Zolmitriptan-induced acute myocardial infarction

Triptans are an established treatment for acute migraine attacks. By activating 5HT1B/1D receptors they lead to vasoconstriction of the cerebral blood vessels which are dilated during migraine attacks. Moreover, they reduce secretion of vasoactive peptides and conduction of pain stimuli over the cerebral cortex. In up to 7% of cases of treatment with triptans, thoracic pain occurs, although this is mostly transient, mild and without lasting ischemia. We present the case of a 45 year-old woman with a history of migraine with visual aura since the age of 20. She had no history of diabetes mellitus, hypertension, smoking or any other risk factors for cardiovascular events before she was admitted to our emergency room with typical chest pain. An electrocardiogram revealed anterior myocardial infarction following her monthly dose of oral zolmitriptan. Catherization revealed a normal coronary arterial system. The laboratory indices for cardiac risk were within normal ranges. The patient was advised to avoid triptans permanently on being discharged. (Cardiol J 2012; 19, 1: 76–78

EXAMINATION OF THE FINGER TAPPING TEST AND MENTAL ROTATION ACHIEVEMENT LEVEL OF THE ORIENTEERING ATHLETES

The purpose of this study is to assess the cognitive skills and the audio visual perceptions of orienteering athletes and to research the relationship between these two. 17 male athletes, who have been playing orienteering sport for at least 2 years, whose average age is 16.3 ± 1.6 years, participated voluntarily in our study. Reaction time test, mental rotation tests were implemented to the participants on successive days, during the same time zone, and in a quiet environment favorable for testing. The "Finger Tapping Test” (FTT), in which the speed of consecutive motor movements was evaluated was implemented via a computer program and the athletes were asked to press the specified key consecutively for 20 seconds. The obtained data was recorded. In conclusion, it was determined that the random-interval audio visual reaction times are longer than the Fix-interval audio visual reaction times. It was concluded that each question was answered in 8.7 seconds on average during the mental rotation test implemented in the study; whereas it was discovered that the correct answer average was 9.8 in the MR test, which consists of 16 questions. When the answers given by the athletes to the test questions were examined, it was determined that 4 athletes, who answered each question approximately in 3 seconds and completed the test in under 1 minute, are not successful in terms of accuracy and duration. These results indicate that the mental rotation performances of the orienteering athletes are not at a good level.  Article visualizations

Clopidogrel versus ticagrelor in chronic kidney disease patients presenting with acute coronary syndrome: A retrospective evaluation

Aim: To compare the efficacy and bleeding risk of clopidogrel versus ticagrelor in patients presenting with the acute coronary syndrome (ACS). Method: This was a single-center retrospective comparison of in-hospital and 1-year major advance cardiovascular events (MACE) in patients with ACS and reduced estimated glomerular filtration rate (eGFR <60 mL/min) who were treated with clopidogrel or ticagrelor in addition to aspirin. Clinicodemographic features, medication use, and laboratory values were recorded. eGFR was calculated by means of the modification of diet in renal disease (MDRD) equation. The Killip classification was used to quantify the severity of heart failure. The primary outcome measures were in-hospital and 1-year MACEs and major and minor bleeding. MACE definition included recurrent myocardial infarction, stroke, and cardiovascular death. Results: In total, 235 patients (40.9% female, mean age 67.8 ± 12.4 years) were included. Of all patients, 56% presented with ST-elevation myocardial infarction (STEMI), whereas 44% had a non-ST-elevation myocardial infarction. Sixty-eight patients were treated with ticagrelor, while 167 patients were administered clopidogrel. The groups were comparable in terms of in-hospital mortality, cerebrovascular accident (CVA), and re-infarction rates. There was no statistical difference between the mortality, CVA and re-infarction rates between the groups at 12-month. In-hospital minor bleedings were more common among ticagrelor users. In-hospital major bleeding frequencies were similar in both groups. There was no statistical difference in terms of major or minor bleeding rates at 12 months. Conclusion: The findings of the present study showed comparable efficacy and bleeding risk in ACS patients who were treated clopidogrel or ticagrelor

Evaluation of congenital rib anomalies with multi-detector computed tomography in the Turkish population

