A simplified acute kidney injury predictor following transcatheter aortic valve implantation: ACEF score

Background: Transcatheter aortic valve implantation (TAVI) is an effective, less invasive treatment alternative for symptomatic severe aortic stenosis (AS). Acute kidney injury (AKI) following TAVI is a common complication and is associated with worse outcomes. The age, creatinine, ejection fraction (ACEF) score is a simple scoring method, including only three parameters: age, creatinine, and ejection fraction (EF). The score was well established in predicting AKI after coronary interventions.Aims: We aimed to evaluate whether this simple scoring method, ACEF, may predict a development of AKI in patients who underwent TAVI.Methods: A total of 173 consecutive patients with symptomatic severe AS who underwent TAVI were included retrospectively. The primary endpoint of the study was the development of AKI. Study population was divided into two groups according to the presence of AKI. The ACEF score was calculated with the formula: age/EF + 1 (if baseline creatinine >2 mg/dl).Results: Twenty-nine patients developed AKI. The median (interquartile range) ACEF score was 1.36 (1.20–1.58). The ACEF score was found to be an independent predictor of AKI (P <0.001). The ACEF score ≥1.36 predicted AKI development with a sensitivity of 96.6% and specificity of 58.8%. Moreover, hypertension, hemoglobin levels, contrast volume, and aortic valve area (AVA) were found to be independent predictors of AKI.Conclusions: Our study revealed that the ACEF score was an independent predictor of AKI. A simple and objective score might be very useful in predicting AKI development in patients undergoing TAVI

Normotensive Postpartum Posterior Reversible Encephalopathy Syndrome (PRES) as a Rare Cause of Seizures: Two Case Reports

Posterior reversible encephalopathy syndrome (PRES) is a syndrome characterized by various neurological findings such as headache, visual disturbances, seizures and altered consciousness, and imaging findings of edema in the posterior cerebral regions. Clinical and radiological findings are often reversible. Etiology may include hypertension, cytotoxic drugs, and autoimmune diseases. It often develops on the background of eclampsia and high blood pressure in the postpartum period. In this article, two cases of PRES, which developed under normal blood pressure values during pregnancy and postpartum period and characterized by seizure, are presented

Broadly tunable two-color lasing of Cr:LiCAF with on-surface and off-surface optical axis birefringent filters: performance comparison

We studied the two-color lasing performance of a Cr:LiCAF laser using crystal quartz on-surface and off-surface optical axis birefringent filters (BRFs). Four different on-surface optical axis BRFs with thicknesses of 2 mm, 4 mm, 8 mm, and 16 mm, and three different off-surface optical axis BRFs with a diving angle of 25° and thicknesses of 2 mm, 4 mm, and 8 mm have been tested. Two-color lasing operation could be achieved in tens of different pairs of wavelengths using both types of BRFs. Regular on-surface optical axis BRFs provided two-color lasing in the 772–810 nm interval, with a discretely tunable wavelength separation of 1 to 37 nm (0.5 to 17 THz). In comparison, the off-surface optical axis BRFs enabled scanning of two-color lasing spectra in a much broader wavelength range between 745 nm and 850 nm with a discretely tunable wavelength separation of 0.8 to 99 nm (0.4 to 46 THz). The results clearly demonstrate the advantages of using off-surface optical axis BRFs to achieve two-color lasing with broadly tunable wavelength separation

The predictors of long-term hospitalization in Turkish heart failure population: A subgroup analysis of journey heart failure-TR study: On behalf of journey heart failure-TR investigators

Background: Heart failure (HF) is an important public health problem. We aimed to investigate the predictors of long-term hospitalization in Turkish HF population. Materials and Methods: Journey-HF-TR study is a multicenter, cross-sectional, noninvasive, and observational study that was conducted in intensive care unit (ICU), coronary care unit (CCU), and cardiology wards in seven geographical regions of Turkey. In this subgroup analysis, patients were classified as two groups according to inhospital stay called the patient with the shorter length of stay (S-LOS) (inhospital stay <5 days; S-LOS) and patients with longer LOS (L-LOS) (inhospital stay ≥5 days; L LOS). Results: The study group was consisted of 1606 patients (57.2% male, mean age: 67. 8 ± 13.0 years old). One thousand and thirty seven patients, whom in-hospital stay duration were recorded in case report form, were included in this analysis. There were 487 patients (32.1%) in S LOS group and 1030 patients (67.9%) in L LOS group. In multivariate analysis, correlation was present for NYHA functional capacity, CKD, ACS related HF, right HF, cardiogenic shock, invasive and noninvasive ventilation, and hemodynamic monetarization. The longer inhospital stay increases the probability of morbidity and mortality. Conclusion: We demonstrated that there was positive correlation between longer hospital stay and HF severity (NYHA III-IV), CKD, cardiogenic shock, right ventricular HF, and HF related to ACS. HFpEF patients have less in-hospital stay than HFrEF and HFmrEF patients

Comparison of the effects of hyperbaric oxygen and normobaric oxygen on sepsis in rats

Introduction: Several studies have been done on sepsis and many therapeutic agents have been developed. All agents were tested on animals prior to trials in humans. In this study, our aim was to investigate the healing effects of hyperbaric oxygen (HBO) and normobaric oxygen (NBO) due to pro-inflammatory cytokines and oxidative stress parameters, and the advantages of each other in an experimental model of sepsis. Material and methods: The rats were randomized into four groups: (1) Sham group (n = 10), intraperitoneal salineinjected group; (2) Control group (n = 10), which were only treated with CEF after induction of sepsis; (3) HBO group (n = 10), treated with HBO after sepsis induction; (4) NBO group (n= 10), treated with NBO after sepsis induction. In all groups, serum TNF- and #945;, as well as parameters of oxidative stress such as glutathione peroxidase, superoxide dismutase and malondialdehyde levels in the lung tissue, were measured. Results: Our study revealed that treatment with HBO and NBO significantly cured the increased oxidative stress and tissue membrane injury following E.coli induced experimental sepsis (p=0,001). Overall, the NBO and HBO treatments were similar. However, the HBO treatment was more efficient than the NBO treatment with respect to the TNF- and #945; levels (p=0,001). Conclusion: HBO or NBO should be used as an agent for the adjuvant treatment of sepsis. It can be concluded that applying HBO therapy as an adjuvant will be more useful for the patients meeting the criteria of sepsis. Advanced studies are required to understand the mechanism of treatment and to investigate the usability and efficiency. [Arch Clin Exp Surg 2016; 5(1.000): 7-12

Predictive value of platelet-to-lymphocyte ratio in severe degenerative aortic valve stenosis

Background: Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve. Materials and Methods: We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg. Results: PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734–0.882; P < 0.001; area under ROC curve: 0.808). Conclusion: We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage