Cold exposure and left ventricular diastolic performance in coronary artery disease

It is known that cold exposure is accompanied by coronary artery vasoconstriction and ischemia in patients with coronary artery disease (CAD). The aim of the present study was to evaluate the response of left ventricular (LV) diastolic and systolic functions, estimated by means of Doppler echocardiography, to cold pressor test (CPT) in patients with CAD. Twenty-five male patients (mean age 50.8 +/- 8.1 years) with documented CAD underwent CPT with Doppler echocardiographic assessment of LV diastolic and systolic functions. According to the development of ischemic response to CPT, all patients were divided into 2 groups: group 1, 10 patients with ischemia and group 2, 15 patients without ischemia during CPT. Cold exposure caused significant increase in blood pressure with no changes in heart rate in all CAD patients. Patients with signs of ischemia during cold exposure had lower transmitral flow velocity during early filling (p < 0.001), prolonged isovolumic relaxation time (p < 0.04), shortened deceleration time of early transmitral flow velocity (p < 0.001), and higher values of Doppler-derived index of myocardial performance (p < 0.0001) than those without ischemic response to CPT. Cold exposure in CAD patients through stimulating of vasoconstriction and ischemia was associated with derangements in LV myocardial performance, manifested by delayed relaxation, impaired stiffness, and reduced contractility.     

P Wave Amplitude and Duration may Predict Immediate Recurrence of Atrial Fibrillation After Internal Cardioversion

Background: Although internal cardioversion (IC) for atrial fibrillation (AF) is effective at restoring sinus rhythm, immediate recurrence (IR) of AF after IC is a major and largely unpredictable clinical problem. The purpose of the study was to determine the role of P wave duration and amplitude in prediction of IR of AF after IC. Forty‐five consecutive patients undergoing IC for chronic AF were evaluated. Material and Methods: After successful IC, 1‐minute ECG recording was obtained in all patients. P wave duration and amplitude in Lead II and V₁ were measured using computer. Forty patients (88%) had successful IC. Thirteen patients experienced IR of AF within 1 minute of restoring sinus rhythm. Results and Conclusion: As a result, the incidence of IR of AF after IC was higher in the patients with shorter P wave amplitude (for lead II P < 0.01 , for V₁P < 0.01 ) and larger P wave duration (for lead II P < 0.01 , for V₁P < 0.05 ).     

Elucidating the role of nitrogen plasma composition in the low-temperature self-limiting growth of indium nitride thin films

In this work, we have studied the role varying nitrogen plasma compositions play in the low-temperature plasma-assisted growth of indium nitride (InN) thin films. Films were deposited on Si (100) substrates using a plasma-enhanced atomic layer deposition (PE-ALD) reactor featuring a capacitively-coupled hollow-cathode plasma source. Trimethylindium (TMI) and variants of nitrogen plasma (N₂-only, Ar/N₂, and Ar/N₂/H₂) were used as the metal precursor and nitrogen co-reactant, respectively. In situ ellipsometry was employed to observe individual ligand exchange and plasma-assisted ligand removal events in real-time during the growth process. Only the samples grown under hydrogen-free nitrogen plasmas (Ar/N₂ or N₂-only) resulted in nearly stoichiometric single-phase crystalline hexagonal InN (h-InN) films at substrate temperatures higher than 200 °C under 100 W rf-plasma power. Varying the plasma gas composition by adding H₂ led to rather drastic microstructural changes resulting in a cubic phase oxide (c-In₂O₃) film. Combining the in situ measured growth evolution with ex situ materials characterization, we propose a simplified model describing the possible surface reactions/groups during a unit PE-ALD cycle, which depicts the highly efficient oxygen incorporation in the presence of hydrogen radicals. Further structural, chemical, and optical characterization have been carried out on the optimal InN films grown with Ar/N₂ plasma to extract film properties. Samples grown at lower substrate temperature (160 °C) and reduced/elevated rf-plasma power levels (50/150 W) displayed similar amorphous character, which is attributed to either insufficient surface energy or plasma-induced crystal damage. InN samples grown at 240 °C under 100 W rf-plasma showed clear polycrystalline h-InN layers with ∼20 nm average-sized single crystal domains exhibiting hexagonal symmetry.

Hollow-cathode plasma-generated hydrogen radicals induce crystal phase transformation from h-InN to c-In₂O₃ during plasma-enhanced atomic layer deposition using trimethyl-indium and Ar/N₂ plasma.     

Comparison of initial efficacy and long-term follow-up of heparin-coated Jostent with conventional NIR stent

The implantation of heparin-coated stents was reported to be well tolerated, but there are conflicting results about acute in-hospital complications. (sub)acute thrombosis rates, and long-term follow-up compared to uncoated stents. We compared the angiographic and clinical results after coronary placement of two stent models: the heparin-coated premounted Jostent and the uncoated premounted NIR stent. Of 710 patients revascularized, a total of 426 patients received Jostent (n = 230) or NIR stent (n = 196) implantation. The primary end points were acute or subacute thrombosis, urgent CABG, AMI or death, while the secondary end points were the comparison of the restenosis rates of the stents at the 6th month and of the functional angina classification of the stent groups at the 1st, 6th and 12th months. There were no significant differences between the Jostent and NIR stent groups regarding angiographic and procedural success. Acute thrombosis rates in the Jostent and NIR stent groups were similar while no subacute thrombosis was observed in either group. The major adverse cardiac event rates of the groups also did not differ. Angiographic restenosis occurred in 17% of the Jostent group and 16% of the NIR stent group (NS). The combined clinical and angiographic restenosis rate was also similar between the Jo and NIR groups (19% and 18%, respectively). Comparison of functional angina classes at the 1st, 6th and 12th months revealed no significant difference between the study groups. In conclusion, when compared with implantation of an uncoated premounted NIR stent, implantation of a heparin-coated premounted Jostent does not provide any more benefit with respect to initial efficacy, sub(acute) thrombosis and 6-month restenosis rates and 12-month clinical outcomes.     

