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© 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.Background: Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for the majority of patients at moderate or high surgical risk. However, some complications occur frequently with this procedure. In this study, we aimed to assess whether the cusp-overlap view (COP) technique may be associated with a reduced incidence of some of these complications compared with the classical three-cusp view (TCV) technique. Methods: In this single-center, retrospective study we investigated; technical success, postprocedural permanent pacemaker implantation (PPMI), new-onset stroke, pericardial tamponade, arrhythmia development, acute renal failure, major bleeding, major vascular complications, procedure-related coronary obstruction, new-onset left bundle branch block (LBBB), paravalvular leak, peri-procedural myocardial infarction (MI), day of hospitalization, death, and major adverse cardiac and cerebrovascular events (MACCE) were determined as the clinical endpoints. Results: A total of 281 consecutive patients who met the study criteria and underwent elective or emergency transfemoral TAVI using the self-expandable CoreValve Evolut valve were included. 176 consecutive patients implanted with the classical TCV technique and 105 consecutive patients implanted with the COP technique were compared. Compared with the TCV group, patients in the COP group had lower PPMI (3.8% vs. 10.8%, p = 0.039), in-hospital mortality (1.9% vs. 8.5%, p = 0.018), and 1-year death (4.8% versus 18.8%, p = 0.001), and MACCE rates (12.4% vs 31.3%, p < 0.001). Conclusion: The COP technique may help to reduce the conduction disturbances, PPMI requirement and complication rates that may develop following TAVI. In addition, it is an interesting result that it reduces mortality and MACCE rates in long-term follow-ups.

Thrombolysis in Cerebral Infarction(TICI) score is used to objectively evaluate cerebral perfusion after intervention in acute stroke with mechanical thrombectomy. In our study, we aimed to compare the results of patients with successful TICI perfusion score (TICI ≥ 2c) with the results of patients with poor TICI perfusion score (TICI 2c) and to investigate the relationship of the CHAFor this retrospective, single-center, cross-sectional study, 278 patients who underwent endovascular thrombectomy were screened consecutively by the interventional neurology department of hospital. The primary endpoint of the study was in-hospital and 1-year all-cause death. All patients underwent cranial imaging to evaluate hemorrhagic transformation after the procedure.It was observed that CHAHigh CHA

SUMMARY OBJECTIVES: While studies on the treatment for the coronavirus disease 2019 (COVID-19) pandemic continue all over the world, factors that increase the risk of severe disease have also been the subject of research. Malnutrition has been considered an independent risk factor. Therefore, we aimed to investigate the clinical effect of dietary habits and evaluate the prognostic value of the Controlling Nutritional Status score in the COVID-19 patients we followed up. METHODS: A total of 2760 patients hospitalized for COVID-19 were examined. Patients were retrospectively screened from three different centers between September 1 and November 30, 2020. A total of 1488 (53.9%) patients who met the criteria were included in the study. Risk classifications were made according to the calculation methods of prognostic nutritional index and Controlling Nutritional Status scores and total scores. The primary outcome of the study was in-hospital mortality. RESULTS: The groups with severe Controlling Nutritional Status and prognostic nutritional index scores had a significantly higher mortality rate than those with mild scores. In the multivariable regression analysis performed to determine in-hospital mortality, the parameters, such as age (OR 1.04; 95%CI 1.02–1.06, p

Background The incidence of postoperative complications following cardiac implantable electronic device (CIED) procedures in patients treated with antithrombotic drugs has not been studied sufficiently. Here we present a comparison of complications after CIED implantations. Methods Using an observational study design, the study included 1807 patients with a taking antiplatelet drugs (n: 1601), nonvitamin K anticoagulants (NOAC) (n: 136), and warfarin (n: 70) undergoing CIED surgery. Primary endpoint was accepted as cumulative events including composite of clinically significant hematoma (CSH), pericardial effusion or tamponade, pneumothorax, and infection related to device system. Secondary outcomes included each compenent of cumulative events. Multivariable analysis was performed to identify predictors of cumulative events. Results The overall cumulative event rate was 3.7% (67 of 1807). Cumulative events occured 3.1% (50 of 1601) in the antiplatelet, 5.1% (7 of 136) NOAC, and 14.3% (10 of 70) warfarin groups (p < 0.001). CSH occurred in 2 of 70 patients (2.9%) in the warfarin group, as compared with 5 of 1601 (0.3%) in the antiplatelet group (p: 0.032). However, no significant differences were found between NOAC and warfarin groups in terms of CSH (0.7% vs. 2.9% respectively, p: 0.267). Warfarin treatment was an independent predictor of cumulative events and increased 2.9-fold the risk of cumulative events. Major surgical complications were rare and did not differ significantly between the study groups. Conclusions The incidence and severity of complications may be lower in patients treated with periprocedurally antiplatelet or NOAC therapy when compared with warfarin therapy. Further randomized control studies are required to confirm our findings

SUMMARY OBJECTIVE: Severe inflammation is reportedly associated with subsequent cardiovascular events, including in patients with coronary artery disease. This study aimed to examine the prognostic value of systemic immune-inflammation index and determine mortality and clinical outcomes in patients with chronic coronary total occlusion. METHODS: Our study evaluated 366 consecutive coronary total occlusion patients. The clinical end points were all-cause mortality and major adverse cardiovascular events, which include target vessel revascularization, myocardial infarction, and cerebrovascular events during 105 months follow-up. RESULTS: The study findings showed 59 (16.1%) all-cause death, 22 (6%) target vessel revascularization cases, 32 (8.7%) myocardial infarction cases, and 13 (3.6%) cerebrovascular events cases, with a median follow-up of 49 months (26–74). Multivariate logistic regression analysis showed that systemic immune-inflammation index was not associated with target vessel revascularization, myocardial infarction, and cerebrovascular events. Multivariate Cox regression analysis found systemic immune-inflammation index to be associated with all-cause death. Kaplan-Meier analysis showed a lower survival rate and myocardial infarction-free survival time in patients with higher systemic immune-inflammation index scores. CONCLUSION: Although systemic immune-inflammation index is a preferable tool for the detection of mortality, it failed to give adverse outcomes. Larger multicenter studies are thus warranted to investigate the effect of systemic immune-inflammation index on clinical outcomes.

