Myocardial infarction with non-obstructive coronary arteries: A comprehensive review and future research directions

Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries (MINOCA). This acute coronary syndrome differs from type 1 myocardial infarction (MI) regarding patient characteristics, presentation, physiopathology, management, treatment, and prognosis. Two-thirds of MINOCA subjects present ST-segment elevation; MINOCA patients are younger, are more often female and tend to have fewer cardiovascular risk factors. Moreover, MINOCA is a working diagnosis, and defining the aetiologic mechanism is relevant because it affects patient care and prognosis. In the absence of relevant coronary artery disease, myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries, coronary microcirculation, or both. Epicardial causes of MINOCA include coronary plaque disruption, coronary dissection, and coronary spasm. Microvascular MINOCA mechanisms involve microvascular coronary spasm, takotsubo syndrome (TTS), myocarditis, and coronary thromboembolism. Coronary angiography with non-significant coronary stenosis and left ventriculography are first-line tests in the differential study of MINOCA patients. The diagnostic arsenal includes invasive and non-invasive techniques. Medical history and echocardiography can help indicate vasospasm or thrombosis, if one finite coronary territory is affected, or specify TTS if apical ballooning is present. Intravascular ultrasound, optical coherence tomography, and provocative testing are encouraged. Cardiac magnetic resonance is a cornerstone in myocarditis diagnosis. MINOCA is not a benign diagnosis, and its polymorphic forms differ in prognosis. MINOCA care varies across centres, and future multi-centre clinical trials with standardized criteria may have a positive impact on defining optimal cardiovascular care for MINOCA patients

Preliminary phytochemical screening and In vitro antioxidant activities of the aqueous extract of Helichrysum longifolium DC

<p>Abstract</p> <p>Background</p> <p>Many oxidative stress related diseases are as a result of accumulation of free radicals in the body. A lot of researches are going on worldwide directed towards finding natural antioxidants of plants origins. The aims of this study were to evaluate <it>in vitro </it>antioxidant activities and to screen for phytochemical constituents of <it>Helichrysum longifolium </it>DC. [Family Asteraceae] aqueous crude extract.</p> <p>Methods</p> <p>We assessed the antioxidant potential and phytochemical constituents of crude aqueous extract of <it>Helichrysum longifolium </it>using tests involving inhibition of superoxide anions, DPPH, H₂O₂, NO and ABTS. The flavonoid, proanthocyanidin and phenolic contents of the extract were also determined using standard phytochemical reaction methods.</p> <p>Results</p> <p>Phytochemical analyses revealed the presence of tannins, flavonoids, steroids and saponins. The total phenolic content of the aqueous leaf extract was 0.499 mg gallic acid equivalent/g of extract powder. The total flavonoid and proanthocyanidin contents of the plant were 0.705 and 0.005 mg gallic acid equivalent/g of extract powder respectively. The percentage inhibition of lipid peroxide at the initial stage of oxidation showed antioxidant activity of 87% compared to those of BHT (84.6%) and gallic acid (96%). Also, the percentage inhibition of malondialdehyde by the extract showed percentage inhibition of 78% comparable to those of BHT (72.24%) and Gallic (94.82%).</p> <p>Conclusions</p> <p>Our findings provide evidence that the crude aqueous extract of <it>H. longifolium </it>is a potential source of natural antioxidants, and this justified its uses in folkloric medicines.</p

TOI-969: a late-K dwarf with a hot mini-Neptune in the desert and an eccentric cold Jupiter

Context. The current architecture of a given multi-planetary system is a key fingerprint of its past formation and dynamical evolution history. Long-term follow-up observations are key to complete their picture. Aims. In this paper, we focus on the confirmation and characterization of the components of the TOI-969 planetary system, where TESS detected a Neptune-size planet candidate in a very close-in orbit around a late K-dwarf star. Methods. We use a set of precise radial velocity observations from HARPS, PFS, and CORALIE instruments covering more than two years in combination with the TESS photometric light curve and other ground-based follow-up observations to confirm and characterize the components of this planetary system. Results. We find that TOI-969 b is a transiting close-in (Pb ∼ 1.82 days) mini-Neptune planet (Formula Presented), placing it on the lower boundary of the hot-Neptune desert (Teq,b = 941 \ub1 31 K). The analysis of its internal structure shows that TOI-969 b is a volatile-rich planet, suggesting it underwent an inward migration. The radial velocity model also favors the presence of a second massive body in the system, TOI-969 c, with a long period of (Formula Presented) days, a minimum mass of (Formula Presented), and a highly eccentric orbit of (Formula Presented). Conclusions. The TOI-969 planetary system is one of the few around K-dwarfs known to have this extended configuration going from a very close-in planet to a wide-separation gaseous giant. TOI-969 b has a transmission spectroscopy metric of 93 and orbits a moderately bright (G = 11.3 mag) star, making it an excellent target for atmospheric studies. The architecture of this planetary system can also provide valuable information about migration and formation of planetary systems

Overexpression of the aphid-induced serine protease inhibitor <i>CI2c </i>gene in barley affects the generalist green peach aphid, not the specialist bird cherry-oat aphid

<div><p>Aphids are serious pests in crop plants. In an effort to identify plant genes controlling resistance against aphids, we have here studied a protease inhibitor, CI2c in barley (<i>Hordeum vulgare</i> L.). The <i>CI2c</i> gene was earlier shown to be upregulated by herbivory of the bird cherry-oat aphid <i>(Rhopalosiphum padi</i> L.<i>)</i> in barley genotypes with moderate resistance against this aphid, but not in susceptible lines. We hypothesized that CI2c contributes to the resistance. To test this idea, cDNA encoding <i>CI2c</i> was overexpressed in barley and bioassays were carried out with <i>R</i>. <i>padi</i>. For comparison, tests were carried out with the green peach aphid (<i>Myzus persicae</i> Sulzer), for which barley is a poor host. The performance of <i>R</i>. <i>padi</i> was not different on the <i>CI2c</i>-overexpressing lines in comparison to controls in test monitoring behavior and fecundity. <i>M</i>. <i>persicae</i> preference was affected as shown in the choice test, this species moved away from control plants, but remained on the <i>CI2c</i>-overexpressing lines. <i>R</i>. <i>padi</i>-induced responses related to defense were repressed in the overexpressing lines as compared to in control plants or the moderately resistant genotypes. A putative susceptibility gene, coding for a β-1,3-glucanase was more strongly induced by aphids in one of the <i>CI2c</i>-overexpressing lines. The results indicate that the CI2c inhibitor in overexpressing lines affects aphid-induced responses by suppressing defense. This is of little consequence to the specialist <i>R</i>.<i>padi</i>, but causes lower non-host resistance towards the generalist <i>M</i>. <i>persicae</i> in barley.</p></div

Paracardiac giant cystic desmoid tumour: Case report

Desmoid tumours, also called aggressive fibromatosis, are an extremely rare type of tumour arising from musculoaponeurotic tissues. Their etiology is still unknown. They are usually benign, but local invasion and relapsing are frequent. Here we report the case of a 45-year-old male patient with widespread invasion of a desmoid tumour involving superior-posterior mediastinum, retroperitoneum and right lumbocostal region. The tumour was inoperable because of important vascular and cardiac invasions. Despite the intra-abdominal location of most desmoid tumours, involvement of the superior mediastinum and their differential diagnosis among the retroperitoneal-mediastinal masses should be definitely kept in mind. Transthoracic ecocardiography should be considered as a first method for the assessment of mediastinal invasion. Copyright © 2013 by Türkiye Klinikleri