Regio- and diastereoselective synthesis of spiropyrroloquinoxaline grafted indole heterocyclic hybrids and evaluation of their anti-Mycobacterium tuberculosis activity

An efficient and eco compatible approach for the regio- and stereoselective synthesis of structurally diverse novel hybrid heterocycles comprising spiropyrrolidine, indenoquinoxaline and indole structural units in excellent yields, has been achieved through a one-pot multicomponent process involving 1,3-dipolar cycloaddition as a key step. The 1,3-dipolar component is the azomethine ylide generated in situ from indenoquinoxaline and l-tryptophan and reacts with various substituted β-nitrostyrenes affording the spiroheterocyclic hybrids. The ring system thus created possesses two C–C and three C–N bonds and four adjacent stereogenic carbons, one of which is quaternary and the reaction proceeded with full diastereomeric control. All the synthesized compounds were assayed for their in vitro activity against Mycobacterium tuberculosis H37Rv using MABA assay. Interestingly, the compound bearing a 2-fluoro substituent on the aryl ring displayed an equipotent activity (MIC 1.56 μg mL⁻¹) to ethambutol against Mycobacterium tuberculosis H37Rv.

An efficient and eco compatible approach for the regio- and stereoselective synthesis of structurally diverse novel spiropyrrolidine tethered indole hybrids in excellent yields employing a one-pot multicomponent 1,3-dipolar cycloaddition strategy.     

Rh (D) alloimmunization treated by double filtration plasmapheresis

Here in this report a 31?year old pregnant woman with positive serum antiglobulin test against anti-D antierythrocyte antibodies who was treated succesfully with double filtration plasmapheresis (DFPP) is presented. The DFPP was started in the early stage of pregnancy together with intravenous immunoglobulin therapy and the antierythrocyte antibody titer of the patient was successfully maintained in a stable level below 1:64 dilution. She delivered successfully on the 30th week of gestation. The favorable outcome of this patient implies that DFPP is an effective and safe treatment modality in pregnant women with red cell alloimmunization.     

Nonpharmaceutical interventions in Turkey and worldwide during COVID-19 pandemic

Nonpharmaceutical interventions (NPIs) are actions apart from getting vaccinated and medications, in order to promote deceleration of the spread of illness among people and communities during pandemic. In this article, we aim to examine NPIs applied in Turkey and worldwide due to the COVID-19 pandemic. Some of the NPIs such as isolation, quarantine, and contact tracing were maintained with updates of the Ministry of Health guidelines in Turkey. Some NPIs including travel and partial or full curfew mobilization restrictions were set in accordance with the various periods by the number of cases. Periods of restrictions at autumn 2021 to summer 2022 are national partial curfews, national extended curfews, local decision-making phase, revised local decision-making phase, partial lockdown, full lockdown and gradual normalization. Mitigation and suppression have been implemented in Turkey with restrictions of varying severity throughout the course of the epidemic. It is seen that the restrictions implemented in Turkey contributed to the flattening of the epidemic curve. Even some countries mainly applied the suppression method, and others applied the mitigation method, in general, it is seen that similar methods were applied with different weights. Examples of different countries demonstrated that NPIs are effective for flattening epidemic curve. NPI have been the main instrument for a year and a half from the beginning of the epidemic to mid-2021 in Turkey as well as worldwide.     

Reliability and Validity Study of Turkish Version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0) Led to Development of a New Pediatric Eosinophilic Esophagitis Scale: GaziESAS

BackgroundThere has been no valid and reliable Turkish scale that measures symptoms in children with eosinophilic esophagitis (EoE). The aim of the study is to test the validity and reliability of the Turkish version of Pediatric Eosinophilic Esophagitis Symptom Scores® (Tr-PEESS v2.0).Methods Relevant forms of Tr-PEESS v2.0 were applied to 2-18 years old children with EoE and to their parents. KINDL QoL patient and parent questionnaires and the GaziESAS scale developed in this study were used to test the convergent validity of Tr-PEESS v2.0. Discriminant validity was evaluated among 3 EoE treatment groups: under treatment, off treatment due to remission, and uncompliant with treatment. Reliability was evaluated by internal consistency, test–retest reliability, and item analysis.Results Fifty-two children/teens (mean age 130.2 ± 60.3 months) and 84 parents were interviewed twice one week apart. The mean duration of EoE was 47.2 ± 35.6 months. Tr-PEESS v2.0 reports correlated with GaziESAS (range 0.361-0.855) and KINDL QoL questionnaires (range −0.316 to 0.413). Parent report of Tr-PEESS v2.0 discriminated children uncompliant with treatment from the ones off treatment and undertreatment. Cronbach’s α values and intraclass correlation coefficients (ICC) values of Tr-PEESS v2.0 ranged from 0.614-0. 895 and 0.646-0.910, respectively.Conclusion Tr-PEESS v2.0 is a valid and reliable tool to use in Turkish children. GaziESAS is a new parent-proxy pediatric EoE scale with an additional adaptive behavior domain that passed scale developmental stages successfully for Turkish children with EoE.