New description of vagal nerve commanted intrapancreatic taste buds and blood glucose level: An experimental analysis

Introduction: There have been thousands of neurochemical mechanism about blood glucose level regulation, but intrapancreatic taste buds and their roles in blood glucose level has not been described. We aimed to investigate if there are taste buds cored neural networks in the pancreas, and there is any relationship between blood glucose levels. Methods: This examination was done on 32 chosen rats with their glucose levels. Animals are divided into owned blood glucose levels. If mean glucose levels were equal to 105 ± 10 mg/dL accepted as euglycemic (G-I; n = 14), 142 ± 18 mg/dL values accepted as hyperglycemic (G-II; n = 9) and 89 ± 9 mg/dL accepted as hypoglycemic (G-III; n = 9). After the experiment, animals were sacrificed under general anesthesia. Their pancreatic tissues were examined histological methods and numbers of newly described taste bud networks analyzed by Stereological methods. Results compared with Mann-Whitney U test P < 0.005 considered as significant. Results: The mean normal blood glucose level (mg/dL) and taste bud network densities of per cm3 were: 105 ± 10 mg/dL; 156±21 in G-I; 142 ± 18 mg/dL and 95 ± 14 in G-II and 89 ± 9 mg/dL and 232 ± 34 in G-III. P values as follows: P < 0.001 of G-II/G-I; P < 0.005 of G-III/G-I and P < 0.0001 of G-III/G-II. We detected periarterial located taste buds like cell clusters and peripherally located ganglia connected with Langerhans cells via thin nerve fibers. There was an inverse relationship between the number of taste buds networks and blood glucose level. Conclusion: Newly described intrapancreatic taste buds may have an important role in the regulation of blood glucose level

Safety and efficacy of Amplatzer duct occluder II and konar-MF™ VSD occluder in the closure of perimembranous ventricular septal defects in children weighing less than 10 kg

IntroductionDevice closure of perimembranous ventricular septal defects (pmVSD) is a successful off-label treatment alternative. We aim to report and compare the outcomes of pmVSD closure in children weighing less than 10 kg using Amplatzer Duct Occluder II (ADOII) and Konar-MF VSD Occluder (MFO) devices.MethodsRetrospective clinical data review of 52 children with hemodynamically significant pmVSD, and sent for transcatheter closure using ADOII and MFO, between January 2018 and January 2023. Baseline, procedural, and follow-up data were compared according to the implanted deviceResultsADOII devices were implanted in 22 children with a median age of 11 months (IQR, 4.1–14.7) and weight of 7.4 kg (IQR, 2.7–9.7). MFO devices were implanted in 30 children with a median age of 11 months (IQR, 4.8–16.6) and weight of 8 kg (IQR, 4.1–9.6). ADOII were implanted (retrograde, 68.1%) in defects with a median left ventricular diameter of 4.6 mm (IQR, 3.8–5.7) and right ventricular diameter of 3.5 mm (IQR, 3.1–4.9) while MFO were implanted (antegrade, 63.3%) in defects with a median left ventricular diameter of 7 mm (IQR, 5.2–11.3) (p > 0.05) and right ventricular diameter of 5 mm (IQR, 2.0, 3.5–6.2) (p < 0.05). The procedural and fluoroscopy times were shorter with the MFO device (p < 0.05). On a median follow-up of 41.2 months (IQR, 19.7–49.3), valvular insufficiency was not observed. One 13-month-old child (6.3 kg) with ADOII developed a complete atrioventricular heart block (CAVB) six months postoperative and required pacemaker implantation. One 11-month-old child (5.9 kg) with MFO developed a CAVB 3 days postoperative and the device was removed. At 6 months post-procedure, only one child with MFO still experiences a minor residual shunt. There was one arterio-venous fistula that resolved spontaneously.ConclusionBoth the MFO and ADOII are effective closure devices in appropriately selected pmVSDs. CAVB can occur with both devices. The MFO is inherently advantageous for defects larger than 6 mm and subaortic rims smaller than 3 mm. In the literature, our series represents the first study comparing the mid-term outcomes of MFO and ADOII devices in children weighing less than 10 kg

