Diagnosis and risk stratification in acute pulmonary embolism: the role of echocardiography.

Pulmonary embolism (PE) is a frequently encountered clinical condition with a high mortality rate that is affected by various factors such as age, hemodynamics, and other comorbidities. Early diagnosis and risk stratification are crucial to achieving a favorable clinical outcome. New risk stratification algorithms have been proposed in order to identify high-risk patients who will benefit from early thrombolytic treatment. Among the various validated diagnostic methods, the role of echocardiography is increasingly accepted. Recent advances in studying right ventricular function have made echocardiography an attractive tool for establishing or excluding the diagnosis of acute PE in the emergency setting and initiating optimal therapy.

Five-vessel aortic arch associated with a bicuspid aortic valve.

Little information exists regarding the prevalence of aberrant or ectopic aortic arch vessels in patients with different cardiovascular anomalies. We present a young patient with an aberrant right subclavian artery associated with an ectopic left vertebral artery and a bicuspid aortic valve.

Late traumatic aortic dissection.

Traumatic dissection of the aorta is a well-documented entity with poor prognosis and broad spectrum of clinical presentations. We report a rare case of an asymptomatic late presentation of aortic dissection after a high-speed vehicle accident. This case highlights the importance of high clinical suspicion for the diagnosis of aortic dissection.

Native aortic valve endocarditis caused by Brevibacterium epidermidis in an immunocompetent patient.

Although Brevibacterium species used to be considered as nonpathogenic microorganisms until recently, it seems that they can cause a wide variety of clinical diseases by acting mostly as opportunistic pathogens. The present case is the second reported case of infective endocarditis by Brevibacterium species; however, it is the first reported infected native aortic valve in an immunocompetent patient.

Responsibilities in cancer preventive care in Greece. A physicians' survey.

BACKGROUND: Colorectal cancer is the second leading cause of cancer death in European countries. Differences in screening implementation may explain USA vs. European survival differences. The proportion of European primary care physicians advising colorectal screening has been reported to be inconsistent. We therefore hypothesised the presence of a belief-related bias among European physicians regarding who is responsible for cancer screening delivery. OBJECTIVES: To index beliefs in cancer screening implementation among a wide sample of Greek physicians. Study design Cross-sectional survey. METHODS: Three hundred and sixty-six physicians involved in primary care activities in 15 provinces answered a questionnaire about responsibility in cancer screening delivery. Results 22.4% and 7.6% of physicians declared that the health system and the patients, respectively, have the main responsibility for cancer screening implementation, while 70 % advocated patient-health system co-responsibility. Beliefs were statistically correlated to age (p=0.039) and specialisation category (p=0.002). Patients' will was mainly indicated by internists, trainee internists and physicians older than 30, while GPs, trainee GPs and house officers were mainly health system-oriented. Worryingly, when physicians were asked about which specialty should inform the population, 81% indicated family doctor (for-fee-service) while the involvement of free-from-fee specialities was inconsistent. CONCLUSION: A considerable disorientation about responsibilities in cancer screening delivery was observed in our study sample. Continual medical education and clear redefinition of primary care physicians' activities are required.