Objective: Monocyte to high-density lipoprotein ratio (MHR) is a biomarker of inflammatory response. In this study, we investigated the relationship between MHR and mortality in patients with chronic coronary artery occlusion (CTO). Method: Retrospective observational study including 493 patients over a follow up period of 73 months. Blood samples were taken before cardiac catheterization for coronary angiography. Results: Median follow-up was 48 months(26-73) . Patients were seperated into two groups: (I) MHR

Objective: Fibrinogen plasma level rises in the event of inflammatory cases. It is known that there is a powerful intercourse between fibrinogen level and plasma viscosity. Albumin plasma level dropes during the inflammatory cases. The aim of this work determine significance of fibrinogen albumin ratio (FAR) as a indicator emphases the burden of atherosclerosis. Method: The study included 83 patients diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) between January and September 2015. The definition of NSTEMI was made according to “Definition of Third Universal Myocardial Infarction” guidelines published on 2013 by European Society of Cardiology. Burden of atherosclerosis was evaluated by Syntax score (SS) and Gensini Score. Patients were seperated two groups as medium-high SS (n=23) and low SS (n=60). FAR levels were compared. Results: FAR was 80.71 ± 30.3 in low SS group and 120 ± 49.72 in the mid-high SS group respectively (p

We aimed to compare the long-term follow-up results of patients with atrial fibrillation (AF) who use vitamin K antagonist (VKA) with effective time in therapeutic range (TTR) and non-vitamin K antagonist oral anticoagulants (NOACs).A total of 1140 patients were followed at 35 different centers for five years. During the follow-up period, the INR values were studied at least 4 times a year and the TTR values were calculated according to the Roosendaal method. The effective TTR level was accepted as60% as recommended by the guidelines. There were 254 patients in the effective TTR group and 886 patients in the NOACs group. Ischemic cerebrovascular disease/ transient ischemic attack (CVD/TIA), hemorrhagic CVD, and mortality were considered primary endpoints based on one-year and five-year follow-ups.Ischemic CVD/TIA (3.9% vs. 6.2%; P = 0.17) and hemorrhagic CVD (0.4% vs. 0.5%, P = 0.69), the one-year mortality rate (7.1% vs. 8.1%; P = 0.59), five-year mortality rates (24% vs. 26.3%; P = 0.46) were not different between the effective TTR and NOACs groups during the follow-up respectively. The CHA2DS2-VASC score was similar between warfarin with the effective TTR group and NOACs group (3 [2-4] vs. 3 [2-4]; P = 0.17, respectively]. Additionally, survival free-time did not differ between the warfarin with effective TTR group and each NOAC in the Kaplan-Meier analysis (dabigatran, P = 0.59; rivaroxaban, P = 0.34; apixaban, P = 0.26; and edoxaban, P = 0.14).There was no significant difference in primary outcomes between the effective TTR and NOAC groups in AF patients.

© 2022 Wiley-VCH GmbH.Calcium-binding proteins (CaBPs) have an essential role in male reproduction by modulating calcium ion metabolism. Although the brain and testis are structurally and functionally different, they show a high degree of transcriptomic and proteomic similarities. The purpose of the present study was to explore some CaBPs (Iba-1, Calbindin, Calretinin and Parvalbumin) and neural cell markers (CNPase, NG2 and Drebrin) expression in rat testis and epididymis during postnatal periods by using immunohistochemistry. Iba-1, calbindin, calretinin, parvalbumin, CNPase, NG2 and drebrin were expressed in the epididymal epithelium in each postnatal period. Iba-1 and calbindin expression showed stage-dependent expression in spermatids. CaBPs and neural cell markers showed a positive reaction in Leydig cells in the postpubertal and mature periods. Sertoli cells, gonocytes, spermatogonium, and peritubular myoid cells showed heterogeneity in the expression of CaBPs and nerve markers throughout postnatal development. Interestingly, CNPase, NG2 and drebrin were positive in spermatocytes, spermatids, and sperm. Expression dynamics of calcium-binding proteins and nerve markers showed differences in germ cells and somatic cells during postnatal development. The expression of these proteins in the testis and epididymis supports that they may have important roles in reproductive physiology.

Objectives: Coronary slow flow phenomenon (CSFP) is the slow or late progression of the opaque material to the distal vascular structures during angiography in patients with normal or near-normal coronary arteries. This study aims to evaluate left atrial volumes and functions using conventional transthoracic and tissue Doppler echocardiographic parameters in patients with CSFP. Materials and Methods: According to criteria determined by Gibson, 50 patients with slow flow in at least one coronary artery were included as cases, and 40 subjects with normal coronary flow were included as controls. Results: In the transmitral and tissue Doppler analysis, mitral early velocity (E), mitral late velocity/mitral early velocity (E/A), and Em were significantly lower in the coronary slow flow (CSF) group. LA, Am, mitral early velocity/earlydiastolic velocity (E/Em), LAVmax, LAVmin, LAVpreA, index volumes, LAAEV, LATEV, and LAAEF were found to be higher in the CSF group. A significant positive correlation was observed between Frame LAD and LAAEF (r=0.66, p

