OBJECTIVEWe aimed to investigate the relation of NT-pro BNP level and left ventricular ejection fraction with premature ventricular complex burden.PATIENTS AND METHODSA total of 94 patients with PVC burden > 5% (age 45.9+12.9 years, 53 males, 41 females) were included in the study. The primary outcome was PVC burden % and main prognostic factors were LVEF% and NT-Pro BNP level. Gender, age, DM, HTN, presence of symptoms, symptom duration and heart rate were used as adjustment predictor variables. We created four different linear multivariable models to compare performance measures of prognostic factors: Model-1 has gender, age, DM, HTN, symptoms and heart rate, while LVEF has been added in addition to model-1 in model-2. Model-3 included NT-Pro-BNP alongside model-1 variables, while model-4 included both LVEF and NT-Pro-BNP variables in addition to model-1 variables. Accordingly, we compare the performance (R2, likelihood ratio X2) of models.RESULTSThe median PVC burden was 18% (IQR; 11-27). When model-1 consisting of gender, age, DM, HTN, presence of symptoms, symptomS duration and heart rate and model-2 consisting of LVEF in addition to variables of model-1 were compared, it was observed that both LRX2 and R2 values improved (likelihood ratio test p-value=0.013). Model-1 compared with model-3 which consisting of NT-pro BNP in addition to variables of model-1, and it was observed that both LRX2 and R2 values improved (likelihood ratio test p-value=0.008). However, when compared to model-1, the most significant improvement was observed in both LRX2 and R2 values in model-4 consisting of model-1 plus NT-Pro-BNP and LVEF (likelihood ratio test p-value <0.001).CONCLUSIONSWe determined that NT-pro-BNP levels and LVEF could predict PVC burden in patients. Higher levels of NT-pro-BNP and lower LVEF values were associated with increased PVC burden.

OBJECTIVEObesity is a serious public health problem associated with excessive food intake. Regulation of food intake in highly organized organisms is under the control of a large number of orexigenic and anorexigenic molecules. Therefore, the main purpose of this study has been to determine the relationship between obesity and some of the circulating orexigenic and anorexigenic peptides that have a role in appetite control and to determine whether the concentrations of these molecules differ according to blood groups.PATIENTS AND METHODSThe study included 400 individuals of whom 100 were obese women, 100 obese men, 100 healthy men and 100 healthy women. Obese women and men were divided into 4 groups, according to their blood groups. In the control group, healthy women and healthy men were similarly divided into 4 blood groups. Each blood group within the groups, therefore, had 25 participants.RESULTSWhen leptin, nesfatin-1, obestatin and neuropeptide-Y, ghrelin and galanin levels of the control group and obese participants were compared, regardless of blood groups, leptin, nesfatin-1, obestatin and neuropeptide-Y were significantly higher, whereas only the ghrelin levels were significantly lower in obese patients. When the amounts of these hormones were measured according to gender, the situation was similar. When leptin, nesfatin-1, obestatin and neuropeptide-Y values of the control and obese participants' blood groups were compared with each other; these hormones were high in all blood groups; however, leptin levels in A blood group, nesfatin-1 levels in AB and O blood group, obestatin levels in AB blood group, neuropeptide-Y levels in A, B, AB blood groups were significantly higher. When the ghrelin levels of the blood groups in the control group and obese participants were compared, it was only significantly lower in the AB blood group. The ghrelin levels in the other blood groups of the obese individuals were again low, but not significantly so. When the distribution of hormones according to gender was evaluated, a situation parallel to the above results was recorded.CONCLUSIONSLeptin, nesfatin-1, obestatin and neuropeptide-Y and galanin levels of obese individuals were significantly higher than the control values, whereas the ghrelin values were significantly lower regardless of blood groups. Also, these hormones in blood partly varied with ABO blood groups. These different concentrations of hormones in ABO blood groups might be related with stimulation or suppression of appetite in human. However, further studies in other ethnic groups are needed to confirm these results.

