Coronary arteriovenous fistulae (CAVF) are a major coronary anomaly, being present in 0.002% of the general population and was first described by Krause in 1865.1,2 The majority are congenital in origin, representing 0.4% of all cardiac malformations.3 These coronary artery anomalies involve one or more coronary arteries abnormally communicating with one of the cardiac chambers (coronary cameral fistulae) or the great vessels adjacent to the heart (coronary artery or arteriovenous fistulae). 4According to the classification by Ogden in 1970, CAVF belong to coronary arteries anomalies that also include anomalous pulmonary artery origins of the coronaries, anomalous aortic origins of the coronaries, congenital atresia of the left main coronary artery, coronary artery bridging, coronary aneurysms, and coronary stenosis. Coronary anomalies may be abnormalities of origin, distribution, or termination. CAVF are considered mainly to be termination abnormalities. 5,6Nomenclature is based upon a descriptive analysis of the vessel of origin and the chamber of termination. According to Sakakibara et al, there are two types of angiographic classification: Type A-proximal type, where the proximal coronary segment is dilated to the origin of the fistula and the distal end is normal; and Type B-distal type, where the coronary artery is dilated over its entire length terminating as a fistula mainly into the right side of the heart (end-artery type) and the proximal coronary segment can or might have regular branches.6 Each one of these groups can be presented with different clinical signs and symptoms.6,7 EpidemiologyThe incidence of coronary anomalies is 0.2 to 1.2% of the population. 6CAVF are present in 0.002% of the general population and comprise 48.7% of all congenital coronary anomalies.8,9 They are the most common of hemodynamically significant coronary lesions. 8-11Among all pediatric coronary vasculature anomalies, approximately half of them are CAVF. 12,13Keywords ► arteriovenous fistula ► cardiac surgery ► coronary artery ► fistula ► symptomatic ► cardiovascular disease ► cardiac catheterization AbstractCoronary arteriovenous fistulae are a coronary anomaly, presenting in 0.002% of the general population. Their etiology can be congenital or acquired. We present a review of recent literature related to their epidemiology, etiology, pathophysiology, clinical presentation, diagnostic approach, and therapeutic management.

There is ongoing scientific interest regarding comorbidities associated with the metabolic syndrome (MeTS). MeTS comprises a combination of parameters that predispose individuals to the development of type 2 diabetes and cardiovascular disease (CVD). Three or more of the following criteria are necessary: fasting glucose > 110 mg/dl (5.6 mmol/l), hypertriglyceridemia > 150 mg/dl (1.7 mmol/l), HDL levels < 40 mg/dl (men)/< 50 mg/dl (women), blood pressure > 130/85 mmHg, waist circumference (values for Mediterranean populations > 94 cm (men)/> 89 cm (women). In this review we attempted to summarize relevant data by searching dermatological literature regarding associations between various skin conditions and MeTS. A multitude of studies was retrieved and a further goal of the present article is to present plausible mechanistic connections. The severity of skin conditions like psoriasis has been linked with MeTS. Parameters of MeTS like insulin resistance are present in patients with early onset androgenic alopecia, hidradenitis suppurativa acne and rosacea. Since MeTS can lead to CVD and type 2 diabetes early detection of patients would be very important. Also therapeutic intervention on MeTS could lead to improvement on the severity of skin conditions. This reciprocal relationship between skin diseases and MeTS in our opinion holds great interest for further investigation.

Key Points Question Are any treatment modalities for frozen shoulder associated with better outcomes than other treatments? Findings In this meta-analysis of 65 studies with 4097 participants, intra-articular corticosteroid was associated with increased short-term benefits compared with other nonsurgical treatments, and its superiority appeared to last for as long as 6 months. The addition of a home exercise program and/or electrotherapy or passive mobilizations may be associated with added benefits. Meaning The results of this study suggest that intra-articular corticosteroid should be offered to patients with frozen shoulder at first contact.

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