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Objectives: Inflammation and coagulation perform a substantial act in the pathophysiology of COVID-19 cases. The systemic immune-inflammation index (SII) is a novel prognosis and inflamation index. In this study, we aimed to research the relation between SII and prognosis in COVID-19 patients. Methods: 315 cases (males, 136 ; females, 179 ; 63.2 ± 11.4 years) with positive PCR and lung tomography evidences compatible with COVID-19 pneumonia were recorded in the research. Patients were separated into 2 groups according to the mortality (Group 1; Surviving patients, Group 2; Ex patients). Clinical, demographic, and laboratory datas for whole patients were registered Laboratory datas were measured from blood parameters taken during hospitalization. The SII was calculated as “ SII = neutrophil count × platelet count / lymphocyte count ”. Results: The mean hospital stay of the patients is 12 (5-26) days. When the patients were assessment of according to clinical features, an important distinction was found between the two groups according to age, gender, cardiovascular disease, chronic renal failure, neurolvascular disease, and diabetes mellitus. When the patients were evaluated according to laboratory parameters, white blood cells, neutrophils, creatinine, D-Dimer, ferritin, CRP values were observed to be significantly higher in Group 2 patients than Group-1 patients. However, lymphocyte count, serum potassium level, albumin and calcium levels were observed to be significantly lower in Group-2 patients than in Group-1 patients. SII level was significantly higher in Group 2 patients than Group-1 patients (1813.4 ±118.7 vs 978.2 ± 93.1, p

Hydroxychloroquine (HCQ) treatment is frequently prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitorization is recommended because HCQ causes QT interval prolongation. The index of cardioelectrophysiological balance (iCEB), calculated as the ratio of QT interval / QRS duration. In recent years, iCEB has been described as an important marker for dysrhthmias. Decreased or increased iCEB is related with lethal ventricular arrhythmias. In our research, we purposed to investigate the relationship between iCEB and HCQ in patients with COVID-19. 200 patients (males, 84; females, 116; 60.4 ± 13.8 years) with PCR positive and chest tomography findings compatible with COVID-19 pneumonia were registered in the research. Demographic, clinical, and laboratory data for all patients were collected. ECG was recorded from all patients on admission to COVID-19 clinic, in oral treatment with HCQ (200 mg, twice daily) for at least 5 days. iCEB (QT/QRS) was calculated from the 12-lead electrocardiogram.The mean age of the patients was 60.4 ± 13.8 years. Compared to admission ECG, ECG on day 5 showed significant increases in heart rate, QT interval, corrected QT (QTc) interval, and iCEB. Our results suggested that iCEB is related with HCQ treatment in patients with COVID-19. Previous studies stated that high iCEB is related with torsade de Pointes (TdP), ventricular tachycardia.

SUMMARY OBJECTIVE: Myocardial speckle-tracking echocardiography can detect subtle abnormalities in the left atrial function. In this study, we aimed to investigate the relationship between left atrial myocardium and tissue function n assessed by two-dimensional speckle-tracking echocardiography and the National Institutes of Health Stroke Scale score in patients with acute ischemic stroke. METHOD: The study was composed of 80 patients (45 men, 35 women, mean age: 67±15 years) with acute ischemic stroke. The patients were divided into two groups based on the calculated National Institutes of Health Stroke Scale score (group 1, National Institutes of Health Stroke Scale score < 16; group 2, National Institutes of Health Stroke Scale score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac functions were evaluated using two-dimensional speckle-tracking echocardiography within 48 hours from admission to the neurology care unit. RESULTS: There were no significant differences between the patients’ clinical parameters. Left ventricular ejection fraction was significantly higher in group 1 than in group 2 (59.2±5.6 to 51.4±6.3, p=0.024). Left atrial longitudinal strain was significantly higher in group 1 than in group 2 (34.48±9.73 to 26.27±7.41, p=0.019). There were no significant differences between other echocardiographic parameters. CONCLUSION: Our results suggest that left atrial longitudinal strain is associated with stroke severity during admission in patients with acute ischemic stroke. Left atrial longitudinal strain is an indicator of left atrial myocardial function.

