OBJECTIVE: Ventricular septum defect (VSD) can be defined as one or more openings located in the septum separating the left and right ventricle. Ventricular septal defects can be congenital or acquired. It is the most common congenital heart anomaly. In this article, we evaluated the VSDs that we treated surgically in our clinic in the light of the literature.MATERIAL AND METHODS: 68 VSD patients were intervened in our clinic. 39 cases were male (57.3%) and 29 cases were female (42.7%). The mean age was 9.10 ± 9.13 (1-48), and the mean weight was 25 ± 16.5 (7-75). When the preoperative New York Heart Association (NYHA) functional capacity (FC) was compared, FC-I was determined as 31 cases (45.5%), FC-II as 30 cases (44.1%), and FC-III as 7 cases (10.2%). The most common preoperative existing anomalies were 15 cases (22.05%) with aortic insufficiency (AR) and aortic valve prolapse (AVP); 18 cases (26.4%) ASD and 8 cases (11.7%) with PDA.RESULTS: When looking at the intervention methods according to VSD types, the most common cases of perimembranous type were right atriotomy in 53 cases (77.9%), right atriotomy in 1 case (1.4%) and tricuspid septal annulus radial incision; 8 cases of muscular type (11.7%) and right atriotomy and left ventriculotomy in 2 cases (2.9%) of Swiss-Chess type; Right ventriculotomy was preferred in 4 cases (5.8%) of DCJA (Doubly Committed Jukstaarterial) type. Between postoperative complications the most frequent one was residual VSD in 9 patients (15.3 %). Mortality was seen in 3 patients (5.09 %) with preoperative PAB 67±7.5 mmHg, LV- RV shunt 49±9.6 mmHg, Qp/Qs 4.7±3.87, PVR 7.5±4.6 values in follow-up. According to the comparison of the pre/postoperative NYHA and RVP statistics (p<0.05), the survival rate without reoperation was estimated as 93.2 %.CONCLUSIONS: Ventricular septal defect is the most common congenital heart disease. The development of ECHO and cardiac angiography has a great share in the diagnosis and classification. It should be preferred to evaluate the defects very well and close them after 3 months.
Aim: Kidney damage caused by ischemia-reperfusion (IR) is a serious clinical problem. Many studies have emphasized the antioxidant and anti-inflammatory properties of Curcumin. Material and Methods: Wistar-Albino male rats were divided into three groups. The sham group was the group in which only laparotomy was performed, the IR group was the group in which the infrarenal aorta was clamped after laparotomy and ischemia-reperfusion was created, and the IR+ curcumin group was the group in which intraperitoneal curcumin was given 1 hour before the procedure and the same procedures were repeated with the IR group. After creating the IR, blood and kidney tissue were taken from the rats and biochemical and histopathological examinations were performed. Results: Potassium (p=0.005), urea (p=0.050), and blood urea nitrogen (p=0.050) levels were higher in the IR+curcumin group. While total antioxidant status was found to be high in the IR+curcumin group (p=0.021), there was no difference in total oxidant status across the groups (p=0.069). Interleukin (IL)-1β and IL-6 were found to be higher in the IR group (p=0.014, p=0.022, respectively). Tumour necrosis factor-α was higher in the IR group than in other groups (p=0.020). Interferon-γ did not differ across groups (p=0.140). In the histopathological examination, the IR group had more damage to the glomerulus and tubular epithelial cells than the other groups (p<0.001). Conclusion: Curcumin, despite its anti-inflammatory and antioxidant characteristics, had no protective effect on renal functions in IR-induced kidney injury. It was found that it suppresses the inflammatory response and is effective in preserving renal tissue structure.
Aim: This study aims to determine the prevalence of aortic aneurysms (AA) on computed tomography (CT) in the emergency department. Material and Methods: A total of 10219 CT images were retrospectively analyzed (7610 thoracic, 6148 abdominal CT). A thoracic aortic diameter greater than 50 mm, an abdominal aortic diameter greater than 30 mm, or an aortic diameter greater than 50% of normal were considered AA. The baseline demographic and clinical characteristics of patients with thoracic AA (TAA) and abdominal AA (AAA) were compared to those without AA. Results: TAA was found in 990 (13%) of 7610 patients who had thoracic CT, while AAA was found in 66 (1.07%) of 6148 patients who had abdominal CT. In aneurysm groups, advanced age (p<0.001), male gender (p<0.001), aortic calcification (p<0.001), hyperlipidemia (p<0.001), coronary artery disease (p<0.001), hypertension (p<0.001), and diabetes mellitus (p<0.001) were more common and significantly different. Smoking was observed more frequently in the group with aneurysms (p<0.001). Among the groups, hospital mortality was higher in the aneurysm group (p<0.001). Surgery was recommended in 30 (3%) of TAA patients whose aortic diameter was greater than 55 mm; however, surgery could be performed in 20 (2%) of these patients. Surgery was recommended for 16 (24%) of AAA patients, but surgery could be performed only in 12 of them (18%). Conclusion: Attention to aortic pathologies, particularly AA, in patients undergoing radiological imaging in the emergency department for various reasons allows for the early detection of asymptomatic but potentially fatal aneurysms.
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