The effects of pharmacomechanical thrombectomy on novel complete blood count parameters in deep vein thrombosis: A retrospective study.

This study aimed to investigate the effects of pharmacomechanical thrombectomy on novel complete blood count parameters in deep venous thrombosis. This retrospective study included 242 patients aged >18 years who were treated for deep venous thrombosis. Patients were grouped as follows: group 1 was accepted as having interventional operations (n = 123) and group 2 was accepted as having only medical advice (n = 119). Routine complete blood count parameters, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) were compared. There was no difference between the groups in terms of admission hemoglobin, hematocrit, mean platelet volume, NLR and PLR (P = .11, P = .24, P = .55, P = .93, and P = .96, respectively). In the pharmacomechanic thrombectomy group, NLR and PLR were significantly reduced after intervention when compared to the admission values (P < .001 and P < .001, respectively). However, the NLR and PLR values of medically treated patients did not differ significantly from their baseline values (P = .16 and P = .08, respectively). In this study, we effectively removed the thrombus load in blocked proximal veins using pharmacomechanical thrombectomy and observed a significant decrease in NLR and PLR, which are current, inexpensive, and accessible parameters.

Protective effect of gel form of gastric gavage applicated aloe vera on ischemia reperfusion injury in renal and lung tissue.

The aloe vera plant has become increasingly popular in recent years. This study aimed to research the effect of aloe vera to prevent renal and lung tissue damage in an experimental ischemia-reperfusion (I/R) injury model. The study included 21 male Wistar Albino rats, which were categorized into control group, n = 7 (no procedures), Sham group n = 7 (I/R); and aloe vera therapy group, n = 7 (aloe vera and I/R). Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) were evaluated from lung and kidney tissues for biochemical investigations. As histopathological, hematoxylin and eosin and anti-iNOS were also examined. In biochemical investigations, SOD, CAT, and GPx levels of the Sham group were found to be lower compared with the other groups (P < 0.05). The aloe vera therapy group was not statistically different from control groups but significantly different compared with the Sham group. In the same way, the MDA levels of kidney and lung tissues were statistically significant in the aloe vera therapy group, compared to the Sham group. In the Sham group, the peribronchial and perialveolar edema were observed in lung parenchyma. Also, excess interstitial hemorrhage, leukocyte infiltration, and alveolar wall thickening were identified in ischemic groups. The histopathological changes were much lighter than in the aloe vera therapy group. In renal tissues, excess epithelial cell deterioration, tubular desqumination, and glomerular atrophy were observed in the Sham group. The histopathological changes were markedly reduced in the aloe vera therapy  group. In the kidney and lung tissue, the level of iNOS activity in the Sham group was significantly higher than in the control and aloe vera therapy group. This study indicated that aloe vera is protective against oxidative damage formed by I/R in distant organs like the lungs and kidneys.

Is hyperbaric oxygen or ozone effective in experimental endocarditis?

BACKGROUND: Infective endocarditis, a disease with high mortality and morbidity, is most commonly caused by Staphylococcus aureus; mortality and morbidity further increase in the presence of methicillin-resistant strains of S. aureus. Linezolid is the first of the oxazolidinones, a new antibiotic group that has been approved for the treatment of infections caused by gram-positive cocci. Linezolid reduces the quantity of microorganisms in vegetation to some extent; in addition, the use of hyperbaric oxygen (HBO) and ozone (O3) therapies is likely to improve targeted antibacterial effect. MATERIALS AND METHODS: Fifty-six adult male Wistar rats weighing 300-350 g were used. The subjects were divided into groups as follows: Group 1 (n = 8): control group that was not inoculated with microorganisms and was untreated; Group 2 (n = 8): control group that was inoculated with microorganisms but was untreated; Group 3 (n = 8): linezolid treatment group; Group 4 (n = 8): O3 therapy group; Group 5 (n = 8): HBO therapy group; Group 6 (n = 8): linezolid + O3 therapy group; Group 7 (n = 8): linezolid + HBO therapy group. RESULTS: In terms of reducing the number of colonies in the aortic valve, linezolid + HBO therapy was found to be the most effective treatment. Then, respectively linezolid + O3, linezolid, HBO, and O3 were found to be effective. CONCLUSIONS: We found that linezolid significantly reduced the number of bacteria in the vegetation in the experimental endocarditis model, and HBO therapy increases the effectiveness of linezolid and makes this better than O3.

