A 71-year-old female with a dual-chamber pacemaker presented to our hospital complaining of repeated chest pain. She was diagnosed with unstable angina. On day 7, the patient suddenly suffered cardiopulmonary arrest due to an inferior ST segment elevation myocardial infarction (STEMI). Pacemaker lost capture was suspected and was later confirmed by a pacemaker check with a high pacing threshold and a low sensing parameter. Emergency coronary angiography revealed that a large filling defect remained due to an extensive thrombus in the proximal left circumflex (LCX) with thrombolysis in myocardial infarction (TIMI) grade 2 flow, and then a repeat thrombus aspiration was performed. After reperfusion, the parameters of the right ventricular lead were gradually returned. We conclude that the loss of the right ventricular lead pacing occurred in this case of acute coronary syndrome (ACS) induced by an LCX thrombus due to an LCX supplying the right ventricular septal.

A 51-year-old man with normal left ventricular ejection fraction (LVEF) underwent radiofrequency catheter ablation (RFCA) for long-standing persistent atrial fibrillation (AF). After isolating the pulmonary veins (PV), we attempted to ablate multiple non-PV AF triggers evoked by isoproterenol and performed repetitive intracardiac electrical cardioversion under considerable dose of barbiturate. Finally, administration of pilsicainide was required to maintain sinus rhythm. Sixty minutes after the procedure, initiation of development of rapid ST-segment elevation was observed on the continuous electrocardiogram monitor and the patient complained of general fatigue. There was occurrence of complete atrioventricular block and he immediately fell into pulseless electrical activity (PEA). Cardiopulmonary resuscitation was initiated and a percutaneous cardiopulmonary system (PCPS) was provided. Echocardiogram showed severe biventricular systolic dysfunction. Although ST-segment change sustained, emergent coronary angiography was normal. Left ventriculogram showed apical to mid ventricular akinesia and preserved basal contractibility, which was typical of takotsubo syndrome (TS). Fortunately, he recovered completely; the PCPS was weaned on day 5, and the LVEF normalized within 2 weeks without any neurological disorders. This is the first case report of PEA due to TS following AF ablation. TS due to stressors of RFCA procedure should be recognized as a possible life-threatening complication. .

While rape and sexual violence have long been a widespread social problem, and one that has garnered significant attention, research that specifically examines the phenomenon of male victimization of sexual violence remains lacking. Addressing the gaps in the research, the current study uses 10 years of law enforcement data from the United States\' National Incident-based Reporting System (2007-2016) on sexual victimization of males 14 years of age or older. The study sought to assess the impact of victim, offender, and incident characteristics associated with the outcome of the case (i.e., open, arrest, and exceptional clearance due to the victim declining or the prosecution refusing to pursue the case) for 20,701 male victims who reported a forcible sex offense to law enforcement as well as agency variation for cleared crimes. Using multilevel multinomial logistic regression, exceptionally cleared cases are more likely to resemble open cases than those resulting in arrest with incident characteristics having a larger influence than victim and offender characteristics. Cases involving concomitant offenses, committed by a stranger, resulting in injury, increase the likelihood of arrest-all of which support the \"real rape\" hypothesis. Exceptionally cleared cases represent more than one-third of cleared cases and there is significant department variation in the usage of exceptional clearance, as a number of agencies are exceptionally clearing more than half of their cleared cases, artificially increasing their clearance rate. These results, in conjunction with research on female victims, suggests that the handling of sexual assault cases reported to law enforcement remains problematic.

UNASSIGNED: Single-failure survival models are commonly used in injury research. We aimed to demonstrate the application of multiple failure survival models in injury research by measuring the association between arrest and IPV recidivism.
UNASSIGNED: We used data from a population-based cohort of 5466 male-female couples with a police-reported, male-perpetrated incident of IPV against their female partners that occurred in Seattle, WA during 1999-2001. We estimated the risk of physical and psychological IPV recidivism (separately) for the 12 months following the index event, according to perpetrator arrest or non-arrest for the index event. We used time-dependent extended Cox regression analyses for time-to-first IPV event and Prentice, Williams and Peterson model-based analyses for time-to-multiple IPV events.
UNASSIGNED: Arrest was associated with a reduction in time-to-first physical IPV recurrence but was not associated with time-to-first psychological IPV recurrence during the 12-month follow-up. Arrest was associated with a significantly decreased risk of physical and psychological IPV during the 12-month follow-up in the multiple failure models. The association between arrest and lower risk of physical IPV recidivism increased with increasing number of follow-up IPV events.
UNASSIGNED: We found arrest to be a plausible deterrent for recurrent IPV reduction. Our study also illustrates the use of multiple failure survival analyses in injury research. Such techniques facilitate inference about estimands that may have greater public health relevance and properly account for injury recurrence. By using multiple failure models, we were able to more deeply understand the relationship between arrest and IPV over time.

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Drowning is one of the fatal accidents frequently encountered during the summer and is the most common cause of accidental death in the world. Anoxia, hypothermia, and metabolic acidosis are mainly responsible for morbidty. Cardiovascular effects may occur secondary to hypoxia and hypothermia. Atrial fibrillation, sinus dysrhythmias (rarely requiring treatment), and, in serious cases, ventricular fibrillation or asystole may develop, showing as rhythm problems on electrocardiogram and Osborn wave can be seen, especially during hypothermia. A 16-year-old male patient who was admitted to our hospital\'s emergency service with drowning is presented in this article. In our case, ventricular fibrillation and giant J wave (Osborn wave) associated with hypothermia developed after drowning was seen. We present this case as a reminder of ECG changes due to hypothermia that develop after drowning. Response to cardiopulmonary resuscitation after drowning and hypothermia is not very good. Mortality is very high, so early resuscitation and aggressive treatment of cardiovascular and respiratory problems are important for life.
Suda boğulmalar özellikle yaz aylarında sıkça karşılaştığımız ölümcül kazalardandır, dünyada kaza ile ölümlerin en sık sebeplerinden biridir. Boğulmalardaki morbiditeden esas olarak anoksi, hipotermi ve sonucunda gelişen metabolik asidoz sorumludur. Kardiyovasküler etkiler hipoksi ve hipotermiye sekonderdir. Elektrokardiyografide (EKG) atriyal fibrilasyon, sinüs disritmileri (nadiren tedavi gerektirir), ciddi olgularda ventriküler fibrilasyon ya da asistol gibi ritim problemleri ve özellikle hipotermi sırasında sık karşılaşılan Osborn dalgaları izlenebilinir. Bu yazıda soğuk suda boğulma sonrasında hastane acil servisine getirilen 16 yaşında erkek hasta sunuldu. Olguda boğulma sonrası gelişen hipotermi ile ilişkili ventriküler fibrilasyon ve dev J dalgaları (Osborn dalgası) izlendi. Bu olguyu sunmamızın nedeni suda boğulma sonrası gelişen hipotermiye bağlı EKG değişikliklerini hatırlatmaktı. Suda boğulma ve hipotermi sonrası kardiyopulmoner resüsitasyona cevap çok iyi değildir. Mortalite oldukça yüksektir, erken resüsitasyon, agresif kardiyovasküler ve respiratuvar tedavi sağkalım için önemlidir.