Objectives: Stroke is a multifactorial disease. Oxidative stress and blood pressure were found to be closely related with cardiovascular and cerebrovascular diseases. Paraoxonase-1 (PON1) has been considered as an anti-atherosclerosis factor. Increased pulse pressure (PP) may lead to an increased risk of cardiovascular and cerebrovascular morbidity and mortality. Nevertheless, there are limitations for PP as an evaluation index. In order to overcome the defects of PP, there is a novel parameter, “pulse pressure/systolic pressure” called “pulse pressure index (PPI)” for evaluation of cardiovascular outcomes. We investigated the association between Paraoxonase-1 (PON1) activities and pulse pressure index (PPI) in acute ischemic stroke patients. Methods: We evaluated and compared the PON-1 activity and PPI in 46 ischemic stroke patients and 32 control patients. PON1 activitity was measured with UV spectrophotometric method by using “Rel Assay Diagnostic” kits. Pulse pressure was calculated by subtraction of diastolic blood pressure from systolic blood pressure. PPI was calculated “pulse pressure / systolic pressure”. Results: Hypertension, age, diabetes mellitus, dyslipidemia signficantly higher in ischemic stroke patients than control group (p

Objective: to evaluate long-term effects of COVID-19, and to determine the risk factors in long-COVID in a cohort of the Turkish Thoracic Society (TTS)-TURCOVID multicenter registry.Methods: thirteen centers participated with 831 patients; 504 patients were enrolled after exclusions. The study was designed in three-steps: (1) Phone questionnaire; (2) retrospective evaluation of the medical records; (3) face-to-face visit. Results: in the first step, 93.5% of the patients were hospitalized; 61.7% had a history of pneumonia at the time of diagnosis. A total of 27.1% reported clinical symptoms at the end of the first year. Dyspnea (17.00%), fatigue (6.30%), and weakness (5.00%) were the most prevalent long-term symptoms. The incidence of long-term symptoms was increased by 2.91 fold (95% CI 1.04-8.13, P=0.041) in the presence of chronic obstructive pulmonary disease and by 1.84 fold (95% CI 1.10-3.10, P=0.021) in the presence of pneumonia at initial diagnosis, 3.92 fold (95% Cl 2.29-6.72, P=0.001) of dyspnea and 1.69 fold (95% Cl 1.02-2.80, P=0.040) fatigue persists in the early-post-treatment period and 2.88 fold (95% Cl 1.52- 5.46, P=0.001) in the presence of emergency service admission in the post COVID period. In step 2, retrospective analysis of 231 patients revealed that 1.4% of the chest X-rays had not significantly improved at the end of the first year, while computed tomography (CT) scan detected fibrosis in 3.4%. In step 3, 138 (27.4%) patients admitted to face-to-face visit at the end of first year; at least one symptom persisted in 49.27% patients. The most common symptoms were dyspnea (27.60%), psychiatric symptoms (18.10%), and fatigue (17.40%). Thorax CT revealed fibrosis in 2.4% patients. Conclusions: COVID-19 symptoms can last for extended lengths of time, and severity of the disease as well as the presence of comorbidities might contribute to increased risk. Long-term clinical issues should be regularly evaluated after COVID-19., NA

Objective: The present study was an investigation of the relationship between fragmented QRS (fQRS) and left ventricular apical thrombus (LVAT) in patients presenting with first acute anterior myocardial infarction (MI). Methods: Consecutive 148 patients (mean age: 60.1+-10.1 years; male: 75.6%) with first acute anterior MI who underwent primary percutaneous coronary intervention (PCI) were included. Study population was divided into 2 groups based on presence of LVAT. fQRS was defined as presence of various RSR' patterns, which included additional R wave or notching of R wave or S wave, and presence of more than 1 R in 2 contiguous leads corresponding to major coronary artery territory on 12-lead electrocardiogram. Patients with bundle branch block were excluded from the study. Results: Of these, 32 (21.6%) had LVAT. Patients with LVAT had higher prevalence of fQRS (53.1% vs. 22.4%; p0.05 for all). Presence of fQRS was independent predictor of LVAT (odds ratio [OR], 2.795; 95% confidence interval [CI], 1.058–7.396) in multivariable logistic regression analysis. Conclusion: Presence of fQRS in leads V4-V6 is independently associated with LVAT in patients presenting with first acute anterior MI.

