Aortic distensibility and coronary artery bypass graft patency

<p>Abstract</p> <p>Background</p> <p>Aortic distensibility is an elasticity index of the aorta, and reflects aortic stiffness. Coronary artery disease has been found to be substantially associated with increased aortic stiffness. In this study we aimed to retrospectively analyze the association of angiographically determined aortic distensibility with the patency rates of coronary bypass grafts</p> <p>Methods</p> <p>The study was conducted in the Cardiology department of the Applied Research Centre for Health of Uludağ University. The coronary angiograms of 53 consecutive coronary bypass patients were analysed retrospectively. Aortic distensibility was calculated using the formula: 2 × (change in aortic diameter)/(diastolic aortic diameter) × (change in aortic pressure). The number of stenosed and patent bypass grafts and the patient characteristics like age, risk factors were noted.</p> <p>Results</p> <p>There were 44 male (83%) and 9 female (17%) cases. Eighteen cases had only one saphenous vein grafting. The number of cases with two, three and four saphenous grafting were 18, 11 and 1; respectively. In the control angiograms the number of cases with one, two, three and four saphenous vein graft obstruction were 15 (31.3%), 7 (14.6%), 1 (2.1%) and 1 (2.1%) respectively. The aortic distensibility did not differ in cases with and without saphenous graft occlusion (p > 0.05). Also left internal mammary artery (LIMA) graft patency was not related to the distensibility of the aorta (p > 0.05). We also evaluated the data for cut-off values of 50 and 70 mmHg of pulse pressure and did not see any significant difference between the groups in terms of saphenous or LIMA grafts.</p> <p>Conclusion</p> <p>In this study we failed to show association of angiographically determined aortic distensibility with coronary bypass graft patency in consecutive 53 patients with coronary artery bypass graft surgery (CABG).</p

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Neuron-specific enolase level and its relationship with neurological deficits in coronary bypass surgery in the heart working with extracorporeal circulation technique

Kardiyak cerrahi sonrası nörolojik komplikasyonlar önemli morbidite ve mortalite sebebidir. Günümüzde başarılı kardiyak cerrahi teknikleriyle, postoperatif (po) kardiyak performansdan çok, gelişen nörolojik bozukluklar üzerinde durulmaktadır. Erken tanıya yönelik çalışmalar önem kazanmıştır. Postoperatif dönemde gelişen nörolojik komplikasyonlarda serebral hasarın tahmininde biyokimyasal belirteç olarak Nöron Spesifik Enolaz (NSE) ve Protein S 100 b üzerinde çalışılmaktadır. Bu çalışmada VDD (vücut dışı dolaşım) desteği olan ve VDD desteği olmadan çalışan kalpte koroner baypas yapılan hastalardaki NSE' nin serum seviyesi ve oluşabilecek nörolojik bozukluklarla olan ilişkisini araştırmayı amaçladık. Çalışmaya elektif koroner arter cerrahisi planlanan 20 koroner arter hastası alındı. VDD desteği olmadan çalışan kalpte koroner arter baypas (KAB) yapılacak hastalar Grup 1 (n=10) ve VDD (X (kross) klemp kullanılmadan) desteği ile opere edilecek hastalar Grup 2 (n=10) olarak gruplandırıldı. Tüm hastalarda preoperatif (bazal), postoperatif 1., 6., 12., 24., 72. saatlerde venöz kan örnekleri alındı ve NSE ölçümleri yapıldı. Ortalama yaş 54.5 olarak bulundu (35-70 yaş arası). Her iki grupta da po mortalite ve nörolojik komplikasyon yoktu. Postoperatif NSE düzeyleri preoperatif değerlere göre her iki grupta da yüksekti ancak istatiksel olarak anlamlı değildi (p> 0.05). Grup 2' de NSE serum konsantrasyon yüksekliği devamlılık gösterirken Grup V de tavan değer po 12. saatte idi ve daha sonra hızlı bir şekilde preoperatif değerlere geriledi. Gruplardaki NSE değerlerindeki yükselmeler karşılaştırıldığında istatiksel anlam ifade etmedi. Grup 2' de NSE serum seviyesindeki yüksekliğinin devamlılığı subklinik serebral etkilenmeye bağlandı. Kardiyak cerrahide VDD desteğinin kullanılması, subklinik nörolojik hasarın artmasına ve bununla ilişkili olarak serum NSE seviyelerinde artışa neden olmaktadır.Neurological complications after cardiac surgery are important causes of mortality and morbidity. Currently, with the successful surgical techniques, neurological dysfunctions are being focused rather than postoperative (po) cardiac performance. Studies related to early diagnosis has gain importance. Neuron specific enolase (NSE) and protein S 100 b are being studied as a biochemical marker for prediction of cerebral damage in neurological complications developing postoperatively. In this study, we aimed to investigate the association of serum levels of NSE in patients undergoing bypass operation with extra corporeal circulatory (ECC) support and having bypass on beating heart without ECC support with potential neurological dysfunctions. Twenty patients scheduled for coronary artery surgery were enrolled into the study. The patients that going to have bypass operation (CAB) in beating heart without ECS constituted group 1 (n=10) and the patients that will be operated with ECC support (without cross clamp use) constituted the group 2. In all patients venous blood samples were drawn preoperatively (baseline), and at 1st, 61h, 12th, 24 and 72"d hours postoperatively. The mean age was 54.5 (35-70). In none of the groups there was po mortality and neurological complications. Postoperative serum NSE levels were higher compared to the baseline values in both groups, but none was statistically significant (p>0.05). While in group 2 elevations in serum concentrations of NSE were consistent till the last sample, in group 1 the peak value was observed at 12th hour and rapidly decreased to preoperative levels. When the elevations of NSE levels were compared between groups, no statistical significance was noticed. The consistent elevation in serum NSE levels was attributed to subclinical cerebral effects. Use of ECC support in cardiac surgery, leads to increase in subclinical damage and subsequent increase in serum NSE levels

