Kounis Syndrome together with Myocardial Bridging Leading to Acute Myocardial Infarction at Young Age

Kounis syndrome, also named as “allergic angina syndrome,” is a diagnosis in which exposure to an allergen causes mostly coronary spasm and rarely plaque rupture, resulting in ischemic myocardial events. Myocardial bridging is defined as an intramural segment of a coronary artery and its systolic compression by overlying fibers. Myocardial bridging generally has a benign prognosis and mostly affects the mid portion of left anterior descending coronary artery. However, some cases with myocardial ischemia, infarction, and sudden death have also been reported. A 17-year-old boy presented to the clinic with acute anterolateral myocardial infarction after having first dose of clindamycin and diagnosed as Kounis syndrome. Further diagnostic workup of the patient showed myocardial bridging at the mid left anterior descending artery. In this report, we present the combination of Kounis syndrome and myocardial bridging leading to myocardial infarction at young age

Serum Presepsin Levels Are Not Elevated in Patients with Controlled Hypertension

Introduction. Hypertension (HT) is a common serious condition associated with cardiovascular morbidity and mortality. The pathogenesis of HT is multifactorial and has been widely investigated. Besides the vascular, hormonal, and neurological factors, inflammation plays a crucial role in HT. Many inflammatory markers such as C-reactive protein, cytokines, and adhesion molecules have been studied in HT, which supported the role of inflammation in the pathogenesis of HT. Presepsin (PSP) is a novel biomarker of inflammation. Therefore, the potential relationship between PSP and HT was investigated in this study. Methods. Forty-eight patients with controlled HT and 48 controls without HT were included in our study. Besides routine clinical and laboratory data, PSP levels were measured in peripheral venous blood samples from all the participants. Results. PSP levels were significantly lower in patients with HT than in controls (144.98±75.98 versus 176.67±48.12 pg/mL, p=0.011). PSP levels were positively correlated with hsCRP among both the patient and the control groups (p=0.015 and p=0.009, resp.). However, PSP levels were not correlated with WBC among both groups (p=0.09 and p=0.67, resp.). Conclusions. PSP levels are not elevated in patients with well-controlled HT compared to controls. This result may be associated with anti-inflammatory effects of antihypertensive medicines

The role of hyponatremia in preeclampsia

Preeclampsia associated hyponatraemia is a quite rare condition that cannot be separated from preeclampsia with severe features completely. This condition may be life-threatening for mothers and fetuses and is needed a multidisciplinary management. A 31-year-old primigravida was referred to our perinatology clinic at 28 weeks 4 days due to preeclampsia. She had nephrotic proteinuria and developed hypervolemic, hypoosmolar, chronic, severe hyponatremia. The pregnant was delivered at 29 weeks of gestation because of severe preeclampsia. The baby died in 48 hours postpartum and maternal hyponatremia improved spontaneously within 72 hours. Studies major on vasopressin about hyponatremia-complicated preeclampsia that its pathogenesis and management is still unclear. Studies that note the importance of vasopressin in the pathogenesis of preeclampsia support the theories and highlight the association of vasopressin and hyponatremia. It is known that the definite treatment is delivery. Maternal outcomes are good but neonatal outcomes are variable. [Med-Science 2017; 6(3.000): 592-7

Novel RDX-Based Cage and Cage-Like Nitramines

1,3,5-Trinitroperhydro-1,3,5-triazine (RDX)-based cage and cage-like nitramines in which two RDX molecules are linked to each other via three and two carbon atoms, respectively, have been investigated computationally using density functional theory (DFT) at a B3LYP/6-31G(d,p) theoretical level. The study focused on finding out how the quantum chemical and detonation properties of RDX change if two RDX molecules come together and form these structures. Both considered nitramines exhibited higher heats of formation (calculated via both PM3 and isodesmic methods) and Kamlet-Jacobs detonation performances and were found to be more sensitive than the reference compounds RDX and octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX)

Antenatal management of twin anemia-polycythemia sequence

Twin-twin transfusion syndrome (TTTS) and recently discovered twin anemia-polycythemia sequence (TAPS) are well-known severe complications of monochorionic pregnancies which are associated with placental anastomoses. TAPS may occur spontaneously with a prevalence of 3% to 5% in monochorionic pregnancies. It also can occur iatrogenically after laser treatment of TTTS in 2% to 13% of monochorionic pregnancies. Optimal perinatal management for TAPS has not been established yet. It has been reported that early well-timed diagnosis of the disease is very important for reducing fetal adverse events Because of the rarity, the literature is limited to the description of small series or case reports of twins affected by TAPS. Here, we describe diagnosis and management of TAPS case that was diagnosed after laser treatment of TTTS and review the literature about clinical characteristics including clinical features, prenatal characteristics, diagnosis, treatments and short-term outcomes of the TAPS. [Med-Science 2018; 7(3.000): 709-12

The role of thyroid-stimulating hormone and thyroglobulin antibody in abnormally invasive placenta