Objective: Acute stroke is an important cause of morbidity and mortality. Myocardial injury is an important complication of acute cerebrovascular events. In this study, we aimed to investigate the relationship between myocardial function assessed by myocardial performance index (MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Method: The study comprised 97 patients (males, 42; females, 55; 65 ± 16 years) diagnosed with acute ischemic stroke. 17 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit. Results: There were no significant differences among demographic parameters of patients. MPI was significantly higher in Group 2 patients than in Group 1 patients (0.59±0.25 vs 0.48±0.20, p=0.004). Conclusion: Our results suggest that MPI is associated with stroke severity on admission in patients with acute ischemic stroke. MPI is an indicator of global myocardial dysfunction with a different from LVEF. MPI, which includes both systolic and diastolic time intervals is an option to assess the global cardiac dysfunction. Amaç: Akut inme morbidite ve mortalitenin önemli nedenlerinden biridir. Miyokardiyal hasarlanma, akut serebrovasküler olayların önemli bir komplikasyonudur. Yapmış olduğumuz bu çalışmanın amacı, akut iskemik inmeli hastalarda Ulusal Sağlık İnme Enstitüleri Ölçeği (NIHSS) ve miyokard performans indeksi (MPİ) ile değerlendirilen miyokard fonksiyonları arasındaki ilişkiyi araştırmaktır. Yöntemler: Çalışmaya akut iskemik inme tanılı 97 hasta (erkek,42; kadın,55; yaş, 65 ± 16) alındı. 17 hasta çalışmadan çıkarıldı. NIHSS skoruna göre hastalar iki gruba ayrıldı (Grup 1, NIHSS skor

Background: Dietary saturated fat and cholesterol are the cause of atherosclerosis and cardiovascular disease. Objectives: This study aimed to assess diet quality after diagnosis of Coronary Heart Disease (CHD). Patients and Methods: This descriptive study was performed on 242 patients with diagnosis of acute coronary syndrome admitted to a coronary care unit in a cardiology clinic between December 2005 and December 2006. The study questionnaire, including questions about personal information such as age, sex, and education level, was completed by face-to-face interview. Additionally, Diet Quality Index (DQI) was used to assess the subjects’ nutritonal status. Then, one-way ANOVA and chi-square tests were used where appropriated to compare the study groups. Besides, linear regression models were used to assess the associations between DQI score and the patients’ sociodemographic characteristics and lifestyle factors. P value ≤ 0.05 was considered to be statistically significant. Results: The patients’ ages ranged from 26 to 85 years and 68.5% of the patients were male. Considering DQI scoring, 22.7%, 75.2%, and 2.1% of the patients got “inadequate/low”, “average”, and “acceptable/high” DQI, respectively. In addition, 28% of the patients consumed 40% of calories from total fat, while 55% consumed 30 - 40% of calories from total fat. Also, nearly 30% of the patients consumed greater than 13% of calories from saturated fat, while 64% consumed 10 - 13% of calories from saturated fat. Conclusions: In this study, most of the CHD patients got low DQI scores. In general, CHD can be prevented. However, if precautions regarding lifestyle modification are not followed, CHD is expected to progress.

The aim of this study is to investigate the impact of ticagrelor as compared to clopidogrel based dual antiplatelet therapy (DAPT) during post-discharge management on the incidence of left ventricular (LV) thrombus in patients with first acute anterior ST elevation myocardial infarction (STEMI).641 patients who met the inclusion criteria were divided into two groups based on the receipt of either ticagrelor or clopidogrel based DAPT.Left ventricular thrombus was detected in 73 (11.4%) patients at the first month echocardiographic examination. Ticagrelor based DAPT was associated with significantly less incidence of LV thrombus when compared to clopidogrel [20 (7.4%) vs 53 (14.0%) OR: 0.50 (0.29-0.86)]. Penalized maximum likelihood estimation (PMLE) logistic regression analyses were performed to fourteen candidate variables for identifying the independent predictors of LV thrombus, ticagrelor (compared with clopidogrel) [OR: 0.53 (0.28-0.96), p = 0.039], body mass index (BMI) [OR: 0.58 (0.44-0.77), p 0.001], KILLIP class (I vs II-IV) [OR: 0.35 (0.14-0.83), p = 0.017], age [OR: 1.22 (1.08-1.40), p 0.001], poor postprocedural myocardial blush grade (MBG) [OR: 3.35 (1.32-8.15), p = 0.012] and LVEF predischarge [OR: 0.79 (0.72-0.86), p 0.001] were found to be associated with LV thrombus.Our study demonstrated that the incidence of LV trombus was significantly lower with ticagrelor than clopidogrel-based DAPT during postdischarge treatment for anterior STEMI patients.

