The Experts below are selected from a list of 645 Experts worldwide ranked by ideXlab platform
William C. Roberts - One of the best experts on this subject based on the ideXlab platform.
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Computed Tomographic and Morphologic Features of Syphilis of the Aorta.
The American journal of cardiology, 2015Co-Authors: Clay M. Barbin, Matthew R. Weissenborn, Joseph E. Guileyardo, William C. RobertsAbstract:This report describes certain computed tomographic and morphologic features of Syphilitic Aortitis in 2 patients in whom the process involved the entire thoracic aorta.
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Syphilis as a Cause of Thoracic Aortic Aneurysm.
The American journal of cardiology, 2015Co-Authors: William C. Roberts, Clay M. Barbin, Matthew R. Weissenborn, A. Carl HenryAbstract:In 2009, we described morphologic findings in 22 patients having resection of an ascending aortic aneurysm in the previous 11 years at the Baylor University Medical Center, and histologic examination of the aneurysmal wall disclosed classic findings of Syphilitic Aortitis. The major purpose of that extensively illustrated report was to describe the characteristic gross features of the aneurysm such that Syphilitic Aortitis might be better recognized at operation and appropriate antibiotics administered postoperatively. The aim of the present study was to emphasize that syphilis remains a major cause of ascending aortic aneurysm. From January 1, 2009, to December 31, 2014, we studied additional 23 patients who had resection of an ascending aortic aneurysm that again histologically had classic features of Syphilitic Aortitis. All 23 patients were found to have Syphilitic Aortitis grossly and histologically. The aneurysm involved the ascending portion of aorta in all 23, the arch portion in 12, and the descending thoracic portion in 10. In conclusion, syphilis has far from disappeared. It remains a major cause of ascending aortic aneurysm.
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Electrocardiographic Total 12-Lead QRS Voltage in Patients Having Operative Resection of Syphilitic Aortic Aneurysm
The American journal of cardiology, 2015Co-Authors: William C. Roberts, Clay M. Barbin, Matthew R. WeissenbornAbstract:Electrocardiographic voltage has been used to determine the presence of left ventricular hypertrophy for about 70 years. Varying electrocardiographic criteria have been applied. We have found total 12-lead QRS voltage to be most useful in this regard. We measured total 12-lead QRS voltage in 24 patients in whom an ascending aortic aneurysm was resected and histologic study of its wall was classic of Syphilitic Aortitis. In these 24 patients total 12-lead QRS voltage ranged from 57 to 161 mm, averaging 120 ± 32 in the 11 men and 106 ± 24 mm in the 13 women. If normal 12-lead QRS voltage in adults is considered to be >175 mm not a single one of the 24 patients had normal voltage. Indeed, most were in the low normal area. Thus, this study provides some evidence via this indirect means that the heart itself is infrequently involved by Syphilitic Aortitis which produces an ascending aortic aneurysm of sufficient size to warrant resection.
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Natural History of Syphilitic Aortitis
The American journal of cardiology, 2009Co-Authors: William C. Roberts, Travis James VowelsAbstract:No large studies of cardiovascular syphilis at necropsy have been reported since 1964. We examined at necropsy 90 patients who had characteristic morphologic findings of Syphilitic Aortitis. None had ever undergone cardiovascular surgery. With the exception of 2 cases seen more recently, the hearts and aortas of the 90 patients were examined and categorized by one of us (W.C.R.) from 1966 to 1990. All 90 had extensive involvement of the tubular portion of the ascending aorta by the Syphilitic process, which spared the sinuses of Valsalva in all but 4 patients. The aortic arch was also involved in 49 (91%) of 54 patients and the descending thoracic aorta in 47 (90%) of 52 patients. Syphilis was the cause of death in 23 (26%) of the 90 patients. It was secondary to rupture of the ascending or descending thoracic aorta in 12, severe aortic regurgitation leading to heart failure in 10, and severe narrowing of the aortic ostium of the right coronary artery in 1 patient. Of the 40 patients who had undergone serologic testing for syphilis, 28 (70%) had a positive (reactive) finding. Those patients with a negative or nonreactive test or who did not undergo a serologic test for syphilis had morphologic and histologic findings in the aorta at necropsy similar to the findings of those patients who had had a positive serologic test for syphilis. In conclusion, cardiovascular syphilis has not disappeared. In patients with dilated ascending aortas, with or without aortic regurgitation, a serologic test for syphilis is recommended. If the findings are positive or if characteristic morphologic features of cardiovascular syphilis are suspected, irrespective of the results of the serologic tests, antibiotic therapy appears desirable.
