The Use of Total Artificial Heart With Example of Cases for End-Stage Heart Failure Therapy

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400098Turkish Soc Cardio

Volume XLIX, Number 13, November 10, 1931

3rd World Heart Failure Congress -- NOV 29-DEC 02, 2012 -- Istanbul, TURKEYWOS: 00031169820000

Is there an association between liver type fatty acid binding protein and severity of preeclampsia?

Objective The aim of this study was to estimate the level of liver fatty acid binding protein (LFABP) in women with preeclampsia. Method A case–control study was conducted in 90 pregnant women who were divided into the following three groups: normal pregnancy (n = 30), mild–moderate preeclampsia (n = 30), and severe preeclampsia (n = 30). Maternal blood samples were obtained during an antenatal clinic visit in normal pregnant women, and at the time of diagnosis in women with preeclampsia. Serum LFABP levels were measured by the quantitative sandwich enzyme immunoassay technique. Results Serum LFABP level was significantly higher in severe and mild–moderate preeclampsia groups than normal pregnancy group (1,709.90 ± 94.82, 1,614.93 ± 118.22, and 1,532.36 ± 140.98 pg/ml, respectively; p\0.001). In multivariate analysis, the severity of preeclampsia was correlated with LFABP level [unadjusted odds ratio (95 % confidence interval), 1.008 (1.003–1.012), p\0.001 and LDH 1.063 (1.029–1.099), p\0.001]. Conclusion Maternal serum LFABP level appears to be correlated with the severity of the preeclampsia and can be used to confirm the diagnosis

Moguća povezanost gestacijskog dijabetesa s upalom

The aim of this study was to investigate whether gestational diabetes mellitus (GDM) is associated with inflammation by comparing serum levels of human chitinase-3-like protein 1 (YKL-40), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This case control study included 29 pregnant women with GDM and 29 pregnant women with normal glucose tolerance matched for age (±2 years) and pre-pregnancy body mass index (±2 kg/m2). The YKL-40/CHI3L1 levels were measured, and NLR and PLR investigated. There were no statistically significant differences in maternal age, gestational age, gravidity and parity. Higher YKL-40 levels were recorded in pregnant women with GDM compared to control subjects (203 (65-300) ng/mL vs. 159.2 (14-290) ng/mL, p=0.007). NLR and PLR were significantly higher in GDM compared with control group. In conclusion, GDM is associated with high levels of YKL-40, NLR and PLR, which indicate inflammatory status.Cilj ovoga istraživanja bio je procijeniti je li gestacijski dijabetes melitus (GDM) udružen s upalom i to usporedbom serumskih razina humanog hitinazi-3-sličnog proteina 1 (YKL-40) te omjera neutrofila/limfocita (NLR) i omjera trombocita/limfocita (PLR). U ovo istraživanje parova bilo je uključeno 29 trudnica s GDM i 29 trudnica s normalnom tolerancijom glukoze. Dob (± 2 godine) i indeks tjelesne mase prije trudnoće bili su podjednaki u obje skupine. Mjerene su razine humanog hitinazi-3-sličnog proteina 1 (YKL-40/CHI3L1) te ispitani omjeri NLR i PLR. Nije bilo statistički značajnih razlika u dobi, gestacijskoj dobi i gravidnosti. Zabilježene su više razine YKL-40 u trudnica s GDM u usporedbi s kontrolnim trudnicama (203 (65-300) ng/mL prema 159,2 (14-290) ng/mL, p=0,007). NLR i PLR bili su značajno viši u skupini s GDM nego u kontrolnoj skupini. U zaključku, GDM je udružen s visokim razinama YKL-40, NLR i PLR koji ukazuju na upalno stanje

Do follicular fluid advanced glycation end products levels affect the ovarian response in unexplained infertility?

Objective: To compare the advanced glycation end products (AGEs) levels in follicular fluid according to the different ovarian responses of women who underwent controlled ovarian stimulation due to unexplained infertility and to examine the relationship between these levels and pregnancy outcomes. Methods: Sixty-three women who underwent fresh IVF/ICSI cycles with GNRH antagonist protocol were divided into 3 groups according to the number of retrieved oocytes as suboptimal (4–9 oocytes), optimal (10–15 oocytes) and high (>15 oocytes) responders. AGEs levels in follicular fluid were measured by ELISA method. Results: AGEs levels were 6.81 ± 2.20 mg/ml, 5.30 ± 2.01 and 6.44 ± 1.43 mg/ml in suboptimal, optimal and high response group, respectively. AGEs level was significantly higher in suboptimal response group than in optimal response group. The cutoff level of 6.19 mg/ml had a sensitivity of 59.3% and a specificity of 66.7% in distinguishing the suboptimal response group from the optimal response group. However, there were no statistically significant difference between AGEs levels and clinical pregnancy and live birth rates. Conclusion: Increased AGEs level in follicular fluid may be associated with decreased ovarian response during controlled ovarian stimulation in unexplained infertility case, however, it does not provide information about pregnancy outcomes