OZET Amac: Bu calismanin amaci, koroner anjiyografi (KAG) laboratuvarina sevk edilen hastalarda koroner arter hastaligi (KAH) varliginin anksiyete ve depresyon gibi psikolojik bozukliuklar ile iliskisini degerlendirmektir. Yontem ve Gerec: Koroner anjiografi yapilan 163 hasta ardisik olarak calismaya dahil edildi. Tum hastalarin sosyodemografik ozellikleri, kardiyovaskuler risk faktorleri, klinik ozellikleri ve mevcut kullandigi ilaclari kaydedildi. Koroner anjiyografi sonrasi anksiyete ve depresyon seviyeleri, Hastane Anksiyete ve Depresyon Olcegine (HADO) gore incelendi. KAH ciddiyetini siniflamak icin KAG sonuclarina gore hastalar asagidaki gibi siniflandirildi: perkutan koroner girisim (PKG); koroner by-pass greftleme (CABG); non-kritik koroner lezyonlar; normal koroner arterler. Sosyodemografik ozellikler, klinik ozellikler, koroner arter ciddiyeti HAD olcumleriyle uygun bicimde karsilastirildi. Bulgular: Calismaya 62 kadin hasta (%38) dahil edildi. 62 hastaya PKG uygulaniken 30 hasta CABG’ye gonderildi. 55 hastad non-kritik KAH varken 12 hastada normal koroner arterler (yavas akim dahil) mevcuttu. Sosyodemografik faktorler arasinda sadece kadin hastalar, dusuk gelirli hastalar veya uyku sorunu olan hastalar sirasiyla erkek hastalara, yuksek geliri olan hastalara veya uyku sorunu olmayanlara kiyasla daha yuksek HAD degerlerine sahipti. Sosyodemografik ozellikler, kardiyovaskuler risk faktorleri, klinik ozellikler ve KAG sonuclarini iceren cok degiskenli regresyon analizinde, anksiyete icin sadece uykusuzluk varligi (s=0,243; p

Neurocysticercosis is a major parasitic disease of the central nervous system, affecting endemic areas worldwide. It spreads through intermediary hosts, pigs and eventually men to his definitive host: humans. It causes lesions in the CNS which have different evolutive stages and can be asymptomatic or clinically evident. Imaging studies play an important role in the diagnosis of the disease and in its appropriate control.

Congenitally corrected transposition of the great arteries (CCTGA) is a rare disease in which there is both ventriculoarterial and atrioventricular discordance. The systemic ventricle is of right morphology and patients are at high risk of developing systemic ventricular dysfunction. We report on a 41 year old male patient with primary PCI and congenitally corrected transposition of the great arteries.

Purpose: We aimed to establish an inflammatory prognostic index (IPI) in early and advanced non-small cell lung cancer (NSCLC) patients based on hematologic and biochemical parameters and to analyze its predictive value for NSCLC survival. Materials and Methods: A retrospective review of 685 patients with early and advanced NSCLC diagnosed between 2009 and 2014 was conducted with collection of clinical, and laboratory data. The IPI was calculated as C-reactive protein × NLR (neutrophil/lymphocyte ratio)/serum albumin. Univariate and multivariate analyses were performed to assess the prognostic value of relevant factors. Results: The optimal cut-off value of IPI for overall survival (OS) stratification was determined to be 15. Totals of 334 (48.8%) and 351 (51.2%) patients were assigned to high and low IPI groups, respectively. Compared with low IPI, high IPI was associated with older age, greater tumor size, high lymph node involvement, distant metastases, advanced stage and poor performance status. Median OS was worse in the high IPI group (low vs high, 8.0 vs 34.0 months; HR, 3.5; p

Background Anxiety disorders are common in children and adolescents, and they can significantly impair quality of life. Genetic, neurobiological, neurochemical, and psychological factors are believed to play a role in the etiopathogenesis of anxiety disorders. Recent evidence suggests that the pathophysiology of anxiety disorders may be associated with oxidative stress. In this study, we investigated whether there are associations between children with anxiety disorders and total oxidant/antioxidant status. Methods The experimental group consisted of 40 patients (children and adolescents) with anxiety disorders. An age- and gender-matched control group composed of 35 healthy subjects was also assessed. Venous blood samples were collected and total antioxidative status (TAS), total oxidative status (TOS), and the oxidative stress index (OSI) were determined. Results Both the TOS and the OSI of the experimental group were significantly higher than those of the control group. There were no significant differences in TAS between the experimental and control groups. Limitations The main limitation of our study was the small sample size. Conclusions This study suggests that oxidative balance is impaired in children with anxiety disorders. Oxidative stress may play a role in the etiopathogenesis of anxiety disorders, and TOS may be a useful diagnostic tool in this context.

We aimed to investigate the Health Related Quality of Life and related clinical variables (HRQoL) of children with Autism Spectrum Disorders (ASD). We included 102 children with ASD (46 with autism, 38 with pervasive developmental disorder not otherwise specified (PDD-NOS) and 18 with Asperger's syndrome (AS)) and 39 typically developing children as a control (TDC), between 3 and 18 years of age. The mothers scored the Pediatric Quality of Life Inventory 4.0 (PedsQLTM 4.0). The physical health, psychosocial health and total summary score of ASD group were significantly lower than TDC. Within ASD group, psychosocial ( p p p

A 43-year-old male patient was admitted to coronary intensive care unit with the diagnosis of acute inferolateral myocardial infarction and with a picture of cardiogenic shock. In physical examination, systolic blood pressure was 50 mmHg and diastolic blood pressure could not be taken. The patient was diagnosed with cardiogenic shock and was started on saline, dopamine and dobutamine infusion. His blood pressure did not increase although the dosage of positive inotropic agents was increased. A cardiac tamponade revealed with urgent echocardiographic evaluation and pericardiocentesis was carried out. Blood pressure returned to normal range within hours after pericardiosentesis. Echocardiographic examination performed on the second day of AMI on the asymptomatic patient revealed thrombosed myocardial rupture. The patient was referred to emergency surgery with the diagnosis of three-vessel disease and myocardial rupture according to urgent angiography. In the operation, the ruptured region in the ventricle free wall was primarily repaired. By-pass surgery was performed with saphenous vein graft to the LAD and CV-OM1 coronary arteries. Key words: Free wall rupture, acute myocardial infarction, treatment.

Background The genetic influence on the myocardial performance index is uncertain, so the aim of the present study was to determine the effects of polymorphism of the angiotensin-converting enzyme (ACE) gene on the right ventricular myocardial performance index (RVMPI) after a first acute anterior myocardial infarction (MI). Methods and Results The subjects were 116 patients with a first acute anterior MI. Based on the polymorphism of the ACE gene, they were classified into 3 groups: deletion/deletion (DD) genotype (group 1, n=45), insertion/deletion (ID) genotype (group 2, n=58), insertion/insertion (II) genotype (group 3, n=13). Echocardiograms were used to determine the RVMPI, left ventricular myocardial performance index (LVMPI), tricuspid E/A, tricuspid deceleration time and the left ventricular diameter diastolic and diameter systolic (LVDd and LVDs). RVMPI and LVMPI were significantly higher in the ACE DD group. Tricuspid E/A, DT, LVDd and LVDs showed no differences among the 3 groups. Conclusion The ID polymorphism of the ACE gene may affect RVMPI and LVMPI after a first acute anterior MI. (Circ J 2005; 69: 211 - 215)

