Author Contributions: M.S. made a substantial contribution to the conception and design of the work and to the acquisition, analysis, and interpretation of data for the work; wrote the manuscript; critically revised the manuscript for important intellectual content; and gave final approval of the current version to be published. F.v.L. made a substantial contribution to the conception and design of the work and to the interpretation of data for the work, performed statistical analysis, wrote the manuscript, critically revised the manuscript for important intellectual content, and gave final approval of the current version to be published. P.R. made a substantial contribution to the conception and design of the work and to the interpretation of data for the work, critically revised the manuscript for important intellectual content, and gave final approval of the current version to be published. C.L. made a substantial contribution to the conception and design of the work and to the acquisition, analysis, and interpretation of data for the work; wrote the manuscript; critically revised the manuscript for important intellectual content; and gave final approval of the current version to be published. All other authors made a contribution to the acquisition of the data for the work, critically revised the manuscript for important intellectual content, and gave final approval of the current version to be published. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Myocardial ischemia-reperfusion injury may complicate coronary artery bypass grafting (CABG) operations. N-Acetylcysteine (NAC) had antioxidant and microcirculatory effects, and inhibits neutrophil aggregation. The aim of this study was to determine the effects of NAC in limiting myocardial ischemia-reperfusion injury in CABG operations. Twenty patients undergoing elective coronary bypass operation with cardiopulmonary bypass were enrolled and randomly assigned to two groups: a control group operated with a routine CABG protocol, and one where NAC was administered intravenously during the operation (NAC group). Blood samples from coronary sinus for tumor necrosis factor-alpha assay, myocardial biopsy specimens for chemiluminescent luminol, and lucigenin measurements of reactive oxygen species were taken. The luminol (specific for (*)OH, H(2)O(2), and HOCl(-) radicals) and lucigenin (specific for O(2) (*-)) levels and the difference ratios after reperfusion were significantly lower in the NAC group. Tumor necrosis factor-alpha levels increased in the control group but, in contrast, a significant decrease was detected in the NAC group (P < 0.01). Creatine kinase-MB levels at 6 and 12 hours were significantly lower in the NAC group (P = 0.02). N-Acetylcysteine has potential effects to limit ischemia reperfusion injury during CABG operations. We believe that its effects on clinical outcome may be more apparent in patients prone to ischemia-reperfusion injury.

Changes in serum Hs-CRP levels can be a potential predictor of the outcomes for patients with PE. Additionally, this value of change can notify the presence of some subgroups of PE (massive and minor PE).

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Our results suggested that expressions of HLA-BW6 and HLA-DRB1*13 alleles may be predictable markers for response to chemotherapy in lung cancer patients.

Nephrotoxicity is associated with the use of high dose colistin, age, gender, hypertension, red blood cells replacement and RIFLE stage. The mortality rate is higher in patients developing nephrotoxicity.

We have had some important improvements in the intensive care units (ICU) like high flow oxygen system (HFOS), therapeutic hypothermia, extra corporeal membrane oxygenation (ECMO), extra corporeal carbon dioxide removal (ECCOR), echocardiography (ECHO) and ultrasonography (US).HFOS gives oxygen to the patients at rates of flow higher (up to 60 L/min) than that delivered traditionally in LFOS (up to 16L/ min). It is obtained 1 cmH2O PEEP for every 10L/min of flow delivered by HFOS. HFOS serves as an important alternative to noninvasive mechanical ventilation especially in the management of the patients with hypoxemic respiratory failure.Post-resuscitation care consists of optimization of oxygenation and ventilation, avoiding hypotension, treating immediate precipitants of cardiac arrest such as acute coronary ischemia and initiating therapeutic (induced) hypothermia. Therapeutic hypothermia decreases cerebral metabolic rate, blood volume, and intracranial pressure, prevents reperfusion injury. So hypotermia protects cerebral functions.ECMO, the type of cardiopulmonary support, has become an essential tool in critical care patients with severe respiratory and cardiac failure, refractory to conventional therapy methods.Critical care ultrasonography (CCUS) and echocardiography have utility for intensivist-performed, immediate diagnoses of life threatening diseases, with no need to transport patients to radiology or cardiology departments or wait for radiologist or cardiologist on a consultative basis. CCUS and echocardiography should be an essential part of training of every ICU physician.

BackgroundHypothyroidism and obstructive sleep apnea (OSA) are both common health problems and can be seen together. Each of these 2 diseases can cause pulmonary hypertension (PH). We aimed to determine whether hypothyroidism with OSA has a significant effect on the frequency and severity of PH.Material/MethodsA total of 236 patients were included in the study. Patients were divided into 3 groups: Group I, Obstructive Sleep Apnea (n=149); Group II, Hypothyroidism (n=56); and Group III, Obstructive Sleep Apnea-Hypothyroidism (n=31). All patients underwent polysomnography and echocardiography and serum levels of thyroid-stimulating hormone (TSH) and free thyroxine 4 (FT4) were analyzed.ResultsThere were 167 male and 69 female participants, and the mean age was 47.8±11.5 (Group I: 81.9% male, 18.1% female; Group II: 44.6% male, 55.4% female; Group III: 64.6% male, 35.4% female). Distribution of mean pulmonary arterial pressure on echocardiography was statistically different among the 3 groups (x2=14.99, p=0.006). When adjusted according to the apnea-hypopnea index (AHI), age, and body mass index (BMI), a significant relation with PH was determined (p=0.002).ConclusionsThe combination of hypothyroidism with OSA is associated with an increased frequency and severity of PH. When PH is found out of line with the severity of OSA, thyroid dysfunction should be investigated.