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The relationship between serum NT-proBNP levels and severity of coronary artery disease assessed by SYNTAX score in patients with acute myocardial infarction

WOS: 000504050500015PubMed: 31648513Background/aim: In the present study, we aimed to investigate the relationship between NT-proBNP and SYNTAX score, which is a measure of the complexity of coronary artery disease. Materials and methods: We enrolled 405 consecutive patients with myocardial infarction who underwent coronary angiographic examination. Patients were divided into 3 groups according to their SYNTAX scores. Those with SYNTAX score = 33 were included in the high SYNTAX score group (HSTX). Results: NT-proBNP levels were found to be significantly higher in the HSTX group compared to the other groups (P < 0.001) and in the ISTX group compared to the LSTX group (P < 0.001). The NT-proBNP levels demonstrated an increase from low SYNTAX score to high SYNTAX score tertiles. Conclusions: NT-ProBNP levels in patients with myocardial infarction on admission were independently associated with extent, severity, and complexity of coronary atherosclerosis as assessed by SYNTAX score

The Relationship Between Serum Fibrinogen Level and Stent Restenosis in Patients with Acute Coronary Syndrome

Amaç: İn-stent restenoz, koroner arterlere stent implantasyonu sonrası stentli bölgenin aşamalı olarak yeniden daralmasıdır. İlaç salınımlı stentlerin kullanılmaya başlanmasıyla restenoz oranları azalmış olsa da hala majör problem olmaya devam etmektedir. Bu çalışmada akut koroner sendrom nedeniyle koroner anjiyografi yapılan hastalarda in-stent restenozu ile fibrinojen düzeyi arasındaki ilişkiyi araştırmayı amaçladık. Gereç ve Yöntemler: İki grup arasında yaş, hipertansiyon, diyabetes mellitus, sigara içimi ve sol ventrikül ejeksiyon fraksiyonu açısından fark yoktu (p>0.005, hepsi için). İSR grubunda erkek cinsiyet ve hiperlipidemi oranı İSR olmayan gruba göre daha yüksekti (sırasıyla, p=0.04; 0.007). Biyokimyasal parametrelerden homosistein ve fibrinojen dışında iki grup arasında fark izlenmedi. Serum homosistein ve fibrinojen seviyesi İSR olan grupta İSR olmayan gruba göre istatistiksel olarak anlamlı derecede yüksek saptandı (sırasıyla, p=0.009; 0.032). Dislipidemi, homosistein ve fibrinojen İSR'nin bağımsız prediktörleri olarak saptandı. Bulgular: Tedavi sonrası WOMAC ağrı, WOMAC tutukluk, WOMAC fonksiyonel durum ve WOMAC toplam skorlarında tedavi öncesi değerlere göre her iki grupta da istatistiksel olarak anlamlı gelişme saptandı (p0.005, for all). Male gender and hyperlipidemia rate were higher in ISR group than non-ISR group (p=0.04; 0.007 respectively). Biochemical parameters were not different between the groups except for homocysteine and fibrinogen. Serum homocysteine and fibrinogen levels were significantly higher in the ISR group than in the non-ISR group (p=0.009; 0.032 respectively). Dyslipidemia, homocysteine and fibrinogen were identified as independent predictors of ISR. Conclusion: Plasma fibrinogen levels may be an important biochemical parameter in predicting the risk of restenosis in patients with bare metal stents implanted for coronary artery disease

Akut Koroner Sendromlu Hastalarda Kronik Total Oklüzyon Sıklığı ve Risk Faktörleriyle İlişkisi

