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Amaç: Atriyal fibrilasyon günlük pratikte en sık karşılaştığımız aritmidir. Hipertansiyon atriyal fibrilasyon için bağımsız risk faktörüdür. P dalga dispersiyonu atriyal fibrilasyon öngörmede kabul görmüş non-invaziv parametrelerden biridir. Çalışmamızda maskeli hipertansiyon tanısı ile takip edilen hastalarda P dalga sürelerinin kontrol grubuna göre farklılık gösterip göstermediği incelemeyi amaçladık. Materyal Metod: Çalışmaya yaş ve cinsiyet açısından benzer 40 maskeli hipertansiyonu olan hasta ile 42 kontrol grubu olarak toplam 82 kişi alındı. Çalışmaya katılan bireylerin laboratuvar verileri ve elektrokardiyografi (EKG) parametreleri retrospektif olarak incelendi. Tüm katılımcıların EKG kayıtlarından P dalga süreleri hesaplandı. Bulgular: P dalga dispersiyon süresi (44,88±5,63 ms ve 38,38±6,21 ms) ve P maksimum süresi (127,28±4,19 ms ve 121,38±6,05 ms) maskeli hipertansiyon grubunda kontrol grubuna göre anlamlı düzeyde yüksek saptandı (p

Tohumluk seçimi, tarımsal üretimde verim ve kaliteyi etkileyen en önemli hususlardan biridir. Bu çalışmada, ticari olarak tohumluk patates yumrusu üretimi ve satışı yapan bazı firmalardan alınan farklı çeşit patates numunelerinde görülen fungal hastalık etmenlerinden Rhizoctonia solani Kühn ve Fusarium spp.’nin yaygınlık oranları araştırılmıştır. Bu amaçla, özellikle ülkemizde çok sık yetiştiricilikleri yapılan bazı çeşitlerinden olan Marabel, Agria, Madeleine ve Marfona’dan oluşan toplam 48 parti patates temin edilmiş, bunlar fungal etmenlerin varlığı açısından değerlendirilmiştir. Tesadüfi olarak seçilmiş 90’ar adet patates yumrusundan oluşan partilerden analizler yapılarak etmenlerin yaygınlıkları belirlenmiştir. Yapılan izolasyon ve karakterizasyon çalışmaları sonrası incelenen tüm örneklerin %3.87’sinin Fusarium spp., %0.11’inin ise R. solani ile bulaşık oldukları tespit edilmiştir.

Depolanmış ürünlerde sorun olan fungal hastalık etmenleri, hasat sonrası ürünlerde kaliteyi sınırlandıran önemli faktörlerden biridir. Hasat sonrası kurutulmalık biberler mikotoksin üreten fungal patojenler tarafından çok sık enfekte olmaktadırlar. Aspergillus niger, Alternaria alternata ve Fusarium incarnatum, birçok bitkide hasat öncesi ve sonrası dönemlerde hastalıklara neden olan potansiyel mikotoksin üretebilen önemli fungal etmenlerdir. Brassica spp. tarafından üretilen ve geniş antimikrobiyal etkiye sahip olan isothiocyanate (ITC)’lar, glukozinolatların biyolojik olarak aktif bozulma ürünleri ile bağlantılı allelokimyasal bileşiklerdir. Bu çalışmada, farklı kimyasal yapıdaki isothiocyanate bileşiklerden methyl isothiocyanate (MITC), 2-propenyl (Allyl) isothiocyanate (AITC), benzyl isothiocyanate (BITC) ve ethyl isothiocyanate (EITC)’ın Aspergillus niger, Alternaria alternata ve Fusarium incarnatum izolatlarına karşı in vitro antifungal etkileri araştırılmıştır. Test edilen Fusarium incarnatum, Aspergillus niger ve Alternaria alternata’nın misel gelişimini tamamen engelleyen konsantrasyonları (MIC) baz alındığında en yüksek antifungal etkinlik MITC tarafından sırasıyla 0.06, 0.09 ve 0.09 μl petri-1 konsantrasyonlarında gösterilmiştir. En düşük antifungal aktivite ise A. niger ile F. incarnatum’a karşı EITC (0.15 ve 0.21 μl petri-1), A. alternata’ya karşı ise AITC ve BITC (0.21 μl petri-1) tarafından gösterilmiştir. Farklı yapıdaki ITC’ların MIC değerlerinde genelde fungisidal etkiye sahip olduğu belirlenmiştir. Elde edilen sonuçlar, oldukça düşük konsantrasyonlarda antifungal etkinlik gösteren isothiocyanate’ların, depolanmış tarımsal ürünlerde bozulmalara neden fungal etmenlere karşı fumigant olarak olarak uygulanabilir potansiyele sahip olduğunu göstermiştir.

