Omega-3 fatty acids may be harmful to thickness of aortic intima-media.

There are several studies confirming an association between nicotine exposure and increase in aortic intima-media thickness (aIMT) as a pre-atherosclerotic lesion. The ω-3 FAs are on the other hand reported to have an anti-atherogenic effect. We aimed to evaluate histopathologically the effect of nicotine exposure during pregnancy and lactation period on fetal growth and aIMT at postnatal 45 days of age in rat pups living in the same conditions and to determine the protective effect of ω-3 FAs. Pregnant rats were assigned into four groups. In nicotine (N) group; pregnant rats received nicotine subcutaneously and extra-virgin olive oil by gavage during pregnancy from 1 to 21 days of gestation and lactation. In nicotine+ ω-3 FAs (N+O) group; nicotine was administered subcutaneously and ω-3 FAs by gavage, in omega-3(O) group; ω-3 FAs were administered by gavage and saline subcutaneously, in control(C) group; saline was administered subcutaneously and extra-virgin olive oil by gavage for the same period.The aIMT was found to be greatest in N+O group, which indicated a significant difference compared to the control group (p < 0.05). No statistically significant difference was found among other groups.Although the majority of studies on ω-3 FAs suggest a beneficial effect, our study showed that exposure to ω-3 FAs increased the aIMT (Tab. 2, Fig. 3, Ref. 25).

Neonatal hemochromatosis in monochorionic twins.

Neonatal hemochromatosis (NH) is a form of neonatal liver failure caused by maternal-fetal alloimmune injury to hepatocytes. The etiology of neonatal hemochromatosis is not exactly understood. However, according to one theory neonatal hemochromatosis is believed to be an alloimmune disorder causing liver injury in the fetus. In order to diagnose neonatal hemochromatosis there are some criteria that should be taken into account, such as positive family history, high serum ferritin levels, high serum alpha-fetoprotein levels and siderosis demonstrated by histology or with magnetic resonance.We present a case of a monochorionic newborn twin who applied to our hospital with sepsis clinical symptoms like clinics, was diagnosed with NH and immediately treated with antioxidant therapy while the other twin with same clinical symptoms did not respond to therapy and passed away. NH should be considered in the differential diagnosis of cases with sepsis-like clinical symptoms that do not respond to antibiotics; early antioxidant therapy in these cases is lifesaving.

Androgenetic alopecia is associated with increased arterial stiffness in asymptomatic young adults.

BACKGROUND: Association of androgenetic alopecia (AGA) with increased incidence of hypertension, a strong risk factor for coronary artery disease, has been suggested. However, there are no data on arterial stiffness measures of asymptomatic young adults with AGA. OBJECTIVE: In this study, we aimed to investigate the association of the AGA with arterial stiffness assessed by cardio-ankle vascular index (CAVI), in asymptomatic young men. METHODS: A total of 162 asymptomatic men aged between 18 and 45 years were consecutively enrolled to the study. Subjects were considered to have AGA if they have ≥3 grade vertex alopecia according to Hamilton-Norwood scale. Arterial stiffness was assessed by CAVI and defined as abnormal if CAVI is ≥8. RESULTS: Frequency of abnormal CAVI was higher in patients with AGA (29.3% vs. 10.0%, P = 0.003). Subjects with AGA had higher mean CAVI than subjects without AGA (7.56 ± 0.93 vs. 7.15 ± 0.79, P = 0.004). Binary logistic regression analysis demonstrated that presence of AGA (OR, 5.6; 95% CI, 1.7-20.0, P = 0.006), age (OR, 1.1; 95% CI, 1.0-1.2, P = 0.03) and diastolic blood pressure (OR, 1.1; 95% CI, 1.0-1.3, P = 0.005) were independently associated with abnormal CAVI. CONCLUSION: We concluded that, AGA might be an indicator of arterial stiffness in asymptomatic young adults.

Link between aortic valve sclerosis and myocardial no-reflow in ST-segment elevation myocardial infarction.

