tbuckley/cabot-search huggingface dataset:
A Novel Presentation: Epsilon Waves in the Electrocardiogram of a Patient with Dravet Syndrome Without Structural Heart Disease
Authors: Alejandro Jesús Bermejo Valdés
Journal: Clinical Cardiology and Cardiovascular Interventions (2024)

We document for the first time epsilon waves on the electrocardiogram of a patient with Dravet syndrome (DS) who does not exhibit structural cardiac pathology. DS, a severe form of pediatric epilepsy, involves mutations in the SCN1A gene, which disrupt sodium ion flow and increase the risk of sudden unexpected death in epilepsy. The epsilon waves, typically associated with arrhythmogenic right ventricular dysplasia, may also suggest a link between neuronal and cardiac dysfunctions. In our case, the epsilon waves appear to originate from abnormalities in sodium channels rather than structural changes in the myocardium. This finding underscores the importance of assessing both neurological and cardiac manifestations in patients with severe epilepsy, opening new avenues for the research and treatment of these interactions in DS.
Pectus carinatum, small pneumothorax, and Brugada patterns: First description and pathophysiological analysis
Authors: Alejandro Jesús Bermejo Valdés
Journal: Clinical Cardiology and Cardiovascular Interventions (2024)

Pectus carinatum is a chest wall deformity where the breastbone and ribs protrude outward, sometimes referred to as “pigeon chest” due to the bird-like appearance of the chest. This condition occurs in approximately 1 in 1000 children, more commonly affecting boys than girls. Pectus carinatum tends to worsen as a child grows, especially during puberty, with about 15% of the children experiencing associated conditions like scoliosis. We present a case report of a young patient with pectus carinatum who experienced a small right apex pneumothorax and exhibited Brugada patterns on electrocardiogram tracing. This is the first clinical case reporting Brugada pattern presentation in both a patient with pectus carinatum and a small pneumothorax. We have conducted a clinical anatomical and electrocardiographic analysis to explore a physiopathological explanation for these findings, considering that our patient has no history or clinical signs of Brugada Syndrome. To further elucidate the clinical, anatomical, and electrocardiographic findings observed in our patient, detailed analyses were conducted. These investigations focused on how the pectus carinatum may influence electrocardiographic patterns through structural alterations of the thoracic wall, potentially modifying the transmural electrical field across the myocardium. This analysis aimed to explore a physiopathological explanation for the Brugada patterns observed, considering our patient’s unique thoracic anatomy and the absence of clinical Brugada Syndrome. We conclude that: 1. Pectus carinatum may create a window that facilitates the less resistive measurement of cardiac action potentials; 2. Small pneumothoraces can induce modifications in the cardiac electrical signal detected by surface electrodes, and pectus carinatum could unmask these modifications; and 3. Surface electrodes may measure subepicardial potentials that include and are modified by adjacent pericardial tissues, potentially resulting in alterations in transmural potential differences, thus producing fictitious Brugada patterns. Similarly, there is a possibility that the right ventricular outflow tract may be included within the subendocardial potentials.
The role of fibroblast growth factor 21 in metabolic processes in patients with gastrointestinal diseases
Authors: Yu.M. Stepanov, L.M. Mosiychuk, I.A. Klenina, O.M. Tatarchuk, O.P. Petishko, O.M. Shevtsova
Journal: GASTROENTEROLOGY (2024)

