A Broken Heart After Witnessing a Dying Heart: A Case of Takotsubo Cardiomyopathy.

Takotsubo cardiomyopathy is a form of non-ischemic cardiomyopathy characterized by transient systolic dysfunction. The prevalence of Takotsubo cardiomyopathy has been estimated to be about 2% overall but about 10% amongst women presenting with clinical manifestations of acute coronary syndrome. The overall mechanism of the disease still remains unclear. However, treatment of Takotsubo cardiomyopathy appears to be similar to congestive heart failure (CHF) medical management. This case highlights the classic presentation exhibited very similar to acute coronary syndrome and diagnostic criteria for Takotsubo (stress-induced) cardiomyopathy.

Cytotoxicity and hemostatic activity of chitosan/carrageenan composite wound healing dressing for traumatic hemorrhage.

Hemorrhage remains a big threat to trauma patients, especially in combat fields. Therefore, we formulated a biocompatible and biopolymer based chitosan/carrageenan composite dressing. This dressing was fabricated using freeze-drying that will serve as a promising material to promote hemostasis and tissue growth required during hemorrhage. The efficacy of dressing was evaluated for its physiochemical analysis, surface morphology, and biodegradability. Further, human dermal fibroblast cells were seeded on dressing and demonstrated non-toxic effects on the cells by showing enhanced cell attachment and proliferation. In vitro hemostatic properties of the dressing were analyzed by human Thrombin-Antithrombin assay. The dressing formed showed steady blood coagulation implying red blood cells and platelet adhesion that helped in thrombin formation, which is responsible for enhancing wound healing. Thus, it is concluded that the composite dressing can be a potent combination to accelerate hemostatic activity against hemorrhage and promote tissue growth for effective wound healing.

A Fistula Where? Left Anterior Descending to Pulmonary Artery Fistula.

Fistulas are abnormal passageways between two organs or vessels that usually do not connect. Coronary artery fistulas occur when one of the coronary arteries is connected to either a heart chamber or another blood vessel. This case presents a coronary artery fistula which may or may not be impacting the patient's heart function. A 69-year-old male with multiple comorbidities presents with a chief complaint of shortness of breath. Catheterization reveals an anomalous left anterior descending to pulmonary artery fistula without a step up in oxygen saturation at the level of the pulmonary artery. Surgical management was deferred as this fistula was not deemed to contribute to the patient's declining cardiac function. Operative management versus embolization would be a feasible alternative for patients who are symptomatic secondary to the coronary artery fistula and remains to be controversial in patients who are asymptomatic. Given the possibility of these fistulae eventually causing symptoms it would be practical to close them early on before symptoms arise or before size of the fistulae becomes an issue. Further research should be conducted to understand the management strategies for patients who present with coronary artery fistulas.

Hemostasis and anti-necrotic activity of wound-healing dressing containing chitosan nanoparticles.

Necrotic tissues are the dead tissues present in the wounded areas, which need to be removed for rapid wound healing. Various biopolymer-based dressings have been exploited to heal infected wounds, but with limited success. In a quest to develop an effective and economic wound dressing, a biodegradable dressing containing chitosan nanoparticles has been successfully developed. Chitosan nanoparticles were prepared by ionic gelation method and then assembled into the porous chitosan dressing, by lyophilization. The resulting dressing was analyzed for morphology, porosity, pore volume, surface area and biodegradability. Higher surface area and porosity of the dressing facilitated its partial biodegradation by enzymatic action. In vitro cellular investigations with Human Dermal Fibroblasts (HDF) confirmed the safety of the dressing for wound healing applications. Human Thrombin-Antithrombin (TAT) based in vitro ELISA assay, for evaluating the hemostasis activity, illustrated an accelerated hemostasis activity, through higher thrombin generation and stable blood clot formation. The blood in contact with the dressing contained two-fold higher levels of TAT, as compared to that in contact with the TAT standard. Our results suggest the potential of the developed dressing for removing the necrotic tissues and accelerating the hemostasis activity, for efficient and rapid wound healing.