Factor XIII Val34Leu polymorphism in patients with cardiac syndrome X

Background: The aim of the study was to examine the frequency of factor XIII polymorphism among patients with cardiac syndrome X (CSX).Methods: This study was designed as a cross-sectional and observational study. Forty-eight female patients with CSX and 36 controls matched by age, gender, diabetes, and hypertension were studied. CSX was defined as typical chest pain during rest or effort, abnormal test result for exercise ECG, and presence of angiographically normal epicardial coronary arteries after ruling out inducible spasm. Factor XIII gene polymorphism was investigated by using CVD Strip Assay (ViennaLab Diagnostic GmbH) commercial kit.Results: The frequency of factor XIII (Val/Leu + Leu/Leu) mutation was significantly higher in patients with CSX (43%) than in controls (19%) (p = 0.02). Frequency of the Leu allele was significantly higher in the patient group (23.5% vs. 11.1%, p = 0.04). Factor XIII (Val/Leu + Leu/Leu) mutation (p = 0.01, OR = 3.42; 95% CI 1.22–9.58) and smoking (p = 0.04, OR = 3.33, 95% CI 1.05–10.58) were identified as independent predictors of the disease in multivariate regression analysis.Conclusions: This study indicates that there is an evidence for association between factor XIII Val34Leu polymorphism and CSX

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Chest pain and normal coronary arteries

Normal epikardiyal koroner arterler ve göğüs ağrısı yada benzeri semptomlar koroner anjiyografik değerlendirme sırasında sıklıkla karşılaşılan bir bulgudur. Bu hastaların bazılarında gerçek miyokardiyal iskemi bulgulan gösterilmiş olmasına rağmen mekanizması net olarak bilinmemektedir. Bu makalede, bu farklı hasta grubunun klinik ve fizyolopatolojik özelliklerini güncel bilgiler ışığında gözden geçirmeyi amaçladık.Normal coronary arteries and angina pectoris or angina-like symptoms is a finding commonly encountered during coronary angiographic evaluation. Althoughl the findings of true myocardial ischemia has been shown in some of these patients, its mechanism is clearly unknown. In this article we aimed to review the clinic and phyisiopathologic properties of these distinct patients’ group in the light of current knowledges

A case of cortriatriatum who became symptomatic after 40 years old

Coıtriatriatum sol atriyumıın membranöz bir yapı ile iki odacığa ayrılması ile karakterizedir. Proksimal odacık pulmoner venlerle bağlantılı iken distal odacık mitral kapak yoluyla sol ventrikül ile bağlantılıdır. İzole cortriatriatumda obstrüksiyonun derecesi pulmoner venöz ve arteriyel hipertansiyonun gelişmesi ve buna bağlı semptomların ortaya çıkmasında en önemli etkendir. Odacıklar arasındaki açıklığın genişliği fizyolojik bozuklukların ve klinik semptomların ortaya çıkmasında temel belirleyicidir. Olgumuz kırk yaş üzerinde sağ kalp yetersizliği semptomlarının ortaya çıktığı, tanısının ekokardiyografi ile konulduğu nonobstrüktif cortriatriatumdur. Membranöz yapının pulmoner venlerin açıldığı sol atriyum bölümü ile sol ventrikül giriş yolu arasında kan akımına büyük ölçüde izin veren bir yapıda olması, bizim olgumuzda da semptomların ileri yaşta ortaya çıkmasına neden olmuştur.Cortriatriarum is characterized by a left atrium with two chambers divided by a discrete membrane. While proximal chamber is connected with pulmonary veins, distal chamber is connected to the left ventricle through mitral valve. In isolated cortriatriatum, degree of obstruction is the most important factors for development of pulmonary venous and arterial hypertension, as well as the related symptoms. The wideness of opening between the chambers is the main determinant of physiologic disorder and clinic symptoms. Here, we describe a case of nonobstructive cortriatriatum presented with symptom of right heart failure in the fifth decade, in whom the diagnose was made by échocardiographie examination. Since the structure of the membrane allowed adequate passage of pulmonary venous blood flow from the left atrium into the left ventricular inflow, our case had remained asymptomatic until the advanced age

