A New Scale for Evaluating the Risks for In-Hospital Falls of Newborn Infants: A Failure Modes and Effects Analysis Study

We aimed to develop a new scale for evaluating risks and preventive measures for in-hospital falls of newborn infants, from admission to discharge of the expectant mother. Our study was prepared in accordance with Failure Modes and Effects Analysis criteria. The risks and preventive measures for in-hospital falls of newborns were determined. Risk Priority Numbers (RPNs) were determined by multiplication of the scores of severity, probability of occurrence, and probability of detection. Analyses showed that risks having the highest RPNs were the mother with epidural anesthesia (RPN: 350 point), holding of the baby at the moment of delivery (RPN: 240), and transportation of baby right after delivery (RPN: 240). A reduction was detected in all RPNs after the application of preventive measures. Our risk model can function as a guide for obstetric clinics that need to form strategies to prevent newborn falls

Usefulness of the uric acid and CHA2DS2-VASc score in prediction of left atrial thrombosis in patients with mitral stenosis and sinus rhythm

Background: The risk of thrombus formation in the left atrium is known to be very high in patients with both mitral stenosis (MS) and atrial fibrillation (AF). However, that risk should not be ignored in patients with MS in sinus rhythm (SR). The aim of this study was to determine the clinical, echocardiographic, and biochemical factors that could have a determining role in the formation of a left atrial (LA) thrombus in patients with MS in SR. Method: A total of 207 consecutive patients with MS who underwent both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for diagnosis or to investigate the presence of a thrombus in the LA and appendage were enrolled in this study. Results: LA thrombus was detected in 21 of 207 patients. CHA2DS2-VASc score was not found to be a predictor of LA thrombosis in patients with MS in SR, despite the higher CHA2DS2-VASc scores observed in those patients. The mitral valve area and mitral valve gradient were not predictive of LA thrombus development; however, LA anteroposterior diameter (LAAPD) was found to be a predictor of LA thrombosis. Levels of high sensitivity-C-reactive protein and uric acid were higher in the patients with LA thrombosis, but only uric acid was found to be a predictor of LA thrombosis in multivariate analysis. Conclusions: A larger LAAPD and an elevated serum uric acid level were found to be independent predictors of LA thrombosis in patients with MS in SR.

Assessment of sustained effects of levosimendan and dobutamine on left ventricular systolic functions by using novel tissue Doppler derived indices in patients with advanced heart failure

Background: Previous studies comparing levosimendan vs. dobutamine have revealed that levosimendan is better in relieving symptoms. Echocardiographic studies have been done using second measurements immediately following a dobutamine infusion or while it was still being administered. The aim of our study was assessment of sustained effects of 24 h levosimendan and dobutamine infusions on left ventricular systolic functions. Methods: A total of 61 patients with acutely decompensated heart failure with New York Heart Association (NYHA) class III or IV symptoms were randomized to receive either levosimendan or dobutamine 2:1 in an open label fashion. Before and 5 days after the initiation of infusions, functional class was assessed, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF), mitral inflow peak E and A wave velocity, and E/A ratios were measured; using tissue Doppler imaging, isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), early (E’) and late (A’) diastolic velocities, and E’/A’ and E/E’ ratios were measured. Results: The NYHA class improved in both groups, but improvements were prominent in the levosimendan group. NT-proBNP levels were significantly reduced in the levosimendan group. Improvements in LVEF and diastolic indices were significant in the levosimendan group. Tissue Doppler-derived systolic indices of IVV and IVA increased significantly in the levosimendan group. Conclusions: Improvements in left ventricular systolic and diastolic functions continue after a levosimendan infusion.

Serum Presepsin Levels Are Not Elevated in Patients with Controlled Hypertension

Introduction. Hypertension (HT) is a common serious condition associated with cardiovascular morbidity and mortality. The pathogenesis of HT is multifactorial and has been widely investigated. Besides the vascular, hormonal, and neurological factors, inflammation plays a crucial role in HT. Many inflammatory markers such as C-reactive protein, cytokines, and adhesion molecules have been studied in HT, which supported the role of inflammation in the pathogenesis of HT. Presepsin (PSP) is a novel biomarker of inflammation. Therefore, the potential relationship between PSP and HT was investigated in this study. Methods. Forty-eight patients with controlled HT and 48 controls without HT were included in our study. Besides routine clinical and laboratory data, PSP levels were measured in peripheral venous blood samples from all the participants. Results. PSP levels were significantly lower in patients with HT than in controls (144.98±75.98 versus 176.67±48.12 pg/mL, p=0.011). PSP levels were positively correlated with hsCRP among both the patient and the control groups (p=0.015 and p=0.009, resp.). However, PSP levels were not correlated with WBC among both groups (p=0.09 and p=0.67, resp.). Conclusions. PSP levels are not elevated in patients with well-controlled HT compared to controls. This result may be associated with anti-inflammatory effects of antihypertensive medicines

