BACKGROUND: Excessive weight and obesity (EwO) are independent factors in the development of heart failure; they lead to a state of myocardiopathy via inflammatory and hormonal mechanisms. If excessively accumulated, epicardial fat favors a proinflammatory state. Ventricular asynchrony is a marker of heart failure progression and has been poorly studied in EwO. The objective was evaluate the relation between epicardial fat, body mass index (BMI) and mechanical synchrony measured by echocardiography, in healthy individuals with EwO. METHODS: We included 55 healthy individuals between the ages of 18 and 35, 17 had a BMI < 25 kg/m2 (30.9%) and 38 had a BMI > 25 kg/m2 (EwO group) (69.09%), anthropometric measurements, transthoracic echocardiogram and synchrony evaluation were obtained. RESULTS: Left atrial volume, telediastolic and telesystolic left ventricular volumes and the baseline volume of the right ventricle were greater in the EwO group (20 mL/m2 vs. 15 mL/m2, p = 0.001; 106 mL vs. 82 mL, p = 0.0149 vs. 32 mL, p = 0.001 and 34 mm vs. 31 mm, p = 0.02, respectively). The Yu index also correlated with epicardial fat, r = 0.53, p < 0.01, whereby the greater the amount of epicardial fat, the greater the dispersion timing of ventricular activation. The systolic synchrony index also correlated with the BMI, p = 0.01. CONCLUSION: Mechanical intraventricular asynchrony is associated to EwO and the amount of epicardial fat; hence, asynchrony may be one more factor leading to heart failure in EwO individuals.
Body Mass Index ; Cardiomyopathies ; Echocardiography ; Heart Failure ; Heart Ventricles ; Obesity* ; Pilot Projects*

Purpose: Pott’s puffy tumor (PPT), characterized by frontal bone osteomyelitis and subperiosteal abscess, typically arises as a complication of head trauma or frontal sinusitis and is associated with diverse triggers. Since 2001, PPT, previously considered rare in the pediatric population, has been increasingly reported, underscoring heightened recognition. By outlining specific protocols and guidelines, a clinical pathway (CP) facilitates rapid identification and treatment of PPT. Methods: We reviewed 11 cases of PPT in patients aged 0 to 18 years who were either hospitalized or discharged from 2 large hospitals in South Florida, United States, from January 31, 2016 through February 1, 2019. This multicenter retrospective case review was complemented by a comprehensive literature review. Additionally, the study team proposed a diagnostic CP tailored for the emergency department setting. Variables of interest included demographic data, clinical presentation, imaging studies, medical and surgical management details, laboratory/microbiological data, and clinical outcomes. Results: A total of 11 patients with PPT were identified, of whom 8 and 7 were boys and African Americans, respectively. The common symptoms were fever, headache, and frontal edema. All patients underwent antibiotic therapy for 6-8 weeks, as well as both computed tomography and magnetic resonance imaging. The imaging studies showed intracranial complications in the 10 patients such as epidural abscess, which were caused by Streptococcus pneumoniae, Streptococcus intermedius, Streptococcus pyogenes, Eikenella spp., and methicillin-sensitive Staphylococcus aureus. The 10 patients underwent endoscopic sinus surgeries, with 6 of them also doing craniotomies. No mortality or sequelae was reported. Conclusion This study contributes to the growing body of literature on PPT, shedding light on its evolving epidemiology, clinical manifestations, and management strategies while emphasizing the pivotal role of emergency physicians for optimal outcomes. The proposed CP aims to establish a standard of care that can be adopted across various pediatric emergency departments.

Purpose: Pott’s puffy tumor (PPT), characterized by frontal bone osteomyelitis and subperiosteal abscess, typically arises as a complication of head trauma or frontal sinusitis and is associated with diverse triggers. Since 2001, PPT, previously considered rare in the pediatric population, has been increasingly reported, underscoring heightened recognition. By outlining specific protocols and guidelines, a clinical pathway (CP) facilitates rapid identification and treatment of PPT. Methods: We reviewed 11 cases of PPT in patients aged 0 to 18 years who were either hospitalized or discharged from 2 large hospitals in South Florida, United States, from January 31, 2016 through February 1, 2019. This multicenter retrospective case review was complemented by a comprehensive literature review. Additionally, the study team proposed a diagnostic CP tailored for the emergency department setting. Variables of interest included demographic data, clinical presentation, imaging studies, medical and surgical management details, laboratory/microbiological data, and clinical outcomes. Results: A total of 11 patients with PPT were identified, of whom 8 and 7 were boys and African Americans, respectively. The common symptoms were fever, headache, and frontal edema. All patients underwent antibiotic therapy for 6-8 weeks, as well as both computed tomography and magnetic resonance imaging. The imaging studies showed intracranial complications in the 10 patients such as epidural abscess, which were caused by Streptococcus pneumoniae, Streptococcus intermedius, Streptococcus pyogenes, Eikenella spp., and methicillin-sensitive Staphylococcus aureus. The 10 patients underwent endoscopic sinus surgeries, with 6 of them also doing craniotomies. No mortality or sequelae was reported. Conclusion This study contributes to the growing body of literature on PPT, shedding light on its evolving epidemiology, clinical manifestations, and management strategies while emphasizing the pivotal role of emergency physicians for optimal outcomes. The proposed CP aims to establish a standard of care that can be adopted across various pediatric emergency departments.

