A rare coronary artery anomaly - type X dual left anterior descending artery: a case report with brief literature review

Introduction: Type X dual left anterior descending artery (LAD), which is a rare subtype of coronary artery anomalies and newly defined in the literature, usually presents an asymptomatic clinical course and is detected incidentally in diagnostic angiography. However, in the presence of obstructive disease, myocardial revascularization may be required. It is critical to identify the presence of Type X dual LAD in order to prevent misdiagnoses in coronary angiography and to prevent complications during angioplasty or surgical myocardial revascularization. We present a case of rare type X dual LAD coronary anomaly presented with chest pain. Case presentation: A 66-year-old female patient was admitted to the hospital with the complaints of atypical chest pain and palpitations. Examinations revealed sinus tachycardia, mitral valve calcific degeneration, mild tricuspid valve insufficiency, and left atrial dilatation on echocardiography, hyperlipidemia and normal troponin I value. Coronary artery disease risk (according to the Framingham risk score) was low (8%), and coronary coronary computed tomography angiography (CCTA). The calcium score was calculated as 1782 Agatston. There were calcified atheroma plaques in the left main coronary artery (LMCA) ostium and distal section causing less than 25% stenosis. A well-developed diagonal branch of LAD was observed. The LAD calibration was thin and terminated at the proximal of anterior interventricular sulcus (AIVS). Therefore, it was evaluated as short LAD. A long LAD was detected, which was arising from the right coronary sinus with a separate ostium, reached the AIVS at the midventricular level after a pre-pulmonic course in front of the right ventricular outflow tract and extended to the apex. The long LAD was located in front of the right ventricle, close to the anterior chest wall. As there were no signs of myocardial ischemia or injury, calcified lesions in coronary arteries were nonstenotic (excluding thus acute coronary syndrome as cause of chest pain) the medical treatment with antilipidemia and hypertension and atherosclerosis modifying medications has been started and she was discharged with recommendations to continue treatment, modify risk factors for coronary artery disease and follow-up visits were scheduled. Conclusion: Our case demonstrated that rare dual type X LAD can be detected by CCTA in a patient evaluated for chest pain. CCTA is a useful tool for detection of coronary anomalies, that should be sought in patients with chest pain, absence of acute myocardial injury and low Framingham risk score

Effect of Two Bathing Methods on Physiologic Parameters in Pediatric Intensive Care

To determine the effect of traditional and disposable bed baths performed in the pediatric intensive care unit (PICU) on the physiologic parameters of children. This research was conducted as a randomized controlled trial with children who were monitored in the PICU. It was found that the pulse and blood pressure immediately after the bath were higher for both bath applications and was the lowest 30 minutes after the bath (p < .05). Children who used traditional baths had a lower body temperature than those who used the disposable bed bath after bathing for the second day. Oxygen saturation averages were found that within the group to be the highest 30 minutes after bathing methods (p < .05). Both bathing methods applied in the PICU had a positive effect on physiologic parameters. It may be recommended to regularly perform the most appropriate bathing for patients with stable hemodynamics in PICUs

Anesthetic Management of a Patient with Motor-sensory polyneuropathy [Motor-Duyu Polinoropatili Olguda Anestezi Yonetimi]

Polyneuropathy that characterized by diffuse axonal degeneration or multifocal segmental demyelination is neuropathy and usually influence peripheral nerves. It can lead to respiratory failure with muscle weakness, atrophy, fasciculations, the involvement of the respiratory muscles. Increased risk of malignant hyperthermia, potential airway problems that may develop after extubation with effected the respiratory muscles, prolonged duration of recovery from non-depolarizing neuromuscular blockade, the discussion of the used neuraxial anesthesia makes anesthesia management important in patient with polyneuropathy. In this presentation aimed to provide general anesthesia management without neuromuscular blockade a patient with motor-sensory polyneuropathy mainly demyelinating who underwent posterior instrumentation due to scoliosis. [Med-Science 2016; 5(3.000): 884-8

Sonoelastographic Findings of Mucocele-Like Lesion in Breast Due to AQUAfilling(R) Gel Injection

AQUAfilling(R) gel has been described as human tissue biocompatible sterile synthetic material. In the literature, there are some cases presenting the complications of gel application. Rupture of implant, leakage, and migration of the gel are the most common complications. The radiologic findings due to gel leaking may mask many breast lesions including malignancy. In this case, the aim was to present the sonographic findings and elastographic features of a histopathologic-proven mucocele-like lesion in breast, due to AQUAfilling(R) gel injection. This appears to be a rather unique case in the literature

THE PREVALENCE OF RECURRENT APHTHOUS STOMATITIS IN PATIENTS WITH HEMATINIC DEFICIENCY

BACKGROUND Recurrent Aphthous Stomatitis (RAS) is one of the most common oral mucosal diseases, characterised by recurrent painful mucosal ulcers. The aim of this study was to evaluate the prevalence of RAS in patients with hematinic deficiencies (HD)

Can PSMA-based tumor burden predict response to docetaxel treatment in metastatic castration-resistant prostate cancer?

