Can amniotic fluid protect developing fetal lungs against the harmful effects of oxidative stress?

BACKGROUND: Preterm births cause fetuses to be born without completing the development of their organs. Due to this undesirable situation, it is the pulmonary tissue which has to be most exposed to harmful effects of extrauterine environment. Early disappearance of the prophylactic and constructive effects of amniotic fluid (AF) on developing tissues, such as pulmonary tissue, facilitates the formation of pulmonary morbidities resulting from oxygen. Setting out from this knowledge, we wanted, in addition to assessing the beneficent effects of AF on pulmonary tissue, to study the importance of AF in morbidities of this tissue thought to originate from oxygen. METHODS: In this experimental study, while the study group was made up of the fetuses of pregnant rats exposed to hyperbaric oxygen, (hyperoxic pregnant rat fetuses-HPRF), the control group was formed of the fetuses of the rats pregnant in the usual room setting (normoxic pregnant rat fetuses-NPRF). The pulmonary and hepatic tissues taken from the fetuses of these pregnant rats on the 21st day of their pregnancy were compared biochemically and histologically. For biochemical assessment, total glutathione (tGSH), catalase (CAT), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α) values and for histopathological assessment, apoptosis, alveolar wall count (AWC), vena centralis count (VCC) were included. RESULTS: Statistical significance was found in the pulmonary tissue values of tGSH on behalf of NPRF, and MDA on behalf of HPRF (p < 0.05). In liver tissue, statistical significance was detected in tGSH and CAT values in favor of NPRF and in MDA, and TNF-α values in favor of HPRF (p < 0.05). DISCUSSION: : Our study has demonstrated that AF protects the pulmonary tissue from the harmful effects of oxygen in the intrauterine period. In addition, our data have suggested that the pulmonary tissue's being deprived of the useful effects of AF owing to premature birth may be an important trigger in the occurrence of the pulmonary morbidities thought to result from oxygen.

First experiences with a new balloon-expandable Myval transcatheter aortic valve: a preliminary study.

BACKGROUND: In the present article, we present our first experiences with a new type of balloon-expandable Myval valve (Meril Life Sciences, Gujarat, India). MATERIALS AND METHODS: A total of 25 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) from June 2020 to November 2020 were included in the study. RESULTS: The mean age of the study population was 83 (75-87) years; 17 (68%) were female, and 20 (80%) had hypertension. The Society of Thoracic Surgeons (STS) score of the group was 5.4% ± 3.5%. TAVI was performed via the transfemoral route on all patients. In 19 (76%) cases, we started the procedure without predilation. In two (10.5%) cases performed without predilation, the prosthesis did not pass the native valve. We had to implant the valve from the descending aorta in one (4%) patient. We used Prostar XL (Abbott Vascular, Santa Clara, CA, USA) for six (24%) patients and ProGlide (Abbott Vascular) for 19 (76%) patients for vascular closure. Two (8%) in-hospital deaths occurred in our study but there were no deaths in the 30-day and 90-day follow-up. Vascular complications were observed in one (4%) patient. None of the patients in our study had severe paravalvular leak (PVL), while two (8%) patients had moderate PVL. A permanent pacemaker (PPM) was required in two (8%) patients for the indication of complete atrioventricular block. The mean hospital stay for the whole group was 4 (3-7) days. CONCLUSION: Based on our experiences, the new balloon-expandable valve Myval is easy to use, efficient, and has only a few negligible drawbacks such as the need for predilation of the sheath. While shaft flexibility may have advantages in some situations including in very tortuous arteries, it may cause some difficulties in alignment of the valves.

Which Inotropic Drug, Dobutamine or Milrinone, Is Clinically More Effective in the Treatment of Postligation Cardiac Syndrome in Preterm Infants?