Joseph A. Prahlow - One of the best experts on this subject based on the ideXlab platform.
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Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction and Death
Cardiology, 2005Co-Authors: Jamie L.w. Kennedy, Jeffrey J. Barnard, Joseph A. PrahlowAbstract:Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections. Most notable in this regard is Syphilitic Aortitis, which tends to result in aortic root dilatation and its associated complications. A less common manifestation of Syphilitic Aortitis is coronary artery ostial narrowing related to aortic wall thickening. Herein, we present the case of a 32-year-old female who died of a myocardial infarct due to coronary artery ostial stenosis secondary to Syphilitic Aortitis.
Margaret Kingston - One of the best experts on this subject based on the ideXlab platform.
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c3 Syphilitic Aortitis identified in a patient newly diagnosed with hiv the emerging tip of an oncoming iceberg
Sexually Transmitted Infections, 2015Co-Authors: Noel B Connolly, Jonathan E. Shaw, Cara Hendry, Margaret KingstonAbstract:Background A 38 year old man presented for HIV testing following his male partner’s diagnosis. Examination revealed systolic and decrescendo diastolic heart murmurs, palpable thrill, bounding pulses, and positive Corrigan’s sign. He had not tested previously for HIV or syphilis and had been in a monogamous relationship for 8 years. We describe this man who was asymptomatic – from both HIV and aortic valve disease – with incidental diagnosis of severe Syphilitic Aortitis following partner notification for HIV. Results HIV antibody test was positive with baseline viral load 239505 copies/ml and CD4 count 103 cell/μL (8%). Syphilis serology was positive with rapid plasma reagin (RPR) 1:4. CXR was unremarkable. ECG was consistent with left ventricular hypertrophy with strain. Echo revealed severe mixed aortic valve disease, left ventricular hypertrophy, good LV systolic function and normal aortic arch appearance. He commenced prednisolone 60 mg OD for 5d, 72 hr before starting three weekly doses of 2.4 MU benzathine penicillin. He was admitted for 48 hr for cardiac monitoring at the start of treatment – which proceeded with no complication. Multidisciplinary involvement with GU physicians, cardiologists and cardiothoracic surgeons was instigated from the start with aortic valve ± root replacement planned imminently. Discussion Resurgence of syphilis in the UK was reported in the late 1990s with an ongoing epidemic since, mainly involving MSM. Cardiovascular syphilis typically occurs 15–30 years following primary infection with Treponema pallidum , with complications in 10% of cases. Could this man be amongst the first cases to develop tertiary syphilis in this latest epidemic?
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C3 Syphilitic Aortitis identified in a patient newly diagnosed with HIV – the emerging tip of an oncoming iceberg?
Sexually Transmitted Infections, 2015Co-Authors: Noel B Connolly, Jonathan E. Shaw, Cara Hendry, Margaret KingstonAbstract:Background A 38 year old man presented for HIV testing following his male partner’s diagnosis. Examination revealed systolic and decrescendo diastolic heart murmurs, palpable thrill, bounding pulses, and positive Corrigan’s sign. He had not tested previously for HIV or syphilis and had been in a monogamous relationship for 8 years. We describe this man who was asymptomatic – from both HIV and aortic valve disease – with incidental diagnosis of severe Syphilitic Aortitis following partner notification for HIV. Results HIV antibody test was positive with baseline viral load 239505 copies/ml and CD4 count 103 cell/μL (8%). Syphilis serology was positive with rapid plasma reagin (RPR) 1:4. CXR was unremarkable. ECG was consistent with left ventricular hypertrophy with strain. Echo revealed severe mixed aortic valve disease, left ventricular hypertrophy, good LV systolic function and normal aortic arch appearance. He commenced prednisolone 60 mg OD for 5d, 72 hr before starting three weekly doses of 2.4 MU benzathine penicillin. He was admitted for 48 hr for cardiac monitoring at the start of treatment – which proceeded with no complication. Multidisciplinary involvement with GU physicians, cardiologists and cardiothoracic surgeons was instigated from the start with aortic valve ± root replacement planned imminently. Discussion Resurgence of syphilis in the UK was reported in the late 1990s with an ongoing epidemic since, mainly involving MSM. Cardiovascular syphilis typically occurs 15–30 years following primary infection with Treponema pallidum , with complications in 10% of cases. Could this man be amongst the first cases to develop tertiary syphilis in this latest epidemic?
