Effectiveness of cardiogoniometry compared with exercise-ECG test in diagnosing stable coronary artery disease in women.

AIMS: To investigate the effectiveness of cardiogoniometry, a novel, non-invasive method, in diagnosing coronary artery disease (CAD) in women and compare it with exercise-ECG test, by using coronary angiography as a reference method. METHODS: It was a single-centre, case-series study including consecutive female patients with stable angina pectoris (AP) undergoing coronary angiography. Exercise-ECG test, done according to the Bruce protocol, and cardiogoniometry were obtained prior to coronary angiography. Clinically significant CAD has been defined as one or more coronary lesions with >70% stenosis. RESULTS: Study included 114 consecutive female patients with median age of 64.0 (58.0-71.0) years, out of which 32 (28.1%) had CAD. Cardiogoniometry yielded a total accuracy of 74.6% with a sensitivity of 75.0% (95% CI 56.6-88.5) and specificity of 74.4% (95% CI 63.6-83.4). Exercise-ECG test yielded a total accuracy of 45.1% with a sensitivity of 68.1% (95% CI 42.7-83.6) and specificity 36.6% (95% CI 25.2-50.3). Cardiogoniometry showed higher accuracy than exercise-ECG test ( P < 0.001). Pathological cardiogoniometry was associated with almost nine times higher risk for CAD (OR 8.7, 95%CI 3.4-22.3, P < 0.001), which remained significant after adjustment for age, and hypokinesia. CONCLUSION: Cardiogoniometry is a non-invasive, easy-to-use and free-of-risk method which showed high effectiveness in diagnosing stable CAD in women and superior to exercise-ECG test. Cardiogoniometry could be introduced as a part of the diagnostic algorithm of screening women for stable CAD and is suitable for use in the primary setting, especially in women unable to undergo stress-testing.

Primary non-Hodgkin lymphoma of the humerus following traumatic injury: case report.

A case of primary non-Hodgkin lymphoma of the right humerus which occurred in a 21-year-old male patient after an impact to the right shoulder in a car accident in July 1983 is described. Seventeen years after the injury, due to a civil lawsuit, the biopsy material was revised. Immunohistochemical analysis showed CD20 and CD79a positivity on large pleomorphic cells, while small reactive lymphocytes were CD3, Bcl-2 and CD20 positive. Molecular analysis carried out with PCR revealed a monoclonal B-lymphocyte population. The diagnosis of diffuse large peripheral B cell lymphoma of the bone was confirmed. The present case concurs with the literature on primary bone lymphoma, in which the diagnostic problem, trauma-related presentation and an excellent prognosis of malignant tumour are emphasized.

Healing of skin necrosis and regression of anticardiolipin antibodies achieved by parathyroidectomy in a dialyzed woman with calcific uremic arteriolopathy.

AIM: To present the impact of parathyroidectomy on the spontaneous healing of necrotic lesions of the skin of the lower leg and on anticardiolipin antibodies regression in a 68-year-old female dialyzed patient with hyperparathyroidism and calcific-uremic arteriolopathy (CUA). METHODS: After the occurrence of initial lesions of the lower leg skin, the intact parathyroid (iPTH) level, calcium (Ca) and phosphorus (P) product were measured, and on two occasions at 6-week intervals, the titer of anticardiolipin antibodies was determined, followed by a clinical monitoring of the progress of necrotic skin lesions. Two months after the occurrence of the skin lesions, the patient's right leg was amputated below the knee due to gangrene, and a histopathological analysis of the skin tissue sample of the amputated lower leg was made. After parathyroidectomy, iPTH, Ca x P product were measured, and on two occasions at 6 weeks' intervals, anticardiolipin antibodies titer was determined, followed by a clinical monitoring of lesions of the left lower leg skin. RESULTS: Before parathyroidectomy, iPTH level and Ca x P product were increased, as well as IgG anticardiolipin antibody titer measured on two occasions 6 weeks apart. The histopathological analysis of the skin tissue sample of the amputated right lower leg showed mural calcification of artery walls and thrombotic occlusions of small arteries, arterioles, and dermal capillaries, in addition to epidermolysis. A week after parathyroidectomy, iPTH level and Ca x P product were within normal range. Two measurements 6 weeks apart revealed no anticardiolipin antibodies. Eight weeks after parathyroidectomy, spontaneous healing of necrotic skin lesions of the left lower leg was observed. CONCLUSION: Regression of anticardiolipin antibodies, normalization of Ca x P product, and healing of the skin lesions after parathyroidectomy all pointed to the elevated PTH level as a crucial factor in the pathogenesis of CUA.

Percepción de los usuarios de un consultorio urbano-marginal, frente a la campaña educativa: en Chile podemos controlar el cólera / Userïs perception of the urban-marginal clinic, facing to the educating campaign: at Chile we are able to control the cholera

Se realizó una entrevista a los usuarios de un consultorio urbano-marginal con la finalidad de conocer su percepción frente a la campaña educativa en Chile podemos controlar el cólera, en el año 1991. Se encontró que el 93 por ciento había recibido información sobre esta enfermedad, destacándose la televisión como principal medio de comunicación. El 40 por ciento indicó que le entregaron un folleto sobre medidas de prevención. Su pensamiento fue que el Ministerio de Salud había hecho todo lo posible en relación al problema del cólera. En otro aspecto, el 57 por ciento de los varones estimó que tenía posibilidades de enfermarse, en cambio las damas lo expresaron en el 33 por ciento; se dan a conocer las razones que fundamentan estas respuestas