The effect of adenosine triphosphate on sunitinib-induced cardiac injury in rats.

In this study, we aimed to show the effect of adenosine 5'-triphosphate (ATP) on sunitinib-induced cardiac injury in rats. The rats (n = 30) were divided equally into three groups as sunitinib group (SG), sunitinib plus ATP group (SAG), and healthy group (HG); 2 mg/kg ATP was injected intraperitoneally (ip) to the SAG group. Same volume normal saline as solvent was administered ip to the other two groups. After 1 h, 25 mg/kg sunitinib was applied orally via catheter to stomach in the SAG and SG groups. This procedure was repeated once daily for 5 weeks. At the end of this period, all animals were sacrificed and their cardiac tissue was removed. Malondialdehyde (MDA), total glutathione (tGSH), tumor necrosis factor α (TNF-α), and nuclear factor κB (NF-κB) levels in rats' cardiac tissues and troponin I (Tp-I) levels in rats' blood samples were evaluated. Histopathological analysis was also performed in cardiac tissues of the animals. MDA, TNF-α, NF-κB, and Tp-I levels were higher in the SG group compared to the SAG and HG groups (p < 0.001). tGSH levels of the SG group were lower than the SAG and HG groups (p < 0.001). The structure and morphology of cardiac muscle fibers and blood vessels were normal in the control group. In the SG group, obvious cardiac muscle tissue damage with dilated myofibers, locally atrophic myofibers, and congested blood vessels were observed. In the SAG group, marked amelioration in these findings was observed. We showed this for the first time that ATP administration exerts a protective effect against cardiac effects of sunitinib.

Effects of entecavir, tenofovir and telbivudine treatment on renal functions in chronic hepatitis B patients.

BACKGROUND AND STUDY AIMS: The aim of this study was to enlighten the controversy about the renal safety of entecavir, tenofovir, and telbivudine treatments in chronic hepatitis B (CHB) patients by comparing these treatments in real-world conditions. PATIENTS AND METHODS: We retrospectively enrolled 104 treatment-naive patients with CHB monoinfection into our study. Patients were treated with entecavir monotherapy (n=38), tenofovir monotherapy (n=35), or telbivudine monotherapy (n=31). We then compared and statistically analyzed the effects of these drugs on the estimated glomerular filtration rate (eGFR) over a 24-month follow-up period. RESULTS: In the entecavir group, time-dependent change in eGFR was not statistically significant (p = 0.357). There was a statistically significant increase in eGFR in the telbivudine group at 12 months (p<0.001) and at 24 months (p<0.001) and, in contrast, a statistically significant decrease in the tenofovir group at 12 months (p<0.001) and at 24 months (p<0.001). There was no significant relationship between entecavir and eGFR change (p = 0.763). We found that tenofovir and telbivudine were independent predictors of eGFR change (decrease in eGFR, p<0.001 and increase in eGFR, p = 0.001, respectively). CONCLUSIONS: We recommend close follow-up of renal functions, especially for patients treated with tenofovir. Telbivudine was superior to the other drugs in terms of renal function. We conclude that an individualized therapy program considering treatment efficacy and side effects is the best option for patients.

A morphometric study of the protective effect of cryotherapy on oral mucositis in cancer patients treated with 5-fluorouracil.

We investigated cytological changes in oral mucosa smears from patients treated with cryotherapy to determine whether cryotherapy prevented mucositis caused by 5-fluorouracil (5-FU) therapy. Patients with gastrointestinal malignancies were divided into four groups; control patients before 5-FU therapy, patients after 5-FU therapy without cryotherapy, patients with cryotherapy before 5-FU therapy and patients with cryotherapy after 5-FU therapy. Oral mucosa samples from all patients were assessed at the beginning and on day 14 of chemotherapy. We used exfoliative cytology to evaluate cellular changes in the oral mucosa that were caused by 5-FU. Smears from each patient were stained using the Papanicolaou method and analyzed using stereology. Smears were taken from each group before and after 5-FU infusion. We found that nuclear volume was decreased significantly in cells of the 5-FU therapy after cryotherapy patients compared to the 5-FU therapy before cryotherapy patients. We also found significantly decreased cytoplasmic volumes in the 5-FU therapy after cryotherapy patients compared to the 5-FU therapy before cryotherapy patients. The results of cytomorphometric estimations revealed that cryotherapy may be used to prevent damage to oral tissue and may decrease the frequency and duration of oral mucositis caused by 5-FU.