Giant Cavernous Haemangioma of the Anterior Mediastinum.

Cavernous hemangiomas of the anterior mediastinum is rare. We present a case of a 56-year-old male patient with a giant cavernous hemangioma of the anterior mediastinum, 18 cm in diameters, approached by left posterolateral thoracotomy. To the best of our knowledge, such a unique case has not been previously presented in the literature.

Video-Assisted Thoracoscopic Surgery Lobectomy for Pulmonary Malignant Melanoma Metastasis.

Malign melanoma (MM) develops as a result of malign transformation of the melanocytes and constitutes 2-4% of all skin cancers, while being the most common cause of mortality among all skin cancers. In addition to other organs, distant organ metastases also include lung metastasis. A metastasectomy is an acceptable treatment option in cases of malign melanoma with isolated lung metastasis. The current report presents a case with isolated lung metastasis that underwent a right upper VATS (video-assisted thoracoscopic surgery) lobectomy due to tumour localization.

Effect of Montelukast on Spinal Cord Ischemia- Reperfusion Injury.

AIM: Paraplegia due to ischemia-reperfusion (I/R) injury of the spinal cord is a devastating complication of thoracoabdominal aortic surgery. Cysteinyl leukotrienes are potent mediators of inflammation that are associated with I/R injury. The present study was designed to investigate the role of montelukast, a selective reversible CysLT1 receptor antagonist, on spinal cord I/R injury in an experimental model. MATERIAL AND METHODS: Twenty-one male Sprague-Dawley rats were randomly assigned to three groups (n=7 per group) as G1 (no aortic occlusion and montelukast administration), G2 (45 min. aortic occlusion; no montelukast administration) and G3 (45 min. aortic occlusion, 10 mg/kg montelukast administration). After neurologic evaluation using the Motor Deficit Index (MDI) score at the 48th hour of reperfusion, lumbar spinal cords were removed for histopathological evaluation and immunohistochemical staining for HSP70, interleukin-6 and myeloperoxidase (MPO). RESULTS: All rats in the G1 group had a normal neurological status and their MDI score was 0 (p < 0.05). The MDI score of G3 was significantly lower than G2 group (2.8 vs. 5.5; p < 0.05). Vacuolar congestion was found to be significantly lower in G1 than the other groups (p=0.0001). The interleukin-6 receptor level was found to be significantly lower in G3 group than the control group (p=0.013). There was no statistically significant difference found among the groups in terms of the degree of HSP70 and MPO staining. CONCLUSION: Increased generation of leukotrienes in postischemic organs play an important role in I/R injury. The findings of the current study demonstrated that montelukast improved motor recovery and decreased IL-6 levels in spinal cord I/R injury.

Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model

ABSTRACT OBJECTIVE: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. METHODS: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. RESULTS: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). CONCLUSION: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.

Relationship between fragmented QRS and paradoxical septal motion in coronary artery bypass graft patients.

OBJECTIVE: Paradoxical septal motion (PSM) can cause confusion in the assessment of ventricular function with scintigraphy even in the absence of ventricular septal damage and ischemia. Fragmented QRS (fQRS) is associated with various cardiac disorders. In this study, we aimed to determine the correlation between paradoxical septal motion and fQRS after coronary artery bypass grafting (CABG). METHODS: We retrospectively reviewed the hospital records showing scintigraphic images and electrocardiograms (ECG) of the patients who had undergone CABG. The patients were classified based on the evaluation of motion and thickening of the septal wall. The patients with regular thickening of the septal wall and abnormal motion were classified as PSM (+) group. The patients with normal motion and thickening of the septal wall were classified as PSM (-) group. fQRS complexes are defined as various RSR patterns either with or without Q-waves on a 12-lead resting ECG. RESULTS: PSM was found to be more common in fQRS patients (p < 0.001). PSM was seen in 91.4 % of cases with fQRS and in 79.8 % of cases without fQRS. No significant differences were found in the phase analysis parameters. A correlation was found between septal wall motion values and the presence of fQRS (r = 0.197, p = 0.012). CONCLUSION: fQRS was associated with PSM. fQRS may cause PSM in patients with CABG without left bundle branch block due to a conduction defect. PSM and fQRS are predictive of cardiac mortality. Patients diagnosed with PSM and fQRS, should be monitored closely.

