Aims/Hypothesis: Early determination of myocardial manifestations of diabetes mellitus is of major importance, since myocardial involvement considerably influences the prognosis of diabetic patients. The aim of this study was to investigate whether young patients with insulin-dependent diabetes mellitus and normal systolic left ventricular (LV) function already show a diastolic LV dysfunction and an increased risk of arrhythmias. Methods: Echocardiography was performed in 87 patients suffering from type I diabetes mellitus, without known cardiac disease and in 87 controls. Patients with a known manifest cardiac disease or a long-term diabetic syndrome were excluded. Morphological parameters were determined using M-mode echocardiography. Doppler echocardiography was used to evaluate parameters of LV diastolic function. The risk of arrhythmia was assessed by means of electrocardiography, heart rate variability, and late potential analysis. Results: The left atrial and ventricular dimensions and systolic functional parameters of all patients were normal. A diastolic dysfunction with a reduction in early diastolic filling, an increase in atrial filling, an extension of isovolumetric relaxation and deceleration time was documented in diabetic patients, as well as an increased number of supraventricular and ventricular premature beats. Conclusion: Even young patients with diabetes mellitus suffer from a diastolic dysfunction while systolic ventricular function is normal. Therefore, echocardiography with measurements of diastolic functional parameters appears to be a sensitive method for evaluating the manifestation and course of early diabetic cardiomyopathy.

Objective: The purpose of this study was to examine which hemodynamic parameters change under the natural volume overload of pregnancy. Study Design: 46 healthy pregnant women were echocardiographically examined during the course of pregnancy. To evaluate left ventricular diastolic function, mitral inflow and pulmonary venous flow profiles were used. Fractional shortening and left ventricular muscle mass were calculated. Results: In the course of pregnancy the left ventricular muscle mass index increased (from 66 ± 6 to 96 ± 9 g/m²), fractional shortening decreased (from 38 ± 4 to 32 ± 6%) and a disturbed diastolic relaxation pattern was documented. Eight weeks after delivery, all left ventricular systolic and diastolic functional parameters returned to normal values. Conclusion: The natural volume overload in pregnancy leads to a reversible ‘physiological’ left ventricular hypertrophy, a short-term decrease in systolic function and a significant change in left ventricular diastolic function.

Use of an antibiotic-loaded spacer allows successful treatment of infected shoulder replacements.

Hydatid disease is caused by the parasitic tapeworm Echinococcus. There are three species: E. granulosus, E. alveolaris and E. voegeli. Only E. alveolaris and E. granulosus are important for human infections. These two species are totally divergent in their manner of infestation. Hydatid disease is a rare parasitic disease that primary involves the liver and the lung. Skeletal disease is rare, accounting for less than 2% of all hydatid lesions, and often presents as a clinical and radiologic diagnostic problem. The skeletal involvement is usually due to secondary extension after haematogenous spread of the infection. The vertebral column, the pelvis and the skull are most commonly involved. Treatment is also difficult because of the invasive nature of bony involvement and the spillage of fluid with subsequent contamination seeding. We present a case of primary hyatid cyst of the tibia. We point out the importance of considering osseous hydatidosis in the differential diagnosis of destructive bone lesions and the necessity of radical resection.

Doppler echocardiographic parameters of LV diastolic function can be of diagnostic importance for discrimination between pathologic and physiologic LV hypertrophy.