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PurposeThis study aimed to identify the main and emerging structural patterns in the growth of the literature on probiotic research in food science, analyze current trends and determine gaps and present future projections.Design/methodology/approachA total of 1,301 scientific documents retrieved from Scopus database dated from 1993 to 2021 were analyzed by using bibliometric and scientometric tools.FindingsThe most influencer journals, leading countries and hotspots were identified by scientometric mapping. “Lactic acid bacteria”, “lactobacillus”, “lactobacillus plantarum”, “viability”, “functional foods” and “microencapsulation” were the top keywords that indicate main emerging areas. After a clear understanding of the current situation, future directions can be better projected. Therefore, investigating new probiotic microorganisms with advanced health promoting properties, adapting the new organisms to various food formulations, identifying the probiotic potential of unexplored traditional fermented foods and developing of nondairy probiotic foods can be the studies of the future.Research limitations/implicationsProbiotic concept has been revised during years and valuable knowledge has been accumulated over past decades. The findings demonstrate the development and trends of probiotic related food science researches. This is the first study to address the limitations of prior systematic literature reviews by applying network analysis and guide future works to fill the identified gaps.Originality/valueThe probiotic concept has been revised for years and valuable knowledge has been accumulated. Within the expanding literature, scientometric and bibliometric analysis will provide valuable contribution for identifying the main patterns, analyzing current trends, determining gaps and presenting future projection. This work presents detailed analysis to determine tendencies in probiotic research in food science.

Background: Percutaneous mitral balloon valvuloplasty (PMBV) has been established as an effective and safe treatment modality for symptomatic patients with severe rheumatic mitral stenosis. While Wilkin Score (WS) ≤ 8 are associated with higher rates of procedural success and lower rates of restenosis, higher WS are associated with lower rates of procedural success and higher rates of restenosis. It is well known that platelets have substantial role in thromboembolic complications of rheumatic mitral stenosis and various studies showed that increased platelet (PLT) activity in rheumatic mitral stenosis. The aim of this study was to assess the usefulness of PLT indices as a predictor of restenosis in patients who underwent PMBV. Methods: We retrospectively enrolled 178 consecutive patients who underwent PMBV. Patients were classified into the two groups. Study group (n=21) included patients whom we performed redo PMBV during their follow-up as a result of mitral restenosis following previous PMBV (index procedure) and control group (n=157) included patients whom did not undergo a redo PMBV. PLT indices including PLT count, Platelecrit and mean platelet volume values were evaluated in these groups. Results: In study group, PLT count (210 ± 49 vs. 241 ± 62, p=0.010), PCT [0.203 (0.173-0.230) vs. 0.260 (0.243-0.290), p

Objectives Although percutaneous coronary interventions become a common treatment modality for coronary artery diseases, lesion localization make these procedures more complex. As the lesion localizes near to the bifurcation site, more complex PCI procedures, overqualified equipments are needed and complication risk increases. Previous studies have demonstrated the strong correlation between wide angulation and significant coronary stenosis. However, a paucity of data exists about the association between bifurcation angle and lesion localization distance. In this study we analysed the effect of coronary bifurcation angle and left main coronary artery length on the atherosclerotic lesion localization. Methods Patients, who underwent coronary angiography between 01.01.2017- 31.12.2019 were scanned. Patients having atherosclerotic lesions causing more than 50% luminal narrowing and Medina classification score (0,0,0) were evaluated. After exclusion, 467 patients were included. 5 bifurcation subgroups (LAD-CX, LAD-Dx, CX-OM, RCA-RV, RPD-RPL) were formed. Distance of lesion to the bifurcation site, bifurcation angle and left main coronary artery length were analysed by 2 experienced cardiologists with invasive quantitaive coronary angiography (QCA) by using "extreme angio and cardiac pacs" software system. Results There was a strong inverse correlation between bifurcation angle and lesion localization distance to the bifurcation site (r = -0.706; p < 0.0001). There was a nonsignificant negative correlation between Left-main coronary artery length and lesion localization. Regression analysis revealed that bifurcation angle is an independent risk factor for predicting the localization of an atheroslerotic lesion in 5 mm length from the point of bifurcation site (β = -0.074, p < 0.0001). A cut-off value of 80.5° coronary bifurcation angle was found to have 84.1% sensitivity and 81.3% specificity in prediction of atherosclerotic lesion localization in 5 mm length from the point of bifurcation site. Conclusion In this study we showed that as the bifurcation angle increases, atherosclerotic lesions tend to approach to the bifurcation site. Since invertentions encompassing bifurcation sites are more complex, lesions with increased angulation may need extra care as they are more likely to present with further complications. Furthermore, bifurcation angle is an independent risk factor for lesion localization.

Background: Proper clinical use of blood and blood products requires competent theoretical and practical knowledge of transfusion medicine. The Curriculum Development and Standard Determination System Medical Specialization Board is prepared Hematology Specialist Education Core Curriculum in Turkey. In this study, we aimed to determine the access of hematologists to the learning objectives defined by curriculum for the transfusion medicine and the factors affecting it.Methods: Hematologists who have been members of Turkish Hematology Society since 2013 have been included in the study, The survey questions were prepared based on the curriculum for transfusion medicine. The study was applied to hematologists with "survey monkey" application. The questionnaire consisted of a competence self-assessment with Likert scale and theoretical multiple-choice knowledge questions. Results: Of the 213 hematologists, 54 (25%) were included in the study. Hematologists rated their competences in the clinical competence areas as 3,65 ± 0,73 (median 3,60) as "I know but not t a sufficient level". The participants 'perception of competence was "I know, but not at a sufficient level'" with an average of 3.31 ± 0.84 (median3.5) in the blood banking field, while the average in hemapheresis and transfusion medicine was 4.04 ± 0.63 (median 4) as "enough". In interventional procedures, hematologists stated that their vocational competences were 2,79± 0,92 (median 2,93) on average as "I have an idea- I know, but not enough". The correct answer to 13 theoretical questions was an average of 6,96 ± 1,89 (median 7). Hematologists performing blood rotation felt significantly more competent than the physicians who could not do the rotation in the blood bank, blood banking t(52) = -3.9, p < .001 , transfusion medicine and interventional competence t(52) = -2.2, p = .04 . Physicians who believed that they are sufficient in the blood banking area, were more confident in transfusion medicine r(54) = .67, p

