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Acute coronary syndromes (ACS) are one of the most common causes of morbidity and mortality worldwide. Primary percutaneous coronary intervention (pPCI) is the main treatment strategy to restore myocardial perfusion. However, the no-reflow phenomenon (NRP) may block coronary flow. The present study focused on assessing and contrasting predictive parameters for NRP in ACS patients. Our research is a retrospective analysis. We assessed the parameters significantly associated with NRP using Cox regression and Receiver operating characteristic (ROC) Curve analysis. The study included 5122 patients who met the criteria. The average age of the patients was 63.9 + 13.2, and 74.4% were male. It was observed that NRP developed in 1.8% of all patients. Age, hemoglobin (Hb), white blood cell (WBC), glucose and low density lipoprotein cholesterol (LDL-C) were determined to be independent predictors of NRP. The power of these parameters to predict NRP was similar, and WBC was the most predictive (Area Under Curve (AUC): 0.605 95% CI: 0.539-0.671, P  = .001). We believe that the use of these simple, practical, and routinely used hematological and biochemical parameters will help us predict the risk of developing NRP before pPCI. This information should improve management., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Our aim in this case was to remove the defective ventricular lead and the ruptured coronary sinus lead., Methods: Entering through the right femoral vein and removing the coronary sinus lead with a pigtail catheter., Results: In our attempt to extract the coronary sinus lead, it fractured. The broken fragment was successfully removed without any complications., Conclusions: In this case, which is very rarely encountered in daily practice, we successfully removed the coronary sinus lead from the body from the femoral vein using a pigtail catheter with a new method., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2025 Özmen and Aydınyılmaz.)

Leptospirosis is major zoonotic disease with global implications, affecting both domestic animals and humans. It is caused by Leptospira interrogans (L. interrogans), which can damage multiple organs, including the kidneys, liver, testes, and uterus. Despite this, L. interrogans can also persist asymptomatically in tissues, akin to nonpathogenic strains. The mechanisms driving asymptomatic infections remain poorly understood. This study investigated the role of L. interrogans in asymptomatic infection within the uterine tissue of canines, focusing on the differential expression of Toll-like receptors (TLRs)2 and 4 and their roles in inflammatory and apoptotic pathways. We hypothesized that TLR2 and TLR4 coexpression is crucial for eliciting inflammation and apoptosis, whereas TLR4 alone might be insufficient. Our findings revealed that in symptomatic infections, both TLR2 and TLR4 are coexpressed, leading to markedly elevated levels of the proinflammatory cytokines IL-10, IL-1β, TNF-α, and IL-6. This enhanced inflammatory response is further evidenced by increased CD4 expression, indicating robust T helper cell activation. In contrast, asymptomatic infections are characterized by exclusive TLR4 expression, with inflammatory markers remaining at baseline levels. Additionally, we observed that L. interrogans induces apoptosis in symptomatic animals through TLR2 and TLR4 mediated activation of Caspase 8 and Caspase 3. These findings illustrate that L. interrogans drives both inflammation and apoptosis via the combination of TLR2 and TLR4 actions. When only TLR4 is activated, the immune response is insufficient, resulting in an asymptomatic disease course. This study provides novel insights into the differential roles of TLR receptors in leptospirosis, offering potential directions for targeted therapeutic strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Diabetes mellitus (DM) and atrial Fibrillation (AF) are among the most common health issues. They are responsible for the highest rates of morbidity and mortality. The importance of sodium glucose cotransporter-2 inhibitors (SGLT-2is) in treating DM has increased significantly in recent years. In our article, we aimed to evaluate the effect of SGLT-2i on the clinical outcomes of AF patients with DM., Methods: Our study is a retrospective, observational study. The patients with AF and DM were divided into two groups: those using SGLT-2i or not using SGLT-2i, and 3-year follow-up results were examined. The endpoints of the study were defined as all-cause death, the development of myocardial infarction (MI), major bleeding requiring hospitalization, and an ischemic cerebrovascular event (CVE). Differences between groups according to SGLT-2i use were analyzed., Results: The study included 485 patients, 205 (42.3%) of whom were male and had an average age of 70.7 ± 9.7 years. A total of 138 of 485 patients (28.5%) received SGLT-2i. All-cause mortality was lower in the group receiving SGLT-2i (p < 0.001). Similarly, a significant reduction in major bleeding events was observed among those who received SGLT-2i treatment (p = 0.009). The incidence of CVEs was lower among SGLT-2i recipients, but the difference was not statistically significant (p = 0.066). SGLT2i usage did not mitigate the risk of MI development (p = 0.317)., Conclusions: In our study, SGLT-2i treatment was associated with a significant reduction in all-cause mortality and major bleeding in diabetic AF patients. Our study provides evidence of the clinical benefit of SGLT-2i in AF patients., Competing Interests: Declarations. Ethics committee approval: The studies involving humans were approved by the University of Health Sciences Erzurum Faculty of Medicine Scientific Research Ethics Committee. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Dual antiplatelet therapy (DAPT) is the treatment of choice for patients with acute and chronic coronary syndromes as it reduces mortality and prevents recurrent thrombotic complications. The assessment of both ischaemic burden and bleeding risk is crucial in deciding which DAPT to choose and how long it should be continued., Objectives: The aim of our study was to perform prospective clinical follow-up of patients receiving fixed-dose combination therapy (ASA 75 mg + clopidogrel 75 mg). Our study is a multicentric, cross-sectional, observational, cohort study., Methods: A total of 1500 patients who were started on fixed-dose combination DAPT for acute or chronic coronary syndrome were included in the study. Primary endpoints were hospitalization for any reason, hospitalization for cardiovascular cause, acute myocardial infarction, stent thrombosis, target vessel revascularization and bleeding; the secondary endpoints were death for any reason or cardiovascular cause and stroke. The significance level adopted in the statistical analysis was 5%., Results: Median age was 63 years; 78.5% of the patients were receiving DAPT treatment for acute coronary syndrome. The rates of hospitalization for cardiovascular reasons, acute myocardial infartion, stent thrombosis and target-vessel revascularization were 7.9%, 2.3%, 1.3% and 4.2%, respectively. While the rate of BARC type 1 bleeding was 3.3%, the rate of BARC type 5, 3, or 2 bleeding was 0.6%. The secondary endpoints which were death from any cause, cardiovascular death and stroke were 0.5%, 0.3% and 0.3%, respectively. Conclusion: Our study shows that fixed-dose combination therapy is effective and safe in appropriately selected patients with acute or chronic coronary syndromes.