Objectives: Collateral circulation is assumed to prevent myocardial ischemia in healthy subjects and in patients with coronary artery disease. Visceral adipose tissue is an active component of total body fat, which holds some biochemical characteristics that have impact on several normal and pathological processes in the human body. In this study, we investigated the relationship between visceral fat ratio and coronary collateral circulation (CCC).Materials and Methods: Totally 148 patients with stable angina pectoris were recruited to the study and all patients’ heights and weights were recorded after the coronary angiography. The study subjects were divided into two groups as those between 1 and 9, and those >10 by classifying their visceral fat ratio with bioelectrical impedance analysis method. Patients were classified as poor CCC group (grade 0 and 1) and good CCC group (grade 2 and 3) based on the Rentrop’s classification of CCC.Results: In the analysis in accordance with collateral classification, visceral fat percentage (13.7±4.7 versus 10.1±4.0, p=0.01) and body mass index (28.2±2.4 versus 27.3±2.3, p=0.040) were found significantly higher in the poor collateral group. Diabetes mellitus was significantly higher in patient with high visceral fat ratio. In multivariate logistic regression analysis for collateral growth, visceral fat percentage [odds ratio (OR): 0.740, %95 confidence interval (CI): 0.602 0.909, p=0.040] and coronary stenosis percentage (OR: 1.220, %95 CI: 1.070-1.390, p=0.003) were found meaningful, independent from the other factors. In ROC analysis, increase in visceral fat level decreased collateral growth with 72.7% sensitivity and 58.5% specificity.Conclusion: The increase in visceral fat seems an independent factor for poor collateral development.

The aim of this study was to investigate the frequency of oral anticoagulant drugs and time in therapeutic range in patients receiving warfarin in addition to the epi-demiological trial of non-valvular atrial fibrillation previously conducted in Turkey (The Atrial Fibrillation: Epidemiological Registry trial). Furthermore, the prevalence of major adverse events and mortality rates of the patients were evaluated during the long-term follow-up period.We created a national data registry for non-valvular atrial fibrillation patients, reflecting all geographic regions by population density. In that context, the study included all consecutive atrial fibrillation patients older than 18 years of age who were admitted to the cardiology outpatient clinic except for patients those with prosthetic heart valvesand rheumatic mitral valve stenosis.This study included 2592 patients from 35 different centers. The mean age was 68.7 ± 11.1 years, and 55.5% of the patients were female. The most common comorbid diseases were chronic kidney disease (69%) and hypertension (65.5%). The time in ther- apeutic range rate in the general population was 40%, and the mortality rate at 5-year follow-up was 29.4%.The Atrial Fibrillation: Epidemiological Registry 2 study showed higher use of anticoagulant in non-valvular atrial fibrillation patients than in previous national stud-ies. Furthermore, this study demonstrated that most of the non-valvular atrial fibrilla- tion patients are in the high-risk group and the time in therapeutic range rates are still low in Turkey. As a result, this is a significant reason for switching from warfarin to non-K vitamin-dependent new oral anticoagulant treatments.

In patients with unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI), long-term mortality remains high despite improvements in the diagnosis and treatment. In this study, we investigated whether serum albumin level is a useful predictor of long-term mortality in patients with UAP/NSTEMI. Consecutive patients (n = 403) who were hospitalized with a diagnosis of UAP/NSTEMI were included in the study. Patients were divided into 2 groups based on the presence of hypoalbuminemia and the relationship between hypoalbuminemia and mortality was analyzed. Hypoalbuminemia was detected in 34% of the patients. The median follow-up period was 35 months (up to 45 months). Long-term mortality rate was 32% in the hypoalbuminemia group and 8.6% in the group with normal serum albumin levels ( P < .001). On multivariate analysis, hypoalbuminemia, decreased left ventricular ejection fraction, and increased age were found to be independent predictors of mortality ( P < .05). The cutoff value of 3.10 g/dL for serum albumin predicted mortality with a sensitivity of 74% and specificity of 67% (receiver-operating characteristic area under curve: 0.753, 95% CI: 0.685-0.822). All-cause long-term mortality rates were significantly increased in patients with hypoalbuminemia. On-admission albumin level was an independent predictor of mortality in patients with UAP/NSTEMI.

Toll-like receptors (TLRs), a part of the innate immune system, have critical roles in protection against infections and involve in basic pathology and physiology. Secreted molecules from the body or pathogens could be a ligand for induction of the TLR system. There are many immune and non-immune types of cells that express at a least single TLR on their surface or cytoplasm. Those cells may be a player in a defense system or in the physiological regulation mechanisms. Reproductive tract and organs contain different types of cells that have essential functions such as hormone production, providing an environment for embryo/fetus, germ cell production, etc. Although lower parts of reproductive organs are in a relationship with outsider contaminants (bacteria, viruses, etc.), upper parts should be sterile to provide a healthy pregnancy and germ cell production. In those areas, TLRs bear controller or regulator roles. In this chapter, we will provide current information about physiological functions of TLR in the cells of the reproductive organs and tract, and especially about their roles in follicle selection, maturation, follicular atresia, ovulation, corpus luteum (CL) formation and regression, establishment and maintenance of pregnancy, sperm production, maturation, capacitation as well as the relationship between TLR polymorphism and reproduction in domestic animals. We will also discuss pathogen-associated molecular patterns (PAMPs)-induced TLRs that involve in reproductive inflammation/pathology.

SUMMARY OBJECTIVE: Intervention in chronic total occlusion lesions involves long procedure time, a serious contrast load, and complex procedures. In this study, we aimed to investigate mortality rate of patients who had procedural coronary angiography done for chronic total occlusion lesions in coronary angiography series and who developed contrast-induced nephropathy. METHODS: A total of 218 patients with chronic total occlusion lesion in at least one coronary artery, from three different medical centers, who underwent procedural coronary angiography were recruited for the study. Patient population was divided into two groups: those who developed contrast-induced nephropathy and those who did not. Mortality due to all causes was investigated between both groups throughout a 100-month follow-up. RESULTS: Mean age of patients with incidence of contrast-induced nephropathy was 66.7±11.8, and 23.8% of them were comprised by female. We found a significantly higher mortality in long-term follow-up in the patient group with contrast-induced nephropathy (42.9 vs. 57.1%, p≤0.001). According to Kaplan-Meier analysis performed additionally, survival during follow-up was significantly shorter in this group and, in logistic regression analysis, it was an independent predictor of mortality (OR 3.02; 95%CI 1.41–6.45, p=0.004). CONCLUSION: We identified that the development of contrast-induced nephropathy is associated with long-term mortality. It might be possible to reduce adverse events with prophylactic approaches before the procedure and close follow-up of such patients after the procedure.

