Kardiyovasküler Cerrahi Sonrası Gelişen Akut Böbrek Yetmezliğinin Tanısında Kullanılan Erken Dönem Belirteçler

Kalp cerrahisinde en önemli postoperatif sorunlardan biri akut böbrek yetmezliğidir (ABY). Özellikle erken dönem gelişen ABY hasta mortalite ve morbiditesi üzerinde etkilidir. Rutinde kullanılan serum üre ve kreatinin değerlerinin böbrek hasarından 24-72 saat sonra yükselmesi nedeniyle; bir çok araştırmacı ABY’nin daha erken teşhis edilebilmesi için, yeni belirteçler araştırmaktadır. Bu çalışmanın amacı kalp cerrahisi sonrası gelişen ABY’nin erken tanısında kullanılabilecek biyobelirteçleri güncel literatür ışığında tartışmaktır

MBL2 and MIF gene polymorphisms in cardiovascular patients with atherosclerotic lesions undergoing heart valve replacement

The basic underlying factor for cardiovascular diseases is atherosclerosis, which is a multifactorial disease driven by environmental and genetic factors. We aimed to study the genetic polymorphism in mannose binding lectin-2 (MBL2) and macrophage migration inhibitory factor (MIF) in the arteries of patients with atherosclerotic lesions who underwent cardiac valve replacement for cardiac valve stenosis. Thirty-five patients (38.9 %) operated with coronary bypass surgery (coronary group, CG), 55 (61.1 %) patients operated with aortic or mitral valve replacement (valve group, VG) and 100 healthy controls were analyzed for codon 54 A/B polymorphism in the MBL2 gene and –173 G/C polymorphism in the MIF gene by using the method of polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). The comparison of the healthy control group with CG and VG in terms of the MBL2 genotypes revealed significantly lower AA genotype and A allele ratios. The comparison of the healthy control group with CG and VG in terms of the MIF genotypes showed significantly lower GG genotype and G allele ratios. We suggest that the lower frequency of the GG genotype/G allele of the MIF gene and of the AA genotype/A allele of the MBL2 gene may be associated with the ethiopathogenesis of CG and VG patients

Persistent left superior vena cava the anatomical and surgical importance

Objective: Persistence of the left superior vena cava (PLSVC) is a congenital anomaly resulting from failure of degeneration of the left cardinal vein. The prevalence of this anatomical variant is approximately 0.3% in the general population. The aim of this study was to determine the prevalence of the persistence of the left superior vena cava in order to avoid potential complications. Subjects and methods: The study was conducted during a five-year period in 152 patients (64 males, 88 females) aged 1–65 years who underwent cardiac surgery for congenital heart diseases. Results: The persistence of the left superior vena cava was found in 5 of 152 patients (3.3%). All persistent left superior vena cavae opened into the coronary sinus. Furthermore, the coronary sinus was enlarged in all patients. The right superior vena cava was absent in one of the five cases (20%) in this study. Conclusion: This anatomical variant must be recognized to avoid the potential complications

Turkish inappropriate medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START

Key summary pointsAim To meet the current need in different European countries for improving prescribing in older adults, we aimed to create an update screening tool getting origin from the two user friendly criterion sets: the STOPP/STARTv2 criteria and CRIME criteria. Findings Based on thorough literature review, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified. As a result, 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Message TIME criterion set is an update screening tool reported from Eastern Europe that included experts from geriatrics and other specialties frequently giving care to older adults and some additional practical explanations for clinical use. Purpose To improve prescribing in older adults, criterion sets have been introduced from different countries. While current criterion sets are useful to some extent, they do not meet the need in some European countries. Turkish inappropriate medication use in the elderly (TIME) criteria was planned to meet this need. Methods In phase 1, the user friendly sets: STOPP/START version2 and CRIME criteria were combined. National experts composed of geriatricians and non-geriatricians were invited to review and comment. In phase 2, thorough literature review was performed and reference-based revisions, omissions, and additions were made. Explanatory additions were added to some criteria to improve application in practice. In phase 3, all working group members reviewed the criteria/explanations and agreed on the final content. Results Phase 1 was performed by 49 expert academicians between May and October 2016. Phase 2 was performed by 23 working group academicians between October 2016 and November 2018 and included face-to-face interviews between at least two geriatrician members and one criterion-related specialist. Phase 3 was completed between November 2018-March 2019 with review and approval of all criteria by working group academicians. As a result, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified from the first draft. A total of 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Conclusion TIME criteria is an update screening tool that differs from the current useful tools by the interactive study of experts from geriatrics and non-geriatrics, inclusion of practical explanations for some criteria and by its eastern European origin. TIME study respectfully acknowledges its roots from STOPP/START and CRIME criteria. Studies are needed whether it would lead improvements in older adults' health

Presenting Turkish Inappropriate Medication use in the elderly (TIME) criteria set in Turkish

Older adults are mostly exposed to polypharmacy and inappropriate medication use (IMU) due to the increasing incidence of chronic diseases and geriatric syndromes with aging. Polypharmacy and IMU use are well-known risk factors for adverse drug reactions (1,2)