Inadvertent misplacement of pacemaker lead presented with acute ischemic stroke

If a permanent pacemaker lead is misplaced in the left ventricle (LV), the lead may interfere with normal functioning of the heart leading various complications, including heart rhythm problems and blood clots. In our case, the LV lead that passed through the patent foramen ovale and was misplaced into the LV was detected in a 78-year-old patient who presented with embolic stroke. Thrombus regression was achieved with anticoagulation, and then the lead extraction was planned. The lead extraction is a priority in acute cases; but it is not the primary approach in long-term leads that were misplaced into the LV. A patient-based individual approach should be preferred in such cases.

The role of smart devices and mobile application on the change in peak VO2 in patients with high cardiovascular risk: a sub-study of the LIGHT randomised clinical trial

BACKGROUND

This investigation aims to assess the influence of a mobile application and smart devices on cardiopulmonary exercise testing (CPET) over a one-year period in individuals who have high risk for cardiovascular disease.

METHODS

This is a post-hoc subgroup analysis of Lifestyle Intervention Using Mobile Technology in Patients with High Cardiovascular Risk: A Pragmatic Randomised Clinical Trial (LIGHT). In the intervention plus standard care standard standard care arms, 138 and 103 patients were recruited, respectively. The 1-year VO2 measurements were adjusted to the baseline VO2 measurements as the study's endpoint. VO2 measurements were taken for each subject during the randomisation and final CPET examinations.

RESULTS

The intervention plus standard care improved VO2 measurements by 1.1 (adjusted treatment effect 1.1, 95% confidence interval (CI): 0.8, 1.4, p < 0.001) compared to standard care following 1-year follow-up.

CONCLUSION

At a 1-year follow-up, the smart device and mobile application technologies increased VO2 measurements in individuals with high cardiovascular risk compared to conventional treatment alone.

Factors Predicting Response in Breast Cancer Receiving Neoadjuvant Therapy and the Role of Ki67 Labeling Index

OBJECTIVE

To determine the predictive value of Ki67 on pathological complete response (pCR) of breast and axilla regions in breast cancer (BC) patients receiving neoadjuvant therapy (NAT).

STUDY DESIGN

Descriptive study. Place and Duration of the Study: Departments of Medical Oncology, Sirnak State Hospital, Aydin State Hospital, Manisa Celal Bayar University, and Dokuz Eylul University, from November 2010 to July 2022.

METHODOLOGY

PCR and various histopathological parameters were evaluated for BC patients receiving NAT. The Youden Index method was used to find the cut-off value for the Ki67 variable according to the receiver operating characteristic (ROC) curve. This value was obtained as 77.5. Breast and axillary responses were individually evaluated to assess response to NAT. Univariate and multivariate logistic regression analysis were used to predict both breast and axillary pCR.

RESULTS

A total number of 280 females receiving NAT for BC were included in the study. Multivariate analysis for breast pCR to NAT showed that Ki67 index (>77.5 vs <77.5, p=0.047) was statistically significant marker. While Ki67 index was significant for breast pCR in both univariate and multivariate analyses, the same was not observed on axillary response (p=0.387).

CONCLUSION

High Ki67 level was significantly associated with breast pCR in BC patients receiving NAT, but a similar effect was not observed on axillary pCR. These findings suggest that breast and axilla tissues have a biological differences in treatment responses.

KEY WORDS

Axillary response, Breast cancer, Ki67 Labeling Index, Neoadjuvant therapy, pathological complete response.

The effect of low HER2 expression on treatment outcomes in metastatic hormone receptor positive breast cancer patients treated with a combination of a CDK4/6 inhibitor and endocrine therapy: A multicentric retrospective study

BACKGROUND

CDK4/6 inhibitors combined with endocrine therapy have significantly improved treatment outcomes for metastatic hormone receptor-positive (HR+) breast cancer patients. However, the impact of low HER2 expression on treatment response and progression-free survival (PFS) remains unclear.

METHODS

This multicenter retrospective study included 204 HR+ breast cancer patients treated with a combination of CDK4/6 inhibitor and endocrine therapy. HER2-zero disease was detected in 138 (68%) and HER2-low disease in 66 (32%) patients. Treatment-related characteristics and clinical outcomes were analyzed, with a median follow-up of 22 months.