Background: Aortic Stenosis (AS) is a common heart valve disease that especially affects the elderly population and is seen with the aging of the society. In recent years Transcatheter aortic valve replacement patients (TAVR) has been increasingly applied worldwide as a procedure for the treatment of severe AS. Recently, various biomarkers and derived marker approaches have been studied in AS patient groups as in many cardiovascular diseases. Since it has been previously shown that increased inflammatory scores and poor nutritional scores are closely associated with the development process and prognosis of cardiovascular diseases, we hypothesized that these scores may be associated with prognosis after TAVR. Therefore, in this study, we aimed to make a detailed evaluation in terms of mortality determinants after TAVR. Methods and Results: 118 TAVR patients were included in the analysis. Median follow-up of 118 patients was 40.5 months. In terms of inflammatory status scores, the systemic immune inflammatory (SII) score (p= 0.027), the neutrophil/lymphocyte ratio (NLR) score (p= 0.012), and the platelet/lymphocyte ratio (PLR) score (p= 0.012) in the death group was found to be significantly higher. As nutritional status scores, the prognostic nutritional index (PNI) score (p= 0.003) was lower in the death group and the median Controlling Nutritional Status (CONUT) score (p= 0.002)) found significantly higher. Conclusion: In severe and high-risk AS patients undergoing TAVR, measurement of malnutrition with the CONUT score and increased inflammatory status with the SII score was associated with an increased risk of all causes mortality in longterm follow-up. It has been determined that the development of complications related to the procedure is an indicator of increased mortality not only in the short term but also in the long-term follow-up. Amaç: Aort Darlığı (AD), özellikle yaşlı nüfusu etkileyen ve toplumun yaşlanmasıyla birlikte görülen yaygın bir kalp kapak hastalığıdır. Son yıllarda Transkateter aort kapak implantasyonu (TAVI), şiddetli AS tedavisi için bir prosedür olarak dünya çapında giderek daha fazla uygulanmaktadır. Son zamanlarda birçok kardiyovasküler hastalıkta olduğu gibi AD hasta gruplarında da çeşitli biyobelirteçler ve türetilmiş belirteç yaklaşımları araştırılmaktadır. Artmış inflamatuvar skorların ve kötü beslenme skorlarının kardiyovasküler hastalıkların gelişim süreci ve prognozu ile yakından ilişkili olduğu daha önce gösterildiğinden, bu skorların TAVI sonrası prognoz ile ilişkili olabileceğini varsaydık. Bu nedenle bu çalışmada TAVI sonrası mortalite belirleyicileri açısından detaylı bir değerlendirme yapmayı amaçladık. Yöntemler ve Sonuçlar: 118 TAVI hastası analize dahil edildi. 118 hastanın medyan takip süresi 40.5 aydı. İnflamatuar durum skorları açısından, sistemik immün inflamatuar (SII) skoru (p= 0.027), nötrofil/lenfosit oranı (NLR) skoru (p= 0.012) ve trombosit/lenfosit oranı (PLR) skoru (p= 0.012) ) ölüm grubunda anlamlı olarak daha yüksek bulundu. Beslenme durumu skoru olarak ölüm grubunda prognostik nütrisyon indeksi (PNI) skoru (p= 0.003) daha düşüktü ve medyan CONUT skoru (p= 0.002) anlamlı olarak daha yüksek bulundu. Sonuç: TAVI uygulanan şiddetli ve yüksek riskli AD hastalarında, CONUT skoru ile malnütrisyon ölçümü ve SII skoru ile artan inflamatuar durum, uzun dönem takipte tüm nedenlere bağlı mortalite riskinin artmasıyla ilişkilendirildi. İşleme bağlı komplikasyonların gelişmesinin sadece kısa dönemde değil uzun dönemde de mortalite artışının bir göstergesi olduğu belirlenmiştir.

Nowadays, the demand for producing and using autonomous vehicle is increasing. Due to the latest developments in technology, the capabilities of these vehicles in accident prevention are increasing. As a result of the accuracy of these capabilities, it is very important because it is human life. In today’s technology, the collision time calculation called TTC (Time to Collision) can be done in two different ways. The first of these methods is lidar-based calculation. In this paper TTC will be calculated using the camera-based method with different combinations of detectors and descriptors. Pros and cons of these methods will be discussed. The aim of this paper is to expose an exacting performance for related methods, especially its diverse combinations are used matching. In these experiments images are used for 10 images taken from real time traffic scenario of preceding vehicle. This paper includes seven methods for detectors and 6 methods for descriptors. These detectors and descriptors are used in 42 different combinations. The analysis includes four parameters such as total keypoint detection, total matches, total time in ms and performance ratio which is total matches divided by total time., Günümüz otonom araç üretme ve kullanma talebi giderek artmaktadır. Teknolojideki gelişmeler nedeniyle bu araçların kaza önleme konusundaki yetenekleri de aynı oranda artmaktadır. Bu yeteneklerin doğruluğunun sonucu olarak insan hayatı söz konusu olduğunda oldukça önemlidir. Günümüz teknolojisinde TTC adı verilen çarpışma süresi hesabı iki farklı şekilde yapılabilmektedir. Bu yöntemden ilki lidar tabanlı hesaplamadır. Bu yazıda TTC, farklı dedektör ve tanımlayıcı kombinasyonları ile kamera tabanlı yöntem kullanılarak hesaplanacaktır. Bu bildirinin amacı, özellikle çeşitli kombinasyonların eşleştirilmesi için kullanılan yöntemler için hızlı. Bu deneylerde, öndeki aracın gerçek zamanlı trafik senaryosundan alınan 10 görüntü kullanılmıştır. Bu bildiri, dedektörler için yedi yöntem ve tanımlıyıcılar için 6 yöntem içermektedir. Bu dedektörler ve tanımlayıcılar 42 farklı kombinasyonda kullanılmaktadır. Analiz toplam anahtar nokta tespiti, toplam eşleşmeler, mili-saniye cinsinden toplam süre ve toplam eşleşmelerin toplam süreye bölünmesiyle elde edilen performans oranı gibi dört parametreyi içerir.