Chest pain and normal coronary arteries

Normal epikardiyal koroner arterler ve göğüs ağrısı yada benzeri semptomlar koroner anjiyografik değerlendirme sırasında sıklıkla karşılaşılan bir bulgudur. Bu hastaların bazılarında gerçek miyokardiyal iskemi bulgulan gösterilmiş olmasına rağmen mekanizması net olarak bilinmemektedir. Bu makalede, bu farklı hasta grubunun klinik ve fizyolopatolojik özelliklerini güncel bilgiler ışığında gözden geçirmeyi amaçladık.Normal coronary arteries and angina pectoris or angina-like symptoms is a finding commonly encountered during coronary angiographic evaluation. Althoughl the findings of true myocardial ischemia has been shown in some of these patients, its mechanism is clearly unknown. In this article we aimed to review the clinic and phyisiopathologic properties of these distinct patients’ group in the light of current knowledges

The association of uncarboxylated matrix gla protein with mitral annular calcification in patients without significant coronary artery disease

Objective: Mitral annular calcification (MAC) is associated with systemic calcification and cardiovascular disease (CVD) events. Matrix Gla protein (MGP) is a strong inhibitor of vascular and soft-tissue calcification and reduced levels of its circulating precursor, uncarboxylated MGP (ucMGP), was found associated with vascular calcification in pilot studies. Methods and Results: In this study, which includes 86 outpatients with no significant coronary artery and chronic kidney diseases, we measured serum ucMGP levels and evaluated MAC using echocardiography. In participants with MAC (n = 44), serum ucMGP levels were lower than the control group (n = 42) (216.1 ± 154.1 vs. 390.2 ± 256.3, P = 0.001, respectively). The patients with MAC were divided into two groups: mild MAC group and moderate MAC group. Serum ucMGP levels were significantly lower in the moderate MAC group than the mild MAC group (139.0 ± 121.8 vs. 248.4 ± 156.3, P = 0.03, respectively). Conclusions: In patients with MAC, serum ucMGP level was significantly low, and this association has been detected for the first time in patients with no significant coronary artery disease (CAD)

Ayr� Olarak çıKan Sol öN Inen Ve Sirkumfleks Arterin çIft Sa�� Koroner Arter Ile Birlikteli��i

In this case presentation, we describe a patient with an unusual coronary anatomic variance in which separate origins of the left anterior descending (LAD), left circumflex (LCX) and double right coronary artery (RCA).Burada nadir görülen çift sağ koroner arter ile ayrı orifislerden çıkan sol ön inen arterle sirkumfleks arterin bir hastada birlikte bulunmasını tanımladık

Adding lipoprotein(a) levels to the GRACE score to predict prognosis in patients with non-ST elevation acute coronary syndrome

WOS: 000322659700006PubMed ID: 23907902Background: High levels of lipoprotein(a) [Lp(a)] are known to be a cardiovascular risk factor associated with premature coronary artery disease. In predicting the long term prognosis in acute coronary syndromes (ACS), the relationship between Lp(a) and risk scoring systems remains unclear. Aim: We investigated whether adding Lp(a) to the GRACE scoring system has an incremental value in predicting prognosis in ACS. Methods: 115 patients (mean age 64 +/- 11 years) with non-ST elevation acute coronary syndromes (NSTE-ACS) were enrolled in this prospective study. Patients were categorised into quartiles according to the Lp(a) levels. Statistically significant variables in the univariate analysis (haemoglobin, creatinine, age, left ventricular ejection fraction, previous myocardial infarction (MI) history, Killip class) were included in the multivariate analysis to determine the independent predictors of cardiovascular outcomes (mortality, rehospitalisation) with and without Lp(a) quartiles for one year follow-up. Results: Previous MI history and Lp(a) quartile were detected as independent predictors of combined cardiovascular events (OR: 2.969 [95% CI 1.413-6.240] and OR: 6.279 [95% CI 1.363-28.927] respectively). Lp(a) quartile also remained as an independent predictor for prognosis when added to a model based on GRACE risk score (OR: 2.589 [95% CI 1.402-4.780]). Serum Lp(a) levels were moderately correlated with GRACE risk score (r = 0.371; p < 0.001). Conclusions: Lipoprotein(a) has an additional prognostic value over GRACE risk score in predicting one-year adverse outcomes in NSTE-ACS. The combination of serum Lp(a) with GRACE risk score could provide enhanced risk stratification in patients with ACS