Although the damage in myocardial infarction has been demonstrated to be related with the magnitude and number of ST elevation, its relation with terminal distortion of QRS is unclear. The relationship between terminal QRS distortion in ECGs on admission and the results of early low dose dobutamine stress echocardiography (LDSE) performed 6 +/- 2 days later was investigated. Patients admitted to our clinic within the first six hours of their chest pain and without a prior infarction diagnosis were divided into two groups based on the admission electrocardiogram as the absence (QRS-, n = 33) or presence (QRS+, n = 29) of distortion of the terminal portion of the QRS in > or = 2 leads (QRS+; J point at > 50% of the R wave amplitude in lateral leads or presence of ST elevation without S wave in leads V1-V3). There were no significant differences between the groups with respect to thrombolytic therapy or reperfusion criteria. During LDSE, the infarct zone wall motion score index (WMSI) in the QRS- group was significantly decreased relative to baseline (from 2.93 +/- 0.65 to 2.37 +/- 0.84, P = 0.02), and it was significantly different compared with WMSI in the QRS+ group (P = 0.005). Improvement of akinetic regions to hypokinetic regions in the infarct zone (IZ) was found to be 33.5% (44/131) in the QRS- group and 17.8% (27/151 P = 0.004) in the QRS+ group. Furthermore, 55.1% (10/29) of the patients in the QRS+ group and only 18.1% (6/33) of those in the QRS- group did not respond to LDSE (P < 0.05). In multiple logistic regression analysis, while there was no relationship between good left ventricular functions (WMSI < 2) and terminal QRS distortion under basal conditions (P = 0.07), an independent relation was observed to exist between them after LDSE (P = 0.03, OR 4.48, 95% CI, 1.13-17.7). Moreover, plasma CK levels were higher in the QRS+ group (P = 0.03), whereas the ejection fraction was worse (P = 0.01). In both groups, there was no correlation between the Selvester score and left ventricle WMSI at baseline, but this correlation was significantly improved with LDSE (QRS-; r = 0.39 P = 0.02 and QRS+; r = 0.44 P = 0.01) The viability in the IZ is relatively less in those patients with terminal QRS distortion observed in their ECG on admission. This simple classification would be useful in predicting left ventricular function at the time of discharge.

Atherosclerosis is a diffuse process that involves vessel structures. In recent years, the relation of noninvasive parameters such as intima-media thickening (IMT), arterial distensibility (AD), and stiffness index (SI) to cardiovascular diseases has been researched. However, we have not found any study that has included all these parameters. The aim of this study is to examine the relation between the presence of coronary artery disease (CAD) and its risk factors to AD, SI, and IMT, which are the noninvasive predictors of atherosclerotic process in the carotid artery. Included in the study were 180 patients who were diagnosed as having CAD by coronary angiography (those with at least ≥ 30% stenosis in the coronary arteries) and, as a control group, 53 persons who had normal appearing coronary angiographies. IMT, AD, and SI values of all the patients in the study were measured by echo-Doppler imaging (AD formula = 2 × (AoS-AoD)/PP × AoD, SI formula = (SBP/DBP)/([AoS - AoD]/AoD). Significantly increased IMT (0.82 ±0.1, 0.57 ±0.1, p < 0.05), decreased AD (0.25 ±0.9, 0.37 ±0.1, p < 0.05), and increased SI (13 ±4, 8 ±3, p < 0.05) values were detected in the CAD group compared to the control group. A significant correlation was found between IMT and presence of diabetes mellitus (DM), systolic blood pressure, total cholesterol, and presence of plaque in carotids, and age. In the coronary artery disease group there was a significant correlation between AD and age, systolic blood pressure, and HDL cholesterol levels, while there was no significant correlation with plaque development. A significant correlation was also found between stiffness index and systolic blood pressure and age; however, there was no relation between number of involved vessels and IMT, AD, and SI. We found sensitivity, specificity, and positive predictive and negative predictive values for CAD diagnosis to be 70%, 75%, 77%, and 66%, respectively. In CAD cases, according to data in this study, IMT and SI increased while AD decreased, and this was detected by carotid artery Doppler ultrasonography. Therefore, it was concluded that these cheaper, noninvasive, and easily available parameters could be used in early diagnosis of CAD.