Objective: In recent years, sodium-glucose cotransporter-2 (SGLT-2) inhibitors are known to improve symptoms and reduce mortality in patients with heart failure (HF). Empagliflozin is an antidiabetic drug that SGLT-2 inhibitor. Empagliflozin has beneficial cardiac effects like other SGLT-2 inhibitors. However, data on how empagliflozin treatment affects echocardiographic parameters are limited. We aim to evaluate the changes in left ventricular myocardial strain parameters with 2-dimensional speckle tracking echocardiography (2D-STE) in patients with diabetes mellitus and normal ejection fraction after empagliflozin treatment.Material and Method: A total of 48 patients were included in our study. The left ventricular ejection fraction (LVEF) of the patients were normal and there were no HF symptoms and findings. Demographic, clinical, and echocardiographic parameters of study population were evaluated. Empagliflozin 10 mg once daily was given to all patients. Initial and at the end of 3rd month, the 2D-STE parameters of all patients were examined.Results: The median age of the study population was 55.0 (45.0 – 62.5, IQR) years and 27 (56.3 %) of them were female. There was a significant increase in the left ventricle global longutidunal strain (LV-GLS) and left ventricle global circumferential strain (LV-GCS) compared to baseline [respectively; -19.7(-17.5;-20.9) vs -19.2(-17.6;-20.2), p= 0.016 and -18.9(-16.0;-20.8) vs -17.1(-15.8;-18.7), p= 0.003]. Although left ventricular global radial strain (LV-GRS) was increased compared to baseline, it was not significant [37.0(31.0-41.6) vs 36.3(32.4-40.3), p= 0.776].Conclusion: In our study, left ventricular myocardial strain parameters such as LV-GLS and LV-GCS were improved in diabetic patients with normal ejection fraction after empagliflozin treatment.

A 32-year-old woman underwent radiofrequency catheter ablation of narrow QRS tachycardia that was terminated with intravenous adenosine.

Background and Aims Malnutrition is associated with poor clinical outcomes in many diseases. The Controlling Nutritional Status (CONUT) is an objective index used for evaluating nutritional status of hospitalised patients. The aim of this study was to investigate the relationship between malnutrition assessed by CONUT score and the prognosis in patients undergoing carotid artery stenting (CAS). Methods and Results The study included 170 patients who underwent CAS because of symptomatic or asymptomatic severe carotid artery stenosis. Median follow-up period was 50 (interquartile range [IQR], 41-60) months. Patients were divided into two groups according to the CONUT score as normal CONUT (score = 2). Primary endpoint was accepted as MACE (major adverse cardiac events) including all-cause death and ischaemic stroke. The prevalence of MACE was significantly higher in the mild-severe CONUT score group (P = .001). Kaplan Meier analysis showed lower survival rates in the mild-severe CONUT score group (log rank = 9.36, P = .002; Figure 5). The Cox regression analysis showed that, the CONUT score was associated with increased risk of MACE for both unadjusted model and age- and gender- adjusted model, while in a full adjusted model the best predictor was age. Conclusion Higher CONUT scores were associated with adverse outcomes in patients with CAS. Malnutrition assessed by the CONUT score is preferable with regards to the detection of MACE in patients with CAS. Larger studies are warranted to investigate if our preliminary findings translate into clinical outcomes in patients with CAS.

Background Recent findings indicate that thrombosis is one of the underlying pathophysiology and complication of COVID‐19 infection. Therefore, the prognosis of the disease may be more favourable in people who were under oral anticoagulant treatment before the COVID‐19 diagnosis. This study aims to evaluate the effects of chronic DOAC use on ICU admission and mortality in hospitalized patients due to COVID‐19 infection. Method Between 1 September and 30 November 2020, 2760 patients hospitalized in our hospital due to COVID‐19 were screened. A total of 1710 patients who met the inclusion criteria were included in the study. The patients were divided into two groups as those who use DOAC due to any cardiovascular disease before the COVID‐19 infection and those who do not. Results Seventy‐nine patients were enrolled in the DOAC group and 1631 patients in the non‐DOAC group. Median age of all study patient was 62 (52‐71 IQR) and 860 (50.5%) of them were female. The need for intensive care, in‐hospital stay, and mechanical ventilation were observed at higher rates in the DOAC group. Mortality was observed in 23 patients (29%) in the DOAC group, and it was statistically higher in the DOAC group (P = .002). In the multivariable analysis, age (OR: 1.047, CI: 1.02‐1.06, P

OBJECTIVE As aneurysm-related events and rupture is not eliminated, postoperative lifelong surveillance is mandatory after endovascular aneurysm repair (EVAR). For surveillance colored Doppler ultrasound (CDUS) is a standard method of noninvasive evaluation having the advantages of availability, cost-effectiveness, and lack of nephrotoxicity and radiation. We evaluated CDUS for primary surveillance tool after elective EVAR by comparing with computerized tomography. METHODS Between January 2018 and March 2020, 84 consecutive post-EVAR patients were evaluated. First, CDUS was performed by two Doppler operators from the Radiology Department and then computed tomographic angiography (CTA) was performed. The operators were blind to CTA reports. A reporting protocol was organized for endoleak detection and largest aneurysm diameter. RESULTS Among 84 patients, there were 11 detected endoleaks (13.1%) with CTA and seven of them was detected with CDUS (r = .884, p

In this 21-day study, we examined the effects of the aqueous methanolic extract of thin-skinned plum (Prunus domestica) on growth, immune response and resistance to a pathogenic bacterium, Yersinia ruckeri in rainbow trout (Oncorhynchus mykiss). Fish were fed with diets containing thin-skinned plum extract doses as 0 (Control) 0.1 (PD01), 0.5 (PD05) and 1% (PD1) ad libitum twice in a day. At the end of the study, growth was affected positively but not significantly. Feed conversion ratio (FCR) was decreased in the PD01 group (P 0.05). There were elevated respiratory burst and potential bacterial killing activities on the 7th day in the PD1 fish group. No differences were observed in lysozyme activity (P 0.05). An increased myeloperoxidase activity was recorded on the 14th day of study. Expression of interleukin and COX-2 genes was elevated on the 7th day of study in the kidney and intestine of treated fish. Histological results indicated no marked changes in organs (gill, kidney, liver and spleen) of PD treated fish groups. Challenge results of fish in all plum extract-treated groups showed an increased survival rate against Y. ruckeri (P 0.05). This study indicated that the thin-skinned plum aqueous methanolic extract could improve innate immunity, survival against Y. ruckeri and decrease the FCR level.

OBJECTIVE We aimed to determine the relationship between LMR and MHR and in-hospital and long-term mortality in patients with ACS. METHODS We retrospectively collected patients with ACS undergoing coronary angiography between January 2012 and December 2013. RESULTS In total, 825 patients with a mean age of 62.4 ± 12.9 years (71.3% male) were enrolled in the study. Patients were divided into three tertiles based on MHR levels and LMR levels. In-hospital mortality of the patients was significantly higher amongst patients in the upper MHR tertile when compared with the lower and middle MHR tertile groups [30 (10.9%) vs 8 (2.9%) and 14 (5.1%); P

Hibernation is a survival adaptation characterized by extended fasting when food is less or unavailable. Prolonged fast may affects various proteins expression including galectins binding β-galactosyl. There is no data on the expression of Galectin-1 and -3 (Gal-1 and -3) during hibernation. This study aimed to examine the expression of Gal-1 and -3 in hibernating Anatolian ground squirrel (Spermophilus xanthoprymnus) gastrointestinal tract. Intense Gal-1 immunostaining was observed in some cells of both gastric lamina propria and villous connective tissue of the small intestine. In colon and cecum, intense Gal-1 immunoreaction was observed in some connective tissue cells around the crypt epithelium, as well as in the smooth muscles of vessel walls, lamina muscularis and tunica muscularis of all the regions. Gastric foveolar epithelium showed moderate nuclear and intracytoplasmic Gal-3 immunostaining. Moreover, Gal-3 immunostaining was detected in villous epithelial cells of the duodenum and ileum. Intense Gal-3 labeling also was present in all the cryptal surface epithelial cells of the colon and cecum. In conclusion, both Gal-1and Gal-3 expression in gastrointestinal tract during hibernation was similar to that of non-hibernating species. In the gastrointestinal tract, Gal-1 did not display different expression pattern, whereas Gal-3 expression was more intense in large intestine epithelium. Hibernasyon, besinin az olduğu veya hiç olmadığı uzun süreli açlık ile karakterize olan durumlarda hayatta kalma adaptasyonudur. Uzun süreli açlık β-galaktozil bağlayan galektinler de dahil olmak üzere bir çok proteinin ekspresyonunu etkileyebilir. Galektinler, β-galaktozil bağlayan proteinlerdir. Hibernasyonda Galektin-1 ve -3 (Gal1 ve-3)’ün ekspresyonuna ilişkin herhangi bir veri bulunmamaktadır. Bu çalışmada hibernasyondaki Anadolu yer sincabı (Spermophilus xanthoprymnus) gastrointestinal kanalında Gal-1 ve 3’ün ekspresyonunun incelenmesi amaçlanmıştır. Hem gastrik lamina propria hem de ince bağırsağın villöz bağ dokusundaki bazı hücrelerde yoğun Gal-1 immün boyanması gözlendi. Gastrointestinal kanalın bütün bölümlerindeki damar duvarları, lamina muskularis ve tunika muskularisindeki düz kaslarda yoğun Gal-1 ekspresyonu gözlendi. Ayrıca kolon ve sekumda kript epiteli etrafındaki bazı bağ dokusu hücrelerinde de yoğun Gal-1 immünoreaksiyonu belirlendi. Gastrik foveoler epitel hücreleri orta derecede nükleer ve intrasitoplazmik Gal-3 immun reaksiyon gösterdi. Duodenum ve ileumun villöz epitel hücrelerinde Gal-3 immün boyaması tespit edildi. Ayrıca, kolon ve sekumdaki kriptlerin yüzey epitel hücrelerinde yoğun Gal-3 boyanması görüldü. Sonuç olarak hibernasyon sürecinde gastrointestinal kanaldaki hem Gal-1 hem de Gal-3 ekspresyonu hibernasyona yatmayan türlerle benzerdi. Gastrointestinal kanal bölümlerinde Gal-1 ekspresyonu açısından farklılık gözlenmezken, Gal-3 ekspresyonu diğer gastrointestinal bölümlere nazaran kalın bağısak epitelinde daha yoğundu.