Amaç: Bu çalışma kliniğimizde akut koroner sendrom sebebiyle yatarak tedavi edilen hastalarda kronik total oklüzyon (KTO) sıklığı ve bunun kardiyovasküler risk faktörleriyle ilişkisini belirlemek amacıyla yapılmıştır.Gereç ve yöntem: Çalışmaya Nisan 2015 – Eylül 2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiyografik değerlendirmeye alınan hastalar dahil edildi. Koroner anjiyografik incelemelerde lezyon bölgesinde TIMI 0 akım olan hastalar KTO olarak kabul edildi. Risk faktörleri anamnez ve laboratuvar bulgularına göre tespit edildi.Bulgular: Çalışmaya kriterlere uyan 904 hasta dahil edildi. İki yüz on dört hastada (%23) KTO tespit edildi. KTO olan hastalarda ortalama yaş (67 11, 60 13, p 0.001), hipertansiyon varlığı (%54.7, %43.0, p 0.004) ve diyabetes mellitus (%41.1, %31.6, p 0.013) istatistiksel olarak daha yüksek saptandı, erkek cinsiyet (%64, %73, p 0.008), prematüre koroner arter hastalığı öyküsü (%10.3, %19.9, p 0.001) ve sigara kullanımı (%28.0, %48.8, p 0.001) ise daha düşük saptandı.Sonuç: Bu çalışmada akut koroner sendrom hastalarında KTO’su olan ve olmayan hasta grupları arasında risk faktörleri açısından anlamlı farklar olduğu tespit edildi Bildiğimiz kadarıyla, bu çalışma literatürdeki kronik total tıkanma ve kardiyovasküler risk faktörleri arasındaki ilişkiyi gösteren ilk çalışmadır.Objective: In the present study, we aimed to determine the frequency of chronic total occlusion and its relationship with cardiovascular risk factors in inpatients with acute coronary syndrome treated in our clinic.Materials and methods: Patients who underwent coronary angiographic evaluation for acute coronary syndrome between April 2015 and September 2018 were included in the study. Patients with TIMI 0 flow in the lesion region were accepted as chronic total occlusion in coronary angiographic examinations. Risk factors were determined according to the anamnesis and laboratory findings.Results: 904 patients were included in the study. Two hundred and fourteen patients (23%) had CTO. Mean age (67 11, 60 13, p 0.001), hypertension (54.7%, 43.0%, p 0.004) and diabetes mellitus (41.1%, 31.6%, p 0.013) were significantly higher in patients with CTO and male gender (64%, 73%, p 0.008), premature coronary artery disease (10.3%, 19.9%, p 0.001) and cigarette smoking (28.0%, 48.8%, p 0.001) were lower.Conclusion: In the present study, there were significant differences in risk factors among patients with and without chronic total occlusion in acute coronary syndrome patients. To the best of our knowledge, this is the first study in the literature to demonstrate the relationship between chronic total occlusion and cardiovascular risk factors

Author's Reply to the Letter to the Editor "Hyperhomocysteinemia Predicts the Severity of Coronary Artery Disease as Determined by the SYNTAX Score in Patients with Acute Coronary Syndrome"

WOS:000552743700016PubMed: 32675936[Özet Yok

Anterior myocardial infarction in a patient with isolated left ventricular non-compaction

WOS: 000472634800028PubMed: 31044686We presented a 55-year-old male patient with isolated left ventricular non-compaction who was admitted to our emergency department for chest pain and exertional dyspnoea. He was hospitalised due to anterior myocardial infarction, and during his assessment, isolated left ventricular non-compaction was diagnosed

Akut Koroner Sendromlu Hastalarda Çok Damar Hastalığı ile Kardiyovasküler Risk Faktörleri Arasındaki İlişki

