Management of a rare case of arrhythmogenic right ventricular dysplasia in pregnancy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Arrhythmogenic right ventricular dysplasia is a heritable disease of the heart muscle characterized by fibrofatty degeneration of cardiomyocytes. Patients present with ventricular arrhythmias or congestive heart failure, and sometimes sudden cardiac death occurs. Prenatal diagnosis has become possible with the detection of mutations, but, to the best of our knowledge, no case of prenatal diagnosis has been reported previously. There is little information about the management of arrhythmogenic right ventricular dysplasia in pregnancy, and the preferred mode of delivery is not certain; therefore, we present the case of a patient with arrhythmogenic right ventricular dysplasia and discuss the prenatal diagnosis, patient management and prognosis in pregnancy.</p> <p>Case presentation</p> <p>A 26-year-old Caucasian woman who presented to our hospital with heart palpitations was diagnosed with arrhythmogenic right ventricular dysplasia, and, after three years of follow up with anti-arrhythmic drugs, she wanted to conceive. During pregnancy, she ceased taking her medication. She tolerated pregnancy very well but her cardiac symptoms recurred after her 30th week of pregnancy. She delivered a baby via cesarean section under general anesthesia in her 38th week of pregnancy. She was discharged without any medications and continued lactation for six months.</p> <p>Conclusion</p> <p>Patients with mild to moderate arrhythmogenic right ventricular dysplasia tolerate pregnancy and breastfeeding very well, but patients with end-stage arrhythmogenic right ventricular dysplasia should be discouraged from conception.</p

Endogenous sex hormones and their associations with cardiovascular risk factors in post-menopausal women

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Aims: Our aim was to understand the relationship between endogenous sex hormones and cardiovascular disease (CVD) risk factors in post-menopausal women. Materials and methods: Eighty-three post-menopausal women from a previous prospectively designed study were included. We analyzed endogenous sex hormones and biochemical parameters. Results: Levels of estradiol and free testosterone were higher in patients with metabolic syndrome. Estradiol correlated positively with interleukin-6 (IL-6), weight, body mass index (BMI), insulin, homocysteine, and homeostasis model assessment of insulin resistance (HOMA-IR). Free testosterone correlated positively with weight, waist circumference (WC), BMI, insulin, HOMA-IR and negatively with HDL and SHBG. DHEAS correlated only with HDL. FSH correlated negatively with age, weight, WC, hip circumference, BMI, systolic blood pressure, diastolic blood pressure, duration of menopause, fasting glucose, HDL, C-reactive protein, and insulin. LH correlated negatively with IL-6, age, WC, duration of menopause and SHBG. Conclusions: We identified endogenous estradiol and free testosterone as the strongest links to CVD risk. They can be used as biomarkers for CVD risk estimation

Postmenopozal kadınlarda uyku kalitesi hiperinsulinemi ile ilişkilidir

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Objective: In this study, our aim was to understand the relationship among sleep disturbances and biochemical, hormonal and inflammatory parameters. Methods: In this prospective study, 57 postmenopausal women without any concomitant disease other than metabolic syndrome were included. We applied Pittsburgh Sleep Quality Index (PSQI) and asked self-reported sleep duration of participants. We compared the results with hormonal and metabolic parameters. Results: Participants with a poor PSQI were older (p=0.022), had a higher hip circumference (p=0.03) and had a longer duration of menopause (p=0.012) when compared to participants with a good PSQI. Participants with a poor PSQI had lower HDL (p=0.008) and higher insulin (p=0.027) when compared to participants with a good PSQI. There was no association between sleep duration and the parameters searched. Conclusion: Sleep complaints are related to hyperinsulinemia and lipid abnormalities.Amaç: Bu çalışmada amacımız uyku bozuklukları ile biyokimyasal, hormonal ve enflamatuar parametreler arasındaki ilişkiyi anlamaktı. Gereç ve Yöntem: Bu prospektif çalışmaya metabolik sendrom dışında bir hastalığı olmayan 57 postmenopozal hasta çalışmaya dahil edildi. Çalışmaya katılanlara Pittsburg Uyku Kalite İndeksi (PUKİ) uygulandı ve katılımcıların bildirdikleri uyku süresi öğrenildi. Sonuçlar hormonal ve metabolik parametrelerle karşılaştırıldı. Bulgular: PUKİ'si kötü olan hastalar PUKİ'si iyi olan hastalarla karşılaştırıldığında daha yaşlı (p=0.022), daha büyük kalça çevresine sahip (p=0.03) ve daha uzun süredir menopozda (p=0.012) oldukları görüldü. PUKİ'si kötü olan hastalar PUKİ'si iyi olan hastalarla karşılaştırıldığında daha düşük HDL (p=0.008) ve daha yüksek insulin seviyelerine sahip oldukları görüldü. Sonuç: Uyku şikayetleri hiperinsulinemi ve lipid bozuklukları ile ilişkilidir. Anahtar sözcükler: seks hormonları, CRP, uyku, postmenopozal, enflamasyon, insuli

The Relationship of mean platelet volume with endogenous sex hormones and cardiovascular risk parameters in postmenopausal women

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Aims: Evaluation of the relationship among mean platelet volume (MPV) and endogenous sex hormones and cardiovascular (CV) risk parameters Methods: We designed a retrospective study in postmenopausal women. Patient charts were reviewed for the results of mean platelet volume, hormonal and biochemical parameters. Results: MPV correlated only with white blood cell and platelet counts(r = -0.270, p = 0.023) and platelet count (r = -0.558, p = 0.001). There was no statistically significant difference in MPV of patients with and without metabolic syndrome. Conclusion: There was no relationship between MPV and endogenous sex hormones and parameters indicating higher CV risk