SUMMARY INTRODUCTION: According to recent studies, the rate of atrioventricular block requiring permanent pacing in patients following transcatheter aortic valve implantation varied between 5.7% and 42.5%. Fragmented QRS is a useful marker of myocardial scar and can predict adverse cardiac events. In this study, we examined association between f ragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation. OBJECTIVE: In this study, we examined association between fragmented QRS and postprocedural rhythm disturbances and the need for permanent pacing in patients who underwent transcatheter aortic valve implantation’ sentence is enough for it. METHODS: We retrospectively analyzed standard 12-lead electrocardiographic recordings of 124 consecutive patients in whom a CoreValve prosthesis was implanted. We examined 12-lead electrocardiogram before and after procedure along with one- and six-month follow-up. We documented QRS fragmentation and postprocedural rhythm disturbances. RESULTS: There was a significant increase in the frequency of left bundle branch block, (21.1 versus 0%, p

SUMMARY OBJECTIVE: Coronary artery bypass graft (CABG) surgery is a well-established treatment modality for patients with multivessel coronary artery disease (CAD). Syntax II Score has been established as novel scoring system with better prediction of postprocedural outcomes. This study aimed to investigate the prognostic value of SYNTAX II Score for predicting late saphenous vein graft (SVG) failure in patients undergoing isolated CABG. METHODS: The records of 1,875 consecutive patients who underwent isolated CABG with at least one SVG were investigated. Those who underwent coronary angiography and SVGs angiography at least 1 year after the CABG were included. Patients were divided into two groups based on the presence or absence of SVG failure. For each group, predictors of late SVG failure and subsequent clinical outcomes were analyzed. RESULTS: According to this study, the presence of hypertension, higher rates of repeat revascularization, and higher SYNTAX II Scores were found to be independent predictors of late SVG failure. In addition, the prognostic value of SYNTAX II Score was found to be significantly higher than anatomical SYNTAX Score in terms of predicting late SVG failure and major adverse cardiovascular and cerebrovascular event. CONCLUSIONS: There was a strong association between SYNTAX II Score and late SVG failure in patients undergoing isolated CABG.

Background: Insulin-like growth factor(IGF) is the primary mediator of growth hormone. IGF-1 may have an importantrole in protecting the myocardial functions following an acute myocardialinfarction (AMI). Literature reveals only a limited number of studiesinvestigating the relationship between the serum IGF-1/IGF binding protein-3 (IGFBP-3)levels and the left ventricular functions post AMI. We aimed to determineIGF-1 and IGFBP-3 levels and evaluate their effect on cardiac functions postAMI.Material and Method: Sixty five patients who were includedin the study and the control group had 26 patients. Blood samples of thepatients were obtained on the second day of their admission. The patientsunderwent echocardiographic examination on the 7th day of theirhospitalization.Results: The serum IGF-1 and IGFBP-3 levels of the patient group werehigher than those of the control group; however only IGF-1 levels werestatistically significant (243,2±87,9 ng/mL versus 177,2±81,8 ng/mL p=0,001).The increase in the wall thickness and LV chamber size did not correlate withthe decrease in LVEF and IGF-1/IGFBP-3 levels. The patients who had minorcardiac events had lower IGF-1 levels but this was not statisticallysignificant (210.5±88.5 versus 253.1±86.1 p>0.05). Conclusion: IGF-1 and IGFBP-3 levels elevatedfollowing an the early AMI, but these markers were not correlated with theechocardiographical measurements in early post MI period., Giriş; İnsülin benzeri büyüme faktörü (İGF), büyüme hormonunun primer mediatördür. İGF-1 akut miyokard infarktüsü (AMİ) sonrası miyokard fonksiyonlarının korunmasında önemli olabilir. Literatürde AMI sonrası İGF-1/İGF binding protein-3 (IGFBP-3) ​​düzeyleri ile sol ventrikül fonksiyonları arasındaki ilişkiyi araştıran sınırlı sayıda çalışma vardır. Bizim amacımız, AMİ sonrası serum İGF-1 ve İGFBP-3 düzeylerini belirlemek ve kardiyak fonksiyonlar üzerindeki etkisini değerlendirmektir.Çalışma planı; Çalışamaya koroner yoğun bakım ünitesine yatırılan ve kabul edilme kriterlerine sahip olan 65 hasta alındı. Kontrol grubu daha önce koroner arter hastalığı olmayan ve dışlanma kriterlerine sahip olmayan 26 kişiden oluşturuldu. Hastaların kan örnekleri aç olarak yatışının ikinci gününde alındı. Serum İGF-1 ve İGFBP-3 düzeyleri ölçüldü. Hastaların ekokardiyografik değerlendirmesi ortalama yatışının 7. gününde yapıldı.Bulgular; Hasta grubunun serum İGF-1 ve İGFBP-3 düzeyleri kontrol grubuna göre daha yüksek tespit edildi. Ancak sadece IGF-1 düzeyleri (243,2 ± 87,9 ng / ml ve 177,2 ± 81,8 ng / ml p = 0.001) istatistiksel olarak anlamlı idi. Sol ventrikül (SV) duvar kalınlığı ve boşluk boyutlarındaki artış veya SV ejeksiyon fraksiyonlarındaki azalma ile İGF-1/İGFBP-3 düzeyleri arasında ilişki saptanmadı. Hasta grubunda minör kardiyak olaylar ile düşük İGF-1 düzeyleri arasında istatiksel olarak anlamlı olmayan bir ilişki tespit edildi. (253,1 ± 86,1 ve 210,5 ± 88,5 p> 0.05).Sonuç; Daha önceki benzer çalışma sonuçlarından farklı olarak AMİ sonrası serum İGF-1 düzeylerinde yükselme tespit ettik. Ancak İGF-1 düzeyleri ile hastane içi kardiyak olaylar ve ekokardiyografik parametreler arasında ilişki bulamadık. AMİ ile İGF / İGFBP düzeyleri arasındaki bağlantılar karmaşık gibi görünmektedir ve bu ilişkiyi açıklamak için daha ileri çalışmalar gereklidir.

Pacemakers are foreign bodies which often used in the treatment of arrhythmias. Infection of pacemaker and the parts associated with pacemaker is extremely rare. The most important risk factors for development of infection; duration of the procedure, complications during operation and immunodeficiency of the patient. These infections are often seen when the pacemaker was inserted or removed as a result of the contamination. Although pacemaker infections are rare, the mortality rate is high. The most common causative agent is staphylococcus, gram negative bacteria and fungi may also be rarely causative agents. Ochrobactrum anthropi is a gram-negative, aerobic, oxidase positive, urease positive, motile and non-lactose-fermenting bacillus previously known as “ Achromobacter group”. It is an opportunistic pathogen that can cause infection in especially immunosupressive patients with permanent central venous catheter. The main infections reported due to this agent; bacteremia, central venous catheter-related sepsis, endocarditis, endophthalmitis, pancreatic abscess, urinary tract infections, meningitis, pelvic abscess and osteomyelitis. In the literature, just one case has been reported which developed pacemaker infection due to this agent. In this manuscript, fifty-four-year-old Afghan nationality patient was presented with the diagnosis of pacemaker and pacemaker lead infections.

