KORONER ARTER HASTALIĞININ BELİRLEYİCISI OLARAK PENIL DOPPLER ULTRASONOGRAFİ İLE SAPTANAN KAVERNOZ ARTER STENOZU: OLGU SUNUMU

An association between Coronary Artery Disease (CAD) and Erectile Dysfunction (ED) has been described. We aimed to show that cavernous artery stenosis may be an important predictor of a silent but serious CAD. A 56-year-old man who had moderate ED was evaluated for risk factors. He had several vascular risk factors for ED and CAD including age, smoking, hypertension, hyperhomocysteinemia and hyperlipidemia. His penile colour Doppler ultrasonography revealed multiple stenotic area in the right cavernous artery. His treadmill exercise test showed significant changes. Then, coronary angiography was performed and it showed the patient had doublevessel CAD. Findings of atherosclerotic plaques in cavernosal arteries with penile Doppler ultrasonography may be address subclinical coronary artery stenosis in patients with ED. Koroner arter hastalığı ile erektil disfonksiyon arasındaki ilişki belirgindir. Bu yazıda kavernozal arter darlığının sessiz fakat ciddi koroner arter hastalığını gösterebileceğinin ortaya konulması amaçlandı. Orta şiddette erektil disfonksiyon yakınması olan 56 yaşındaki hasta risk faktörleri açısından değerlendirildi. Hastanın yaş, sigara, hipertansiyon, hiperhomosisteinemi ve hiperlipidemi olmak üzere çok sayıda vasküler risk faktörü vardı. Penil Doppler ultrasonografide sağ kavernozal arterde çok sayıda darlık saptandı. Treadmill egzersiz testinde belirgin değişiklikleri olan hastanın yapılan koroner anjiografisinde iki damarda stenoz saptandı. Erektil disfonksiyonlu hastalarda penil Doppler ultrasonografi ile kavernozal arterlerde saptanan aterosklerotik plaklar subklinik koroner arter hastalığı habercisi olabilir

Circadian blood pressure rhythm in normotensive offspring of hypertensive parents

Background: The aim of this study was to explore the circadian blood pressure (BP) rhythm using ambulatory BP monitoring (ABPM) in normotensive children with a family history of essential hypertension. Methods: Group 1 consisted of children with hypertensive mothers and/or fathers (n = 20), Group 2 consisted of children with hypertensive grandparents (n = 20), and Group 3 consisted of children with normotensive parents (n = 20). All participating children underwent a 24-h ABPM and echocardiography. Results: Significantly higher systolic burden was found in children with hypertensive parents (p < 0.05) and grandparents (p < 0.05) compared to controls. Ambulatory BP measurements had a higher daytime systolic BP in Group 1 compared to controls (p < 0.05). While left ven­tricular (LV) posterior wall thickness was similar in Group 1 and Group 2, it was significantly higher in both of these groups compared to the controls. The LV mass index (LVMI) was signifi­cantly higher in Group 1 than in controls (p < 0.05). However, diastolic BP was significantly higher in dippers compared to non-dippers (p < 0.05). LV posterior wall thickness, interven­tricular septum thickness and LVMI were significantly higher among non-dippers compared to dippers (p < 0.05). In children with a family history of hypertension, a positive correlation between nocturnal systolic BP and LVMI was found, and increasing nocturnal BP values were associated with increasing LVMI (p < 0.01). Conclusions: In children with a family history of hypertension, target-organ damage may precede the clinical detection of hypertension, and in those with a nocturnal non-dipper status, a more marked effect on LVMI may occur

DIAGNOSIS AND TREATMENT OF DIABETIC FOOT ULCERS

Diyabetik ayak ülserleri diyabetin sık görülen ve ciddi bir kronik komplikasyonudur. Diyabetikayak ülserleri diyabetik hastalarda önemli bir morbidite ve mortalite nedenidir. Diyabetikayak ülserlerinin izlem ve tedavisi periferik arter hastalığı, nöropati, travma ve enfeksiyongibi ilişkili nedenler doğrultusunda bireyselleştirilmelidir. Cerrahi ve cerrahi dışı temel yarabakımı prensipleri bu yaraların etkin bir şekilde iyileşmesinde vazgeçilmez bir unsurdur.Ayak ülseri oluşumunun önlenmesi de tedavisi kadar önemlidir ve diyabetin bu ciddikomplikasyonuna karşı en ekonomik yaklaşımıdır. Bu yazıda diyabetik ayak ülserleri nedenlerive patofizyolojisi birlikte incelenmiş, klinik değerlendirme ve tedavi seçenekleri gözdengeçirilmiştir.Diabetic foot ulcers are common and serious chronic complications of diabetes. They are animportant cause of mortality and morbidity. The management of diabetic foot ulcers shouldbe individualized according to the causes of the ulcer such as peripheral arterial disease,neuropathy, pressure trauma, and infection. Basic principles of wound care, includingsurgical and nonsurgical components, are essential to effective healing of these wounds.Prevention of foot ulceration is also important, and the most cost-effective strategy formanaging this serious complication of diabetes. In this article, we performed a review ofdiabetic foot ulcers in terms of its causes, pathophysiology, clinical approach andmanagement

Which Patients Can Benefit from Pillar Palatal Implant Procedure?

