Risk factors of postoperative atrial fibrillation in patients undergoing beating heart coronary artery bypass

Aim: This study aims to establish new-onset atrial fibrillation (AF) risk factors and postoperative outcomes after off-pump coronary artery bypass graft (CABG) surgery. Material and Methods: Four hundred ninety patients who underwent off-pump CABG were enclosed in study. Patients divided into two groups in line with the development of new-onset AF as AF group (n=62) and non-AF group (n=428). Groups were compared in terms of preoperative clinical features and perioperative data, and multivariate analysis accomplished to identify independent clinical predictors of AF following off-pump CABG. Results: AF was presented in 62 (12.7%) of the patients, and those were significantly older and had significantly higher additive EuroSCORE scores than without AF. Also patients with postoperative AF had significantly prolonged intensive care unit and longer hospital stays at postoperative period. In the multivariant logistic regression analysis performed, advanced age, mean Euroscore, Mild to moderate mitral regurgitation, Prolonged air leak from thorax drain, mean ventilation time, severe pleural effusion, need for inotropic drug support were found to be risk factors for postoperative AF. Conclusion: Our study showed that age, high Euroscore, mild to moderate mitral regurgitation, prolonged ventilation time, severe pleural effusion and low cardiac output were risk factors of postoperative AF in patients underwent off-pump CABG. Also In patients who developed postoperative AF, prolonged intensive care unit and hospital stays were observed. Prospective randomized studies with larger patient series are recommended to support our study.</jats:p

Dressler’s Syndrome after Coronary Artery Bypass Surgery in pandemic period; A case report and review of the literature

The incidence of Dressler’s syndrome (postcardiac injury syndrome) has increased in parallel with the ascending performance of coronary artery bypass surgery in recent years. Although there is a lack of data about the incidence of postcardiac injury syndrome after coronary artery bypass surgery and it was reported to be 1.7%. The diagnosis of Dressler’s syndrome is mainly made through the exclusion of differential diagnosis and during this process diagnosis may be delayed or missed. Especially, during the pandemic period, it might confuse with COVID 19 infection. This report presents the management of a Dressler’s syndrome case admitted with complaints of dyspnea, chest pain, and fever in the early postoperative follow-up period for coronary artery bypass surgery.</jats:p

Ophthalmologic Findings in Children with Leukemia: A Single-Center Study

Objectives: Ophthalmologic disease in patients with acute leukemia occurs due to primary leukemic infiltration (involvement), or secondary to the disease and its treatment. In recent years the life expectancy of acute leukemia patients has increased with the advent of modern therapies. The present study aimed to determine the incidence of ocular manifestations in children with acute leukemia. Materials and Methods: The study included 120 patients diagnosed with acute leukemia at Baskent University Hospital, Pediatric Hematology Department between 1995 and 2010. All the patients were examined by an ophthalmologist via direct and indirect ophthalmoscopy. Results: Among the patients, 83 (69.2%) were diagnosed with acute lymphoblastic leukemia, 35 (29.1%) with acute myeloblastic leukemia, and 2 (1.7%) with mixed-lineage leukemia. In all, 58 ophthalmic manifestations were noted in 41 patients (34.2%). In our patients, 12 ophthalmologic involvements were present at admission and 46 ocular findings occurred during follow-up. The incidence of these manifestations increased with age. Conclusion: Ophthalmologic manifestations were not correlated with gender, hematological parameters at disease onset, type of leukemia, or the frequency of relapse and survival. To more clearly determine the effect of ophthalmologic manifestations on the prognosis of leukemia, larger scale and multi-center studies are needed

The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis

We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs

Effects of rivaroxaban on myocardial ischemia-reperfusion injury in rats

Myocardial infarction and further ischemia-reperfusion injury is a life-threatening conditions in humans. In this study, the effects of rivaroxaban, an anticoagulant agent, were aimed to be studied in a myocardial ischemia-reperfusion (I/R) injury model in rats. Male Wistar-albino rats were allocated into three groups; Rivaroxaban (n=15), control (n=15) and sham (n=10). Myocardial ischemia (30 minutes) and then reperfusion (120 minutes) were surgically performed in the rivaroxaban given (3mg/kg/day by gavage for 10 days before surgical procedures) and the control groups. Electrocardiography changes, blood pressure and heart rate were recorded before ischemia, and during the periods of ischemia and the reperfusion. Hemodynamic and blood parameters were recorded. Necrotic tissue in the myocardium was determined by the triphenyl tetrazolium chloride dye method. The extent of myocardial necrosis and risk area was calculated using a computer-assisted image program. In the rivaroxaban administered group, the size of necrotic area in the myocardium decreased significantly, however, mean heart rate and mean arterial blood pressure did not change. K+ and CK levels in serum, which are indicative of tissue necrosis, were significantly lower in the rivaroxaban group compared to the control group (p [Med-Science 2022; 11(4.000): 1456-60

Effect of caffeic acid phenethyl ester in doxorubicin induced descending aorta damage

925-930Doxorubicin (DOX), a chemotherapeutic agent used in cancer treatment, can cause cardiotoxicity as an adverse effect. In this study, potential protective effect of Caffeic acid phenethyl ester (CAPE), a well-known antioxidant agent, was investigated in doxorubicin induced aortic damage model. Total of 28 adult Wistar albino rats were equally divided into four groups as: Control, DOX, CAPE+DOX, CAPE. Accordingly, 10 μmol/kg CAPE for 10 days and/or 10 mg/kg doxorubicin for 3 days was given intraperitoneally. Control group received saline and ethanol as the vehicles of doxorubicin and CAPE, respectively. GSH, MDA, CuZn-SOD and CAT levels in descending aorta were investigated as the oxidative stress markers and histopathological changes were evaluated. GSH level was significantly higher in CAPE group as compared to the other groups (P <0.05) while there were no significant differences in MDA, CuZn-SOD and CAT levels among the groups (P>0.05). In microscopic view, tunica media of aorta was significantly thinner in DOX group as compared to CAPE group. Tunica media thickness significantly increased in CAPE+DOX group as compared to DOX group. CAPE treatment ameliorates the histopathological changes that are characterized by the reduced wall thickness induced by doxorubicin. However, CAPE treatment did not seem to effect biochemical parameters that are indicative of oxidative stress. The results indicated that CAPE can be protective against doxorubicin induced aortic vessel damage

Isolated coronary artery bypass surgery in patients with mild to moderate ischemic mitral regurgitation: Early results

The optimal management of moderate ischemic mitral regurgitation (MR) remains controversial. Some surgeons advocate coronary artery bypass alone, while others suggest concomitant mitral valve annuloplasty. We aimed to evaluate the early results of isolated coronary artery bypass operation on the cases with mild-to-moderate ischemic MR. Between May 2010 and May 2011, 59 patients (64% male, mean age: 50.5 years) with a preoperative diagnosis of mild-to-moderate ischemic MR underwent a coronary bypass operation. Patients evaluated with preoperative and postoperative (in twelve-month period with an average of five months) transthoracic echocardiogram (TTE). Postoperative mortality was not observed in study group. The preoperative functional capacity of the patients as well as the variables of mild MR and moderate MR showed a statistically significant difference in a positive way when compared with the postoperative functional capacity and MR variables. Postoperative TTE evaluation revealed that only 2 cases have severe MR (3,4%) also 62,7 % of patients have mild and 33.9% of patients have moderate MR. While there was a significant difference in a positive way between the preoperative and postoperative period in terms of left atrial diameter, no significant difference was found for the variables of ejection fraction and pulmonary artery pressure. Among the patients whom undergoing coronary bypass surgery, if there is mild or moderate MR revealed with the TTE prior to the operation, performing only coronary bypass operation will be adequate, and our early results in this matter are satisfactory. But, if severe MR revealed with TTE, performance of mitral valve repair or replacement should be evaluated additional to coronary bypass operation. [Med-Science 2018; 7(1.000): 114-117

Successful Mitral Valve Replacement in Patient with Severe Hemolytic Anemia due to Tight Mitral Stenosis

A 43 year-old woman complained of palpitation and shortness of breath admitted to our hospital. Transthoracic echocardiography revealed severe mitral stenosis and moderate mitral regurgitation. In routine blood tests hemoglobin and lactate dehydrogenase levels were 7.6 g/dL, 520 IU/L respectively. Coombs test was negative. After studying the other intrinsic or extrinsic causes of hemolytic anemia patients anemia was diagnosed as intravascular hemolytic anemia due to tight mitral stenosis. Therefore, mitral valve replacement planned and performed. Hemolysis was resolved after the mitral valve replacement. In conclusion, we report a case of hemolyt ic anemia due to mitral stenosis resolved by mechanical mitral valve replacement. [Med-Science 2016; 5(2.000): 738-41