Background: Brucellosis is the most important public health problem worldwide, and the annual incidence of the disease in humans is 2.1 million. The Brucella genome is highly conserved, with over 90% similarity among species. The aim of this study was to perform species-level identification of Brucella spp. strains isolated from humans diagnosed with brucellosis and to further investigate the phylogenetic relationships using multiple locus variable number of tandem repeats analysis (MLVA)-16 and 16S rRNA sequencing analysis. Materials and Methods: Brucella spp. was isolated from the blood cultures of 54 patients who tested positive for brucellosis through serological examinations. Real-time PCR was used to identify the isolates in species, and the genus level of Brucella was confirmed with 16S rRNA. All isolates were subjected to phylogenetic analysis using variable number of tandem repeat analysis with multiple loci. Results: Subsequent analysis via real-time PCR confirmed these isolates to be of the Brucella melitensis species. The 16S rRNA sequence analysis showed 100% homogeneity among the isolates. MLVA revealed the formation of five different genotypic groups. While two groups were formed based on the 16S rRNA sequence analysis, five groups were formed in the MLVA. Conclusions: The study concluded that 16S rRNA sequence analysis alone did not provide sufficient discrimination for phylogenetic analysis but served as a supportive method for identification. MLVA exhibited higher phylogenetic power. The widespread isolation of B. melitensis from human brucellosis cases highlights the importance of controlling brucellosis in small ruminants to prevent human infections.

Objective: Heart failure is a leading cause of death and the most common diagnosis leading to hospitalization. Its awareness is lower than that of other cardiovascular diseases, both in the general population and among patients with heart failure (HF). This study aimed to establish the current level of knowledge about HF in patients with HF with reduced ejection fraction (HFrEF) and mildly reduced ejection fraction (HFmrEF) in Türkiye., Methods: This questionnaire-based survey study is multicenter, conducted across 34 centers from December 2021 to July 2022. We performed a survey consisting of two sets of questions focusing on individual characteristics of the patients and HF-related knowledge., Results: The study included a total of 2,307 outpatient HF patients, comprising 70.5% males and 29.5% females with a mean age of 64.58 ± 13 (56-74) years and a mean body mass index value of 32.5 ± 10 kg/m2. HFrEF and HFmrEF were determined in 74.7% and 25.3% of patients, respectively. Thirty percent of the patients were unaware that they had HF. While 28.7% of the patients thought that they had sufficient information about HF, 71.3% believed they lacked adequate knowledge. In the study, 25.2% of the participants identified dyspnea, 22% identified tiredness, and 25.4% identified leg edema as the most common symptoms of HF. Only 27.4% of patients recognized all three typical symptoms of HF., Conclusion: We found that the study population's knowledge about HF symptoms and the nature of the disease was poor. Educational and awareness activities are necessary to optimize outcomes and benefits.