Objective:The aim of this prospective study is to determine which patients may benefit from pillar procedure as a treatment for snoring.Methods:A total of 37 patients (25 males and 12 females) with a history of snoring were implanted with 3 pillar palatal implants. Flexible fiberoptic examination was used to evaluate the upper airway, especially the retropalatal and retrolingual areas. Visual analog scale (VAS) and polysomnography were performed on before and 3rd months after the pillar procedure. The implantation was performed under local anesthesia.Results:The mean VAS score was reduced from 9.3±0.6 to 6.2±1.1 at the 3rd month. VAS scores of snoring intensity were reduced >50% in 24 of the patients (64.8%). The mean apnea-hypopnea index (AHI) was 11.7±2.3 before the implantation and was reduced to 8.4±1.6 at the 3rd month. VAS and AHI had a close relation with gender, body weight, and oropharynx class. There were no major complications, such as infection, extrusion, and major bleeding.Conclusion:Pillar procedure has a high success rate if it is done with appropriate patient selection, but overall effectiveness remains limited. Initial AHI and VAS values, oropharynx and tonsil position scores, and gender are important determinants of pillar procedure

Intensive Care Management of Critical and Severe SARS-CoV-2 Infection in Pregnancy: A Retrospective Observational Study

Objective: This study examined the clinical consequences of pregnancy coexisting with severe acute respiratory syndrome coronavirus 2 in the intensive care unit (ICU). Materials and Methods: The study was designed as a retrospective observational study. After the ethical approval of the local ethics committee, the study was conducted for a period when the number of young coronavirus disease-2019 (COVID-19) cases increased in our country. The patients enrolled in the study were pregnant/puerperal patients followed up in our third-level ICU. Results: The mean age of 35 pregnant women included in the study was 29.57±4.36 years. Twenty-one of the births (80.8%) were preterm births. Twelve (34.3%) patients received invasive mechanical ventilation (IMV), and 5 (41.7%) of these patients were deceased. Twenty-six (74.3%) underwent a cesarean section (C/S). There were 5 (14.3%) patients who needed extracorporeal membrane oxygenation and 3 (8.5%) patients who needed continuous renal replacement therapy. The 28-day neonatal mortality rate for 26 births was 3.8%. The maternal mortality rate in the ICU was 14.3%. Conclusion: The preterm birth rate was high in our pregnant patients followed up in the ICU with a diagnosis of COVID-19. Because of clinical and radiological progression in pregnant women, it is difficult to indicate any gestational week in which maternal outcomes are better to undergo C/S. IMV mortality is not higher than in non-pregnant patients, so endotracheal intubation should not be avoided in appropriate patients, whether pregnancy continues or not. The absence of fully vaccinated patients in the study group revealed the protective effect of vaccination during pregnancy

A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood

IntroductionA nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). Materials and methodsK2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. ResultsAnalyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers’ results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. ConclusionsWith the novel use of a freshly prepared blood panel, manufacturer-specific RIs’ were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude

Renal complications of lipodystrophy: A closer look at the natural history of kidney disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/1/cen13732_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144612/2/cen13732.pd

Recent Advances in Health Biotechnology During Pandemic

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in 2019, cut the epoch that will make profound fluctuates in the history of the world in social, economic, and scientific fields. Urgent needs in public health have brought with them innovative approaches, including diagnosis, prevention, and treatment. To exceed the coronavirus disease 2019 (COVID-19) pandemic, various scientific authorities in the world have procreated advances in real time polymerase chain reaction (RT-PCR) based diagnostic tests, rapid diagnostic kits, the development of vaccines for immunization, and the purposing pharmaceuticals for treatment. Diagnosis, treatment, and immunization approaches put for- ward by scientific communities are cross-fed from the accrued knowledge of multidisciplinary sciences in health biotechnology. So much so that the pandemic, urgently prioritized in the world, is not only viral infections but also has been the pulsion in the development of novel approaches in many fields such as diagnosis, treatment, translational medicine, virology, mi- crobiology, immunology, functional nano- and bio-materials, bioinformatics, molecular biol- ogy, genetics, tissue engineering, biomedical devices, and artificial intelligence technologies. In this review, the effects of the COVID-19 pandemic on the development of various scientific areas of health biotechnology are discussed

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