Rhabdomyolysis due to the additive effect of statin therapy and hypothyroidism: a case report

We describe a patient with previously undiagnosed hypothyroidism who developed rhabdomyolysis while taking a statin. He had no other precipitating factors. The statin was stopped, intravenous fluids were started immediately and L-thyroxin was given after confirming the diagnosis of hypothyroidism. His symptoms improved over a few days. Because rhabdomyolysis is a rare but potentially life threatening disorder when complicated by acute tubular necrosis and renal failure, physicians must pay special attention when starting statins in patients with hyperlipidemia

The PEPSI Exoplanet Transit Survey (PETS) - IV. Assessing the atmospheric chemistry of KELT-20b

Most ultra-hot Jupiters (UHJs) show evidence of temperature inversions, in which temperature increases with altitude over a range of pressures. Temperature inversions can occur when there is a species that absorbs the stellar irradiation at a relatively high level of the atmospheres. However, the species responsible for this absorption remains unidentified. In particular, the UHJ KELT-20b is known to have a temperature inversion. Using high resolution emission spectroscopy from LBT/PEPSI we investigate the atomic and molecular opacity sources that may cause the inversion in KELT-20b, as well as explore its atmospheric chemistry. We confirm the presence of Fe I with a significance of 17σ. We also report a tentative 4.3σ detection of Ni I. A nominally 4.5σ detection of Mg I emission in the PEPSI blue arm is likely in fact due to aliasing between the Mg I cross-correlation template and the Fe I lines present in the spectrum. We cannot reproduce a recent detection of Cr I, while we do not have the wavelength coverage to robustly test past detections of Fe II and Si I. Together with non-detections of molecular species like TiO, this suggests that Fe I is likely to be the dominant optical opacity source in the dayside atmosphere of KELT-20b and may be responsible for the temperature inversion. We explore ways to reconcile the differences between our results and those in literature and point to future paths to understand atmospheric variability...

The PEPSI Exoplanet Transit Survey (PETS) I: Investigating the presence of a silicate atmosphere on the super-Earth 55 Cnc e

The study of exoplanets and especially their atmospheres can reveal key insights on their evolution by identifying specific atmospheric species. For such atmospheric investigations, high-resolution transmission spectroscopy has shown great success, especially for Jupiter-type planets. Towards the atmospheric characterization of smaller planets, the super-Earth exoplanet 55 Cnc e is one of the most promising terrestrial exoplanets studied to date. Here, we present a high-resolution spectroscopic transit observation of this planet, acquired with the PEPSI instrument at the Large Binocular Telescope. Assuming the presence of Earth-like crust species on the surface of 55 Cnc e, from which a possible silicate-vapor atmosphere could have originated, we search in its transmission spectrum for absorption of various atomic and ionized species such as Fe , Fe+, Ca , Ca+, Mg and K , among others. Not finding absorption for any of the investigated species, we are able to set absorption limits with a median value of 1.9 x RP. In conclusion, we do not find evidence of a widely extended silicate envelope on this super-Earth reaching several planetary radii.Comment: MNRAS, in pres

Rhabdomyolysis due to the additive effect of statin therapy and hypothyroidism: a case report

Abstract We describe a patient with previously undiagnosed hypothyroidism who developed rhabdomyolysis while taking a statin. He had no other precipitating factors. The statin was stopped, intravenous fluids were started immediately and L-thyroxin was given after confirming the diagnosis of hypothyroidism. His symptoms improved over a few days. Because rhabdomyolysis is a rare but potentially life threatening disorder when complicated by acute tubular necrosis and renal failure, physicians must pay special attention when starting statins in patients with hyperlipidemia.</p

Do live birth rate and obstetric outcomes vary between immediate and delayed embryo transfers following freeze-all cycles?

Research question: Do live birth rates (LBR), obstetric and perinatal outcomes vary between women who underwent frozen embryo transfer (ET) in the immediately subsequent menstrual cycle, and with those who underwent delayed frozen ET

Odkształcenie aorty, jej rozszerzalność oraz moduł elastyczny wiążą się z obecnością i nasileniem zwapnień w tętnicach wieńcowych