Introduction: Acute coronary syndrome (ACS), one of the most common causes of death worldwide, is a condition characterised by ischaemia and/or infarction due to reduced coronary blood flow. The most prevalent cause of ACS is coronary artery disease. In this study, we aimed to investigate the relationship between blood parameters that we commonly use in the laboratory [C-reactive protein (CRP), albumin, neutrophils and lymphocytes] and coronary artery disease (CAD)., Methods: This retrospective, single-centre study included 100 patients who underwent coronary angiography, with the diagnosis of acute coronary syndrome between January and June 2023, and 106 patients with high clinical suspicion and normal coronary arteries as a control group. The NLR was obtained from the ratio of neutrophils to lymphocytes and the CAR was obtained from the ratio of CRP to albumin. We analysed the relationship between CAD and NLR and CAR according to laboratory findings and demographic characteristics of the patients., Results: The average age of the study group was 59 ± 10 years. NLR and CAR values were higher in the patient group than the control group (5.2 ± 3.3 vs 2.27 ± 1.2, p = 0.004 and 0.5 ± 0.1 vs 0.097 ± 0.095, respectively, p < 0.001). Albumin ratios were found to be statistically significantly lower in the patient group than the patient group (42.4 ± 4 vs 44 ± 3.3, respectively, p = 0.01). In addition, CAR and NLR showed a significant diagnostic value for CAD in receiver operating characteristic curve analysis (area under the curve: 0.68 ± 0.07, p = 0.003; 0.66 ± 0.09 p ≤ 0.001)., Conclusions: NLR and CAR values, which are important indicators of inflammation, were found to be higher in the patient group. We believe it may be important to monitor these patients more frequently and follow them closely in terms of CAD, especially if the rate is higher in individuals without CAD who come for out-patient clinic check-ups.

Background: Coronavirus disease 2019 (COVID-19) causes various signs and symptoms, especially lung involvement, during acute infection and in the long term. In this study, we evaluated the follow-up results of patients with chronic COVID-19 over a 24-week period., Methods: The study included a total of 100 post-COVID-19 patients (confirmed by real-time polymerase chain reaction (PCR) of a nasopharyngeal swab) who presented to the post-COVID-19 outpatient clinic with chronic COVID-19 symptoms 12 weeks after diagnosis, between April and June 2021. All of the patients in the study had a history of hospitalization and were grouped based on the severity of the acute COVID-19 infection (moderate: group 1, severe: group 2)., Results: A comparison of pulmonary function test parameters at week 12 showed that forced expiratory volume (FEV1)%, forced vital capacity (FVC)%, diffusing capacity of the lungs for carbon monoxide (DLCO)%, and DLCO divided by the alveolar volume (DLCO/VA)% values were significantly lower in group 2 than in group 1 (p<0.001 for all). At week 24, only DLCO and DLCO/VA values were lower (<0.001 for both). The mean modified Medical Research Council (mMRC) dyspnea scores of groups 1 and 2 were 1.4 ± 0.9 and 2.8 ± 1.1 at 12 weeks and improved to 0.9 ± 0.6 and 1.6 ± 0.6 at 24 weeks, respectively. The groups' mMRC scores at 12 and 24 weeks differed significantly (p=0.001, p=0.02). There was no difference in levels of IgM and IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein between the groups at 12 or 24 weeks (p>0.05 for all)., Conclusion: Improvement in pulmonary function parameters and mMRC scores may take longer than 24 weeks, especially in patients with severe COVID-19. Our results indicated that the levels of IgM and IgG neutralizing antibodies did not differ between patients with moderate and severe illness at 12 or 24 weeks., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Özmen et al.)

Competing Interests: All the authors declare no conflict of interest.