Amaç: Derin ven trombozu (DVT) birçok nedene bağlı olarak ortaya çıkan önemli bir mortalite ve morbidite sebebidir. Otoimmun hastalıklar, maligniteler, geçirilmiş majör cerrahi girişimler, immobilite ve hiperhomosisteinemi metabolik hastalıklar DVT’ye yatkınlık oluştur. Homosistein metabolizmasını etkileyen vitamin B12 ve vitamin D eksikliğinin DVT gelişimi ile ilişkili olabileceği yönünde çalışmalar mevcuttur. Biz çalışmamızda DVT gelişmiş hastalarda, vitamin B12 ve vitamin D düzeylerinin kontrol grubuna göre kıyaslarak incelemeyi amaçladık.Materyal Metod: Çalışmamıza Aralık 2015-Aralık 2020 tarihleri arasında DVT saptanan 97 hasta ve DVT’si olmayan 91 birey alındı. Hasta ve kontrol grubunun serum vitamin B12 ve vitamin D düzeyleri ile klinik ve diğer tetkik sonuçları hastane bilgi sisteminden retrospektif olarak değerlendirildi.Bulgular: Çalışmaya alınan hasta ve kontrol grubu arasında demografik özellikler açısından fark saptanmadı. Serum vitamin D (19.64±8.68 vs 23.63±7.99, p, Background: Deep vein thrombosis (DVT) is an important cause of mortality and morbidity that occurs due to many causes. Autoimmune diseases, malignancies, previous major surgical interventions, immobility and hyperhomocysteinemia, metabolic diseases predispose to DVT. There are studies suggesting that vitamin B12 and vitamin D deficiency, which affect homocysteine metabolism, may be associated with the development of DVT. In our study, we aimed to compare vitamin B12 and vitamin D levels in patients with DVT compared to the control group. Materials and Methods: Between December 2015 and December 2020, 97 patients with DVT and 91 individuals without DVT were included in our routine. Serum vitamin B12 and vitamin D levels, clinical and other examination results of the patient and control groups were evaluated retrospectively from the hospital information system.Results: There was no difference in demographic characteristics between the patient and control group included in the study. Serum vitamin D (19.64±8.68 vs 23.63±7.99, p

Objectives: The study aims to retrospectively evaluate the 1-year results of endovascular treatment with rheolytic thrombectomy(TR) or catheter-directed thrombolytic(CDT) infusion therapy in acute femoro-popliteal bypass graft occlusion. Methods: The patients who had a history of femoro-popliteal by-pass operation and during their follow-up diagnosed with ipsilateral acute limb ischemia between 2016 and 2018 were included. The total of 13 patients were included and they were divided into two groups according to their treatment methods (RT, n=8 vs CDT, n=5). Results: There was no statistically significant difference between the two groups in terms of demographic data and Rutherford embolism classification. Reolitic thrombectomy and catheter-directed thromolytic infusion primary patency values were 87.5% and 80% for 6 months, 75% and 60% for 12 months, respectively. Secondary patency values were found to be 100% in both groups for 6 months, and 87.5% and 80% for 12 months, respectively. There was no significant difference between the two groups in terms of primer and sekonder patency. Conclusion:Endovascular therapy can be preferred in the treatment of acute femoro-popliteal by-pass graft occlusion in selected patient groups due to its less invasiveness, early mobilization, and low mortality and morbidity rates compared to surgery

We consider a SIR-type compartmental model divided into two age classes to explain the seasonal exacerbations of bacterial meningitis, especially among children outside of the meningitis belt. We describe the seasonal forcing through time-dependent transmission parameters that may represent the outbreak of the meningitis cases after the annual pilgrimage period (Hajj) or uncontrolled inflows of irregular immigrants. We present and analyze a mathematical model with time-dependent transmission. We consider not only periodic functions in the analysis but also general non-periodic transmission processes. We show that the long-time average values of transmission functions can be used as a stability marker of the equilibrium. Furthermore, we interpret the basic reproduction number in case of time-dependent transmission functions. Numerical simulations support and help visualize the theoretical results. Mathematics Subject Classification (2020) 93A30 · 92D30 · 34A34

