A 15-year-old girl with a large pericardial effusion

Pericarditis is a rare manifestation of tuberculosis and can be fatal. We describe a 15-year-old girl admitted for a large pericardial effusion. Subxiphoid pericardial biopsy was performed. Biopsy samples were positive for M. tuberculosis DNA by PCR, which confirmed the diagnosis of tuberculous pericarditis.     

Constrictive/restrictive cardiac physiology: Pericarditis or right ventricular infarction?

Here we report on the case of a 71 year old man who presented with signs and symptoms suggestive of right heart failure and was diagnosed with and successfully treated for constrictive pericarditis. Radiographic, hemodynamic, and intra-operative pathological findings typical of constrictive pericarditis are presented. The potential for right ventricular infarction which can mimic the hemodynamic findings in constrictive pericarditis is also discussed. Pericardiectomy was recommended and was successful in improving the patient's systemic vascular congestion and symptoms.     

Acute chest pain: The role of MR imaging and MR angiography

MR imaging (MRI) and MR angiography (MRA) have gained a high level of diagnostic accuracy in cardiovascular disease. MRI in cardiac disease has been established as the non-invasive standard of reference in many pathologies. However, in acute chest pain the situation is somewhat special since many of the patients presenting in the emergency department suffer from potentially life-threatening disease including acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Those patients need a fast and definitive evaluation under continuous monitoring of vital parameters. Due to those requirements MRI seems to be less suitable compared to X-ray coronary angiography and multislice computed tomography angiography (CTA). However, MRI allows for a comprehensive assessment of all clinically stable patients providing unique information on the cardiovascular system including ischemia, inflammation and function. Furthermore, MRI and MRA are considered the method of choice in patients with contraindications to CTA and for regular follow-up in known aortic disease. This review addresses specific features of MRI and MRA for different cardiovascular conditions presenting with acute chest pain.     

Efficacy of an inactivated Mycoplasma hyorhinis vaccine in pigs

Lameness and polyserositis in pigs caused by Mycoplasma hyorhinis are generally treated with antibiotics and may require multiple doses. The costs of these antibiotics combined with economic losses from culling and reduced feed conversion due to lameness are hardships to the swine producer. In this study we have demonstrated efficacy of an inactivated M. hyorhinis vaccine administered to three-week old caesarian-derived colostrum-deprived piglets. Three doses of vaccine (high, medium, and low) were evaluated and compared to a placebo control. Mycoplasma hyorhinis challenge occurred three weeks after vaccination. Pigs were observed for lameness and respiratory distress for three weeks following challenge. Pigs were then euthanized and a gross pathological evaluation for polyserositis and arthritis was performed. A minimum immunizing dose of vaccine was defined as containing at least 7.41 × 10⁷ CCU of M. hyorhinis per 2.0 mL dose as represented by the medium dose vaccine. This vaccine provided significant reductions in lameness and pericarditis with preventive fractions of 0.76 (95% CI [0.26, 0.92]) and 0.58 (95% CI [0.31, 0.74]), respectively, compared to the placebo control group. A significant increase in post-challenge weight gain (P < .0001) was also achieved with this vaccine, with an average daily gain (ADG) of 0.92 lbs/day compared to 0.57 lbs/day in the placebo group.     

中心静脉导管留置治疗结核性心包积液的临床评价

目的 探讨中心静脉导管留置引流在治疗结核性心包炎伴有大量心包积液的应用价值.方法 将76例结核性渗出性心包炎患者随机分为A组和B组,均予以全身规则抗结核治疗.A组留置中心静脉导管引流及心包腔内注药,B组常规心包穿刺抽液及心包腔内注药.结果 A组与B组相比,两组间在消除心包填塞症状时间,退热时间,心包积液消失时间等方面有显著性差异（P＜0.01）.结论 心包穿刺留置导管引流心包积液安全可行,操作简便,可迅速消除心包填塞症状,能及时彻底引流心包积液,疗效明显,降低了缩窄性心包炎的发生率.     

Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multi-centre all-case analysis.

AIMS: Effective prevention of recurrent pericarditis remains an important yet elusive goal. Corticosteroid therapy often needs to be continued for a prolonged period and causes severe side effects. We performed a multi-centre all-case analysis to investigate the efficacy of colchicine in preventing subsequent relapses of pericarditis, and addressed the hypothesis that pretreatment with corticosteroids may attenuate the beneficial effect of colchicine. METHODS AND RESULTS: One hundred and forty published and unpublished cases of patients treated with colchicine after at least two relapses of pericarditis were aggregated from European centres. Of those, 119 were included in the study group. Only 18% of the patients had relapses under colchicine therapy, and 30% after its discontinuation. There were significantly more relapses among male patients after colchicine treatment (36 vs. 17%, P=0.046), and those with previous corticosteroid treatment (43 vs. 13%, P=0.02). Multivariate logistic regression analysis identified previous corticosteroid therapy (OR 6.68, 95% CI: 1.65-27.02) and male gender (OR 4.20, 95% CI: 1.16-15.21) as independent risk factors for recurrence following colchicine therapy. CONCLUSION: Treatment with colchicine is highly effective in preventing recurrent pericarditis, while pretreatment with corticosteroids exacerbates and extends the course of recurrent pericarditis.