Atrial electromechanical coupling intervals in pregnant subjects

Atrial fibrillation (AF), which is the most common cardiac arrhythmia, may cause serious symptoms and impair quality of life.1 The development of AF is associated with many risk factors, including age, male gender, hypertension, heart failure, valvular disease, diabetes mellitus (DM) and left atrial (LA) enlargement.2-4 Electrical and/or mechanical remodelling of the atria is thought to be a pathophysiological characteristic of AF.5The pregnant state may be pro-dysrhythmic. This is related to the cardiovascular, hormonal, haemodynamic and autonomic changes during healthy pregnancy. Levels of oestrogen and β-human chorionic gonadotropin increase dramatically. Haemodynamic changes include an increase in circulating blood volume, which increases cardiac output. This results in myocardial stretch and an increase in cardiac end-diastolic volume. High plasma catecholamine concentrations and adrenergic receptor sensitivity increase sympathetic tone. All these changes in pregnant women may make them more prone to dysrhythmogenesis.6Most pregnant women complain of palpitations, dizziness and even syncope, but these symptoms are rarely associated with cardiac dysrhythmias. AF is the most common clinically significant cardiac arrhythmia in the general population but it is rarely seen in pregnant women. When it occurs, it can represent a benign, self-limited lone episode of AF or may be secondary to congenital or rheumatic valvular disease, hypertrophic cardiomyopathy, thyroid disease, or pre-excitation syndrome.Two simple electrocardiogram (ECG) markers, namely maximum P-wave duration (Pmax) and P-wave dispersion (PD), have been used to evaluate intra- and inter-atrial conduction times and the inhomogeneous propagation of sinus impulses, which are well-known electrophysiological characteristics of the atrium prone to fibrillation.7,8 Prolonged Pmax and PD have been reported to represent an increased risk for AF in patients with no underlying heart disease.7,8 Besides, evidence from laboratory and epidemiological research suggests that systemic inflammation may play a role in AF aetiology.9 It has also been demonstrated that atrial electromechanical coupling, measured by tissue Doppler imaging (TDI), as significantly longer in patients with paroxysmal AF than in control groups.10,11To our knowledge, no study evaluating PD and atrial electromechanical coupling has been investigated in pregnant subjects without additional systemic disease. Therefore, in this study we aimed to examine atrial electromechanical coupling and PD, reflecting inter-atrial conduction times in pregnant subjects.     

Duration of the effect of intravitreal triamcinolone acetonide as treatment for diffuse diabetic macular edema

PURPOSE: To evaluate the duration of the effect of intravitreal triamcinolone acetonide on visual acuity in patients with diffuse diabetic macular edema. DESIGN: Clinical interventional case series. METHODS: Subjects were 31 patients (38 eyes) with diffuse diabetic macular edema who received an intravitreal injection of 20- to 25-mg triamcinolone acetonide. Mean follow-up time was 13.2 +/- 6.0 months (6.03-25.2 months). RESULTS: Visual acuity and intraocular pressure began to increase significantly (P =.003) within the first week, reaching a plateaulike maximum at 1 to 7 months postinjection, returning to baseline values 8 to 9 months postinjection. CONCLUSIONS: The effect of an intravitreal injection of approximately 20- to 25-mg triamcinolone acetonide in patients with diffuse diabetic macular edema lasts approximately 7 to 8 months. This information may be helpful in determining the optimal dosage of intravitreal triamcinolone acetonide for the treatment of diffuse diabetic macular edema.     

Safety of intravitreal high-dose reinjections of triamcinolone acetonide

PURPOSE: To report side effects after intravitreal high-dose reinjections of triamcinolone acetonide. DESIGN: Clinical interventional case series. METHODS: Forty-six patients (47 eyes) received at least two intravitreal injections of approximately 20 to 25 mg triamcinolone acetonide for treatment of diabetic macular edema (n = 6 eyes), exudative age-related macular degeneration (n = 23), and other diseases. Intervals between injections were 6.7 +/- 3.4 months, 8.0 +/- 4.6 months, and 10.2 months, respectively, before the second (n = 47 eyes), third (n = 9), and fourth (n = 2) injection. Mean follow-up was 20.7 +/- 8.9 months. RESULTS: After no reinjection were complications detected, other than those known to occur after a single intravitreal injection. After the first, second, and third injection, respectively, intraocular pressure remained normal in 24 (51%), 25 (53%), and 5 (56%) eyes. CONCLUSIONS: Intravitreal high-dosage reinjections of triamcinolone acetonide may be tolerated within a mean follow-up of approximately 21 months.     

Hemizentralarterienverschluss bei Moyamoya-Syndrom

Moyamoya syndrome is a rare cerebrovascular disorder characterized by bilateral progressive supraclinoidal stenosis or occlusion of the internal carotid artery and development of collateral vessels in the lenticulostriate region. The syndrome manifests itself in association with another disease or other clinical symptoms. We present the case of a 12-year-old girl with hemicentral retinal artery occlusion due to moyamoya syndrome associated with clinical and laboratory findings of presumed systemic lupus erythematosus.     

