ST-Segment Elevation Myocardial Infarction in a Young Woman: Undiagnosed Turner Syndrome.

We report a case of a 34-year-old woman who presented with an ST-segment elevation myocardial infarction with acute heart failure and a subsequent diagnosis of mosaic Turner syndrome (TS). The report also discusses cardiovascular disease in patients with TS and the current recommendations for screening and follow-up in these patients. (Level of Difficulty: Beginner.).

Consumption of energy beverage is associated with attenuation of arterial endothelial flow-mediated dilatation.

AIM: To investigate whether consumption of an energy drink will acutely impair endothelial function in young healthy adults. METHODS: Energy drinks are being consumed more and more worldwide, and have been associated with some deaths in adolescents and young adults, especially when consumed while exercising. After fasting and not smoking for at least 8 h prior, eleven medical students (9 males) received an electrocardiogram, blood pressure and pulse check, and underwent baseline testing (BL) of endothelial function using the technique of endothelium-dependent flow mediated dilatation (FMD) with high-resolution ultrasound (according to recommended guidelines of the University of Wisconsin Atherosclerosis Imaging Research Program Core Laboratory). The subjects then drank an energy beverage (EB), a 24-oz can of Monster Energy, and the above was repeated at 90 min after consumption. The relative FMD (%) was calculated as the ratio between the average post-cuff release and the baseline diameter. Each image was checked for quality control, and each artery diameter was measured from the media to media points by two experts, 3 measurements at the QRS complex, repeated on 3 separate beats, and then all were averaged. RESULTS: Subjects characteristics averages (given with standard deviations) include: Age 24.5 ± 1.5 years, sex 9 male and 2 female, weight 71.0 ± 9.1 kg, height 176.4 ± 6.0 cm, BMI 22.8 ± 2.7 kg/m2. The hemodynamics were as follows, BL vs EB group respectively (mean ± SD): Heart rate 65.2 ± 11.3 vs 68.2 ± 11.8 beats per minute, systolic blood pressure 114.0 ± 10.4 mmHg vs 114.1 ± 10.4 mmHg, diastolic blood pressure 68.8 ± 9.3 mmHg vs 70.6 ± 7.1 mmHg; all were not significantly different. However after drinking the EB, a significantly attenuated peak FMD response was measured (mean ± SD): BL group 5.9% ± 4.6% vs EB group 1.9% ± 2.1%; P = 0.03). Given the increased consumption of energy beverages associated with exercise in young adults, more research is needed. CONCLUSION: Energy beverage consumption has a negative impact on arterial endothelial function in young healthy adults.

Silicone Membranes to Inhibit Water Uptake into Thermoset Polyurethane Shape-Memory Polymer Conductive Composites.

Electroactive shape memory polymer (SMP) composites capable of shape actuation via resistive heating are of interest for various biomedical applications. However, water uptake into SMPs will produce a depression of the glass transition temperature (Tg ) resulting in shape recovery in vivo. While water actuated shape recovery may be useful, it is foreseen to be undesirable during early periods of surgical placement into the body. Silicone membranes have been previously reported to prevent release of conductive filler from an electroactive polymer composite in vivo. In this study, a silicone membrane was used to inhibit water uptake into a thermoset SMP composite containing conductive filler. Thermoset polyurethane (PU) SMPs were loaded with either 5 wt% carbon black (CB) or 5 wt% carbon nanotubes (CNT) and subsequently coated with either an Al2O3- or silica-filled silicone membrane. It was observed that the silicone membranes, particularly the silica-filled membrane, reduced the rate of water absorption (37 °C) and subsequent Tg depression versus uncoated composites. In turn, this led to a reduction in the rate of recovery of the permanent shape when exposed to water at 37 °C.

Controlling the Actuation Rate of Low-Density Shape-Memory Polymer Foams in Water.

SMPs have been shown to actuate below their dry glass transition temperatures in the presence of moisture due to plasticization. This behavior has been proposed as a self-actuating mechanism of SMPs in water/physiological media. However, control over the SMP actuation rate, a critical factor for in vivo transcatheter device delivery applications, has not been previously reported. Here, a series of polyurethane SMPs with systematically varied hydrophobicity is described that permits control of the time for their complete shape recovery in water from under 2 min to more than 24 h. This control over the SMP actuation rate can potentially provide significant improvement in their delivery under conditions, which may expose them to high-moisture environments prior to actuation.