We investigated the efficacy and safety of hydroxychloroquine for empirical treatment of outpatients with confirmed COVID-19. Methods: In this prospective, single-center study, we enrolled ambulatory outpatients with COVID-19 confirmed by a molecular method who received hydroxychloroquine. The patients were divided into low-and moderaterisk groups based on the Tisdale risk score for drug-associated QT prolongation, and the QT interval was corrected for heart rate using the Bazett formula (QTc). The QTc interval was measured by electrocardiography both pretreatment (QTc1) and 4 h after the administration of hydroxychloroquine (QTc2). The difference between the QTc1 and QTc2 intervals was defined as the ΔQTc. The QTc1 and QTc2 intervals and ΔQTc values were compared between the two risk groups. Results: The median and interquartile range (IQR) age of the patients was 47.0 (36.2-62) years, and there were 78 men and 74 women. The median (IQR) QTc1 interval lengthened from 425.0 (407.2-425.0) to 430.0 (QTc2; 412.0-443.0) milliseconds (ms). However, this was not considered an increased risk of ventricular tachycardia associated with a prolonged QTc interval requiring drug discontinuation, because none of the patients had a ΔQTc of >60 ms or a QTc2 of >500 ms. Moreover, the median (quartiles; minimum-maximum) ΔQTc value was higher in patients in the moderate-risk group than those in the low-risk group (

We report spontaneous corneal perforation in a patient with lamellar ichthyosis. The patient presented with complaints of pain, redness, diminished vision, and discharge in her right eye for 15 days. Visual acuities were light perception in the right and 20/400 in the left eye. Cicatricial ectropion in both lower eyelids and 2 mm perforation site in the center of the right cornea were observed. Lamellar ichthyosis was suspected because of scaling and excessive dryness of entire body skin and was confirmed by skin biopsy. Amniotic membrane transplantation and transient tarsorraphy was performed and systemic anti-ichthyosis therapy was started. The follow-up visits were not possible because of patient inconsistency. In patients with cicatricial ectropion secondary to ichthyosis, corneal health should be closely monitored because of the perforation risk.

A 32-year-old man was urgently referred to our hospital with severe tricuspid insufficiency following a car accident. The completely flail anterior leaflet, due to the rupture of the papillary muscles, was revealed by a two-dimensional transthoracic echocardiography. In the operation, we also detected a tear on the anterior leaflet and the rupture of numerous chordae tendineae of the other leaflets. Valve repair was not considered feasible, therefore the tricuspid valve was replaced with a 31 mm mechanical prosthesis. The patient's recovery from surgery was uneventful, and he was discharged on the seventh postoperative day.Keywords: cardiac injury, tricuspid valve, tricuspid insufficiency Introduction Unfortunately, with the increase in the number of vehicles, traffic accidents have become a serious health problem. Cardiac injuries following chest trauma vary from simple myocardial contusions to severe damage to the intracardiac structures. Traumatic tricuspid valve insufficiency is a rare clinical entity. 1� We present a patient who developed tricuspid insufficiency following blunt chest trauma. Case ReportA traffic accident in August 2011 left a 48-yearold man with thoracic and abdominal trauma, due to his chest hitting the steering wheel. Unfortunately, he was not wearing a seat belt. He was admitted to the state hospital. There, he underwent an urgent splenectomy because of massive bleeding due to splenic rupture. Also, a chest tube was inserted to treat a left-side hemopneumothorax. On the fifteenth day following the accident, he was discharged from the hospital. A few weeks later, he was referred to our hospital with complaints of palpitation, dyspnea on effort, and fatigue. A physical examination revealed hepatomegaly, distention of the juguler veins, peripheral edema and a 3-4/6 systolic murmur on the left lateral sternal border. The cardiac silhouette was enlarged with a chest X-ray. A two-dimensional transthoracic echocardiography showed dilatation of the right atrium (approximately 6.5 cm), and severe tricuspid regurgitation due to papillary muscle rupture (Fig. 1). Coronary angiography revealed normal coronary arteries. On the basis of these findings, the patient was taken to surgery.A cardiopulmonary bypass was performed using aortic and bicaval cannulation. Moderate systemic hypothermia, topical cooling and antegrade cold blood cardioplegia were used for myocardial protection. After the midsternotomy and pericardiotomy, a large amount of haemorrhagic pericardial effusion was evacuated.When the right atrium was opened, the anterior and the posterior papillary muscles were found to be ruptured (Fig. 2). In addition to numerous ruptured chordae tendineae, there was a tear on the anterior leaflet.Valve repair was not suitable for this case, therefore the tricuspid valve was replaced with a 31 mm mechanical prosthesis. A temporary epicardial pacemaker wire was inserted. Sinus rhythm spontaneously resumed. The Case Report Ann Thorac Cardiovasc Surg 2013; 19: 222-224 Online November 15, 2012 doi: 10.5...

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Combinative use of NT-proBNP and CVIBS can detect the presence of diastolic abnormalities on echocardiography. A good correlation was found between the NT-proBNP and CVIBS values in detecting diastolic dysfunction in essentially hypertensive patients.