Electrical storm is a life-threatening medical emergency that requires immediate diagnosis and treatment. It can remain a clinical challenge despite anti-arrhythmic drugs and catheter ablation therapies. Autonomic modulation techniques have gained increased recognition in the treatment of refractory electrical storm cases. In our case, we present a patient with recurrent ventricular tachycardia/fibrillation episodes one week after a myocardial infarction. Patient's arrhythmia was refractory to antiarrhythmic drugs and hemodynamical status was unstable, thus catheter ablation under temporary mechanical circulatory support was the initial strategy. Ventricular fibrillation episodes relapsed 48 h after catheter ablation and we proceeded with autonomic modulation treatment options. Bilateral stellate ganglion blockade was performed under ultrasound guidance using bupivacaine. Sinus bradycardia was present and no ventricular arrhythmias were detected on post-procedure ECG. Stellate ganglion blockade was complemented with video-assisted thoracoscopic cardiac sympathetic denervation. After the last procedure, patient remained on sinus rhythm, was hemodynamically stable and extubated successfully.

Abstract Background Transvenous lead extraction may become a complicated process and special sheath systems used for extraction may not be available in the laboratory. Transvenous lead extraction from femoral vein by using ablation catheter and snare may be an alternative and cost-effective method to transvenous lead extraction with specialized lead extraction sheaths. The aim of the present study is to evaluate the factors that may be associated with the use of transfemoral technique during extraction of chronically implanted leads. Methods We retrospectively analyzed consecutive patients who underwent transvenous extraction of pacemaker, cardiac resynchronization therapy (CRT) and intracardiac defibrillator (ICD) leads in our institution in between 01.01.2016 and 01.01.2019. The indications for lead extraction were based on the European Heart Rhythm Association recommendations. Manual traction was applied to all leads at the beginning of each case. If manual traction was not successful, a subclavian approach by using locking stylet (Liberator Universal Locking Stylet, Cook Medical) or femoral approach was used. Femoral approach was performed using the flexible 13F long sheath and a second sheath for ablation catheter. Ablation catheter was wrapped around the lead and the tip of the ablation catheter was caught with gooseneck snare. Downward traction was applied on the body of the lead by using ablation catheter and gooseneck snare complex to release either end of the lead. Results A total of 160 leads in 94 patients were extracted during the time interval between 01.01.2016 and 01.01.2019. The indications for extraction were cardiac device related pocket erosion and infection in 71 (75.6%) and lead failure in the 23 (24.4%) cases. Extracted system was ICD in 48 (51.1%), CRT in 9 (9.6%) and pacemaker in 37 (39.3%) cases. The median time from the preceding procedure was 62.5 (IQR:32.3- 95.3) months. Lead extraction was performed by manual traction in 35 (37.2%) patients, by locking stylet method in 7 (7.4%) and by femoral approach in 52 (55.3%) patients. Clinical success was achieved in 93 (98.9%) cases and all of the patients discharged uneventfully without a major complication as death, cardiac avulsion or tear requiring pericardiocentesis or emergent surgery. Procedural success with femoral approach was achieved in 51/52 (98%) patients (99 leads). Ordinal regression revealed the time from the preceding procedure as the only parameter that was significantly associated with the usage of femoral approach (OR:1.065 ( 95% CI 1.039-1.100) p < 0.001). Conclusion Based on our experience, transfemoral approach by using ablation catheter and gooseneck snare seems to be an effective and safe method for chronically implanted lead extraction. It may be particularly be useful when manual traction is unsuccessful and special toolkids are not available for extraction.

In this study, we present the spatial and temporal evolution of EEG signal spectrum under anaesthesia. Studied features include SEF-90, α-β power ratios, spectral entropy that are known to be used in commercially available depth of anaesthesia monitors. As an additional and comparing feature, we also present Higuchi fractal dimension that is used for analysis of non-linear systems. By means of spatial analysis, we verified the shift of occipitally dominant alpha activity to frontal regions and demonstrated corresponding topographic plots.

1. Malondialdehyde (MDA) levels of erythrocyte membranes of sickle-cell disease patients were measured as an indicator of peroxidative damage and allopurinol was used as a lipid peroxide scavenger. 2. Incubating sickle-cell erythrocytes with allopurinol significantly reduced MDA levels of erythrocyte membranes compared with before-treatment values. 3. Allopurinol seems to reduce the peroxidative damage in sickle-cell erythrocytes, but the mechanism is still unknown.

The purpose of this prospective study was to investigate the levels of Lp(a), Apo(a), VLDL, LDL and HDL in 23 patients with pregnancy induced hypertension (PIH) and in 20 control. The Mann-Whitney U tests was used for comparisons between the two groups. Serum Lp(a) and Apo(a) levels were significantly raise in the PIH group (p<0.05 and p<0.05 respectively) and no significant correlations could be demonstrated for other lipoproteins.