Benefit of CHA2DS2-VASc score in predicting implantable cardioverter defibrillator shocks

Introduction: Implantable cardioverter defibrillators (ICDs) reduce the risk of sudden death in eligible patients. However, it is thought that there is a relationship between the ICD shocks and increased morbidity and mortality. In this study, we examined the relationship between ICD shocks and the CHA2DS2-VASc scoring, which has gained frequent use in predicting cardiac events recently. Material and Methods: Retrospective baseline characteristics and three-year follow-ups of patients with ICDs with appropriate indication were studied. Patients were divided into two groups: patients who have received ICD shock(s) and patients who have not received any ICD shock. These groups were compared for baseline characteristics and CHA2DS2-VASc scores. Results: CHA2DS2-VASc scores of heart failure (HF) patients in our study population were significantly higher than those who did not receive any shock within three years following the ICD implantation. The rate of appropriate or inappropriate ICD shocks was %16 in the HF patients implanted with ICD for primary prevention while it was %66 in patients implanted with ICD for secondary prevention. The incidence of atrial fibrillation was 68% in 37 patients who received inappropriate shock while it was 7% in those who did not receive inappropriate shock (those who received appropriate shocks or did not receive any shock) (p<0.001). Conclusion: In conclusion, this study demonstrated a relation between the CHA2DS2-VASc score and appropriate and inappropriate ICD shocks. The CHA2DS2-VASc score is a simple tool that may predict ICD shocks

Different approaches to enhance resveratrol content in wine

Resveratrol is a polyphenol with antioxidant properties and possible beneficial effects on human health. Grapes, peanuts, berries, cacao beans and red wine contain resveratrol. Resveratrol attracts attention due to its bioactive properties, however, the concentration of this compound is not high in grape and wine. Therefore, different studies have been carried out to increase resveratrol level in these products. Several factors such as the grapevine variety, the climatic conditions and the viticultural practices used to create stress on the vine affect the level of resveratrol. Winemaking technologies applied during pre-fermentation, fermentation and post–fermentation stages could also have an effect on the concentration of this stilbene. In addition, recent studies have evaluated biotechnological approaches through the use of different bacteria and yeast strains to produce wine with increased resveratrol content. In this review, the most important factors contributing to increase the resveratrol concentration in grapes and wines are examined. Besides, analytical methods to determine resveratrol content in wine are addressed

A young lady with severe dyspnea in postpartum period after long term ınfertility treatment

Lenfanjioleimyomatozis (LAM) çoğunlukla genç kadınları etkileyen, genellikle solunum yetmezliği ve ölüme ilerleyebilen bir tablodur. 33 yaşında postpartum periyodda kadın hasta ilerleyici nefes darlığı ve yüksek CA-125 seviyeleri ile başvurdu. Hastada bilateral şilopnömotoraks, şilöz asit mevcut idi ve açık akciğer biyopsisi ile LAM tanısı aldı. Hastanın takibi oldukça karmaşıktı ve şilöz asit ve plevral efüzyonlar tedaviye çok dirençliydi. Betadin plörodezisi şilotoraksların tedavisinde oldukça başarılı oldu. Literatürde yüksek CA-125 seviyeleri ile başvuran LAM vakası sunulmamıştır. Takipte CA-125 seviyelerinin yararlı bir parametre olabileceğini düşünmekteyiz. (Tur Toraks Der 2011; 12: 127-30