Background. Recently, the number of patients with obesity and metabolic syndrome has increased. Numerous studies to find new regulators of metabolic processes have led to the disco­very of a new fibroblast growth factor 21 (FGF21). The purpose of the study was to determine the correlation between FGF21 and meta­bolic processes among patients with gastrointestinal pathology. Materials and methods. The study was conducted in 80 patients with gastrointestinal diseases aged 18 to 66 years, the average age was (39.04 ± 1.03) years. Among the subjects, there were 56 men (70.0 %) and 24 women (30.0 %). Body composition was assessed using the Tanita MC-780MA apparatus (Japan). Serum leptin, FGF21, insulin levels were measured by enzyme-linked immunosorbent assay, and the HOMA-IR was calculated. Free fatty acids in the serum of patients were evaluated on Chromateс Crystal-5000, a gas chromatograph with a flame ionization detector. Results. The study found positive correlations between FGF21 levels and indicators of bioimpedance analysis: body mass index (r = 0.24; p = 0.004), fat mass (r = 0.26; p = 0.01) and visceral fat (r = 0.29; p = 0.01). In addition, a relationship was detected between FGF21 levels and laboratory data: insulin (r = 0.32; p = 0.001), HOMA-IR (r = 0.31; p = 0.001), leptin (r = 0.32; p = 0.001), triglyceride/high-density lipoprotein ratio (r = 0.48; p = 0.0001), and the content of certain free fatty acids. This indicates that FGF21 affects the development of obesity and metabolic disorders. It was found that FGF21 is associated with visceral obesity in patients with digestive diseases (odds ratio = 1.28, p = 0.0022). FGF21 levels above 1,317.5 pg/mL (sensitivity of 71.0 %, specificity of 53.1 %) indicate the presence of visceral obesity in patients with gastrointestinal di­seases. Conclusions. As a result of a comprehensive study, new data were obtained on the role of FGF21 as a key regulator of metabolic disorders, which is confirmed by the established relationships of this indicator with the components of lipid and carbohydrate metabolism disorders, cytokine imbalance, and hormonal activity of adipose tissue in patients with pathology of the digestive system.
Features of the course of hepatorenal syndrome in decompensated portal hypertension (case report)
Authors: M.I. Tutchenko, D.V. Rudyk, M.S. Besedinskyi, S.L. Chub, Yu.V. Nerushchenko
Journal: GASTROENTEROLOGY (2024)

Hepatorenal syndrome is a critical and potentially life-threatening complication in patients with advanced liver cirrhosis, characterized by the development of renal dysfunction in the absence of underlying structural kidney disease. Despite some encouraging studies of pharmacological treatments, the development of hepatorenal syndrome in people with cirrhosis implies a poor prognosis, as renal failure is usually irreversible unless a liver transplantation is performed. The purpose is to show the peculiarities of hepatorenal syndrome and the method of its successful treatment. The article describes a clinical case of hepatorenal syndrome in the postoperative period in a 54-year-old woman who was hospitalized urgently with bleeding esophageal varices. She has a history of liver cirrhosis associated with HCV and portal vein thrombosis, portal hypertension syndrome, blee­ding esophageal varices, ascites. After stabilization of hemodynamic parameters, the patient underwent a portoazygous disconnection, which included devascularization of the distal esophagus, proximal stomach, and esophageal transection. The first day of the postoperative period was complicated by the development of hepatorenal syndrome. Only its timely diagnosis in decompensated portal hypertension, with the elimination of pathophysiological components of the pathological process, allows correcting this complex pathology. When draining ascites, detoxification of the body is possible, which makes it possible to partially compensate for impaired kidney function. Albumin replacement therapy helps maintain osmotic balance.
Synergistic effects of ursodeoxycholic acid, and quercetin on liver function and systemic inflammation in non-alcoholic fatty liver disease and atrial fibrillation patients
Authors: O.B. Teslenko, S.V. Fedorov, M.V. Bielinskyi, A.S. Herashchenko, N.B. Nyshchuk-Oliinyk
Journal: GASTROENTEROLOGY (2024)

