A Turbulence Model for the Heat Transfer Near Stagnation Point of a Circular Cylinder

A one-equation low-Reynolds number turbulence model has been applied successfully to the flow and heat transfer over a circular cylinder in turbulent cross flow. The turbulence length-scale was found to be equal 3.7y up to a distance 0.05δ and then constant equal to 0.185δ up to the edge of the boundary layer (wherey is the distance from the surface and δ is the boundary layer thickness). The model predictions for heat transfer coefficient, skin friction factor, velocity and kinetic energy profiles were in good agreement with the data. The model was applied for Re ≤250,000 and Tu∞≤0.07

Atorvastatin pretreatment diminishes the levels of myocardial ischemia markers early after CABG operation: an observational study

<p>Abstract</p> <p>Background</p> <p>Statin pretreatment has been associated with a decrease in myocardial ischemia markers after various procedures and cardiovascular events. This study examined the potential beneficial effects of preoperative atorvastatin treatment among patients undergoing on-pump CABG operation.</p> <p>Methods</p> <p>Twenty patients that had received atorvastatin treatment for at least 15 days prior to the operation and 20 patients who had not received any antihyperlipidemic agent prior to surgery were included in this study. CK-MB and troponin I levels were measured at baseline and 24 hours after the operation. Perioperative variables were also recorded.</p> <p>Results</p> <p>Twenty-four hours after the operation, troponin I and CK-MB levels were significantly lower in the atorvastatin group: for CK-MB levels, 12.9 ± 4.3 versus 18.7 ± 7.4 ng/ml, p = 0.004; for troponin I levels, 1.7 ± 0.3 versus 2.7 ± 0.7 ng/ml, p < 0.001. In addition, atorvastatin use was associated with a decrease in the duration of ICU stay.</p> <p>Conclusions</p> <p>Preoperative atorvastatin treatment results in significant reductions in the levels of myocardial injury markers early after on-pump CABG operation, suggesting a reduction in perioperative ischemia in this group of patients. Further studies are needed to elucidate the mechanisms of these potential benefits of statin pretreatment.</p

'?the effectiveness of statins in decreasing the incidence of systemic inflammatory response syndrome after coronary artery bypass surgery??

Koroner Arter Bypass Greft Cerrahisi Sonrası Sistemik İnflamatuar Yanıt Sendromu İnsidansını Azaltmada Statinlerin Etkinliğinin Araştırılması''Amaç: Sistemik inflamatuar yanıt sendromu koroner arter bypass greft operasyonu sonrası sıklıkla gözlenmektedir. Son çalışmalar preoperatif statin tedavisinin C-reaktif protein, sitokinler ve adezyon molekülleri gibi inflamasyon ile ilgili değişkenlerde bariz bir azalma ile ilişkili olduğunu göstermiştir. Bu yüzden preoperatif atorvastatin tedavisinin kardiyopulmoner bypass sonrası sistemik inflamatuar yanıta etkisini araştırdık.Gereç ve Yöntem: Elektif koroner arter bypass ameliyatı yapılan kırk hasta iki gruba ayrıldı. Hastalar atorvastatin (20 mg/gün, grup I, n=20) veya plasebo (grup II, n=20) tedavisi ile cerrahi öncesi randomize edildi. Tüm hastalar kardiyopulmoner bypass ile opere edildi ve preoperatif ve postoperatif 24. saatlerde inflamasyon parametreleri için kan örnekleri alındı.Bulgular: Her iki grupta da preoperatif demografik veriler açısından farklılık yoktu. Postopertif 24. saatteki medyan hsCRP seviyesi çalışma grubunda 88,0 (18), kontrol grubunda 113 (22), mean interlökin?6 seviyesi ise çalışma grubunda 43,4 ± 18,5, kontrol grubunda 69,6 ± 19,2 olarak tespit edildi ve her iki parametrenin de çalışma grubunda anlamlı olarak daha düşük olduğu gözlendi (p<0.05).Sonuç: Kardiyopulmoner bypass ile elektif koroner arter bypass cerrahisi uygulanan hastalarda preoperatif atorvastain tedavisi inflamasyon parametrelerinin seviyesini azaltır ve sistemik inflamatuar yanıt sendromunu önlemede etkili olabilir.Anahtar Kelimeler: Sistemik inflamatuar yanıt sendromu, C-reaktif protein, interlökin?6, kardiyopulmoner bypass.?The effectiveness of statins in decreasing the incidence of systemic inflammatory response syndrome after coronary artery bypass surgery??Objective: Systemic inflammatory response syndrome is frequently seen after coronary artery bypass graft surgery. Recent studies show that, preoperative use of statin treatment is associated with a decrease in inflammatory mediators such as C-reactive protein, cytokines and adhesion molecules. Thus, we?ve evaluated the effect of preoperative atorvastatin treatment on systemic inflammatory response after coronary artery bypass surgery.Material and methods: Fourty patients, who had elective coronary artery bypass surgery operation, were divided into two groups. Patients were randomized preoperatively as atorvastatin (20 mg/day, group I, n = 20) and placebo (group II, n = 20) groups. All of the patients were operated via cardiopulmonary bypass technique and blood samples were taken at preoperatively and postoperative 24th hours. Findings: No significant changes were detected in case of preoperative demographic data. Post-operative 24th hour median hsCRP was 88,0 (18) in study group and 113 (22) in the control group, whereas mean interleukin?6 was 43,4 ± 18,5 in study group and 69,6 ± 19,2 in the control group and both of the parameters were significantly lower in the study group (p<0.05).Results: Preoperative atorvastatin treatment in patients who had elective coronary artery bypass surgery decreases inflammation parameters and may be effective in preventing systemic inflammatory response syndrome.Key words: Systemic inflammatory response syndrome, C-reactive protein, interleukin?6, cardiopulmonary bypass