Precise estimation of ram fertility is important for sheep farming to sustain reproduction efficiency and profitability of production. There, however, is no conventional method to accurately predict ram fertility. The objective of this study, therefore, was to ascertain proteomic profiles of ram sperm having contrasting fertility phenotypes. Mature rams (n = 66) having greater pregnancy rates than average (89.4 ± 7.2%) were assigned into relatively-greater fertility (GF; n = 31; 94.5 ± 2.8%) whereas those with less-than-average pregnancy rates were assigned into a lesser-fertility (LF; n = 25; 83.1 ± 5.73%; P = 0.028) group. Sperm samples from the outlier greatest- and least-fertility rams (n = 6, pregnancy rate; 98.4 ± 1.8% and 76.1 ± 3.9%) were used for proteomics assessments utilizing Label-free LC-MS/MS. A total of 997 proteins were identified, and among these, 840 were shared by both groups, and 57 and 93 were unique to GF and LF, respectively. Furthermore, 190 differentially abundant proteins were identified; the abundance of 124 was larger in GF while 66 was larger in LF rams. The GF ram sperm had 79 GO/pathway terms in ten major biological networks while there were 47 GO/pathway terms in six biological networks in sperm of LF rams. Accordingly, differential abundances of sperm proteins between sperm of GF and LF rams were indicative of functional implications of sperm proteome on male fertility. The results of this study emphasize there are potential protein markers for evaluation of semen quality and estimation of ram sperm fertilizing capacity.

The largest pool of macrophages in the body is harboured by the intestinal mucosa. As the principal phagocytic component of the immune system, macrophages are essential for maintaining mucosal homeostasis as they prevent commensal bacteria from adhering to mucosal epithelial cells. This study provides a RAM11 immunohistochemical and electron microscopic investigation of the existence, localization and distribution of intestinal macrophages in organized gut-associated lymphoid tissue (GALT), including Peyer's patches (PPs), the sacculus rotundus (SR) and the appendix, in the Angora rabbit. Although rabbit intestinal macrophages did not express the tissue macrophage marker macrosialin (CD68), they expressed RAM11. RAM11-positive intestinal macrophages were mostly localized to the subepithelial dome region, interfollicular area and germinal centres (GCs) of the GALT and the lamina propria or submucosa of the ileum and jejunum devoid of PPs and were also observed in the follicle-associated epithelium of PPs, but not in that of the SR and appendix. RAM11-positive macrophages containing engulfed apoptotic bodies were present in the GCs of the lymphoid follicles in the GALT. Electron microscopy further revealed multiple macrophages containing apoptotic bodies within the GCs of the follicles in the GALT. Some macrophage aggregations were observed in the GC and between the GC and the corona region of the follicles in the SR and appendix. Rabbit intestinal macrophages thus undertake both potent phagocytic activity and the efficient scavenging of apoptotic cells. Immunohistochemical data suggest that RAM11 can be reliably used for the determination of intestinal macrophages in the GALT of rabbits.

Keskin, Muhammed/0000-0002-4938-0097; WOS: 000411505100002 PubMed: 28694392 Objective: This study is an examination of 1) overall mortality trend in the Turkish Adult Risk Factor (TARF) study stratified by sex and place of residence, and 2) brief report on main aspects of the 2016 survey. Methods: The period of last 18 years was divided into 2 for trend analysis of data. Required information on deaths was obtained. Baseline age >= 40 years at the beginning of each period was the inclusion criterion. Cox regression analyses were performed. Results: Among over 2500 participants in each, deaths were recorded in 281 and 334 individuals in Periods 1 and 2, respectively, and baseline mean age was 54.6 years and 56.4 years, respectively, in each period. Age-adjusted hazard ratio for mortality in Period 2 remained virtually the same for rural males, rose to borderline significance for urban males and rural females (p=0.06, p=0.09), and increased 1.72-fold for urban females (p=0.006), as compared to Period 1. Whereas males gained an average of 3.8 years of survival in the later period compared with the earlier period, females gained only 1.8 years. This narrowed the difference in mean age at death in favor of women from 2.5 years to 0.5 year. Of 1144 participants to be surveyed in the TARF 2016, 48 were lost to follow-up, 695 were examined, and 39 participants were ascertained to be deceased. In 362 cases, verbal information was obtained regarding health status. Conclusion: Gain in survival in Turkish women has distinctly stagnated compared with men, and hazard of death has risen significantly for women and urban residents in the past decade, suggesting interaction between female sex and urban residence. Both phenomena require recognition and adoption of appropriate measures. Turkish Society of Cardiology; TOFAS, Istanbul We are indebted to the Turkish Society of Cardiology, and particularly to the firm TOFAS, Istanbul, for their partial support for the TARF survey, and to the Turkish Institute of Public Health for logistical support.

WOS:000595335800014 PMID: 33030023 2 They suggested providing more detailed information on the enrolled patients regarding history of coronary artery disease (CAD). However, we consider that doing that is not needed. In studies evaluating the treatment of cardiovascular diseases (interventional treatment, drug treatment, or markers with a possible prognostic value), it is typically needed to group the patients based on the presence of hypertension, presence of diabetes with regard to HbA1c levels, treatment compliance, and duration of the disease

Toll-like receptors (TLRs) belonging to pattern recognition receptors are involved in maintaining testicular and epididymal immune homeostasis. The purpose of the current study was to investigate TLR4 expression in rat testis and epididymis throughout postnatal development. Weak staining was detected in peritubular myoid cells and immature Sertoli cells while no staining was observed in gonocytes during prepubertal period. However, TLR4 expression began to appear in spermatocytes in pubertal period and gradually increased in spermatids. An intense staining was observed in steps 5-19 spermatids in post pubertal and mature periods. Similarly, TLR4 expression in the testes steadily increased from pubertal period to mature period. Puberty also caused a significant increase in TLR4 expression in epididymis. TLR4 expression in cauda epididymis was lower as compared to those of other epididymal segments. The majority of epididymal epithelial cells exhibited apical TLR4 expression, whereas basal cells showed intense intracytoplasmic immunoreaction. We detected an intense staining in epididymal smooth muscle cells. The expression levels of TLR4 showed dynamic changes in both spermatogenic cells, and entire testicular and epididymal tissues during postnatal development. These results suggest that TLR4 expression contributes not only to inflammation but also to the development of spermatogenic cells.