Background. Non-alcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) co-occur with signifi­cant clinical implications, necessitating therapeutic strategies that address the multifaceted nature of these conditions. This study evaluated the efficacy of standard treatment alone versus combined treatments with ursodeoxycholic acid (UDCA) and quercetin in patients with NAFLD and AF, focusing on improvements in liver function, lipid profile, systemic inflammation, and fibrosis markers. Aim: to evaluate and compare the efficacy of standard treatment alone versus standard treatment combined with ursodeoxycholic acid with and without quercetin in patients with non-alcoholic fatty liver disease and concurrent atrial fibrillation. Materials and methods. In a prospective, randomi­zed, controlled trial, 127 patients with diagnosed NAFLD and concurrent AF were enrolled. They were divided into three groups: group 1 — standard treatment (n = 42), group 2 — standard treatment plus UDCA (n = 44), and group 3 — standard treatment plus UDCA and quercetin (n = 41). The primary outcomes included changes in liver function tests (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase, alkaline phosphatase), lipid profile (total cholesterol, low- and high-density lipoprotein cholesterol (HDL-C), triglycerides), and non-invasive liver fibrosis scores (NFS, FIB-4). Secondary outcomes focused on systemic inflammation markers (C-reactive protein, galectin-3, soluble ST2) and fibronectin levels. Results. All treatment groups showed significant improvements in liver function tests and lipid profiles. Group 3 exhibited the most substantial reductions in ALT, AST, and improvements in HDL-C, indicating enhanced hepatoprotective and lipid-modulating effects. Systemic inflammation markers and fibronectin levels decreased significantly in groups receiving UDCA and quercetin, with the most pronounced effects observed in group 3, suggesting potent anti-inflammatory and anti-fibrotic action. Additionally, significant improvements in NFS and FIB-4 scores in group 3 highlight the anti-fibrotic potential of combining UDCA and quercetin with standard treatment. Conclusions. The addition of UDCA and quercetin to standard treatment for patients with NAFLD and AF significantly improves liver function, lipid metabolism, and reduces systemic inflammation and fibrosis, compared to standard treatment alone. These findings suggest a synergistic effect of UDCA and quercetin, offering a promising therapeutic strategy for managing the complex interplay between NAFLD and AF.
Arterial stiffness in non-alcoholic fatty liver disease
Authors: T.V. Chendey, Ye.S. Sirchak, V.I. Chendey
Journal: GASTROENTEROLOGY (2024)

Background. The presence of metabolic-associated pathology, namely obesity, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease (NAFLD), significantly accelerates the development of the cardiovascular continuum. This is associated with an increased risk of major cardiovascular events (myocardial infarction, stroke). An important organ damage in hypertension (HTN) is the remodeling of small arteries and an increase in stiffness of large arteries. The relationship between NAFLD, dyslipidemia, hypertriglyceridemia, obesity (especially abdominal), diabetes, and HTN is well studied, but there is a lack of clinical studies examining changes in arterial stiffness in NAFLD. Aim of the research was to study the parameters of arterial stiffness in patients with NAFLD. Materials and methods. Eighty-two Caucasian patients with NAFLD (mean age (56.8 ± 1.1) years, 59.8 % men) were enrolled. Participants were divided into two groups: group 1 (n = 44) — NAFLD and concomitant HTN, group 2 (n = 38) — HTN without NAFLD. All patients underwent a standard general clinical examination, laboratory and instrumental work-up. In addition, all patients were assessed for the parameters of arterial stiffness via non-invasive arteriography. Results. Patients with NAFLD had significantly higher office systolic and diastolic blood pressure (by 15.2 and 10.4 %, respectively, p &lt; 0.01) despite comparable drug therapy. The same trends were observed in relation to the central aortic pressure, which was 19.3 % higher in patients with NAFLD (p &lt; 0.01), and central pulse pressure that was 35.9 % higher than in patients without NAFLD (p &lt; 0.01). Brachial artery augmentation index in NAFLD turned to be elevated compared to patients without NAFLD (p &lt; 0.01), but aortic augmentation index was comparable between groups. The return time interval in group 1 was 50.3 % higher than in group 2 (p &lt; 0.01). Finally, patients with NAFLD had a significant increase in pulse wave velocity by 52.3 % compared to those without NAFLD with average value exceeding 12 m/sec (p &lt; 0.01). Conclusions. There is an association between NAFLD and worse indices of arterial stiffness in patients with concomitant HTN.
Influence of age, body mass index and gender on sonographic indicators of the liver in patients with metabolic dysfunction-associated steatotic liver disease
Authors: V.B. Yagmur, L.V. Demeshkina, S.L. Melanich, R.M. Kyslova
Journal: GASTROENTEROLOGY (2024)

