Introduction: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. Methods: Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. Conclusion: Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.

CUR administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta I/R rat model.

IntroductionPrevious studies have demonstrated that thymoquinone has protective effects against ischemia reperfusion injury to various organs like lungs, kidneys and liver in different experimental models.ObjectiveWe aimed to determine whether thymoquinone has favorable effects on lung, renal, heart tissues and oxidative stress in abdominal aorta ischemia-reperfusion injury.MethodsThirty rats were divided into three groups as sham (n=10), control (n=10) and thymoquinone (TQ) treatment group (n=10). Control and TQ-treatment groups underwent abdominal aorta ischemia for 45 minutes followed by a 120-min period of reperfusion. In the TQ-treatment group, thymoquinone was given 5 minutes. before reperfusion at a dose of 20 mg/kg via an intraperitoneal route. Total antioxidant capacity, total oxidative status (TOS), and oxidative stress index (OSI) in blood serum were measured and lung, kidney, and heart tissue histopathology were evaluated with light microscopy.ResultsTotal oxidative status and oxidative stress index activity in blood samples were statistically higher in the control group compared to the sham and TQ-treatment groups (P<0.001 for TOS and OSI). Control group injury scores were statistically higher compared to sham and TQ-treatment groups (P<0.001 for all comparisons).ConclusionThymoquinone administered intraperitoneally was effective in reducing oxidative stress and histopathologic injury in an acute abdominal aorta ischemia-reperfusion rat model.

ObjectiveTo determine whether intraperitoneal silymarin administration has favorable effects on the heart, lungs, kidney, and liver and on oxidative stress in a rat model of supraceliac aorta ischemia/reperfusion injury.MethodsThirty male Wistar albino rats were divided equally into three groups: sham, control, and silymarin. The control and silymarin groups underwent supraceliac aortic occlusion for 45 min, followed by a 60 min period of reperfusion under terminal anesthesia. In the silymarin group, silymarin was administered intraperitoneally during ischemia at a dose of 200 mg/kg. Rats were euthanized using terminal anesthesia, and blood was collected from the inferior vena cava for total antioxidant capacity, total oxidative status, and oxidative stress index measurement. Lungs, heart, liver and kidney tissues were histologically examined.ResultsIschemia/reperfusion injury significantly increased histopathological damage as well as the total oxidative status and oxidative stress index levels in the blood samples. The silymarin group incurred significantly lesser damage to the lungs, liver and kidneys than the control group, while no differences were observed in the myocardium. Furthermore, the silymarin group had significantly lower total oxidative status and oxidative stress index levels than the control group.ConclusionIntraperitoneal administration of silymarin reduces oxidative stress and protects the liver, kidney, and lungs from acute supraceliac abdominal aorta ischemia/reperfusion injury in the rat model.

Objective: Osteomyelitis may complicate diabetic foot ulcers (DFUs). As a new inflammation-based prognostic factor, CRP:albumin ratio's significance is not known in osteomyelitis among patients with or without diabetes. Method: Patients with type 2 diabetes and DFUs were divided into two groups: group 1 (n=47) comprised patients without osteomyelitis, and group 2 (n=50) comprised patients with osteomyelitis. Results: Erythrocyte sedimentation rate (ESR) (88.5±23.0 versus 42.0±22.2), white blood cell count (WBC) (14.7±6.9x103 versus 10.0±4.4x103), C-reactive protein (CRP) level (15.6±9.9 versus 2.4±3.3) and CRP:albumin ratio (6.6±4.9 versus 0.7±1.0) were significantly higher, and albumin level was significantly lower in group 2 compared to group 1 (p<0.001 for all). The presence of osteomyelitis was significantly and positively correlated with ESR (r=0.721; p<0.001), WBC (r=0.380; p<0.001), CRP (r=0.667; p<0.001) and CRP:albumin ratio (r=0.638; p<0.001), and negatively correlated with albumin (r=−0.590; p<0.001). A CRP:albumin ratio of 1.74 or above could predict osteomyelitis with 92.0% sensitivity, 80.9% specificity, and the best area under the curve (AUC) score (AUC=0.957; 95% CI: 0.924–0.991). ESR (odds ratio (OR): 1.071 (1.025–1.119); p=0.02) and CRP:albumin ratio (OR: 2.65 (1.437–4.885); p=0.002) were independent predictors in the final model for stepwise linear regression analyses for the estimation of osteomyelitis. Conclusion: CRP:albumin ratio is a cheap and repeatable inflammatory marker and can successfully detect osteomyelitis in patients with DFU.

