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Pulmonary Rehabilitation (PR) is clinically recognized in newborns and clinics and intensive care units that are related with neonatal management. The primary problems in the scope of PR seen in newborns are respiratory distress syndrome, hyalin membrane disease, post-extubation collapse, bronchopulmonary dysplasia, congenital diaphragmatic hernia, congenital heart diseases, and cardiac surgery complications. It is essential to initiate a physiotherapy program in 48 hours in newborn intensive care units with frequent and close patient follow-up. On the grounds that cases involve newborns, developmental-themed and holistic approaches are required. Positioning, percussion techniques, range of motion exercises, oxygen treatment, and positive pressure resuscitator are routines followed in clinics in newborns with PR. Casespecific physiotherapy and a rehabilitation program in ventilated newborns and/or those developing complications are performed with continual monitoring of blood pressure, pulmonary variables, and blood gases. Due to more complicated clinical progress of pulmonary problems in risky, premature, and low birth weight newborns, contents of PR should be configured as instantaneously adjustable to clinical variables. These type of cases should be followed-up in school age and the years ahead in terms of the developmental aspect. Trendelenburg position in chest physiotherapy of newborns must be restricted because of the high risk of intracranial pressure increase, pneumonia risk due to gastroesophageal reflux, and even cerebral hemorrhages may be caused in babies weighing lower than 1500 g if it is applied in the first 3 days of birth. Precautions should be taken in bronchial drainage and supplementary oxygen use due to the severe problems that they can cause. For newborns with increased survivability and with development in neonatology, support of neonatal therapists with further knowledge, clinical investigations, and practical experiences will increase the treatment success of the newborn multidisciplinary team. [ABSTRACT FROM AUTHOR]

Systemic venous anomalies are rare congenital anomalies. Although they appear in different symptoms, they are usually asymptomatic and they can be detected incidentally during investigation of other congenital heart anomalies. The knowledge of this kind of anomalies before cardiac angiography and open heart surgery is important to prevent time loss and unexpected complications. Echocardiography transabdominal view is used and angiography is performed for confirmation. We report two cases in which absent suprarenal inferior vena cava with vena azygos continuity was present. One is isolated and one is present with cardiac atrioventricular septal defect. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed to evaluate our clinical experiences and investigate results of percutaneous closure of secundum atrial septal defects (ASD) in our clinic. Materials and methods: We retrospectively included 70 patients (19 male, 51 female) undergoing percutaneous ASD closure procedure with mean age of 36±14.8 (17-75) in our clinic between March 2008 and January 2010. Results: Defect diameter measured by transesophageal echocardiography was 19.7±6.3 mm (6-32 mm). Device size used for percutaneous closure of ASD was 23.7±6.2 (12-36). Devices used for percutaneous closure were nitinol based devices including Amplatzer (64.7%), Cardiofix (26.7%) and biodegredable BioStar (8.6%). The percutaneous closure procedure was successful at 68 of 70 (97%) patients. In 2 patients procedure failed. Failure reason was device embolization in one patient and device strut fracture in other; so these 2 patients referred to surgery. During follow up 2 more patients also referred to surgery because of device embolization in first day control. In 3 patients (4.2%) supraventricular arrythmias that are converted to sinus by cardioversion are observed. Mean follow up interval was 18.6±9.6 months (1-44) and during this period peripheral vascular complications, cerebrovascular accidents, thrombus on devices, device erosion or death is not observed. Conclusion: Percutaneous closure of secundum ASD which started to replace surgical treatment of ASD in last decades is safe and effective method in short to mid-term period. However because of potentially serious complication risks it should be performed in special centers by operators who are experienced in treating structural heart diseases. [ABSTRACT FROM AUTHOR]

Cholesterol lowering with statins has been proven to reduce vascular events in primary and secondary prevention of coronary artery disease (CAD). Epidemiologic studies found no or little association between blood cholesterol levels and stroke. However, randomized trials in patients with CAD have shown that statins decrease stroke incidence. These statin trials indicate 21% relative risk reductions for stroke. In subgroup analysis of the Heart Protection Study, simvastatin had no effect on stroke recurrence, in patients with a previous stroke. Recently, Stroke Prevention by Aggressive Reduction in Cholesterol Levels study showed that treatment with high dose atorvastatin reduced risk of stroke in patients with recent stroke and transient ischemic attack and no known CAD. In this review, we will discuss the effects of statins on stroke and the potential mechanisms of action. [ABSTRACT FROM AUTHOR]

Objective: Atrial fibrillation (AF) is one of the most frequent complications that may occur after open-heart surgery. Clinical reports regarding comparison of different anti-arrhythmic agent's usage to maintain sinus rhythm after open-heart surgery are not conclusive. We examined the effects of different anti-arrhythmic agents administration before operation on postoperative AF incidence, duration of hospitalization and complications. Methods: Overall, 180 patients (130 men and 50 women, mean age 58.13±11.71 years) who were candidates for open-heart surgery, were included in this prospective, single-blind study. All patients divided into five different groups. All anti-arrhythmic drugs were administered approximately 7 days before the operation. Propafenone was given to Group 1 (G1); sotalol to Group 2 (G2); amiodarone to Group 3 (G3) and diltiazem to Group 4 (G4) at doses of 300 mg/day, 80 mg/day, 400 mg/day and 180 mg/day orally respectively. The fifth group (G5) did not receive any of anti-arrhythmic drugs. The medication was continued for ten days postoperatively. Statistical analysis was performed using Chi-Square and one-way ANOVA tests. Results: Atrial fibrillation developed during postoperative period in 18.1% patients in G1, 9.1% patients in G2, 16.2% patients in G3, 28.6% patients in G4 and 38.1% patients in G5. The prevalence of postoperative AF was significantly higher in G5 as compared with other groups (p=0.026). There were significant differences across groups in duration of hospitalization (p=0.033), with shortest mean duration of hospitalization in G2 (8.9±2.7 days). Conclusion: Any anti-arrhythmic agent started 7 days before the operation and continued for 10 days, may reduce the prevalence of postoperative AF, morbidity and duration of hospitalization. However, we found that sotalol and amiodarone were more effective than other anti-arrhythmic agents in our patient population. [ABSTRACT FROM AUTHOR]