Congenital left main coronary artery aneurysm

Left main coronary artery aneurysm (LMCAA) is an uncommon coronary abnormality seen in 0.1% of patients during routine diagnostic coronary angiographies. The most common etiology is atherosclerosis in acquired cases. However, it can also be a congenital malformation. We present the case of a 26 year-old female with a large LMCAA. She was diagnosed with tetralogy of Fallot initially. (Cardiol J 2011; 18, 4: 430–433

GIS-Based Analysis of Agricultural Land Use Changes in Socio-Economically Less Developed Rural Settlements: The Case of Saray, Şarköy, and Hayrabolu Districts (Tekirdağ/Türkiye)

Agricultural land cover has changed over time, and monitoring these changes has become an effective tool in development processes by linking them to ecological and socio-economic issues. In this context, the main hypothesis of the study is that “determining land use changes spatially and temporally using CORINE Land Cover data is crucial in development-oriented planning processes.” The study analyzes changes in agricultural land use based on CORINE land cover classes between 1990 and 2018 in the districts of Saray, Şarköy, and Hayrabolu in Tekirdağ Province, which have low levels of socio-economic development. The research aims to answer the following questions: during which periods did significant changes occur in agricultural areas in Saray, Şarköy, and Hayrabolu? What are the total rates of increase or decrease in these areas? Into what types of land have agricultural are+as significantly transformed? The methodology was developed using Geographic Information Systems (GIS)-based maps, graphs, and tables. The findings reveal the spatial and temporal dimensions of changes in agricultural land use and land cover between 1990 and 2018. The data obtained are anticipated to provide a concrete foundation for developing rural development policies and ensuring the sustainable use of natural resources

The effect of myocardial fibrosis on left ventricular torsion and twist in patients with non-ischemic dilated cardiomyopathy

Background: Left ventricular (LV) rotation, twist, and torsion are important aspects of thecardiac performance. Myocardial fibrosis can be identified as the late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). In this study, we investigated the associationbetween myocardial fibrosis and LV rotational parameters in patients with nonischemic dilated cardiomyopathy (NDC).Methods: Twenty-two NDC patients were enrolled. LV dimensions, volumes and ejection fraction (EF) were measured, conventional tissue Doppler imaging data was acquired. Speckletracking imaging was performed to measure LV deformation, LV rotational parameters. Bloodsamples were obtained for NT-proBNP. Late gadolinium enhanced cardiac magnetic resonance (LGE-CMR) was used to assess cardiac fibrosis index.Results: Myocardial deformation was similar between LGE+ and LGE– groups. LGE+patients have significantly higher basal and lower apical systolic rotation, lower twist andtorsion when compared to LGE– patients. However, untwisting rate was similar between thegroups. Torsion was significantly correlated with LVEF and MR-index. Patients with reversedapical systolic rotation had significantly greater NT-proBNP values, basal systolic rotation andsignificantly lower apical systolic rotation, torsion, and MR-index.Conclusions: Cardiac fibrosis index is closely related with myocardial torsion and LV systolicfunction and may be used for the evaluation of cardiac condition. Reversed apical systolicrotation indicated more extensive cardiac fibrosis as it may reflect severe LV dyssynchrony andpoor LV performance

Determination of the Change of Agricultural Landscapes Based on CORINE Land Cover Agricultural Land Classes Using GIS and Visual Quality Value with the AHP Method: The Case of Tekı̇rdağ Province

Agricultural landscapes contribute positively to the visual texture of the city and change over time. In this context, this study aims to determine the visual landscape quality of agricultural landscapes based on parameters on expert approach the hypothesis; it is important and necessary to determine the visual landscape values based on the change in agricultural landscapes over time. Within the framework of the developed hypothesis, it aims to make an expert-based visual landscape assessment of the agricultural landscapes of Tekirdağ Province, located in the northwestern part of Türkiye, based on nine subclasses created according to the CORINE land cover (CLC) classes, on the basis of 4 main parameters. Using the AHP technique, the priorities of the parameters and agricultural landscape classes and the relationships between basic parameters and visual preferences were determined. In this direction, the questions; What are the priorities of parameters that are effective in determining the visual quality of agricultural landscapes on the basis of expert approach?; What kind of changes have occurred in agricultural landscapes during the years 1990-2000-2006-2012-2018 in 9 subclasses created according to the CLC classes? and; How should the visual landscape quality values of the agricultural landscape subclasses created according to the CLC classes be ranked? The results of the study can be used as a tool in landscape planning and management studies as a factor in strengthening landscape quality

Unusual causes of peritonitis in a peritoneal dialysis patient: Alcaligenes faecalis and Pantoea agglomerans

