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The effects of marine aquaculture on the environment were evaluated by studying the water quality of Güllük Bay (Turkey). Marine aquaculture, both extensive and intensive, is one of the most important activities carried out in this area. The intensive culture of fish (Dicentrarchus labrax) is the most important polluting element in Güllük Bay. Records of long term (seasonally) monitoring of the ambient water dissolved oxygen concentration, the inorganic nutrients (ammonia, nitrate, nitrite, and phosphate) and chlorophyll a concentrations were generated to assess sea water quality of Güllük Bay. Surface water (0.5 m) samples were collected from seven fish farm areas in the cage of Güllük Bay (here after reported as the cage stations). Reference surface water was also concurrently sampled at three stations. Modifications in the cage stations water quality were assessed as the difference between the magnitude of a specific parameter recorded at cage station and the concurrently recorded value of the parameter at the reference station, relative to the mean value at the reference station. In this study, results in the specific modifications are discussed at the study period. An aquaculture area had consistently positive modifications in phosphate concentration, but not in nitrogen or chlorophyll a concentrations. Chlorophyll a concentrations showed non positive modifications only in June. In addition to these site specific modifications nitrogen concentrations were positively modified in August and October.

Background: This retrospective study evaluated factors associated with mortality and morbidity in patients having functionally biventricular heart (FBH) and functionally univentricular heart (FUH) undergoing total anomalous pulmonary venous connection (TAPVC) repair. Methods: We reviewed medical records retrospectively and identified 72 patients undergoing TAPVC repair between July 2002 and December 2010; and 62 patients had FBH and 10 patients had FUH. The median age and weight at repair was 9.1 months (range, 8 days–16 years) and 6.7 kg (range, 2.5–57 kg). The TAPVC anatomy was supracardiac in 41 (56.9%), cardiac in 18 (25%), infracardiac in eight (11.1%), and mixed in five patients (6.9%). Results: There were seven early deaths (2 FBH [25%] and 5 FUH [62.5%]) and one late death (FUH). Presence of FUH (p < 0.01), heterotaxy syndrome (p = 0.03), young age (p < 0.01), low weight (p < 0.01) and long CPB time (p = 0.04) at the time of surgery were statistically significant risk factors for mortality. Morbidity was related to long duration of postoperative mechanical ventilation, intensive care unit and hospital stay. Presence of FUH was the only significant risk factor for morbidity (p < 0.01). After a mean follow‐up of 52.1 months (range, 3–74 months), 59 (92%) of 64 survivors were asymptomatic without any medication, and five have mild symptoms with regular physical activity. Conclusion: Operative results of TAPVC have dramatically improved in recent years. However, patients having FUH (especially with concomitant palliative surgery), heterotaxy syndrome, low weight, early age, and long CPB time still have an increased operative mortality. (J Card Surg 2012;27:376‐380)

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In this work, trace metals such as Hg, Pb, As, Cd, Cu, Fe, Mn and Zn in underground water samples obtained from three wells, an ash-pond and drinking water located near the Yatagan Thermal Power Plant were measured. As, Hg, Cu and Zn contents of the underground water were lower than those reported in the EEC (European Economic Community) and WHO (World Health Organization) guidelines. In contrast, the levels of Fe, Pb, Cd and Mn in some groundwater samples were higher than EEC and WHO guideline values. The trace metal concentrations in coal ash-pond water were observed to be lower than water quality standards with the exception of Pb. The obtained results indicated that the trace metal concentration in the sampled drinking water site did not exceed WHO limits.