Ternary Diagrams of Poly(vinylidene fluoride) and Poly[(vinylidene fluoride)‐co‐hexafluoropropene] in Propylene Carbonate and Dimethyl Sulfoxide

Experiments on the thermoreversible gelation of a ternary system composed of poly(vinylidene fluoride) (PVDF) and poly[(vinylidene fluoride)‐co‐hexafluoropropene] (P(VDF‐co‐HFP)) in propylene carbonate (PC) or DMSO solutions are carried out and the resulting ternary diagrams are plotted for various systems. The results show that the gelation occurs at relatively low concentrations. The miscibility area of the ternary diagram is larger with DMSO than with PC. In addition, the concentration at the gelation point increases with increasing temperature. The gelation line is almost independent of the molecular structure of PVDF in PC but varies in DMSO. This variation of the miscibility is essentially connected to the carboxylic functions on the PVDF chain.     

Pomegranate seed extract attenuates chemotherapy-induced acute nephrotoxicity and hepatotoxicity in rats

Cisplatin (CDDP), one of the most active cytotoxic agents against cancer, has adverse side effects, such as nephrotoxicity and hepatotoxicity. The present study was designed to investigate the potential protective effect of pomegranate seed extract (PSE) against oxidative stress caused by CDDP injury of the kidneys and liver by measuring tissue biochemical and antioxidant variables and immunohistochemically testing caspase-3-positive cells. Twenty-four Sprague-Dawley rats were divided into 4 groups: control; CDDP: injected intraperitoneally with CDDP (7 mg/kg body weight, single dose); PSE: treated for 15 consecutive days by gavage with PSE (300 mg/kg per day); and PSE+CDDP: treated by gavage with PSE 15 days after a single injection of CDDP. The degree of protection against CDDP injury afforded by PSE was evaluated by determining the levels of malondialdehyde as a measure of lipid peroxidation. The levels of glutathione and activities of glutathione peroxidase, glutathione S-transferase, and superoxide dismutase were estimated from liver and kidney homogenates; the liver and kidney were also histologically examined. PSE elicited a significant protective effect toward liver and kidney by decreasing the level of lipid peroxidation; elevating the levels of glutathione S-transferase; and increasing the activities of glutathione peroxidase, glutathione S-transferase, and superoxide dismutase. These biochemical observations were supported by immunohistochemical findings and suggested that PSE significantly attenuated nephrotoxicity and hepatotoxicity by the way of its antioxidant, radical-scavenging, and antiapoptotic effects. This PSE extract could be used as a dietary supplement in patients receiving chemotherapy medications.     

Estimation of the femur length from its proximal measurements in Anatolian Caucasians by artificial neural networks

Femora are a well preserved section of the skeleton after death. Therefore, they are commonly used in the field of forensic sciences, physical anthropology and anatomy. In addition, femur morphometry is helpful in finding sex or side (left or right) differences. The femur also shows characteristics of certain populations. Femur length is important for calculation of individual stature. In this study, the artificial neural network method was used to estimate femur length. In total, 230 femora exemplar were used. The three input parameters of the method were the distance between trochanter major top point and trochanter minor bottom point, the diameter of caput femoris and the diameter of collum femoris. By using these parameters, the artificial neural network estimation on femur length was performed. The results show that the method is capable of performing this estimation. In addition, sex discrimination was performed and achieved with 82% accuracy. As well as the identification of sex or side differences, morphometry of the proximal femur is necessary and important for surgical procedures.     

Suicide of elderly persons: Towards a framework for prevention

Suicide is an act of intentionally terminating one's own life. Although suicide rates vary across demographic categories, they have increased by approximately 60% in the last 50 years. Many studies of adolescent suicidal behavior have noted impulsivity to be a common feature in the younger age group, while with older people there is evidence of planning and a strong intent to die. In fact, older people are most successful as an age group with approximately one in four attempts resulting in death. While very comprehensive statistics are available on many aspects of this problem for the Turkish population as a whole, this data does not include physical factors like illnesses, legal domiciles like nursing homes, economic standards and history of attempted suicides. This necessary data would add greatly to the available data and accuracy of research in this area. Whereas Turkish national risk factor procedures are available, precaution procedures and suicide attempt data is not. There is no way of knowing how many deceased had a history of repetitions. It is suggested that this could be attributed to routine failure to observe and mitigate risk factors. The size of this problem is being demonstrated with this presented case report about a planned complex suicide with multiple sharp forced injuries and substance intoxication; a completed suicide that was potentially preventable with timely detection and intervention. In accordance, suicidal risk factors in the old age population, precautions, along with the characteristics of this suicidal case, are evaluated within existing published work. Geriatr Gerontol Int 2011; 11: 107–113.