The effect of irritable bowel syndrome on carotid intima-media thickness, pulse wave velocity, and heart rate variability

Objective: Irritable bowel syndrome (IBS), a subgroup of functional somatic disorders, may be associated with autonomic dysfunction (AD). Heart rate variability (HRV), a measure of autonomic dysfunction, may predict survival. The aim of this study was to investigate the effect of IBS on HRV parameters, carotid intima-media thickness (CIMT) and carotid-femoral pulse wave velocity (cf-PWV) as surrogates of AD, subclinical atherosclerosis and arterial stiffness, respectively. Methods: Our study was cross-sectional and observational. Thirty consecutive patients with IBS and 30 control participants underwent 24-hour Holter monitoring, cf-PWV assessment and CIMT measurement. The diagnosis of IBS was based on Rome III criteria. There were 24 patients with IBS-Constipation (80%), 4 patients with IBS-Diarrhea (13.3%), and 2 patients with IBS-Mixed (6.7%) in IBS group. Student t-test and χ2 test were utilized in order to compare continuous and categorical variables between two groups, respectively. Results: Biochemical parameters did not differ between groups except for slightly increased creatinine in patients with IBS. cf-PWV and CIMT values were similar between groups. SDNN index and RMSSD were significantly impaired in patients with IBS compared to controls. Frequency analyses revealed lower LF, HF, and VLF in subjects with IBS. Conclusion: We demonstrated decreased parasympathetic modulation in patients with constipation predominant IBS. However, we could not demonstrate any changes in vascular structure and functions measured by carotid intima-media thickness and pulse wave velocity. Our results do not support accelerated atherosclerosis in IBS population (Anadol

Management with Guidance of Minimally Invasive Cardiac Output Monitoring (PiCCO®) in Coronary Artery Bypass Surgery and Postoperative Results

Objective:Our study aimed to assess the correlation between the measured PiCCO® parameters and extubation time and intensive care unit (ICU) length of stay in patients who underwent coronary artery bypass grafting (CABG) surgery and were managed by monitorization of cardiac output and cardiac performance parameters with PiCCO®.Method:This study was conducted by retrospective analysis data of all 44 patients who underwent CABG surgery during December 2015-March 2016 and were managed through PiCCO® monitorization. The patients’ demographic characteristics (age, sex, weight, height, body mass index), American Society of Anesthesiologists physical conditions, comorbidities, ejection fractions, anesthetic management, operative details, hemodynamic data, PiCCO® parameters, extubation times, cardiovascular surgery ICU lengths of stay, requirements for vasoactive agent and blood transfusion, mortality, and morbidity were recorded from patient records and evaluated the correlation between the measured PiCCO® parameters and extubation time and ICU length of stay inpatients.Results:A significant increase was detected in the parameters of cardiac contractility and performance monitored with PiCCO® in the postoperative period (p<0.05). No significant correlation was found between PiCCO® parameters and extubation time and ICU length of stay (p<0.05).Conclusion:Coronary revascularization patients managed with the guidance of PiCCO® showed improved myocardial contractility and cardiac performance and no increase beyond what is anticipated in the extubation time and ICU lengths of stay of the patients. Thus, we believe that optimum volume and hemodynamic targets can be achieved in patients managed through monitorization of cardiac function parameters

Results of thrombolytic treatment in patients with ST elevation myocardial infarction

