A novel biochemical marker for predicting the severity of ACS with unstable angina pectoris: Asprosin

WOS: 000439103800039PubMed ID: 29274804Ischemic Heart Disease (IHD) is the leading cause of death world-wide, accounting for 12.7% of global mortality[1] . Acute Coronary Syn-drome (ACS) covers a wide spectrum of clinical conditions ranging fromunstable angina to Non-ST Elevation Myocardial Infarction (N-STEMI)and ST Elevation Myocardial Infarction (STEMI). New treatments andmanagement guidelines emerge for the care of patients with ACS; riskstratification is the cornerstone in the initial evaluation of these patients[2] . That inflammatory mediators play a role duringthe evolution of ACSis indicated by the widespread coronary inflammation found during un-stable angina pectoris (UAP), throughout theentire coronary artery bed,and in the extent that ACS outcome is related to a concurrent inflamma-toryresponse[3,4] . Circulatingasprosin,a protein hormone, responds tolow dietary glucose by triggering the release of liver glucose stores, andthe reduction of asprosin protects against the hyperinsulinism associat-ed with metabolic syndrome

Double appendix

Introduction: Duplication of the vermiform appendix is a rare congenital abnormality and the majority of cases were diagnosed incidentally. Presentation of the Case: A twenty five year old male was admitted to the emergency department complaining of diffuse abdominal pain, nausea, and vomiting. The patient had a treatment history for nephrolithiasis only. The patient's vital signs and laboratory findings were normal. The physical examination confirmed the presence of the epigastirc pain. At patient's direct urinary system graph, there was a stone opacity in the left kidney localization and gas shadows were present in the abdomen. Dense gas in the abdomen was reported at abdominal ultrasound. For differential diagnosis of acute abdominal conditions unenhanced helical abdominal computed tomography was taken for the patient due to unresolved clinical complaints. An eight milimeter calculus was observed at the left renal pelvis and the double appendix at cecum localization on computed tomography. After exclusion of acute abdominal conditions, the patient's analgesia was achieved. The patient was discharged with recommendation of getting urology and general surgery consultation. Discussion: Although the finding of appendiceal duplication is an uncommon congenital abnormality, misdiagnosis and mismanagement of this situation may yield poor clinical outcomes and serious medical consequences. Conclusion: Anatomical variations should be considered as a precursor of future pathological processes. ©2014 Japan Health Sciences University & Japan International Cultural Exchange Foundation