Penetrating cardiac injury in blunt trauma: a case report

Künt toraks travmasına bağlı olarak nadiren kardiyak yaralanmalar görülebilmektedir. Kardiyak yaralanma genellikle hayatı tehdit eden durum yaratır, acil cerrahi müdahele geretirir ve bu hastaların perioperetif dönemde dikkatli takip edilmesi gerekir. Klinik tablo, yaralanma şekli, hastaneye ulaşana dek geçen süre, kanama miktarı, kardiyak tamponad varlığı veya ilave yaralanmalar gibi değişik faktörlere bağlıdır. Bu yazıda, künt toraks travmasına bağlı olarak penetran kardiyak yaralanma tespit edilen bir olgu sunuldu. Acil serviste araç içi trafik kazası nedeniyle değerlendirilen 61 yaşındaki erkek olgunun akciğer grafisinde pulmoner kontüzyon, kot kırığı ve kardiyak tamponad saptandı. Acilen ameliyata alınan hastada sağ atriyum yaralanması gözlendi. Kardiyak yaralanma primer dikiş tekniği ile onarıldı. Sonuç olarak, künt toraks travmalı hastalarda kardiyak yaralanma ihtimali yüksektir. Bu hastalarda dikkatli fiziksel inceleme, erken tanı ve tedavi gereklidir.Cardiac injuries may rarely be observed due to blunt thoracic traumas. Cardiac injury often creates a life-threatening condition requiring urgent surgical intervention, and follow-up of these patients should be carefully carried out in the perioperative period. These injuries depend on various factors including clinical presentation, type of injury, the time that passes until the patient reaches the hospital, bleeding, cardiac tamponade, or additional injuries. This article aimed to report a case who suffered penetrating cardiac injury in blunt thoracic trauma. Evaluated in the emergency department due to a motor vehicle accident, the 61-year-old male patient's chest x-ray revealed pulmonary contusion, rib fractures and cardiac tamponade. The patient was operated emergently. Right atrial injury was observed in the operation. The cardiac injury was repaired with primary suture technique. Cardiac injury in patients with blunt thoracic trauma is likely to be observed. In these patients, careful physical examination, early diagnosis, and treatment are very important

Yüksek Riskli Hastalarda Poliglikonat (Maxon) Sütürle Desteklenen Sternum Kapama Tekniğinin Aseptik Sternal Ayrışma Üzerine Etkisi

Giriş: Sternal ayrışma, kardiyak cerrahi sonrası ciddi bir komplikasyondur. Bu çalışmanın temel amacı yüksek riskli hastalarda poliglikonat sütür (Maxon) ile desteklenen sternum kapama tekniğinin sternal ayrışmayı önlemedeki etkinliğinin araştırılmasıdır. Hastalar ve Yöntem: Bu retrospektif çalışmaya, (Aralık 2011-Ocak 2013), kardiyak cerrahi için standart median sternotomi uygulanan 136 hasta dahil edildi. Tüm hastalar sternal ayrışma için obezite, osteoporoz, kronik obstrüktif akciğer hastalığı, kronik aktif sigara içiciliği gibi bir veya daha fazla risk faktörüne sahipti. Tüm hastalarda sternum kapatılması esnasında çelik tele ilave olarak interkostal aralıklardan geçilerek poliglikonat sütürler konuldu. Bulgular: Hiçbir hastada sternal ayrışma veya mediastinit görülmedi. Sadece 3 hastada (%2.2), sternal ayrışma olmadan sternum alt kısmında yüzeysel yara infeksiyonu gözlendi ve bunlar da antibiyotik tedavisi ile başarıyla tedavi edildi. Sonuç: Bu çalışma, yüksek riskli hastalarda, klasik çelik tele ilave olarak interkostal aralıklardan poliglikonat sütürler geçilerek desteklenen sternum kapama yönteminin sternal stabiliteyi artırdığını ve aseptik sternal ayrışmayı önlediğini göstermektedir.Introduction: Sternal dehiscence is a serious complication after cardiac surgery. The main objective of this study will be to determine the effects of polyglyconate suture (Maxon) reinforced sternum closure technique on prevention of aseptic sternal dehiscence in high-risk patients. Patients and Methods: This retrospective study (December 2011 to January 2013) comprised 136 consecutive patients undergoing standard median sternotomy for cardiac procedures. All of these patients have one or more risk factor of sternal dehiscence such as obesity, osteoporosis, chronic obstructive pulmonary disease and chronic active cigarette smoker. In all patients, in addition to steel wire during sternal closure polyglyconate sutures were placed, passing through the intercostal space. Results: No sternal dehiscence or mediastinit occurred these patients. Only 3 patients (2.2%) were observed superfi cial wound infection at lower part of sternum without sternum dehiscence and treated successfully by antibiotic therapy. Conclusion: This study shows that besides the classic steel wire, additional polyglyconate sutures placed intercostal spaces can be inhance sternum stability and prevent aseptic sternal dehiscence in high risk patients