Some related fixed point theorems for multivalued mappings on two metric spaces

The definition of related mappings was introduced by Fisher in 1981. He proved some theorems about the existence of fixed points of single valued mappings defined on two complete metric spaces and relations between these mappings. In this paper, we present some related fixed point results for multivalued mappings on two complete metric spaces. First we give a classical result which is an extension of the main result of Fisher to the multivalued case. Then considering the recent technique of Wardowski, we provide two related fixed point results for both compact set valued and closed bounded set valued mappings via F-contraction type conditions

Complications and recurrence after Karydakis Flap surgery

Introduction: Pilonidal sinus is a disease affecting individuals at young age. Numerous surgical methods have been described in the treatment of pilonidal sinus disease. Currently, there is no treatment method providing a rapid recovery with low recurrence risk. Aim: In this study, we aimed to evaluate the results of our patients who underwent Karydakis surgery. Material and methods: Results of 112 patients operated on between 2012 and 2019 were retrospectively evaluated. Only the patients who underwent Karydakis surgery were included in the study. Results: Of all patients, 20 were female and 92 were male. The mean age was 21 years in the female and 20.8 years in the male patients. The mean BMI was 29.6 kg/m2 . The patients were followed up for a mean of 28 months. Postoperative length of stay in hospital was 2.1 days. The complications included wound dehiscence in 10.2%, infection in 3.6%, and bleeding (hematome) in 7.1%. Four patients developed recurrence during follow-up. Conclusions: Karydakis surgery is a preferable surgical technique with low rates of complications and recurrence

Fixed point results for F-contractions on space with two metrics

WOS: 000423281300005In this paper, taking into account two metrics on a space, we present a new fixed point theorem for F-contractions. Our theorem includes both Agarwal and O'Regan's and Wardowski's results as properly. Also we provide a nontrivial example showing this fact

A Software Communications Architecture Compliant Software Defined Radio Implementation

Today’s exceedingly rapid pace of technological advances make communica-tion devices become obsolete shortly after they are produced. To keep up with this pace, communications systems must be designed to maximize the trans-parent insertion of new technologies at virtually every phase of their lifecycles. When these new technologies are inserted, the upgraded devices should still be able to communicate with each other and with legacy systems.\ud \ud The term software defined radio was coined in 1990s to overcome these prob-lems. A software defined radio is a communications device whose functionality is defined in software. Defining the radio behavior in software removes the need for hardware alterations during a technology upgrade.\ud \ud In order to maintain interoperability, the radio systems must be built upon a well-defined, standardized, open architecture. Defining an architecture also enhances scalability and provides plug-and-play behavior for the components of\ud a radio.\ud \ud We have conducted a thorough research on software defined radios and software\ud architectures that are applicable to communications devices. We have\ud implemented an open-source software defined radio that is compatible with the\ud Software Communications Architecture. The implementation serves as a proof-of-concept for the architecture.\ud \ud We provide a core framework design for the architecture that is reusable in\ud future radio implementations. We present the lessons we have learned during\ud the implementation and examine our results from a software engineering point\ud of view.\ud \ud In this study, we explore and present the advantages and difficulties of implementing\ud a radio system using the Software Communications Architecture

Powikłania i nawroty po leczeniu torbieli pilonidalnej metodą rekonstrukcji płatowej Karydakisa

Wprowadzenie: Torbiel pilonidalna (TP) jest schorzeniem dotykającym młode grupy wiekowe. Opisano liczne metody chirurgiczne stosowane w jej leczeniu. Jak dotąd nie powstała jednak metoda leczenia zapewniająca szybki powrót do zdrowia z niskim ryzykiem ponownego wystąpienia. Cel: Celem niniejszego badania było dokonanie oceny wyników uzyskanych u pacjentów leczonych w naszym ośrodku techniką rekonstrukcji płatowej Karydakisa. Materiał i metodyka: Dokonano retrospektywnej oceny wyników uzyskanych u 112 chorych operowanych w latach 2012–2019. Do badania włączono wyłącznie pacjentów poddawanych rekonstrukcji metodą Karydakisa. Wyniki: Populacja pacjentów składała się z 20 kobiet i 92 mężczyzn. Średnia wieku wynosiła 21 lat u kobiet i 20,8 lat u mężczyzn. Średni wskaźnik masy ciała (BMI) to: 29,6 kg/m2 . Chorych poddawano obserwacji kontrolnej przez okres wynoszący średnio 28 miesięcy. Długość hospitalizacji po operacji wynosiła 2,1 dni. Powikłania obejmowały rozejście rany w 10,2% przypadków, zakażenie w 3,6% przypadków i krwawienie (krwiak) w 7,1% przypadków. U 4 osób doszło do nawrotu choroby w okresie obserwacji. Wnioski: Rekonstrukcja płatowa Karydakisa jest preferowaną techniką chirurgiczną, charakteryzującą się niskim poziomem powikłań i nawrotó