Background: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a large proportion of patients with AF are older than 75 years of age. Mitral annular calcification (MAC), which is usually observed in advanced age, is associated with increased risk of AF and cardio-embolic stroke in the general population. Objectives: This study was performed to assess whether presence of MAC and its severity predict cardio-embolic stroke in elderly patients with first diagnosed AF. Methods: In this cross-sectional study, 72 elderly patients suffering from acute cardio-embolic stroke with first diagnosed AF and 79 elderly control group patients with first diagnosed AF and without stroke were investigated. A parasternal short-axis view at the level of the mitral annulus was used for MAC measurements. The severity of MAC was measured from the anterior to posterior edge at its greatest width. Results: MAC thicknesses were significantly higher in the stroke group. ROC curve analysis showed that a cut point of 2.5 mm for the value of MAC thickness exhibited 68.1% sensitivity and 77.2% specificity for detecting cardio-embolic stroke in elderly patients with AF. In multivariate logistic regression analysis, MAC thickness (OR = 1.173, 95% CI 1.083-1.270; p < 0.001) was found to be independent predictor of cardio-embolic stroke in elderly patients with AF. Conclusion: MAC thickness may provide useful information for the relevant risk evaluation of elderly patients with AF. Pre-stroke MAC presence and its severity appear to have better clinical value for predicting cardio-embolic stroke in elderly patients with AF, independent from traditional risk factors for stroke.

Background/aim: We aimed to investigate the relationship between risk factors and the presence of coronary artery disease (CAD) in a young population with stable angina pectoris (SAP).Materials and methods: A total of571 individuals younger than 60 years old, admitted to the outpatient clinic with chest pain and referred for coronary angiography between January 2015 and December 2017, were included in the study. All clinical and biochemical parameters were documented in the hospital records. Coronary angiography of patients was monitored from records. The individuals were divided into two groups. The patient group consisted of 363 individuals with at least one-vessel stenosis of ≥70%, and the control group consisted of 208 individuals with normal coronary angiography. We compared the traditional and nontraditional risk factors of these two groups in terms of the presence of CAD.Results: Prevalence of male sex and smoking were higher in the patient group, and the prevalence of hypertension and diabetes were similar in the two groups. In the patient group, mean age, blood cholesterols, serum gamma-glutamyltransferase, hemoglobin, and white blood cell and lymphocyte levels were higher, while estimated glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C), platelets, and neutrophil/lymphocyte and platelet/lymphocyte ratios were lower. Low eGFR and HDL-C levels, older age, male sex, smoking, and high levels of low-density lipoprotein cholesterol and lymphocytes were independent risk factors for the presence of CAD in young patients.Conclusion: Contrary to studies performed in the elderly, traditional and nontraditional risk factors could not exactly predict the presence of CAD in a young population with SAP.

Background It is well known that approximately 20% of patients who undergo cardiac surgery experience weight loss in postoperative period. However, there is a lack of data on postoperative consequences of malnutrition. This study aimed to investigate the relationship between nutritional status and long-term outcomes in patients undergoing isolated coronary artery bypass grafting (CABG). Material and methods A total of 586 patients who underwent isolated CABG in our center between January 2015 and March 2016 were included in this study. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of all-cause death, non-fatal myocardial infarction (MI), and stroke. Patients were divided into two groups based on their MACCE outcomes. Prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores were used to show the nutritional status. Results The mean follow-up time of the whole study group was 38.08 ± 13.4 months. The follow-up time was 39 ± 13 months in patients with mortality, while it was 20 ± 15 months in those without mortality. The PNI and GNRI values were lower in patients with major adverse cardiac and cerebrovascular events (MACCE) compared to patients without MACCE. The median CONUT score was higher in patients with MACCE. Conclusion Our study showed that nutritional indices including PNI, CONUT, and GNRI were associated with long-term MACCE and mortality in patients who underwent isolated CABG. The use of these scores in order to predict prognosis in patients treated with CABG seems to be an applicable method in clinical practice.

Because of cardiac hypertrophy and electrophysiological alterations associated with preeclampsia, worsening of preexisting arrhythmias or occurrence of de novo arrhythmias are common in patients with preeclampsia. Tp-e/QT and Tpe/QTc ratios are accepted as reliable indexes for predicting ventricular arrhythmias. In this study, we examined the impact of preeclampsia on ventricular repolarization indices in patients with preeclampsia by using the QT, QTc and Tp-e interval, Tp-e/QTratio, and Tp-e/QTc ratio.We analyzed electrocardiographic recordings of sixty pregnant women with preeclampsia and thirty age-matched healthy pregnant women. Women presenting with preeclampsia were divided into 2 groups and classified as early (gestational age 34 weeks at clinical onset) or late (≥34 weeks) onset preeclampsia. Ventricular repolarization indices were evaluated.The QT and Tp-e intervals were found to be longer in patients with earlyonset preeclampsia compared to patients with late-onset preeclampsia and helthy pregnants (377.6 ± 23 ms vs 374.3 ± 15 ms, 362 ± 15 ms82.6 ± 9.4 ms vs 74.0 ± 10.6 ms, 68.6 ± 10 ms). In adition, Tp-e/QT and Tp-e/QTc ratio were significantly higher in this patient population compared to others (0.21 ± 0.02 vs 0.19 ± 0.02, 0.18 ± 0.020.19 ± 0.02 vs 0.16 ± 0.02, 0.15 ± 0,02, p 0.05 respectively).Our data showed that preeclampsia has unfavorable effects on electrocardiographic indices of ventricular repolarization compared to healthy pregnant women. This effect is more prominent in patients with early-onset preeclampsia.

Objectives Vascular calcification is a well-known phenomenon and affects coronary and carotid arteries as well as other arterial beds. Presence of arterial calcification is associated with major adverse events in patients undergoing percutaneous coronary artery or carotid artery intervention. Even though there is a clear association between worse outcome and coronary-carotid calcification, there is no research that interrogated the relationship between iliac arterial calcification and clinical outcomes because of lack of data. Therefore, in this study, we aimed to investigate the impact of iliac arterial calcification on procedure success rates and long-term outcomes among patients undergoing endovascular intervention. Methods The records of 453 consecutive patients who underwent endovascular intervention due to symptomatic peripheral artery disease were analyzed. Patients were divided into two groups based on the presence or absence of heavy calcification of iliac arteries. For each group, technical aspects of procedures and subsequent clinical outcomes were analyzed. Results According to our study, the rate of restenosis following endovascular intervention at 6 and 12 months were similar between two groups. On the other hand, long-term restenosis was significantly higher in patients with heavy calcification of iliac arteries as compared to patients with low calcification on iliac arteries (32.2% vs. 12.8%, p < 0.05). Conclusions Our data showed that there was a strong association between heavy calcification of iliac arteries and long-term restenosis in patients undergoing endovascular intervention.

Yaşam beklentisi arttıkça, aort darlığı (AS) prevalansı da artar. Cerrahi aort kapak replasmanı (s-AVR), ciddi ko-morbid durumların yokluğunda düşük operatif mortalite ile gerçekleştirilir ve hem semptomlarda düzelme hem de survey katkısı sağlamaktadır. Bununla birlikte, hastaların% 30'unda sol ventrikül disfonksiyonu, ileri yaş ve eşlik eden hastalıklar nedeniyle AVR uygulanamaz. Ayrıca, bu hastalarda koroner arter hastalığı yüksek prevalansa sahiptir ve aynı nedensel faktörlerin çoğunu paylaşmaktadır. Bu vaka sunumumuzda basamaklı yaklaşımla sol ana arter stentleme ve transkateter aort kapak replasmanı yapılması sonrası dramatik iyileşme görülen bir hastayı sunuyoruz.

Background/aim: It has been suggested that there is a significant progress in coronary artery disease (CAD) by many pathophysiological mechanisms. Nondipper hypertension (NDH) has been shown to have higher target organ damage and have a higher rate of cardiovascular mortality and morbidity. In this study, we investigated the effect of nondipper hypertension on the progression of coronary atherosclerosis. Materials and methods: A total of 186 patients who underwent coronary angiography twice between 6 months and 3 years were included in the study. Coronary angiography was repeated on the admission day due to angina or positive exercise test and the patients were divided into groups. Results: Progression of coronary artery disease was detected in 58 of 186 patients. Seventy-one of the total patients were found to be nondipper hypertensive. Nondipper hypertension, hypertension, diabetes mellitus, low-density lipoprotein, and total cholesterol were found to be effective in the progression of CAD. Among these parameters, it was seen that nondipper hypertension and hyperlipidemia were the most important independent risk factors. Conclusion: Coronary artery disease is a progressive disease, and this progression depends on many reasons. In our study, we showed that nondipper hypertension is a new parameter that is effective in CAD progression.

Aim: We investigated the relationship between mild renal dysfunction (MRD) and the presence of coronary artery disease (CAD) in people under 60 years of age. Materials & methods: A total of 634 (317 patients with vessel stenosis ≥50% and 317 with normal angiography) individuals diagnosed with stable angina pectoris and estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 were included in the present study. Results: The mean eGFR was lower (95.3 ± 23.7 vs 109.7 ± 22.3, respectively, p = 0.002) and the number of patients with MRD was higher in patients with CAD (137, 43.2%) than in the control group (52, 16.4%, p

The CHA2DS2-VASC score, used for embolic risk stratification in atrial fibrillation (AF), has been reported recently to predict adverse clinical outcomes in patients with acute coronary syndrome (ACS), regardless of having AF. We investigated the correlation between the CHA2DS2-VASC score and contrast-induced nephropathy (CIN) in patients with ACS who underwent urgent percutaneous coronary intervention (PCI). A total of 1,408 patients were enrolled in the study. The CHA2DS2-VASC score was calculated for each patient. Based on the receiver operating characteristic analysis, the study population was divided into 2 groups: CHA2DS2-VASC score ≤3 group (n = 944) and CHA2DS2-VASC score ≥4 group (n = 464). Patients were then reallocated to 2 groups according to the presence or absence of CIN. CIN was defined as a rise in serum creatinine0.5 mg/dl or25% increase in baseline within 72 hours after PCI. Overall, 159 cases (11.3%) of CIN were diagnosed. Receiver operating characteristic curve analysis revealed good diagnostic value of CHA2DS2-VASC score in predicting CIN (area under the curve 0.769, 95% confidence interval 0.733 to 0.805; p0.001). When patients with a CHA2DS2-VASC score of ≥4 were compared with those with a CHA2DS2-VASC score of ≤3, patients with high score had a higher frequency of CIN (23.9% vs 5.1%; p0.001), and multivariate analysis identified the CHA2DS2-VASC score of ≥4 as an independent predictor of CIN. In conclusion, CHA2DS2-VASC score can be used as a new, simple, and reliable tool to predict CIN in patients with ACS who underwent urgent PCI.

Background Contrast-induced nephropathy (CIN) is associated with increased mortality after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Recently, fragmented QRS complex (fQRS) on 12-lead electrocardiography has been introduced as a marker of cardiovascular disease and is associated with increased morbidity and mortality. Hypothesis fQRS on ECG is associated with CIN and in-hospital mortality after primary PCI in patients with STEMI. Methods Eight hundred ninety-five patients with first STEMI treated by primary PCI were enrolled in the study. Patients were divided into 2 groups according to the presence or absence of fQRS as shown by 12-lead electrocardiography in the first 24 hours. fQRS was defined by presence of an additional R wave (R″), or notching of the S wave, or >1 R′ in 2 contiguous leads. Patients were then reallocated to 2 groups according to presence or absence of postprocedural CIN, which was defined as a rise in serum creatinine of 0.5 mg/dL or a 25% increase from baseline value within 72 hours after the procedure. Results Patients with a fQRS were older and had significantly lower left ventricular ejection fraction. CIN occurred in 77 (8.6%) patients. The prevalence of CIN and in-hospital mortality was significantly higher in the fQRS(+) group. In multivariate analysis, fQRS was found to be an independent predictor of CIN (odds ratio: 3.125, P = 0.029) and in-hospital mortality (odds ratio: 9.062, P = 0.009). Conclusions The fQRS is an independent predictor of postprocedural CIN and in-hospital mortality in STEMI patients.

