Coronary intervention for acute coronary syndrome in a 51-year-old man with immune thrombocytopenic purpura: a case report

INTRODUCTION: Treatment of the rare cases of patients with chronic idiopathic thrombocytopenic purpura with acute coronary syndrome can be a significant problem. The patient in our case report was treated successfully with percutaneous coronary intervention. CASE PRESENTATION: A 51-year-old man of Turkish origin who had idiopathic thrombocytopenic purpura was admitted to our hospital with severe chest pain. His electrocardiography was normal on admission but dynamic ischemic changes were observed during follow-up. He underwent immediate coronary angiography. In his angiography, left anterior descending artery stenosis was 90% together with the diagonal ostium. Percutaneous coronary intervention was performed successfully. Bleeding complications were not observed after the procedure. CONCLUSIONS: We report the presence of a rare case of chronic idiopathic thrombocytopenic purpura in a patient with acute coronary syndrome. In this situation a serious multidisciplinary approach is required before coronary intervention

The Effect of Social Support and Workplace Breastfeeding Conditions of Mothers Working in an Education Research Hospital on Breastfeeding Period

Objective: Breast milk is considered to be natural, reference nutrition for infants. The American Academy of Pediatrics and World Health Organization recommend that infants should be exclusively breastfed for about 6 months and breasteeding should be continued at least for 12 months as long as both the mother and the infant desire. It is known that mothers who started to work during breastfeeding period have difficulty in continuing breastfeeding due to inconvenient workplace conditions and breastfeeding breaks. Social support, known to have a role in coping with stress, has also been shown to be effective in maintaining breastfeeding. The aim of our study is to evaluate the problems faced by the mothers working in a training and research hospital related to the workplace environment and conditions and their social support. Method: The study group consisted of mothers who had children under three years of age and working in a training and research hospital. Eighteen questions prepared by the researchers, and questions in the Multidimensional Scale of Perceived Social Support were addressed to the mothers participating in the study about their breastfeeding period, return time to their work, breast-feeding permission, and milking, etc. Results: Fifty-one working mothers were reached during the study period. It was seen that 29 (56.9%) working mothers used formula during breastfeeding period. When mothers exclusively breastfed their infants, and those used formula during breastfeeding period were compared, it was seen that the mothers who used formula returned earlier to work (p = 0.036). Conclusion: Study results supported that the period of maternity leave should be longer to avoid using formulas more frequently, and to support exclusive breastfeeding for the first 6 months. It was concluded that employers should provide more suitable conditions for breastfeeding mothers to support breastfeeding

Epicardial adipose tissue and pericoronary fat thickness measured with 64-multidetector computed tomography: potential predictors of the severity of coronary artery disease

OBJECTIVE: The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease. METHODS: The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowin

Is it everthing start atrial fibrosis or inflammation? Reply

[Abstract Not Available

Red Cell Distribution Width and Coronary Artery Calcification Reply

[Abstract Not Available

Recurrent Acute Coronary Syndromes With Normal Homocystein Level: A Mutation of MTHFR Gene

A 29-year-old female patient, complaining of squeezing retrosternal chest pain, was admitted to our emergency department. Her angina pectoris had started fifteen days ago and accentuated during the last two days. In her medical history, it was determined that during the last four years she had been admitted to hospitals with the same complaint twice, troponins were found to be elevated, she was hospitalized and coronary angiography (CAG) was totally normal. The young woman with recurrent acute coronary syndrome had a mutation in the MTHFR gene. On the determination of normal coronary arteries, we have demonstrated the localization of myocardial infarction via magnetic resonance imaging. In our case we have found no other risk factors except MTHFR 1298 gene mutation for coronary artery disease. MTHFR 1298 gene mutation may cause this state of hypercoagulopathy

Use of Different Iron Preparations for Prophylaxis and Effects on Iron Status in Infancy

Aim: To evaluate using different iron preparations for iron deficiency and/or iron deficiency anemia prophylaxis in infants and their iron status. Methods: In this study, we retrospectively evaluated the electronic patient records of 651 healthy children aged 9 to 13 months who met the inclusion criteria and who were followed up in pediatric follow-up outpatient clinics between January 2023 and June 2023. Results: A total of 651 children with a mean age of 11.2 +/- 1.4 months, 54.7% of whom were boys, who met the inclusion criteria were included in the study; 56.5% of the children were using Fe + 3 salt and the others were using Fe + 2 salt, microencapsulated iron, or sucrosomial iron drops. After the fifth month of prophylaxis, when the effects of the iron preparations used on the mean laboratory values were evaluated, it was found that hemoglobin, serum iron, and ferritin levels were lower in sucrosomial iron and microencapsulated iron users compared to other preparations (p = 0.001). When statistically pairwise comparisons were made between the groups, hemoglobin and serum iron values were found to be lower in the group using sucrosomial iron compared to the groups using Fe + 2 and Fe + 3 salts (p < 0.0001). Hemoglobin and ferritin levels were higher in the group using Fe + 2 salt compared to both sucrosomial iron and microencapsulated iron groups (p < 0.0001). When the infants were evaluated according to iron status, it was found that 208 (31.9%) had iron deficiency. Iron deficiency was found to be less in infants of families who defined their economic status as rich and in infants who used iron regularly (p-values 0.044 and 0.001, respectively). Iron deficiency/iron deficiency anemia was observed at a higher rate in the group using sucrosomial iron and microencapsulated iron prophylaxis (p = 0.001). Conclusions: To prevent iron deficiency, it is very important to use appropriate iron preparations for prophylaxis and to feed foods with high iron content. Although we found that families were willing to use different iron preparations other than iron salts for their infants, the results presented herein indicate that the rate of iron deficiency was lower in patients using iron salts. However, randomized controlled studies are needed to determine whether these preparations are effective in iron prophylaxis in infants

A fatal complication after repair of post-infarction ventricular septal rupture: heparin-induced thrombocytopenia with thrombosis: case report

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