摘要：Lactic acidosis is a rare complication of malignancies and is seen more frequently in high grade lymphoma and leukemia. Although, its pathogenesis is not well understood, it remains a surrogate of poor prognosis. Herein, we present a case of Burkitt-like lymphoma presenting with metabolic abnormalities including lactic acidosis and hypoglycemia along with atrial tachycardia. We will discuss the different mechanisms involved in these metabolic disturbances and we will provide insight on novel therapeutic strategies based on our understanding of the underlying pathophysiology.

摘要：The subcutaneous implantable cardioverter-defibrillator(S-ICD)has recently been approved for commercial use in Europe,New Zealand and the United *** is comprised of a pulse generator,placed subcutaneously in a left lateral position,and a parasternal subcutaneous lead-electrode with two sensing electrodes separated by a shocking *** an entirely subcutaneous system it avoids important periprocedural and long-term complications associated with transvenous implantable cardioverter-defibrillator(TV-ICD)systems as well as the need for fluoroscopy during implant *** candidates include pediatric patients with congenital heart disease that limits intracavitary lead placements,those with obstructed venous access,chronic indwelling catheters or high infection risk,as well as young patients with electrical heart disease(e.g.,Brugada Syndrome,long QT syndrome,and hypertrophic cardiomyopathy).Nevertheless,given the absence of intracavitary leads,the S-ICD is unable to offer pacing(apart from shortterm post-shock pacing).It is therefore not suitable in patients with an indication for antibradycardia pacing or cardiac resynchronization therapy,or with a history of repetitive monomorphic ventricular tachycardia that would benefit from antitachycardia *** data from initial clinical studies and post-commercialization"real-life"case series,including over 700 patients,have so far been promising and shown that the S-ICD successfully converts induced and spontaneous ventricular tachycardia/ventricular fibrillation episodes with associated complication and inappropriate shock rates similar to that of ***,by using far-field electrograms better tachyarrhythmia discrimination when compared to TV-ICDs has been *** results from ongoing clinical studies will determine the S-ICD system’s long-term performance,and better define suitable patient profiles.