SummaryBackgroundThe metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG.MethodsWe prospectively included 152 patients (109 males and 43 females; mean age 60.1 ± 8.6 years) who underwent elective CABG on CPB between January and September 2011. Early postoperative morbidity and mortality rates were compared between subjects with and without the MS. Diagnosis of the MS was based on the American National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria.ResultsOf the study group, 64 patients (42%) had the MS. The two groups were similar in age and gender. In the postoperative period, rates of atrial fibrillation, wound infection, pulmonary complications, and lengths of intubation, hospitalisation and intensive care unit stay were significantly higher in MS patients (p < 0.01). The MS was significantly associated with wound infection (OR 6.64, 95% CI: 1.72–25.75), pulmonary complications (OR 6.44, 95% CI: 1.58–26.33), arrhythmia (OR 5.47, 95% CI: 1.50–19.97) and prolonged intubation (OR 1.17, 95% CI: 1.05–1.32). The mortality rate was 3.1% in the MS group and 1.1% in the non-MS group, with no significant difference (p > 0.05).ConclusionThe MS was associated with a higher rate of early postoperative morbidity following CABG, without having a significant effect on the mortality rate.

ObjectiveThe effects of energy source on the maintenance of sinus rhythm and the contribution of demographic characteristics to the case selection in patients submitted to ablation performed concurrently with mitral valve surgery were analyzed.MethodsCryothermal (n=42; 43.8%) and radiofrequency (n=54; 56.3%) energy were employed in 96 patients submitted to mitral valve replacement and Cox maze IV procedure. Patients were called for control visits between 15 days and 12 months after discharge. The causal relationship between recurrence of atrial fibrillation and factors such as left atrial diameter, C-reactive protein, hypertension, left ventricular ejection fraction, chronic obstructive pulmonary disease, and body mass index was determined.ResultsMaintenance rates of the sinus rhythm with radiofrequency and cryoablation were 97.6% and 96.3%, respectively, in the first postoperative month, whereas at the 12th postoperative month were 88.1% and 83.3%. No significant difference was found between groups in relation to the energy source. Sensitivity and specificity for left atrial diameter with a cut-off value of 50.5 mm were 85.7% and 70.7%, respectively. Sensitivity and specificity for C-reactive protein with a cut-off value of 12 mg/dL on the 15th postoperative day were 83.3% and 88.9%, respectively. The effect of body mass index on atrial fibrillation recurrence was 3.2 times. Sensitivity and specificity for left ventricular ejection fraction 37% cut-off value were 96.3% and 11.4%, respectively. Atrial fibrillation in hypertensive cases was 5.3 times more. In patients with chronic obstructive pulmonary disease, recurrence of atrial fibrillation was 40%. The causal relation between recurrence of atrial fibrillation and the studied factors was established.ConclusionDemographic characteristics have a significant impact on ablation efficiency, while the type of energy source does not.

Introduction Thrombocytopenia observed after bioprosthetic aortic valve replacement has remained a puzzle to solve. Aim To analyze thrombocytopenia occurring after bioprosthetic aortic valve replacement by comparison to mechanical aortic valve replacement and coronary artery bypass grafting procedures. Material and methods The study was conducted retrospectively on a total of 297 patients who underwent bioprosthetic aortic valve replacement, mechanical prosthetic aortic valve replacement and coronary artery bypass grafting at the cardiovascular surgery department of our clinical center between January 2013 and September 2017. Preoperative and postoperative first 14-day thrombocyte levels of the patients were analyzed. Results The postoperative blood thrombocyte level decrease was found to be more significant in patients who underwent bioprosthetic aortic valve replacement than in patients who underwent mechanical aortic valve replacement and coronary artery bypass grafting ( p < 0.01). There was also a statistically significant difference in the time to reach the lowest postoperative platelet levels according to type of surgery ( p = 0.001; p < 0.01). Conclusions When compared to the patients who underwent coronary artery bypass grafting and mechanical prosthetic aortic valve replacement, postoperative thrombocytopenia was found to be more severe in patients who underwent bioprosthetic aortic valve replacement, with a dramatic decrease in thrombocyte count being observed on the postoperative second day. It was found that the thrombocytopenia recovers without causing any problem. We think that the shear forces may play a role in this recovery through washout of chemicals responsible for thrombocytopenia from the glutaraldehyde treated bioprostheses.