© 2021 Informa UK Limited, trading as Taylor & Francis Group.Purpose: Thyroid hormones and antibodies are known to participate in angiogenesis and invasion and also thyroid hormone receptors are expressed in the placenta. We aimed to evaluate the relationship of serum levels of thyroid-stimulating hormone (TSH), thyroid hormones (TH), and anti-thyroid antibodies with abnormally invasive placenta (AIP). We also aimed to investigate whether they are related with cesarean hysterectomy and massive blood transfusion need in AIP cases. Methods: A total of 88 pregnant patients were enrolled in this prospective case-control study (30 with AIP, 28 with non-adherent placenta previa totalis (PPT) and 30 controls). Serum TSH, thyroid hormone [T3 (triiodothyronine) and T4 (thyroxine)] and thyroid antibodies against thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) levels were studied in maternal serum at initial admission to our Perinatology Unit (at early third trimester). The factors associated with increased risk of AIP, cesarean hysterectomy, massive blood transfusion, and adverse perinatal outcomes were evaluated with multiple logistic regression analysis. Adjusted odds ratios and 95% confidence intervals were also calculated. Results: Serum TSH and TgAb levels were significantly lower in the AIP group than both PPT and control groups (p =.01, p <.001 and p <.001, p <.001 respectively). Decreased serum levels of TSH (<2.16 mIU/L) and TgAb (<2.70 mIU/L) levels and high previous cesarean section rates were found to be independently associated with AIP in pregnant women with PPT (OR: 0.4, 95% CI: 0.1–0.9; p =.04, OR: 0.7, 95%CI: 0.4–1.3, p =.02 and OR: 0.1, 95% CI: 0.1–0.5, p =.01). Decreased serum TSH and TgAb levels were found to be independently associated with an increased rate of cesarean hysterectomy and massive blood transfusion in AIP cases (OR: 3.7, 95% CI: 1.4–9.8; p =.01, OR: 1.8, 95% CI: 1.1–3.1; p =.03 and OR: 2.6, 95% CI: 1.0–6.5; p =.05, OR: 2.2, 95% CI: 1.1–4.1 p =.02). Decreased TSH and TgAb serum levels were also found to be independently associated with adverse perinatal outcomes in AIP cases (OR: 3.4, 95% CI: 1.3–11.0; p =.01 and OR: 1.978, 95% CI: 2–3.6; p =.03). Conclusion: Decreased serum TSH and TgAb levels, and previous history of cesarean section were all found to be significantly associated with AIP in cases with PPT. We suggest that maternal serum TSH and TgAb levels can provide additional contribution to obstetric Doppler ultrasound in the diagnosis of AIP and thus can reduce the risks of unplanned cesarean hysterectomy in cases with PPT

Effects of Nasal CPAP Treatment on Insulin Resistance, Lipid Profile, and Plasma Leptin in Sleep Apnea

Background Obstructive sleep apnea has been linked with metabolic syndrome characterized by dyslipidemia, dyscoagulation, hypertension, and diabetes mellitus type 2 and their cardiovascular consequences. This study was designed to determine the effects of 8 weeks of therapy with continuous positive airway pressure (CPAP) on insulin resistance, glucose, and lipid profile, and the relationship between leptin and insulin-resistance parameters in patients with moderate-to-severe obstructive sleep apnea

Evaluation of atrial conduction features with tissue doppler imaging in patients with chronic obstructive pulmonary disease

The electrical activity of atria can be demonstrated by P waves on surface electrocardiogram (ECG). Atrial electromechanical delay (AEMD) measured with tissue Doppler imaging (TDI) echocardiography can be a useful non-invasive method for evaluating atrial conduction features. We investigated whether AEMD is prolonged in patients with chronic obstructive pulmonary disease (COPD)

“CONTRAST” STUDY: COMPARİSİON OF NEPHROPROTECTİVE THREE PROTOCOLS: ACETYLCYSTEİNESODİUM BİCARBONATE-THEOPHYLLİNE, TO PREVENT CONTRAST-İNDUCED NEPHROPATHY

Aim. The purpose of this study was to compare three prophylactic regimens, sodium-bicarbonate based hydration, sodium-bicarbonate + N-acetylcysteine (NAC), and sodium-bicarbonate + NAC + theophylline, for the prevention of contrast induced nephropathy.Material and methods. We prospectively randomized 151 patients with baseline eGFR values between 30–59 ml/min/1.73m² who were also undergoing coronary angiography with three prophylactic treatments: intravenous hydration with sodiumbicarbonate (3 ml/kg/h for 1 hours before and 1 ml/kg/h for 6 hours after contrast exposure, group 1; n=50), hydration + NAC (600 mg p. o. twice daily the preceding day and the day of angiography, group 2; n=50), and hydration + NAC + theophylline (600 mg p. o. NAC and 200 mg theophylline p. o. twice daily for the preceding day and the day of angiography, group 3; n=51). The incidence of contrast induced nephropathy (0,5 mg/dl increase in serum creatinine from the baseline value 48 hours after intravascular injection of contrast) from the three groups was compared.Results. Of the 151 patients, 4 patients (7.8%) in group 3 experienced CIN (p=0.01). CIN did not develop in group 1 and 2.Conclusion. Among patients with eGFR values between 30–59 ml/min/1.73m² undergoing coronary angiography, use of sodium-bicarbonate based hydration alone and sodium-bicarbonate with NAC was associated with a reduction in the rate of contrast induced nephropathy. Sodium-bicarbonate with theophylline therapy was found to have no effect for the prevention of contrast-induced nephropathy