The Impact of Hospitalization Time on Major Cardiovascular Event Frequency in Patients with ST-Elevation Myocardial Infarction Over a 6-Month Follow-up

MakaleWOS:000964102000002Aim: The mortality rates related to acute myocardial infarction have significantly decreased recently due to early-period cardiovascular interventions. Some studies have shown that there is no difference in cardiovascular outcomes between the early discharge and the late one. In this study, we planned to investigate the effects of early and late discharge on the frequency of major events in patients treated for acute ST-segment elevation myocardial infarction (STEMI) in our clinic. Methods: Angiography records, demographic characteristics, and laboratory parameters of the patients who were diagnosed with acute STEMI in our clinic between February 2020 and December 2021 were examined. Patients were classified as being in Group 1 (discharge within 48 h) or Group 2 (discharge after 48 h), and rates of recurrent hospitalization, heart failure attacks, cardiovascular events, and death were compared between the two groups. Results: A total of 321 patients were included in our study. There were 129 patients in Group 1 and 192 patients in Group 2. There was no difference between the two Groups in terms of gender, age, or affected coronary vessels. The ejection fraction was lower in the late discharge group (p=0.004). The postoperative ventricular arrhythmia rate was found to be statistically significantly higher in the late discharge group (p=0.046). There was no difference in cardiovascular events between the first and sixth months in either group (p-values of 0.096 and 0.649, respectively). Conclusion: Considering the positive economic and psychosocial effects of early discharge for the patient and physician, when planning the discharge of patients with STEMI, patients with low comorbidity, unaffected ejection fractions, no malignant arrhythmia in their follow-up, and appropriate laboratory parameters can be evaluated for early discharge

Üniversite öğrencilerinde huzursuz bacaklar sendromu sıklığı ve yaşam kalitesi ile ilişkisi

Amaç: Bu çalışmanın amacı üniversite öğrencileri arasında huzursuz bacaklar sendromu sıklığını, semptom şiddetini ve huzursuz bacaklar sendromunun yaşam kalitesi ile ilişkisini araştırmaktır. Gereç ve Yöntem: Katılımcı öğrencilere huzursuz bacaklar sendromu tanı kriterlerini içeren dört soru soruldu ve bu dört soruya ‘evet’ cevabı veren öğrenciler Nöroloji uzmanı tarafından Uluslararası Huzursuz Bacaklar Sendromu Çalışma Grubu (UHBÇG) kriterlerine göre değerlendirildi ve huzursuz bacaklar sendromu tanısı konuldu. Huzursuz bacaklar sendromu bulunan öğrencilere hastalık şiddetini ölçmek için UHBÇG Şiddet Skalası uygulandı ve yaşam kalitesini değerlendirmek için tüm katılımcılara Kısa form-36 (KF-36) uygulandı. Bulgular: Çalışmaya 238’i (%53,2) kız, 209’u (%46,8) erkek olmak üzere toplam 447 öğrenci katıldı. Öğrencilerin %7.6’sında huzursuz bacaklar sendromu saptandı. Huzursuz bacaklar sendromu şiddeti ortalama 13,1 ± 5,44 olarak belirlendi. Huzursuz bacaklar sendromu bulunan öğrencilerde KF-36 fizik ve mental bölümü skorları anlamlı düzeyde düşük saptandı. Huzursuz bacaklar sendromu S şiddet düzeyi ile KF-36 fizik bölümü skorları arasında anlamlı negatif ilişki saptandı. Sonuç: Üniversite öğrencilerinin halen toplumda yeterince bilinmeyen ve yaşam kalitesini olumsuz etkileyebilen huzursuz bacaklar sendromu açısından değerlendirilmesinin faydalı olacağını düşünmekteyiz

An Interesting Association with Pulmonary Hypertension: Swyer-James-Macleod Syndrome

Pulmonary hypertension (PH) is a chronic disease that has increased awareness in recent years and has high morbidity and mortality. There are many unexplained points outside the current PH classification. Congenital heart diseases and lung pathologies are important causes of PH. Swyer-James-Macleod syndrome is a syndrome characterized by unilateral pulmonary arterial flow reduction due to involvement mostly in childhood and contralateral lung hyperlucency in imaging methods. It is rare for this syndrome to be observed together with congenital heart diseases and to be defined in a patient with PH

Ankaradaki eskici ve antikacı kültürü

Ankara : İhsan Doğramacı Bilkent Üniversitesi İktisadi, İdari ve Sosyal Bilimler Fakültesi, Tarih Bölümü, 2016.This work is a student project of the The Department of History, Faculty of Economics, Administrative and Social Sciences, İhsan Doğramacı Bilkent University.by Çekiç, Can Eyup

Acute effects of cardiac resynchronization therapy on arterial distensibility and serum norepinephrine levels in advanced heart failure

Background: Cardiac resynchronization therapy (CRT) has become an accepted method for treating refractory heart failure (HF). Arterial distensibility is an index of arterial stiffness and a surrogate marker for atherosclerosis. The present study aims to assess the acute effects of ventricular resynchronization therapy with biventricular stimulation on arterial distensibility, echocardiographic parameters and serum norepinephrine levels in patients with drug refractory HF

Effect of P2X7 receptor on activation of microglia and IL1 beta following ischemia

..