HASTANELERDE HİZMET KALİTESİ VE HALKLA İLİŞKİLERİN HASTA MEMNUNİYETİNE ETKİSİ

Müşteri memnuniyeti hizmet kalitesi, halkla ilişkiler ve pazarlama iletişimi konularından bir tanesidir. Bu çalışma, Konya Meram Tıp Fakültesi Hastanesi Kalp ve Damar Cerrahisi Servisinde tedavi gören hastaların, hastane tarafından verilen hizmetlerle ilgili memnuniyet düzeylerini ölçmek ve hizmet kalitesini artırmak amacıyla yapılmıştır. Kesitsel tipteki bu araştırma, yatarak tedavi gören ve taburcu edilen 298 hastada, Nisan 2014-Ekim 2015 tarihleri arasında anket tekniği kullanılarak yapılmıştır. Araştırmaya katılanların % 51'i erkek, % 49'u ise kadındır. Memnuniyet oranları poliklinik hizmetlerinde % 82, klinik hizmetlerinde % 74, diğer sağlık ve bürokratik işlemlerde % 77, personel hizmetlerinde % 80, hasta haklarında % 82, fiziksel durumda % 68, kafeterya hizmetlerinde % 66 olarak ortaya çıkmıştır. Hastaların % 73'ü hastaneyi sağlık hizmeti almak isteyen tanıdıklarına önereceklerini belirtmişlerdir. Çalışmada, yatarak tedavi gören hastaların büyük çoğunluğu hastane hizmetlerinden memnundurService quality and customer satisfaction is a subject of public relation and marketing communication. This research was made in order to evaluate the level of satisfaction of patients who receive treatment at Cardiovascular Surgery Service of Konya Meram Medical Faculty Hospital, regarding the services provided in the hospital, and increase quality of the services provided. As a cross-sectional research, it was made with questionnaire technique between April 2014 and October 2015, including 298 patients who received inpatient treatment and were discharged from the hospital. 51% of the participants in the research were men and the 49% of them were women. Satisfaction rates were ensued as 82% in polyclinic services, 74% in clinic services, 77% in other healthcare services and bureaucratic procedures, 80% in personnel services, and 82% in rights of patients, 68% in physical condition and 66% in cafeteria services. 73% of the patients indicated that they would recommend to familiars who would like to receive health care service. Based on the research, a great majority of the patients who receive inpatient treatment are satisfied with the hospital service

Inappropriate sensing events revealing electrocautery-induced implantable cardioverter-defibrillator lead failure

WOS:000362968700030

Forgotten Guidewire: Case Report

Santral venöz kateterizasyon; açık kalp cerrahisi gibi bazı özellikli ameliyatlar, uzun süreli intravenöz ilaç kullanımı, parenteral beslenme, geçici kalp pili yerleştirilmesi ve hemodiyaliz ama-- cıyla uygulanan invaziv vasküler erişim yoludur. Santral venöz kateterin takılması esnasında hemo-- toraks ve pnömotoraks gibi mekanik komplikasyonlar veya kateterin kullanımı sırasında kateter trombozu ve enfeksiyon gibi problemler gelişebilir. Bu makalede, bir olgu vasıtası ile santral venöz kateterizasyona bağlı daha nadir görülen bir komplikasyon olan kılavuz tel unutulması sunuldu.Central venous catheterization is an invasive vascular access way that is used in speci— al operations like open heart surgery, long term intravenous medical therapy, parenteral nutrition, placement of temporary pacemaker and hemodialysis. During central venous catheterization, me— chanic complications like hemothorax and pneumothorax or problems like catheter thrombosis and infection can develop. In this article, we presented rare complication related to central veno— us catheterization —lost guide wire— via case