An 87 -year-old female who was undergoing peritoneal dialysis presented with peritonitis caused by Alcaligenes faecalis and Pantoea agglomerans in consecutive years. With the following report we discuss the importance of these unusual microorganisms in peritoneal dialysis patients

The prognostic value of mean platelet volume in patients with coronary artery disease:An updated systematic review with meta-analyses

Background: Mean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD. Methods: PubMed, Web of Science, and Scopus were the major databases used for literature search. The risk of bias was assessed using the quality in prognostic factor studies. We used random-effects pairwise analysis with the Knapp and Hartung approach supported further with permutation tests and prediction intervals (PIs). Results: We identified 52 studies with 47,066 patients. A meta-analysis of nine studies with 14,864 patients demonstrated that one femtoliter increase in MPV values was associated with a rise of 29% in the risk of long-term mortality (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.22-1.37) in CAD as a whole. The results were further supported with PIs, permutation tests and leave-one-out sensitivity analyses. MPV also demonstrated its stable and significant prognostic utility in predicting long-term mortality as a linear variable in patients treated with percutaneous coronary intervention (PCI) and presented with acute coronary syndrome (ACS) (HR 1.29, 95% CI 1.20-1.39, and 1.29, 95% CI 1.19-1.39, respectively). Conclusion: The meta-analysis found robust evidence on the link between admission MPV and the increased risk of long-term mortality in patients with CAD patients, as well as in patients who underwent PCI and patients presented with ACS

Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the liver component of the metabolic syndrome. We investigated the diastolic and systolic functional parameters of patients with NAFLD and the impact of metabolic syndrome on these parameters. Methods: Thirty-five non-diabetic, normotensive NAFLD patients, and 30 controls, were included in this study. Each patient underwent transthoracic conventional and tissue Doppler echocardiography (TDI) for the assessment of left ventricular (LV) diastolic and systolic function. Study patients were also evaluated with 24-hour ambulatory blood pressure monitoring. Results: NAFLD patients had higher blood pressures, increased body mass indices, and more insulin resistance than controls. TDI early diastolic velocity (E&#8217; on TDI) values were lower in NAFLD patients than the controls (11.1 &#177; 2.1 vs 15.3 &#177; 2.7; p < 0.001). TDI systolic velocity (S&#8217; on TDI) values were lower in NAFLD patients than the controls (9.34 &#177; 1.79 vs 10.6 &#177; 1.52; p = 0.004). E&#8217; on TDI and S&#8217; on TDI values were moderately correlated with night-systolic blood pressure, night-diastolic blood pressure, and night-mean blood pressure in NAFLD patients. Conclusions: Patients with NAFLD have impaired LV systolic and diastolic function even in the absence of morbid obesity, hypertension, or diabetes. (Cardiol J 2010; 17, 5: 457-463

The association of functional mitral regurgitation and anemia in patients with non-ischemic dilated cardiomyopathy

Background: We investigated the association between anemia and functional mitral regurgitation (MR) in non-ischemic dilated cardiomyopathy (DCM) patients with sinus rhythm and normal renal function. Methods: Sixty non-ischemic DCM patients with sinus rhythm and left ventricular ejection fraction < 40% were recruited. Functional MR was quantified with the proximal isovelocity surface area method. MR was graded according to the mitral regurgitant volume (Reg Vol) or effective regurgitant orifice (ERO) area. The clinical, biochemical and echocardiographic correlates of functional MR severity were investigated in patients with DCM. Results: Hemoglobin degrees were significantly different between various MR levels (mild MR 13.9 &#177; 1.7 mg/dL, moderate MR 12.3 &#177; 1.5 mg/dL, moderate to severe MR 10.8 &#177; 0.9 mg/dL). Receiver operating characteristic (ROC) analysis was performed to assess the utility of hemoglobin levels to predict moderate or severe functional MR. A hemoglobin level less than 12.5 mg/dL predicted moderate or high MR with 80% sensitivity and 58% specificity (AUC: 0.789, 95% CI: 0.676&#8211;0.901, p < 0.0001). Logistic regression analysis was performed to determine the independent predictors of moderate or severe levels of MR. The left atrium diameter (OR: 19.3, 95% CI: 1.4-27.1, p = 0.028) and presence of anemia (OR: 11.9, 95% CI: 1.22-42.5, p = 0.0045) were independent predictors of moderate or severe functional MR. Conclusions: The presence of anemia and enlarged left atrium are independent predictors of moderate or severe functional MR in non-ischemic DCM patients with normal renal function. Hemoglobin levels less than 12.5 mg/dL should alert the physician for the presence of moderate or severe MR in patients with DCM. (Cardiol J 2010; 17, 3: 274-280

Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients

Background Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. Methods Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. Results A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). Conclusions Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218. opens in new tab.