Primer spontan pnömotoraksta elektrokardiyografik değişiklikler

Background: This study aims to evaluate the electrocardiographic (ECG) changes in patients with primary spontaneous pneumothorax. Methods: A total of 48 patients (42 males, 6 females; mean age 29.7;plusmn;12.5 years, range 15 to 58 years) with PSP were prospectively analyzed between November 2010 and November 2011. Pneumothorax size was calculated using the Rhea method. At least two standard 12-lead ECG were obtained for each patient (after the diagnosis of pneumothorax and prior to drain placement - ECGpneumothorax, and after a complete re-expansion of the lung was achieved and confirmed radiologically - ECGre-expanded). P wave measurement, PR distance, QRS distance, QT interval and QT interval corrected for heart rate (QTc) were calculated. Heart rate (bpm), axis deviation measurement and the QRS amplitudes in precordial leads were calculated. Results: There were 29 cases (60.4%) of left-sided and 19 cases (39.6%) of right-sided pneumothorax. The mean relative volume of pneumothorax was 43.0;plusmn;21.5%. The most common symptoms included chest pain in 34 patients (70.8%) and dyspnea in 14 patients (29.2%). The pneumothorax duration was ;lt;=24 hours in 30 patients (62.5%) and ;gt;24 hours in 18 patients (37.5%). There was a statistically significant difference between before and after the treatment for QT duration, axis deviation, heart rate, QRSV1, QRSV4, QRSV5 and QRSV6 (respectively; p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). A total of seven patients had relevant QRS abnormalities including incomplete right bundle branch block in three patients, ST elevation in two patients and T-wave pointedness in one patient. Conclusion: Our study results suggest that left and right lung pneumothorax may cause axis variation, which is more pronounced in women, and that voltage increases after drainage in QRSV 4, 5 and 6 leads. In addition, pneumothorax may lead to specific ECG variations such as right bundle branch block and ST variations.Amaç: Bu çalışmada primer spontan pnömotoraks olgularındaki elektrokardiyografik (EKG) değişiklikler değerlendirildi.Ça­lış­ma­pla­nı:­Primer spontan pnömotorakslı toplam 48 hasta (42 erkek, 6 kadın; ort. yaş: 29.7±12.5 yıl; dağılım 15-58 yıl) Kasım 2010 - Kasım 2011 tarihleri arasında prospektif olarak incelendi. Pnömotoraks alanı Rhea metodu ile hesaplandı. Her hastaya en az iki kere standart 12 derivasyonlu EKG çekildi (pnömotoraks tanısından sonra ve göğüs tüpü uygulamasından önce - EKGpnömotoraks ve akciğerin yeniden ekspanse olması ve radyolojik olarak doğrulanmasından sonra - EKGre-ekspanse). P dalgası ölçümü, PR mesafesi, QRS mesafesi, QT intervali ve kalp hızı için düzeltilmiş QT aralığı (QTc) hesaplandı. Ayrıca kalp hızı (dakikada nabız sayısı), aks deviasyonu ölçümleri ve prekordial derivasyonlarda QRS amplitüdleri hesaplandı.Bul gu lar: Pnömotoraks hastaların 29'unda (%60.4) sol, 19'unda (%39.6) sağ hemitoraksta idi. Pnömotoraks alanının ortalaması %43.0±21.5 idi. En sık görülen semptomlar, 34 hastada (%70.8) göğüs ağrısı, 14 hastada (%29.2) nefes darlığı idi. Pnömotoraks süresi 30 hastada (%62.5) =24 saat iken, 18 hastada (%37.5) >24 saat idi. Tedavi öncesi ve tedavi sonrası QT süresi, aks deviasyonu, kalp hızı, QRSV1, QRSV4, QRSV5 ve QRSV6 değerleri arasında istatistiksel olarak anlamlı bir fark saptandı (sırası ile p=0.001, p=0.023, p=0.001, p=0.010, p=0.046, p=0.000, p=0.008). Üç hastada sağ dal bloku, iki hastada ST yükselmesi ve bir hastada T dalgası sivriliği olmak üzere toplam yedi hastada ilişkili QRS anormallikleri saptandı.So nuç: Çalışma bulgularımız hem sağ hem de sol pnömotoraksın kadınlarda daha belirgin olmak üzere, aks değişikliğine neden olabileceğini ve QRSV 4, 5 ve 6 derivasyonlarında voltajın drenaj sonu arttığını göstermektedir. Ayrıca pnömotoraks sağ dal bloku ve ST değişikliği gibi özellikli EKG değişikliklerine de yol açabilir