BACKGROUND Saphenous vein grafts (SVGs) are still frequently used in coronary artery bypass graft surgery (CABG). However, the patency rate of SVGs is lower than arterial grafts. CHA2DS2-VASc score gives important information about the prognosis of various cardiovascular diseases. In this study, we aimed to investigate the association between CHA2DS2-VASc score and saphenous vein graft disease (SVGD) in patients with history of CABG surgery. METHODS A total of 241 patients who had undergone CABG surgery and who underwent coronary angiography due to stable angina pectoris symptoms were reviewed retrospectively. SVGD was defined as ≥50% stenosis in at least one SVG. Patients were divided into two groups according to the presence or absence of SVGD. RESULTS It was found that CHA2DS2-VASc scores were significantly higher in SVGD group. In multivariate logistic regression analysis, time interval after CABG [odds ratio (OR) = 1.077, 95% confidence interval (CI) 1.004-1.155; P = 0.037], and CHA2DS2-VASc score ≥ 4 (OR = 10.10, 95% CI 4.739-21.276; P

WOS: 000462476400011 PubMed: 30900581 To compare central corneal thickness (CCT) measurements obtained by the AL-Scan, Lenstar LS900, Galilei, and ultrasound pachymetry (UP) in normal and cataractous eyes. Methods: Eighty eyes of healthy subjects were included in the study. Each subject was assessed by four different methods of measurements using the AL-Scan, Lenstar LS900, Galilei, and UP by a single examiner. To assess the intraobserver repeatability, three consecutive measurements were taken for the AL-Scan. Results: The mean CCT [+/- standard deviation (SD)] for the AL-Scan, Lenstar LS900, Galilei, and UP were 554.6 +/- 30.9 mu m, 542.9 +/- 31.3 mu m, 570.7 +/- 30 mu m, and 552.7 +/- 32.8 mu m, respectively. The differences between pairs of mean CCT for the methods are statistically significant for the pairs of Galilei-UP, AL-Scan-Galilei, and Lenstar LS900-Galilei. Bland-Altman plots showed that AL-Scan-UP have the closest agreement, followed by Lenstar-UP and AL-Scan-Lenstar. Galilei was found to have the poorest agreement with the other three methods. The intraobserver repeatability of the AL-Scan was very good with an intraclass correlation coefficient (ICC) of 0.980. Conclusion: We found that CCT measurements between the AL-Scan-UP, Lenstar LS900-UP, and AL-Scan-Lenstar LS900 showed very strong correlation and comparable agreement. AL-Scan-UP showed the closest agreement and these devices can be used interchangeably in clinical practice. Galilei significantly showed higher value of CCT compared to other methods. It was also observed that the Al-Scan had excellent intraobserver repeatability.

Amaç: Akut miyokard infarktüslü (AMİ) hastalarda insülin benzeri büyüme faktörü-1 (İGF-1) düzeylerini araştırdık ve IGF-1’de bir azalmanın uzun vadeli prognozu etkileyip etkilemeyeceğini belirlemeyi amaçladık.Yöntemler: AMİ nedeniyle hastanemize başvuran 65 hasta ve 25 sağlıklı kontrol birey çalışmaya dahil edildi. İGF-1 ve insülin benzeri büyüme faktörü bağlayıcı protein-3 (IGFBP-3) seviyelerini belirlemek için AMİ’ den sonra en erken zamanda ve 10 ay sonra tüm hastalardan ve kontrol grubundan kan örnekleri alındı. Hastalar AMİ’ den 10 ay sonra kardiyak olayları açısından değerlendirildi.Bulgular: İGF-1 düzeyleri, AMI hastalarında sağlıklı kontrollerden daha yüksekti (p = 0,002); 10 ay sonra, hem İGFBP-3 hem de İGF-1 seviyeleri daha yüksekti. Düşük ve yüksek İGF-1 ve IGFBP-3 düzeyleri olan hastalarda kardiyak olay oluşumunda anlamlı fark bulunmadı (hem başlangıç ​​hem de 10 aylık değerler için).Sonuç: Serum total İGF-1 ve İGFBP-3 düzeyleri, AMİ hastalarında kontrol hastalarına göre daha yüksekti; ancak, İGF-1 ve iGFBP-3 seviyeleri ile AMİ sonrası 10 aylık dönemde kardiyak olaylar arasında korelasyon bulunamadı. AMİ sonrası İGF-1 ve İGFBP-3 düzey normalleşmesi için gereken süreyi netleştirmek ve AMİ sonrası hastaların uzun dönem prognozu üzerindeki etkilerini belirlemek için ilave çalışmalara ihtiyaç vardır., Background: We investigated the levels of insulin-like growth factor-1 (IGF-1) in acute myocardial infarction (AMI) patients, and we determined whether a decrease in IGF-1 could influence long-term prognosis.Methods: In total, 65 patients who were admitted to our hospital for AMI and 25 healthy controls were included in this study. Fasting blood samples were obtained from all patients immediately after AMI and 10 months later to determine their IGF-1 and insulin-like growth factor binding protein-3 (IGFBP-3) levels. Fasting blood samples were obtained from the control group. The patients were also evaluated for cardiac events 10 months after AMI.Results: The IGF-1 levels were higher in the AMI patients than in the healthy controls (p=0.002); after 10 months, both the IGFBP-3 and IGF-1 levels were higher. No differences were found in cardiac event occurrence between patients with low and high IGF-1 and IGFBP-3 levels (for both the baseline and 10-month values).Conclusions: The serum total IGF-1 and IGFBP-3 levels were higher in the AMI patients compared to the control patients; however, there was no correlation between the IGF-1 and IGFBP-3 levels and cardiac events during the 10-month period after AMI. Additional studies are needed to clarify the time required for IGF-1 and IGFBP-3 level normalization after AMI, and to determine the effects of IGF-1 and IGFBP-3 on the long-term prognosis of patients after AMI.

WOS: 000461433300012 PubMed: 30482511 Objective: To examine the effect of pregnancy on the lacrimal system through tear osmolarity measurement and the Schirmer test. Material and Method: The study consisted of two groups of 30 women between 20 and 40 years old; the women in the study group were in their first trimester of pregnancy, and the women in the control group were not pregnant and did not have any diseases other than refractive error. Tear osmolarity measurement with the TearLab osmolarity system and tear function test Schirmer 1 were carried out on one, randomly chosen eye of each participant. The pregnant women's measurements were repeated on the same eye in their last trimester. Results: The study group's first trimester tear osmolarity measurement was 304.9 +/- 8.0 mOsm/L, while their last trimester tear osmolarity measurement was 300.2 +/- 7.1mOsm/L and the control group's was 306.3 +/- 6.2 mOsm/L. There was a statistical difference between the study group's first and last trimester results and between the study group's last trimester and the control group's results ( p < 0.05). The Schirmer test results were 18.1 +/- 6.3mm for the study group's first trimester, 16.6 +/- 6.9mm for the last trimester and 21.3 +/- 9.0mm for the control group. There was a statistically significant difference between the study group's last trimester results and the control group's Schirmer test results ( p < 0.05). Conclusion: Both the tear osmolarity values and Schirmer values were found to decrease significantly towards the end of pregnancy. These results suggest that decrease in both test results may play a protective role in the ocular surface during pregnancy. Ondokuz Mayis UniversityOndokuz Mayis University [PYO.TIP.1904.13.026] This study was funded by Ondokuz Mayis University Scientific Research and Project Board (Project number: PYO.TIP.1904.13.026).

