OBJECTIVES: Nesfatin-1 is an antiifl ammatory, antiapoptotic, and anorexigenic peptide that has many roles in cardiomyocyte metabolism and viability. Infl ammation plays an important role in the pathogenesis of atherosclerosis. In this study, we aimed to evaluate the alterations in serum nesfatin-1 levels of the patients undergoing coronary artery bypass operation due to atherosclerotic coronary artery disease. MATERIALS AND METHODS: The study included 49 patients (30 men, 19 women) undergoing coronary artery bypass surgery. Serum nesfatin-1 levels were measured from venous blood samples of the patients collected before and three months after the operation. The relationship of nesfatin-1 levels with accompanying conditions was also analyzed. RESULTS: Nesfatin-1 levels at third month, postoperatively, were signifi cantly higher than preoperative nesfatin-1 levels of the patients (41.94± 13.90 pg/ml and 27.06 ± 8.01pg/ml, respectively; p < 0.001). Both preoperative and postoperative nesfatin-1 levels were negatively correlated with age (p < 0.001). The postoperative increase in nesfatin-1 levels was signifi cantly higher in diabetic patients than in nondiabetic patients (p<0.001). CONCLUSION: This study revealed that serum nesfatin-1 levels increased signifi cantly in patients undergoing coronary artery bypass operation. Nesfatin-1 level may have a role in assessing myocardial perfusion during the follow-up of these patients (Tab. 4, Fig. 4, Ref. 25).

Minimally invasive coronary artery bypass grafting (CABG) is a new technique developed in recent years apart from the conventional method. Our first objective is to compare the postoperative early outcomes of conventional and minimally invasive multivessel (MIM) CABG methods, and second objective is to compare perioperative differences between two surgical techniques. This retrospective, comparative study was conducted at a university hospital with 100 patients, who underwent CABG surgery from November, 1 2019 to June, 1 2020. The data of 50 patients, who underwent MIM CABG (Group M), was certain. Among the patients operated with the conventional method (Group C), 50 patients were randomly selected from the same time period. Examination of early postoperative outcomes revealed that Group C had significantly higher intensive care unit (ICU) stay (p=0.013), significantly higher mechanical ventilation time in ICU (p<0.001), and significantly higher isolated systolic blood pressure (p=0.013). Examination of perioperative variables revealed that Group C had significantly shorter duration of surgery (p<0.001), significantly shorter aortic cross-clamp time (p<0.001), significantly shorter cardiopulmonary bypass (CPB) time (p<0.001), significantly lesser graft numbers (p<0.001), significantly lesser left internal mammary artery use (p<0.05), and significantly lesser inotropic support after CPB was discontinued (p<0.05). In the light of these results, MIM CABG was associated with enhanced postoperative early outcomes with prolonged surgery time compared to conventional method.

BackgroundCardiovascular diseases (CVD) are among the causes of morbidity and mortality in the world. Significant advances have been made in the diagnosis, treatment and prognosis of CVD. New biomarkers and therapeutic targets are needed to reduce the incidence of this disease. Recently, there is growing evidence that circulating microRNAs can be used as diagnostic biomarkers in this disease. Methods We compared five microRNA (hsa-miR-21-5p, hsa-mi181a-5p, hsa-miR-199a-5p, hsa-miR-199b-5p and hsa-miR-320a) expression levels associated with ischemia/reperfusion before and after bypass graft surgery in serum samples of patients (N=46) with coronary artery disease and healthy control subjects (N=48). Expression measurements were made for each miRNA preoperatively and postoperatively at 1. and 24. hours, and then compared with the control subjects. Troponin I, creatine phosphate kinase and creatine kinase myocardial band cardiac markers were measured before and 1 and 24 hours postoperatively and compared to miRNA expressions and controls. Quantitative real-time PCR was used for expression analysis. The data were analyzed by Mann-Whitney test, chi-squared test, Logistic Regression analysis, and Kruskal-Wallis test with the statistical package SPSS. Results The five miRNAs were down-regulated compared to controls. The expression level for miR-199a at 24 h postoperatively was significantly lower than at 1 h (p=0.001). Receiver operating characteristic analysis showed that the area under the curve of miR-199a-5p was 0.810 (sensitivity 87% and specificity 68.5%) in preoperative patients. Conclusions: miR-199a and miR-199b in serum are a novel non-invasive biomarker candidate for coronary artery disease.

