Bu çalışmada postkardiyotomik şok nedeniyle ekstrakorporeal membran oksijenasyon desteği alan hastalarda nötrofil-lenfosit oranı ve böbrek hasarı arasındaki ilişki araştırıldı. Ça lış ma pla nı: Ocak 2007 -Temmuz 2018 tarihleri arasında merkezimizde postkardiyotomik şok nedeniyle ekstrakorporeal membran oksijenasyon desteği alan ve en az 48 saat hayatta kalan toplam 119 hasta (38 erkek, 81 kadın; ort. yaş 54.4±13.0 yıl; dağılım 24-74 yıl) retrospektif olarak incelendi. Hastaların ameliyat öncesi ve sonrası nötrofil-lenfosit oranları, demografik özellikleri, böbrek fonksiyon parametreleri ve ekstrakorporeal membran oksijenasyona ilişkin verileri kaydedildi. Böbrek hasarının gelişimi ve evreleri revize Akut Böbrek Hasarı Ağı ve Böbrek Hastalığında Küresel Sonuçların İyileştirilmesi kriterlerine göre belirlendi. Bul gu lar: Ameliyat öncesi nötrofil-lenfosit oranı ve böbrek hasarı arasında anlamlı bir ilişki saptanmadı (p>0.05). Ameliyat sonrası nötrofil-lenfosit oranı, böbrek hasarı gelişen hastalarda, böbrek hasarı olmayan hastalara kıyasla, daha yüksekti (sırasıyla 8.68 [0.84-42.00] ve 4.02 [1.04-21.21], p= 0.004). Hastalar Akut Böbrek Hasarı Ağı (p= 0.015) ve Böbrek Hastalığında Küresel Sonuçların İyileştirilmesi (p= 0.006) kriterlerine göre böbrek hasarı evrelerine ayrıldıklarında, daha ciddi böbrek hasarı olan hastalarda nötrofil-lenfosit oranı daha yüksek bulundu. Alıcı işletim karakteristik analizi ile böbrek hasarı tespitinde nötrofil-lenfosit oranının kesim değeri 6.71 olarak saptandı. 6.71'in üzerinde bir değere sahip hastalarda, böbrek hasarı gelişiminin olasılık oranı 5.941 idi. So nuç: Ameliyat öncesi değil fakat, ameliyat sonrası nötrofillenfosit oranı, postkardiyotomik şok nedeniyle ekstrakorporeal membran oksijenasyon desteği alan hastalarda böbrek hasarının varlığı ve derecesi ile ilişkilidir. Nötrofil-lenfosit oranı, bu hasta grubunda basit ve ucuz bir enflamasyon belirtecidir. Anah tarsöz cük ler: Ekstrakorporeal membran oksijenasyonu, enflamasyon, nenötrofil-lenfosit oranı, postkardiyotomik şok, böbrek hasarı.

Regular exercise rates were lower in outpatients with previous coronary revascularization. Education level and regular follow-up visits were associated with adherence to physical activity in these patients.

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Atherosclerotic true aneurysms of the superficial femoral artery (SFA) and profunda femoris artery (PFA) are rare and difficult to detect. The synchronous presence of SFA and PFA aneurysms is even rarer. Herein, we present a case with ipsilateral true SFA and PFA aneurysms diagnosed with rupture. A review of the international literature is made, and the diagnosis and treatment options of this rare condition are discussed. A 75-year-old male was admitted to our hospital with an aneurysm on the distal SFA and the ipsilateral PFA, as well as a hematoma around the PFA. It was difficult to determine the source of the rupture before surgery, even with proper imaging. Successful ligation of the PFA and an aneurysmectomy followed by a bypass grafting for the SFA were performed. An intraoperative examination revealed that the SFA aneurysm had ruptured. In elderly males with a history of ectasia or aneurysm on the aorta or peripheral arteries, a synchronous aneurysm on the SFA or the PFA should be suspected.

RDW levels were significantly increased in patients with MAC, and RDW was determined as an independent predictor for presence of MAC. Therefore, increased RDW can be used as a marker of continuing inflammatory process in MAC patients.

Objective: To compare the anatomical and physiological scoring systems and the outcomes of surgical management of penetrating cardiovascular trauma at a rural center. Methods: Seventy-seven patients underwent emergency surgery at our center between January/2012 and October/2018 due to penetrating cardiovascular trauma. Injury Severity Score (ISS), Revised Trauma Score (RTS), New Injury Severity Score (NISS), and Trauma and Injury Severity Score (TRISS) were calculated. The validation of these risk scores to predict mortality was assessed by the area under the receiver operating characteristic curve analysis. Results: All trauma scores were correlated with mortality. As ISS, NISS, and TRISS values increased and RTS values decreased, the mortality rate increased. The area under the curve (AUC) in the receiver operating characteristic curve analysis was 0.943 for TRISS, 0.915 for RTS, 0.890 for ISS, and 0.896 for NISS (P<0.001 for each). Logistic regression analysis revealed that scores were correlated with mortality (P<0.001 for each). By investigating cardiac injuries alone, only TRISS and RTS results correlated with mortality for cardiac injuries (Mann-Whitney U test, P=0.003 and P=0.01, respectively). The AUC was only statistically significant for TRISS and RTS (AUC=0.929, P<0.05 for both). For vascular injuries, all the scores were significantly correlated with in-hospital mortality (Mann-Whitney U test, P<0.001 for each). TRISS had the highest AUC (AUC=0.946, P<0.001). Conclusion: TRISS has the highest predictivity for in-hospital mortality in patients with penetrating cardiovascular trauma.

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