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Interstitial fibrosis is a histopathological hallmark of hypertrophic cardiomyopathy (HCM). Although extracellular matrix (ECM) biomarkers, including matrix metalloproteinases, are overexpressed in HCM patients, they do not correlate with sudden cardiac death (SCD) risk. The objective of this study was to determine whether scleraxis, a transcription factor that regulates collagen gene expression, is detectable in HCM patients and correlates with disease burden. Between 2017 and 2018, a total of 46 HCM patients were enrolled (58 [+ or -] 14 years (31 males, 15 females)) with a mean 5 year SCD risk of 2.3% [+ or -] 1.3%. Cardiac MRI confirmed HCM in all patients with a mean interventricular septal thickness of 20 [+ or -] 2 mm. Late gadolinium enhancement (LGE) was present in 32 (70%) study participants occupying 18% [+ or -] 7% of the left ventricular (LV) myocardium. Serum scleraxis levels were significantly higher in the HCM patients by approximately twofold as compared to controls (0.76 [+ or -] 0.06 versus 0.32 [+ or -] 0.02 ng/mL, p < 0.05). No correlation was demonstrated between serum scleraxis levels and markers of disease severity in HCM patients, including maximum LV wall thickness, %LGE, and SCD risk factors. Serum scleraxis is elevated in the HCM population. Future studies are warranted to evaluate the prognostic value of scleraxis in identifying high-risk HCM patients who require aggressive management for prevention of SCD. Key words: hypertrophic cardiomyopathy, scleraxis, collagen, cardiac fibrosis, transthoracic echocardiography, cardiac MRI, extracellular matrix. La fibrose interstitielle est la marque histopathologique de la cardiomyopathie hypertrophique (CMH). Bien que des biomarqueurs de la matrice extracellulaire (MEC), y compris les metalloproteinases matricielles, soient surexprimes chez les patients atteints de CMH, ils ne sont pas en correlation avec le risque de mort subite cardiaque (MSC). Cette etude avait pour objectif d'etablir si le facteur scleraxis, qui participe a la transcription regulant l'expression des genes du collagene, est detectable chez les patients atteints de CMH, et s'il est en correlation avec le fardeau de la maladie. De 2017 a 2018, nous avons inscrit a l'etude 46 patients atteints de CMH (ages de 58 [+ or -] 14 ans (31 hommes, 15 femmes)) presentant un risque de MSC a 5 ans moyen de 2,3 % [+ or -] 1,3 %. L'examen d'IRM cardiaque a permis de confirmer que tous les patients atteints de CMH presentaient un septum interventriculaire d'une epaisseur moyenne de 20 [+ or -] 2 mm. Le rehaussement tardif apres gadolinium (RTG) etait present chez 32 (70 %) des participants a l'etude avec une occupation du myocarde ventriculaire gauche (VG) de 18 % [+ or -] 7 %. Les taux seriques du facteur scleraxis etaient nettement plus eleves chez les patients atteints de CMH, d'environ le double par rapport aux temoins (0,76 [+ or -] 0,06 par rapport a 0,32 [+ or -] 0,02 ng/mL, p < 0,05). Chez les patients atteints de CMH, nous n'avons observe aucune correlation entre les taux seriques du facteur scleraxis et des marqueurs de la gravite de la maladie, y compris en matiere d'epaisseur maximale du VG, de pourcentage de RTG et de facteurs de risque de MSC. Les taux seriques de facteur scleraxis sont eleves chez les patients atteints de CMH. De futures etudes seraient necessaires en vue d'evaluer la valeur pronostique du facteur scleraxis en vue de depister les patients atteints de CMH a risque eleve, qui necessitent une prise en charge energique en vue de prevenir la MSC. Mots-des : cardiomyopathie hypertrophique, facteur scleraxis, collagene, fibrose cardiaque, echocardiographie transthoracique, IRM cardiaque, matrice extracellulaire., Introduction Hypertrophic cardiomyopathy (HCM) is a heritable disorder of the heart muscle with a well-described genetic, pathological, and clinical profile (Loar et al. 2015). As an autosomal dominant disease caused [...]

Objective: To examine the role of endophytic tumor volume (TV) assessment (endophycity) on perioperative partial nephrectomy (PN) outcomes. Patients and Methods: Retrospective review of 212 consecutive laparoscopic and open partial nephrectomies from single institution using preoperative imaging and 1-year follow-up. Demographics, comorbidities, RENAL nephrometry scores, and all peri- and postoperative outcomes were recorded. Volumetric analysis performed using imaging software, independently assessed by two blinded radiologists. Univariate and multivariate statistical analysis were completed to assess predictive value of endophycity for all clinically meaningful outcomes. Results: Among those undergoing minimally invasive surgery (MIS), lower tumor endophycity was associated with higher likelihood of trifecta outcome (negative surgical margin, <10% decline in estimated glomerular filtration rate, the absence of complications) irrespective of max tumor size. For MIS, estimated blood loss increased with greater tumor endophycity regardless of tumor size. Among those who underwent open partial nephrectomy, lower tumor endophycity was associated with trifecta outcomes for tumors >4 cm only. On multivariate analysis with log-scaled odds ratios (OR), tumor endophycity and total kidney volume had the strongest correlation with tumor-related complications (OR = 3.23, 2.66). The analysis identified that tumor endophycity and TV on imaging were inversely correlated with of trifecta outcomes (OR = 0.53 for both covariates). Conclusions: Volumetric assessment of tumor endophycity performed well in identifying PN outcomes. As automated imaging software improves, volumetric analysis may prove to be a useful adjunct in preoperative planning and patient counseling. [ABSTRACT FROM AUTHOR]

Adult intussusception is relatively rare, with only 5% to 16% of intussusceptions occurring in adults. The authors report a case of colocolic intussusception caused by an adenocarcinoma of the ascending [...]

Presents the use of abdominal computed tomographic (CT) in the screening of an adult with cystic fibrosis. Description of findings on a CT scan of the abdomen; Signs and symptoms of cystic fibrosis; Effectiveness of ultrasound in increasing the specificity of the diagnosis in patients with abnormal test results.

Examines the occurrence of abdominal pain and bloating on patients with chronic medical condition. History on abdominal surgery; Identification of pathological condition associated with medical condition; Administration of computed tomographic scan in the abdomen.