We investigated the efficacy and safety of hydroxychloroquine for empirical treatment of outpatients with confirmed COVID-19. Methods: In this prospective, single-center study, we enrolled ambulatory outpatients with COVID-19 confirmed by a molecular method who received hydroxychloroquine. The patients were divided into low-and moderaterisk groups based on the Tisdale risk score for drug-associated QT prolongation, and the QT interval was corrected for heart rate using the Bazett formula (QTc). The QTc interval was measured by electrocardiography both pretreatment (QTc1) and 4 h after the administration of hydroxychloroquine (QTc2). The difference between the QTc1 and QTc2 intervals was defined as the ΔQTc. The QTc1 and QTc2 intervals and ΔQTc values were compared between the two risk groups. Results: The median and interquartile range (IQR) age of the patients was 47.0 (36.2-62) years, and there were 78 men and 74 women. The median (IQR) QTc1 interval lengthened from 425.0 (407.2-425.0) to 430.0 (QTc2; 412.0-443.0) milliseconds (ms). However, this was not considered an increased risk of ventricular tachycardia associated with a prolonged QTc interval requiring drug discontinuation, because none of the patients had a ΔQTc of >60 ms or a QTc2 of >500 ms. Moreover, the median (quartiles; minimum-maximum) ΔQTc value was higher in patients in the moderate-risk group than those in the low-risk group (

We report spontaneous corneal perforation in a patient with lamellar ichthyosis. The patient presented with complaints of pain, redness, diminished vision, and discharge in her right eye for 15 days. Visual acuities were light perception in the right and 20/400 in the left eye. Cicatricial ectropion in both lower eyelids and 2 mm perforation site in the center of the right cornea were observed. Lamellar ichthyosis was suspected because of scaling and excessive dryness of entire body skin and was confirmed by skin biopsy. Amniotic membrane transplantation and transient tarsorraphy was performed and systemic anti-ichthyosis therapy was started. The follow-up visits were not possible because of patient inconsistency. In patients with cicatricial ectropion secondary to ichthyosis, corneal health should be closely monitored because of the perforation risk.

A 32-year-old man was urgently referred to our hospital with severe tricuspid insufficiency following a car accident. The completely flail anterior leaflet, due to the rupture of the papillary muscles, was revealed by a two-dimensional transthoracic echocardiography. In the operation, we also detected a tear on the anterior leaflet and the rupture of numerous chordae tendineae of the other leaflets. Valve repair was not considered feasible, therefore the tricuspid valve was replaced with a 31 mm mechanical prosthesis. The patient's recovery from surgery was uneventful, and he was discharged on the seventh postoperative day.Keywords: cardiac injury, tricuspid valve, tricuspid insufficiency Introduction Unfortunately, with the increase in the number of vehicles, traffic accidents have become a serious health problem. Cardiac injuries following chest trauma vary from simple myocardial contusions to severe damage to the intracardiac structures. Traumatic tricuspid valve insufficiency is a rare clinical entity. 1� We present a patient who developed tricuspid insufficiency following blunt chest trauma. Case ReportA traffic accident in August 2011 left a 48-yearold man with thoracic and abdominal trauma, due to his chest hitting the steering wheel. Unfortunately, he was not wearing a seat belt. He was admitted to the state hospital. There, he underwent an urgent splenectomy because of massive bleeding due to splenic rupture. Also, a chest tube was inserted to treat a left-side hemopneumothorax. On the fifteenth day following the accident, he was discharged from the hospital. A few weeks later, he was referred to our hospital with complaints of palpitation, dyspnea on effort, and fatigue. A physical examination revealed hepatomegaly, distention of the juguler veins, peripheral edema and a 3-4/6 systolic murmur on the left lateral sternal border. The cardiac silhouette was enlarged with a chest X-ray. A two-dimensional transthoracic echocardiography showed dilatation of the right atrium (approximately 6.5 cm), and severe tricuspid regurgitation due to papillary muscle rupture (Fig. 1). Coronary angiography revealed normal coronary arteries. On the basis of these findings, the patient was taken to surgery.A cardiopulmonary bypass was performed using aortic and bicaval cannulation. Moderate systemic hypothermia, topical cooling and antegrade cold blood cardioplegia were used for myocardial protection. After the midsternotomy and pericardiotomy, a large amount of haemorrhagic pericardial effusion was evacuated.When the right atrium was opened, the anterior and the posterior papillary muscles were found to be ruptured (Fig. 2). In addition to numerous ruptured chordae tendineae, there was a tear on the anterior leaflet.Valve repair was not suitable for this case, therefore the tricuspid valve was replaced with a 31 mm mechanical prosthesis. A temporary epicardial pacemaker wire was inserted. Sinus rhythm spontaneously resumed. The Case Report Ann Thorac Cardiovasc Surg 2013; 19: 222-224 Online November 15, 2012 doi: 10.5...

Combinative use of NT-proBNP and CVIBS can detect the presence of diastolic abnormalities on echocardiography. A good correlation was found between the NT-proBNP and CVIBS values in detecting diastolic dysfunction in essentially hypertensive patients.