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Background/Aim: Cuffed-tunneled catheter patients encounter various problems during their catheterization period. Early detection and resolution of these problems prolong the life of the catheter. The purpose of the present study was to investigate the problems and solution methods of cuffed-tunneled catheters in hemodialysis patients during their use in light of our experience and literature. Methods: The study was designed as a retrospective cohort study. Twenty-four months of patient data who had a diagnosis of renal failure and who received cuffed-tunneled hemodialysis catheters between January 2013 and June 21  in the Department of Cardiovascular Surgery of Adiyaman University Faculty of Medicine were analyzed electronically based on the hospital data recording system. The demographic characteristics, localization of the inserted catheter, and duration of catheter use were determined. Primary and secondary patency ratios were calculated and recorded along with the complications in the patients and our treatment approaches to these complications. Finally, the collected data were discussed with reference to the literature data. Results: The data from 322 cuffed-tunneled catheters were collected in a total of 228 patients during the observation period. It was found that no revision procedure was applied to 73 patients (catheter) during the 24-month period, and a total of 204 revision procedures were applied to 155 patients. The revision procedure consisted of 110 thrombolytic treatments, 64 vein exchanges, 18 tunnel changes, and 12 catheter changes. Primary and secondary patency ratios at 6, 12, 18, and 24 months were calculated as 90.79%, 63.60%, 40.11%, and 32.02% and 96.05%, 89.91%, 72.37%, and 58.33%, respectively. The most common factors that affected primary and secondary patency ratios were determined to be gender (P<0.001 and P=0.056, respectively), body mass index (P<0.001 and P<0.001, respectively) and diabetes mellitus (P=0.018 and P=0.690, respectively). Conclusion: Thrombolytic treatment is an effective and safe method in catheter thrombosis, which is one of the most important factors rendering the cuffed-tunneled hemodialysis catheters dysfunctional. Also, in tunnel infections, tunnel replacement is a salvage procedure in patients with vascular access problems.

Objective: The objective of this study was to evaluate the clinical efficacy and appropriateness of colistin therapy in patients with hematological malignancies. Methods: Age, gender, type of hematologic malignancy, and potential carbapenem-resistant microorganism risk factors were all noted in this retrospective study. In empirical and agent-specific treatment groups, differences in demographic features, risk factors, treatment responses, and side effects were compared. Results: Sixty-three patients were included, 54% were male, and the median age was 49. In the last three months, the hospitalization rate history was 68%, and four patients had a hospitalization history in the ICU. Carbapenem-resistant K. pneumoniae colonization was present in 22 patients (35%). Gram-negative microorganisms were isolated in 34 patients (54%). The carbapenem, quinolone, and colistin resistance rates were 82%, 76%, and 4% respectively. Clinical and microbiological response rates were 60% and 69%. 7 and 28-day mortality rates were 17% and 35%. There was no significant difference in demographic data and comorbidities in empirical (n=48) and agent-specific (n=15) treatment groups. The rate of carbapenem and glycopeptide treatments before colistin was higher in the empirical treatment group (p = 0.004; p = 0.001). The rate of starting combined antibiotics was higher inthe empirical treatment group (p = 0.016). Two of the patients developed renal failure in the first week after treatment. Conclusion: The use of empirical colistin may be unavoidable given the risk considerations. Shortly, colistin-resistant strains may also be a factor affecting treatment success negatively.

Objective: microRNAs (miRNAs) have important potential as biomarkers in the diagnosis and prognosis of ischemia/reperfusion (I/R) injury in coronary artery bypass grafting surgery (CABG). This study investigated the relationship between preoperative (preop) and postoperative (post-op) cardiac parameters and miRNA expressions in CABG. Methods: We analyzed a total of 94 individuals (CABG, n= 46 and healthy control, n=48). Quantitative real-time polymerase chain reaction (qRT) was performed to determine plasma miRNA expressions (miR-21, miR-181a, miR-199a, miR-199b, and miR-320a-5p) in triplicates: before surgery, 1 hour after surgery, and 24 hours after surgery. The target genes and pathways of miRNA were determined using bioinformatic analysis. The biomarker potentials of miRNAs were evaluated with receiver operating characteristic (ROC) curve analysis. Results: All miRNAs were significantly downregulated (p < 0.05). Troponin I, LVEF, CPK, and CK-MB were found to be statistically significant for operation groups (p < 0.05). miRNA expressions and cardiac markers were associated with troponin I and/or CK-MB. In ROC analyses, miR-199a was a good diagnostic marker. CREBRF and ZNF704 genes may be a target for these miRNAs. Conclusions: Downregulation of miR-199a has a regulatory role in ischemia/reperfusion. They may contribute to CABG pathology through these two genes involved in signaling cascades to turn on protein response and ion binding.