Surgical Repair for Isolated Aortic Interruption in a Young Adult

Interrupted aortic arch (IAA), a rare congenital malformation of the aortic arch, is defined as a loss of luminal continuity between the ascending and descending portions of the aorta. It is rarely diagnosed as an isolated anomaly in adulthood. Surgical repair is feasible through a sternotomy or thoracotomy incision. In this report, we describe the surgical repair of an isolated IAA in a 29-year-old patient by performing an ascending-to-descending aortic bypass via a sternotomy with cardiopulmonary bypass

Surgical Management of Liver Hydatid Cyst Related Non-traumatic Emergencies: Single Center Experience

Background: Vast majority of complaints and physical examination findings of hydatid disease are common in emergency room patients. Different emergency presentations of hydatid cyst disease and their treatment are evaluated. We studied preoperative laboratory findings of these patients to identify any parameters to predict hydatid cyst-biliary system communication. Methods: We reviewed the files of patients who underwent emergency surgery due to liver hydatid cysts and related conditions between March 2010 and March 2014 in Ankara Numune Research and Training Hospital, Turkey, retrospectively. Patients were grouped, regarding to the presence of biliary system involvement. Results: Twelve patients (9 males, 3 females) were included. We identified two groups. Biliary system involved group (n=9) had significantly higher pre-operative gamma glutamine transferase and alkaline phosphatase levels (P=0.036). No significant difference was noted regarding other pre-operative laboratory findings. Mortality rate was 17%. Conclusion: Medical literature lacks sufficient information about hydatid disease related non-traumatic emergency surgeries. Preoperative elevated gamma glutamyl transferase and alkaline phosphatase levels may be questioned as a warning about cyst-biliary communication in hydatid cyst patients with abdominal pain in the emergency room. Future studies with larger sample sizes are needed. In addition, prolongation of the time before diagnosis in these patients may result in life threatening complications

Effects of arteriovenous fistula on clinical, laboratory and echocardiographic findings in renal allograft recipients

Purpose: Left ventricular hypertrophy (LVH) is frequently observed in patients with end-stage renal disease and renal allograft recipients, and is an independent and strong predictor of morbidity and mortality. Presence of a patent arteriovenous fistula (AVF) after renal transplantation may contribute to the persistent LVH. We investigated the clinical, laboratory, and echocardiographic findings in patients with renal transplants with or without AVF

Double chambered right ventricle in adulthood: a case report

Double chambered right ventricle (DCRV) is a rare disorder observed in adulthood and is usually misdiagnosed. The DCRV is a form of right ventricular out flow tract obstruction. In this rare pathology, the right ventricle is divided into two chambers by a muscular band, including high-pressure proximal and low-pressure distal chamber. It develops over time and mostly in patients with an abnormally short distance between the moderator band and pulmonary valve. Most of DCRV patients are diagnosed before 20-years of age. However, despite rarely seen, DCRV may be diagnosed in adults. As it complicates diagnosis, it should be seriously taken into consideration

Effect of sol-gel modifications on formation and morphology of nanocrystalline lanthanum aluminate

Oksuzomer, Faruk/0000-0003-0827-8667; Koc, Serkan Naci/0000-0003-4472-4337WOS: 000242522000015LaAlO3 powders are prepared by sol-gel method. The effect of preparation conditions on morphological properties and crystal formations are investigated. iso-Propanol/tert-butanol and ethyl acetoacetate/ethylene glycol monomethylether are used solvents and complexing agents, respectively. Samples are dried with conventional and freeze-drying methods and calcined between 600 and 1000 degrees C. TGA, DTA, XRD, SEM and TEM methods are used for characterization. It is observed that freeze-dried sample prepared with tert-butanol has the lowest LaAlO3 formation temperature and uniform rhombohedral crystals. But conventionally dried sample, prepared with iso-propanol has smallest agglomerates at 1000 degrees C and does not show clear crystallization temperature in DTA analysis. The XRD peaks of LaAlO3 crystal are observed at 600 degrees C for all samples prepared by various sol-gel conditions. (C) 2006 Elsevier Ltd. All rights reserved