We describe a case of a solid variant of serous cystadenoma of the pancreas. The preoperative examination results led to a diagnosis of a nonfunctional pancreatic islet cell tumour, and the patient underwent a pylorus-preserving pancreaticoduodenectomy. The tumour was diagnosed as a solid variant of serous cystadenoma by histopathological examination. Solid variant of serous cystadenoma of the pancreas is difficult to diagnose preoperatively. More cases must be accumulated and investigated to obtain clues for accurate diagnosis.
solid serous cystadenoma; pancreas; pancreatic tumour
The present case report describes a patient with an artificial mitral valve and dual chamber pacemaker implanted due to perioperative complete atrio-ventricular block. One year later an upgrade to cardiac resynchronization therapy (CRT) combined with ICD function was performed due to significant progression of heart failure symptoms. Beneficial effects of CRT are demonstrated, but unfavourable haemodynamic consequences of right atrial appendage pacing are also underlined. Important interatrial conduction delay during atrial paced rhythm resulted in a significant time difference between optimal sensed and paced atrio-ventricular delay (AVD). This report provides a practical outline how to determine the interatrial delay and the sensed-paced AVD offset under echocardiography in patients treated with CRT.
cardiac resynchronization therapy; atrio-ventricular delay; echocardiography; atrial pacing; heart failure
Ezetimibe is a selective cholesterol absorption inhibitor with an excellent side-effect profile, able to reduce low-density lipoprotein (LDL) cholesterol by 15-25% from baseline in monotherapy and on top of statins and fibrates. Yet, it seems that ezetimibe produces quantitative rather than qualitative changes in LDL, with small net effects on atherogenic dyslipidaemia. This is supported by findings from the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) study on atherosclerosis progression, where the addition of ezetimibe to simvastatin in patients with heterozygous familial hypercholesterolaemia did not affect the mean change in carotid intima-media thickness, although a significant reduction in LDL cholesterol levels was observed. The Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study has further shown that combination treatment with simvastatin significantly reduced LDL cholesterol levels in patients with aortic stenosis, but did not affect the primary end point of aortic valve and cardiovascular events, although a significant reduction in the risk of ischaemic events was reported. Formal cardiovascular outcome trials are underway and these will provide additional insights into the long-term effects of ezetimibe on clinical events as well as on atherogenic dyslipidaemia, beyond LDL cholesterol levels.
ezetimibe; cardiovascular risk; atherosclerosis; dyslipidaemia
The study aim was to evaluate risk factors of obesity in Polish children aged 7 to 9 years.
Material and methods
A representative group of 2571 children (1268 girls and 1303 boys) was randomly selected according to the European Childhood Obesity Group protocol. Weight and height were measured and body mass index (BMI) was calculated. A questionnaire was completed by the children's parents with respect to behavioural and family-related risk factors of obesity. International Obesity Task Force criteria were used for classification of children's obesity.
Obesity was found in 3.7% of girls and 3.6% of boys. There was a statistically significant association between the prevalence of obesity in girls and their mother's obesity: OR = 5.06 (1.96–13.05), p < 0.001, father's obesity: OR = 5.19 (1.96–13.69), p < 0.001, and both parents’ obesity: OR = 5.43 (1.39–21.29), p = 0.01. Obesity in boys was significantly associated with mother's obesity: OR = 5.6 (2.6–12.02), p < 0.001, father's obesity: OR = 6.21 (2.89–13.37), p < 0.001, and both parents’ obesity: OR = 7.22 (2.44–31.33), p < 0.001. Skipping or irregular eating of breakfast was a risk factor for obesity in girls with OR = 2.71 (1.33–5.51), p = 0.005. Neither family income nor parents’ education level was related to their offspring's obesity. TV watching, physical activity level and eating in fast food places were not significant risk factors for obesity.
Eating breakfast regularly seems to protect girls from obesity development while low physical activity is not a significant obesity risk factor in this age group for either boys or girls. This finding stresses the more important role of healthy diet than physical activity promotion in obesity prevention in prepubertal children.
obesity risk factors; children; parental obesity; physical activity
Prostaglandin-2 (PGE-2), one of the products of cyclooxygenase-2 (COX-2) induced catalysis, may play a critical role in the carcinogenesis of esophageal squamous cell carcinoma (ESCC). We investigated the efficacy of using serum PGE-2 concentration as a biomarker for this cancer type.
Material and methods
Prostaglandin-2 levels were analyzed in the serum of 65 ESCC patients and in 47 healthy individuals. The concentrations of cyclooxygenase-2 (COX-2) were measured in tumor tissues and normal tissues obtained from 31 surgically treated ESCC patients.
Serum PGE-2 concentration was significantly higher in ESCC patients than in control patients (p = 0.004), especially in the early stages (I + II) of cancer (p < 0.0001). We observed significant inverse relationships between serum PGE-2 levels and: tumor stage, primary tumor progression, lymph and distant metastasis. The COX-2 concentration was significantly elevated in tumors as compared to normal tissues (p = 0.008). A significant correlation between serum PGE-2 and tumor COX-2 was observed (rho = 0.46, p = 0.009). However, ROC analysis showed that serum PGE-2 may be a weak prognostic factor for ESCC.
Our results suggest that an elevated concentration of serum PGE-2 in the early stages of cancer may possibly be associated with tumor initiation and cancer development in ESCC. The exact role of these findings in early detection of this highly lethal cancer requires further research.
prostaglandin-2; cyclooxygenase-2; squamous cell carcinoma; esophagus
Cardiotoxicity due to anthracyclines, trastuzumab and other potential cardiotoxic drugs is still a problem of modern chemotherapy. For years researchers have tried to find biological markers that can predict changes in the heart. The most thoroughly tested markers are troponin and natriuretic peptides. Some studies have proven that these markers can indeed be useful. In studies which have shown the predictive role of troponin I the assessment of this marker was performed very frequently. It is not possible to carry out such serial measurements in many centers because of typical 1-day hospital stay times. The predictive role of natriuretic peptides still needs further investigation. This review considers the newest research from recent years.
biological markers; cardiotoxicity; chemotherapy; left ventricular dysfunction