Background. The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing along with the increasing prevalence of obesity. There are close relationships between these two pathologies due to the functioning of adipose tissue as an endocrine organ with a complex influence on various metabolic processes. It is known that premenopausal women are less prone to fatty liver disease than men. The aim was to study the influence of gender, body mass index (BMI) and age on sonographic indicators and the degree of liver steatosis in patients with metabolic dysfunction-associated steatotic liver disease. Materials and methods. Ninety-two patients with MASLD were included in the study, 48 women and 44 men. Inclusion criterion was metabolic dysfunction-associated steatotic liver disease, exclusion criteria were any non-metabolic factors of chronic diffuse liver disease. Patients were divided into groups by gender and age. Women were divided by age according to the presence and absence of menopause, men were divided into groups below and above 45 years — the conventional age of the beginning of the decline in gonadotropic function. The analysis of structural changes of the liver, namely the assessment of the size, contours, structure, echogenicity, and visualization of blood vessels in the B-mode was carried out with the help of ultrasound examination on Toshiba Xario 660 (Japan). The degree of steatosis was assessed by the controlled attenuation parameter. Results. In men, the right, left and caudate liver lobes were significantly larger (p &lt; 0.05) than in women, which is due to the higher weight of men in the absence of a difference in the BMI. There was no significant difference between men and women in degree of steatosis (p &gt; 0.05). A moderate positive correlation (r = 0.63) was found between BMI and the controlled attenuation parameter; in women, there was no connection between these indicators. Analysis of correlations in women of different ages, divided by the presence of menopause, found that before menopause, there was no dependence of steatosis indicators on BMI, while with the onset of menopause, the coefficient of correlation between these indicators was 0.39 (р &lt; 0.02). Conclusions. No significant difference was found between the frequency of various degrees of steatosis in MASLD according to the controlled attenuation parameter in men and women. There was a dependence of the severity of liver steatosis on the BMI in men, the dependence of steatosis on the body mass index in women was manifested starting from the menopause period, which suggests the protective role of female sex hormones.
Stress perceived levels among Crohn’ disease patients according to sampling characteristics and difficulties occurring in their daily life
Authors: Elsa Vitale, Roberto Lupo, Alessia Lezzi, Stefano Botti, Ivan Rubbi, Laura Valenzano, Daniela Secondo, Marcello Antonazzo, Antonino Calabrò, Maicol Carvello, Luana Conte
Journal: GASTROENTEROLOGY (2024)

Background. The diagnosis of a chronic disease represents a turning point in patients’ lives, which inevitably marks them. The aim of this study was to analyze perceived stress levels among Crohn’ disease (CD) patients depending on sampling characteristics and several difficulties occurred in their daily life in order to better address stress management interventions to increase their quality of life as patients who should cohabitate with CD for all their lives. Materials and methods. An on-line, multicenter, observational, cross-sectional study was carried out through social Internet pages. Specifically, through the Facebook and Instagram groups belonging to the CD patients. Results. A total of 785 CD interviewers were achieved in this study, 597 were female and 188 were male. Significant higher stress perceived levels were assessed among females (p &lt; 0.001) and CD interviewers who knew their disease until 10 years (p &lt; 0.001). Higher levels in stress perceptions were reported in all the difficulties proposed, in which CD interviewers reported a quite level of difficulties occurred on them (p &lt; 0.001). Conclusions. This study demonstrated that patients with Crohn’s disease live in a condition of high stress and that this condition implies changes in the quality of life with considerable difficulty.
Abstracts of the Research-to-Practice Conference with International Participation “XII Scientific Session of the Institute of Gastroenterology of the NAMS of Ukraine. The Latest Technologies in Theoretical and Clinical Gastroenterology” Dedicated to the 60th Anniversary of the State Institution “Institute of Gastroenterology of the NAMS of Ukraine” (Ukraine, Bukovel, June 12–14, 2024)
Authors: No Authors
Journal: GASTROENTEROLOGY (2024)

No abstract
Mykola Motsakov — in the field of the Red Cross
Authors: M. Chaban, Z. Shevtsova, V. Gaponov
Journal: GASTROENTEROLOGY (2024)

The article represents a life and a professional path of zemstvo doctor Mykola Petrovych Motsakov. His contribution to the development of the medical service in Katerynoslav has been presented: he worked in the community of mourning sisters, was the first chief doctor in the field of the Red Cross. He died prematurely in the prime of his life in the line of duty. Excerpts from the diary of Princess Vera Urusova about his mother have been provided. The presented material will contribute to the popularization of the figure of the Ukrainian zemstvo doctor.
The Plasma Metabolome and Risk of Incident Kidney Stones
Authors: Pietro Manuel Ferraro, Yukun Li, Raji Balasubramanian, Gary C. Curhan, Eric N. Taylor
Journal: Journal of the American Society of Nephrology (2024)