Pacing lokalizasyonunda zorluklar nedeniyle mekanik triküspid kapağı olan hastalarda transvenöz yol ile kalıcı pacemaker implantasyonu nadiren bildirilmiştir. Bu olguda, triküspid kapak replasmanı yapılan bir hastadakoroner sinüs yoluyla sol ventriküler pacing sunuldu., Permanent pacemaker implantation by the transvenous route in patients with a mechanical tricuspid valvehas rarely been reported because of the difficulties in determining the appropriate pacing location. Herein, wepresent the case of a patient undergoing tricuspid valve replacement who required a permanent pacemakerusing the coronary sinus.

Contrast-induced acute kidney injury (CI-AKI) is a common complication of diagnostic and therapeutic catheterizations, especially in the setting of acute coronary syndrome (ACS). Fibrinogen is a well-known cardiovascular risk factor. We evaluated whether serum fibrinogen level is associated independently with CI-AKI in patients with ACS who underwent a percutaneous coronary intervention (PCI).Patients (n=710, aged 61 ± 13, 69% men) were classified into two groups: CI-AKI and non-CI-AKI. CI-AKI was defined as an increase of at least 0.5 mg/dl or at least 25% in the serum creatinine level within 72 h following PCI.CI-AKI occurred in 75 (10.6%) patients. We found significantly higher serum fibrinogen levels in patients who developed CI-AKI than in those who did not (498 ± 152 vs. 386 ± 96 mg/dl, P0.001). Multivariate logistic regression analysis showed that serum fibrinogen level (odds ratio 1.006, 95% confidence interval 1.003-1.009, P0.001), age, glomerular filtration rate, female sex, and white blood cell count were correlated with the development of CI-AKI.Serum fibrinogen level is associated independently with a higher risk of CI-AKI in patients with ACS undergoing PCI.

RESULTS: The mean age of the patients was 15,4 years (range: 2 months – 80 years). The male/female ratio was 3.42 (24/7). Bilateral surgery was performed in 10 patients, right side in 10 and left side in 11 patients. While 26 patients had congenital blepharoptosis, the duration for the others were changing 2 to 10 years. The mean levator function was 2.25 mm (range: 0–6 mm). The most used materials were silicone rod in 29, poliamide suture in 9, and autogenous fascia lata in 3 patients. The mean follow up was 19.8 months (range: 4 months – 8 years). The recurrence rates were 20.6% in silicone rod group, 11% in poliamide suture group, and 0% in autogenous fascia lata group.

Aim: The aim of this study is to investigate whether there is a relationship between inflammation and volume status in patients underwent peritoneal dialysis (PD). Patients and method: This cross-sectional study included 159 PD patients. The median duration of PD was 17 (range, 1-151) months. All patients were examined using bioelectrical impedance analysis to estimate the ratio of extracellular water to total body water (ECW/TBW), which was used to assess their volume status. The patients were categorized as having one of the following three volume statuses: hypervolemic (above + 2 SD from the mean, which was obtained from healthy controls), normovolemic (between + 2 SD and -2 SD), or hypovolemic (below -2 SD from the mean). Five patients with hypovolemia were excluded from the study. Fifty-six patients were hypervolemic whereas 98 patients were euvolemic. High-sensitive C-reactive protein (hs-CRP) levels were measured to evaluate inflammation in all patients. Results: hs-CRP value levels were significantly higher in hypervolemic patients compared with euvolemic patients [7.1 (3.1-44.0) mg/L vs. 4.3 (3.1-39.6), p: 0.015, respectively]. Left ventricular hypertrophy was more frequent in hypervolemic patients compared with euvolemic patients (53.6% vs. 30.6%, p: 0.004, respectively). ECW/TBW ratio positively correlated with hs-CRP (r: 0.166, p: 0.039). Gender, hs-CRP, and residual Kt/V urea were found to be independent risk factors for hypervolemia in multivariate analysis. Conclusion: Inflammation is associated with hypervolemia in PD patients. Residual renal functions play an important role to maintain euvolemia in PD patients.

High SYNTAX score is a predictor of adverse cardiovascular events, including mortality, in acute coronary syndromes (ACSs). Decreased serum albumin (SA) concentration is associated with an increased risk of cardiovascular events. We aimed to investigate whether SA levels at admission are associated with high SYNTAX score and in-hospital mortality in patients with ACS. The study included 1303 patients with ACS who underwent coronary angiography (CA). The patients were divided into 2 groups as high SYNTAX score (≥33) and lower SYNTAX score (≤32). Baseline SA levels were significantly lower in patients with high SYNTAX score than with lower SYNTAX score (3.46 ± 0.42 mg/dL vs 3.97±0.37 mg/dL, respectively; P < .001). On multivariate logistic regression, SA (

Contrast-induced acute kidney injury (CI-AKI) is a major issue after percutaneous coronary intervention (PCI), especially in the setting of acute coronary syndrome (ACS). Contrast-induced acute kidney injury is associated with increased mortality and morbidity. Inflammation plays an important role in the pathophysiology of CI-AKI. Procalcitonin (PCT) is introduced as a new marker of inflammation. We sought to examine whether admission PCT levels predict the development of CI-AKI. Patients (n = 814) were divided into 2 groups, namely, CI-AKI (−) and CI-AKI (+). An increase in serum creatinine of ≥0.5 mg/dL from baseline within 48 to 72 hours of contrast exposure was defined as CI-AKI. Contrast-induced acute kidney injury occurred in 96 (11.8%) patients. The PCT levels were significantly higher in patients with CI-AKI than in those without, 0.11 (0.056-0.495) vs 0.04 (0.02-0.078) µg/L; P < .001. After multivariable analysis, PCT remained a significant independent predictor of CI-AKI (odds ratio 2.544; 95% CI [1.207-5.347]; P = .014) as well as age, women, white blood cell, hemoglobin, glomerular filtration rate, creatine kinase myocarial band, and SYNTAX score. In conclusion, serum PCT levels are independently associated with a risk of CI-AKI in patients with ACS who underwent urgent PCI.

