An Unusual Appearance of Double Right Coronary Artery

Double right coronary artery (RCA) is an extremely rare coronary artery anomaly. We aimed to report an atherosclerotic double RCA which appeared after primary percutaneous intervention performed to treat acute inferior myocardial infarction. This is the first case in the literature, which the coronary arteries that can be accepted as double RCA have been hidden by total atherosclerotic occlusion of the proximal part of the RCA. In this paper, also the definition, correct diagnosis, and appropriate diagnostic methods for double RCA were discussed

Patients with primary restless legs syndrome have higher prevalence of autonomic dysfunction and irritable bowel syndrome

CONCLUSION The presence of autonomic nervous system impairment in patients with pRLS and the strong link between IBS and pRLS merit further, more extensive investigation

Child pedestrian fatalities in Diyarbakir, Turkey

Objective: As there is an increase in modernization, transportation, unskilled, and drunk drivers, injuries from traffic accidents have taken on an epidemic form all over the world. The present study aims to describe the demographic data of childhood pedestrian fatalities in a large urban area in Turkey.Methods: The demographic data of childhood pedestrian fatalities in a large urban area in Turkey was described retrospectively, with respect to age, gender, injury pattern and location. Cases less than 16 years of age were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1998 and 2003.Results: There were 232 childhood pedestrian fatalities among a total of 267 children involved in lethal traffic accidents. The mean age of the victims was 7.2 years, most of them being in the 6-10 years of age group (49.1%). Male predominated among our victims (76.3%). With regard to injury location, the most common site was the head (73.7%). There was an increase in pedestrian fatalities in the summer season (33.6%). There was no difference in rates of pedestrian deaths between years.Conclusion: Child pedestrian deaths have constituted a significant percentage of all child fatalities due to traffic accidents in our region. There were 6.4 deaths per 100,000 populations, and this rate was also higher than in other populations

Child pedestrian fatalities in Diyarbakir, Turkey

Objective: As there is an increase in modernization, transportation, unskilled, and drunk drivers, injuries from traffic accidents have taken on an epidemic form all over the world. The present study aims to describe the demographic data of childhood pedestrian fatalities in a large urban area in Turkey.Methods: The demographic data of childhood pedestrian fatalities in a large urban area in Turkey was described retrospectively, with respect to age, gender, injury pattern and location. Cases less than 16 years of age were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1998 and 2003.Results: There were 232 childhood pedestrian fatalities among a total of 267 children involved in lethal traffic accidents. The mean age of the victims was 7.2 years, most of them being in the 6-10 years of age group (49.1%). Male predominated among our victims (76.3%). With regard to injury location, the most common site was the head (73.7%). There was an increase in pedestrian fatalities in the summer season (33.6%). There was no difference in rates of pedestrian deaths between years.Conclusion: Child pedestrian deaths have constituted a significant percentage of all child fatalities due to traffic accidents in our region. There were 6.4 deaths per 100,000 populations, and this rate was also higher than in other populations.C1 Dicle Univ, Fac Med, Dept Forens Med, Diyarbakir, Turkey.Dicle Univ, Fac Med, Dept Orthoped & Trauma, Diyarbakir, Turkey.Dicle Univ, Fac Med, Dept Pediat, Diyarbakir, Turkey.Pamukkale Univ, Fac Med, Dept Forens Med, Denizli, Turkey

Child pedestrian fatalities in Diyarbakir, Turkey

Objective: As there is an increase in modernization, transportation, unskilled, and drunk drivers, injuries from traffic accidents have taken on an epidemic form all over the world. The present study aims to describe the demographic data of childhood pedestrian fatalities in a large urban area in Turkey. Methods: The demographic data of childhood pedestrian fatalities in a large urban area in Turkey was described retrospectively, with respect to age, gender, injury pattern and location. Cases less than 16 years of age were collected retrospectively from the files of the Branch of the Council of Forensic Medicine in Diyarbakir between 1998 and 2003. Results: There were 232 childhood pedestrian fatalities among a total of 267 children involved in lethal traffic accidents. The mean age of the victims was 7.2 years, most of them being in the 6-10 years of age group (49.1%). Male predominated among our victims (76.3%). With regard to injury location, the most common site was the head (73.7%). There was an increase in pedestrian fatalities in the summer season (33.6%). There was no difference in rates of pedestrian deaths between years. Conclusion: Child pedestrian deaths have constituted a significant percentage of all child fatalities due to traffic accidents in our region. There were 6.4 deaths per 100,000 populations, and this rate was also higher than in other populations

