Hair whitening and obesity are independently related to ascending aorta dilatation in young-middle aged men

OBJECTIVE: Hair whitening (HW) is strongly linked with aging. Ascending aortic dilation (AAD) and HW share common etiologic factors. We investigated the association of HW with ascending aortic diameters. METHODS: Our study included 93 male subjects aged below 50 years. All patients underwent echocardiography to measure ascending aortic diameter, in addition to routine biochemistry tests, physical examination, and thorough medical history. HW score (HWS) was defined according to the percentage of white hair (HWS 1: <25%; HWS 2: 25–50%; HWS 3: 50–75%; and HWS 4: 75–100). RESULTS: Patients with highest HWS were older and had a higher percentage of hypertension (HT) and family history of HW. Moreover, this subgroup had increased ascending aortic diameter, higher serum uric acid, and lower total bilirubin concentrations. Multivariate analyses including age, HT, height, waist circumference, c-reactive protein, and family history of HW identified body weight and HWS as the independent predictors of ascending aortic diameter. CONCLUSION: An independent association between the degree of HW and AAD exists in middle-aged men, which may depend on coexisting factors that enhance both pathologies rather than causality. We think that oxidative stress may be one of these stressors

Loküle perikart efüzyonunun sağ parasternal perikardiyosentez ile başarılı tedavisi

A 46-year-old woman with a previous diagnosis of inoperable stage IV small cell lung cancer presented to the emergency department with shortness of breath. Physical examination showed apale woman who appeared malnourished. Her vital signs were as follows: pulse rate 115 beats/min,respiration rate 22 breaths/min, body temperature 37.5°C, and blood pressure 95/65 mm Hg. Breathsounds were diminished on the left base and widespread coarse crackles were heard over the leftlung. Other system examination fi ndings were within normal limits. A 12-lead electrocardiogramshowed sinus tachycardia and lower voltage without marked ST changes. A chest X-ray showedinfi ltrates on the left upper zones, and a large left-sided pleural effusion (Figure 1A). Transthoracicechocardiograpy (TTE) showed a large loculated pericardial effusion measuring 3.2 cm inmaximal width on the right side of the heart with cardiac tamponade, which was also confi rmedby multislice computed tomography (Figure 1B). Due to the increased risk of general anesthesia

ST yükselmeli miyokart enfarktüsü sonrası gelişen kalp durması nedeniyle tedavi amaçlı hipotermi uygulanan hastalarda nörolojik sonlanım: Üçüncü basamak merkez tecrübesi

WOS: 000375094600003PubMed ID: 27111307Objective: Therapeutic hypothermia improves neurologic prognosis after cardiac arrest. The aim of this study was to report clinical experience with intravascular method of cooling in patients with cardiac arrest resulting from ST-segment elevation myocardial infarction (STEMI). Methods: Thirteen patients (11 male, 2 famele; mean age was 39.6+/-9.4 years) who had undergone mild therapeutic hypothermia (MTH) by intravascular cooling after cardiac arrest due to STEMI were included. Clinical, demographic, and procedural data were analyzed. Neurologic outcome was assessed by Cerebral Performance Category (CPC) score. Results: Anterior STEMI was observed in 9 patients. One patient died of cardiogenic shock complicating STEMI. Mean cardiopulmonary resuscitation (CPR) duration and door-to-invasive cooling were 32.9+/-20.1 and 286.1+/-182.3 minutes, respectively. Precooling Glasgow Coma Scale score was 3 in 9 subjects. Twelve patients were discharged, 11 with CPC scores of 1 at 1-year follow-up. No major complication related to procedure was observed. Conclusion: In comatose survivors of STEMI, therapeutic hypothermia by intravascular method is a feasible and safe treatment modality.Amaç: Kalp durması sonrası tedavi amaçlı hipotermi uygulamasının nörolojik prognoz üzerine olumlu etkisi gösterilmiştir. Bu yazıda, ST yükselmeli miyokart enfarktüsüne (STYME) bağlı kalp durması geçiren hastalarda damariçi yöntemle yapılan soğutma tedavisine ilişkin çalışmamız sunuldu. Yöntemler: ST yükselmeli miyokart enfarktüsü sonrası kalp durması nedeniyle damariçi yöntemle tedavi amaçlı hipotermi uygulanan 13 hasta (11 erkek, 2 kadın; ortalama yaş 39.6±9.4 yıl) çalışmaya dahil edildi. Klinik, demografik ve soğutma işlemine ait veriler incelendi. Nörolojik takipler Serebral Performans Kategorisi skorlaması kullanılarak yapıldı. Bulgular: Dokuz hastada akut ön duvar miyokart enfarktüsü tespit edildi. Bir hasta kardiyojenik şok nedeniyle kaybedildi. Ortalama kardiyopulmoner canlandırma süresi ve kapı invaziv soğutma süresi sırasıyla 32.9±20.1 ve 286.1±182.3 dakikaydı. Soğutma öncesi dokuz hastada Glaskow Koma Skalası 3 bulundu; 12 hasta taburcu edildi, 11 hastanın bir yıllık takipte Serebral Peformans Kategorisi skoru 1 olarak saptandı. Soğutma işleminden kaynaklanan ciddi komplikasyon gözlenmedi. Sonuç: ST yükselmeli miyokart enfarktüsü sonrası koma halinde bulunan hastalarda damariçi yöntemle yapılan tedavi amaçlı hipotermi faydalı ve güvenli bir tedavi seçeneğidir