The Neuroprotective Effect of Kefir on Spinal Cord Ischemia/Reperfusion Injury in Rats.

OBJECTIVE: The main causes of spinal cord ischemia are a variety of vascular pathologies causing acute arterial occlusions. We investigated neuroprotective effects of kefir on spinal cord ischemia injury in rats. METHODS: Rats were divided into three groups : 1) sham operated control rats; 2) spinal cord ischemia group fed on a standard diet without kefir pretreatment; and 3) spinal cord ischemia group fed on a standard diet plus kefir. Spinal cord ischemia was performed by the infrarenal aorta cross-clamping model. The spinal cord was removed after the procedure. The biochemical and histopathological changes were observed within the samples. Functional assessment was performed for neurological deficit scores. RESULTS: The kefir group was compared with the ischemia group, a significant decrease in malondialdehyde levels was observed (p<0.05). Catalase and superoxide dismutase levels of the kefir group were significantly higher than ischemia group (p<0.05). In histopathological samples, the kefir group is compared with ischemia group, there was a significant decrease in numbers of dead and degenerated neurons (p<0.05). In immunohistochemical staining, hipoxia-inducible factor-1α and caspase 3 immunopositive neurons were significantly decreased in kefir group compared with ischemia group (p<0.05). The neurological deficit scores of kefir group were significantly higher than ischemia group at 24 h (p<0.05). CONCLUSION: Our study revealed that kefir pretreatment in spinal cord ischemia/reperfusion reduced oxidative stress and neuronal degeneration as a neuroprotective agent. Ultrastructural studies are required in order for kefir to be developed as a promising therapeutic agent to be utilized for human spinal cord ischemia in the future.

Left Ventricular Twist Mechanics Are Impaired in Patients with Coronary Slow Flow.

PURPOSE: Coronary slow flow (CSF) is a rare condition described as the delayed angiographic passage of a contrast agent in the absence of stenosis in epicardial coronary arteries. Left ventricular (LV) systolic and diastolic dysfunctions have been described in the presence of CSF. However, the effect of CSF on LV twist functions has not been assessed. We aimed to evaluate the effects of CSF on LV twist mechanics using speckle tracking echocardiography (STE). METHODS: Twenty CSF patients (24-60 years) were enrolled according to the exclusion criteria. Twenty subjects with similar demographic characteristics and normal coronary arteries were the controls. Participants were evaluated with conventional echocardiography and STE. RESULTS: The general characteristics of the two groups were similar. LV twist, LV torsion, and apical rotation were impaired in the CSF group (P = 0.015, P = 0.012, and P < 0.001, respectively). Time to peak twist (TPT) and time to peak untwisting (TPU) were prolonged in CSF patients (P < 0.001 and P < 0.001, respectively). In the CSF group, rotation-deformation delay was shortened (P < 0.001) and global longitudinal strain (GLS) was lower (P < 0.001). The thrombolysis in myocardial infarction (TIMI) frame count was negatively correlated with LV twist, LV torsion and apical rotation (P = 0.002, r = -0.624; P = 0.002, r = -0.624; and P = 0.002, r = -0.632, respectively). CONCLUSIONS: We demonstrated that LV twist mechanics are impaired in CSF patients. Worse LV twist parameters were associated with greater TIMI frame count.

U-vein compressor improves early haemodynamic outcomes in radiocephalic arterio-venous fistulae in under 2-mm superficial veins.

