Sezen Bağlan Uzunget

Impact of Admission Blood Glucose on Coronary Collateral Flow in Patients with ST-Elevation Myocardial Infarction

In patients with acute myocardial infarction, glucose metabolism is altered and acute hyperglycemia on admission is common regardless of diabetes status. The development of coronary collateral is heterogeneous among individuals with coronary artery disease. In this study, we aimed to investigate whether glucose value on admission is associated with collateral flow in ST-elevation myocardial infarction (STEMI) patients. We retrospectively evaluated 190 consecutive patients with a diagnosis of first STEMI within 12 hours of onset of chest pain. Coronary collateral development was graded according to Rentrop classification. Rentrop 0-1 was graded as poor collateral development, and Rentrop 2-3 was graded as good collateral development. Admission glucose was measured and compared between two groups. Mean admission glucose level was 173.0 ± 80.1 mg/dl in study population. Forty-five (23.7%) patients had good collateral development, and 145 (76.3%) patients had poor collateral development. There were no statistically significant differences in demographic characteristics between two groups. Three-vessel disease was more common in patients with good collateral development (p=0.026). Mean admission glucose level was higher in patients with poor collateral than good collateral (180.6 ± 84.9 mg/dl versus 148.7 ± 56.6 mg/dl, resp., p=0.008). In univariate analysis, higher admission glucose was associated with poor collateral development, but multivariate logistic regression analysis revealed a borderline result (odds ratio 0.994, 95% CI 0.989–1.000, p=0.049). Our results suggest that elevated glucose on admission may have a role in the attenuation of coronary collateral blood flow in acute myocardial infarction. Further studies are needed to validate our results.

Atipik klinik ile tespit edilen atipik yerleşimli kardiyak miksoma

Atriyal miksomalar, en sik karsilasilan benign primer kardiyak tumorlerdir. Literaturde tanimlandigi uzere bircok komplikasyona yol acmaktadir. Cogunlukla solda atriyumda olsa da atriyum ve interatriyal septuma bagli olarak, herhangi bir kardiyak boslukta ortaya cikabilir. Bu olgu raporunda 55 yasindaki bir kadin hastamizi sunduk. Kardiyoloji poliklinigine tek tarafli gecici gorme kaybi etyolojisinin arastirilmasi amaciyla danisildi. Transozofageal-ekokardiyografide kardiyak miksoma olarak suphe edilen bu kitlelenin cerrahi esnasinda sol atriyum posteriyor duvar, sol ust pulmoner ven cevresinden kaynaklandigi tespit edildi ve kitle tamamen cikartildi. Patolojik inceleme sonucunda tani kardiyak miksoma olarak dogrulandi. Gecici iskemik semptomlari olan ancak atriyal fibrilasyonu olmayan hastalarda sol atriyumda potansiyel kitle tanisini koymak icin ekokardiyografi yapilmalidir.

Evaluation of activated charcoal and lipid emulsion treatment in model of acute rivaroxaban toxicity

Aim: Reducing or reversing the toxicity effects of new oral anticoagulants is an important question.The purpose of the present study is to evaluate the effect of lipid emulsion (LE) and Activated Charcoal (AC) therapy on the intoxication of rivaroxaban, on mice. Methods: Adult male Balb/c mice weighing approximately 30 g were used in the study. Seven groups were assigned, with six mice in each group. Groups were defined; given only rivaroxaban, given only LE, given only AC, after the administration of rivaroxaban LE applied group in the 1st hour, after the administration of rivaroxaban LE applied group in the 3rd hour, after the administration of rivaroxaban AC applied group in the1st hour, after the administration of rivaroxaban AC applied group in the 1st hour and LE applied group in the 3rd hour. PT and Anti‐Factor Xa activity were measured in all blood samples from subjects. Results: A statistically significant difference was found when all groups were compared in terms of mean PT values and Anti‐FactorXa values. However, no statistically significant difference was found in the mean PT and Anti‐FactorXa values when only rivaroxaban administrated group and after the administration of rivaroxaban LE and/or AC applied groups were compared one to one. No deaths occurred in groups during the observation. Conclusion: Although the administration of either AC or LE alone or in combination resulted in a decrease in the mean values of PT and anti‐Factor Xa, in case of rivaroxaban toxicity, but one‐to‐one comparison of the groups was not statistically significant.