Aim: To predict the development of radial artery thrombus (RAT) in patients with radial approach coronary angiography of platelet-to-hemoglobin ratio (PHR). Materials & methods: This study was designed to evaluate the relationship between RAT and PHR. A total of 1156 patients who had coronary angiography via the transradial approach between 2021 and 2022 in the authors' center were included in the study. Results: Radial thrombus was detected in 52 (4.5%) patients. PHR was higher in the group with thrombus and was statistically significant. In the regression model, PHR was an independent predictor of the development of radial thrombus (p = 0.007). Conclusion: High PHR may be an independent predictor of the development of radial thrombus.

Background COVID-19 is a multisystemic disease that affects many organs, and the use of some parameters is recommended both during hospitalization and follow-up. In this study, we investigated the relationship between blood (liver and kidney function tests, lactate, and D-dimer), infection (C-reactive protein (CRP), lymphocyte count, ferritin, and albumin), and cardiac (creatine kinase-myocardial band (CK-MB), troponin, and brain natriuretic peptide (BNP)) parameters with intensive care unit (ICU) admission and mortality. Materials and methods Patients hospitalized in Erzurum City Hospital with the diagnosis of COVID-19 between April 2020 and November 2022 were included in this retrospective study. The patient's files and electronic media records were retrospectively reviewed, and the patient's anamnesis, physical examination, clinical findings, biochemical parameters, and treatment methods were recorded. The ICU needs of the patients and the treatment processes in intensive care were found in the in-hospital records. The hospital records and six-month mortality data were obtained retrospectively with the necessary permissions. Thus, blood parameters and their relation to each other in terms of prognosis were evaluated in determining the six-month mortality rates of the patients and estimating the need for ICU. Results A total of 5100 patients were included in the study. The mean age of patients with mortality was 74.2 ± 11.2 and that without mortality was 59.9 ± 15.7 (p < 0.001). In the mortality (+) group, 61.5% of patients were male, and in the mortality (-) group, 47.4% of the patients were male (p < 0.001). The mean age of patients with ICU admission was 69.6 ± 13.6 and without ICU admission was 60.3 ± 15.9 years (p < 0.001). In the ICU admission (+) group, 60.5% of patients were male; and in the ICU admission (-) group, 47.2% of patients were male (p < 0.001). Death and ICU admission were observed more frequently in elderly and male patients (p < 0.001 for both mortality and ICU admission). Blood parameters were evaluated both in the mortality and ICU groups, and organ function tests, blood count parameters, inflammatory markers, and cardiac parameters were significantly associated with poor outcomes. Cox regression analysis showed that lactate, albumin, Ln(troponin), and Ln(BNP) were independent predictors of mortality and ICU admission. Receiver operating characteristics (ROC) curve analysis showed that Ln(troponin) and Ln(BNP) levels predicted the development of mortality and ICU admission better than other parameters. Discussion COVID-19 can cause problems in different systems as a result of an inflammatory response, secreted cytokines, hypercoagulability, and direct tissue damage. When treating patients, a more appropriate approach is to evaluate different parameters together rather than focusing on a single parameter and deciding accordingly. However, evaluating alterations in many parameters in a disease that affects many systems is difficult and increases the risk of mistakes. Although each blood parameter separately is important, it was observed that the cardiac parameters troponin I and BNP have better predictive values than others in predicting the course and prognosis of COVID-19. Conclusion Blood parameters are used in COVID-19 diagnosis, treatment, and follow-up. Although it is not primarily a cardiac disease, cardiac markers can provide better results in showing the course and prognosis of COVID-19., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Aksakal et al.)

Background: There is limited data in the literature about the clinical importance and prognosis of pericardial effusion (PE) in patients discharged after recovering from COVID-19, but large-scale studies have yet to be available. This study investigated the prevalence, risk factors, prognosis, late clinical outcomes, and management of PE in COVID-19. Materials and Methods: Between August 2020 and March 2021, 15,689 patients were followed up in our pandemic hospital due to COVID-19. Patients with positive polymerase chain reaction (PCR) test results and PE associated with COVID-19 in computed tomography (CT) were included in the study. The patients were divided into three groups according to PE size (mild, moderate, and large). Transthoracic echocardiography (TTE) records, laboratory data, clinical outcomes, and medical treatments of patients discharged from the hospital were retrospectively reviewed. Results: According to the PE size (mild, moderate, large) of 256 patients with PE at admission or discharge, the mean age was 62.17 ± 16.34, 69.12 ± 12.52, and 72.44 ± 15.26, respectively. The mean follow-up period of the patients was 25.2 ± 5.12 months. Of the patients in the study population, 53.5% were in the mild group, 30.4% in the moderate group, and 16.1% in the large group. PE became chronic in a total of 178 (69.6%) patients at the end of the mean three months, and chronicity increased as PE size increased. Despite the different anti-inflammatory treatments for PE in the acute phase, similar chronicity was observed. In addition, as the PE size increased, the patients' frequency of hospitalization, complications, and mortality rates showed statistical significance between the groups. Conclusions: The clinical prognosis of patients presenting with PE was quite poor; as PE in size increased, cardiac and noncardiac events and mortality rates were significantly higher. Patients with large PE associated with COVID-19 at discharge should be monitored at close intervals due to the chronicity of PE and the increased risk of tamponade.

