RESUMO
<p>A 58 year-old man was referred to our hospital with a fever after dental treatment. He had undergone an operation for aortic root replacement 9 months earlier. <i>Streptococcus </i>species were cultured with venous blood culture. An echocardiogram revealed vegetation attached to the prosthetic valve. The prosthetic valve function was good and he did not suffer from heart failure, therefore he was treated with antibiotics. Five days after starting antibiotics, we observed embolization of the brain and the kidney as well as an elevation of his inflammatory reaction. Accordingly, we performed emergency surgery. There was no paravalvular abscess or valve dysfunction, so we simply resected the vegetation and debrided the surrounding tissue. Post-surgical antibiotic therapy was continued for 5 weeks and then he was switched to oral medication. Three years after surgery, he is free from any PVE recurrence.</p>
RESUMO
BACKGROUND/AIMS: To determine the nutritional markers important for assessing the degree of pancreatic insufficiency due to chronic pancreatitis in routine clinical practice. METHODS: A total of 137 patients with chronic pancreatitis were followed up for more than 1 year. They were divided into two groups: a pancreatic diabetes mellitus (DM) group, consisting of 47 patients undergoing medical treatment for DM of pancreatic origin, and a nonpancreatic DM group, consisting of 90 other patients (including 86 patients without DM). Serum albumin, prealbumin, total cholesterol, cholinesterase, magnesium, and hemoglobin were compared between the two groups. RESULTS: The total cholesterol was significantly lower in the pancreatic than the nonpancreatic DM group (164 mg/dL vs 183 mg/dL, respectively; p=0.0028). Cholinesterase was significantly lower in the former group (263 U/L vs 291 U/L, respectively; p=0.016). Among the 37 patients with nonalcoholic pancreatitis, there was no difference in the cholinesterase levels between the pancreatic and nonpancreatic (296 U/L vs 304 U/L, respectively; p=0.752) DM groups, although cholesterol levels remained lower in the former (165 mg/dL vs 187 mg/dL, respectively; p=0.052). CONCLUSIONS: Cholinesterase levels are possibly affected by concomitant alcoholic liver injury. The total cholesterol level should be considered when assessing pancreatic insufficiency due to chronic pancreatitis.