RESULTS

The objective response rate (ORR) was 72.7% in the HER2 low group and 66.6% in the HER2 zero group (p = 0.54). Median PFS was not significantly different between the HER2-low and HER2 zero groups (19 months vs.18 months, p = 0.89), although there was a trend toward longer PFS in the HER2-low group for first-line treatment (24 months progression-free survival rate 63% vs 49%). In recurrent disease, the median PFS was 25 months in the HER2-low group and 12 months in the HER2-zero group (p = 0.08), while in de novo metastatic disease, the median PFS was 18 months in the HER2-low group and 27 months in the HER2-zero group (p = 0.16). The order of CDK4/6 inhibitor use and the presence of visceral metastasis were identified as independent variables affecting PFS.

CONCLUSION

Low HER2 expression did not significantly impact treatment response or PFS in HR+ breast cancer patients treated with a CDK4/6 inhibitor and endocrine therapy. Because of the conflicting results in the literature, further prospective studies are needed to evaluate the clinical significance of HER2 expression in HR+ breast cancer.

Isolated Maternal Hypothyroxinemia May be Associated with Insulin Requirement in Gestational Diabetes Mellitus

An insulin regimen may be necessary for about 30% of the patients with gestational diabetes mellitus (GDM). We aimed to investigate the association of free T4(fT4) levels with insulin requirement in pregnant women with GDM. We included pregnant women whose TSH levels were within the normal range and who were diagnosed with GDM, and excluded patients with thyroid dysfunction, chronic illnesses, or any previous history of antithyroid medication, levothyroxine, or antidiabetic medication use. The diagnosis and treatment of GDM were based on American Diabetes Association guidelines. Demographic features, previous history of GDM and gestational hypertension were recorded. Baseline (at diagnosis of GDM) fasting blood glucose, HbA1c, TSH, fT4, and fT3 levels were analyzed. We grouped the patients according to their baseline fT4 levels: isolated maternal hypothyroxinemia (IMH) (group A) vs. in the normal range (group B). We grouped those also based on insulin requirement in 3rd trimester. Of the patients (n=223), insulin requirement was present in 56, and IMH in 11. Insulin requirement was more frequent in group A than in group B (p=0,003). HbA1c (≥47,5 mmol/mol) and fT4 level (lower than normal range) were positive predictors for insulin requirement (OR:35,35, p=0,001; and OR:6,05, p=0,008; respectively). We showed that IMH was closely associated with insulin requirement in GDM. Pregnant women with IMH and GDM should be closely observed as regards to glycemic control. If supported by future large studies, levothyroxine treatment might be questioned as an indication for patients with GDM and IMH.

Cough-induced bubbles formation in the heart: Is it related with a poor prognosis?

In current practice, it is not well-known whether the development of air bubbles spontaneously in the heart during routine transthoracic echocardiography examination has a clinical consequence. Even though there have been published case reports regarding the formation of air bubbles due to iatrogenic reasons, we could not find a case of a patient demonstrating spontaneous air bubbles formation due to only coughing. Thus, in this report, we present a case of an adult patient who had unexpected air bubbles in the heart after coughing. Furthermore, the patient experienced a catastrophic cerebrovascular accident after diagnosing such an event in the same day. We thought that spontaneously occurring air bubbles in the heart might have resulted in cerebrovascular accident by passing through patent foramen ovale, which we have diagnosed after we had seen that the spontaneously occurred air bubbles had also appeared in left chambers. To our knowledge, this might be the first case of such a patient in the literature. <Learning objective: The appearance of cough-induced air bubbles in the left heart might be a precursor to peripheral air embolism, and thus, predictive of very poor prognosis. Thus, medical workers should be aware of this poor finding.>.