The impact of vitamin E supplementation on semen parameters and pregnancy rates after varicocelectomy: a randomised controlled study.

In this study, we aimed to investigate the impact of vitamin E supplementation on semen parameters and pregnancy after varicocelectomy. Forty-five infertile male patients who were diagnosed with varicocele and underwent subinguinal varicocelectomy were included in the study. After performing subinguinal varicocelectomy, the patients were randomised into two groups: 22 receiving vitamin E for 12 months, and 23 as the control group without receiving any supplementation. The pre-operative parameters of semen analyses and pregnancy rates of both groups were compared with those of post-operative parameters. There were no statistically significant differences between the groups in terms of sperm count and motile sperm percentage, in pre-operative, post-operative 3rd month, post-operative 6th month and post-operative 12th month periods. Repeated-measures anova was performed, and sperm count, percentage of change in sperm count, motile sperm count and percentage of change in motile sperm count of the groups were compared. The administration of vitamin E increased all of these parameters; however, they were not found to be statistically significant. In conclusion, vitamin E supplementation might improve the sperm parameters after varicocelectomy; however, further studies including larger number of samples are needed to make a proper decision on vitamin E supplementation after varicocelectomy.

Evaluation of blood platelet count and function in patients with erectile dysfunction.

We evaluated and compared blood total platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) values of patients with erectile dysfunction (ED) and control subjects. A total 57 male patients (mean age 49.7 ± 12 years) with ED and 59 control men (mean age 49.7 ± 10.7 years) were included in the study. All patients were evaluated using medical history with International Index of Erectile Function (IIEF) scores, physical examination and routine blood analysis. Total blood count, including white blood cell (WBC), total platelet counts, MPV and PDW parameters, were recorded in both groups. MPV values were detected to be significantly higher in patients with ED than control group: 10.7 ± 1 and 9.72 ± 1.5, respectively (P = 0.001). Similarly, PDW values were significantly higher in patients with ED than control group: 14.6 ± 2.8 and 12.9 ± 1.9, respectively (P = 0.001). However, mean platelet and mean WBC counts were similar in both groups (P = 0.45). We demonstrated that MPV and PDW values significantly increased in patients with ED compared with the control group. According to these findings, platelet function might play an important role in patients with ED that warrants further research.

Factors affecting morbidity and mortality in pancreatic injuries.

PURPOSE: Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. METHODS: The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively. RESULTS: The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 ± 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 ± 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality. CONCLUSIONS: Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.

Factors affecting morbidity and mortality in hollow visceral injuries following blunt abdominal trauma.

BACKGROUND AND AIM: Hollow visceral injuries following blunt abdominal trauma are uncommon. The potential risk factors affecting morbidity and mortality are not well known. The purpose of our study was to evaluate the outcomes of hollow viscus perforation after blunt abdominal trauma. MATERIALS AND METHODS: Patient files of 56 adult patients who were treated with diagnosis hollow viscus injuries due to blunt abdominal trauma between the years 2000 and 2011 at the Dicle University Medical School General Surgery Clinic were retrospectively evaluated by analyzing the relationship between morbidity-mortality and potential risk factors. RESULTS: Fifty-six patients formed the study group, with median age of 37.5 ± 17,0 (range, 16-78) years and a significant male (80.3%) predominance. The median Injury Severity Score was 4 (1-25). The median length of hospital stay 7.5 (1-21) days. The mean age in the group with morbidity (47.1 ± 17.4) was significantly higher than the group without morbidity (34.3 ± 15.8) (p<0.05). Also, re-operation (p=0.0013), treatment modality (p=0.037), cause of injuries (0.0046) were other factors that affect morbidity. CONCLUSIONS: These findings suggest that factors affecting morbidity were cause of injuries, re-operation and treatment in patients with hollow viscus injury caused by blunt abdominal trauma. And factors affecting mortality were the injured organ, the presence of shock and median injury severity score.

Evaluation of the protective effect of quercetin against cisplatin-induced renal and testis tissue damage and sperm parameters in rats.

The protective effect of quercetin on cisplatin-induced renal and testicular tissue damage was investigated using biochemical, histopathological and histological approaches. A total of 40 male rats were divided into 5 groups as follows: control; cisplatin alone; quercetin alone; cisplatin + quercetin; and quercetin + cisplatin. Cisplatin was administered to rats at a single dose of 7 mg kg(-1) intraperitoneal. Quercetin was administered by gavage daily for 10 days at dosage 50 mg kg(-1) . At the end of the study serum, total antioxidant capacity (TAC) levels and total oxidant status (TOS) were determined. Malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT) and xanthine oxidase (XO) were studied separately in serum, renal tissue and testicular tissue. Renal and testicular morphological alterations were assessed, histopathologically. Epididymal sperm concentration, motility and morphology were investigated. Testicular and renal TAC and TOS values did not alter significantly. Renal CAT levels were increased by cisplatin and cisplatin plus quercetin groups that is reversed by administration of quercetin before cisplatin. MDA, CAT, SOD ve XO levels of testicular tissue did not differ significantly. Cisplatin and cisplatin plus quercetin groups had decreased sperm motility ratio and increased abnormal spermatozoa. Quercetin partially reverses some of the cisplatin-related pathological effects on kidney and testis.

The effects of pomegranate on bacterial translocation in rats with obstructive jaundice.

BACKGROUND: Obstructive jaundice may promote bacterial overgrowth and altered intestinal barrier function, with resultant increased bacterial translocation. AIMS: This study aimed to evaluate potential effects of pomegranate on bacterial translocation after bile duct ligation in rats. MATERIALS AND METHODS: Wistar albino rats were randomized into four groups. Group 1 underwent sham operation; Group 2 underwent sham operation and simultaneous treatment with pomegranate; Group 3 underwent common bile duct ligation, and Group 4 underwent common bile duct ligation and simultaneous treatment with pomegranate. After 8 days, the samples of systemic blood, liver, spleen and mesenteric lymph nodes (MLNs) were obtained under sterile conditions for microbiological culture. The segments of the ileum were removed for histopathological examination. RESULTS: Bacterial translocation significantly decreased in Group 4 compared to Group 3 (p = 0.007). The bacterial counts (Colony forming unit: CFU/g) of Group 3 were significantly higher than those of Groups 1, 2 and 4 (p < 0.05). The mean ileal villus heights in the Groups 1, 2, 3 and 4 were 480.5±20.5 µm, 494.7±17.3 µm, 356.3±25.7 µm and 420.7±23.7 µm, respectively. The mean villus height in Group 4 was higher than that of Group 3 (p = 0.010). CONCLUSIONS: Pomegranate has significant protective effects on intestinal mucosa barrier in obstructive jaundice and reduces bacterial translocation.  

Sigmoid colon torsion: mortality and relevant risk factors.

INTRODUCTION: Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department. MATERIALS AND METHODS: The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality. RESULTS: The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of "omega ans" in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p =0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002). CONCLUSIONS: Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.  

Evaluation of serum oxidative and antioxidative status in patients with erectile dysfunction.