Deterioration of Chronotropic Responses and Heart Rate Recovery Indices in Men With Erectile Dysfunction

Introduction: Erectile dysfunction (ED) and cardiovascular (CV) diseases share common risk factors and ED has been accepted as an early manifestation of CV disease. Exercise stress testing (EST) is used to evaluate CV functions in men with ED. Low exercise workload, a slower heart rate recovery (HRR) after exercise, and inability to increase heart rate during EST (chronotropic incompetence) are independent negative predictors of adverse CV outcomes. Aim: To assess the association among EST parameters, ED, and testosterone levels. Methods: The study population consisted of 41 patients with ED and 40 controls. All participants underwent treadmill EST to assess cardiac autonomic functions. HRR indices were calculated by subtracting 1st (HRR1), 2nd (HRR2), and 3rd (HRR3) minute heart rates during the recovery period from maximal heart rate. Total exercise duration, exercise capacity and chronotropic response, and plasma testosterone levels were evaluated. Erectile functions were evaluated with the Sexual Health Inventory for Men. Patients were divided into subgroups according to severity and duration of ED. Main Outcome Measures: Mean HRR1 (30.6 ± 11.9 vs 36.9 ± 9.9; P = .01), HRR2 (44.9 ± 12.4 vs 54.9 ± 7.8; P < .001), and HRR3 (50.1 ± 11.7 vs 63.0 ± 7.9; P < .001) were significantly lower in the ED than in the control group. Total exercise duration (9.4 ± 1.9 vs 10.9 ± 1.7 minutes; P < .001), exercise capacity (12.5 ± 1.9 vs 13.6 ± 1.4 metabolic equivalents; P = .004), and chronotropic response (0.88 ± 0.1 vs 1.0 ± 0.1; P < .001) were worse in the ED group. However, we found no association between severity and duration of ED and EST parameters. In addition, serum testosterone levels were significantly correlated with HRR1 (r = 0.36, P = .02) in men with ED. Conclusion: Our data suggested that cardiac autonomic functions are impaired in patients with ED. A weak correlation between cardiac autonomic dysfunction and low testosterone levels in patients with ED was noted. However, further studies are needed to elucidate the prognostic significance and clinical implications of impaired autonomic functions and testosterone replacement therapy in patients with ED. Kucukdurmaz F, Agar G, Resim S. Deterioration of Chronotropic Responses and Heart Rate Recovery Indices in Men With Erectile Dysfunction. Sex Med 2018;6:8–14

A Child with 3p Deletion Syndrome Who Recovered from Influenza-Related Acute Respiratory Distress Syndrome

Influenza virus can cause serious complications, especially in patients with comorbid illnesses. Acute respiratory distress syndrome (ARDS) is among the most common causes of influenza-related morbidity and mortality. Herein we present the case of a boy with a genetic disorder who recovered from influenza-related ARDS. A 3-year-old boy with 3p deletion syndrome was admitted for refractory cough and fever. During his follow-up, sudden respiratory failure concomitant with ARDS occured. He was transferred to the pediatric intensive care unit (PICU) and intubated. Broad-spectrum anti-biotherapy and oseltamivir were administered. Nazopharnygeal swab polymerase chain reaction (PCR) analysis revealed H1N1. Venitalition parameters were set according to that recommended for ARDS. On the ninth day of his admission, the patient was discharged from PICU. Appropriate ventilation strategies together with early oseltamivir therapy improves outcomes of influenza-related ARDS