OBJECTIVE: The aim of this study was to evaluate the relationship between red blood cell distribution width (RDW) and mean platelet volume (MPV) with development of postoperative atrial fi brillation (PoAF) after offpump coronary artery bypass grafting (CABG). BACKGROUND: The RDW and MPV have been associated with some cardiovascular disorders. METHODS: A total of 93 patients who underwent off-pump CABG were included in this study. The patients were divided into two groups as developing and nondeveloping PoAF groups in the postoperative period. We measured whether RDW and MPV levels are a predictive value for development PoAF. RESULTS: There were 24 patients with PoAF enrolled (mean age: 66 ± 7.8 years) and 69 patients without PoAF (mean age: 56.26 ± 11.53 years). The PoAF was signifi cantly correlated with age (p = 0.004), hematocrit (p: 0.010), RDW (p = 0.007) and creatinine (p = 0.006). Only advanced age (p = 0.012) was identifi ed as an independent predictor of PoAF. For predicting PoAF, there was 79.2 % sensitivity and 65.2 % specifi city for RDW (p = 0.001) and 62.5 % sensitivity and 55.1 % specifi city for MPV (p = 0.062). CONCLUSIONS: We found that RDW levels and MPV were not an independent predictor of the development of PoAF. However, elevated RDW levels and MPV may be one of the predictive values for PoAF development (Tab. 3, Fig. 2, Ref. 27). Text in PDF www.elis.sk. KEY WORDS: red blood cell, mean platelet volume, atrial fi brillation, coronary artery bypass, off-pump.
Bu çalışmada, on-pump koroner arter baypas greftleme yapılan hastalarda tiyol-disülfid homeostazının etkileri araştırıldı.Ça lış mapla nı:Ocak 2018 -Ekim 2018 tarihleri arasında izole on-pump koroner arter baypas greftleme yapılan toplam 51 hasta (43 erkek, 8 kadın; ort. yaş 61.8±8.7 yıl; dağılım, 38-78 yıl) çalışmaya dahil edildi. Tiyol-disülfid homeostazı parametreleri ameliyat öncesi dönemde (T1), kros-klempin kaldırılmasından 30 dk. sonra (T2) ve ameliyat sonrası altıncı saatte (T3) çalışıldı. Ameliyat sonrası dönemde hastalarda atriyal fibrilasyon gelişimi ve inotropik ilaç gereksinimi gibi hemodinamik parametreler değerlendirildi.Bul gu lar: Ameliyatın farklı zaman noktalarında ölçülen tiyoldisülfid homeostazı parametreleri arasında önemli farklılıklar vardı (p<0.001). İkili lojistik regresyon analizinde T2-disülfid/ nativ tiyol oranının ameliyat sonrası atriyal fibrilasyon gelişimini öngören bağımsız bir değişken olduğu görüldü (p= 0.042). T2-disülfid düzeyleri ile kros-klemp zamanı arasında pozitif ve anlamlı korelasyonlar vardı (r:0.307, p=0.029). So nuç:On-pump koroner arter baypas greftleme yapılan hastalarda tiyol-disülfid homeostazı disülfide doğru değişmektedir. İskemi zamanının uzamasına paralel olarak disülfid düzeyleri artış gösterir. İskemik dönemde azalmış nativ tiyol ve artmış disülfid düzeyleri, ameliyat sonrası atriyal fibrilasyon gelişiminde öngördürücü olabilir.Anah tar söz cük ler: Koroner arter baypas greftleme, oksidatif stres, tiyol-disülfid homeostazı.
Objectives. Myxomas are the most common benign primary heart tumors. They have serious complications including intracardiac blood flow obstruction and embolic events. The aim of the study was to assess our experiences related to patients undergoing surgical resection for cardiac myxomas. Methods. The medical records of 39 patients, aged 16 to 76 years (mean, 47.5 years), who were operated on for primary cardiac myxomas between January 1994 and December 2016 at our clinic were retrospectively evaluated. Demographic, clinical, operative and postoperative data were obtained from these hospital medical records. Cardiac myxomas were diagnosed by transthoracic echocardiography. Preoperative coronary angiography was performed in patients over 40 years of age and those with symptoms of coronary disease. In routine follow-up after discharge the patients were checked by echocardiography. Long-term cumulative survival was analyzed using the Kaplan-Meier method. Results. There was no in-hospital mortality. The majority (61.5%) of patients were female. The most common encountered localization of myxoma was the left atrium (76.9%), and the classic posterior approach from interatrial groove was preferred in 32 (82.1%) patients. Mean follow-up was 6.05 ± 3.75 years (range, 1-10 years). Five (12.8%) patients were lost on long-term follow-up. Kaplan-Meier curves, cumulative proportion surviving of patients at 1-, 2-, 5-, and 10-year were 97.4%, 91.7%, 84.7%, and 84.7%, respectively. No hospital mortality was observed in any of the patients. There was no recurrence in our series. Conclusions. Myxoma is the disease that can lead to complications such as embolic events and intracardiac blood flow obstruction. It can be excised with a low rate of morbidity and mortality. Surgical resection should be performed promptly after diagnosis in order to prevent potential complications.
Objective Del Nido cardioplegia (DNC) has been used in pediatric cardiac surgery for many years with a single dose application and its usage in adult cardiac surgery has been increasing in recent years, with results being published. In this study, we aimed to investigate the effect of DNC on the development of postoperative atrial fibrillation (PoAF). Methods In this retrospective observational comparative study, 255 patients who underwent isolated on-pump coronary artery bypass grafting, between January 2019 and November 2019, were enrolled. The patients were divided into two groups: DNC (n=132) and blood cardioplegia (BC) (n=123). Intraoperative and postoperative data were evaluated and compared in terms of the development of PoAF. Results We found that the development of PoAF and the length of hospital stay remain significantly higher in the BC group (P=0.044, P<0.001, respectively). In addition, the aortic cross-clamp time and the cardioplegia volume delivered were significantly lower in the DNC group ( P =0.042, P <0.001, respectively). In multivariate logistic regression analysis, only higher cardioplegia volume was determined as an independent predictor for PoAF development (OR 1.001; 95% CI 1.000-1.001; P =0.033). We did not found difference between groups in terms of troponin T, inotropic drug support, need for intraaortic balloon pump and mortality. Conclusion This study showed that DNC can be used safely in adult coronary bypass surgery and PoAF development effect is reduced.
The use of central venous port catheter is a very useful method for long-term therapy in patients with malignancy. Catheter insertion technique and maintenance of equipment is very important to the prevention of catheterrelated complications. The most frequent complications are deep venous thrombosis, port infection, catheter obstruction. İn this article, pneumonia occurrence after chemotherapy infusion in a patient who has a completely extravasated central venous port catheter discussed.Key words: Venous catheter complication, catheter dislocation, chemotherapy ÖZETSantral venöz port kateteri kullanımı uzun dönem tedavi uygulanan malignite hastalarında oldukça kullanışlı bir yöntemdir. Katetere bağlı komplikasyonlardan korunmada kateterin yerleştirilme tekniği ve bakımı önem teşkil etmektedir. En sık görülen komplikasyonlar; derin ven trombozu, port enfeksiyonu, kateter obstrüksiyonudur. Bu makalede nadir bir komplikasyon olan kateterin tümünün ekstravaze yerleştirilmesini takiben ilaç uygulaması sonrası pnömoni gelişen bir olgu tartışılmıştır.Anahtar kelimeler: Venöz kateter komplikasyonu, kateter dislokasyonu, kemoterapi GİRİŞMalignite hastalarında uzun süreli kemoterapi tedavisi ve parenteral beslenme amacı ile santral venöz yerleşimli subkutan port kullanımının yaygınlaş-ması ile beraber kateterizasyona bağlı komplikasyon sayısı da artmaktadır [1]. Bu komplikasyonlar genellikle derin ven trombozu, arter ponksiyonu, hematom, pnömotoraks, kateter migrasyonu, dislokasyon, port enfeksiyonu, kateter obstrüksiyonu ve cilt ülserasyonu şeklinde olmaktadır [1,2]. Subkutan venöz kateterin ekstravazasyonu ise oldukça nadir bir komplikasyondur [3]. Bu makalede subkutan venöz port kateterinin damar dışı yerleştirilmesini takiben pnömoni kliniği gelişen olguyu sunmayı amaçladık. OLGU56 yaşında kadın hasta kliniğimize subkutan venöz port kateteri dislokasyonu ön tanısı ile başvurdu. Hastanın öyküsünden meme karsinomu tanısı sonrası sol mastektomi uygulandığı öğrenildi. Mastektomi sonrası kemoterapi verilmesi amacı ile 4 hafta önce başka bir merkezde sağ subklaviyen ven lokalizasyonundan subkutan yerleşimli santral venöz port kateteri takılmış. Hastaya takılan kateterin yerinin kontrol edilmesi için postero-anterior akciğer grafisi çekilmiş. Grafiyi değerlendiren hekim kateterin yerinde olduğuna karar vererek kemoterapi alabileceğini söylenmiş. Bunun üzerine hastaya üç kür kemoterapi uygulanmış. Son kemoterapi kürünü takiben ateş ve öksürük şikâyeti gelişmesi üzerine çekilen postero-anterior akciğer grafisi ile hasta gö-ğüs hastalıkları bölümüne refere edilmiş. Hastanın yapılan muayenesi ve akciğer grafisinde sağ akciğer alt zonda infiltratif görünüm ve plevral effüzyon bulguları görülmüş. Bulguların pnömoni lehine olduğu düşünülerek antibiyoterapi başlanmış. Bu süre içinde kemoterapiye de ara verilmiş. Başka bir merkezde yapıldığından bu radyolojik tetkiklerin aslına ulaşılamadı, bilgiler radyoloji raporlarından alındı. Hastaya plevral effüzyon nedeni ile torasentez gibi girişimsel tanı yöntemleri veya balgam yaym...
Objective To evaluate the 6 months efficacy and safety of cyanoacrylate closure for the treatment of incompetent great saphenous veins (GSVs) in comparison with radiofrequency ablation (RFA). Methods In this multicenter, retrospective, clinical trial, 398 symptomatic subjects with incompetent GSVs were assigned to either cyanoacrylate closure or RFA. The primary endpoint, complete closure of the target GSV, was determined using duplex ultrasound examination starting from one-, three-, and six-month visits. Results All patients were followed for 6 months and there was no difference between the groups in terms of mean follow-up time. Hospital stay and return to work/activity were shorter in the cyanoacrylate ablation (CAA) group, and these differences between the groups were statistically significant. Ecchymosis was observed higher in the RFA group and was statistically significant. Conclusions In this study, in which we examined the CAA and RFA methods, we found that both methods were effective and reliable; however, we found that patients in the CAA group had a more comfortable postoperative period and returned to work earlier.
Objectives: Atherosclerosis is a chronic disease that causes various cardiovascular complications. The onset and progression of atherosclerosis depends primarily on genetic factors and life style, but the underlying cellular and molecular mechanisms are still unclear. In recent studies, circulating cytokines have been shown to play an important role in inflammatory events. Interleukin-6 (IL-6) plays an important role in the regulation of proinflammation. In this study, a single nucleotide polymorphism of IL-6 gene at position-174 was studied. Our aim was to investigate the relationship between IL-6-174G/C polymorphism and atherosclerosis. Methods: In this prospective randomized study, 104 patients were included in both groups. We used Polymerase Chain Reaction-Restriction Fragment Lenght Polymorphism (PCR-RFLP) method to amplify the polymorphism region. Results: Allele frequency distributions of IL-6-174G/C polymorphism in the study and control groups were evaluated. There were no statistically significant diversity between A and B allele frequencies. Conclusions: The allele frequency and genotype distribution between the groups was not statistically different, which indicates another mechanisms on regulation of these cytokines. Single gene polymorphisms are generally not reproducible. Therefore, broad-based studies should be carried out considering suitable conditions and multi-factor features.
Peripheral artery disease (PAD) is a common disease among women and is expected to increase in the coming years. Diagnostic and therapeutic management of PAD in women is difficult due to their gender-related differences, comorbid factors, atypical symptoms, more functional disorders, the presence of advanced disease, being older age of the disease onset, smaller vessel diameter, and psychosocial factors. Especially due to the high prevalence of asymptomatic disease, late admission status and further disease on admission affect the success of the treatment negatively. By focusing more on PAD in women and more clinical studies, genderspecific differences can be identified. Hereby, there is a need to develop appropriate strategies to improve women's overall quality of life. In this review, we aimed to draw attention to the female gender with PAD, which is increasingly occurring.
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