Background: This study aimed to evaluate the congenital anomalies of ribs in the Turkish population using multi-detector computed tomography (CT) and to reveal the prevalence and distribution of these anomalies according to genders and directions. Materials and methods: This study included 1120 individuals (592 male, 528 female) over 18 who applied to our hospital with a suspicion of Covid-19 and who had thoracic CT. Anomalies such as a bifid rib, cervical rib, fused rib, SRB anomaly, foramen rib, hypoplastic rib, absent rib, supernumerary rib, pectus carinatum, and pectus excavatum, which were previously defined in the literature, were examined. Descriptive statistics were performed with the distribution of anomalies. Comparisons were made between the genders and the directions. Results: A prevalence of 18.57% rib variation was observed. Women had 1.3 times more variation than men. Although there was a significant difference in the distribution of anomalies by gender (p=0.000), there was no difference in terms of anomaly direction (p>0.05). The most common anomaly was the hypoplastic rib, followed by the absence rib. While the incidence of the hypoplastic rib was close in women and men, 79.07% of the absence rib was seen in women (p<0.05). The study also includes a rare case of bilateral first rib foramen. At the same time, this study includes a rare case of rib spurs extending from the left 11th rib to the 11th intercostal space. Conclusions: This study demonstrates detailed information about congenital rib anomalies in the Turkish population, which may vary between people. Knowing these anomalies is essential for anatomy, radiology, anthropology, and forensic sciences

Evaluating the impact of climate risk on financial access and stability in G20 countries : a panel data approach (2006-2017)

The burgeoning international concern over environmental sustainability has brought to the forefront the unique challenges climate change poses to global economies and financial markets. In the light of this, the role of International Financial Institutions like the International Monetary Fund and the World Bank in transitioning towards a green economy is increasingly critical. This study aims to elucidate the influence of climate risk on financial access and stability within G20 countries, spanning from 2006 to 2017. Employing a comprehensive panel data analysis, which accounts for cross-sectional dependence and slope heterogeneity, a fixed effects model is utilized. The Global Climate Risk Index (CRI) scores, provided by Germanwatch, serve as the primary measure of climate risk, with lower scores indicating heightened risk. The investigation reveals a non-linear relationship, where enhanced financial access correlates with diminishing climate risk, underscoring the positive impact of climate change policies on financial system efficiency. However, no significant connection is found between climate risk and financial fragility, a phenomenon potentially attributed to the resilience of countries with advanced credit markets and preemptive risk insurance measures by households. These findings imply that while climate change significantly influences financial access in G20 countries, its effect on financial fragility within the studied period is negligible. The study underscores the potential for policy interventions in climate change mitigation to augment financial system efficiency. Ensuring the consistency of professional terminology, the analysis provides insights into the nuanced relationship between climate risk and financial dynamics in major economies.peer-reviewe

Caesarean Section with Spinal Anesthesia and Postspinal Headache

Purpose: To find out ‘what is the leading cause of postpartum headache in patients undergoing caesarean section with spinal anesthesia under elective conditions?’Methods: Our study was conducted with retrospective, controlled assessment of 304 patients who underwent caesarean section with spinal anesthesia under elective conditions at our institution between 1 June 2012 and 1 November 2012. The patients were assessed in terms of postpartum headache. They were divided into 2 groups: the group with headache versus the group without headache (the latter was the control group). Both groups were compared with respect to age, body mass index (BMI), number of previous pregnancies, indications for caesarean section, the spinal needle used during spinal anesthesia, preoperative and postoperative amount of fluid administration, and mobilization time.Results: None of the factors that are effective in development of headache, i.e. age, multiparity, the indication for caesarean section, BMI, and needle type, was statistically significant in logistic regression analysis. Only the needle type was significantly related to headache in Chi-Square test. All headache episodes were mild and improved with conservative therapy. We did not find any difference between groups with respect to age, BMI, number of previous pregnancies, indications for caesarean section, preoperative and postoperative amount of fluid administration, and mobilization time.Conclusion: In patients undergoing cesarean section with spinal anesthesia under elective conditions the main cause of headache is the type of the spinal needle used

Non ST-segment elevation myocardial infarction in patient with essential thrombocythemia

A 68-year-old woman presented with acute chest pain and a greatly increased platelet count. Cardiac catheterization revealed subtotal occlusion and a thrombus-like filling defect in the right coronary artery. The patient was successfully treated with intravenous tirofiban. Essential thrombocythemia was diagnosed based on bone marrow findings, clinical presentation and laboratory analysis. The relationship between intracoronary thrombus and essential thrombocythemia is discussed

Non ST-segment elevation myocardial infarction in patient with essential thrombocythemia

A 68-year-old woman presented with acute chest pain and a greatly increased platelet count. Cardiac catheterization revealed subtotal occlusion and a thrombus-like filling defect in the right coronary artery. The patient was successfully treated with intravenous tirofiban. Essential thrombocythemia was diagnosed based on bone marrow findings, clinical presentation and laboratory analysis. The relationship between intracoronary thrombus and essential thrombocythemia is discussed