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Objective: Global mobility has heightened the necessity to addressing racial diversity in healthcare. Recognizing variations that influence diagnosis and treatment can enhance patient outcomes. We aimed to assess if the Neutrophil Lymphocyte Ratio (NLR) reflects inflammation differently in Arab-origin immigrant patients admitted to the Anaesthesia Intensive Care Unit (ICU) compared to non-immigrants. Materials and Methods: This retrospective, single-center study examined ICU records from January 2011 to January 2014. Patients were categorized as Turkish or Arab immigrants. Exclusions comprised patients under 18, those deceased within 24 hours of admission, malignancy cases, systemic steroid users, and those with immunosuppressive histories. A total of 100 patients over 18 were analyzed. Results: Of the 100 patients (63 men, 33 women), 49 were immigrants and 51 non-immigrants. No significant differences were found in CRP, neutrophil-lymphocyte count, or NLR upon admission. However, CRP and neutrophil counts differed significantly on culture-positive days (p<0.005). NLR did not significantly vary between the groups on culture-positive days. Conclusion: No substantial association was observed between NLR levels in critically ill Arab-origin immigrants versus non-immigrants in the ICU. Larger studies and detailed genetic analyses are warranted to inform critical patient care. [ABSTRACT FROM AUTHOR]

Objective: To clarify the effect of the learning curve (LC) on minimally invasive direct coronary artery by-pass (MIDCAB) outcomes for the first time. Methods: Patients who underwent MIDCAB were enrolled in this study. The patients’ characteristics were recorded prospectively. A 75 patients were divided into three groups, with the first 25 patients undergoing MIDCAB in group 1 and the last 25 patients undergoing MIDCAB in group 3. Results: Comparison of the groups revealed that the operation time significantly decreased after 50 cases (p=0.003). Duration for access to the pericardium was similar between groups (p=0.094), but duration for preparing vessels progressively decreased from group 1 to group 3 (p=0.001). In addition, anastomosis duration significantly decreased in group 3 (p=0.005). In addition, the hospitalization time was significantly shorter in group 3 (p=0.018). The complication rate was significantly lower in group 3 and group 2 than in group 1 (p=0.030). Additionally, major cardiovascular and cerebrovascular events (MACCE) in the first postoperative year was detected in 20% of patients in group 1 and 8% of patients in group 2 and group 3, and the statistical difference was significantly better in favour of group 2 and group 3 (p=0.043). Conclusion: The present study is the first to define the LC for MIDCAB, and we achieved significantly lower blood loss within 24 h after operation and lower complication rates after 25 cases, and perioperative transfusion rate, operation time, and hospitalization period were significantly decreased after 50 cases. Moreover, the number of MACCEs in the first postoperative year was significantly lower after 25 cases. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to determine the protective effect of cilostazol on myocardium in obese Wistar rats with induced ischemia-reperfusion injury (IRI). Methods: Four groups with 10 Wistar rats were included: 1] Sham Group: IRI was not established in normal weight-Wistar rats. 2] Control Group: IRI but no cilostazol in normal weight-Wistar rats. 3] Cilostazol in normal weight-Wistar rats: IRI and cilostazol was administered. 4] Cilostazol in obeseWistar rats: IRI and cilostazol was administered. Results: Tissue adenosine triphosphate (ATP) levels were significantly higher and superoxide dismutase (SOD) levels significantly lower in the control group than in the sham group and normal weight cilostazol group (p=0.024 and p=0.003). Fibrinogen levels were 198 mg/dL in the sham group, 204 mg/dL in the control group, and 187 mg/dL in the normal-weight cilostazol group (p=0.046). Additionally, plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the control group (p=0.047). The level of ATP was significantly lower in the normal-weight cilostazol group than in the obese group (104 vs 131.2 nmol/g protein, p=0.043). PAI-1 level was 2.4 ng/mL in the normal weight cilostazol group and 3.7 ng/mL in the obese cilostazol group (p=0.029). Normal-weight Wistar rats with cilostazol had significantly better histologic outcomes than the control group and obese Wistar rats (p=0.001 and p=0.001). Conclusion: Cilostazol has a protective effect on myocardial cells in IRI models by decreasing inflammation. The protective role of cilostazol was reduced in obese Wistar rats compared with normal-weight Wistar rats. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 51-year-old man was referred to our institution for dyspnea on exertion and non-productive cough, of three-month history. A silent inferior myocardial infarction was detected incidentally on an ECG that manifested itself as inferior Q waves. Two-dimensional transthoracic echocardiography demonstrated a second large cardiac chamber (6x5 cm) adjacent to the inferior-basal left ventricle wall, with a narrow neck and to-and-fro signals during Doppler US evaluation. Ventriculography showed a pseudoaneurysm, like an hourglass, on the inferior wall of the left ventricle which was approximately 6x5 cm in diameter. Coronary angiography showed triple vessel disease with total occlusion of the circumflex coronary artery. These findings were consistent with left ventricular pseudoaneurysm resulting from an old inferior myocardial infarction. After diagnosis of left ventricular pseudoaneurysm and concomitant coronary artery disease, surgery was recommended. He underwent coronary artery bypass surgery including the repair of the pseudoaneurysm. But, unfortunately the patient died in during the operation. This case illustrates that pseudoaneurysm can develop after silent myocardial infarction with nonspecific symptoms. In addition, if false aneurysm invades adjacent organs such as lungs, then the risk of surgical mortality increases. [ABSTRACT FROM AUTHOR]

Background: To present the surgical experience at a tertiary academic center of treating patients with traumatic arteriovenous fistulas (AVFs) who in whom endovascular treatment was contraindicated or in whom unsuccessful endovascular treatment had been performed., Methods: A total of 27 patients with traumatic AVFs who underwent surgery between September 2014 and May 2016 were included. The site of injury, timing of surgery, and the surgical methods utilized were analyzed retrospectively., Results: Arteriovenous fistulas were located in the lower extremity in 26 patients (96.29%) and in the upper extremity in one patient (3.7%). Etiological factors included gunshot injuries in 23 patients (85.18%) and penetrating injury in four patients (14.81%). AVFs in the lower extremity were between the popliteal artery and vein in 21 patients and between the femoral artery and vein in five patients. The one patient with upper-extremity AVF had a communication between the brachial artery and cephalic vein. Primary repair of the artery and vein after ligation, arterial graft interposition plus primary vein repair, and arterial and venous graft interposition were performed for surgical repair in two, five, and 20 patients, respectively. The saphenous vein was used for grafting in all cases needing grafts., Conclusion: In patients enduring penetrating trauma in the close vicinity of major vascular structures, a detailed history-taking and physical examination should be performed along with auscultation. The endovascular approach may represent the initial choice of management because of its lower rate of complications, noninvasive nature, decreased in-hospital costs, and decreased loss of work productivity. However, surgery is still unavoidable option in a significant proportion of patients who are either hemodynamically unstable, contraindicated for endovascular treatment, or in whom endovascular treatment was unsuccessful.