The Relationship between the Retinal Nerve Fiber Layer Thickness and the Presence of Fragmented QRS Complexes in Patients with Hypertension
Tolga Doğan, Mucahit Yetim, Macit Kalçık, Sucattin İlker Kocamış, Oya Dönmez, Lütfü Bekar
J Clin Exp Invest 2019;10(1):em00719.
https://doi.org/10.5799/jcei/5758
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Background: Fragmented QRS (fQRS) detected on electrocardiography (ECG) has been demonstrated to be a marker of myocardial fibrosis in hypertensive patients. Retinal microvascular abnormalities reflect cumulative microcirculatory damage resulting from hypertension and atherosclerosis. In this study, we aimed to evaluate the retinal nerve fiber layer (RNFL) thickness in hypertensive patients with and without fQRS complexes detected on ECG.
Methods: Consecutive patients who were diagnosed with hypertension were included in the study. ECG and transthoracic echocardiography were performed to all patients. fQRS was defined as additional R’ wave or notching/splitting of S wave in two contiguous ECG leads. The RNFL thickness was measured by a spectral-domain optical coherence tomography device along a circle around the center of the optic disc.
Results: This observational case-control study enrolled 62 (42 female, mean age: 54.3±9.9 years) hypertensive patients with fQRS and 42 (24 female, mean age: 53.1±11.8 years) hypertensive control patients without fQRS between April 2017 and October 2017. There was no significant difference between groups regarding demagraphic, laboratory and echocardiographic parameters. In all retinal quadrants, the mean RNFL thickness did not differ significantly between patients with fQRS(+) and fQRS(-) group.
Conclusion: The presence of fQRS in the ECG had no significant effect on the RNFL thickness in hypertensive patients. Detection of fQRS may not be used as a useful non-invasive technique in the evaluation of atherosclerosis in hypertensive patients.
Keywords: echocardiography, electrocardiography, fragmented QRS, retinal nerve fiber layer, optical coherence tomography
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Can End-tidal Carbon Dioxide Levels Be Used for Determining Tissue Oxygen Saturation in Smokers and Nonsmokers?
Sadiye Yolcu, Adem Kaya
J Clin Exp Invest 2019;10(1):em00720.
https://doi.org/10.5799/jcei/5759
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Objectives: End-tidal carbon dioxide (EtCO2) monitoring has been used in a range areas, such as invasive sedation procedures, during cardiopulmonary resuscitation, ventilation monitoring of patients with altered mental status, trauma and respiratory system diseases in emergency departments. Near-infrared spectroscopy (NIRS) allows continuous, noninvasive measurement of tissue hemoglobin oxygen saturation (StO2) in muscle and has been studied for a wide range of conditions.
In this study we aim to determine the levels of EtCO2 and StO2 in smokers and nonsmokers and the relationship between these two parameters.
Methods: We examined 201 healthy volunteers including 156 smokers and 45 nonsmokers. We measured thenar muscle StO2 via NIRS device. The EtCO2 was determined by a capnograph. Baseline measurements were obtained from all participants after not-smoking for two h. Second measurements were taken 5 min after smoking was finished.
Results: The mean baseline EtCO2 of the smoker group was 42.61±4,94 (min:31, max:54) mmHg and mean baseline StO2 for this group was 77.81±4.71% (min:69, max:86). In smokers, mean baseline EtCO2 (p:0.00), baseline StO2 (p:0.001), fifth min EtCO2 (p:0.00), fifth min StO2 (p:0.02) levels, and pack*year (p:0.00) were significantly different between males and females. In nonsmokers baseline EtCO2 and baseline StO2 levels were correlated (p:0.035,r:0.315). But we couldn’t find significance between females and males for mean baseline EtCO2 (p:0,246) and baseline StO2 (p:0.264) levels in this group.
Conclusion: Smoking affects tissue oxygenation. In nonsmokers baseline EtCO2 and baseline STO2 levels were correlated, but there was no correlation for these two parameters in smokers. Clinicians may use EtCO2 levels for predicting the tissue oxygenation in nonsmoker patients.
Keywords: end-tidal carbon dioxide, near-infrared spectroscopy, tissue hemoglobin oxygen saturation, smoker, nonsmoker
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Ceftriaxone Induced Unilateral Facial Angioedema
Recep Alanli
J Clin Exp Invest 2019;10(1):em00721.
https://doi.org/10.5799/jcei/5760
Case Report
[Abstract]
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[References]
ABSTRACT
We report a case receiving treatment with diclofenac sodium and ceftriaxone, who presented with facial unilateral angioedema attacks twice. Unilateral angioedema is a rare adverse reaction after NSAID usage. There is no previous report in the literature about ceftriaxone induced unilateral facial angioedema. To our knowledge this is the first reported case of unilateral facial angioedema following ceftriaxone treatment.
Keywords: Angioedema, ceftriaxone, facial edema
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Synchronous Hodgkin Lymphoma and Papillary Thyroid Carcinoma: The Importance of Positron Emission Tomography/Computed Tomography (PET/CT)
Burak Uz
J Clin Exp Invest 2019;10(1):em00722.
https://doi.org/10.5799/jcei/5761
Letter to Editor
[Abstract]
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[References]
ABSTRACT
We report a 50-year-old male with synchronous Hodgkin lymphoma (HL) and papillary thyroid carcinoma (PTC). The patient was diagnosed as having HL of the nodular sclerosis type on excisional biopsy of an enlarged right scalene node in March 2018. After further examinations including bone marrow biopsy and positron emission tomography/computed tomography (PET/CT) with 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG), he was classified as having stage IVA HL with bone marrow involvement. The patient’s medical history was unremarkable for any chronic disease or previous throid disease. He had no history of irradiation to head and neck, nor had any regular medications. Her mother had a diagnosis of breast carcinoma.
Keywords:
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