Biochemiczne markery pierwszego trymestru w ciąży bliźniaczej

Objective: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. Materials and methods: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy. Results: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p>0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy- Associated Plasma Protein A (PAPP-A) and fβ-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2 %) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fβ-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). Conclusions: Our study revealed that median PAPP-A and fβ-hCG levels for twins were less than twice those of singleton values.Cel pracy: Celem naszego badania było zbadanie surowiczych markerów pierwszego trymestru oraz przezierności karkowej (NT) w ciążach bliźniaczych w naszej populacji. Metoda: Przeanalizowano wyniki wszystkich testów podwójnych wykonanych w naszym szpitalu w ciągu trzech lat. Wyodrębniono grupę ciąż bliźniaczych (n=49) i porównano ją z trzy razy większą grupą kontrolną prawidłowych ciąż pojedynczych (n=147). Wyniki: Nie znaleziono istotnych statystycznie różnic w wieku, wieku ciążowym i masie ciała ciężarnych pomiędzy grupami (p>0,05). Stwierdzono podobne wyniki pomiaru NT w obu badanych grupach. Mediana MoM białka PAPP-A i poziom fβ-hCGw ciążach bliźniaczych był istotnie wyższy niż w ciążach pojedynczych. Dwanaście procent ciąż bliźniaczych było efektem technik wspomaganego rozrodu. Ciąże w wyniku IVF oraz ciąże spontaniczne wykazywały się podobnych wynikiem MoM białka PAPP-A (2,2 vs. 1,2 odpowiednio) i fβ-hCG (Mann-Whitney U; p=0,195 i p=0,958). Wnioski: Średni poziom białka PAPP-A i fβ-hCG dla ciąż bliźniaczych był mniej niż dwa razy większy niż dla pojedynczych ciąż

Maternal serum amyloid A levels in pregnancies complicated with preterm prelabour rupture of membranes

Objective: The aim of the study was to investigate a possible association between maternal serum amyloid A levels (SAA) and maternal and fetal parameters in pregnancies complicated with preterm prelabor rupture of membranes (PPROM). Material and methods: A total of 88 pregnant women (PPROM group, n=44 and control group, n=44) were included into this prospective case control study. Serum blood samples for SAA were obtained from both groups within 1h since the rupture of the membranes and before administration of any medicine. The samples were kept frozen at -70°C until the analysis. The recorded risk factors were: age, gravidity, parity, delivery mode, gender, fetal birth weight, APGAR scores, white blood cell count, microCRP, neutrophil/lymphocyte ratio (NLR), and maternal serum SAA levels. Results: Demographic characteristics showed no statistically significant differences between the groups (p>0.05). The mode of delivery mode was cesarean section: 41% and 43.2% in the study and the control group, respectively, and this difference was statistically significant between the groups (

Predictive Utility of Systemic Immune Inflammation Index (SII) in Identifying Endometrial Carcinoma in Premalignant Endometrial Lesions

INTRODUCTION: It is important to detect endometrial cancer (EC) in endometrial intraepithelial neoplasia (EIN) patients. It was aimed to determine the role of systemic immune inflammation index (SII) in predicting concurrent EC in women with EIN. METHODS: In this retrospective study, 429 women with EIN divided into three groups according to final histopathologic results: benign(n=151), EIN(n=152), and EC(n=126). Demographic and clinical data, pathologic and laboratory result were collected. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII index were calculated and compared among groups. RESULTS: The SII, PLR and NLR values of benign, EIN and EC groups were compared and all values of EC group were the highest. The ROC analysis showed that although all markers had statistical significance, the AUC of SII was the highest. The SII score>0.67 (95%CI: 7.17-37.3) had a 16.35-fold, preoperative platelet count > 287 (95%CI: 1.91-6.2) had a 3.45-fold and age >49 years (95%CI: 1.97-5.92) had 3.42-fold increased risk for EC. DISCUSSION AND CONCLUSION: Although age and preoperative platelet count were found independent risk factors, SII was the strongest predictor for EC in women with EIN. SII can be used as a predictive marker for identifying concurrent EC or having risk for developing EC in women with EIN

Oncological and functional outcomes of patients who underwent open partial nephrectomy for kidney tumor

