Catastrophic secondary antiphospholipid syndrome with peripheral nervous system involvement: a case report.

A 34-year-old woman was admitted to our emergency room with a high fever, abdominal pain, dyspnea and confusion. High fever and abdominal pain had first occured after a cystocele operation 5 months earlier. Later, congestive heart failure with mural thrombus formation, peripheral polyneuropathy and ischemic cerebrovascular accident were identified in clinical follow-ups, and multiple arterial and venous thromboses were seen on cranial and abdominal magnetic resonance imaging angiography. The patient's symptoms improved with anticoagulant treatment. Antiphospholipid syndrome with elevated serum anticardiolipin IgG levels was diagnosed, and ischemic peripheral polyneuropathy with axonal degeneration was determined by sural nerve biopsy. In antiphospholipid syndrome, elevated anticardiolipin antibodies appear to be the most common acquired blood protein defect causing thrombosis. Disseminated vascular thrombosis in catastrophic antiphospholipid syndrome can result in multiorgan failure with increased morbidity and mortality. It rarely occurs secondary to various infections as in the case of our patient, who suffered postoperative intraabdominal infection. It is important to note that peripheral nervous system involvement is rare in antiphospholipid syndrome.</p

Sudden cardiac arrest in a patient with an anomalous left main coronary artery originating from the pulmonary artery

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an uncommon cardiac abnormality. The clinical picture of ALCAPA may range from asymptomatic course with normal life span to sudden cardiac death. Moreover, from the standpoint of resuscitation science, it constitutes a disadvantageous anatomy for coronary perfusion pressure, generated by chest compressions, which is critical for the return of spontaneous circulation. Here, we report an ALCAPA case diagnosed after out-of-hospital cardiac arrest and successful cardiopulmonary resuscitation

The delivery methods used in cardiac stem cell therapy

Cardiac stem cell therapy is considered a promising alternative for the treatment of heart failure resulting from ischemic heart disease. Although short-term results demonstrate the beneficial effects of cardiac stem cell therapy on left ventricular functions and neo-vascularization, long-term effects have yet to be established. Various methods have been used for cardiac stem cell therapy, yielding varying degrees of success. However, the number of studies that compare the efficacy of these delivery approaches is still inadequate. Further studies are required to increase the efficiency of stem cell therapy, to delineate the pros and cons of different delivery techniques, and to provide more insight into identification, localization, and efficacy of transplanted cells within the target organ

Halk Sağlığı ve COVID-19

ÖZETKardiyovasküler hastalıklar, yeni koronavirüs hastalığı (COVID-19) için hem risk faktörü olarak hem de hastalığın bir sonucu olarak karşımıza çıkabilmektedir. Bu nedenle kardiyak görüntüleme hastalığın ayırıcı tanısında, kardiyak komplikasyonların saptanmasında ve tedavisinin yönlendirilmesinde önemlidir. Ekokardiyografi, kolay ulaşılabilmesi ve yatak başında hızlı bir şekilde uygulanabilmesi nedeniyle COVID-19 hastalarında önemli ve tercih edilen bir kardiyak görüntüleme yöntemidir. Ancak ekokardiyografik görüntüleme COVID-19 hastalarında, hastayla yakın temas gerektirmesi nedeniyle hem sağlık çalışanları için önemli risk oluşturmakta, hem de direkt ve indirekt yollarla hastalığın yayılımına yol açabilmektedir. Bu nedenle COVID-19 pandemisi döneminde hastadan hekime ve hekimden hastaya kontaminasyon riskini en aza indirmek için görüntüleme işleminin gerekliliği dikkatlice değerlendirilmeli ve gereksiz işlemlerden sakınılmalıdır. Sağlık çalışanları hastalığın yayılmasını önlemek için gerekli tedbirlere en üst düzeyde uymalı ve uygun kişisel koruyucu ekipman kullanmalıdır. Bu yazıda ekokardiyografinin hasta yönetimine nasıl kılavuzluk edebileceği ve kimlere nasıl uygulanması gerektiği konusu gözden geçirilmektedir.Anahtar Kelimeler: COVID-19; ekokardiyografi; transözofageal ekokardiyograf