A Probable Covid-19 Case Presented with Acute Upper Limb Ischemia.

The arterial revascularization procedure is still a challenging issue in Covid-19 associated limb ischemia. Herein we aimed to present a case of a 64 year-old woman with acute ischemic signs in upper extremity who was diagnosed as a probable Covid-19 case incidentally after admission. Although late admission and failed recurrent embolectomies lead to an eventful course, intra-arterial thrombolysis seemed to present a benefitable treatment option for our patient.

Investigation of the Effect of Preoperative Hypoalbuminemia, Blood Urea Nitrogen and Creatinine Levels on Postoperative Atrial Fibrillation on Off-Pump Coronary Bypass Surgery Patients.

BACKGROUND: Postoperative atrial fibrillation (PoAF) is one of the most common complications to occur after open heart surgery. It has been shown that hypoalbuminemia accompanies some cardiovascular disorders. The present study evaluates the effects of pre-procedural albumin, blood urea nitrogen (BUN), and creatinine levels on PoAF. METHODS: The data of 81 patients who underwent off-pump coronary artery bypass graft (CABG) surgery was evaluated. Patients who developed atrial fibrillation (AF) in the first 48 hours post surgery constituted the PoAF (+) group, while those without AF constituted the PoAF (-) group. The pre-procedural hematological parameters of patients in both groups were included in the analysis. RESULTS: The PoAF (+) group was comprised of 57 patients (70.3%) with a mean age of 65.5 ± 9.8 years, while the PoAF (-) group was comprised of 24 patients (29.7%) with a mean age of 60.6 ± 9.6 years. A comparison of the demographic characteristics of the two groups showed that age (P = .036), frequency of renal failure (P = .007), and frequency of DM (P = .001) were higher in the PoAF (+) group. An examination of the laboratory data revealed a negative correlation between Hct (P = .001) and albumin (P = .000) levels and presence of PoAF. Also, the MPV (P = .02), BUN (P = .007), and Cr (P = .043) values were higher in the PoAF (+) group. CONCLUSION: The present study, whose focus was on the effects of albumin levels on the occurrence of PoAF, found that low levels of pre-procedural albumin, as one of the major proteins in the blood, is a risk factor for the development of PoAF.

Avoiding Liver Injury with Papaverine and Ascorbic Acid Due to Infrarenal Cross-Clamping: an Experimental Study.

OBJECTIVE:: Ischemia-reperfusion injury after acute ischemia treatment is a serious condition with high mortality and morbidity. Ischemia-reperfusion injury may result in organ failure particularly in kidney, lung, liver, and heart. In our study, we investigated the effects of papaverine and vitamin C on ischemia-reperfusion injury developed in the rat liver after occlusion-reperfusion of rat aorta. METHODS:: 32 Sprague-Dawley female rats were randomized into four groups (n=8). Ischemia was induced with infrarenal aortic cross-clamping for 60 minutes; then the clamp was removed and reperfusion was allowed for 120 minutes. While the control group and the ischemia-reperfusion group did not receive any supplementary agent, two other groups received vitamin C and papaverine hydrochloride (papaverine HCL). Liver tissues were evaluated under the light microscope. Histopathological examination was assessed by Suzuki's criteria and results were compared between groups. RESULTS:: In ischemia-reperfusion group, severe congestion, severe cytoplasmic vacuolization, and parenchymal necrosis over 60% (score 4) were observed. In vitamin C group, mild congestion, mild cytoplasmic vacuolization and parenchymal necrosis below 30% (score 2) were found. In papaverine group, moderate congestion, moderate cytoplasmic vacuolization and parenchymal necrosis below 60% (score 3) were observed. CONCLUSION:: An ischemia of 60 minutes induced on lower extremities causes damaging effects on hepatic tissue. Vitamin C and papaverine are helpful in reducing liver injury after acute ischemia reperfusion and may partially avoid related negative conditions.

Avoiding liver injury with papaverine and ascorbic acid due to infrarenal cross-clamping: an experimental study

Abstract Objective: Ischemia-reperfusion injury after acute ischemia treatment is a serious condition with high mortality and morbidity. Ischemia-reperfusion injury may result in organ failure particularly in kidney, lung, liver, and heart. In our study, we investigated the effects of papaverine and vitamin C on ischemia-reperfusion injury developed in the rat liver after occlusion-reperfusion of rat aorta. Methods: 32 Sprague-Dawley female rats were randomized into four groups (n=8). Ischemia was induced with infrarenal aortic cross-clamping for 60 minutes; then the clamp was removed and reperfusion was allowed for 120 minutes. While the control group and the ischemia-reperfusion group did not receive any supplementary agent, two other groups received vitamin C and papaverine hydrochloride (papaverine HCL). Liver tissues were evaluated under the light microscope. Histopathological examination was assessed by Suzuki's criteria and results were compared between groups. Results: In ischemia-reperfusion group, severe congestion, severe cytoplasmic vacuolization, and parenchymal necrosis over 60% (score 4) were observed. In vitamin C group, mild congestion, mild cytoplasmic vacuolization and parenchymal necrosis below 30% (score 2) were found. In papaverine group, moderate congestion, moderate cytoplasmic vacuolization and parenchymal necrosis below 60% (score 3) were observed. Conclusion: An ischemia of 60 minutes induced on lower extremities causes damaging effects on hepatic tissue. Vitamin C and papaverine are helpful in reducing liver injury after acute ischemia reperfusion and may partially avoid related negative conditions.