Purpose One subset of peripheral arterial disease is aortoiliac occlusive diseases (AIOD). AIOD is the term for all arterial lesions between the infrarenal distal aorta and common femoral artery. Implantation of kissing stents (KS) with covered stents (CS), bare-metal stents (BMS) is one of the endovascular treatment (ET) modalities for AIOD involving aortic bifurcation. In this study, we report the outcomes of the KS technique in infrarenal AIOD. Methods Between January 2014 and September 2017, 31 patients who underwent ET were treated with KS technique either with balloon-expandable BMS or balloon-expandable CS. Technical details, clinical success, complications, and patency at follow-up were documented. Results The majority of patients were male (77.4%), and the median age was 62 years (range, 45-78 years). All patients were classified according to the TASC II criteria. Eight patients (25.8%) were classified as TASC B. Fifteen patients (48.4%) were classified as TASC C, and 8 patients (25.8%) were classified as TASC D. These 23 patients were classified as complex AIOD group. BMS was used in 17 patients (54.8%), and CS was used in 14 patients (45.2%). Technical and clinical success was achieved in 100% of treated cases. The median follow-up was 24 months (range, 24-34 months). Primary patency rates at 12, 18, and 24 months after ET were 100%, 96.8%, and 90.3%, respectively. Conclusion We found that the KS technique has satisfying 24-month results, even in complex AIOD lesions, with high technical success and acceptable midterm patency. Key Words: Aorta, Arterial occlusive diseases, Endovascular procedures, Iliac artery, Stents.

Amaç: Atriyal fibrilasyon (AF) erişkin popülasyonda en sık görülen aritmi olup tromboemboli riskinde önemli artışa sebep olmaktadır. ATRIA risk skorlaması AF hastalarında tromboemboli riskini değerlendirmek için geliştirilmiştir. Çalışmamızda AF saptanan hastalarda, ATRIA risk skoru ile C-reaktif peptid (CRP)/Albumin oranı arasındaki ilişkiyi incelemeyi amaçladık.Materyal ve Metod: Çalışmamıza Aralık 2015-Aralık 2021 tarihleri arasında non-valvüler AF’u olan 240 hasta alındı. Hastaların klinik bilgileri ve tetkik sonuçları hastane bilgi sisteminden retrospektif olarak taranarak ATRIA skorları hesaplandı. Bulgular: Çalışmaya 240 hasta alındı. Hastaların yaş ortalaması 67.35±9.5 olup, %42.9’u erkek idi. Hastaları %27.9’unda diyabetes mellitus, %44.2’sinde hipertansiyon, %24.2’sinde hiperlipidemi, %32.1’inde koroner arter hastalığı mevcuttu. ATRIA skoruna göre yüksek riskli grubun daha yüksek glukoz, kreatinin, CRP ve CRP/Albumin oranına sahip olduğu saptanmıştır. Korelasyon analizinde, ATRIA skoru ve CRP/Albumin oranı arasında pozitif korelasyon tespit edildi (r=0.687; p=0.001; p, Background: Atrial fibrillation (AF) is the most common arrhythmia in the adult population and causes a significant increase in the risk of thromboembolism. The ATRIA risk scoring system was developed to assess the risk of thromboembolism in AF patients. In our study, we aimed to investigate the relationship between the ATRIA risk score and the C-reactive peptide (CRP)/Albumin ratio in patients with AF.Materials and Methods: 240 patients with non-valvular AF between December 2015 and December 2021 were included in our study. ATRIA scores were calculated by retrospectively scanning the clinical information and examination results of the patients from the hospital information system. Results: 240 patients were included in the study. The mean age of the patients was 67.35±9.5, and 42.9% were male. 27.9% of the patients had diabetes mellitus, 44.2% had hypertension, 24.2% had hyperlipidemia and 32.1% had coronary artery disease. According to the ATRIA score, the high-risk group was found to have higher glucose, creatinine, CRP and CRP/Albumin ratios. In the correlation analysis, a positive correlation was found between the ATRIA score and the CRP/Albumin ratio (r=0.687; p=0.001; p

