We aimed to investigate the role of inflammation parameters and platelet activation in geriatric patients with hypertension. Therefore, we compared the levels of those parameters in patients with hypertensive urgency and emergency. We also investigated the potential relationship between those parameters. Ninety-six hypertensive (HT) patients (aged > 60) were included in the study in two groups: HT emergency (N = 48, group 1) and HT urgency (N = 48, group 2). Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and high-sensitive C reactive protein (hs-CRP) were compared between those groups. Optimum cut-off levels of each parameter were determined by the use of Receiver operating characteristic (ROC) curve analysis. Pearson correlation test was used to examine the relationship between variables. The mean MPV and hs-CRP levels were significantly higher in patients with HT emergencies (both P < 0.001). Mean NLR was also significantly different between the two groups (P = 0.011). Pearson correlation analysis revealed a positive but weak correlation between the MPV and NLR (r = 0.245, P = 0.016), the hs-CRP level (r = 0.394, P < 0.001), and the WBC count (r = 0.362, P < 0.001). Increased platelet activity and inflammation are associated with the end organ failure. Levels of MPV and other inflammatory parameters may be useful in the management of geriatric patients with HT.

Rationale: Adolescent depression is often linked to biological changes associated with stress. However, new approaches and treatment strategies for early intervention and prevention of depression in children and adolescents are still limited. Ashwagandha is an Ayurvedic herb widely used in the management of anxiety and stress. However, there is no information in the current literature on its potential effect on adolescent depression. Objectives: This study aimed to investigate the effects of depression on proapoptotic proteins and neuroinflammation and the antidepressant effect of Ashwagandha on depression-like symptoms in adolescent rats exposed to the Chronic Unpredictable Mild Stress (CUMS) model. Methods: In the study, CUMS model was used to induce depression in adolescent rats. Rats were treated with Ashwagandha or Sertraline. To evaluate the antidepressant effects, behavioral tests as well as biochemical and histological analyses were performed. Forced Swim Test (FST), Sucrose Test and Elevated Plus Maze Test were performed as behavioral tests. Brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were measured by the ELISA method in the fronto-parietal cortex. Proapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-α and IL-1β), as well as glial fibrillary acidic protein (GFAP), were evaluated immunohistochemically in the fronto-parietal cortex. Results: Proapoptotic proteins (Bax and Caspase-3) and inflammatory markers (TNF-α and IL-1β) were increased in the CUMS group. BDNF and GFAP levels were decreased. Ashwagandha treatment was more effective than Sertraline in reducing the levels of these proteins and markers. Additionally, Ashwagandha prevented weight loss. Conclusions: Ashwagandha showed antidepressant-like effects in adolescent rats, reducing apoptosis, inflammation, and neuroinflammation, suggesting potential for treating adolescent depression. Graphical

Phenylethylamine HCL (PEA HCL), more commonly called Captagon on the market, is a synthetic stimulant consisting of a theophylline molecule covalently bonded to an amphetamine molecule. The pathophysiology of myocardial infarction (MI) causing amphetamine-like compounds such as amphetamine and phenylethyline is not clear, this effect may be attributed to the vessel wall narrowing and destabilization of the thrombus. In the literature, some cases of acute myocardial infarction (AMI) associated with amphetamine and ephedrine abuse already been reported. To our knowledge, there is only a cases reporting AMI associated with the use of PEA commonly called Captagon. In this case, we wanted to contribute to the literature by presenting the case of a 23-year-old who developed PEA due to captagon tablet use.

Background: We aimed to evaluate the perfusion index (PI) level at the 10th minute of admission to the emergency department in patients with non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris (USAP). In addition, we aimed to evaluate whether PI is useful in differentiating NSTEMI and USAP patients in the emergency department in the early stage.Materials and Methods: Eighty NSTEMI (Group 1) and 50 USAP (Group 2) patients who were consecutively admitted to our emergency department between November 2017 and May 2019 and diagnosed with acute coronary syndrome were included in the study. In both patient groups, PI measured with the Massimo-SET Root 7362A RDS7 non-invasive pulse oximetry probe and other routine laboratory measurements were measured and compared.Results: The mean PI was significantly lower in NSTEMI patients (p <0.001). At 30-day patient follow-up, the PI of the reduce was significantly lower (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016). At 30-day patient follow-up, the level of PI was significantly lower in the died patients than the survived patients (P <0.001). The area under the curve was significantly lower for PI in NSTEMI patients (area under the curve 0.313, p = 0.016).Conclusions: Although our study shows that PI may be an early marker in the distinguish of NSTEMI and USAP patients and may be useful in predicting the mortality of these patients, more extensive studies will support our hypothesis.