We evaluated and compared serum oxidative and antioxidative parameters of patients with erectile dysfunction (ED) and control subjects. Twenty married male patients with ED for at least 12 months (Group 1) and 20 volunteer healthy, sexually active, married and age-matched men (Group 2) were included in the study. Group 1 and 2 were compared concerning serum mean total antioxidant capacity (TAC), total oxidant status (TOS), paraoxonase1 (PON1), arylesterase, total thiol and oxidative stress index (OSI). Mean patient age was 47.9 ± 8.1 and 44.4 ± 10.6, respectively, in Group 1 and 2. Serum TAC levels were 1.7 ± 0.5 and 2.3 ± 0.3, respectively, in Group 1 and 2 (P = 0.002). Serum TOS levels were 21.8 ± 20.5 and 11.7 ± 2.2, respectively, in Group 1 and 2 (P = 0.035). Serum PON1 levels were 69.8 ± 13.1 and 164.9 ± 56.5, respectively, in Group 1 and 2 (P < 0.001). Serum arylesterase levels were 336 ± 12 and 370.4 ± 47.9, respectively, in Group 1 and 2 (P = 0.003). Serum total thiol levels were 733.1 ± 253 and 885.5 ± 95.3, respectively, in Group 1 and 2 (P = 0.016). Serum OSI was 0.14 ± 0.17 and 0.05 ± 0.11, respectively, in Group 1 and 2 (P = 0.021). Mean blood platelet count was significantly higher in Group 1 (P = 0.001). A positive correlation between platelets and oxidative state and a negative correlation between platelets and antioxidative state were found. Oxidative stress was detected to be increased, whereas antioxidative parameters were detected to be decreased in patients with ED.

Quercetin has a protective role on histopathological findings on testicular ischaemia-reperfusion injury in rats.

We investigated the effects of quercetin on pathological findings on testicular ischaemia-reperfusion (I/R) injury in rats. Twenty-four male Wistar albino rats were randomly assigned into four groups: Group 1, control (n = 5); Group 2, sham (n = 4); Group 3, I/R (n = 8); and Group 4, I/R + quercetin (n = 7). Bilateral testicular artery and vein were occluded for 1 h, followed by reperfusion in I/R and I/R + quercetin animals. Quercetin (20 mg kg(-1) per day) was administrated once daily by gavage to Group 1 and Group 4, respectively, after reperfusion. At the end of the study, bilateral orchiectomies were performed for histopathologic examination. The tissue damage was evaluated with light microscopy. Normal inter-stitium and seminiferous tubules were observed in control group. In the sham group, rats were seen minimal oedema around the seminiferous tubules and congested vascular structures. In Group 3, oedema, vascular congestion and haemorrhage between seminiferous tubules were observed. In Group 4, histopathologic features were markedly less than Group 3 (P = 0.03). Our study demonstrated that quercetin seems to have a protective effect on testis histopathology in rats with testicular I/R.

Unusual extraperitoneal rectal injuries: a retrospective study.

PURPOSE: Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. METHODS: Eleven patients who had been treated for unusual rectal injuries in the General Surgery Clinic of Dicle University between 2004 and 2011 were retrospectively reviewed. RESULTS: The reasons for rectal injuries included foreign bodies in four cases, sexual intercourse in three cases, iatrogenic injuries in two cases, electric shock in one case, and animal horns in one case. All cases had extraperitoneal rectal injuries and all injuries were grade 2 injuries, except for the electrical burn. Primary repair was adequate for the treatment of six patients. Four patients underwent primary repair and ostomy, whereas one of the patients underwent debridement and an ostomy. The patients recovered without complications, except for one patient with sphincter insufficiency. CONCLUSION: The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.

Comparison of spermatic vein histology in patients with and without varicocele.

The aim of this study was to investigate and compare histological characteristics of spermatic veins in patients with and without varicocele. Between February 2009 and July 2009, spermatic veins were obtained from 13 patients with varicocele. Microsurgical subinguinal low ligation was performed in all patients. Spermatic veins of patients without varicocele were obtained from 12 patients who underwent radical nephrectomy. Histologically, sections of veins were stained with haematoxylin and eosin. Mean tunica adventitia thickness size of the spermatic veins was 0.35 ± 0.08 mm and 0.22 ± 0.1 mm respectively in patients with varicocele and control group (P = 0.001). Similarly, mean tunica media thickness size of the spermatic veins was 0.25 ± 0.05 mm and 0.09 ± 0.04 mm respectively in patients with varicocele and control group (P < 0.001). No significant differences were detected regarding the tunica adventitia and tunica media thicknesses when patients with grade 2 varicocele were compared with patients with grade 3 varicocele (P > 0.05). No significant differences were detected between the tunica adventitia and tunica media thicknesses of patients with varicocele and sperm parameters (P > 0.05). Our study demonstrated that tunica adventitia and tunica media thicknesses seem to be increased in patients with varicocele compared with normal subjects.

Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction.

We investigated the effects of Antep pistachio on International Index of Erectile Function (IIEF) scores, penile color Doppler ultrasound (PCDU) parameters and serum lipid levels in patients with ED. A total of 17 married male patients with ED for at least 12 months were included in this prospective study. Patients were put on a 100 g pistachio nuts diet for 3 weeks. IIEF and PCDU were evaluated before and after the pistachio diet. In addition, plasma total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured before and after dietary modifications from all subjects. Mean IIEF-15 score was 36 ± 7.5 before the diet and 54.2 ± 4.9 after the diet (P=0.001). Similarly, an increase in all five domains of IIEF was observed after the diet (P<0.05). Mean peak systolic velocity values before and after the pistachio diet were 35.5 ± 15.2 and 43.3 ± 12.4 cm s(-1), respectively (P=0.018). After the pistachio diet, TC and LDL levels decreased significantly, whereas HDL level increased (P=0.008, 0.007 and 0.001, respectively). We demonstrated that a pistachio diet improved IIEF scores and PCDU parameters without any associated side effects in patients with ED. Furthermore, the lipid parameters showed statistically significant improvements after this diet.

Corpus cavernosum electromyography: could it be a parameter to predict ageing?

UNLABELLED: In this study, we investigated whether electromyography of corpus cavernosum (CC-EMG) results vary with age and whether CC-EMG could be a parameter to predict ageing of cavernous smooth muscle. Recordings of electrical activity of corpus cavernosum (EACC) were retrospectively investigated in 134 patients with erectile dysfunction. Penile colour Doppler ultrasonography and cavernosometry were also performed for all of the patients. The total number and duration of EACC and amplitudes between positive and negative peaks were compared between the flask state for 10 min and after intracavernosal papaverine injection. The mean age of the 47 patients in group 1 was 35.2 ± 6.3 years (range, 23-44), the mean age of the 45 patients in group 2 was 51.1 ± 3.1 years (range, 45-56) and the mean age of the 42 patients in group 3 was 61.8 ± 4.6 years (range, 57-77). Total IIEF-5 score was 7.6 ± 2.1 in group 1, 7.9 ± 2.4 in group 2 and 7.9 ± 2.1 in group 3. There were no statistically significant differences among the groups regarding electrical potential frequencies, durations and amplitudes of electromyographic recordings. CONCLUSION: We do not think that CC-EMG findings could be used efficiently as a predictor of ageing.

Complete myocardial revascularization using arterial grafts only in patients with unstable angina: impact on early outcome.

OBJECTIVE: The aims of this study were 1) to assess early clinical outcomes for patients with unstable angina (UA) who undergo urgent/emergent coronary artery bypass grafting (CABG); and 2) to evaluate the feasibility and safety of complete revascularization using strictly arterial grafts in this patient group. PATIENTS AND METHODS: Between September 2001 and May 2005, a total of 961 patients underwent CABG at our center. One hundred and sixty-seven (17.4 %) of these individuals underwent urgent or emergent CABG because of UA, and 794 (82.6 %) underwent elective CABG for stable angina (SA). Of the 167 patients with UA, 59 (35.3 %) underwent complete revascularization using arterial grafts only (AO subgroup: internal thoracic arteries and radial arteries) and the other 108 received a combination of arterial and venous grafts (AV subgroup: 1 internal thoracic artery plus saphenous vein grafts). RESULTS: The UA group had a significantly higher proportion of women and a significantly higher rate of left main coronary artery disease than the SA group ( P = 0.016 and P = 0.0001, respectively). Cardiopulmonary bypass time was significantly longer in the UA group ( P = 0.01). Higher proportions of the UA group required inotropic support ( P = 0.001), intra-aortic balloon pump support ( P = 0.001), and re-exploration for bleeding or cardiac tamponade ( P = 0.005). This group also had a significantly longer mean time on mechanical ventilation ( P = 0.001) and a longer mean intensive care unit stay ( P = 0.01). The rates of operative mortality (first 30 days) in the SA and UA groups were 1.8 % and 6 %, respectively ( P = 0.001). There were no statistical differences between the AO and AV subgroups with respect to any of the preoperative or intraoperative findings. The AO group had a significantly shorter mean intensive care unit stay than the AV group ( P = 0.05). The AV group had a roughly fivefold higher operative mortality than the AO group (8.3 % vs. 1.7 %, respectively), but this difference was not statistically significant ( P = 0.17). CONCLUSION: Urgent or emergent CABG in the setting of UA is associated with increased but acceptable rates of mortality and morbidity. Complete myocardial revascularization using arterial grafts only (combinations of internal thoracic and radial arteries) is feasible and safe in this patient group.