Purpose The frequency of iatrogenic femoral artery pseudoaneurysm (FAP) diagnoses has recently increased due to the growing use of diagnostic and interventional procedures involving large diameter sheaths, as well as more potent anticoagulation procedures. In this study, we aimed to present our experience with ultrasound-guided thrombin injection (UGTI) in patients with iatrogenic FAP. Methods We studied patients with FAP who were under anticoagulant or antiplatelet therapies preoperatively, or who had received a loading dose during an interventional procedure. The outcomes of patients with FAP treated with UGTI were compared with those of patients who underwent open surgical repair for pseudoaneurysms. Results Among the 55 patients included in this study, 24 had UGTI while 31 had open surgery. The success rate was 95.8% when taking into consideration primary and secondary attempts. The mean duration of the procedure was shorter in patients with UGTI (10.1 ± 3.54 minutes) when compared with those who underwent open surgery (76.55 ± 26.74 minutes, P ≤ 0.001). In addition, the total complication frequency was significantly higher in the open surgery group (P = 0.005), as was their length of hospital stay (P < 0.001). Cost analysis showed significant differences between UGTI ($227.50 ± $82.90) and open surgery ($471.20 ± $437.60, P = 0.01). Conclusion We have found that UGTI is the safer and more effective choice of treatment in appropriate patients with FAP, as opposed to surgery.

To evaluate the outcomes of radiofrequency ablation (RFA) therapy performed on patients with great saphenous vein insufficiency.Descriptive study.Bahcelievler State Hospital, Istanbul, Turkey, between January 2018 and May 2021 Methodology: A total of 709 patients (382 females, 327 males), who were treated with radiofrequency ablation (RFA) in the clinic, were included in the study. The demographic, anthropometric, clinical, laboratory, and radiological data of the patients were obtained retrospectively from the medical records. Pre and post treatment clinical, etiologic, anatomical, pathophysiologic (CEAP) scores, the venous clinical severity score (VCSS), and the visual analog scale (VAS) were evaluated.The median age of the patients was 48 (19-65) years, and the median follow-up period was 36 (6-53) months. At follow-up, after treatment, 673 (94.9%) of the patients had a CEAP clinical score of C0. Postoperative complications were recorded in 56 (7.9%) patients. Significant improvement was observed in the patients' CEAP, VAS, and VCSS scores at the follow-up (p0.001).There was a high success rate in achieving short- and long-term venous occlusion in varicose vein treatment with RFA. Characterized by a fast recovery, good perioperative and postoperative outcomes, and a low frequency of side effects, RFA is effective and safe in the treatment of varicose veins.Chronic venous insufficiency, Radiofrequency ablation, Patient-reported outcomes.

Objectives: EuroSCORE II, logistic EuroSCORE and SYNTAX scores were compared in patients who underwent CABG in order to find the ideal scoring system for mortality.Methods: This retrospective study attempted to examine the preoperative demographic characteristics, echocardiographic findings, operation notes and files, perfusion cards and observation notes of 228 patients who had undergone CABG surgery in our clinic.Results: It was found that predictive point of SYNTAX score was greater than 27.5 (>27.5), the logistic regression (LR +) value was 1.5 in order to determine mortality rate. Predictive value of EuroSCORE II was higher than 1.82 (>1.82) and LR+ value was 2.20. It was found that EuroSCORE II was enough to predict one-year mortality rate although its positive predictive value was low. Predictive value of logistic EuroSCORE was higher than 5.71 (>5.71) and the LR+ value was 5.13 to assess the mortality rate. Logistic EuroSCORE was also sufficient to predict one-year mortality rate.Conclusion: Logistic EuroSCORE was found to be the most effective scoring system in predicting one-year mortality in this study. We conclude that randomized clinical trials need to be performed in order to find an ideal cardiac risk scoring system., Amaç: Bu çalışmanın amacı koroner arter bypass greftleme (CABG) operasyonu geçiren hastalarda mortalite açısından uygun skorlama sistemini bulmak amacı ile EuroSCORE II, Lojistik EuroSCORE ve SYNTAX skorlarının karşılaştırılmasıdır.Gereç ve Yöntem: Kliniğimizde CABG cerrahisi geçiren 228 hastanın demografik özellikleri, ekokardiyografik bulguları, operasyon notları ve dosyaları, perfüzyon ve gözlem notları değerlendirildi. Bulgular: Mortaliteyi belirlemek amacıyla SYNTAX skorunun prediktif değeri 27.5’ten (>27.5) büyüktü, lojistik regresyon (LR+) değeri ise 1.5 idi. EuroSCORE II’nin prediktif değeri 1.82’den yüksekti (>1.82) ve LR+ değeri 2.20 idi. EuroSCORE II’nin pozitif prediktif değerinin düşük olmasına rağmen bir yıllık mortalite oranını tahmin etmede yeterli olduğu bulundu. Mortalite oranını değerlendirmede Lojistik EuroSCORE’un prediktif değeri 5.71’den büyüktü (>5.71) ve LR+ değeri 5.13 idi. Lojistik EuroSCORE da bir yillik mortalite oranini tahmin etmede yeterliydi.Sonuç: Çalışmamızda bir yıllık mortaliteyi tahmin etmede Lojistik EuroSCORE en etkin skorlama sistemi olarak bulunmuştur. İdeal kardiyak risk skorlama sistemini bulmak için randomize klinik çalışmalara ihtiyaç olduğu kanısındayız.