OBJECTIVE: This study aimed to detect which of the two main medicines suggested in the treatment of postligation cardiac syndrome (PLCS)-dobutamine or mirinone-possesses a more therapeutic effect. While doing this, clinicians are provided with a broader perspective on the treatment and follow-up of cases. The desire was to increase the treatability and monitor ability of the cases in question and hence their survivability. STUDY DESIGN: A retrospective review of a cohort of infants with PLCS was conducted between March 2012 and December 2018. In the treatment of infants with PLCS, dobutamine (dobutamine study group-DSG) or milrinone (milrinone study group-MSG) was used. The respiration, cardiac, echocardiography, and perfusion parameters of the cases were assessed both before and after ligation. Based on the data obtained, both the effects of the medicines on PLCS and the difference between their therapeutic effects were studied. The accuracy of prognostication was assessed with receiver operating characteristic analyses. RESULTS: PLCS was detected in 29 (34.1%) of 85 patent ductus arteriosus ligation cases in total. Of all the PLCS cases, 13 (44.8%) were treated with dobutamine and 16 (55.2%) with milrinone. It was observed that the effects of the medicines on the respiratory system and cardiovascular system manifested in the third and 6th hour, respectively. It was detected that both medicines had more effect on the systolic blood pressure (SBP) (area under the curve [AUC]: 0.997/0.996, p = 0.001/0.002) than on the diastolic blood pressure (AUC: 0.911/0.843, p = 0.032/0.046). CONCLUSION: Dobutamine and milrinone, two primary medicines that can be used in the treatment of cases with PLCS, possess similar therapeutic effects on this pathology. In addition, their postoperative therapeutic effects on the SBP are more in the foreground.

Relation of p - wave dispersion with presystolic a - wave and aortic valve sclerosis in asymptomatic subjects.

BACKGROUND: P-wave duration and P-wave dispersion (PWD) are thought to be the surrogate marker of devoloping atrial fibrillation (AF). The main purpose of present study was to investigate the association between presystolic wave (PSW), aortic valve sclerosis, and PWD. PATIENTS AND METHODS: Patients with sinus rhythm admitted to the cardiology outpatient clinic were consecutively enrolled. Maximum (Pmax) and minimum (Pmin) P-wave duration and PWD were measured. Echocardiography was used to assess the aortic valve morphology and presence of PSW. The patients were divided into two groups according to presence or absence of AVSc and PSW. RESULTS: A total of 100 patients were enrolled consecutively. Patients with both PSW and AVSc had higher PWD values compared with those without PSW (42 ± 15 vs 65 ± 20) and AVSc (52 ± 21 vs 69 ± 19). The patients were categorized on the basis of median PWD values. According to univariate analysis, there was significant association between PWD and presence of PSW (P: .004), presence of AVS (P: .011), hypertension (P: .01) interventricular septal thickness (IVST) (P: .026), and posterior wall thickness (PWT) (P: .022). Multivariate logistic regression analyses demonstrated presence of PSW (95% confidence interval (1.058-6.505, P: .037) as an independent determinant of PWD. CONCLUSION: Assessment of presystolic A-wave on echocardiography examination may provide important information regarding the atrial conduction velocities that is a electrophysiological cause of AF. While there was a significant association between AVSc and PWD in univariate analysis, this significance disappeared in multivariate analysis.

The value of syntax score to predict new-onset atrial fibrillation in patients with acute coronary syndrome.

BACKGROUND AND AIM: New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACS). Also, Syntax score (SS) is a scoring system that is derived from angiographic images and is associated with long-term mortality and major adverse cardiac events. In this study, we aimed to assess the relationship between SS and NOAF with known predictors of atrial fibrillation. METHODS: In a prospective, single-center, cross-sectional study, 692 patients who were diagnosed with coronary artery disease for the first time were enrolled consecutively. NOAF was defined as atrial fibrillation, which was documented after hospital admission. SS was calculated by a computer software. Multivariable logistic regression analyzes were used to detect the relationship between variables and NOAF. RESULTS: New-onset atrial fibrillation was detected in 82 patients (11.8%). Patients with NOAF had higher SS (22, interquartile range 18.3-25.1, vs. 12, interquartile range 7-19.5, p < 0.001). According to multivariable logistic regression analysis for NOAF, SS were independently and significantly associated (OR, 1.103; 95% confidence interval, 1.047-1.163; p < 0.001). Other independent predictors of NOAF were TIMI flow <3, C reactive protein, left ventricular ejection fraction, left atrial volume index and E/E' ratio. The optimal cut-off value for SS was 18 for the development of NOAF with 82% sensitivity and 68% specificity (area under the curve: 0.795, 95% confidence interval 0.749-0.841, p < 0.001). CONCLUSION: Syntax score may be helpful to identify for patients who would develop atrial fibrillation in the setting of ACS.

Presystolic wave is associated with carotid intima media thickness.

INTRODUCTION: Carotid intima media thickness (CIMT), a direct marker of atherosclerosis, has emerged as a promising means for cardiovascular risk evaluation. Presystolic wave (PSW) is commonly detected by the Doppler interrogation of the left ventricular outflow tract (LVOT). It is thought to be a result of a stiff left ventricle and impaired LV compliance. Herein, we aimed to investigate a possible association between carotid intima media thickness, an atherosclerotic marker, and PSW. METHOD: We prospectively enrolled 282 patients divided into two groups based on the presence of PSW: 221 (89F; mean age: 49.3 ± 11.5 years) had PSW on Doppler examination while 61 patients (32F; mean age: 46.4 ± 10.3 years) did not. Both groups were compared with respect to demographic, clinical properties, and CIMT. RESULTS: Both groups had comparable age, body mass index, and diabetes mellitus, hypertension, dyslipidemia, smoking, and family history for coronary heart disease. PSW-positive group had significantly higher CIMT (PSW-positive: 0.59 ± 0.22 mm vs PSW-negative: 0.42 ± 0.11 mm; P < 0.001) than PSW-negative group. Multivariate analysis showed that the independent predictors of increased CIMT were age (95% CI; 1.044-1.101, P < 0.001), dyslipidemia (95% CI; 0.147-0.664, P = 0.002), and the presence of PSW (95% CI; 2.168-7.836, P < 0.001).Correlation analysis showed that PSW velocity is correlated with increased CIMT in PSW-positive group (r: 0.418, P < 0.001). CONCLUSION: Assessment of PSW on TTE is easy and feasible method. Presence of PSW and increased PSW velocity on TTE might provide information that we should be careful in terms of subclinical atherosclerosis.

Can Platelet Mass Index Be a Parameter to Predict Intraventricular Hemorrhage in Very-Low-Birth-Weight Newborns?

OBJECTIVE: Intraventricular hemorrhage (IVH) is an important problem in neonatal units not only in terms of its consequences but also its follow-up and the prediction of its emergence in newborns. In this study, we have compared platelet parameters such as platelet count (PC), mean platelet volume (MPV), and platelet mass index (PMI) in terms of IHV in very-low-birth-weight (VLBW) newborns. Thus, we have tried to determine platelet values to guide clinicians in both the prediction and follow-up of IVH. STUDY DESIGN: This is a retrospective, multicenter, and case-controlled study. In this study, 386 cases of VLBW newborns (below 1,500 g) and gestational age below 32 weeks, hospitalized and monitored between August 8, 2012, and April 7, 2018, were included. The platelet values of the cases on their 12th hour postpartum (PC1, MPV1, and PMI1) and the platelet values on days 5 to 7 (PC2, MPV2, and PMI2) were recorded in their study cards. A p-value of <0.05 was accepted as statistically significant. RESULTS: While there was no difference of PC1, MPV1, PMI1, PC2, or MPV2 values (p > 0.05), PMI2 values in the severe stage IVH group cases were found to be significantly lower compared with other platelet parameters (p < 0.05). CONCLUSION: PMI2 values can provide clinicians with important knowledge that may aid them in recognizing important pathologies such as IVH.

Obestatin Reduces Intestinal Damage in Experimental Necrotizing Enterocolitis in Newborn Rats.

OBJECTIVE: To investigate the effect of pretreatment with obestatin (OB), an endogenous hormone also found in mother's milk, in experimental necrotizing enterocolitis (NEC). STUDY DESIGN: Pups were randomized into four groups: control, OB-control, NEC, and OB-NEC. NEC was induced by asphyxia and hypothermia in the NEC and OB-NEC groups. OB was administered to the OB-control and OB-NEC groups. Macroscopic scoring of the intestinal tract was evaluated and tissue samples were obtained for histopathological and biochemical examination on the fourth day. RESULTS: OB improved the macroscopic appearance of the gut and the clinical score during the experiment (p < 0.05). The rate of occurrence of NEC in the OB-NEC group was lower than the NEC group (p = 0.001). OB prevented necrosis and reduced the number of apoptotic cells in the OB-NEC group compared with the NEC group (p = 0.006). Furthermore, interleukin-6 and malondialdehyde levels in the OB-NEC group were lower than the NEC group (p < 0.05). CONCLUSION: OB reduced intestinal damage and prevented necrosis through anti-inflammatory and antiapoptotic effects in experimental NEC. This effect of OB should be confirmed in clinical studies. Furthermore, future research should investigate whether OB plays a role in NEC pathogenesis or NEC is associated with OB levels in the serum and in breast milk.

A potential serious complication in infants with congenital obstructive uropathy: Secondary pseudohypoaldosteronism.

Patients who have secondary pseudohypoaldosteronism (PHA) in addition to hyponatraemia, hyperpotassaemia and high serum aldosterone levels for the age were included in this retrospective study.Among eight patients, seven patients were diagnosed with PHA secondary to obstructive uropathy (OUP), whereas one patient had PHA secondary to ileostomy. Six patients with OUP had simultaneous urinary tract infection (UTI) and in all except one patient, secondary PHA recovered with only UTI treatment before applying surgical correction. All the patients were younger than 3 months age. In three patients with PUV diagnosis, salt wasting recurred in an UTI episode under 3 months of age.

The efficacy of propranolol in very preterm infants at the risk of retinopathy of prematurity: Which newborn and when?

PURPOSE: Retinopathy of prematurity (ROP), a proliferative vitreoretinopathy resulting from the vascular disorder of the retina, is the most frequent cause of blindness in childhood. In our time, ROP in advanced stage, a serious problem in premature infants, has no other treatment more effective and with fewer side effects than laser photocoagulation (LPC) treatment, which narrows visual field. The search for methods with fewer side effects than LPC has increased in recent times for the treatment of ROP. We aimed to investigate the effects in question of propranolol on ROP in various stages (stages 1, 2, and 3 ROP). METHODS: This study is designed as a randomized, placebo-controlled, single-centered, double-blind clinical trial with parallel groups. A total of 126 very preterm infants, followed up in our unit from April 2011 to January 2013, were randomly selected and included in our study. They were separated into the groups of 0, 1, and 2 depending on their stage of ROP. In addition, all the patients were divided into control group (CG) and propranolol treatment group (PTG). While the cases in the CG were administered physiological saline solution, the cases in the PTG were administered propranolol (2 mg/kg/day) in the neovascularization phase (second phase) of the ROP. RESULTS: Propranolol given to the group of stage 0-1 ROP was observed to have had no effect on the level of statistical significance between the CG and PTG in terms of increase in ROP stages (p > 0.05). However, propranolol was found to be more useful in patients with stage 2 ROP (p < 0.05). CONCLUSION: When given in the neovascularization phase of the ROP, propranolol was found to be effective in the stage 2 (advanced stage) ROP patients but in stage 0-1 (early-stage) ROP patients, its efficacy was not sufficient.

Effects of Lycopene in Hyperoxia-Induced Lung Injury in Newborn Rats.

