Platypnea orthodeoxia syndrome (POS) is a rare syndrome traditionally defined as dyspnea or hypoxemia observed when changing from a recumbent to an upright or seated position. A patent foramen ovale (PFO) is oft part of the underlying pathophysiology. Here, a 70-year-old woman with known PFO presents with new symptoms of a platypnea orthodeoxia syndrome. A pulmonary arterial hypertension (PAH), treated with Ambrisentan for years, was also known. In order to clarify the etiology of the new hemodynamic state we performed a transesophageal echocardiography (TEE) in an upright position, which excluded a PFO related cause of symptoms. A further investigation shown a COPD (Chronic Obstructive Pulmonary Disease), the treatment of which relieved of symptoms. This is the first described case of Platypnea orthodeoxia syndrome in patient with PAH. Although PFO is a common cause of POS and a PFO closure is often advised, careful differential diagnosis should be kept in mind.

Atrial fibrillation (AF) is the most common cardiac arrhythmia and ischemic stroke represents the most important complication. When the oral anticoagulation cannot be taken due to bleeding problems and considerations, the percutaneous occlusion of the left atrial appendage (LAA) is a possible solution. We present a case of a very late thrombosis of the LAA-Occluder device. The thrombus was diagnosed only after the patient suffered a stroke and a regression could not be achieved, neither with apixaban nor with warfarin alone. A successful result could be observed with the combination of high dose warfarin with aspirin 100mg/day. The possible etiology of this rare complication is an incomplete endothelialization of the device.

S. aureus is a pathogenic bacterium that causesinfections. Its virulence is due to surface components, proteins, virulence genes, SCCmec, pvl, agr, and SEs, which are low molecular weight superantigens. SEs are usually encoded by mobile genetic elements, and horizontal gene transfer accounts for their widespread presence in S. aureus. This study analyzed the prevalence of MRSA and MSSA strains of S. aureus in two hospitals in Greece between 2020–2022 and their susceptibility to antibiotics. Specimens collected were tested using the VITEK 2 system and the PCR technique to detect SCCmec types, agr types, pvl genes, and sem and seg genes. Antibiotics from various classes were also tested. This study examined the prevalence and resistance of S. aureus strains in hospitals. It found a high prevalence of MRSA and that the MRSA strains were more resistant to antibiotics. The study also identified the genotypes of the S. aureus isolates and the associated antibiotic resistances. This highlights the need for continued surveillance and effective strategies to combat the spread of MRSA in hospitals. This study examined the prevalence of the pvl gene and its co-occurrence with other genes in S. aureus strains, as well as their antibiotic susceptibility. The results showed that 19.15% of the isolates were pvl-positive and 80.85% were pvl-negative. The pvl gene co-existed with other genes, such as the agr and enterotoxin genes. The results could inform treatment strategies for S. aureus infections.

The transfer of pressure through the entire circulation and control of blood flow are necessary preconditions for the development of pulmonary circulation. For these tasks to be fulfilled optimally and taking into account the normally low pressure in the pulmonary circulation, the pulmonary arteries must normally show high elasticity (compliance) [6]. The relationship between pressure and volume, called volume elasticity or arterial compliance, is used to describe this issue. This is usually defined by the quotient: Compliance(C)= (stroke volume)/ (pulse pressure) = SV/PP (I), where: pulse pressure = systolic pressure minus diastolic pressure. This calculates the blood volume that can be accommodated in a vessel, with a predefined diameter, at a known pressure. An