Objective: To report long-term functional and oncological outcomes of OPN Methods: We enrolled 182 patients who underwent consecutive OPN with a diagnosis of kidney tumor in our clinic between April 2002 and February 2020 and were selected from our prospective OPN database. Preoperative demographic and clinical characteristics, intraoperative and pathological results, and patients' postoperative functional and oncological follow-up data were retrospectively analyzed. Overall survival (OS) and disease- free survival (DFS) were evaluated using Kaplan-Meier survival analysis. The time-dependent variation between preoperative and postoperative functional results was statistically analyzed and presented in a graph. Results and limitations: The mean age was 54.4 ± 10.8 yr, and the median age-adjusted Charlson comorbidity index (ACCI) was 1 (interquartile range [IQR] 0-1). The mean tumor size was 3.1 ± 1.2 cm, and the median RENAL score was 6 (IQR 5-8). The most common malign histopathological subtype was clear cell carcinoma with 76.6%, and five cases (3.4%) had positive surgical margins (PSMs). The most common surgical techniques were the retroperitoneal approach (98.9%) and cold ischemia (88.5%). Estimated glomerular filtration rate (eGFR) preservation was 92% (80.8-99.3, IQR), which translates to 32% chronic kidney disease (CKD) upstaging. Acute kidney injury (AKI) was detected in 27 (14.8%) patients according to RIFLE criteria. The intraoperative complication rate was 5.5%, and the postoperative overall complication rate (Clavien-Dindo 1-5) was 30.2%. Major complications (Clavien-Dindo 3-5) were observed in 13 (7.1%) patients. The median oncological follow-up was 42 mo (21.3- 84.6, IQR), and the 5- and 10-yr OS were 90.1% and 78.6%, 5 and 10-yr DFS were 99.4% and 92.1%, respectively. No local recurrence was observed in 5 (3.4%) patients with PSMs; only one had distant metastasis in the 8th postoperative month. The retrospective design, the small number of patients who underwent PN based on mandatory indication, and one type of surgical approach may limit the generalizability of our findings. Conclusions: This study confirms excellent long-term oncologic and functional outcomes after OPN in a cohort of patients selected from a single institution. In light of the information provided by the literature and our study, our recommendation is to push the limits of PN under every technically feasible condition in the treatment of kidney tumors to protect the kidney reserve and achieve near-perfect oncological results

Parva yetmezliğinin cerrahi tedavisinde üç farklı uygulamanın retrospektif karşılaştırmalı analizi ve postoperatif sonuca etkili faktörlerin belirlenmesi

Amaç: Çalışmamızın amacı vena safena parva yetmezliğine bağlı varislerin cerrahi tedavisinde klasik stripping, parva ligasyonu ve köpük skleroterapi tekniklerinin postoperatif semptom, rekürrens ve sonuç üzerine etkinliklerinin karşılaştırmalı olarak değerlendirilmesi ve postoperatif sonuç ve semptom gelişimi üzerine etkili faktörlerin belirlenmesidir. Materyal, Metod: Ege Üniversitesi Kalp ve Damar Cerrahisi Anabilim Dalında 2004 –2011 yılları arasında, vena safena parva yetmezliği ile birlikte olan varisleri nedeniyle klasik stripping (n=45), parva ligasyonu (n=36) ve ligasyon ile birlikte köpük skleroterapi (%2 polidocanol, n=40) toplam 121 olgu çalışmaya alınmıştır. Olguların yaş ortalaması 47.4±11.3 yıl, ortalama izlem süresi 25.8±20.4 aydır. Preoperatif ve postoperatif CEAP sınıfı, rekürrens gelişimi, semptom, ve doppler bulguları univaryans ve multivaryans analizlerle değerlendirilmiştir. Bulgular: Olgulara uygulanan operasyon tipinin postoperatif semptom gelişimi, CEAP sınıfı veya doppler bulguları üzerine anlamlı hiçbir etkisi olmamıştır. Üç teknik arasında etkinlik açısından hiçbir fark yoktur. Postoperatif CEAP sınıfının belirleyicisi postoperatif perforan yetmezliği (p=0.001, RR:5.148); postoperatif semptom rekürrensinin belirleyicisi preoperatif CEAP sınıfı (p=0.001,RR:4.8) bulunmuştur. Ligasyon grubunda postoperatif CEAP sınıfının belirleyicisi preoperatif parva çapı >5 mm (p=0.002, RR:1.901); postoperatif semptom rekürrensinin belirleyicileri olarak preoperatif parva çapı >5 mm (p=0.039, RR:7.8) ve preoperatif derin venöz yetmezlik (p=0.044, RR:1.304) bulunmuştur. Stripping grubunda postoperatif his kusuru (p=0,041, RR:4.168) belirgindir. Bir yıllık semptomsuz yaşam oranları açısından gruplar arasında anlamlı bir fark bulunmamıştır (p=0.651) Sonuçlar: Parva yetmezliğine bağlı varislerin cerrahi tedavisinde, üç teknik arasında belirgin bir etkinlik farkı yoktur. Preoperatif CEAP sınıfının yüksek oluşu, postoperatif semptom gelişimi üzerine etkilidir. Postoperatif perforan ven yetmezliği oluşu, postoperatif yüksek CEAP sınıfı oranını artırmaktadır. Ligasyon yapılan hastalarda preoperatif derin venöz yetmezliği varsa veya vena safena parva çapı 5 mm'in üzerinde ise postoperatif semptom rekürrensi daha sıktır. Stripping yapılması, postoperatif nöropati gelişimi açısından risk faktörüdür