Introduction: Atherosclerosis is a chronic inflammatory process and inflammation is an important component of acute coronary syndrome (ACS). Platelet-to-lymphocyte ratio (PLR) is a useful parameter showing the degree of the inflammatory response. Aim: To explore the association between PLR and long-term mortality in patients with ACS. Material and methods: A total of 538 patients who had a diagnosis of ACS between January 2012 and August 2013 were followed up to 60 months. On admission, blood sampling to calculate PLR and detailed clinical data were obtained. Results: In total, 538 patients with a mean age of 61.5 ±13.1 years (69% male) were enrolled in the study. Median follow-up was 79 months (IQR: 74–83 months). Patients were divided into 3 tertiles based on PLR levels. Five-year mortality of the patients was significantly higher among patients in the upper PLR tertile when compared with the lower and middle PLR tertile groups (55 (30.7%) vs. 27 (15.0%) and 34 (19.0%); p < 0.001, p = 0.010 respectively). In the Cox regression analysis, a high level of PLR was an independent predictor of 5-year mortality (OR = 1.005, 95% CI: 1.001–1.008, p = 0.004). Kaplan-Meier analysis according to the long-term mortality-free survival revealed the higher occurrence of mortality in the third PLR tertile group compared to the first (p < 0.001) and second tertiles (p = 0.009). Conclusions: PLR, which is an easily calculated and universally available marker, may be useful in long-term risk classification of patients presenting with ACS.

Anatolian ground squirrel (Spermophilus xanthoprymnus) is a true hibernator. This animal transiently reduces pulmonary function during hibernation. Continuance of pulmonary function is very important to survive ground squirrels during the hibernation. Natriuretic peptides may be key players in the modulation of pulmonary hemostasis. However, NPs’ role in pulmonary function during hibernation remains unclear. We aimed to investigate the localization and distribution of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) in squirrel lungs during pre-hibernation and hibernation periods using immunohistochemistry. Our immunohistochemical data indicate that ANP, BNP, and CNP were produced by the mucosal epithelium of terminal and respiratory bronchioles, smooth muscle cells in the lamina propria of terminal bronchioles and vascular smooth muscle cells, alveolar type II cells, and macrophages. ANP immunoreactivity was weaker than BNP and CNP immunoreactivities in these cells. The results also demonstrate that the number of ANP, BNP and CNP positive alveolar type II cells tended to increase, although statistically non-significant, during the hibernation period, but the expression of NPs in other pulmonary cells is unaffected by hibernation. This study firstly investigates ANP, BNP and CNP distribution in the Anatolian ground squirrel lung. However, further studies are required to dissect their functional roles during the hibernation.

Peyer's patches are known as the immune sensors of the intestine because of their ability to transport luminal antigens. The objective of this study was both to assess the prenatal and postnatal development of sheep ileal Peyer's patches with respect to histomorphology, distribution of CD4+ and CD8+ cells, and localization of proliferating and apoptotic cells, and to examine the morphology of M cells and expression of CK18 in follicle associated epithelium (FAE). We also hypothesized that CK18 could be a potential marker for M cell. Peyer's patches completed their histomorphological development in prenatal period and involuted in the postnatal period. The distribution of the CD4+ and CD8+ cells was similar in the last trimester of pregnancy (days 120-150) and the postnatal period, but differed in the early stages of foetal development (days 70-120). In the prenatal period, the follicular area displayed high levels of proliferation and apoptosis. We observed CK18 immunoreaction only in FAE. While M cells were devoid of microfolds in the early stages of the prenatal period, these cells acquired a prismatic shape and bore distinct apical microfolds in the late prenatal period and postnatal period. As a result, it was determined that, in sheep, the development of the ileal Peyer's patches occurred in the prenatal period, independent of exogenous antigenic stimulation, and in association with high levels of lymphopoiesis and apoptosis in the follicles. We found, for the first time, that CK18 is a novel and reliable marker for FAE in sheep ileal Peyer's patches. We suggest that CK18 positive cells in FAE are M cells.

The Anatolian ground squirrel (Spermophilus xanthoprymnus) is a typical example of true mammalian hibernators. In order to adapt to extreme external and internal environments during hibernation, they lower their body temperatures, heart rates and oxygen consumption; however, pathological events such as ischemia and ventricular fibrillation do not occur in their cardiovascular systems. During the hibernation, maintenance of cardiac function is very important for survival of ground squirrels. Natriuretic peptides (NPs) are key factors in the regulation of cardiovascular hemostasis. Since NPs' role on the protection of heart during hibernation are less clear, the aim of this study was to investigate dynamic changes in NPs content in the cardiac chambers and to reveal the possible role of NPs on establishing cardiac function in ground squirrel during hibernation using immunohistochemistry. The immunohistochemical results indicate that cardiac NP expressions in atrial and ventricular cardiomyocytes were different from each other and were sex-independent. ANP and BNP were expressed in a chamber-dependent manner in female and male squirrel hearts. Furthermore, cardiac NPs expression levels in hibernation period were lower than those at the pre-hibernation period. During prehibernation period, ANP, BNP and CNP were expressed in the white and beige adipocytes of epicardial adipose tissue (EAT); while during hibernation period, the brown adipocytes of EAT were positive for BNP and CNP. These data suggest that the hibernation-dependent reduction in levels of NPs, particularly ANP, in cardiac chambers and EAT may be associated with low heart rate and oxygen consumption during hibernation. However, further studies are needed to better delineate the roles of NPs during the hibernation.