Background: An association between aortic stiffness and atherosclerosis has been previously demonstrated by pulse wave velocity. Whether echocardiographically assessed aortic stiffness also correlates with the extent of atherosclerosis has not yet been established. Aim: To evaluate the association between echocardiographically measured aortic stiffness and atherosclerosis. Methods: A total of 162 patients (mean age 54 &#177; 9 years, age range 36-83 years, 102 male and 60 female) at high risk of atherosclerosis underwent transthoracic echocardiography and sphygmomanometer-based brachial blood pressure measurement for aortic stiffness parameters (strain, distensibility and elastic modulus), and multidetector computed tomography for the presence and quantity of coronary artery calcium (CAC). Results: It was found that aortic strain and distensibility were significantly lower in patients with CAC than in patients without CAC (7.6 &#177; 2.7% vs 9.3 &#177; 3.4%, p < 0.001 and 3.0 &#177; 1.1 mm Hg-1.10-3 vs 3.9 &#177; 1.7 mm Hg-1.10-3, p < 0.001, respectively). However, elastic modulus E(p) was significantly higher in patients with CAC than in patients without CAC (7.9 &#177; 3.8 N/m2 vs 6.0 &#177; 2.5 N/m2, p = 0.001). In addition, aortic strain and distensibility, and elastic modulus, were found to be significant predictors of the presence and quantity of CAC in multivariate logistic and linear regression analyses (all p < 0.05). Conclusions: Echocardiographically measured aortic stiffness is positively, significantly and independently associated with atherosclerosis. Kardiol Pol 2010; 68, 12: 1353-1359Wstęp: Zależność między sztywnością aorty i miażdżycą udokumentowano za pomocą prędkości fali tętna. Dotychczas nie ustalono, czy sztywność aorty oceniana echokardiograficznie także koreluje z nasileniem miażdżycy. Cel: Celem pracy była ocena związku między mierzoną echokardiograficznie sztywnością aorty i miażdżycą. Metody: W grupie 162 pacjentów wysokiego ryzyka miażdżycy (w wieku średnio 54 &#177; 9 lat, zakres 36-83 lata, 102 mężczyzn i 60 kobiet) przeprowadzono przezklatkowe badanie echokardiograficzne, badanie ciśnienia tętniczego na tętnicy ramiennej z użyciem sfigmomanometru w celu oceny parametrów sztywności ścian aorty (odkształcenie, rozszerzalność i moduł elastyczny) oraz wielorzędową tomografię komputerową, aby ocenić obecność i liczbę zwapnień w tętnicach wieńcowych (CAC). Wyniki: Wykazano, że wartości odkształcenia i rozszerzalności aorty były znacząco niższe u pacjentów z CAC w porównaniu z osobami bez CAC (odpowiednio 7,6 &#177; 2,7% v. 9,3 &#177; 3,4%, p < 0,001 oraz 3,0 &#177; 1,1 mm Hg-1.10-3 v. 3,9 &#177; 1,7 mm Hg-1.10-3, p < 0,001). Natomiast moduł elastyczny E(p) był istotnie wyższy u pacjentów z CAC niż u osób bez CAC (7,9 &#177; 3,8 N/m2 v. 6,0 &#177; 2,5 N/m2, p = 0,001). Ponadto odkształcenie i rozszerzalność aorty oraz moduł elastyczny stanowiły istotne czynniki predykcyjne obecności i liczby CAC w wieloczynnikowej analizie logistycznej, a także w analizie regresji liniowej (wszystkie p < 0,05). Wnioski: Sztywność ściany aorty mierzona echokardiograficznie wykazuje niezależny, dodatni i statystycznie istotny związek z miażdżycą. Kardiol Pol 2010; 68, 12: 1353-135

Assessment of left ventricular function by tissue Doppler imaging in patients with ankylosing spondylitis

Ankylosing spondylitis (ASp)is a chronic, inflammatory and systemic disease affecting pericardium, myocardium and the conduction system of the heart. In this study, we aimed to analyse left ventricular systolic and diastolic functions using tissue Doppler imaging (TDI). 30 patients with ASp and 30 healthy volunteers having the similar demographic characteristics were included. Left ventricular systolic and diastolic functions were assessed by using two dimensional (2D) echocardiography, M-mode, pulsed-wave (PW) and tissue Doppler echocardiography. The peak systolic velocity (Sm), early diastolic myocardial peak velocity (m), late diastolic myocardial peak velocity (Am), isovolumic acceleration (IVA), myocardial precontraction time (PCTm), myocardial contraction time (CTm), myocardial relaxation time (RTm), and myocardial performance index (MPI) were measured at septal and lateral mitral annulus. In conventional echocardiography, end-diastolic interventricular septum and posterior wall diameters were higher in patients with ASp than the control group. The ratio of E/A was significantly lower and deceleration time was significantly prolonged in patients with ASp, but mitral E and A velocities, isovolumic relaxation time and MPI were similar in patient and control group (P&gt;0.05). Left ventricular lateral and septal wall tissue Doppler echocardiography showed that Em, Em/Am ratio and CTm were significantly lower, IVRTm was longer and MPI was higher in patients with ASp. No significant differences were detected between the groups for IVA, Sm, Am, PCTm, PCTm/CTm ratio (P&gt;0.05). We have demonstrated that in patients with ASp, diastolic functions were impaired but systolic functions were preserved by using TDI