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Background: Type II Diabetes Mellitus (DM) was accompanied by subclinical impairment of Right Ventricular (RV) systolic dysfunction. Two-Dimensional (2D) Speckle Tracking Echocardiography (STE) allows a precise evaluation of myocardial function. Aim of the Study: The aim of this study was to assess the RV systolic function in asymptomatic normotensive subjects with type II DM compared with control subjects, using strain/ strain rate qualification by 2D STE. Subjects and Methods: Prospective study enrolled 100 subjects, they were classified into two groups: Group I included seventy subjects known to have type II DM (36 males and 34 females), mean age 41.37±4.72 years, and group II included thirty healthy subjects (15 males and 15 females) with mean age 39.40±3.14 years. All subjects had normal Left Ventricular (LV) Ejection Fraction (EF), calculated by conventional 2D Trans-Thoracic Echocardiography (TTE). Subjects who had diseases affecting LV and RV systolic functionwere excluded as hypertension, coronary artery disease, valvular diseases, arrhythmias, pulmonary diseases and pulmonary hypertension. All studied population were subjected to informed verbal consent, full history taking. General and cardiac examination were done. Resting standard 12-leads Electrocardiogram (ECG) has been recorded for analysis. HaemoglobinA1c (HbA1c %) level was measured for group I. 2D TTE and 2D STE were done for all subjects. LV global longitudinal strain (LVGLS%), RVGLS%, RV segmental peak Longitudinal Systolic Strains (LSS%) and RV segmental longitudinal systolic strain rates (LSSRs 1/sec) were assessed by 2D STE. Data were collected and statistically analysed. Results: Both groups showed no statistically significant difference regarding LV linear internal dimensions, EF, LV Mass Index (LVMI), RV inflow linear dimensions, Fractional Area Change (FAC) and Tricuspid Annular Post-Systolic Excursion (TAPSE). Mean values of LVGLS and RVGLS were significantly lower in group I than in group II, as mean values for GLS of LV & RV were (-19.93 ± 1.48,-21.49±3.80
Upper Urinary Tract Urothelial Carcinoma (UTUC) remain rare. Radical Nephroureterectomy (RNU) is the Gold standard for management of these tumours. We are reporting a clinical image of a 45-year-old patient admitted in emergency for left lumbar pain (nephritic colic). The checkups requested computed tomography scanner showed a nephromegaly and left hydronephrosis upstream of a suspicious parietal thickening of the lumbar ureter with cortical and functional repercussion, neighborhood infiltration, and atypical lateral-aortic ganglia. Left lower calicial lithiasis of stasis, pancreatic nodular lesion and the left adrenal gland. The patient was a candidate for an open Radical Left Nephroureterectomy (RNU) (Figure 1). Figure 1: Radical Nephroureterectomy (RNU) picture U (Ureter) R (Renal). There are prognostic factors of tumors of the upper urinary excretory tract, which are the patient’s status, the preoperative, the operation and the anatomopathology [1]. According to current literature data, the oncology outcomes of radical nephrouretrectomy by laparoscopic are lower than those of open RNU surgery [2].
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