Association of whole blood viscosity with thrombus presence in patients undergoing transoesophageal echocardiography

Whole blood viscosity (WBV) is considered as a reasonable proxy measure of blood flow, and it has been investigated in different cohort settings, including in patients with deep venous thrombosis, arterial thrombosis, acute stent thrombosis, and left ventricular apical thrombus formation following acute coronary syndrome. To determine the association between WBV and the presence of thrombus in the left atrium (LA) or left atrial appendage (LAA) in individuals who had transoesophageal echocardiography (TEE). The clinical data from 262 consecutive patients who had TEE at our facility were included in this retrospective cohort study. WBV was determined at both a high shear rate (HSR) and low shear rate (LSR) using hematocrit and total protein levels. In 22 cases (8.3%), the thrombus was detected. According to multivariable analyses, WBV at HSR and LSR were independently linked with thrombus detection in TEE. In a receiver operating characteristic (ROC) analysis, the area under curve (AUC) values of WBV at HSR and LSR were 0.77 and 0.76, respectively. To predict the presence of thrombus in TEE; the ideal value of WBV at HSR was > 16.6 with 81% sensitivity and 69% specificity and the ideal value of WBV at LSR was > 51.4 with 81% sensitivity and 70% specificity. This was the first study to indicate that significantly higher levels of WBV at both the HSR and LSR were linked to the presence of thrombus in the LA and LAA in cases who underwent TEE.

The relation between left ventricular systolic function parameters and preceding or prepreceding beat-to-beat distance in patients with atrial fibrillation: an echocardiographic study

We aimed at investigating the relation between left ventricle (LV) systolic parameters and beat-to-beat distances and also whether this relation is different in heart failure with reduced ejection fraction (HFrEF) patients with atrial fibrillation (AF). The relation between peak velocity in left ventricular outflow (V_LVOT), left atrioventricular plane displacement (LAVPD) or peak systolic tissue Doppler velocity of lateral mitral annulus (Lateral S') and preceding beat-to-beat distance (RR₁) or prepreceding beat-to-beat distance (RR₂) were analyzed by linear regression analysis. From this analysis, three parameters were obtained: slope of regression line, constant of regression line, and square of regression coefficient (r²) of linear relation. In the group with HFrEF, the slope and r² values of the regression line showing the relationship between the RR₁ interval and V_LVOT, LAVPD, and Lateral S' values were higher and the constants were lower. In the Kendall rank correlation analysis, the slope, constant, and r² values of the regression analysis between RR₁ interval and V_LVOT or Lateral S' were in significant correlation with LVEF. The r² of V_LVOT-RR₁ analysis, slope of this analysis, and slope of Lateral S'-RR₁ regression line values were mostly predictive for detecting HFrEF. It was concluded that the novel parameters obtained by linear regression analysis between LV systolic function parameters and RR₁ interval, but not RR₂, might be beneficial for evaluating systolic heart failure in patients with AF. They might have potential for future research about the physiopathology of heart and prognosis in patient with AF.

Is there a Relationship between Serum IGF-1 and Thyroid Nodule, Thyroid or Ovarian Volume in Polycystic Ovarian Syndrome?

Context

Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited.

Objective

We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS.

Design

The study was performed between June 2017 and August 2019 as prospective design.

Subjects and Methods

Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS.

Results

Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume.

Conclusion

Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.

Evaluation of websites reached using Google in the modern digital era related to approach to cholesterol

OBJECTIVE

The Google search engine is widely used as a source of medical information; however, legal and medical governance of the accuracy of the content retrieved is lacking. The aim of this study was to assess the most read Turkish-language texts related to cholesterol during a specific period according to the validity of the content.

METHODS

Google Trends was queried on January 5, 2019 for the search term 'cholesterol' and the 9 other most popular search phrases used in Turkey that included the word cholesterol. In all, 100 links were obtained for each phrase, generating a total of 1000 links. Once duplicates were eliminated, a total of 604 links was used for the study. Since there is currently no validation scoring system for this purpose in the literature, the authors created a checklist according to well-accepted recent guidelines focused on cholesterol. The content of the texts acquired was classified as misleading, insufficient but favorable, or sufficient and favorable.

RESULTS

The source of the online texts studied was universities (n=8, 1.3%), hospitals (n=6, 0.9%), personal blogs (n=200, 33.1%), health websites (n=183, 30.2%), and medical journals (n=207, 34.2%). In all, 235 texts (38.9%) were classified as sufficient and favorable and 35 (5.7%) were categorized as misleading. A medical practitioner was named in 378 texts (62.5%). All of the results from universities and hospitals were ranked in the favorable group. A statistical difference in the word count was seen in a comparison of the misleading and favorable texts.

CONCLUSION

Google can connect users to a significant quantity of material related to cholesterol that includes a wide range from misleading information to sufficient and favorable texts. The variation in the quality of the content on websites accessible via Google necessitates that cholesterol resource material should be selected with great care.