WOS: 000331022700022, PubMed: 24361544, Attention deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurobehavioral disorder of childhood. The etiopathogeny of ADHD has not been totally defined. Recent reports have suggested a pathophysiological role of neurotrophins in ADHD. In this study, we evaluated serum levels of nerve growth factor (NGF) in patients with ADHD. The sample population consisted of 44 child or adolescent patients diagnosed with ADHD according to DSM-IV criteria; 36 healthy subjects were included in the study as controls. Venous blood samples were collected, and NGF levels were measured. The mean serum NGF levels of the ADHD patients were significantly higher than those of the controls. Age and gender of the patients were not correlated with serum NGF levels. There were no significant differences in NGF levels among the combined and predominantly inattentive subtypes of ADHD. Our study suggests that there are higher levels of serum NGF in drug naive ADHD patients, and that increased levels of NGF might have an important role in the pathophysiology of ADHD.

The isolated noncompacted ventricular myocardium (NCVM), characterized by excessively prominent trabecular meshwork and deep intertrabecular recesses, is seen in the early period of embryogenesis. Clinical manifestations of NCVM are symptoms associated with depressed left ventricular systolic function, with ventricular arrhythmias, and with systemic embolization. Characteristics on echocardiography have been defined as absent coexisting cardiac abnormalities, non-compacted trabecular endocardium with deep endomyocardial spaces, predominant localisation of the trabeculation to mid-lateral, apical and mid-inferior segments, and a colour Doppler evidence of deep perfused intertrabecular recesses. We describe a case of isolated noncompaction of the left and right ventricular myocardium in a 17-year-old man who presented initially with palpitation and syncope.

BACKGROUND The development of left ventricular remodeling after acute myocardial infarction is a predictor of heart failure and mortality. The genetic influence on cardiac remodeling in the early period after acute myocardial infarction, is however, unclear. The aim ofthis study was to investigate the relationship between angiotensin-converting enzyme (ACE) gene polymorphism and left ventricular remodeling in the early period in patients with anterior myocardial infarction. METHOD The study population consisted of 142 patients with their first attack of acute anterior myocardial infarction. Echocardiographic examinations were performed within 24 h of the first attack (first evaluation) and on the fifth day of acute myocardial infarction (second evaluation). Left ventricular end systolic and diastolic diameters, left ventricular end systolic and diastolic volumes, ejection fraction, mitral flow velocities (E, A, E/A), deceleration time, isovolumic relaxation time and myocardial performance index were calculated. ACE I/D polymorphism was determined using polymerase chain reaction amplification. RESULTS On the basis of polymorphism of the ACE gene, the patients were classified into the three groups: group 1, deletion/deletion (n=59) genotype, group 2 insertion/deletion (n=69), and group 3 insertion/insertion (n=14) genotype. When the first and second sets of echocardiographic results of the groups were compared, all parameters were not different among three groups. In group analysis, Left ventricular systolic diameters, left ventricular diastolic diameters, left ventricular end diastolic diameters, left ventricular ejection fraction and myocardial performance index between first and second echocardiographic results were significantly different in deletion/deletion group and only myocardial performance index and left ventricular ejection fraction in insertion/deletion group (P

The authors investigated the relationship between the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and the blood flow characteristics of common carotid (CCA) and brachial arteries (BA) by color Doppler ultrasound (CDUS) in patients with acute anterior myocardial infarction (AAMI). Sixty four patients (11 women and 53 men), aged 25 to 77 years, with AAMI were studied. The ACE genotypes were established. Peak-systolic (PSV) and end-diastolic velocity (EDV) of right and left CCA, PSV of right BA, and intimal-medial thickness (IMT) of both CCAs were measured by CDUS. All results were evaluated statistically. The ACE genotypes were distributed as follows: 43.8% DD, 43.8% ID, and 12.5% II. PSVs of BA and both CCAs were lower in patients with DD and ID than with II (p0.05). IMTs of both CCAs did not differ among patients with various ACE genotypes (p>0.05). These results suggest that ACE I/D polymorphism influences Doppler blood flow parameters of both BA and CCA, but does not affect IMT of CCA.