OBJECTIVE: The"no-reflow" phenomenon is associated with a worse prognosis at follow-up for patients with acute ST-segment elevation myocardial infarction (STEMI). Predicting and preventing no-reflow is therefore a crucial step in improving the prognosis of STEMI patients. The purpose of this study was to investigate the association between aortic valve sclerosis (AVS) and myocardial no-reflow in patients with STEMI. PATIENTS AND METHODS: Patients with a first-time diagnosis of STEMI were enrolled consecutively. No-reflow was defined as a final TIMI 3 flow with a myocardial blush of grade < 2, temporary epicardial coronary no-reflow, and distal coronary occlusion. AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow. RESULTS: No-reflow developed in 41 patients. In univariate analysis, age, male gender, smoking, culprit lesion Syntax score (SX score), and hypertension were significantly associated with no-reflow. Multivariate binary logistic regression analyses demonstrated age [95 % confidence interval (CI), 1.024-1.096; p=0.001), AVS (95 % CI, 1.002-1.100; p=0.039], culprit lesion SX score (95 % CI, 1.08-1.021 p=0.008), and symptom-to-balloon time (95 % CI, 1.020-1.097; p=0.002) as independent determinants of myocardial no-reflow. CONCLUSION: AVS was significantly and independently associated with myocardial no-reflow in STEMI patients.

A rare association: Sirenomelia with adrenalomegaly in an infant of diabetic mother.

Sirenomelia or the Mermaid syndrome is a rare congenital anomaly with an incidence of one in 60,000 to 70,000 pregnancies. Sirenomelia is characterized by complete fusion of the lower limbs, commonly associated with renal agenesis, absent external genitalia and other gastrointestinal defects. A 37-week, 3040-g infant was born to a 35-year-old multigravida mother with type 2 diabetes mellitus and hyperlipidemia. To our knowledge, this is the first case of sirenomelia with adrenalomegaly.

Aortic valve sclerosis in acute coronary syndrome patients : potential value in predicting coronary artery lesion complexity.

OBJECTIVE: The purpose of the present study was to investigate the relation between aortic valve sclerosis (AVS) and coronary artery lesion complexity as assessed using the SYNTAX score (SxScore) in acute coronary syndrome (ACS) patients. PATIENTS AND METHODS: A total of 164 patients with a first time diagnosis of acute coronary syndrome were consecutively enrolled. AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow. The SxScore was calculated using dedicated computer software. RESULTS: There were significantly higher SxScores in subjects with AVS than those without AVS (18 ± 6 vs 12 ± 5, p = 0.02). In the univariate analysis, age (p = 0.03) and presence of AVS (p = 0.007) were significantly associated with higher SxScores. Logistic regression analysis demonstrated AVS [95 % confidence interval (CI) 0.17-0.86, p = 0.017] and age (95 % CI 1.01-1.21, p = 0.028) as independent determinants of higher SxScores. CONCLUSION: Aortic valve sclerosis was significantly and independently associated with a high SxScore in acute coronary syndrome patients.

Mean platelet volume on admission is associated with further left ventricular functions in primary PTCA patients.

AIM: In ST elevation myocardial infarction (STEMI) patients, mean platelet volume (MPV) is associated with infarct related artery patency both before and after reperfusion. In anterior STEMI patients successfully treated with primary percutaneous coronary intervention (PCI), the relationship between left ventricular (LV) function and MPV on admission is unknown. METHODS: 97 anterior STEMI patients successfully revascularizated with PCI between January 2010 and February 2011 are included. MPV on admission is recorded. All patients underwent transthoracic echocardiography within 3 days or before discharge. Patients were divided into two groups according to left ventricular ejection fraction (LVEF), as systolic dysfunction (LVEF < 50%, 1st group) and normal systolic functions (LVEF > 50%, 2nd group). The 1st group included 61 (47 males) patients and the 2nd group included 36 (35 males) patients. RESULTS: MPV was; 9.5+/-1.1 femtoliter (fL) in the 1st and 8.8+/-0.8 fL in the second group. The difference between the groups was significant (p = 0.001). There was a significant difference in the Troponin I levels and white blood cell (WBC) counts on admission between two groups (30+/-29 vs 12.2+/-15.1 ng/mL, p = 0.001 and 12.3+/-3.8 vs 10.6+/-3.4 counts ×109/L, p = 0.027, respectively). CONCLUSIONS: In anterior STEMI patients treated with percutaneous coronary intervention, increased MPV on admission is associated with impairment in left ventricular systolic function.

Circadian variation in circulating platelet aggregates.

Acute coronary events are more likely to occur in the morning and it has recently been shown that platelet aggregability increases significantly then. To determine whether circulating platelet aggregates show such a circadian variation, we measured in vivo platelet aggregation in atherosclerotic patients and healthy subjects at three-hour intervals throughout a 24-hour period. We found a significant variation in circulating platelet aggregates, the highest being at 6 a.m. and the lowest at 9 a.m. We suggest that it may be important to consider the duration of action of anti-aggregating drugs and timing their administration with respect to circadian variation in circulating platelet aggregates.