Preoperative cardiac risk factors associated with in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery: a single-centre study

INTRODUCTION

In the present study, our aim was to ascertain the preoperative cardiac risk factors related to the in-hospital mortality in the elderly patients (aged over 65 years) who required preoperative cardiology consultation for hip fracture surgery.

MATERIAL AND METHODS

The present study was a retrospective, single-centre study, which enrolled consecutive elderly patients without heart failure scheduled for hip fracture surgery in our institution. In all patients, an anesthesiologist performed a detailed preoperative evaluation and decided the need for the cardiac consultation. Patients underwent preoperative cardiac evaluation by a trained cardiologist using the algorithms proposed in the recent preoperative guidelines. The in-hospital mortality was the main outcome of the study.

RESULTS

In total, 277 elderly patients undergoing hip fracture surgery were enrolled in this analysis. The overall in-hospital mortality rate was 12.1% (n=30 cases). In a multivariate analysis, we found that insulin dependency, cancer, urea, presence of atrial fibrillation (AF) (OR: 3.906; 95% CI 1.470 to 10.381; p=0.006) and pulmonary artery systolic pressure (PASP) (OR: 1.057; 95% CI 1.016 to 1.100; p=0.006) were the predictors of in-hospital mortality. The receiver operating characteristic curve analysis revealed that the optimal value of PASP in predicting the in-hospital mortality was 35 mm Hg (area under the curve=0.71; 95% CI 0.60 to 0.81, p<0.001) with sensitivity of 87.7% and specificity of 59.5%.

CONCLUSION

The present research found that the preoperative cardiac risk factors, namely AF and PASP, might be associated with increased in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery.

The effect of the age on outcomes at a cardiac rehabilitation center in Turkey

OBJECTIVE

The aim of this study was to assess the effectiveness of a 12-week phase II cardiac rehabilitation (CR) program in Turkish patients aged between ≤65 years and >65 years using psychical parameters, echocardiography measurements, lipid profiles, and psychological parameters.

METHODS

A total of 68 patients who completed a phase II CR program were enrolled in this retrospective study. The echocardiography measurements, as well as assessment of physical parameters, psychological state, and serum lipid level of the patients were evaluated before the entry into the program and just after the completion. Patients were divided into 2 groups: those aged 65 years and under and those over the age of 65, and the effects of the CR program were compared.

RESULTS

There was a statistically significant difference in the average heart rate (HR), left ventricular ejection fraction (LVEF), Beck Depression Inventory (BDI) score, and State-Trait Anxiety Inventory (STAI) I-II scores of young patients before and after cardiac rehabilitation. The LVEF, high-density lipoprotein (HDL), BDI, STAI-I, and STAI-II parameters of older patients were statistically significant. In the comparison between those who were 65 years and under and those over the age of 65, the change in the mean HR (+11.24±12.62 bpm vs. +3.96±12.50 bpm; p=0.039), LVEF (+21.31±21.37% vs. +9.55±13.50%; p=0.035) and STAI I scores (-11.33±11.51 points vs. -23.25±14.08 points; p=0.025) were significantly different.

CONCLUSION

The results of the present study revealed that patients in a Turkish population aged 65 and over benefited from CR as much as younger patients did in terms of physical parameters, echocardiography measurements, lipid profiles, and psychological parameters.

COVID-19 and acute myocarditis: current literature review and diagnostic challenges

SUMMARY INTRODUCTION In the current literature, there has been an upsurge of cases of COVID-19-induced acute myocarditis. In this case-based review, we aimed to describe the clinical characteristics, imaging findings, and in-hospital course of acute myocarditis. In addition, the limitations of the myocarditis diagnosis were discussed since only fulminant myocarditis cases have been mentioned in the current literature. METHODS We performed a review of the literature of all patients who were diagnosed with COVID-19-induced acute myocarditis using the databases of PubMed, Embase, and the Cochrane. RESULTS 16 case reports were found to be related to COVID-19-induced acute myocarditis. We observed that the ECG findings in most of the COVID-19 patients were non-specific, including diffuse ST-segment elevation, non-specific intraventricular conduction delay, sinus tachycardia, and inverted T-waves in anterior leads. Echocardiographic findings of COVID-19-induced acute myocarditis patients ranged from preserved left ventricular ejection fraction (LVEF) without segmental abnormalities to reduced LVEF with global hypokinesia. Interestingly, a few patients with COVID-19-induced acute fulminant myocarditis were steroid-responsive and had an amelioration with glucocorticoid and immunoglobulin therapy. CONCLUSION Despite the COVID-19 pandemic worldwide, a limited number of cases has been shared in the current literature. There are a lot of difficulties in the differential diagnosis of acute myocarditis in the context of COVID-19.

The antifungal activity and cytotoxicity of silver containing denture base material

OBJECTIVE

Denture base materials are susceptible to fungal adhesion, which is an important etiological issue in the pathogenesis of denture stomatitis. The purpose of this in vitro study was to evaluate the antifungal activity and cytotoxicity of denture base material containing silver microparticles.

MATERIALS AND METHODS

The polymethyl methacrylate (PMMA) denture base material was used, and silver microparticles were added to the polymer powder in different concentrations by volume (0%, 0.25%, 0.5%, and 1%). Their antifungal activity against Candida albicans was assessed in terms of colony-forming units. PMMA disc specimens containing silver microparticles were eluted with culture medium for 1, 2, and 5 days. The cytotoxicity of the eluates to cultured L929 mouse fibroblast cells was evaluated using a real-time cell analysis (RTCA) system and the 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay.

RESULTS

The antifungal effect against C. albicans increased with the percentage of silver microparticles (P < 0.05). For both tests, both RTCA and the MTT assay, no time- or silver-dependent cytotoxicity of PMMA denture base material containing silver microparticles was observed.

CONCLUSIONS

PMMA denture base material containing silver microparticles have antifungal activity and no cytotoxic effect.

Derotation of the mallet piece: A crucial point in mallet fracture surgery

Mallet fracture is an avulsion of the extensor tendon and fracture of the dorsal rim of the articular surface of distal phalanx at the same time. If a part of the mallet fracture is angled or rotated to such a degree that prevents full anatomic reduction, malunion and deformities may occur as a result. The objective of this study was to describe a new surgical technique to provide derotation of the mallet fracture. A 22G or 21G needle is used like a joystick to reduce the mallet fracture with small, gentle movements. The extension block pinning technique described by Ishiguro was applied after proper alignment had been achieved. Bony union was achieved for all patients 6 weeks later. Derotation of type 2 and 3 mallet pieces with closed reduction to prevent surgical failure is simple but effective.

Predictors of femoral hematoma in patients undergoing elective coronary procedure: a trigonometric evaluation

Vascular complications in the femoral artery puncture site are the most common complications of the coronary angiography. Femoral hematoma is the leading participant of the vascular complications. We investigated the femoral hematoma predictive value of angle of sheath to trochanter major in patients undergoing elective coronary procedures. In this prospective analysis, we evaluated the femoral hematoma predictive value of angle of sheath to trochanter major on 246 patients undergoing elective coronary procedures. In this prospective analysis, we evaluated the femoral hematoma predictive value of angle of sheath to trochanter major on 246 patients undergoing elective coronary procedures. Patients were divided into two as femoral hematoma (n = 23) and control (n = 223) groups according to post-procedure femoral hematoma status. Other independent predictors of femoral hematoma were also evaluated. In-hospital multivariable analysis revealed higher rates of femoral hematoma for patients with chronic renal failure (OR 24.97, 95% CI 3.04-78.88, p = 0.003), with higher diastolic blood pressure after the procedure (OR 1.08 95% CI 1.00-1.16, p = 0.037), with femoral vein puncture during procedure (OR 17.74, 95% CI 2.67-54.74, p = 0.003) and with higher angle of sheath to trochanter major (OR 1.52, 95% CI 1.13-2.05, p = 0.005). The best cut-off value of the angle of sheath to trochanter major to predict femoral hematoma was 15.6° with 74% sensitivity and 70% specificity (AUC: 0.75; 95% CI 0.63-0.86; p < 0.001). The angle of sheath to trochanter major provides an independent predictor of femoral hematoma in patients undergoing elective coronary procedures. Our data suggests the importance of fluoroscopic guidance during femoral artery access with the predictive role of the angle of sheath to trochanter major.

Autologous osteochondral transplantation (mosaicplasty) in articular cartilage defects of the patellofemoral joint: retrospective analysis of 33 cases

OBJECTIVE

The purpose of this retrospective study was to evaluate the results of osteochondral autografting (mosaicplasty) in isolated articular cartilage defects of the patellofemoral joint.

MATERIALS AND METHODS

Thirty-three patients who underwent mosaicplasty for patellofemoral (either patella or trochlea) cartilage defects (modified Outerbridge classification: grades III and IV) of the knee joint were retrospectively reviewed. There were 25 male and 8 female patients with a mean age of 31.3 ± 6.7 (range 22-47) years. The average size of the lesion was 2.4 ± 0.55 cm² (range 1.5-4.0). Patients with patellofemoral malalignment were excluded. All patients were followed at least one year with a mean of 19.3 ± 4.3 months (range 12-24 months) using Lysholm knee score.

RESULTS

The mean preoperative Lysholm knee score was 51.9 ± 2.6 (47-58) points and increased to 85.5 ± 4.2 (75-89) points at the final follow-up. There was a significant increase in Lysholm score during follow-up period (p = 0.0001). The results were good in 24 cases and fair in 9 cases. No patients had poor results. No patients had infection. Five patients had postoperative mild painful hemarthrosis. Of these patients, four were treated with rest, ice, compression (elastic bandage) and elevation and the remaining one was treated by aspiration. No patients needed secondary open or arthroscopic drainage. No systemic complications occurred during the follow-up.

CONCLUSIONS

Mosaicplasty is an effective technique for the treatment of articular cartilage defects of the patellofemoral joint knee which restores the joint function in a short period of follow-up. However, a meticulous surgical technique should be followed to restore the native articular surface and the congruity of the joint.

Investigation of histopathological effects after intra-arterial sugammadex injection in an experimental animal model

PURPOSE

Intra-arterial injection of medications are related to mortality and morbidity. It was aimed to investigate the histopathological effects caused by two different intra-arterial doses of sugammadex, a new selective relaxant binding agent used to reverse the effects of steroidal systemic muscle relaxants used in surgeries carried out under general anesthesia.

METHODS

A total of 15 rabbits were randomly divided into 3 groups. The control group was given 1 mL saline bolus into the central artery of the ear. The other two groups (Group Sgdx2 and group Sgdx16) were given 2 and 16 mg/kg sugammadex, respectively, intra-arterially.

RESULTS

In control group, histopathological evaluation was in normal limits. The cross-sections belonging to Group Sgdx2 did not have any significant pathological change compared with control group (p > 0.05). Edema and single-cell necrosis were significantly higher in Group Sgdx16 when compared to control group (p < 0.05). In comparison to Group Sgdx2, single-cell necrosis was significantly higher in Group Sgdx16 (p < 0.05).

CONCLUSION

Being broadly used in anesthesia, sugammadex should be administered with care because when given by intra-arterial route it may cause tissue damage and tissue loss and the patients' arteries should be carefully checked.

Brain Natriuretic Peptide and the Severity of Aortic Regurgitation: Is There Any Correlation?

We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 ± 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 age-matched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild ( n = 16); group C, ≥ 3 and < 6 mm, moderate ( n = 26); group D, ≥ 6 mm, severe ( n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.

Investigation of endocrine and immunological response in fat tissue to hyperbaric oxygen administration in rats

Though HBO treatment is becoming more common, the mechanism of action is not fully known. The positive effects of HBO administration on the inflammatory response is thought to be a possible basic mechanism. As a result, we aimed to research whether endocrine and immunological response of fat tissue changes in rats given HBO treatment model. This research was carried out on Wistar albino rats, they were treated with hyperbaric oxygen therapy. Their fatty tissue were taken from the abdomen, gene expression of the cytokines and adipokines were analyzed with Real time PCR method. When the gene expression of hormones and cytokines by fat tissue was examined, the leptin, visfatin, TNF-α, IL-1β and IL-10 levels in the HBO treatment group were statistically significantly increased compared to the control group (p=0.0313, p=0.0156, p=0.0156, p=0.0156, p=0.0313). In conclusion, in our study we identified that HBO administration affected the endochrinological functions of fat tissue.