Purpose: Pott’s puffy tumor (PPT), characterized by frontal bone osteomyelitis and subperiosteal abscess, typically arises as a complication of head trauma or frontal sinusitis and is associated with diverse triggers. Since 2001, PPT, previously considered rare in the pediatric population, has been increasingly reported, underscoring heightened recognition. By outlining specific protocols and guidelines, a clinical pathway (CP) facilitates rapid identification and treatment of PPT. Methods: We reviewed 11 cases of PPT in patients aged 0 to 18 years who were either hospitalized or discharged from 2 large hospitals in South Florida, United States, from January 31, 2016 through February 1, 2019. This multicenter retrospective case review was complemented by a comprehensive literature review. Additionally, the study team proposed a diagnostic CP tailored for the emergency department setting. Variables of interest included demographic data, clinical presentation, imaging studies, medical and surgical management details, laboratory/microbiological data, and clinical outcomes. Results: A total of 11 patients with PPT were identified, of whom 8 and 7 were boys and African Americans, respectively. The common symptoms were fever, headache, and frontal edema. All patients underwent antibiotic therapy for 6-8 weeks, as well as both computed tomography and magnetic resonance imaging. The imaging studies showed intracranial complications in the 10 patients such as epidural abscess, which were caused by Streptococcus pneumoniae, Streptococcus intermedius, Streptococcus pyogenes, Eikenella spp., and methicillin-sensitive Staphylococcus aureus. The 10 patients underwent endoscopic sinus surgeries, with 6 of them also doing craniotomies. No mortality or sequelae was reported. Conclusion This study contributes to the growing body of literature on PPT, shedding light on its evolving epidemiology, clinical manifestations, and management strategies while emphasizing the pivotal role of emergency physicians for optimal outcomes. The proposed CP aims to establish a standard of care that can be adopted across various pediatric emergency departments.

Purpose: Pott’s puffy tumor (PPT), characterized by frontal bone osteomyelitis and subperiosteal abscess, typically arises as a complication of head trauma or frontal sinusitis and is associated with diverse triggers. Since 2001, PPT, previously considered rare in the pediatric population, has been increasingly reported, underscoring heightened recognition. By outlining specific protocols and guidelines, a clinical pathway (CP) facilitates rapid identification and treatment of PPT. Methods: We reviewed 11 cases of PPT in patients aged 0 to 18 years who were either hospitalized or discharged from 2 large hospitals in South Florida, United States, from January 31, 2016 through February 1, 2019. This multicenter retrospective case review was complemented by a comprehensive literature review. Additionally, the study team proposed a diagnostic CP tailored for the emergency department setting. Variables of interest included demographic data, clinical presentation, imaging studies, medical and surgical management details, laboratory/microbiological data, and clinical outcomes. Results: A total of 11 patients with PPT were identified, of whom 8 and 7 were boys and African Americans, respectively. The common symptoms were fever, headache, and frontal edema. All patients underwent antibiotic therapy for 6-8 weeks, as well as both computed tomography and magnetic resonance imaging. The imaging studies showed intracranial complications in the 10 patients such as epidural abscess, which were caused by Streptococcus pneumoniae, Streptococcus intermedius, Streptococcus pyogenes, Eikenella spp., and methicillin-sensitive Staphylococcus aureus. The 10 patients underwent endoscopic sinus surgeries, with 6 of them also doing craniotomies. No mortality or sequelae was reported. Conclusion This study contributes to the growing body of literature on PPT, shedding light on its evolving epidemiology, clinical manifestations, and management strategies while emphasizing the pivotal role of emergency physicians for optimal outcomes. The proposed CP aims to establish a standard of care that can be adopted across various pediatric emergency departments.

Purpose: Pott’s puffy tumor (PPT), characterized by frontal bone osteomyelitis and subperiosteal abscess, typically arises as a complication of head trauma or frontal sinusitis and is associated with diverse triggers. Since 2001, PPT, previously considered rare in the pediatric population, has been increasingly reported, underscoring heightened recognition. By outlining specific protocols and guidelines, a clinical pathway (CP) facilitates rapid identification and treatment of PPT. Methods: We reviewed 11 cases of PPT in patients aged 0 to 18 years who were either hospitalized or discharged from 2 large hospitals in South Florida, United States, from January 31, 2016 through February 1, 2019. This multicenter retrospective case review was complemented by a comprehensive literature review. Additionally, the study team proposed a diagnostic CP tailored for the emergency department setting. Variables of interest included demographic data, clinical presentation, imaging studies, medical and surgical management details, laboratory/microbiological data, and clinical outcomes. Results: A total of 11 patients with PPT were identified, of whom 8 and 7 were boys and African Americans, respectively. The common symptoms were fever, headache, and frontal edema. All patients underwent antibiotic therapy for 6-8 weeks, as well as both computed tomography and magnetic resonance imaging. The imaging studies showed intracranial complications in the 10 patients such as epidural abscess, which were caused by Streptococcus pneumoniae, Streptococcus intermedius, Streptococcus pyogenes, Eikenella spp., and methicillin-sensitive Staphylococcus aureus. The 10 patients underwent endoscopic sinus surgeries, with 6 of them also doing craniotomies. No mortality or sequelae was reported. Conclusion This study contributes to the growing body of literature on PPT, shedding light on its evolving epidemiology, clinical manifestations, and management strategies while emphasizing the pivotal role of emergency physicians for optimal outcomes. The proposed CP aims to establish a standard of care that can be adopted across various pediatric emergency departments.