Background: Right ventricular failure (RVF) is a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Prediction of this clinical situation in LVAD patients with different clinical scores is still an enigma. The aim of this study is to analyze the predictive power of clinical parameters and risk scores and their combinations to discriminate RVF after LVAD implantation. Methods: A retrospective, single center review of 71 patients who underwent continuous flow-LVAD implantation between September 2013 and September 2016, was performed. RVF was defined as need for RVAD and/or administration of inotropic agents more than 14 days after LVAD implantation. Patients with and without RVF were divided into two groups and predictive power of the nine parameters (tricuspid annular plane systolic excursion (TAPSE), Michigan score, Pennsylvania score, central venous pressure/pulmonary artery wedge pressure ratio (CVP/PCWP), and right ventricular stroke work index, pulmonary artery pulsatility index, CRITT score, ALMA score, European registry for patients with mechanical circulatory support (EUROMACS) right heart failure model and their combinations were analyzed to predict postoperative RVF. Results: Of 71 patients, 21 had RVF after implantation. For the variables that can be used to discriminate between RVF and non-RVF groups, the diagnostic performance of the best cutoff points and tests was obtained using receiver operating characteristic (ROC) curve analysis. Discrimination analysis was performed to determine the combinations of tests. For all single risk scores and parameters; the area under the ROC curve (AUC) was below 0.7 which is considered to be a poor level of discrimination except EUROMACS score (AUC: 0.789, P < .001) and CRITT score

Continuous-flow left ventricular assist devices (LVADs) reduce peak systolic flow, increase diastolic flow, and eliminate pulsatility of circulation. Altered blood flow may lead to a change in end-organ perfusion. Analysis of the flow dynamics of the arteries of end organs, such as the brain, may indicate whether an organ is perfused sufficiently.The aim of this study is to evaluate and identify the flow pattern changes of carotid (CA) and middle cerebral arteries (MCA) in LVAD patients and to compare with heart failure patients and healthy volunteers. Eighty-nine individuals were included in this cross-sectional study. Participants were divided into three groups: LVAD patients (n = 31), heart failure patients (n = 26), and healthy volunteers (n = 27). Carotid and transcranial Doppler ultrasonography were performed for all study groups for peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility (PI), and resistive (RI) indices of CA and MCA. Flow dynamics were compared between the groups. Doppler ultrasonographic data were analyzed at a median 12 (3-47) months after LVAD implantation. CA-PSV was lower in LVAD group compared with the other two groups (P < .001), MCA-PSV of LVAD and heart failure groups were similar and lower than healthy volunteers (P < .05). The highest values for CA-EDV were found in the LVAD group (P < .05). MCA-EDV values were found to be lowest in heart failure group (P < .05). For PI and RI, in all CA and MCA, the LVAD group had lower indices compared with the other two groups (P < .001). In addition, MCA flow analysis in patients with LVADs was identified for the first time with this study. K E Y W O R D Scarotid artery, middle cerebral artery, pulsatility index, resistive index, ventricular assist device 458 | KARAHAN et Al.

Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients.

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This multi-center point prevalence study evaluated children who were diagnosed as having coronavirus disease 2019 (COVID-19). On February 2nd, 2022, inpatients and outpatients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the study from 12 cities and 24 centers in Turkey. Of 8605 patients on February 2nd, 2022, in participating centers, 706 (8.2%) had COVID-19. The median age of the 706 patients was 92.50 months, 53.4% were female, and 76.7% were inpatients. The three most common symptoms of the patients with COVID-19 were fever (56.6%), cough (41.3%), and fatigue (27.5%). The three most common underlying chronic diseases (UCDs) were asthma (3.4%), neurologic disorders (3.3%), and obesity (2.6%). The SARS-CoV-2-related pneumoniae rate was 10.7%. The COVID-19 vaccination rate was 12.5% in all patients. Among patients aged over 12 years with access to the vaccine given by the Republic of Turkey Ministry of Health, the vaccination rate was 38.7%. Patients with UCDs presented with dyspnea and pneumoniae more frequently than those without UCDs ( p < 0.001 for both). The rates of fever, diarrhea, and pneumoniae were higher in patients without COVID-19 vaccinations ( p = 0.001, p = 0.012, and p = 0.027). Conclusion : To lessen the effects of the disease, all eligible children should receive the COVID-19 vaccine. The illness may specifically endanger children with UCDs. What is Known: • Children with COVID-19 mainly present with fever and cough, as in adults. • COVID-19 may specifically threaten children with underlying chronic diseases. What is New: • Children with obesity have a higher vaccination rate against COVID-19 than children without obesity. • Among unvaccinated children, fever and pneumoniae might be seen at a higher ratio than among vaccinated children.

Purpose: The aim of this study was to analyze neurocognitive function in patients who underwent continuous flow left ventricular assist device (LVAD) implantation. Material and Method: This cross-sectional study included three groups: LVAD ( n = 31), heart failure patients ( n = 26), and healthy volunteers ( n = 27). The Rey Auditory-Verbal Learning Test (RAVLT), Judgement of Line Orientation Test (JLOT), Trail Making Test (TMT), Stroop Color-Word Interference Test (SCWIT), Verbal Fluency Test (VFT), Symbol-Digit Modality Test (SDMT) were used to assess the neurocognitive functions. Data were analyzed at a median 12 (3–47) months after LVAD implantation. The LVAD patients were also divided by aortic valve opening (AVO) into three subgroups as “closed” ( n = 9), “1–6” ( n = 8) and “7–10” ( n = 14) opening per ten beats and data were re-analyzed accordingly. Results: There was no significant difference among the groups according to SCWIT, JLOT, SDMT, TMT, and VFT scores. Post-hoc analyzes of RAVLT scores showed significant differences between the LVAD and the other two groups in favor of the LVAD group. Also, the patients with AVO “7–10” the response times were longer and learning scores were found to be lower than those without AVO. Conclusion: With continuous-flow LVAD, neurocognitive functions were not impaired. The learning performance was better in cases where there was no AVO and flow was completely device dependent. We may speculate that neurocognitive functions are not worsening with continuous cerebral blood flow and even it may improve learning performance.