AIM: In this study, we sought to determine the early postoperative results of arterio-venous fistulae (AVF) created by U-vein compressors with veins between 1.5 and 2 mm in size. METHODS: Pre-operative venous mapping was done. The fistula tract was marked at 0-, 4-, 8- and 12-cm points; 0 cm was the estimated point where the anastomosis would be done. With Doppler ultrasonography, transverse diameters in the estimated fistula tract were measured at the 0-, 4-, 8- and 12-cm points. A superficial vein that would be used as the fistula tract was dilated using U-vein compressors. In the first postoperative hour, the flow in the anastomosis, and the transverse diameter of the fistula tract at the 0-, 4-, 8- and 12-cm points were measured by Doppler ultrasonography. RESULTS: Forty patients were included in the study. U-vein compressors were used for 20 patients. Postoperative expansion of vein diameters and postoperative flow velocities were found to be statistically significantly different in patients where a U-vein compressor had been used (p < 0.001). CONCLUSION: We present a technique to dilate veins that are between 1.5 and 2 mm in diameter, which are generally accepted as poor vessels to create radiocephalic arteriovenous fistulae.

Application of radiofrequency ablation procedure on a morbidly obese patient with a venous ulcer and large saphenous vein.

Venous ulcers that occur due to chronic venous insufficiency are seen on the upper medial malleol of the ankle. Treatment of venous ulcers is protracted and generally the success rate is low. Co-morbid factors play an important role in the success of treatment of venous ulcers. In this case report, we demonstrate successful venous ulcer treatment in a morbidly obese patient with co-morbid conditions.

Effects of VEGF and MSCs on vascular regeneration in a trauma model in rats.

In the human body, vascular injuries that are caused by trauma, vessel lumen stenosis, and occlusions are often irreversible and can lead to sequelae formation as the vessels cannot reproduce fast enough. To solve this problem, the blood flow must be returned to the region as fast as possible. The adipose tissue contains progenitor cells with angiogenic potential and can be used to resolve the issue. In the present study, mesenchymal stem cells (MSCs) derived from rat adipose tissue, vascular endothelial growth factor (VEGF), and their mixture were applied on the dorsum of a rat, which was traumatized and its contribution to vascular regeneration was reviewed. No application was made to the control group. The results showed that the percentage of necrotic area was significantly lower in the MSC group than that of all the other groups. When the VEGF group was compared to the VEGF + MSCs, the percentage of necrotic area was observed to be similiar. However, VEGF showed effects only when a large quantites of VEGF was applied to the flap area. VEGF could not fully respond to the needs, whereas MSCs can produce VEGF according to the needs of tissue. This makes them superior to stem cells.

The assessment of septal wall motion in patients undergoing CABG by myocardial perfusion-gated SPECT.

PURPOSE: In this study, we aimed to assess the presence and prevalence of paradoxical septal motion (PSM) by myocardial perfusion-gated single-photon emission computed tomography (SPECT) imaging in patients undergoing coronary artery bypass grafting (CABG). METHODS: A total of 172 patients (145 men and 27 women, with a mean age of 64.81 ± 8.93 years) undergoing CABG surgery were included in the study. All selected scintigraphic studies of the patients undergoing CABG were reprocessed. Semiquantitative interpretation of septal perfusion, wall motion, and wall thickening was performed with QPS and QGS programs. Phase analysis parameters were also obtained using the Emory Cardiac Toolbox. According to myocardial perfusion-gated SPECT results, the patients were trichotomized as follows: group 1 (nonischemic PSM): regular perfusion and thickening of the septal wall and abnormal motion of the septal wall; group 2 (ischemic PSM): abnormal perfusion, motion, and thickening of the septal wall; group 3 (non-PSM): normal perfusion, motion, and thickening of the septal wall. The data in each of the three groups were compared using Student's t-test and one-way analysis of variance. RESULTS: No PSM (normal perfusion, motion, and thickening of the septal wall) was observed in 19.2% of patients undergoing CABG, whereas nonischemic PSM (regular perfusion and thickening of the septal wall and abnormal motion of the septal wall) was observed in 60.5% of patients and ischemic PSM (abnormal perfusion, motion and thickening of the septal wall) was seen in 20.3% of patients. CONCLUSION: According to our study results, PSM is fairly common in patients undergoing CABG. It will be beneficial to use myocardial perfusion scintigraphy-gated SPECT, which is a noninvasive examination method, to identify the presence of PSM and investigate whether it is accompanied by ischemia or infarction.

The normal anatomy and variations of the bronchial arteries: evaluation with multidetector computed tomography.

INTRODUCTION: In this study, we aimed to reveal the normal anatomy and variations of the bronchial arterial system and to determine the sex distribution of these variations by retrospectively reviewing the images of patients who underwent thoracal multidetector computed tomographic angiography for various reasons. MATERIALS AND METHODS: Multidetector computed tomographic images of a total of 208 patients (151 men; mean age, 59 years) were retrospectively reviewed to assess the normal anatomy and variations of the bronchial arterial system. RESULTS: A total of 531 bronchial arteries (median, 3; minimum, 1; maximum, 5; mean, 2.5) were detected. The number (mean diameter) of the right bronchial arteries were higher than the left bronchial arteries (290 [1.43 mm] and 241 [1.26 mm], respectively; P < .05 for both number and diameter). The mean number (diameter) of the bronchial arteries were higher with men than with women (2.58 [1.45 mm] and 2.47 [1.32 mm], respectively; P < .05 for both number and diameter). The most common (24%) branching pattern was the combination of 1 right intercostal-bronchial trunk and 1 left bronchial artery, and, secondarily (13.46%), the combination of 2 right (1 intercostal-bronchial trunk and 1 bronchial artery) and 1 left bronchial arteries. Seventy-eight ectopic bronchial arteries were detected in 59 cases (28.3%). They most commonly originated from the aortic arch (37.2%), the descending aorta below the level of T6 (35.9%), or the aortic branches (16.7%). The number of right ectopic bronchial arteries was significantly higher than the left ectopic bronchial arteries (50 [64%] vs 28 [36%]; P < .01). The incidence of ectopic bronchial arteries was statistically higher with men versus women (45 [29.8%] vs 14 [24.6%]; P < .05). CONCLUSION: The origins, numbers, diameters, and courses of the bronchial arteries can vary substantially among individuals. Multidetector computed tomographic angiography enables a detailed road map of the bronchial arterial system to interventional radiologists and thoracic surgeons.

Increased Platelet Distribution Width Is Associated With Severity of Coronary Artery Disease in Patients With Acute Coronary Syndrome.

Platelet activation plays a pivotal role in acute coronary syndrome (ACS). We investigated the relationship between platelet distribution width (PDW) and severity of coronary artery disease (CAD) in patients with ACS. A total of 502 patients with ACS were enrolled. High (n = 151) and low PDW (n = 351) groups were defined as patients having values in the third tertile (>17%) and lower 2 tertiles (≤17%). There were significantly higher Gensini score (44 [10-168] vs. 36 [2-132], P < .001), and neutrophil-lymphocyte ratio (3.1 [0.8-12.4] vs. .2.5 [0.3-13], P = .012) and baseline platelet counts were significantly lower (220 [61-623] vs. 233 [79-644] 10(3)/mm3, P = .022) in the high PDW group. The variables PDW >17%, diabetes mellitus, and myocardial infarction were found to be associated with high Gensini score (odds ratio [OR]: 1.91, 95% confidence interval [CI]: 1.27-2.88, P = .002; OR: 2.85, 95% CI: 1.91-4.25, P < .001; OR: 2.67, 95% CI:1.74-4.1, P < .001, respectively). An increased PDW (>17%) is associated with severity of CAD in patients with ACS.

Use of a superficial femoral artery autograft as a femoral vein replacement.