ST yükselmeli akut miyokard infarktüsünün (STEMI) en önemli tedavisi primer perkütan koroner girişim (PKG) ile tıkalı olan damarda reperfüzyonun sağlanmasıdır. Fakat bunun için 24 saa tecrübeli bir ekibe ihtiyaç vardır. Bu nedenle dünyada hala trombolitik tedavi ile reperfüzyon en yaygın uygulanan reperfüzyon tedavisidir. Ülkemizde STEMI'li olgularda uygulanan trombolitik tedavi ile ilgili oldukça sınırlı sayıda veri vardır. Bu çalışmadaki amacımız yaklaşık 8 yıllık bir dönemde hastanemizde uygulanan trombolitik tedavi sonuçlarını retrospektif olarak inceleyip bildirmektir. Çalışmaya 1999-2007 yılları arasında hastanemiz acil servisine başvurup STEMI tanısı konularak yatırılan ve fibrinolitik tedavi uygulanan 321 hasta alındı. STEMI tanısında Dünya Sağlık Örgütü kriterleri kullanıldı. Hastaların demografik özellikleri, STEMI'nin lokalizasyonu, trombolitik tedavinin etkinliği ve yan etkileri retrospektif olarak gözden geçirildi. Çalışmaya alınan STEMI'lı 321 hastanın (291'i erkek, 30'u kadın) yaş ortalaması 57,35 yıldı. Erkeklerin yaş ortalaması 56,45±9,09 yıl, kadınlarinki ise 66,10±11,2 yıldı. STEMI lokalizasyonu 165 (%51) hastada anterior, 139 (%43) hastada inferiyor ve 17 (%5) hastada da diğer bölgelerdeydi. 199 (%62) hastada trombolitik ilaç olarak streptokinaz uygulanırken, 122 (%38) hastada doku plazminojen aktivatörü (tPA) kullanıldı. 258 (%80) hastada uygu- lanan reperfüzyon tedavisi başarılı kabul edilirken, 63 (%20) hastada ise başarısız olarak kabul edildi. STEMI'de primer PKG fibrinolitik tedaviye üstün olmasına rağmen, uygulanmasında pek çok kısıtlamalar vardır. Dolayısıyla fibrinolitik tedavi kolaylıkla her zaman ve her yerde uygulanabilir etkili ve önemli bir tedavi alternatifidir.Restoration of full antegrade flow in the ST elevation myocardial infarction by percutaneus coronary intervention (PCI) is the principal treatment of choice. However an experienced team is mandatory which is available 24 hour a day. Therefore reperfusion with thrombolytic treatment is the most common reperfusion of choice worldwide. Limited number of data about usage of thrombolytic treatment in STEMI is available in our country. The objective of current study is to evaluate the results of trombolytic treatment retrospectively and to report it. Three hundred twenty-one patients diagnosed as STEMI and treated with fibrinolytic therapy at Rize State hospital between 1999-2007 years were enrolled in the current study. World Health Organization's criterias was used in diagnosis of STEMI. Demographic characteristics of patients, type of the STEMI, effects and side effects of the therapy were evaluated retrospectively. The mean age of 321 patients with STEMI (291 male and 30 female) was 57,35 years. Average age of male and female patients was 56,45±9,09, 66,10±11,20 respectively. The localization STEMI was anterior in 169 patients, inferior in 139 patients and other localizations in 17 patients. Streptokinase was administered in 199 patients and tissue plasminogen activator (tPA) in 122. 258 patients (80%) had successful outcome and remaining 63 patients (20%) had poor outcome. Although primary PCI is superior to fibrinolytic therapy in patients with STEMI, there are lots of limitations in clinical practice. Therefore fibrinolytic therapy is an effective treatment of choice in STEMI which is easy to perform in anywhere and anytim

Neurogenic Pulmonary Edema (A Case Report)

Neurogenic pulmonary edema is a life threatening complication of severe central nervous system injury. The most common cause of neurogenic pulmonary edema is subarachnoid hemorrhage followed by head trauma and epilepsy. The rare causes are cervical spine trauma, multiplesclerosis, cerebellar hemorrhage and intracranial tumors. Neurogenic pulmonary edema is characterized by an increase in extravascular lung water in patients who have sustained a sudden change in neurologic condition. The exact pathophysiology is unclear but it probably involves an adrenergic response to the central nervous system injury which leads to increased catecholamine, pulmonary hydrostatic pressure and increased lung capillary permeability. The presenting symptoms are nonspecific and often include dyspnea, tachypnea, tachycardia, hypoxemia, pinkfroty secretion, bilateral pulmonary infiltrates and crackles. These symptoms start within minutes or hours and resolves 48-72 hours that typically for neurogenic pulmonary edema. Basic principles of treatment, surgical decompression, reduce intracranial pressure, controlled ventilation with suplemental oxygen, positive end expiratory pressure and diuresis. We report a case with neurogenic pulmonary edema that occured after head trauma. (Journal of the Turkish Society Intensive Care 2012; 10: 59-62

Decreased heart rate variability in irritable bowel syndrome has no effect on carotid intima-media thickness and pulse wave velocity

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYDurakoglugil, Emre/0000-0001-5268-4262;WOS: 000329858400496[No abstract available]Turkish Soc Cardio