Atrial fibrillation after coronary artery bypass grafting in elderly patients: incidence and risk factor analysis.

OBJECTIVE: New-onset atrial fibrillation (AF) is the most frequent arrhythmic complication after coronary artery bypass grafting (CABG). Elderly patients who undergo this operation may have a different risk profile from the general population. The aim of this study was to identify risk factors for post-CABG AF in the elderly population. METHODS: Between September 2001 and December 2005, 426 elderly patients (age >/= 65 years) underwent CABG at our center. Ninety-one developed post-CABG AF (AF group), and the other 335 (no-AF group) did not develop this complication. Multivariate analysis (odds ratio, +/- 95 % CI, P value) was used to identify independent clinical predictors of post-CABG AF. RESULTS: The incidence of post-CABG AF in elderly patients during the study period was 21.4 %. Multivariate analysis identified age (OR 1.07, P < 0.009), age >/= 75 years (OR 1.77, P < 0.042), preoperative renal insufficiency (OR 5.09, P < 0.035), EuroSCORE (OR 1.18, P < 0.038), and cross-clamping time (OR 1.02, P < 0.012) as predictors of AF occurrence. The AF group had a significantly longer mean intensive care unit (ICU) stay (3.8 +/- 4.7 vs. 2.5 +/- 1.3 days for AF vs. no-AF; P = 0.0001), and a significantly higher proportion of patients with prolonged (>/= 6 days) ICU stays (8.8 % vs. 3.2 %, respectively; P = 0.033). Hospital mortality was 3.2 % in the no-AF group and 2.2 % in the AF group ( P = 0.74). CONCLUSION: This study of elderly patients reveals some novel predictors of post-CABG AF, most notably preoperative renal insufficiency and EuroSCORE. It is important to identify risk factors for post-CABG AF in all patient groups as this knowledge might lead to better prevention of this problem and its potential consequences.

Does smoking change the efficacy of combination therapy with vitamin E and colchicines in patients with early-stage Peyronie's disease?

This study was conducted to find out if smoking has an effect on the results of combination therapy with vitamin E and colchicines in patients with early-stage Peyronie's disease (PD). A total of 58 potent patients suffering from early-stage PD were included in the study (mean age 47.3 years, range 25-73 y). The time from onset of the disease was <6 months and no patient had ED. The patients with severe fibrotic or calcified plaques were not included in the study. Of the patients, 36 were smokers (Group 1) and 22 were non-smokers (Group 2). All the patients received vitamin E (800 IU daily) and colchicines (1 mg daily) for 6 months. Follow-up ranged from 5 to 13 months (mean 10.3 m). The combination therapy was effective and well tolerated in both groups. There were no significant differences between the two groups according to age, disease duration, related disease (diabetes, hypertension, hypercholesterolemia, and hypertriglyceridemia), plaque sizes, and plaque numbers. The resolution in pain and increase in penile curvature and plaque size were similar rates in both groups (p > 0.05), while decrease in penile curvature and plaque size were higher in Group 2 (p < 0.05). No patient discounted the therapy due to side effects. The oral combination therapy with vitamin E and colchicines appears to be an effective procedure in patients with early-stage PD and smoking may have worsening effects on the treatment results.