Jamie L.w. Kennedy - One of the best experts on this subject based on the ideXlab platform.
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Syphilitic Coronary Artery Ostial Stenosis Resulting in Acute Myocardial Infarction and Death
Cardiology, 2005Co-Authors: Jamie L.w. Kennedy, Jeffrey J. Barnard, Joseph A. PrahlowAbstract:Cardiovascular abnormalities are well-known manifestations of tertiary syphilis infections. Most notable in this regard is Syphilitic Aortitis, which tends to result in aortic root dilatation and its associated complications. A less common manifestation of Syphilitic Aortitis is coronary artery ostial narrowing related to aortic wall thickening. Herein, we present the case of a 32-year-old female who died of a myocardial infarct due to coronary artery ostial stenosis secondary to Syphilitic Aortitis.
Alessandro Giordano - One of the best experts on this subject based on the ideXlab platform.
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Usefulness of 18F-FDG PET/CT in Disease Extent and Treatment Response Assessment in a Patient With Syphilitic Aortitis
Clinical Nuclear Medicine, 2013Co-Authors: Giorgio Treglia, Silvia Taralli, Fabio Maggi, Antonella Coli, Libero Lauriola, Alessandro GiordanoAbstract:A 40-year-old man was admitted to our hospital for surgical treatment of aortic insufficiency and coronary ostial stenosis. Histopathology and serological tests revealed a Syphilitic Aortitis. 18F-FDG PET/CTwas performed to assess the extent of Aortitis, showing increased radiopharmaceutical uptake along the ascending aortic wall. A repeated FDG PET/CTafter antibiotic therapy showed a markedly reduced uptake in the aortic wall, suggesting resolution of the infection according to clinical and serological data. This case highlights the usefulness of FDG PET/CT for the assessment of disease extent and treatment response in patients with Syphilitic Aortitis.
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usefulness of 18f fdg pet ct in disease extent and treatment response assessment in a patient with Syphilitic Aortitis
Clinical Nuclear Medicine, 2013Co-Authors: Giorgio Treglia, Silvia Taralli, Fabio Maggi, Antonella Coli, Libero Lauriola, Alessandro GiordanoAbstract:A 40-year-old man was admitted to our hospital for surgical treatment of aortic insufficiency and coronary ostial stenosis. Histopathology and serological tests revealed a Syphilitic Aortitis. 18F-FDG PET/CTwas performed to assess the extent of Aortitis, showing increased radiopharmaceutical uptake along the ascending aortic wall. A repeated FDG PET/CTafter antibiotic therapy showed a markedly reduced uptake in the aortic wall, suggesting resolution of the infection according to clinical and serological data. This case highlights the usefulness of FDG PET/CT for the assessment of disease extent and treatment response in patients with Syphilitic Aortitis.
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Usefulness of (18)F-FDG PET/CT in disease extent and treatment response assessment in a patient with Syphilitic Aortitis.
Clinical nuclear medicine, 2013Co-Authors: Giorgio Treglia, Silvia Taralli, Fabio Maggi, Antonella Coli, Libero Lauriola, Alessandro GiordanoAbstract:A 40-year-old man was admitted to our hospital for surgical treatment of aortic insufficiency and coronary ostial stenosis. Histopathology and serological tests revealed a Syphilitic Aortitis. F-FDG PET/CT was performed to assess the extent of Aortitis, showing increased radiopharmaceutical uptake along the ascending aortic wall. A repeated FDG PET/CT after antibiotic therapy showed a markedly reduced uptake in the aortic wall, suggesting resolution of the infection according to clinical and serological data. This case highlights the usefulness of FDG PET/CT for the assessment of disease extent and treatment response in patients with Syphilitic Aortitis.