Kounis syndrome, resulting in acute coronary syndromes, as a result of allergic or hypersensitivity reaction is triggered by several factors. Vasospasm which is mediated by mediators released after mast cell activation, is the responsible mechanism for comprising of type 2-myocardial infarction. Mad honey containing grayanotoxin is previously shown to be associated with gastrointestinal, neurological and cardiac disorders. In this case report, we presented a Kounis syndrome that has occurred after the mad honey intake and treated successfully, previously not mentioned in the literature.

WOS: 000441766000012, PubMed ID: 30119153, Background/aim: In Turkey, lenalidomide plus dexamethasone (RD) has been used to treat relapsed/refractory multiple myeloma (RRMM) since 2010. This retrospective, single-center study evaluated the efficacy and tolerability of RD in patients with RRMM between October 2010 and June 2016. Materials and methods: Patients' records were reviewed, and overall (OS) and progression-free survival (PFS) were assessed. Results: One hundred and twenty patients (71 males; 59.2%) were included in the study. The median number of prior lines of treatment was one (1-4); 72 patients (60.0%) received RD as second-line therapy and 51 patients (42.5%) had previously undergone autologous stem cell transplantation (ASCT). The overall response rate was 72.5%, with 19% of these patients achieving a complete response. The median length of follow-up and duration of response to RD was 14 months and 19 months, respectively. Median OS and PFS were 32 and 21 months, respectively. Prior ASCT, an overall response, and treatment with RD for >12 cycles were identified as independent prognostic factors for OS and PPS. Adverse events (AEs) occurred in 69 (57.5%) and 14 patients (11.7%) discontinued treatment due to AEs. Conclusions: We found RD to be safe, well tolerated, and effective in RRMM in everyday clinical practice in Turkey., Celgene Corporation, Editorial assistance in the preparation of this manuscript was provided by Sandralee Lewis, PhD, of the Investigator Initiated Research Writing Group (an initiative of Ashfield Healthcare Communications, a part of UDG Healthcare plc), and was funded by Celgene Corporation.

OBJECTIVES: Acute ST-segment elevation myocardial infarction patients presenting persistent no-flow after wire insertion have a lower survival rate despite successful mechanical intervention. The neutrophil-to-lymphocyte ratio has been associated with increased mortality and worse clinical outcomes in ST-segment elevation myocardial infarction. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would also be associated with a persistent Thrombolysis In Myocardial Infarction flow grade of 0 after wire insertion in patients undergoing primary percutaneous coronary intervention. METHODS: A total of 644 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention within 12 hours of symptom onset were included in our study. Blood samples were drawn immediately upon hospital admission. The patients were divided into 3 groups according to their Thrombolysis In Myocardial Infarction flow grade: Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion, Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. RESULTS: The neutrophil-to-lymphocyte ratio was significantly higher in the group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion compared with the group with Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and the group with Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. The group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion also had a significantly higher in-hospital mortality rate. Persistent coronary no-flow after wire insertion was independently associated with the neutrophil-to-lymphocyte ratio. CONCLUSIONS: An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

The aim of this study was to investigate the electrocardiographic parameters in patients consuming synthetic cannabinoids.Thirty-five patients who were consuming synthetic cannabinoids were enrolled to the study, prospectively. The control group included 35 healthy age and sex-matched volunteers. The standard 12-lead surface electrocardiograms of the study population were recorded. P maximum (PPAltered electrocardiography parameters linked with atrial and ventricular arrhythmia development may be observed in patients consuming synthetic cannabinoids. These patients should be evaluated regularly for cardiovascular disease and arrhythmia development. The electrocardiogram, which is a cheap and easy test to apply, can be used to determine the pro-arrythmic risk in patients consuming synthetic cannabinoids.

Aim: A lower lymphocyte count and a high monocyte count give important clues about the prognosis of various cardiovascular diseases. We hypothesized that lymphocyte-to-monocyte ratio (LMR) was associated with the saphenous vein graft disease (SVGD) in patients with coronary artery bypass graft (CABG). Patients & methods: A total of 218 patients with previous history of CABG surgery, who underwent coronary angiography due to stable angina symptoms, were investigated, retrospectively. Results: LMR levels were significantly lower in the SVGD group. Multiple logistic regression analyses showed that LMR levels were independent predictors of SVGD (OR: 0.648; 95% CI: 0.469–0.894; p = 0.008). Conclusion: Our results suggested that LMR levels may provide useful information for the relevant risk evaluation of SVGD in CABG patients.

The SYNTAX score (SXscore) is an anatomic scoring system based on coronary angiography (CA) that not only quantifies lesion severity and complexity but also predicts poor cardiovascular outcomes, including mortality, in patients with acute coronary syndromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. The aim of this study was to investigate the association of PLR with the severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS who underwent urgent CA. A total of 1,016 patients with ACS who underwent urgent CA were included in the study from August 2012 to March 2014. Admission PLR values were calculated before CA was performed. The SXscore was determined from baseline CA. The patients were divided into 2 groups, those with low SXscores (≤22) and those with intermediate to high SXscores (≥23). PLRs were significantly higher in patients with intermediate to high SXscores compared with those with low SXscores (p0.001). In-hospital mortality was significantly higher in the groups with high PLR and intermediate to high SXscores. In multivariate analysis, the independent predictors of intermediate to high SXscore were PLR (odds ratio 1.018, 95% confidence interval 1.013 to 1.023, p0.001) together with the left ventricular ejection fraction (odds ratio 0.935, 95% confidence interval 0.910 to 0.960, p0.001), and age (odds ratio 1.029, 95% confidence interval 1.029 to 1.054, p=0.02). A PLR≥116 had 71% sensitivity and 66% specificity in predicting intermediate to high SXscore. In conclusion, the PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SXscore in patients with ACS who undergo urgent CA.

reSultS: The mean age was 47 ± 13 years and 38 (74.5%) of the patients were male. No significant difference was found in echocardiographic parameters including ejection fraction, fractional shortening, left ventricular mass, left ventricular mass index, left ventricular posterior wall thickness, inter ventricular septal thickness, left atrial diameter, early diastolic filling/late diastolic filling ratio before and after the period of PD. Left ventricular end-systolic diameter and left ventricular end-diastolic diameter values were significantly lower found in the period after PD.