IntroductionThe purpose of this study was to report the midterm outcomes of primary stenting of iliac arteries with additional factors which affect the outcome and to compare the results between patients with simple and complex aorta iliac occlusive disease (AOID).Material and methodsFrom January 2015 and March 2018, the study consisted of 103 lesions in 93 patients with common iliac artery (CIA) and/or external iliac artery (EIA) lesions which accompanied with severe claudication or critical limb ischemia. Balloon-expandable stents (BMS), self-expandable stents (SES) and covered stents (CS) were used to treat the lesions.ResultsLesions of 93 patients that were in CIA and/or EIA and treated with ET were included to the study (n=103). Seventy-one (68.9%) lesions were classified as simple AIOD group (TASCII A-B) while 32(31.1%) were classified as complex AIOD (TASCII C-D) group. In 72.8% of the lesions only mild calcification was detected while 27.2% lesions had moderate or severe calcification. Mean stent diameter for CIA position was 8.26±0.8mm and for EIA position was 7.52±0.8mm. Mean lesion length in patients treated with BMS were 52.5±21.0mm while SES were 63.6±28.3(p=0.03). Technical success was achieved in 101(98.1%) lesions. Significant differences in primary (93% vs 63%) and secondary (98% vs 82%) patency rates at 24 months were found between patients in simple and complex AIOD group (pConclusionsConclusion: In our study, it was found that the primary stenting in patients who had AIOD had satisfactory results with high immediate success, low complication rates and acceptable midterm outcomes.

Pseudoaneurysm of the deep femoral artery (FAP) due to penetrating trauma is less common and can be a challenging condition for surgeons. The conventional treatment strategy for FAP due to penetrating trauma is open surgical repair. With emerging technologies, less invasive techniques are being used in these patients. We report a 37-year-old male patient with delayed presentation of FAP secondary to a stab wound and treated successfully with ultrasound-guided thrombin injection.