Key Points Information on metabolomic profiles in kidney stone formers is limited. This article describes investigations of associations between plasma metabolomic profiles and the risk of incident, symptomatic kidney stones. Three novel metabolites had negative associations with kidney stones: β -cryptoxanthin and two forms of sphingomyelin. Background Information on metabolomic profiles in kidney stone formers is limited. To examine independent associations between plasma metabolomic profiles and the risk of incident, symptomatic kidney stones in adults, we conducted prospective nested case-control studies in two large cohorts. Methods We performed plasma metabolomics on 1758 participants, including 879 stone formers (346 from the Health Professionals Follow-Up Study [HPFS] cohort, 533 from the Nurses' Health Study [NHS] II cohort) and 879 non–stone formers (346 from HPFS, 533 from NHS II) matched for age, race, time of blood collection, fasting status, and (for NHS II) menopausal status and luteal day of menstrual cycle for premenopausal participants. Conditional logistic regression models were used to estimate the odds ratio (OR) of kidney stones adjusted for body mass index; hypertension; diabetes; thiazide use; and intake of potassium, animal protein, oxalate, dietary and supplemental calcium, caffeine, and alcohol. A plasma metabolite–based score was developed in each cohort in a conditional logistic regression model with a lasso penalty. The scores derived in the HPFS (“kidney stones metabolite score [KMS]_HPFS”) and the NHS II (“KMS_NHS”) were tested for their association with kidney stone risk in the other cohort. Results A variety of individual metabolites were associated with incident kidney stone formation at prespecified levels of metabolome-wide statistical significance. We identified three metabolites associated with kidney stones in both HPFS and NHS II cohorts: β -cryptoxanthin, sphingomyelin (d18:2/24:1, d18:1/24:2), and sphingomyelin (d18:2/24:2). The standardized KMS_HPFS yielded an OR of 1.23 (95% confidence interval, 1.05 to 1.44) for stones in the NHS II cohort. The standardized KMS_NHS was in the expected direction but did not reach statistical significance in HPFS (OR, 1.16; 95% confidence interval, 0.97 to 1.39). Conclusions The findings of specific metabolites associated with kidney stone status in two cohorts and a plasma metabolomic signature offer a novel approach to characterize stone formers.
Short-and-medium term outcomes of Piccolo Device closure of patent ductus arteriosus in premature infants: A single center review
Authors: Jesus Jaile IV,
Journal: Clinical Cardiology and Cardiovascular Interventions (2024)

Introduction: Obstruction of the left pulmonary artery (LPA) or descending aorta requiring late intervention is a rare complication after transcatheter closure with Piccolo device, but a multidisciplinary approach is often needed to discover and manage the patient when it does occur. We report our center’s experience with the Piccolo device, including 3 cases of late LPA stenosis requiring surgical debridement and pulmonary artery plasty. Methods: Retrospective chart review of 60 patent ductus arteriosus closures using Amplatzer Piccolo device in premature infants. Results: 60 cases of device closure in premature infants. Transient LPA stenosis was noted in 8% of patients, LPA stenosis requiring surgical intervention in 5% of patients. LPA velocity of 2.7 m/s at any point following device placement by echocardiogram, and right pulmonary artery (RPA) to LPA ratio of 1.5 to 1 by 2D echo are predictive indicators of need for surgical intervention. Differential lung perfusion scans may also provide important prognostic and follow-up data after intervention. Conclusion: Transient LPA stenosis is expected after device closure of a patent ductus arteriosus in premature infants. A multidisciplinary approach and vigilant follow-up are required to discover late complications including LPA occlusion and manage the patient when it does occur.
Thymoma Presenting as Right-Side Heart Failure in a Healthy Patient: A Case Report
Authors: Pietro Candela
Journal: Clinical Cardiology and Cardiovascular Interventions (2024)

Thymoma is a rare tumor yet the most common neoplasm of the anterior mediastinum, accounting for 20-25% of all mediastinal tumors. Its incidence peaks in the fourth and fifth decades of life. Usually thymoma is diagnosed incidentally on chest imaging, or when investigating patients with myasthenia gravis, or with chest symptoms such as cough, chest pain, or dyspnea. We report here an unusual case of recidivant thymoma presenting with right heart failure in a 69 years old man.