted in all birthing facilities.     

Rheumatologists’ perspective on coronavirus disease 19 (COVID-19) and potential therapeutic targets

Clinical Rheumatology - The ongoing pandemic coronavirus disease 19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a matter of global concern....     

PET/CTA detection of muscle inflammation related to cholesterol crystal emboli without arterial obstruction

Background

PET/CTA was used to evaluate the effect of cholesterol crystal emboli (CCE) on muscle injury. Cholesterol crystals (CCs) released during plaque rupture travel downstream and lodge in muscle triggering inflammation and tissue injury.

Methods

Thigh muscles in three groups of rabbits (n = 22) were studied after intra-arterial injection of CCs, Group I (n = 10); polystyrene microspheres, Group II (n = 5); or normal saline, Group III (n = 7). After 48 hours, muscle inflammation and injury were measured by fluorodeoxy-glucose uptake using PET/CTA, serum tissue factor (TF), and creatinine phosphokinase (CPK). Macrophages were stained with RAM11 and CCs with Bodipy.

Results

SUVmax of thigh muscles was greater for Group I vs Group II and III (0.40 ± 0.16 vs 0.21 ± 0.11, P = .038 and 0.23 ± 0.06, P = .036). CPK levels rose significantly in Group I vs Group II and III (6.7 ± 6.0 vs 0.6 ± 0.4, P = .007 and 0.9 ± 0.4 mg·dL^?1, P = .023). No arterial thrombosis was detected by CTA or histology of embolized arteries and TF did not rise significantly. There were extensive macrophage infiltrates surrounding muscle necrosis in Group I only.

Conclusions

Cholesterol crystal emboli triggered muscle inflammation and necrosis with an intact circulation. PET/CTA may help in the early detection of inflammation caused by CCs.