We investigated whether admission estimated glomerular filtration rate (eGFR) values are associated with no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Patients (n = 673; 59 ± 13 years; 77.1% men) were stratified into 3 groups according to eGFR at admission: normal renal function (eGFR ≥ 90 mL/min/1.73 m2), mild renal impairment (eGFR 60-89 mL/min/1.73 m2), and moderate renal impairment (eGFR 30-59 mL/min/1.73 m2). No-reflow phenomenon was defined as thrombolysis in myocardial infarction flow grade

N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are associated with short- and long-term mortality in acute coronary syndrome (ACS). We investigated whether baseline NT-proBNP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore). We enrolled 509 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤22), intermediate SXScore (23-32), and high SXScore (≥33). The NT-proBNP levels demonstrated an increase from low SXScore tertile to high SXScore tertile. The NT-proBNP levels according to the SXScore tertiles are as follows: low and intermediate (median 635 vs 1635, P = .014), low and high (median 635 vs 4568, P < .001), and intermediate and high (median 1635 vs 4568, P < .001). In multivariate analysis, NT-proBNP remained an independent predictor of high SXScore (odds ratio: 2.688, 95% confidence interval: 1.315-5.494, P = .007) together with age ( P = .002), neutrophil–lymphocyte ratio ( P = .017), and presence of non-ST-segment elevation ACS ( P = .002). The NT-proBNP was independently associated with burden of coronary atherosclerosis in patients with ACS.

We investigated the relationship between red cell distribution width (RDW) and contrast-induced nephropathy (CIN) in patients (aged 61 ± 12, 69% men) with acute coronary syndrome (ACS). Consecutive patients diagnosed with ACS (n = 662) who underwent percutaneous coronary intervention (PCI) were included in the study. Patients were divided into 2 groups: CIN and no CIN. Contrast-induced nephropathy was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after PCI. Contrast-induced nephropathy occurred in 81 (12.2%) patients. Red cell distribution width, creatinine, and high-sensitivity C-reactive protein levels were significantly higher in the CIN group than in the no-CIN group. Multivariate regression analysis revealed that baseline RDW level (odds ratio 1.379, 95% confidence interval 1.084-1.753, P = .009), age ( P = .025), creatinine ( P = .004), and left ventricular ejection fraction ( P = .011) were independent risk factors for the development of CIN. In conclusion, increased RDW levels are independently associated with a greater risk of CIN in patients undergoing PCI for ACS.

Background Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk for CIN. N-terminal pro-brain natriuretic peptide (NT-proBNP) is closely linked to the prognosis as a strong predictor of both short- and long-term mortality in patients with ACS. Hypothesis We hypothesized that NT-proBNP levels on admission can predict the development of CIN after PCI for ACS. Methods A total of 436 patients (age 62.27 ± 13.01 years; 64.2% male) with ACS undergoing PCI enrolled in this study. Admission NT-proBNP levels were measured before PCI. Serum creatinine values were measured before and within 72 hours after the administration of contrast agents. Patients were divided into 2 groups: CIN group and no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after contrast administration. Results CIN developed in 63 patients (14.4%). Baseline NT-proBNP levels were significantly higher in patients who developed CIN compared to those who did not develop CIN (median 774 pg/mL, interquartile range 177.4–2184 vs median 5159 pg/mL, interquartile range 2282–9677, respectively; P < 0.001). Multivariate analysis found that NT-proBNP (odds ratio [OR]: 3.448, 95% confidence interval [CI]: 1.394-8.474, P = 0.007) and baseline creatinine (OR: 6.052, 95% CI: 1.860-19.686, P = 0.003) were independent predictors of CIN. Conclusions Admission NT-proBNP level is an independent predictor of the development of CIN after PCI in ACS.

OBJECTIVES Reduced baseline coronary flow in an infarct-related artery (IRA) before a primary percutaneous coronary intervention (PPCI) increases mortality in patients with ST-elevation myocardial infarction (STEMI). Increased neutrophil/lymphocyte (N/L) ratio has been linked to poor clinical outcomes in patients with STEMI. We investigated whether the N/L ratio, as measured at admission, was associated with IRA patency before mechanical reperfusion in patients with STEMI undergoing PPCI. PATIENTS AND METHODS A total of 404 patients who had undergone PPCI on a single culprit artery were enrolled in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PPCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA) and TIMI 2 or 3 group (patent IRA). RESULTS The N/L ratios were found to be significantly higher in the TIMI flow 0/1 group when compared with the TIMI flow 2/3 group (6.08±3.94 vs. 4.01±2.87, P=0.001). The absence of early IRA patency was associated with higher Syntax score, mean platelet volume, creatine kinase-myocardial band, and troponin T levels (P=0.0001, P=0.03, P

The European Union’s (EU) financial assistance is an important instrument to use in preparing Candidate Countries (CCs) for membership. The EU’s financial assistance programs are implemented under the Decentralized Implementation System (DIS) in CCs. Building up an adequate institutional capacity during the accession period is of high importance for the effective use of the available resources and also for preparing the countries for their full absorption capacity of the EU’s Structural and Cohesion Funds. The experiences and best practices obtained during the implementation of previous accession programs provide valuable lessons for the CCs. Experience shows that the financial allocations may not be used fully by the beneficiary countries because of many different reasons such as a complex implementation system, excessive controls, too much eligibility criteria and inadequate administrative capacity. Considerable attention is therefore devoted to analyzing and improving the performance of the financial assistance programs. Tackling the low absorption problem encountered in the Member States (MSs) and CCs is becoming one of the central issues discussed at the EU and the national levels. Turkey is benefiting from the EU’s Instrument for Pre-Accession Assistance (IPA). In this study, Turkey’s performance in the use of the IPA funds and the elements affecting the absorption capacity are assessed based on the experiences obtained both during the setting up of the DIS structure and in the outcomes of the implementation so far.

Although mean platelet volume (MPV) is an independent correlate of impaired angiographic reperfusion and 6-month mortality in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), there is less data regarding the association between platelet distribution width (PDW) and in-hospital major adverse cardiovascular events (MACEs). A total of 306 patients with STEMI pPCI were evaluated. No reflow was defined as a post-PCI thrombolysis in myocardial infarction (TIMI) flow grade of 0, 1, or 2 (group 1). Angiographic success was defined as TIMI flow grade 3 (group 2). The values of MPV and PDW were higher among patients with no reflow. In-stent thrombosis, nonfatal myocardial infarction, in-hospital mortality, and MACEs were significantly more frequent among patients with no reflow. In multivariate analysis, PDW, MPV, high-sensitivity C-reactive protein, and glucose on admission were independent correlates of in-hospital MACEs. Admission PDW and MPV are independent correlates of no reflow and in-hospital MACEs among patients with STEMI undergoing pPCI.