Introduction: The aim of this study was to retrospectively review patients who were diagnosed with cardiac injury and underwent an emergency surgery. Patients and Methods: Between January 2009 and December 2014, 37 patients diagnosed with cardiac injury were retrospectively evaluated. Patients were evaluated according to the demographics, mean time from admission to surgery, concurrent interventions, type and localization of cardiac injury, and preoperative mean arterial blood pressure. Results: Eight patients who suffered from cardiac arrest underwent emergency surgery by thoracotomy. On admission to emergency service (ES), 22 patients were in shock. In ES, because the hemodynamic situation of six patients worsened despite fluid therapy, they underwent surgery without performing additional tests or imaging. The localization of the injuries were the right ventricle in 19 patients, left ventricle in 15 patients, right atrium in 2 patients, and both the right and left ventricles in 1 patient. In 34 patients, the primary suturing technique was sufficient for repair but two patients were operated on using cardiopulmonary bypass. The mean time from admission to surgery was 3.16 ± 2.37 h. The mean duration of intensive care unit stay was 2.37 ± 2.1 days. On an average, 5.16 ± 4.21 units of packed erythrocyte suspension were transfused. The mortality rate was 37.83% (n= 14). Conclusion: Improvements in emergency interventions, transportation, and availability of echocardiography in the emergency departments have to be more appropriate and efficient for better outcome in the new series., Giriş: Bu çalışmada 2009-2014 yılları arasında acil serviste kardiyak yaralanma tanısı alan ve acil olarak operasyona alınan hastaları literatüre katkı sağlamak amacıyla retrospektif olarak inceledik. Hastalar ve Yöntem: Kliniğimizde Ocak 2009-Aralık 2014 tarihleri arasında acil serviste kardiyak yaralan- ma tanısı alan ve acil olarak operasyona alınan 37 hasta retrospektif olarak incelendi. Hastalar demografik özellikleri, operasyona alınma süresi, ek girişim yapılıp yapılmadığı, yaralanma şekli, kalpte yaralanan bölge, operasyon öncesi arteryel kan basınçları, operasyonun yapılma şekline göre değerlendirildi. Bulgular: Sekiz hasta acil serviste kardiyopulmoner resüsitasyon eşliğinde acil torakotomi ile ameliyata alın- dı. Yirmi iki hastada şok tablosu mevcuttu. Altı hasta sıvı tedavisine rağmen tabloda kötüleşme olması dolayı- sıyla ek tetkik beklenmeden operasyona alındı. Diğer hastalarda ise ekokardiyografi ve bilgisayarlı tomografi sonucunda kardiyak yaralanma olduğu saptanarak operasyona alındı. On dokuz hastada yaralanma sağ ventri- külde, 15 hastada sol ventrikülde, 1 hastada sağ ve sol ventrikülde, 2 hastada ise sağ atriyumdaydı. Otuz dört hastada yaralanmalar primer olarak süturasyon ile onarıldı. Bir hastada mitral kapak replasmanı, 2 hastada ise onarım kardiyopulmoner baypas altında yapıldı. Bir hastada sol internal mammarian arter yaralanması, 2 hastada femoral arter yaralanması ve 1 hastada ise vena kava inferior yaralanması vardı. Beş hastada mide ve ince bağırsak yaralanmaları olduğu için genel cerrahi ile operasyona devam edildi. Hastaların ortalama ameliyata alınma süresi 3.16 ± 2.37 saat olarak bulundu. Ortalama yoğun bakım ünitesinde yatış 2.37 ± 2.1 gün olarak hesaplandı. Hastalarda ortalama olarak 5.6 ± 4.21 ünite eritrosit süspansiyonu kullanıldı. Hastane mortalitesi 14 hasta ile %37.83 idi. Sonuç: Hastane öncesi acil müdahale ve transport imkanlarının gelişmesi, ekokardiyografinin acil servislerde ulaşılabilirliğinin artmasıyla kalp yaralanmalarının daha yüz güldürücü sonuçlarla yeni serilerde karşımıza çıkacağını umut ediyoruz.

Objective: Extremity thromboembolism is a serious cause of morbidity and mortality in cardiovascular diseases. Comparing with the lower extremity arteries, upper extremity acute arterial occlusions are rarer and constitute 15-32% of all cases. Trauma, collagen vascular diseases, malignant tumors, myxoma, subclavian artery stenosis, myocardial infarction and thromboangiitis obliterans are often identified as etiologic factors. The first option in the treatment of these patients is surgical embolectomy. Endarterectomy, patchplasty and arterial bypass operations can be counted in treatment options of chronic patients. Material and Methods: In this study, we retrospectively analyzed clinical features and prognosis of 58 patients consisting of 31 women and 27 males who were admitted to our emergency department with acute arterial embolism. Results: Mean age of our group was 67.05±17.09. Proximal brachial artery thrombosis was found in 3 patients. The other 55 patients had thrombosis in the brachial artery and its distal branches. After the diagnosis of patients in the emergency room 100 units/kg of subcutaneous enoxaparine was applied. Selective arterial embolectomy surgery was performed under local anesthesia in all patients with access from the antecubital region. Arteriotomy was closed using saphenous patch plasty technique in two patients. Compared with preoperative demographic data and thromboembolism etiology, 21 (36%) patients were diagnosed as atrial fibrillation. Those patients had not been followed and treated for atrial fibrillation. In 5 (8.6%) patients malignancy was detected as an etiologic factor. Four (6.8%) patients died during their follow-ups in the clinic, 3 (75%) of those patients had an atrial fibrillation. Conclusion: Acute peripheral arterial occlusion constitutes a significant part in emergency vascular surgery. Therefore early diagnosis and prompt surgical treatment are very important for the results. Atrial fibrillation (AF) holds an important place in upper extremity acute arterial occlusion, but other etiological factors such as malignancy is necessary to not forget. AF who has acute upper extremity arterial embolism patients with AF have higher mortality rates and the clinical management and treatment of those patients must be monitored more closely. We believe that the development of treatment modalities and further work needs to be done in order to find an appropriate treatment.