Wpływ rosuwastatyny i atorwastatyny na zaburzenia erekcji u chorych z hipercholesterolemią

Background and aim: The aim of this study was to evaluate the effect of atorvastatin and rosuvastatin on erectile dysfunction in hypercholesterolaemic patients.Methods: Ninety consecutive male hypercholesterolaemic patients (mean age 50.4 ± 7.9 years) who were otherwise healthy were included into the study prospectively. None of the patients had any cardiovascular risk factors except hypercholesterolaemia.The patients were divided into two groups. One group received atorvastatin while the other group was given rosuvastatin. All patients were followed for six months and International Index of Erectile Function-5 (IIEF-5) score and blood samples were re-evaluated.Results: Patients were in similar ages in both groups. There were also no statistical differences in terms of blood glucose levels, total cholesterol, low density lipoprotein, high density lipoprotein, triglyceride and mean IIEF score in both groups at the beginning. After six months, no IIEF score changes were observed in the rosuvastatin group after the medication. However, the IIEF score was significantly lower in the atorvastatin group (p = 0.019).Conclusions: Rosuvastatin showed no effect on erectile dysfunction, while we observed increased erectile dysfunction with atorvastatin. Our study reveals that different statin types may have different effects on erectile dysfunction.Wstęp i cel: Celem niniejszej pracy była ocena wpływu atorwastatyny i rosuwastatyny na zaburzenia erekcji u chorych z hipercholesterolemią.Metody: Do badania włączono prospektywnie kolejnych pacjentów z hipercholesterolemią (średnia wieku 50,4 ± 7,9 roku), u których nie występowały inne choroby. U żadnego z pacjentów nie występowały inne czynniki ryzyka sercowo-naczyniowego poza hipercholesterolemią. Uczestników badania podzielono na dwie grupy. Osoby z jednej grupy otrzymywały atorwastatynę, a osoby z drugiej grupy — rosuwastatynę. Wszystkich chorych obserwowano przez 6 miesięcy, po czym ponownie przeprowadzono ocenę zaburzeń erekcji z użyciem skali IIEF-5 oraz analizę próbek krwi.Wyniki: Pacjenci z obu grup byli w podobnym wieku. Nie stwierdzono również statystycznych różnic między grupami pod względem wyjściowych wartości stężenia glukozy we krwi, cholesterolu całkowitego, lipoprotein frakcji LDL, lipoprotein frakcji HDL, triglicerydów i średniej punktacji w skali IIEF. Po 6 miesiącach leczenia nie zanotowano zmian w punktacji IIEF w grupie przyjmującej rosuwastatynę, natomiast w grupie stosującej atorwastatynę punktacja IIEF była istotnie niższa (p = 0,019).Wnioski: Rosuwastatyna nie miała wpływu na zaburzenia erekcji, natomiast atorwastatyna spowodowała nasilenie tych zaburzeń. W badaniu wykazano, że różne rodzaje statyn mogą odmiennie wpływać na zaburzenia erekcji

Fragmented QRS on admission electrocardiography predicts long-term mortality in patients with non-ST-segment elevation myocardial infarction

Cetin, Mustafa/0000-0001-6342-436X; Yildirimturk, Ozlem/0000-0001-9841-4524WOS: 000383624300003PubMed: 26392007Background: Early diagnosis and identification of high-risk non-ST elevation myocardial infarction (NSTEMI) is an important issue. Fragmented QRS (fQRS) complexes are defined as various RSR' patterns on 12-lead resting electrocardiography (ECG). Previous studies revealed that fQRS is related with increased ventricular arrhythmias and cardiovascular mortality. the relation between fQRS and mortality in acute coronary syndromes, mitral valve disease severity and structural heart disease has been shown in different studies. the aim of this study was to investigate relation between fQRS and long-term cardiovascular mortality in NSTEMI patients. Methods: Patients who admitted to our emergency unit and diagnosed NSTEMI between 2012 and 2013, 433 patients were included prospectively. fQRS complexes determined in 85 patients. Patients were divided into two groups according to fQRS existence. All patients evaluated for their clinical, laboratory, electrocardiographic, and echocardiographic characteristics. Angiographic features of 315 patients who underwent coronary angiography was also recorded. In-hospital, 30-day and 12-month mortality was compared between these groups. Results: Demographic characteristics and cardiovascular risk factors were similar in both groups except hyperlipidemia. GRACE risk score was higher in patients with fQRS and positively correlated with existence of fQRS. in hospital and 30-days mortality were similar but late mortality was higher in fQRS group. Predictors of late mortality were found to be age, heart rate, male sex in addition to fQRS. CONCLUSION: We found a relation between fQRS and late mortality. Fragmented QRS may be seen as a cautionary signal for extensive myocardial damage and thereby increased long-term mortality for patients with NSTEMI

Can utilization of therapeutic hypothermia with cold saline infusion and external cooling be increased in Turkey? Reply

We have recently read with great interest the manuscript by Aruğaslan et al. describing experience with mild therapeutic hypothermia in patients with cardiac arrest complicating ST elevation myocardial infarction.[1] Thanks are due to the authors for sharing their valuable experience with mild therapeutic hypothermia in the comatose patient group