effect of synthetic cannabinoids on P-wave dispersion: an observational study

Objective: The aim of this study was to investigate the effect of synthetic cannabinoids [SC] on P-wave dispersion [PD] in patients who consume SC

Materials and Methods: The study population included 72 patients who consumed SC and 36 age- and sex-matched healthy controls. The severity of addiction was detected using the addiction profile index [BAPI]. The PD was measured by 12-lead ECG obtained upon admission to hospital. Statistical analyses were performed using the SPSS v20.0 statistical software package

Results: The mean age of the patients and controls was 26.9 +/- 7.0 and 26.3 +/- 6.5 years, respectively. Mean duration of SC consumption was 1.7 +/- 0.7 years. Mean BAPI score of patients who consumed SC was 12.8 +/- 3.4. Patients who consumed SC had a significantly higher PD value than controls [37.7 +/- 11.5 vs. 30.6 +/- 6.4 ms, p < 0.001]. The BAPI score was significantly correlated with PD value [r = 0.675, p < 0.001]. In the linear regression model that included PD value, age and heart rate, PD value was significantly and independently correlated with BAPI score [r2 of the model = 0.339; p < 0.001]

Conclusions: In this study, patients who consumed SC had significantly higher PD values than controls, and the BAPI score correlated with the PD value. Hence SC consumption could lead to an increased risk of cardiovascular disease through prolonged PD. We recommend the use of the simple and inexpensive ECG to assess cardiovascular risk in patients who consume SC

Increased Neutrophil/Lymphocyte Ratio in Patients with Depression is Correlated with the Severity of Depression and Cardiovascular Risk Factors

OBJECTIVE: Chronic inflammation is associated with cardiovascular (CV) risk factors and psychiatric disorders. The neutrophil to lymphocyte ratio (NLR) has been investigated as a new biomarker for systemic inflammatory response. The aim of the study is to investigate the relation of NLR with severity of depression and CV risk factors. METHODS: The study population consisted of 256 patients with depressive disorder. Patients were evaluated with the Hamilton Rating Scale for Depression (HAM-D). Patients were classified into four groups according to their HAM-D score such as mild, moderate, severe, and very severe depression. Patients were also evaluated in terms of CV risk factors. RESULTS: Patients with higher HAM-D score had significantly higher NLR levels compared to patients with lower HAM-D score. Correlation analysis revealed that severity of depression was associated with NLR in depressive patients (r=0.333, p<0.001). Patients with one or more CV risk factors have significantly higher NLR levels. Correlation analysis revealed that CV risk factors were associated with NLR in depressive patients (r=0.132, p=0.034). In logistic regression analyses, NLR levels were an independent predictor of severe or very severe depression (odds ratio: 3.02, 95% confidence interval: 1.867-4.884, p<0.001). A NLR of 1.57 or higher predicted severe or very severe depression with a sensitivity of 61.4% and specificity of 61.2%. CONCLUSION: Higher HAM-D scores are associated with higher NLR levels in depressive patients. NLR more than 1.57 was an independent predictor of severe or very severe depression. A simple, cheap white blood cell count may give an idea about the severity of depression.

Successful accessory renal artery denervation in a patient with resistant hypertension

Renal sympathetic denervation is safe and effective in patients with resistant hypertension. In all of the studies of renal artery denervation, patients with accessory renal arteries are excluded. So there is not any data regarding renal sympathetic denervation applied to the accessory renal arteries. We present a young female patient with resistant hypertension despite use of five different antihypertensive drugs. The patient had a well developed [diameter >4 mm] left renal accessory. We believe that if we omitted the well developed accessory renal artery, we would not have maintained adequate blood pressure control. Thus, we applied radiofrequency ablation to both renal arteries and left accessory artery. Immediately after the procedure, the patient's blood pressure was reduced to 110/60 mmHg and this effect was continued during the first month of follow-up

Two cases of acute myocarditis with multiple intracardiac thrombi: the role of hypercoagulable states

In acute myocarditis, thrombus formation is an important prognostic factor. Early diagnosis and treatment of intracardiac thrombus is critical, especially when there are multiple thrombi. When a patient presents with multiple cardiac thrombi not only cardiac disorders, but other diseases such as malignancies, rheumatologic disorders and thrombophilia must be considered in the differential diagnosis. Although the presence of hypercoagulable states does not generally affect the treatment choice, it may have an impact on continuation and duration of the anticoagulant therapy. In this paper, we present two cases of acute myocarditis with multiple intracardiac thrombi. Additionally, these cases had hypercoagulable states which might have contributed to the thrombus formation