Correlation between Cold Pressure Testing (CPT)/ 99 Tc MIBI-SPECT defects and intracoronary acetylcholine (ACH) paradoxical constriction was published by our group. The usefulness of CPT non -invasive diagnosis of dysfunction (ED) was demonstrated by our observation in coincidence with other authors. There is little information on ED incidence on moderate risk asymptomatic (MRA) patients according to ATP III/Framingham index. Objective: This study is aimed at analyzing the incidence and localization of 99 Tc MIBI/ SPECT myocardial perfusion (MP) defects during CPT as indicator of ED on MRA patients. Methods: 124 patients (78 female) currently compounding PARADIGMA Study Register were analyzed. PARADIGMA is a prospective multicenter study that will include once completed a total number of 450 MRA patients according to ATP III/ Framingham index (Ͻ 20% events at 10 years ), with normal exercise MP and no cardiovascular disease history. CPT-MP imaging was obtained in all these patients. MP extension score was used in a 17 segment model , reported by two observers on consensus. Mann-Whitney U Test statistical analysis was performed. l Results: positive CPT 25/113 patients (22,12 %). CPT extension perfusion score positive 5,77Ϯ2,38(pϽ0.0001). CPT was positive in 30,76 % men and 17,56 % women (pϽ0.001). Localization : anterior wall 4 3%,i n ferior wall 47 %, lateral wall 4,5% and anterior with inferior walls 4,5 %. Conclusion: These results suggest high incidence of ED on MRA patients, who are also free from exercise --related ischemia. There were no significant differences in clinical data and defects localization. Further studies will indicate whether this positive CPT population would have higher risk of cardiovascular events during follow-up Age, Bood Pressure and Cholesterol pns (*) AGE SBP DBP CHOLEST. HDL LDL TRIGL. CPT ( ϩ ) 55.9 Ϯ10 130Ϯ 12 84 Ϯ 5 245 Ϯ 90 48 Ϯ 19 156Ϯ 49 246 Ϯ143 CPT (-) 53.5 Ϯ 9 129 Ϯ 15 79 Ϯ9 228 Ϯ 45 51 Ϯ 12 157 Ϯ 34 160 Ϯ72 7.2Effects of percutaneous intramyocardial plasmid gene transfer of vascular endothelial growth factor (phVEGF-A165 ) on myocardial perfusion measured by N-13 ammonia-PET.

Blunt abdominal trauma is a frequent emergency and is also associated with significant morbidity and mortality. Spleen is the commonest organ injured. In this study, we meet a special complication after splenectomy, atelectasis and mediastinal shift, and this is the complication with hemodynamic unstable. Without bronchoscopy, the patient is told to inspire deeply by blowing balloons with pressure 8-10 cm H 2 O and recovered uneventfully.

Acute appendicitis is the most common cause of acute abdominal disorders requiring surgery. The mainstay of treatment is an appendectomy for more than 100 years. However, symptoms of acute appendicitis confuse many other conditions making diagnosis a challenge. In addition, as with all operations, postoperative complications exist, including wound infections, intra-abdominal abscesses, ileus and adhesions. For some specific patients (the first trimester of pregnancy or who have contraindications), surgery is not the best choice. So it is important to confirm if antibiotics-first approach is effective and may be used as an alternative treatment for appendectomy.

<p><strong>Background and Objective:</strong> Sharp force injuries (SFI), inflicted by cutting or stabbing, result in variable outcome depending upon the nature and site of the injury. This study evaluated the cases of SFIs and their outcome with reference to the time of presentation, demographic data, wounded organs, and surgical procedure performed.<br /><strong>Methods:</strong> This retrospective study analyzed the clinical data of 20 patients who presented with sharp force injury (knife stabbing and penetrating abdominal trauma) and were admitted between April 2015 and November 2016. The management and outcome of patients were recorded.<br /><strong>Results:</strong> All patients in this study were male and aged between 21 and 30 years. Knife stabbing was the only mechanism of injury in all cases. Colon (50%) was the commonest organ injured followed by intestine (40%) and liver (30%). Mortality rate was 10%. There were two cases with negative laparotomy (10%). Wound sepsis (10%) was the commonest complication.<br /><strong>Conclusions: </strong>SFI involving abdominal area are managed either conservatively or with primary repair and laparotomy to save internal organs. Early presentation and prompt management leads to reduced chances of complications and mortality.</p>