Time-of-day dependent neuronal injury after ischemic stroke: Implication of circadian clock transcriptional factor bmal1 and survival kinase akt

WOS: 000426897800060PubMed ID: 28421530Occurrence of stroke cases displays a time-of-day variation in human. However, the mechanism linking circadian rhythm to the internal response mechanisms against pathophysiological events after ischemic stroke remained largely unknown. To this end, temporal changes in the susceptibility to ischemia/reperfusion (I/R) injury were investigated in mice in which the ischemic stroke induced at four different Zeitgeber time points with 6-h intervals (ZT0, ZT6, ZT12, and ZT18). Besides infarct volume and brain swelling, neuronal survival, apoptosis, ischemia, and circadian rhythm related proteins were examined using immunohistochemistry, Western blot, planar surface immune assay, and liquid chromatography-mass spectrometry tools. Here, we present evidence that midnight (ZT18; 24:00) I/R injury in mice resulted in significantly improved infarct volume, brain swelling, neurological deficit score, neuronal survival, and decreased apoptotic cell death compared with ischemia induced at other time points, which were associated with increased expressions of circadian proteins Bmal1, PerI, and Clock proteins and survival kinases AKT and Erk-1/2. Moreover, ribosomal protein S6, mTOR, and Bad were also significantly increased, while the levels of PRAS40, negative regulator of AKT and mTOR, and phosphorylated p53 were decreased at this time point compared to ZT0 (06:00). Furthermore, detailed proteomic analysis revealed significantly decreased CSKP, HBB-1/2, and HBA levels, while increased GNAZ, NEGR1, IMPCT, and PDE1B at midnight as compared with early morning. Our results indicate that nighttime I/R injury results in less severe neuronal damage, with increased neuronal survival, increased levels of survival kinases and circadian clock proteins, and also alters the circadian-related proteins.Necmettin Erbakan University [161330001]; Turkish Academy of Sciences (TUBA)This study was supported by The Turkish Academy of Sciences (TUBA) and Necmettin Erbakan University (Scientific Research Project: 161330001)

Evidence that activation of P2X7R does not exacerbate neuronal death after optic nerve transection and focal cerebral ischemia in mice

WOS: 000408296600003PubMed ID: 28669743Conflicting data in the literature about the function of P2X7R in survival following ischemia necessitates the conductance of in-depth studies. To investigate the impacts of activation vs inhibition of the receptor on neuronal survival as well as the downstream signaling cascades, in addition to optic nerve transection (ONT), 30 min and 90 min of middle cerebral artery occlusion (MCAo) models were performed in mice. Intracellular calcium levels were assessed in primary cortical neuron cultures. Here, we show that P2X7R antagonist Brilliant Blue G (BBG) decreased DNA fragmentation, infarct volume, brain swelling, neurological deficit scores and activation of microglial cells after focal cerebral ischemia. BBG also significantly increased the number of surviving retinal ganglion cells (RGCs) after ONT and the number of surviving neurons following MCAo. Importantly, receptor agonist BzATP resulted in increased activation of microglial cells and induced phosphorylation of ERK,AKT and JNK. These results indicated that inhibition of P2X7R with BBG promoted neuronal survival, not through the activation of survival kinase pathways, but possibly by improved intracellular Ca2+ overload and decreased the levels of Caspase 1, IL-1 beta and Bax proteins. On the other hand, BzATP-mediated increased number of activated microglia and increased survival kinase levels in addition to increased caspase-1 and IL-1 beta levels indicate the complex nature of the P2X7 receptor-mediated signaling in neuronal injury.Turkish Academy of Sciences (TUBA)This work was supported by Turkish Academy of Sciences (TUBA)

Clinical outcomes and independent risk factors for 90-day mortality in critically ill patients with respiratory failure infected with sars-cov-2: A multicenter study in turkish intensive care units

Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P 2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO2 /FiO2 ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality. Copyright@Author(s)

Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations

International audiencePurpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA.Materials and methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process.Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit.Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines