Clinical features and factors affecting in-hospital mortality of patients who underwent pericardiocentesis due to moderate to severe pericardial effusion

Introduction: The aim of this study was to determine the primary etiology of pericardial effusion in patients undergoing percutaneous pericardiocentesis. Possible in-hospital mortality related predictors were also investigated. Patients and Methods: A retrospective analysis was made of the clinical and laboratory features of 268 patients who underwent pericardiocentesis due to moderate to severe pericardial effusion between January 2009 and March 2020. Results: The patients comprised 57.5% males and 42.5% females with a mean age of 62.3 ± 15.4 years. Cardiac compression was detected in 220 (82.1%) patients, of which 208 (77.6%) were clinically tamponade and 12 (4.5%) were asymptomatic cardiac compression. The most common symptom was dyspnea (58.6%) and 10.8% of patients were asymptomatic. Pericardial fluid was exudate in 235 (87.7%) patients. The most common causes were malignancy (37.3%) followed by idiopathic (22.1%) and iatrogenic (12.7%) causes. The patients with asymptomatic cardiac compression were more likely to have malignant effusion than those with other etiologies (p= 0.001). In-hospital mortality developed in 37 (13.8%) patients. The independent predictors of in-hospital mortality were determined as follows; etiology other than infectious or idiopathic (OR= 3.447; 95% CI= 1.266, 9.386; p= 0.015), and receiving antithrombotic therapy (OR= 2.306; 95% CI= 1.078, 4.932; p= 0.031). Conclusion: Malignancy is the most common cause of moderate to severe pericardial effusions. The detection of cardiac compression in asymptomatic patients may be an important indicator of malignancy. Receiving antithrombotic therapy and having a non-idiopathic and non-infectious etiology may be predictors of in-hospital mortality

The effects of carotid artery stenting on short-term clinical outcomes and evaluation of restenosis

Objectives: Data on restenosis and long-term outcomes of carotid stenting are limited. The aim of this study was to investigate cardiovascular effects of carotid stenting on clinical outcome and restenosis in patients with symptomatic severe carotid artery stenosis.Materials and methods: Twenty patients (mean age: 68±7 years, 11 male) who have been decided to perform stenting in joint Committee of Cardiology, Cardiovascular Surgery and Neurology Clinics were included.Patients were evaluated both clinically and Doppler ultrasonographically for frequency of cardiovascular events and restenosis. Restenosis is defined as the reapperance of stenosis with a diameter reduction of ≥%50 with peak systolic velocity higher than 224 cm/s.Results: Comorbidities in patients were; coronary artery disease in 14, peripheral artery disease in three, and both chronic renal failure and congestive heart failure in two. Stent diameters were ranged from 6 to 8 mm, and stent lengths were 30 and 40 mm. During the procedure 5 patients had predilatation and 19 had postdilatation. None of the patients had >%30 resudial stenosis after the procedure. All procedures were technically successful. After the procedure only one transient ischemic attack was seen. There were no restenosis, myocardial infarction, death or stroke at 30th day end of the first year of follow up. Diabetes and heart failure were found as predictors for restenosis.Conclusion: In highly selected cases, carotid artery stenting is an effective and safe method in the short term. Restenosis did not seem to be a restricting problem for the success of carotid artery stentin

Predictors of Percutaneous Lead Extraction Major Complications: A Tertiary Center Experience

Background and Aim: Over the years, transvenous lead extraction (TLE) procedures (TLEP) have been increasing because of factors such as infection, loss of device function, and lead-related complications. This study aimed to evaluate the factors affecting major complications during TLEP. Materials and Methods: Between January 2011 and May 2023, patients who underwent TLE of cardiac implantable electronic devices were included in the study. The demographic and procedural features of all patients were evaluated according to major complications. Results: A total of 121 consecutive patients (192 leads) underwent TLEP. The mean age was 63 ± 17.3 years, and 76% were male. Most leads were active fixation leads (67%) and 74 procedures (61%) required an extraction device. The mean lead dwell time was 5.6 ± 5.2 years. Major complications were observed in 16 procedures (13.2%) and 5 of them (4.1%) resulted in exitus. When we compared the groups according to the major complication, the rates of chronic obstructive pulmonary disease (4 vs. 3; P = 0.020), existence of passive fixation leads (PFL) (24 vs. 9; P = 0.013), and device indication (P = 0.012) were higher in the complication group. Multivariate analysis revealed that only the presence of PFL was associated with major complications. (odds ratio 4.486, 95% confidence interval 1.365-14.748; P = 0.013) Conclusion: The present study showed that the presence of a PFL is a predictive factor for major complications

Decreased heart rate recovery may predict a high SYNTAX score in patients with stable coronary artery disease

An impaired heart rate recovery (HRR) has been associated with increased risk of cardiovascular events, cardiovascular, and all‐cause mortality. However, the diagnostic ability of HRR for the presence and severity of coronary artery disease (CAD) has not been clearly elucidated. Our aim was to investigate the relationship between HRR and the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score in patients with stable CAD (SCAD). A total of 406 patients with an abnormal treadmill exercise test and ≥50% coronary stenosis on coronary angiography were included. The HRR was calculated by subtracting the HR in the first minute of the recovery period from the maximum HR during exercise. The SYNTAX score ≥23 was accepted as high. Correlation of HRR with SYNTAX score and independent predictors of high SYNTAX score were determined. A high SYNTAX score was present in 172 (42%) patients. Mean HRR was lower in patients with a high SYNTAX score (9.8 ± 4.5 vs. 21.3 ± 9, p < 0.001). The SYNTAX score was negatively correlated with HRR (r: -0.580, p < 0.001). In multivariate logistic regression analysis, peripheral arterial disease (OR: 13.3; 95% CI: 3.120–34.520; p < 0.001), decreased HRR (OR: 0.780; 95% CI: 0.674–0.902; p = 0.001), peak systolic blood pressure (OR: 1.054; 95% CI: 1.023–1.087; p = 0.001), and peak HR (OR: 0.950; 95% CI: 0.923–0.977; p < 0.001) were found to be independent predictors of a high SYNTAX score. Our results showed that HRR is significantly correlated with the SYNTAX score, and a decreased HRR is an independent predictor of a high SYNTAX score in patients with SCAD

Güçlü Yönler Öz Yeterlilik Ölçeği Türkçe Formunun Geçerlik ve Güvenirliği

anemonBuaraştırmanın amacı, Tsai, Chaichanasakul, Zhao, Flores ve Lopez (2014) tarafından geliştirilen “Strengths Self EfficacyScale” Güçlü Yönler Öz Yeterlilik Ölçeği’nin Türkçe formunun geçerlik vegüvenirliğinin incelenmesidir.Araştırmanın çalışma grubunu 2017-2018 öğretimyılı bahar döneminde Ankara Üniversitesi ve Recep Tayyip ErdoğanÜniversitesi’nden 289 öğrenci (118 erkek, 171 kadın) oluşturmaktadır.Doğrulayıcı faktör analizi sonucunda uyum iyiliği değerleri ?2(df=44)= 114.96, p&lt;.001, ?2/df=2.80, RMSEA=.079, CFI=.98, GFI=.93, NFI=.97, NNFI=.97, SRMR=.044’dür.Ayrılma geçerliği için ölçeğin, Yaşam Doyumu Ölçeği ilearasındaki ilişki r=.271, p&lt;.01 olarak bulunmuştur. Ölçeğin bütünü içinCronbach Alfa iç tutarlılık katsayısı .899, test tekrar test korelasyonur=.735, p&lt;.01, eşit uzunluk ve eşit olmayan uzunluk Spearman Brown değeri.83 ve Guttman yarı test değeri de .82 olarak bulunmuştur.The purposeof this study is to adapt Strengths SelfEfficacy Scale (SSES) developed by Tsai, Chaichanasakul, Zhao, Flores ve Lopez(2014) into Turkish and to examine its reliability and validity. The study groupconsists of 289 undergraduate students (118 men, 171 women) studying in AnkaraUniversity and Recep Tayyip Erdoğan University in spring term of 2017-2018academic year. As a result of confimatory factor analysis, goodness of fit testwas ?2(df=44)= 114.96, p&lt;.001, ?2/df=2.80, RMSEA=.079, CFI=.98, GFI=.93, NFI=.97, NNFI=.97, SRMR=.044.For determining divergent validity, therelationship between SSES and Life Satisfaction Scale was examined r=.271, p&lt;.01. Cronbach Alpha coefficient was .899, test retest correlation wasr=.735, p&lt;.01, equal and unequal length Spearman Brown were .83 and Guttmanwas .82.46282

Validity and Reliability of the Strengths Self Efficacy Scale Turkish Version

anemonBuaraştırmanın amacı, Tsai, Chaichanasakul, Zhao, Flores ve Lopez (2014) tarafından geliştirilen “Strengths Self EfficacyScale” Güçlü Yönler Öz Yeterlilik Ölçeği’nin Türkçe formunun geçerlik vegüvenirliğinin incelenmesidir.Araştırmanın çalışma grubunu 2017-2018 öğretimyılı bahar döneminde Ankara Üniversitesi ve Recep Tayyip ErdoğanÜniversitesi’nden 289 öğrenci (118 erkek, 171 kadın) oluşturmaktadır.Doğrulayıcı faktör analizi sonucunda uyum iyiliği değerleri ?2(df=44)= 114.96, p&lt;.001, ?2/df=2.80, RMSEA=.079, CFI=.98, GFI=.93, NFI=.97, NNFI=.97, SRMR=.044’dür.Ayrılma geçerliği için ölçeğin, Yaşam Doyumu Ölçeği ilearasındaki ilişki r=.271, p&lt;.01 olarak bulunmuştur. Ölçeğin bütünü içinCronbach Alfa iç tutarlılık katsayısı .899, test tekrar test korelasyonur=.735, p&lt;.01, eşit uzunluk ve eşit olmayan uzunluk Spearman Brown değeri.83 ve Guttman yarı test değeri de .82 olarak bulunmuştur.The purposeof this study is to adapt Strengths SelfEfficacy Scale (SSES) developed by Tsai, Chaichanasakul, Zhao, Flores ve Lopez(2014) into Turkish and to examine its reliability and validity. The study groupconsists of 289 undergraduate students (118 men, 171 women) studying in AnkaraUniversity and Recep Tayyip Erdoğan University in spring term of 2017-2018academic year. As a result of confimatory factor analysis, goodness of fit testwas ?2(df=44)= 114.96, p&lt;.001, ?2/df=2.80, RMSEA=.079, CFI=.98, GFI=.93, NFI=.97, NNFI=.97, SRMR=.044.For determining divergent validity, therelationship between SSES and Life Satisfaction Scale was examined r=.271, p&lt;.01. Cronbach Alpha coefficient was .899, test retest correlation wasr=.735, p&lt;.01, equal and unequal length Spearman Brown were .83 and Guttmanwas .82.46282

İş Sağlığı ve Güvenliği Açısından Örnek Bir Matbaa İşletmesinin Değerlendirilmesi

6331 sayılı İş Sağlığı ve G&uuml;venliği Kanunu&rsquo;nun 30 Haziran 2012 tarihinde y&uuml;r&uuml;rl&uuml;ğe girmesiyle işyerlerinde iş g&uuml;venliği ile ilgili d&uuml;zenlemelerin yapılması matbaa işletmelerinde de zorunlu hale gelmiştir. Bu konuda matbaa işletmelerine yol g&ouml;stermesi, iş kazalarının ve maddi hasarlı kazaların &ouml;nlenmesi i&ccedil;in &ouml;rnek bir matbaa işletmesi incelenmiştir. Bu &ccedil;alışmanın amacı matbaa işletmelerindeki işverenlerin/y&ouml;neticilerin/&ccedil;alışanların iş g&uuml;venliği ile ilgili hususlara dikkatlerini &ccedil;ekmektir. Risk değerlendirmesi, iş g&uuml;venliği uzmanının &ouml;nc&uuml;l&uuml;ğ&uuml;nde yapılması gereken teknik bir konu olup bu &ccedil;alışmada matbaa işletmelerindeki iş sağlığı ve g&uuml;venliği konusundaki eksikliklere dikkat &ccedil;ekilmek istenilmiş, bu ama&ccedil;la fiziki eksikliklerden bir kısmı &ouml;rnek bir matbaa işletmesi &uuml;zerinden incelenmiş ve alınması gereken &ouml;nlemler belirtilmiştir. Her matbaanın riskleri, &ccedil;alışma ortamındaki ve ekipmanlarındaki kusurları/hataları değişmekle beraber iş sağlığı ve g&uuml;venliği konusunda matbaa işletmelerinin &ccedil;oğunda g&ouml;r&uuml;lebilenleri &ouml;rneklendirilmeye &ccedil;alışılmıştır. Matbaa işletmelerine &ouml;rnek ve rehber olması amacıyla yapılan bu &ccedil;alışma ile ayrıca bu eksiklikler ve yanlış uygulamaların d&uuml;zeltilmesi ve iş sağlığı ve g&uuml;venliği ile ilgili risklerin en aza indirilmesi hedeflenmiştir

AKUT MİYOKARD ENFARKTÜSÜNDE VENTRİKÜLER SEPTUM RÜPTÜRÜ

Ventriküler septum rüptürü (VSR), akut miyokard enfarktüsünün (AMI) nadir görülen, fatal bir komplikasyonudur

Association between Intermountain Risk Score and long-term mortality with the transcatheter aortic valve implantation procedure

Background: Since its first introduction, the spectrum and frequency of use of transcatheter aortic valve implantation (TAVI) have increased throughout the world. Therefore, it is crucial to determine which patients are at high mortality risk with TAVI. The Intermountain Risk Score (IMRS) is a score calculated from laboratory parameters. This study aimed to determine the long-term mortality of TAVI patients using the IMRS and to compare it with traditional scoring systems.Methods: The study included a total of 133 patients undergoing TAVI at our hospital from 2010 to 2019. Demographic data, co-morbid diseases, echocardiographic and laboratory parameters were collected retrospectively. The performance of IMRS was assessed as compared to the mortality determined in the overall patient population.Results: During the follow-up, 54.9% of patients (60 patients) (Group 1) survived; the mortality in Group 2 (60 patients) was 45.1%. The survival period had a mean of 1433 (±124) days. The mean IMRS was 1.67 (0.7) in Group 1 and 2.33 (0.72) in Group 2 (P &lt;0.001). In multivariable analyses, only high risk of IMRS (hazard ratio [HR], 3.430; 95% confidence interval [CI], 1.537–7.653; P = 0.003) and EuroSCORE II (HR, 1.141; 95% CI, 1.011–1.288; P = 0.03) independently predicted long-term mortality.Conclusions: From the evaluation of all laboratory and echocardiography parameters, long-term mortality (&gt;30 days) following the TAVI procedure can be said to be higher in patients with a high IMRS. The data from this study can be considered of value in demonstrating the clinical significance of IMRS calculation before the TAVI procedure