The aim of this study was to evaluate the therapeutic effect of lycopene on a hyperoxia-induced lung injury model in rat pups. Full-term rat pups were included in the study 12-24 h after delivery. The pups were separated into 4 groups: normoxia control (NC), hyperoxia control (HC), hyperoxia + lycopene (HL), and normoxia lycopene (NL). The normoxia groups were housed in ambient air, and the hyperoxia groups in > 85% O2. HL and NL groups received 50 mg lycopene in oil/kg body weight/day delivered intraperitoneally (i.p.), the other groups received oil alone. On day 11, the rat pups were sacrificed and their lungs removed. Statistically significant injury was observed in all histological parameters measured (MLI, proliferating cell nuclear antigen (PCNA), and apoptosis) in the HC group (HC vs NC, p = 0.001). This injury could not be reversed with lycopene treatment (HC vs HL, 0.05; NC vs HL, p = 0.001). With hyperoxia, statistically significant decreases were observed in biochemical parameters in terms of SOD, MDA, and IL-6 values (HC vs NC: SOD, p = 0.02; MDA, p = 0.043; IL-6, p = 0.001). The use of lycopene did not provide any improvement in these values (HC vs HL, p > 0.05). Hyperoxia or lycopene had no effect on IL-1ß and GPx (p > 0.05). When comparing NC and NL groups, negative effects were observed in the group given lycopene in terms of MLI, PCNA, apoptosis, and IL-6 (all parameters, p = 0.001). We observed that 50 mg lycopene in oil/kg body weight/day given via i.p. had no curative effect on the hyperoxia-induced lung injury in newborn rats and may even induce adverse effects.

Evaluation of symmetrical increased echogenicity of bilateral caudothalamic grooves detected on cranial ultrasonography by comparing with susceptibility-weighted imaging.

OBJECTIVE: To assess symmetrical increased echogenicity of bilateral caudothalamic grooves (SIEBCG) detected on newborn cranial ultrasonography (CUS) using magnetic resonance susceptibility-weighted imaging (SWI). MATERIALS AND METHODS: A total of 14 newborns (8 girls; 12 premature with mean gestational age of 30 weeks and 5 days, 2 mature) who were detected to have SIEBCG on routine serial CUS and underwent cranial magnetic resonance imaging (MRI) were recruited for the study. The cranial MRI examinations including SWI acquired on the same day of SIEBCG detection and serial CUS to assess the progress of SIEBCG lesions in the following 6 month period were retrospectively evaluated and compared for the presence of germinal matrix hemorrhage. RESULTS: On SWI, solely one patient (7, 1%) had signal alteration on caudothalamic groove compatible with grade 1 germinal matrix hemorrhage. Two patients (14, 2%) had parenchymal (on cerebellar and parietal white matter) millimetric hemorrhagic foci. Seven patients (50%) had signs of presumptive hypoxic insult including hyperintense dots on centrum semiovale and periventricular white matter in five, and increased signal intensity on the globus pallidi in two, on T1-weighted images. Four patients (28, 6%) had normal findings. Of these, 10 patients became normal on follow-up CUS at postterm-equivalent age, whereas four were missing. CONCLUSION: Symmetrical increased echogenicity of bilateral caudothalamic grooves seen on newborn CUS may be the indicator of other pathologies as ischemic insult or focal parenchymal hemorrhage. In the presence of SIEBCG, further examination with SWI should be performed.

Xanthelasma Is Associated with an Increased Amount of Epicardial Adipose Tissue.

OBJECTIVE: In the present study, we aimed to compare the amount of epicardial adipose tissue in subjects with and without xanthelasma. SUBJECTS AND METHODS: Fifty-two subjects with xanthelasma and 52 age- and gender-matched control subjects were enrolled in this study. Epicardial adipose tissue was assessed by measuring epicardial fat thickness (EFT) with echocardiography. Participants were dichotomized according to median EFT, which was 4 mm. The group with EFT >4 mm was defined as the supramedian group. Body mass index (BMI) was calculated by weight (kilograms) divided by height (meters) squared. Conditional logistic regression analysis was performed to find independent factors associated with supramedian EFT (>4 mm). RESULTS: Subjects with xanthelasma had higher BMI (31.2 ± 5.6 vs. 28.6 ± 5.7, p = 0.01) and higher levels of total cholesterol (216 ± 54 vs. 181 ± 42 mg/dl, p < 0.001), LDL cholesterol (142 ± 45 vs. 115 ± 36 mg/dl, p = 0.003) and triglycerides (median, 154 vs. 101 mg/dl, p = 0.01) than control subjects. EFT was significantly higher in subjects with xanthelasma than in controls (5.04 ± 2.02 vs. 3.81 ± 2.03 mm, p = 0.002). In the conditional logistic regression analysis, the presence of xanthelasma (OR, 3.55; 95% CI, 1.43-8.78, p = 0.006) and lower HDL cholesterol level (OR, 0.96; 95% CI, 0.92-0.99, p = 0.023) were independently associated with supramedian EFT. CONCLUSION: The amount of epicardial adipose tissue found in subjects with xanthelasma was higher than in subjects without xanthelasma. In addition, the presence of xanthelasma was independently associated with supramedian EFT.

Transcatheter aortic valve implantation in a patient with myelofibrosis and severe thrombocytopenia.

Transcatheter aortic valve implantation (TAVI) has been commonly used to treat patients with aortic stenosis who have a contraindication to, or a high risk of, corrective surgery. Anti-thrombotic treatment is an important part of the TAVI procedure to avoid thrombotic complications during both peri- and post-procedural periods. However, no specific data are available regarding the safety of TAVI with or without anti-thrombotic treatment, either during the surgical procedure or follow up period in patients with thrombocytopenia, such as myelofibrosis. Here, the case is reported of a patient with myelofibrosis and severe thrombocytopenia who underwent a TAVI procedure without anti-thrombotic treatment such as heparin, acetyl salicylic acid, or clopidogrel.

Relationship between Nitrate-Induced Headache and Coronary Artery Lesion Complexity.

OBJECTIVE: The aim of the present study was to investigate the association between nitrate-induced headache (NIH) and the complexity of coronary artery lesions in patients with stable coronary artery disease (CAD). SUBJECTS AND METHODS: Two hundred and seventy-five patients with anginal chest pain who underwent coronary angiography were enrolled in the present study. NIH was defined as the presence of headache due to nitrate treatment (isosorbide mononitrate 40 mg) after excluding confounding factors. Coronary artery lesion complexity was assessed by the SYNTAX score (SXscore) using a dedicated computer software system. RESULTS: The mean SXscore was lower in the patients with NIH than in patients without NIH (7.3 ± 5.2 vs. 14.4 ± 8.5, respectively; p < 0.001). Additionally, patients with NIH had a lower rate of multivessel disease compared with those without NIH (the mean number of diseased vessels was 1.5 ± 0.7 and 2.0 ± 07, respectively; p < 0.001). In multivariate analysis, increasing age (p = 0.02) and headache (p = 0.001) were found to be independent determinants of SXscore. CONCLUSION: The present study demonstrated an independent inverse association between NIH and SXscore. The NIH could provide important predictive information about coronary artery lesion complexity in patients with stable CAD.

Giant right atrial thrombus in premature newborn.

Pediatric guidelines for treatment options of right atrial thrombosis in newborn are quite limited. Herein we present a case with giant atrial thrombosis resulting from umbilical venous catheter and intend to discuss the therapy in the area of current literature on right atrial thrombus in newborn and children.

Fetal intracranial hemorrhage related to maternal autoimmune thrombocytopenic purpura.

BACKGROUND: Maternal autoimmune thrombocytopenic purpura (AITP) can cause fetal intracranial hemorrhage. CASE REPORT: A 19-year-old primigravida was referred to our institution for prenatally detected ventriculomegaly at 30th week of gestation. Her personal and family histories were unremarkable. Her platelet count was 54 × 109/L. Fetal neurosonography showed intraparenchymal hemorrhage. AITP was diagnosed in the mother and platelet count decreased at 34 × 109/L. Patient was treated with methylprednisolone and intravenous immunoglobulin. She delivered a 2,340-g infant at 37 weeks with elective cesarean section. The platelet count of the newborn was 181 × 109/L and coagulation tests were normal. No antiplatelet specific antibodies were detected in cord blood. Postnatal MRI evaluation confirmed grade IV intracranial hemorrhage. The newborn baby has suffered from mild spasticity and seizures. CONCLUSIONS: Clinicians must be vigilant about the catastrophic fetal complications of maternal AITP; a close follow-up with a multidisciplinary cooperation between obstetricians, hematologists, and neonatologists must be warranted.

