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2020| January-March | Volume 4 | Issue 1
Online since
April 17, 2020
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CASE SERIES
Cardiac rhythm management devices and ablation procedures in psychiatric patients: A case series and review of the literature
Konstantinos A Gatzoulis, Dimitrios Tsiachris, Georgia Balta, Christos-Konstantinos Antoniou, Petros Arsenos, Polychronis Dilaveris, Dimitrios Tousoulis
January-March 2020, 4(1):21-25
DOI
:10.4103/hm.hm_74_19
Psychiatric patients often present with symptoms similar to those indicating the need for a cardiac rhythm management device or even cardiac arrhythmia ablation. However, due to the unreliability of symptom self-reporting, the ability of the underlying neuropsychiatric condition to elicit similar phenomena, and the perceived reduced compliance and increased complication rates among this population, both of the above approaches remain underutilized with often detrimental effects. In the present case series, it is attempted to describe an alternative, electrophysiology study-guided approach to these patients, aiming to both firmly establish the need for invasive intervention (including implantation of pacemakers – three cases, implantable cardioverter-defibrillators – three cases, and electrophysiological ablations – two cases), as well as dispel preconceptions, bordering on stigma, regarding their outcomes.
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ORIGINAL ARTICLES
Escalation: Raising the college students' awareness regarding early signs of abusive relationships
Abir K Bekhet, Courtney A Kailunas, Alina T Atayan
January-March 2020, 4(1):1-6
DOI
:10.4103/hm.hm_23_19
Background:
Abusive relationships are highly prevalent in our society, but often go unnoticed. Research showed that dating violence continues to escalate in college student populations.
Purpose:
The purpose of this study is to determine the effectiveness of the video as a chosen method of education in raising the college students' awareness regarding warning signs of an abusive relationship.
Design:
This study used a descriptive qualitative design.
Sample/Data Collection:
Five focus groups of college students' participants (freshmen to seniors) were recruited to participate in the “Escalation” workshop. To facilitate discussion, each focus group originally had 15 college students for a total of 75 college students' participants. Five participants dropped of the study the last minute due to conflicting schedules and personal situations. Each focus group lasted for 90 min and consisted of watching a 38 min “Escalation” video that depicts scenarios of abusive relationships and a pre- and a post-qualitative discussion.
Results:
The results of the study and the identified themes illustrate the broadened perspectives participants gained through participating in the workshop. Insights from participants became less focused on physical abuse and began to include more mental and emotional effects of abuse in their responses. This study showed that most participants were not previously aware of the progression and scope of violent relationships.
Discussion/Conclusion:
By recognizing the early signs of an abusive relationship, it is more likely for victims and/or peers to intervene in a safe manner rather than continuing to allow an abusive relationship to escalate to its full potential of violence and physical harm.
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Adverse childhood experiences and the structure of personality in patients with takotsubo syndrome versus myocardial infarction
Lutz Goetzmann, Elisabeth Olliges, Barbara Ruettner, Karin Meissner, Karl-Heinz Ladwig, Christian Möller, Daniela Deftu-Kloes, Stefan Pohl, Gert Richardt, Christoph Burgdorf, Alexander Steger, Joram Ronel
January-March 2020, 4(1):12-20
DOI
:10.4103/hm.hm_76_19
Context and Aims:
Psychosocial risk factors are known to result in either takotsubo syndrome (TTS) or myocardial infarction (MI). In this article, the results of a cross-sectional study are presented within the framework of “progressive somatization” by comparing the psychosocial traits of TTS and MI patients.
Design/Subjects and Methods:
136 patients were administered a battery of questionnaires comprising the Childhood Trauma Questionnaire (CTQ), the Toronto Alexithymia Scale (TAS-20), the Experiences in Close Relationships-Revised Questionnaire, and the Operationalised Psychodynamic Diagnosis Structural Questionnaire (OPD-SQ). Life events prior to the onset of cardiac disease were recorded.
Statistical Analysis:
Descriptive statistics data were expressed in absolute numbers, percent, and mean and standard deviation. To identify differences between groups, T-tests for independent samples, Chi-square-tests and Mann-Whitney-Tests were used. Pearson correlations were computed to assess the relationship between the patient samples as well as between the patient samples and norms.
Results:
Few differences were found between TTS and MI patients, with both groups reporting moderate-to-severe “emotional neglect” in their childhood (CTQ). Compared to the norm group, TTS and MI patients showed higher values of “alexithymia” (TAS-20), and MI patients reported higher “attachment avoidance”. There are more “structural limitations of the personality” in TTS and MI patients than in a psychosomatic sample (OPD-SQ).
Conclusions:
TTS as well as MI patients suffer from “adverse childhood experiences” and “structural limitations of personality.” The results sustain the psychosomatic theory of progressive somatization that leads to severe bodily diseases. Patients might benefit from a specific psychotherapeutical support.
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CASE REPORT
Type A aortic dissection after abdominal aortic surgery
Murtaza A Chishti, Vijay Mohan Hanjoora, Monish S Raut, Ashish Sharma
January-March 2020, 4(1):26-27
DOI
:10.4103/hm.hm_80_19
Aortic dissection after open surgical repair of infrarenal aortic aneurysm and after endovascular procedures is a rarely observed complication. We present one such interesting case where vigilant monitoring plays an important role to diagnose aortic dissection early and subsequently manage successfully.
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LETTER TO THE EDITOR
Stroke and percutaneous coronary intervention: An overview
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
January-March 2020, 4(1):28-29
DOI
:10.4103/hm.hm_79_19
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ORIGINAL ARTICLES
Induction of cardiomyogenesis in stem cells isolated from human exfoliated deciduous teeth
Herman S Cheung
January-March 2020, 4(1):7-11
DOI
:10.4103/hm.hm_68_19
Background:
The natural transition from neonatal deciduous teeth to adult permanent teeth is a physiological phenomenon. Miura
et al
. reported the isolation and characterization of stem cells from the pulp of human exfoliated deciduous teeth (SHED). The great majority of current stem cell therapies use human adult stem cells. Since adult stem cells are multi-potent. SHED have demonstrated to have the capability to differentiate into osteogenic and odontogenic cells, adipocytes, and neural cells. When transplanted in immunocompromised mice, SHED were able to form bone. In addition, SHED have been able to differentiate into functional odontoblast and angiogenic endothelial cells.
Aims and Objective:
There are two objectives in our study; First, we want to confirm that SHED cells differentiate into osteogenic and neurotic cells. Second, we shall also examine whether SHED stem cells can also differentiate into cardiomyocytes.
Material and Method:
SHED stem cells are subjected to cardiomyogenic, neurogenic, and osteogenic induction treatment. The treated cells are the subjected to real time PCR and mmuno-histochemical analysis. The presence of calcium deposits with Alizarin Red S staining for SHED cells treated with osteogenic media was used to confirm osteogenic differentiation.
Results:
Our study confirmed that SHED cells differentiate into osteogenic and neurotic cells. For the first time we showed that SHED cells can also differentiate into cardiomyocytes.
Conclusion:
Due to their potentials and its neural crest origin, SHED are an ideal stem cell source for tissue regeneration.
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