SUMMARYData on restenosis after stent implantation in myocardial bridges (MB) are very limited. Six-month angiographic results for 12 symptomatic patients who underwent stent implantation for myocardial bridges were compared retrospectively with those of 39 patients who underwent direct stent implantation for de novo atherosclerotic lesions in the left anterior descending artery. Diameter stenosis decreased from 69 ± 8% to 4 ± 5% in the MB group and from 79 ± 8% to 7 ± 6% in the control group after stent deployment. Systolic narrowing was abolished in all patients with MB. In follow-up, quantitative angiography revealed late loss of 1.8 ± 1.3 mm in the MB group and 0.9 ± 0.9 mm in the control group (P = 0.025). The in-stent restenosis rate was also higher in the MB group compared to the control group (67% versus 28%; P = 0.037). Despite favorable immediate results, stent implantation in MBs may not be promising because of the higher in-stent restenosis rate compared to stenting in de novo atherosclerotic lesions. ( A myocardial bridge (MB) is an anatomical variation in which a part of a coronary artery (mostly left anterior descending artery (LAD)) courses under a segment of myocardium that compresses the lumen during systole despite a normal appearance during diastole. The reported incidence of MB varies over a wide range according to the method of diagnosis, changing from 0.5 to 2.5% in angiographic studies to 15 to 85% in autopsy series.1-3) Although known as a benign and asymptomatic condition in a majority of the patients, MBs may cause angina, myocardial ischemia, infarction, life-threatening cardiac arrhythmias, and even sudden cardiac death. [4][5][6][7][8] The clinical management of patients with symptomatic MB is not well established. On the basis of previous pathophysiological and clinFrom the

SUMMARYA 62-year-old man with hypertension and hypercholesterolemia was referred to our unit for evaluation of chest pain. A very rare variant of single coronary artery, in which the anomalous right coronary artery originated as a separate branch from the left anterior descending artery, was incidentally found on his coronary angiography. The anomalous right coronary artery in our case appears to be unique in that it courses intraseptally rather than rightwards proximally and has obstructive atherosclerotic lesions resulting in inferior ischemia. Moreover, the acute angle made by the anomalous right coronary artery to turn toward the atrioventricular groove may have reduced the flow velocity and contributed to the development of inferior ischemia. Anomalous origin of the right coronary artery (RCA) from the left anterior descending coronary artery (LAD) is relatively uncommon and generally of no clinical significance. [2][3][4][5][6][7][8][9] We describe a patient in whom the exertional angina and reversible inferior perfusion defect in technetium-99m radionuclide myocardial perfusion imaging are likely to be the result of an anomalous right coronary artery arising from the left anterior descending artery that differs from those reported previously because of its unique proximal course. CASE REPORTThe patient is a 62-year-old Turkish man with hypertension and hypercholesterolemia as risk factors for coronary heart disease. He had had retrosternal pressure-like chest pain on heavy exertion, relieving with rest, in the previous 6From the

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulasenegative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042). a Including all NVE, PVE, pacemaker, and catheter port endocarditis patients. b N indicates the denominator with any identified pathogen. c Coxiella burnetii seropositivity; anti-phase 1 IgG antibody titer ≥ 1:800 A P value of <0.05 was considered significant Eur J Clin Microbiol Infect Dis

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In this study, chitosan-coated alginate microspheres were prepared by the ionic complexation of alginate and chitosan biopolymers to use in embolization and/or chemoembolization studies. Biopolymeric microspheres were prepared by the ionic gelation technique of alginate with a suitable divalent cation (i.e. CaCl2) in a suspension medium composed of mineral oil and petroleum ether including emulsifier (i.e. Tween-80) and then obtained microspheres were coated with chitosan in an aqueous chitosan solution while the medium was magnetically stirred. The obtained microspheres are in the size range of 100-400 microm and they can be prepared as required by changing the preparation conditions (i.e. stirring rate, concentration of biopolymers, molecular weight and concentration of chitosan, etc.). In the in vivo studies, New Zealand rabbits were used as the test animals. Both complete and partial embolization of the kidney were achieved by using the microspheres. The renal angiograms obtained before/after embolization and the histopathological observations showed the feasibility of the chitosan-coated alginate microspheres as an alternative embolization and/or chemoembolization agent.