Elastic properties of the aorta and factors affecting aortic stiffness in patients with

Objectives: In this study, we evaluated aortic stiffnessand echocardiographic and laboratory factors affectingaortic stiffness in patients with metabolic syndrome(MetS).Materials and methods: Forty-six patients (25 male,mean age 47.3±6.5 years) with the diagnosis of MetS accordingto the Adult Treatment Panel III Final Report criteriawere included. Forty-four age and gender matchedhealthy subjects (18 male, mean age 46.0±6.1 years)were recruited as the control group. Aortic strain, distensibilityand stiffness index were calculated by M-modeechocardiography and diastolic parameters were measured.Results: Left ventricular mass index (LVMI), decelerationtime (DT), isovolumic relaxation time (IVRT) wereincreased and mitral E/A ratio was decreased in patientswith MetS compared to controls. In the MetS patients,aortic distensibility was significantly decreased (10.4±3.5cm2.dyn-1.10-6 vs. 12.7±3.4 cm2.dyn-1.10-6, p=0.002),and ASI was significantly increased (6.5±2.0 vs. 3.2±0.8,p<0.001). ASI was positively correlated with triglycerides,fasting glucose, uric acid, hsCRP, LVMI, DT, IVRT andsystolic blood pressure level, and was negatively correlatedwith HDL-cholesterol and mitral E/A ratio. In regressionanalysis, hsCRP (p=0.05) and systolic blood pressurelevel (p<0.001) were independent predictors of ASI.Conclusions: ASI is increased in patients with MetS. Inthese patients; decrease in aortic elasticity properties wasassociated with left ventricular diastolic dysfunction. Highsystolic pressure and hsCRP levels were found to be independentpredictors of ASI.Key words: Metabolic syndrome, Echocardiography,elastic properties of aorta, hsCR

The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

BACKGROUND: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. METHODS: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. RESULTS: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. CONCLUSION: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series

How preschoolers and preschool teachers perceive their mutual relationships:reflections on observed behaviours

###EgeUn###In this study, we aimed to examine reflections of preschoolers’ and teachers’ perceptions concerning their relationships on observed behaviours. Together with 8 teachers, a total of 55 6-year-old children (38 girls and 17 boys) participated in the study which was conducted within the urban parts of Izmir, Turkey. For assessing relationship perceptions of children and teachers, we used two forms, Semi-structured Play Interview and Teacher Relationship Interview. Student Observation Form and Caregiver Interaction Scale were used to observe relationship-based behaviours of children and teachers. We have found a link between the way in which children perceive their relationships with their teachers and their behaviours concerning those relationships. There was no meaningful correlation between teachers’ perceptions and their observed relationship-based behaviours. In addition, how a teacher perceives his/her relationship with a particular child was found to be different than how that child perceives his/her relationship with the teacher. Findings were discussed to make suggestions for preschool education field and future studies. © 2019, © 2019 ASPE

Parenteral penisilin kullanımını takiben gelişen akut koroner sendrom olgusu: Kounis sendromu /A case of acute coronary syndrome following the use of parenteral penicillin:Kounis syndrome

Kounis syndrome refers to the concurrence of acute coronary events and allergic or hypersensitivity reactions. In this report, we describe the case of a male patient, in whom acute ST-segment elevation and myocardial infarction developed immediately after injection of depot penicillin, and we discuss the Kounis syndrome. A 52-year-old male patient had chest pain, hypotension and ST-elevation on leads DI and aVL of electrocardiography 30 minutes after intramuscular penicillin injection due to cryptic tonsillitis. Kounis syndrome was considered as a possible diagnosis according to the presentation. Histamine and tryptase levels were not studied due to the delay on arrival to the emergency department. The patient promptly underwent coronary angiography, which revealed only diffuse plaques in all main coronary arteries without any obstructive lesion. We found only increased immunoglobulin (Ig) E, which is associated with the syndrome. With this report, we remind clinicians to consider Kounis syndrome in patients who are subjected to allergenic substances and demonstrate acute chest pain

Usefulness of the Neutrophil-to-Lymphocyte Ratio to Predict Bare-Metal Stent Restenosis

Inflammation plays a crucial role in the pathogenesis of in-stent restenosis (ISR). Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and prognosis in patients with coronary artery disease. The aim of the present study was to investigate the predictive value of preprocedural NLR on development of ISR in patients undergoing coronary stent implantation. We retrospectively analyzed clinical, hematologic, and angiographic data of 624 patients (mean age 60.5 +/- 10.2 years, 71.8% men) who had undergone coronary stent implantation and a further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural NLR. Restenosis occurred in 21 patients (10.1%) in the lowest tertile, in 62 (29.8%) in the middle tertile, and in 107 (51.4%) in the highest NLR tertile (p 2.73 had 80% sensitivity and 75% specificity in predicting ISR. In conclusion, high preprocedural NLR is a powerful and independent predictor of bare-metal stent restenosis in patients with stable and unstable angina pectoris. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:1405-1410

Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography

Introduction: Coronary angiography is a principle diagnostic and therapeutic procedure in modern cardiology practice. The transradial access for cardiac catheterization has overtaken the transfemoral approach because of many advantages. However, some patients suffer radial pain after the procedure. Unfortunately, this complication has been poorly evaluated in previous studies. The present study aimed to determine the prevalence of radial pain after transradial coronary angiography and investigate factors that influence post-procedural pain. Methods: This is a cross-sectional study in which a total of 100 consecutive patients who underwent elective transradial coronary angiography ± percutaneous coronary intervention between January 2015–2016 were evaluated. The patients were asked about presence of disturbing pain in the forearm especially wrist region after the procedure. Verbal rating scale was used to evaluate pain assessment. The patients were divided as early pain group (two hours after the procedure) and prolonged pain group (one month after the procedure) and analysis was performed. Results: A total of 55 patients suffered from pain in the early phase (after two hours), and 26 of patients had prolonged pain at one month after the radial intervention. Independent pain predictors in the early pain group were male operator (p = 0.004, OR = 3.386, 95% CI: 1.484–7.725) and experience of operator (OR = 4.147, 95% CI: 1.637–10.506, p = 0.003). On the other hand, the younger age of patients (OR = 0.955, 95% CI: 0.915–0.966, p = 0.032) and experience of operator (OR = 3.947, 95% CI: 1.547–10.047, p = 0.004) were the independent predictors of prolonged radial pain. Conclusion: Pain after radial coronary angiography is not uncommon. Experience, operator gender, and age of the patients were independent predictors of pain after transradial coronary angiography