Purpose We investigated the role of PSMA-derived tumor burden in predicting docetaxel (DTX) therapy response in metastatic castration-resistant prostate cancer (mCRPC). Methods Fifty-two mCRPC patients who received at least six cycles of DTX as the first-line treatment following Ga-68-PSMA PET/CT were enrolled in this retrospective study. Total PSMA-derived tumor volume (TV-PSMA) and total lesion PSMA activity (TL-PSMA) were derived from metastatic lesions. A >= 50% decline in PSA was defined as a response; a >= 25% increase in PSA was defined as progression. Univariate/multivariate logistic and cox regression analyses were performed to predict PSA response, OS, and TTP. Results Twelve (23%) patients had PSA progression after chemotherapy, while 40 patients (77%) achieved a PSA response. On univariate analysis, a significant association was found between TV-PSMA (p = 0.001), TL-PSMA (p = 0.001), pre-PSA (p = 0.012), LDH (p = 0.003), Hg (p = 0.035), and PSA response to DTX. High TV-PSMA (> 107 cm(3)) (p = 0.04) and high LDH (> 234 U/L) (p = 0.017) were 8.2 times and 12.2 times more likely for DTX failure in multivariate regression analyses. The median TTP was 16 months, and the median OS was not reached. Patients with high TV-PSMA (p = 0.017), high TL-PSMA (> 1013 cm(3)) (p = 0.042), high age (> 70 years) (p = 0.016), and high LDH (p <= 0.001) had significantly shorter OS, while only high TV-PSMA (p = 0.038) and high age (p = 0.006) were significantly related with shorter TTP. High TV-PSMA (p = 0.017) and high age (p = 0.01) were significant predictors for shorter OS, while only high age (p = 0.006) was a significant predictor for shorter TTP in multivariate analysis. Conclusion Patients with high TV-PSMA had a significantly higher risk for DTX failure. PSMA-based tumor burden prior to DTX therapy seems to be a reliable predictive tool for survival in mCRPC patients

Genome-wide association studies of molybdenum and selenium concentrations in C. arietinum and C. reticulatum seeds

WOS: 000460774100001Chickpea is the second most important and ancient pulse crop with its use in human diet for approximately 7500years as one of the Neolithic founder crops. Previous studies on chickpea have predominantly focused on agronomic traits, with only limited research being dedicated to developing micronutrient-rich crops over the last half century. The objectives of this study were to identify genetic variation and population structure of Cicer reticulatum (C. reticulatum) and Cicer arietinum (C. arietinum) species and reveal marker-trait associations of seed molybdenum (Mo) and selenium (Se) concentrations in seeds by genome-wide association studies (GWAS). In this study, a population of 180 individuals including 107 wild (C. reticulatum) and 73 cultivated (C. arietinum) Cicer species was used in two different locations for 2years, and 121,840 high-quality single nucleotide polymorphism (SNP) were identified across eight chromosomes through genotyping by sequencing (GBS) analysis. GWAS was performed for 180 individuals and alternatively two subpopulations separately, and 16 SNP markers were found significantly associated with seed Mo and Se concentrations, consistently among the four environments. The results demonstrated the high potential of GWAS mapping in revealing markers associated with Mo and Se micronutrients for wild (C. reticulatum) and cultivated (C. arietinum) species.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [214O278]This study was funded by The Scientific and Technological Research Council of Turkey (TUBITAK) with the project number of 214O278

Genetic heterogeneity in hereditary hearing loss: Potential role of kinociliary protein TOGARAM2

Hearing loss (HL) is a heterogenous trait with pathogenic variants in more than 200 genes that have been discovered in studies involving small and large HL families. Over one-third of families with hereditary HL remain etiologically undiagnosed after screening for mutations in the recognized genes. Genetic heterogeneity complicates the analysis in multiplex families where variants in more than one gene can be causal in different individuals even in the same sibship. We employed exome or genome sequencing in at least two affected individuals with congenital or prelingual-onset, severe to profound, non-syndromic, bilateral sensorineural HL from four multiplex families. Bioinformatic analysis was performed to identify variants in known and candidate deafness genes. Our results show that in these four families, variants in a single HL gene do not explain HL in all affected family members, and variants in another known or candidate HL gene were detected to clarify HL in the entire family. We also present a variant in TOGARAM2 as a potential cause underlying autosomal recessive non-syndromic HL by showing its presence in a family with HL, its expression in the cochlea and the localization of the protein to cochlear hair cells. Conclusively, analyzing all affected family members separately can serve as a good source for the identification of variants in known and novel candidate genes for HL