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ÖzetBu çalışma ile hastanemizde takip edilen enfektif endokardit (EE) olgularının epidemiyolojik, klinik, laboratuar özellikleri ile Brusella endokarditinin merkezimizdeki sıklığının ve özelliklerinin belirlenmesi amaçlanmıştır. Çalışmaya, 2008-2012 yılları arasında, kliniğimizde takip edilen ve modifiye Duke kriterlerine göre EE tanısı konulan 24 hasta (12 kadın,12 erkek; ortalama yaş; 41,3 yıl, yaş aralığı; 12-85 yıl) alındı. Hastaların demografik, klinik, ekokardiyografik, laboratuar, tedavi ve takip verileri değerlendirildi. Hastaların 20'sinde (%83,3) doğal kapak, 3'ünde (%12,5) mekanik protez kapak, 1'inde (%4,2) kalıcı kalp pili ile ilişkili EE saptandı. Doğal kapak tutulumunda en sık mitral etkilenmişti (Mitral %45; aortik kapak %35; triküspit kapak %10). Protez kapaklarda da en sık etkilenen kapak mitral kapak (%100) idi. En sık görülen semptomlar arasında ateş (% 66,7), titreme ve terleme (%37,5), halsizlik (%12,5) mevcuttu. Transtorasik ve/veya transözofageal ekokardiyografide en sık bulgu vejetasyondu (%66,6). Kültürlerde en sık Brusella (%33), stafilokok (%21) ve streptokok (%17) üredi; 5 (%20,8) olguda ise üreme olmadı. Toplamda 9 hastaya (%37,4) cerrahi tedavi uygulandı. Brusella tanısı konulanların % 50'si nativ aortik kapak, % 12,5 protez aortik kapak, %25 protez mitral kapak ve % 12,5 nativ mitral kapak idi. Brusella endokarditinin kliniği EE kliniği ile benzerdi. Brusella endokarditinde cerrahi+medikal tedavi en sık uygulanan tedaviydi. Genç yaş (ortalama yaş;38,9 yıl), aortik tutulum (%62,5), nativ kapak tutulum (%62,5), uzun süren inkübasyon periyodu (ortalama 10 gün) Brusella endokarditinin özellikleri arasında idi. EE özellikleri literatürdeki sonuçlar ile benzerlik göstermekteydi. Merkezimizdeki EE hastalarının 1/3'i gibi yüksek oranlarda Brusella endokarditi görülmekteydi. Genç yaş, aortik tutulum, nativ kapak, uzun inkübasyon periyodu gibi özellikleri taşıyan endokarditlerde Brusella endokarditi mutlaka düşünülmelidir. Anahtar kelimeler: Brusella endokarditi; enfektif endokardit. AbstractThe purpose of this study is to determine the epidemiological, clinical and laboratory characteristics and prevalence of Brucella endocarditis followed in our hospital was. The study were included 24 infective endocarditis (EE) patients (12 female, 12 male, mean age, 41.3 years, range, 12-85 years) followed in our clinic between 2008-2012 and diagnosed with modified Duke criteria. The demographic, clinical, echocardiographic, laboratory variables, treatment and follow-up data were evaluated. EE was associated with in 20 patients (83.3%), natural valve, 4 (12.2%), mechanical prosthetic valve and 1 patient (4.2%) a permanent pacemaker. Among natural valves, mitral valve was the most frequently involvement (45% of mitral, aortic 35%, tricuspid valve 10%). Mitral valve was most commonly affected prosthetic valves (100%). The most common symptoms included fever (66.7%), chills and sweating (37.5%), fatigue (12.5%). Vegetation was the most common lesion (66.6%) in transthoracic and/or transesophageal echocard...

Introduction The growth Stimulation expressed gene 2 (ST2) (or interleukin 1 receptor-like 1, also known as IL1RL1) is considered a biomarker of poor prognosis in cardiovascular diseases. The aims of this study are to investigate ST2 in the pericardial fluid (PF) of coronary artery disease patients and to contribute to the understanding of the pathophysiology of coronary artery disease. Methods 40 patients (blood plasma and PF) who underwent coronary artery bypass surgery and 40 controls (blood plasma only) were included in this study. Soluble ST2 (sST2) level was determined by enzyme-linked ımmunosorbent assay method in plasma and PF, and sST2 gene expression was determined by quantitative real-time polymerase chain reaction (QRT-PCR) method. Results The sST2 level was found to be 44.89 ng/ml and 390.357 ng/ml in the control and patient groups’ plasma, and 223.992 ng/ml in the PF of the patient group. An increase in sST2 level was detected in the patient group compared to the control group ( P <0.001). The sST2 expression in plasma was higher in the patient group than in the control group. Additionally, sST2 was more expressed in the plasma of the patient group than PF ( P <0.001). Conclusion The fact that sST2 was detected for the first time in a high level in PF showed that this biomarker was closely related with the heart and strengthened its potential to be used as a biomarker. Therefore, sST2 can contribute to the understanding of the pathophysiology of coronary artery disease.