This study investigates country-wide genotype variations through the genotyping of Brucella strains isolated from domestic ruminants and humans. The Brucella spp. isolated from samples taken from animals and humans were first identified as B. abortus and B. melitensis by real-time PCR, and the MLVA-16 approach was then used for the genotyping of the identified isolates. For the study, 416 Brucella spp. were isolated from aborted fetus samples examined between 2018 and 2021, and 74 Brucella spp. from infected humans. Of the 74 human isolates analyzed, 1.3% were identified as B. abortus and 98.7% (73/74) as B. melitensis. The MLVA-16 typing method revealed 30 clonal groups for B. abortus and 37 clonal groups for B. melitensis from which the dominant genotypes and similarities with human isolates in Türkiye were determined., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Pesticide exposure is thought to be one of the common reasons for the decline in amphibian populations, a phenomenon that is a major threat to global biodiversity. Although the single effects of pesticides on amphibians have been well studied, the effects of mixtures are not well known. The present study aimed to evaluate the acute toxicity of the insecticide thiacloprid and the fungicide trifloxystrobin on early developmental stages of Xenopus laevis using various biochemical markers (glutathione S-transferase, glutathione reductase, acetylcholinesterase, carboxylesterase, glutathione peroxidase, catalase, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, Na + K + -adenosine triphosphatase [ATPase], Ca 2+ -ATPase, Mg 2+ -ATPase, and total ATPase). The median lethal concentrations (LC50s) of thiacloprid and trifloxystrobin were determined to be 3.41 and 0.09 mg a.i. L -1 , respectively. Tadpoles were exposed to the LC50, LC50/2, LC50/10, LC50/20, LC50/50, and LC50/100 of these pesticides. Both pesticides significantly affected (inhibited/activated) the biomarkers even at low concentrations. The pesticides showed a synergistic effect when applied as a mixture and altered the biomarkers more than when applied individually. In conclusion, we can assume that tadpoles are threatened by these pesticides even at environmentally relevant concentrations. Our findings provide important data to guide management of the ecotoxicological effects of these pesticides on nontarget amphibians.  Environ Toxicol Chem 2021;40:2846-2860. © 2021 SETAC., (© 2021 SETAC.)

Background: Heart failure (HF) remains a significant health problem despite advances in diagnosis and treatment options. Malnutrition and increased inflammation predict poor disease prognosis. The parameters of the Naples prognostic score (NPS) include albumin, total cholesterol, neutrophil-lymphocyte ratio (NLR), and lymphocyte-monocyte ratio (LMR). We aimed to assess the potential of NPS as a predictor of long-term mortality in patients with HF., Methods: A total of 1728 patients with HF who applied to our center between 2018 and 2022 were included in this study. The NPS was computed and the patients were divided into three groups according to their NPS values as follows: NPS = 0 (Group 1), NPS = 1-2 (Group 2), and NPS = 3-4 (Group 3). We also evaluated the association between NPS value and HF mortality., Results: The patients were followed for a mean follow-up duration of 30 months. The mortality rate was 8.3% (145 patients). We carried out Model-1 and -2 Cox regression analyses to identify long-term mortality determinants. Model-2 was constructed by adding NPS to Model-1. NPS was significantly associated with HF mortality (Hazard Ratio: 2.194, 95% Confidence Interval: 1.176-4.091, p  = 0.014). According to the Kaplan-Meier plot and log-rank analyses, there was a statistically significant difference in the long-term mortality of patients with HF and their NPS values for the entire cohort., Conclusion: Based on our findings, NPS showed promise as an independent predictor of long-term mortality in individuals with HF.