Objectives This study aims to identify the factors affecting the activities of daily living, balance, and prosthesis satisfaction in patients with non-traumatic lower limb amputation (LLA). Patients and methods This cross-sectional study included a total of 195 patients (120 males, 75 females; mean age 65.9±11.6 years; range, 40 to 90 years) who underwent LLA between January 2009 and April 2017. All patients were evaluated in terms of age, sex, amputation etiology, side, level, comorbidity, length of hospital stay, prosthesis adjustment, ambulation level, functional outcome, and complications. Prosthesis adjustment, physical balance ability, and daily living activities were assessed using the Turkish versions of the Trinity Amputation and Prosthesis Experience Scales (TAPES), Berg Balance Scale (BBS), and Nottingham Extended Activities of Daily Living Scale (NEADLS), respectively. Results There was no significant difference between male and female patients in terms of prosthesis and amputation adaptation, physical balance, and activities of daily living. The BBS, TAPES, and NEADLS scores were lower in the patients aged over 65 years (p

Pulmonary arterial hypertension (PAH), can be defined as mean pulmonary artery pressure (PAP) is higher than 25 mmHg during resting wheras higher than 30mmHg during exercising. Although it progresses asymptomatically for years, most frequently comes out as exertional dyspnea. Since prognosis changes depending on the reason beneath, its mortality is high if it is not treated.

Background Coronary artery bypass grafting is applicable with very low mortality and morbidity rates around the world. However, exposure to even one of the risk factors increases mortality and morbidity significantly. There are three acute kidney injury definitions, and classification methods are applicable (Kidney Disease: Improving Global Outcomes (KDIGO); Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE);” (for accuracy) and Acute Kidney Injury Network (AKIN)), for understanding and grading of renal impairment. With these definitions, it became possible to take measures at an early stage and start the management process. Methods for assessing renal impairment after coronary artery bypass grafting (CABG) specifically in patients with diabetes mellitus require further investigation. We compared these three acute kidney injury definitions for prediction of outcomes in diabetic patients undergoing coronary artery bypass grafting procedure. Methods Between January 2010 and December 2013, a total of 617 consecutive patients with diabetes mellitus undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass in our institution were included in the study. Results We considered 617 CABG operations on diabetes mellitus patients for this study from January 2010 to December 2013. The three scores provided good discriminative capacity in the global patient sample, with the area under the ROC curve (AUC) being higher, RIFLE (0.803, 95% CI: 0.724–0.882). The goodness of fit was good for all scales. Conclusions Especially in on-pump CABG patients with diabetes mellitus, we can use AKIN, RIFLE, and KDIGO scoring systems to predict early diagnosis for acute kidney injury (AKI). In our analysis, the KDIGO criterion was superior to AKIN and RIFLE with regard its prognostic power.

Background: The complexity of coronary artery disease is usually a neglected factor in risk stratification systems. We aimed to analyze the discriminative ability of the clinical SYNTAX score (CSS) for acute kidney injury (AKI) following on- and off-pump coronary artery surgery. Methods: A total of 193 patients were reviewed in this study. Patients were divided into two groups according to the surgical procedure (group I: off-pump coronary artery bypass grafting, n = 89; group II: on-pump coronary artery bypass grafting, n = 104). Preoperative demographic data, the CSS and postoperative renal functions were evaluated. The postoperative AKI classification was made using the RIFLE (Risk, Injury, Failure, Loss of function, and End-stage renal disease) criteria. Results: Postoperative AKI occurred in 14 of 89 patients (15.7%) in group I and in 29 of 104 patients in group II (27.8%; p = 0.046). The CSS did not vary much between the groups (31.52 ± 13.08 vs. 29.89 ± 15.70; p = 0.638). In group I, the CSS was not different between patients with AKI and those without AKI (30.167 ± 3.93 vs. 31.91± 14.75; p = 0.78). In group II, the CSS was 36.85 ± 18.33 in patients with AKI and 28.02 ± 12.32 in those without, and the difference was significant (p = 0.02). The discriminative ability of the CSS for postoperative AKI using the AUC analysis was 0.500 in group I and 0.840 in group II. Conclusion: The CSS may be a simple and successful means of risk prediction of postoperative AKI in on-pump coronary artery surgery.

Lumbar disc herniation surgery is usually performed through a posterior approach. Vascular injuries can be counted among the complications. 39 years old male patient had lower extremity pain which has started after lumbar disc herniation surgery and continued for a month. Iliac arterial pseudoaneurysm has been detected in computerized tomography. It was successfully treated with vascular surgery [Cukurova Med J 2016; 41(0.100): 5-7]

Today there is a widespread use of endovascular treatment (EVT) for traumatic vascular injuries in adults, but there is lack of evidence of its use in adolescent patients with vascular injuries. With this case, we present successful EVT of 14-year-old adolescent with a right subclavian artery pseudoaneurysm (SAP) due to war injury. SAP was successfully excluded with deployment of 6×50 mm flexible, self-expanding covered nitinol stent graft (The GORE® VIABAHN® Endoprosthesis (W.L. Gore & Associates, Flagstaff, AZ)). Patient was discharged from hospital 2 days after the procedure with dual antiplatelet therapy (clopidogrel and aspirin). 3 months after discharge control DUS showed patent stent graft without any residual lesions. As a result, EVT is an alternative approach to treatment of SAP. It is safe, effective, and less invasive therapy for SAP in adults as well as in adolescents. We aim to contribute to the literature with this first case report.

We report a 51year-old male patient admitted to our emergency department because of sudden abdominal pain, hypotension, and dyspnea. On physical examination, abdominal tenderness was observed, primarily in the lower abdomen. Hemoglobin was 8.5g/dl and hematocrit was 26%. Renal function was within normal limits. Ruptured giant left IIIAA ( diameter 11 cm ) with massive hematoma on the left side of retroperitoneal space and extensive left kidney ( diameter 26x18x20 cm ) hydronephrosis ( Figure 1a,1b ) was detected with contrast-enhanced computed tomography (CT). The patient been consulted to the urology department at the same time and decided left nephrectomy for left kidney hydronephrosis. The patient was immediately taken to operation room due to hemodynamic instability. Proximal control was obtained by percutaneous endoaortic balloon occlusion catheter. The aneurismal sac was reached after midline laparotomy (figure 2). Ligation was performed to both the proximal and distal neck of aneurismal sac. After this procedure aneursimal sac was opened and drained. Concomitantly nephrectomy was performed. The postoperative follow up was uneventful. Symptoms of ischemic colon and claudicating were not observed and renal function tests were impaired. The patient was discharged on day 7 postoperatively. At 6 months postoperative, the patient remained well.

Lomber disk hernisioperasyonu genellikle posterior yaklaşımla yapılmakta olup vasküleryaralanmalar operasyonun komplikasyonları arasında sayılabilmektedir. Sunulan 39yaşındaki olguda geçirilmiş lomber disk hernisi sonrası başlayan ve bir aydırdevam eden bacak ağrısı vardı. Yakınmaları operasyon sonrasında çıktığıöğrenilen hastada çekilen bilgisayarlı tomografi sonrasında iliak arter psödoanevrizmasıgörüldü. Olgu cerrahi olarak başarıyla tedavi edildi., Lumbar disc herniation surgery is usually performed through a posterior approach. Vascular injuries can be counted among the complications. 39 years old male patient had lower extremity pain which has started after lumbar disc herniation surgery and continued for a month. Iliac arterial pseudoaneurysm has been detected in computerized tomography. It was successfully treated with vascular surgery

1Karaman Devlet Hastanesi Kalp ve Damar Cerrahisi Kliniği; Karaman, Turkey 2International Hastanesi Kalp ve Damar Cerrahisi Kliniği, İstanbul; Turkey Bakırköy Dr Sadi Konuk Eğitim ve Araştırma Hastanesi Kalp ve Damar Cerrahi Kliniği, İstanbul, Turkey

altında yapılan operasyonlar sırasında ciddi kanama riski taşır. Yakın zamanda kanama geçirmiş hastalarda da cerrahi tedavi mutlak zorunlu ise uygun medikasyon altında ilk 2 hafta içinde operasyonun güvenle planlanabileceği görüşündeyiz

Acute ischemia of an upper extremity occurs less frequently than vascular events of the leg and accounts for 15%-32% of all cases. Embolectomy provides prompt and effective treatment in the majority of cases. Recurrence of embolism and failed reperfusion can result in poor outcomes, even extremity loss. Adjunctive managements become important in this patient group. In this report, we present percutaneous intraarterial drip tissue plasminogen activator infusion to rescue the extremity in a patient with small cell lung cancer who experienced thromboembolism an additional six times following embolectomy.