Effect of iodine loading on the thyroid hormone level of newborns living in Kayseri province.

INTRODUCTION: Excessive iodine exposure during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the level of iodine loading among newborns living in Kayseri province. A total of 59 newborns, who were admitted due to disorders in thyroid hormone levels, were included in the study. Materials and METHODS: Among the patients who applied with thyroid hormone dysfunction, newborns with a spot urine iodine level ≥ 20 µg/dL were included in the study between the years 2003 and 2013. Free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), thyroglobulin (Tg), breast milk iodine, thyroid ultrasonography, and control measurements of fT3, fT4, TSH, and Tg levels were obtained accordingly from both groups of patients who received or did not receive treatment. RESULTS: The average age of the patients was 15 days with a 36/23 girl to boy ratio. Statistically, no significant difference was noticed between all the girls and boys with respect to all the measured values. The etiologic search showed that out of 59 cases, in 18 cases (30.5%) only the mother and in 19 cases only the newborns (32.2%) had a history of povidone iodine exposure; in 8 cases both mothers and their babies had exposure to povidone iodine (13.6%). In 14 cases (23.7%), the source of iodine loading could not be determined. Levothyroxine (L-thyroxine) treatment was initiated in 56% of the patients (n = 33). Out of 33 patients who were under treatment with L-thyroxine, in 13 cases only the mother had history of povidone iodine exposure; in 12 cases, only the baby had a history of povidone iodine exposure; in 1 case, both mother and her baby had a history of povidone iodine exposure, but the etiology could not be found in 7 cases. CONCLUSION: The use of antiseptics-containing iodine for mothers before and after birth and for newborns, especially for umbilical cleansing, can lead to iodine loading and hypothyroidism. If transient hypothyroidism develops within this period, then it may not be detected promptly. This can later lead to retardation in psychomotor development and disorder in learning skills during the childhood period.

Mean platelet volume at admission is a determinant of left ventricular thrombus formation after primary percutaneous coronary intervention for first anterior wall myocardial infarction.

OBJECTIVE: Left ventricular thrombus (LVT) is one of the important complications of acute anterior wall myocardial infarction (MI). Mean platelet volume (MPV) is one of the platelet indices reflecting platelet reactivity. In this present study we investigated the effect of MPV on LVT formation after primary percutaneous coronary intervention (PPCI) for first anterior wall MI. METHODS AND RESULTS: A total of 205 acute anterior wall MI patients were included into this prospective observational study. Patients were divided into two groups according to the presence of LVT. The thrombus (-) group consisted of 161 patients and the thrombus (+) group of 44 patients. Complete blood count (CBC) parameters were measured at admission. Routine biochemical tests and echocardiographic examinations were performed. Groups are compared according to different parameters. With respect to CBC parameters: MPV (9.03 ± 0.76 vs 8.06 ± 0.83) was significantly higher in the thrombus (+) group, platelet count (184.09 ± 52.21 vs 219.88 ± 52.31) was significantly higher in the thrombus (-) group, WBC count (14.01 ± 4.43 vs 11.30 ± 3.53) was also significantly higher in the thrombus (+) group. Furthermore, peak troponin-T level (32.63 ± 20.18 vs 18.70 ± 23.82), CK-MB level at admission (133.49 ± 117.40 vs 71.79 ± 93.96), peak CK-MB level (245.47 ± 89.67 vs 167.37 ± 110.61) were significantly higher in the thrombus (+) group. Logistic regression analysis revealed that MPV was an independent risk factor of LVT formation. CONCLUSION: In acute anterior wall MI patients MPV is associated with the presence of LVT and is an independent risk factor of LVT formation.