Posttraumatic arteriovenous fistulas (AVFs) are common complications of vascular penetrating trauma. Here we present a case of a 59-year-old woman who had a history of gunshot injury 42 years ago causing AVF between superficial femoral artery (SFA) and superficial femoral vein (SFV). SFV was resected. Ipsilateral SFA was used to restore SFV. SFA was reconstituted using a 7-mm polytetrafluorethylene graft. The patient has normal venous and arterial flow at 3- and 15-month follow-up.

Fragmented QRS is associated with frequency of premature ventricular contractions in patients without overt cardiac disease.

OBJECTIVE: In this study, we aimed to demonstrate whether the presence of fragmented QRS (fQRS) is associated with the frequency of premature ventricular contractions (PVCs). METHODS: We retrospectively analyzed 282 cases by 24-hour Holter monitorings (HMs) between August 2012 and February 2013. Firstly, the patients were divided into 2 groups with respect to presence of fQRS and then divided into 3 groups with respect to frequency of PVCs as Group 1: seldom PVC (<120 PVCs/day), Group 2: moderate-frequency PVC (120-720 PVCs/day), and Group 3: frequent PVC (>720 PVCs/day). We investigated the predictors of frequent PVCs by using multinomial logistic regression analysis. RESULTS: Ninety-eight patients had fQRS. There was no difference between the 2 groups with respect to body mass index, gender, hypertension, and diabetes mellitus. Patients with fQRS were older (54.9±15.6 vs. 47.0±16.3, p<0.001) and had more family history of coronary artery disease (25% vs. 13%, p=0.012). Patients with fQRS was more likely to be on aspirin therapy (28.6% vs. 10.4%, p<0.001) and have a larger left atrium diameter (33.5±5.7 vs. 30.4±5.8, p=0.001). Presence of fQRS was significantly associated with the frequency of PVCs (for frequent PVC 27.7% vs. 7.6%, p<0.001; for moderate-frequency PVC 18.4% vs. 11.4%, p=0.012); 26.2% of Group 1 (n=202) had fQRS, 46.2% of Group 2 (n=39) had fQRS, and 65.9% of Group 3 (n=41) had fQRS. In the multinomial regression analysis, only age (odds ratio: 4.24, 95% confidence interval 2.08-8.64, p=0.001) and fQRS (odds ratio: 2.11, 95% confidence interval 1.00-4.45, p=0.05) were predictors of frequent PVCs. CONCLUSION: This study demonstrated that the presence of fQRS is associated with frequent PVCs in patients without overt structural heart disease.

The relationship between fragmented QRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome.

BACKGROUND: Fragmented QRS (fQRS) complexes on 12-lead electrocardiography (ECG) have been reported to be predictors of cardiac events and all-cause mortality in coronary artery disease (CAD). AIM: To investigate the relationship between fQRS complexes and SYNTAX and Gensini scores in patients with acute coronary syndrome (ACS). METHODS: A total of 302 patients (223 men and 79 women) with ACS (133 ST elevated myocardial infarction [STEMI], 107 non-STEMI [NSTEMI], and 62 unstable angina pectoris [USAP]) were evaluated retrospectively in this study. An fQRS pattern was found in 70 patients (fQRS group) but was not found in 232 patients (non-fQRS group). SYNTAX score > 22 and Gensini score > 20 were defined as high SYNTAX and Gensini scores. The relationship between the presence of fQRS on 12-lead ECG and SYNTAX and Gensini scores was assessed. RESULTS: SYNTAX score (p < 0.001), Gensini score (p < 0.001), NYHA class (p < 0.001), QRS duration (p < 0.001), number of disease vessels (p = 0.003), and high sensitive troponin T levels (p = 0.026) were significantly higher in the fQRS group. The number of fQRS leads (HR 5.79, 95% CI 2.78-12.06, p < 0.001, HR 3.41, 95% CI 1.32-8.78, p = 0.016, respectively) was found to be an independent predictor of high SYNTAX score and high Gensini score in multivariate analysis. CONCLUSIONS: The number of fQRS leads on 12-lead ECG on admission is associated with the severity and complexity of CAD in patients with ACS.

Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model.

OBJECTIVE: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. METHODS: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. RESULTS: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). CONCLUSION: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.