Amaç: Akut koroner sendrom olgularında ciddi darlık olan koroner arter sayısı ile kardiyovasküler risk faktörleri arasındaki ilişki değerlendirildi. Yöntemler: Bu çalışma retrospektif olarak dizayn edildi. 2016–2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiografi yapılan 904 hasta çalışmaya dahil edildi. Ciddi koroner arter darlığı olmayan ve koroner operasyon geçiren hastalar çalışma dışı bırakıldı. Hastalar kritik koroner arter darlıklarına göre tek damar hastalığı (TDH) ve çok damar hastalığı (ÇDH) olacak şekilde iki gruba ayrıldı. ÇDH ile TDH olanlar klasik kardiyovasküler risk faktörleri açısından karşılaştırıldı. Bulgular: Hastaların 544’ünde (%60) ÇDH 365’inde (%40) TDH saptandı. ÇDH olan grupta yaş, hipertansiyon ve diyabet mellitus istatistiksel olarak daha fazla saptandı (sırasıyla p<0.001, p=0.003, p=0.005). TDH olan grupta ise erkek cinsiyet, aile öyküsü ve sigara içiciliği istatistiksel olarak daha fazla saptandı (sırasıyla p=0.006, p<0.001, p<0.001). Sonuç: Diyabet ve hipertansiyon ÇDH grubunda yüksek saptanırken aile öyküsü ve sigara içiciliği TDH grubunda yüksek saptandı. Akut koroner sendrom hastalarında bu risk faktörlerin göz önünde bulundurulması önemlidir.Aim: The relationship between the number of coronary arteries with severe stenosis and cardiovascular risk factors was evaluated in patients with acute coronary syndrome. Material-Method: This study was designed retrospectively. 904 patients who underwent coronary angiography for acute coronary syndrome between 2016–2018 were included in the study. Patients who underwent coronary bypass surgery and didn’t have severe coronary artery disease were excluded. The patients were divided into two groups according to critical coronary artery stenosis as single vessel disease and multiple vessel disease. The relationship between multivessel disease and risk factors was compared. Results: Multivessel disease was detected in 544 (60%) patients and single vessel disease in 365 (40%) patients. Age, hypertension and diabetes were found to be higher in multivessel disease (respectively p<0.001, p=0.003, p=0.005). Male gender, family history and smoking were found to be higher in the single vessel disease. Conclusion: Diabetes and hypertension were higher in multivessel disease group, while family history and smoking were higher in single vessel disease group. It is important to consider these risk factors in patients with acute coronary syndrome

The Association Between Multivessel Disease and Cardiovascular Risk Factors in Patients with Acute Coronary Syndrome

Amaç: Akut koroner sendrom olgularında ciddi darlık olan koroner arter sayısı ile kardiyovasküler risk faktörleri arasındaki ilişki değerlendirildi. Yöntemler: Bu çalışma retrospektif olarak dizayn edildi. 2016–2018 tarihleri arasında akut koroner sendrom sebebiyle koroner anjiografi yapılan 904 hasta çalışmaya dahil edildi. Ciddi koroner arter darlığı olmayan ve koroner operasyon geçiren hastalar çalışma dışı bırakıldı. Hastalar kritik koroner arter darlıklarına göre tek damar hastalığı (TDH) ve çok damar hastalığı (ÇDH) olacak şekilde iki gruba ayrıldı. ÇDH ile TDH olanlar klasik kardiyovasküler risk faktörleri açısından karşılaştırıldı. Bulgular: Hastaların 544’ünde (%60) ÇDH 365’inde (%40) TDH saptandı. ÇDH olan grupta yaş, hipertansiyon ve diyabet mellitus istatistiksel olarak daha fazla saptandı (sırasıyla p<0.001, p=0.003, p=0.005). TDH olan grupta ise erkek cinsiyet, aile öyküsü ve sigara içiciliği istatistiksel olarak daha fazla saptandı (sırasıyla p=0.006, p<0.001, p<0.001). Sonuç: Diyabet ve hipertansiyon ÇDH grubunda yüksek saptanırken aile öyküsü ve sigara içiciliği TDH grubunda yüksek saptandı. Akut koroner sendrom hastalarında bu risk faktörlerin göz önünde bulundurulması önemlidir.Aim: The relationship between the number of coronary arteries with severe stenosis and cardiovascular risk factors was evaluated in patients with acute coronary syndrome. Material-Method: This study was designed retrospectively. 904 patients who underwent coronary angiography for acute coronary syndrome between 2016–2018 were included in the study. Patients who underwent coronary bypass surgery and didn’t have severe coronary artery disease were excluded. The patients were divided into two groups according to critical coronary artery stenosis as single vessel disease and multiple vessel disease. The relationship between multivessel disease and risk factors was compared. Results: Multivessel disease was detected in 544 (60%) patients and single vessel disease in 365 (40%) patients. Age, hypertension and diabetes were found to be higher in multivessel disease (respectively p<0.001, p=0.003, p=0.005). Male gender, family history and smoking were found to be higher in the single vessel disease. Conclusion: Diabetes and hypertension were higher in multivessel disease group, while family history and smoking were higher in single vessel disease group. It is important to consider these risk factors in patients with acute coronary syndrome