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Purpose: To assess ocular hemodynamic response to intravitreal pegaptanib in patients with age related macular degeneration (AMD). Methods: Both eyes of twenty patients with choroidal neovascular membrane of at least four MPS (Macular Photocoagulation Study) disc area in one eye due to AMD were undergoing ocular hemodynamic evaluation. Blood fl ow velocities of both eyes were measured by Color Doppler Ultrasonography (CDU) before and at fi rst, fourth weeks after intravitreal pegaptanib injection and calculated the arterial resistivity indices. The Wilcoxon-signed rank test was used for statistical analysis. Results: In the treated eyes, the mean PSV (Peak Systolic Velocity) of OA (Ophthalmic Artery) increased signifi cantly to a value of 45.37±17.92 at the fi rst (p=0.007), then returned to an insignifi cant value of 42.19±14.35 at the fourth week (p>0.05). The mean PSV of CRA (Central Retinal Artery) increased signifi cantly to a value of 21.59±6.21 at the fi rst week (p=0.12) and, then remained in a signifi cant value of 21.06±4.95 at the fourth week (p=0.006). The mean EDV (End-Diastolic Velocity) of CRA increased signifi cantly to a value of 6.07±2.30 at the fi rst week (p=0.001) and, then remained in a signifi cant value of 6.20±2.24 at the fourth week (p= 0.001). The mean PSV of PCA (Posterior Ciliary Artery) increased signifi cantly to a value of 30.66±10.73 at the fi rst week in comparison to the value of at the fourth week (p=0.038). However, there was no signifi cantly difference with value of 26.57±5.91 at the fourth week (p>0.05), when compared with pretreatment measurement (27.60±7.84). CDU measurements in untreated eyes did not show any signifi cant change following and before the injection. Conclusion: Resistivity indices of CRA, PCA and OA were not altered following intravitreal pegaptanib as an anti-VEGF agent in patients with AMD.

Anzer honey is well known in Turkey and used for its medicinal properties, especially for pharyngitis, tonsillitis, ulcers and cancer. In this study, we investigated whether Anzer honey, which is shown to have antioxidant, anti-tumoral, and antiinflammatory properties, has a protective effect against X-ray induced genotoxic damage by cytogenetic methods. Peripheral blood lymphocytes isolated from 20 healthy volunteers were divided into two groups and cultivated by conventional methods. Study group lymphocytes were treated with 10% diluted honey while those in the control group were not. Both groups were exposed to a high dose (2 Gy) X-ray at the 48th hour of culture. Conventional cytogenetic staining and Giemsa banding methods were applied to evaluate chromosomal breakage and ring formation. Micronucleus frequencies were determined by the cytokinesis-block micronucleus (CBMN) assay. Paired sample t test was used to compare groups. Anzer honey, which was analyzed melissopalynologically, was used. Micronucleus frequency was significantly decreased in the study group (CI = 348.75 ± 31, median 326, min. 98, max. 704) compared to the control group (CI = 489.10 ± 27, median 500, min. 216, max. 645) (p = .001). Chromosomal breakage was also significantly decreased in the study group (CI = 118.70 ± 16, median 109, min. 12, max. 316) compared to the control group (CI = 233.60 ± 25, median 225, min. 65, max. 492) (p < .0001). This is the first study indicating that genotoxic damage in the peripheral blood lymphocytes of healthy volunteers induced by X-radiation may be prevented or alleviated by adding Anzer honey in vitro. These results encourage further research about the protective effects of honey. Research Highlights• Anzer honey has a genoprotective effect against radiation-induced genotoxicity, probably by preventing oxidation damage.

Objective: To compare intraocular pressure, central cornea thickness, anterior chamber depth, axial length and thickness of retina nerve fiber layer between women with polycystic ovary syndrome and healthy at the same age segment. Methods: Between August 2015-January 2016, 46 women who have polycystic ovary syndrome and 53 healthy women have been included to the study. After a complete ophthalmologic examination, intraocular pressure, central cornea thickness, anterior chamber depth, axial length and retinal nerve fiber layer thickness were investigated. In the statistical analysis of the data, Independent Samples t test was utilized to compare the groups. Results: While mean age was 23.4 ± 4.5 (16-35) in the group with polycystic ovary syndrome, average age level was found as 24.0 ± 6.1 (18-54) among the controls (P=0.549). Intraocular pressure values were measured and determined as 17.7 ± 2.6 mmHg in the group with polycystic ovary syndrome, while the values were 15.2 ± 2.4 mmHg in the controls (P <0,001). Although it was 79.4 ±10.2 µm in the group with polycystic ovary syndrome, retinal nerve fiber layer thickness in the nasal quadrant was found to be 73.8 ± 10.9 µm among the controls (P <0.001). Conclusion: We found that the increased levels seen in intraocular pressure and retinal nerve fiber layer thickness in the nasal quadrants of the patients with polycystic ovary syndrome were statistically significance. Hence, we recommend that the patients with polycystic ovary syndrome should be specially analyzed as to eye assessment.